Complications of collagen biostimulators in Brazil: Description of products, treatments, and evolution of 55 cases.

BACKGROUND: Complications of temporary and permanent fillers have been extensively studied. However, there is a lack of comparative data regarding poly-L-lactic acid (PLLA), calcium hydroxyapatite (CaHA), and polycaprolactone (PCL) known as collagen biostimulators. AIMS: This study addressed the complications of collagen biostimulators concerning their diagnosis, type of product, treatment, and monitoring. PATIENTS/METHODS: An electronic questionnaire was sent to Brazilian dermatologic ultrasound experts to identify complications related to biostimulators. The type of biostimulator, location of application, number of vials injected, application plan, time between injection treatment and complication, injector profile, treatment, and prognosis were assessed. RESULTS: Fifty-five cases were identified, of which 49.1% were caused by PLLA-Elleva®, 23.6% by CaHA (alone or combined with hyaluronic acid), 20.0% by PLLA-Sculptra®, and 7.3% by PCL. The most affected area was the face (72.7%), with nodules being the most common clinical form (89.1%), generally occurring late (60.0%) (>1 month). Only one case was injected at an incorrect depth (musculoaponeurotic system-SMAS). Despite several treatments, including saline (45.5%), hyaluronidase (25.5%), diluted corticosteroids (23.6%), and energy-based devices (10.9%), only five cases showed complete resolution. Hyaluronidase was beneficial in complications related to fillers when there was an association of calcium hydroxyapatite with hyaluronic acid (p < 0.01). CONCLUSIONS: Complications from collagen biostimulators were more common on the face, typically manifesting about 1 month after treatment. These issues seemed to be related more to the properties of the products rather than inadequate technique. Furthermore, hyaluronidase demonstrated efficacy only in cases where there was an association with HA.

Brain Neuroplasticity after Treatment with Antiseizure: A Review.

Epilepsy is a disease characterized by the periodic occurrence of seizures. Seizures can be controlled by antiseizure medications, which can improve the lives of individuals with epilepsy when given proper treatment. Therefore, this study aimed to review the scientific literature on brain neuroplasticity after treatment with antiseizure drugs in different regions of the brain. According to the findings, that several antiseizure, such as lamotrigine, diazepam, levetiracetam, and valproic acid, in addition to controlling seizures, can also act on neuroplasticity in different brain regions. The study of this topic becomes important, as it will help to understand the neuroplastic mechanisms of these drugs, in addition to helping to improve the effectiveness of these drugs in controlling the disease.

Teaching-Learning Process of Medical Students with Real Anatomical Parts: A Practical Intervention Strategy / Proceso de Enseñanza-Aprendizaje de los Estudiantes de Medicina con Piezas Anatómicas Reales: Una Estrategia de Intervención Práctica

SUMMARY: The COVID-19 pandemic caused several changes in the teaching of human anatomy, among them the use of different teaching methodologies based on E-learning. However, studies evaluating electronic tools have not provided clear evidence of effective student learning. Thus, this was the first study to evaluate medical students after completing human anatomy courses in the E- learning modality. We recruited first term (Group A, n=25) and second term (Group B, n=13) medical students. We applied a practical assessment based on 50 human anatomy markingson real anatomical specimens and cadavers, to be completed in Questionnaire 01 (Phase I). After detecting low scores on Questionnaire 01 by both groups, we applied a practical and face-to-face tutoring system for 14 days (Phase II). Afterwards, we re-evaluated both groups by repeating the same scores (Questionnaire 02, Phase III). According to the paired analysis of questionnaires 01 and 02 by Student's T-test, both groups showed significant increase in the final scores obtained in questionnaire 02 (Phase III). The evidence showed that the remote format lecture system weakened the learning and retention process of basic anatomical knowledge by medical students. On the other hand, in-person practical teaching proved to be efficient in the formative process of the students, a fact proven by the significant increase in the scores of the students in the 02 questionnaire, for both groups.

La pandemia por COVID-19 provocó varios cambios en la enseñanza de la anatomía humana, entre ellos el uso de diferentes metodologías de enseñanza basadas en E-learning. Sin embargo, los estudios que evalúan las herramientas electrónicas no han proporcionado evidencia clara de un aprendizaje efectivo de los estudiantes. Este fue el primer estudio que evaluó a estudiantes de medicina luego de cursar cursos de anatomía humana en la modalidad E-learning. Reclutamos estudiantes de medicina de primer término (Grupo A, n=25) y segundo término (Grupo B, n=13). Se aplicó una evaluación práctica basada en 50 marcas de anatomía humana sobre especímenes anatómicos reales y cadáveres, para ser completado en el Cuestionario 01 (Fase I). Tras detectar puntuaciones bajas en el Cuestionario 01 por parte de ambos grupos, se aplicó un sistema de tutorías prácticas y presenciales durante 14 días (Fase II). Posteriormente, reevaluamos ambos grupos repitiendo las mismas puntuaciones (Cuestionario 02, Fase III). Según el análisis apareado de los cuestionarios 01 y 02 por la prueba T de Student, ambos grupos mostraron aumento significativo en los puntajes finales obtenidos en el cuestionario 02 (Fase III). La evidencia mostró que el sistema de conferencias en formato remoto debilitó el proceso de aprendizaje y retención de conocimientos anatómicos básicos por parte de los estudiantes de medicina. Por otro lado, la docencia práctica presencial demostró ser eficiente en el proceso formativo de los alumnos, hecho que demuestra el aumento significativo de las puntuaciones de los alumnos en el cuestionario 02, para ambos grupos.

Desejo e culpa: a sedução diabólica em Eça de Queiroz / Desire and guilt: the diabolical seduction in Eça de Queiroz

O presente texto pretende, a partir de visita à obra clássica de Eça de Queiroz (1880/1963), O mandarim, localizar elementos deste romance fantástico que pos-sam nos oferecer pistas de trabalho, em ato literário, para compreender alguns con-ceitos da teoria psicanalítica freudo-lacaniana. Considerando que a associação entre o desejo inconsciente e a sedução diabólica é desde Freud uma constante, inter-rogamos, a partir do recurso do pacto, utilizado por Queiroz, as implicações e os desdobramentos clínico-teóricos a partir de três pontos conceituais. São eles, em particular, a questão das movimentações narcísicas que marcam um sujeito no inte-rior do par dialético insatisfação e busca de realização; o conceito de gozo como o que se inscreve, além do princípio de prazer; e a dimensão da culpa que se realiza via masoquismo face à não assunção do sujeito pela responsabilidade quanto ao seu desejo e que se localiza no personagem principal do romance no campo do maso-quismo mora

Arte e pesquisa em psicanálise: das aberturas de uma fotografia para encontros com realidade / Art and Research in Psychoanalysis: concerning the possibilities opened by a photograph to different encounters with realities

Trabalhamos o debate sobre a pluralidade de sentidos de uma obra de arte, tomando como enfoque o registro fotográfico. Partimos da descrição dos achados de uma pesquisa de orientação psicanalítica voltada à investigação de fenômenos sociais e conduzida através da metodologia das narrativas memorialísticas. Dividida em três tempos, narrar, criar e partilhar, essa metodologia tem como cerne interventivo a tradução de histórias de vida em obras de arte. O debate sobre os hiatos constitutivos da imagem é feito a partir de autores do campo psicanalítico como Sigmund Freud e Tânia Rivera, e do campo das artes, como Jacques Rancière e Roland Barthes. Trabalhando sobre a ideia da incidência da fotografia no tempo e no sujeito, pensamos as dimensões subjetiva, estética e política dessa pesquisa, e as possibilidades de criação e recepção de uma obra de arte(AU)

We debate the plurality of meanings of a work of art, focusing on the particularities of photography. We depart from the description of the findings derived from psychoanalytic research of social phenomena guided by the methodology of the Narrative Memoir. This methodology is divided into three moments: to narrate; to create; and to share, and involves the translation of life stories into works of art. The debate concerning the constitutive gaps of an image is conducted through psychoanalytic authors such as Sigmund Freud and Tania Rivera, assisted by authors in the field of aesthetics, such as Jacques Rancière and Roland Barthes. As we investigate the effects of photography on time an on the subject, we reflect on the subjective, aesthetic and political dimensions of this research, as well as on the processes of creation and reception of a work of art(AU)

Microcephaly Diagnosis: Maternal Perspectives About the Organization of the Health Care Network / Diagnóstico de la microcefalia: perspectivas maternas acerca de la organización de la red de atención a la salud / Diagnóstico da microcefalia: perspectivas maternas sobre a organização da rede de atenção à saúde

Objetivo: entender a organização da Rede de Atenção à Saúde (RAS) a partir de vivências de mães e de familiares no processo assistencial para o diagnóstico de microcefalia. Materiais e métodos: pesquisa descritiva e exploratória, de abordagem qualitativa, realizada com 14 mães de crianças com microcefalia. Para a definição da amostra, foram elencados os seguintes critérios de inclusão: ser mãe de criança diagnosticada com microcefalia decorrente do zika vírus, ter parido e ser residente do município de Mossoró, Rio Grande do Norte, Brasil. Enquanto critérios de exclusão, foram especificados: mães que não aceitaram participar do estudo. A população desta investigação foi definida no ano de 2018. Para a análise dos dados, foi empregado o método da análise temática do conteúdo de Minayo. Resultados: os resultados foram divididos nas seguintes categorias: 1. acesso aos serviços, aos exames e ao acompanhamento profissional; 2. percepção das mães acerca do seguimento na RAS. Foi possível apreender os obstáculos vivenciados na RAS para o diagnóstico e o seguimento das crianças com síndrome congênita decorrente do zika vírus. Conclusões: evidenciou-se a dificuldade de operacionalização de protocolo proposto para a RAS quer seja pelo conhecimento insuficiente acerca da síndrome, impossibilitando a manutenção do fluxo organizacional estabelecido pelo protocolo, quer seja pela escassez de tecnologias duras que auxiliem na efetivação dessa assistência.

Objective: To understand the organization of the Health Care Network (Rede de Atenção à Saúde, RAS) from the experiences of mothers and family members in the assistance process for the diagnosis of microcephaly. Materials and methods: A descriptive and exploratory research study with a qualitative approach, conducted with 14 mothers of children with microcephaly. For the definition of the sample, the following inclusion criteria were listed: being a mother of a child diagnosed with microcephaly due to Zika Virus, having given birth, and being a resident of the municipality of Mossoró, Rio Grande do Norte, Brazil. Regarding the exclusion criterion, the following was specified: mothers who did not accept to participate in the study. The population of this research was defined in 2018. Minayo's method of thematic content analysis was employed for data analysis. Results: The results were divided into the following categories: 1. Access to the services, exams, and professional monitoring; 2. Perception of the mothers about follow-up in the RAS. It was possible to apprehend the obstacles experienced in the RAS for the diagnosis and follow-up of children with congenital syndrome due to the Zika Virus. Conclusions: The difficulty of operationalizing the proposed protocol for the RAS was evidenced, either due to insufficient knowledge about the syndrome, making it impossible to maintain the organizational flow established by the protocol, or to the scarcity of hard technologies that assist in the implementation of this assistance.

Objetivo: entender la organización de la Red de Atención a la Salud (RAS) desde vivencias de madres y de familiares en el proceso asistencial para el diagnóstico de microcefalia. Materiales y métodos: investigación descriptiva y exploratoria, de enfoque cualitativo, realizado con 14 madres de niños con microcefalia. Para definir la muestra, se consideraron los siguientes criterios de inclusión: ser madre de niño diagnosticado con microcefalia resultante del virus zika, haber parido y ser residente del municipio de Mossoró, Rio Grande do Norte, Brasil. Como criterios de exclusión, se especificaron: madres que no aceptaron a participar en el estudio. La población del estudio se definió en el 2018. Para analizar los datos, se empleó el método de análisis temático de contenido de Minayo. Resultados: los resultados se dividieron en las categorías: 1. acceso a los servicios, a las pruebas y al seguimiento profesional; 2. percepción de las madres acerca del seguimiento en la RAS. Se logró aprehender los obstáculos vivenciados en la RAS para o diagnóstico y el seguimiento de los niños con síndrome congénito resultante del virus zika. Conclusiones: se evidenció la dificultad de operacionalización de protocolo propuesto para la RAS, ya sea por el conocimiento insuficiente acerca del síndrome, imposibilitando el mantenimiento del flujo organizacional establecido por el protocolo, ya sea por la escasez de tecnologías duras que auxilien en la efectuación de esta asistencia.

Aspectos relacionados às internações por intercorrências gestacionais / Related aspects with hospitalizations due to pregnancy complications

Objetivo: Analisar aspectos relacionados às internações por intercorrências gestacionais. Método: Estudo quantitativo, retrospectivo, realizado em maternidade pública de Teresina, Piauí, Brasil, com 367 prontuários de gestantes internadas na ala de alto risco, no período de 2015-2016. Realizou-se análises descritivas e inferenciais. Resultados: Gestantes possuíam média de 25,1 anos (Desvio padrão=7,2), a maioria com companheiro (68,4%), ensino fundamental incompleto (32,7%), do lar (58,6%) e procedentes do interior do Piauí (47,7%). As intercorrências gestacionais mais frequentes foram: Pré-eclâmpsia Grave (33,9%), Amniorrexe Prematura (16,4%) e Oligohidramnio (16,1%). Os aspectos relacionados à Pré-eclâmpsia Grave foram faixa etária (p-valor=0,03) e situação conjugal (p-valor=0,03); à Amniorrexe Prematura foram situação conjugal (p-valor=0,01), procedência (p-valor=0,03) e Infecção do Trato Urinário (p-valor<0,01); e, ao Oligohidramnio associado à procedência (p-valor=0,01). Conclusão: A assistência no período pré-natal, parto e puerpério deve ser recurso utilizado na prevenção e controle de intercorrências que podem atenuar danos ao binômio mãe e filho. (AU)

Objective: To analyze aspects related to hospitalizations due to pregnancy complications. Method: Quantitative, retrospective study, carried out in a public maternity hospital in Teresina, Piauí, Brazil, with 367 medical records of pregnant women hospitalized in the high-risk ward, in the period 2015-2016. Descriptive and inferential analyzes were carried out. Results: Pregnant women had an average of 25.1 years (standard deviation = 7.2), most with a partner (68.4%), incomplete elementary school (32.7%), home (58.6%) and coming from from the interior of Piauí (47.7%). The most frequent gestational complications were: Severe Preeclampsia (33.9%), Premature Amniorrexis (16.4%) and Oligohydramnios (16.1%). The aspects related to severe preeclampsia were age group (p-value = 0.03) and marital status (p-value = 0.03); Premature Amniorrexis were marital status (p-value = 0.01), origin (p-value = 0.03) and Urinary Tract Infection (p-value <0.01); and the Oligohydramnium associated with the origin (p-value = 0.01). Conclusion: Assistance in the prenatal, childbirth and puerperium period should be a resource used in the prevention and control of complications that can mitigate damage to the mother and child. (AU)

Objetivo: analizar aspectos relacionados con las hospitalizaciones por complicaciones del embarazo. Métodos: Estudio cuantitativo, retrospectivo, realizado en un hospital público de maternidad en Teresina, Piauí, Brasil, con 367 registros médicos de mujeres embarazadas hospitalizadas en la sala de alto riesgo, en el período 2015-2016. Se realizaron análisis descriptivos e inferenciales. Resultados: las mujeres embarazadas tuvieron un promedio de 25.1 años (desviación estándar = 7.2), la mayoría con una pareja (68.4%), escuela primaria incompleta (32.7%), desde casa (58.6%) y provenientes de del interior de Piauí (47.7%). Las complicaciones gestacionales más frecuentes fueron: preeclampsia severa (33.9%), amniorrexis prematura (16.4%) y oligohidramnios (16.1%). Los aspectos relacionados con la preeclampsia severa fueron el grupo de edad (valor p = 0.03) y el estado civil (valor p = 0.03); La amniorrexis prematura fue el estado civil (valor p = 0.01), el origen (valor p = 0.03) y la infección del tracto urinario (valor p <0.01); y el oligohidramio asociado con el origen (valor p = 0.01). Conclusión: La asistencia en el período prenatal, de parto y puerperio debe ser un recurso utilizado en la prevención y el control de complicaciones que pueden mitigar el daño a la madre y al niño. (AU)

Antiphospholipid Antibody Syndrome and Infertility.

Antiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 years was performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation and inflammatory signaling pathways, to provide important advances in its treatment.

A Síndrome do anticorpo antifosfolípide (SAF) é uma doença sistêmica, autoimune e pró-trombótica caracterizada por anticorpos antifosfolípides, trombose, aborto recorrente, complicações durante a gestação, e, ocasionalmente, trombocitopenia. O objetivo do presente estudo foi revisar a fisiopatologia da SAF e sua associação com a infertilidade feminina. Foi feita uma revisão bibliográfica dos últimos 20 anos nas bases de dados PubMed, Scielo e Bireme. A SAF pode estar associada à infertilidade primária, interferindo na decidualização endometrial e com baixas reservas ovarianas. Os anticorpos antifosfolípides também apresentam efeito negativo direto na placentação, se ligando ao trofoblasto e diminuindo sua capacidade de invasão, além de efeitos pró-inflamatórios, tais como ativação do sistema de complemento e recrutamento de neutrófilos, contribuindo para a insuficiência placentária, crescimento intrauterino restrito e perda fetal. Quanto a trombose, a SAF resulta em distúrbios trombóticos difusos, com uma desregulação do balanço homeostático. Conhecer a fisiopatologia da SAF, que apresenta associação importante com a infertilidade feminina, é essencial para novas abordagens terapêuticas, principalmente no que tange imunomodulação e os caminhos de ativação inflamatórios.

Antiphospholipid antibody syndrome and infertility / Síndrome anticorpo antifosfolípide e infertilidade

Abstract Antiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 yearswas performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation andinflammatory signaling pathways, to provide important advances in its treatment.

Resumo A Síndrome do anticorpo antifosfolípide (SAF) é uma doença sistêmica, autoimune e prótrombótica caracterizada por anticorpos antifosfolípides, trombose, aborto recorrente, complicações durante a gestação, e, ocasionalmente, trombocitopenia. O objetivo do presente estudo foi revisar a fisiopatologia da SAF e sua associação com a infertilidade feminina. Foi feita uma revisão bibliográfica dos últimos 20 anos nas bases de dados PubMed, Scielo e Bireme. A SAF pode estar associada à infertilidade primária, interferindo na decidualização endometrial e combaixas reservas ovarianas. Os anticorpos antifosfolípides também apresentam efeito negativo direto na placentação, se ligando ao trofoblasto e diminuindo sua capacidade de invasão, além de efeitos pró-inflamatórios, tais como ativação do sistema de complemento e recrutamento de neutrófilos, contribuindo para a insuficiência placentária, crescimento intrauterino restrito e perda fetal.Quanto a trombose, a SAF resulta em distúrbios trombóticos difusos, com uma desregulação do balanço homeostático. Conhecer a fisiopatologia da SAF, que apresenta associação importante com a infertilidade feminina, é essencial para novas abordagens terapêuticas, principalmente no que tange imunomodulação e os caminhos de ativação inflamatórios.

Glycerol inoculation in eggs of young broiler breeders at different embryonic periods.

Small eggs have lesser amounts of nutrients to be used by the embryo, and the yolk glycerol is the main substrate for glycogen production, which is the main energy source in the last days of incubation. Thus, the present study aimed to assess the effect of a glycerol injection in light weight eggs at 2 different days of incubation. To this end, 336 light eggs (55.6 to 58.6 g) from 32-wk-old broiler breeders were incubated. The eggs were divided into 3 treatment groups: 1 group inoculated with saline solution on the 17th d of embryonic development (E17) (control group), the second group injected with a 6 mg glycerol/mL solution at E17, and the third group injected with 6 mg glycerol/mL on the 18th d of incubation (E18). Incubation parameters, liver and muscle glycogen, and broilers performance at 7 d of age were evaluated. Glycerol administration in ovo did not influence hatchability, period of embryonic death or early hatching. Chicks exposed to glycerol in ovo feeding (IOF) used more yolk than birds inoculated with saline solution. Glycerol inoculation at E18 enhanced liver glycogen deposition (P = 0.001) and also improved broilers performance at 7 d, although this improvement in performance and glycogen reserves was not observed when eggs were inoculated at 17 d of incubation. Birds receiving glycerol IOF at E18 showed higher feed intake and body weight gain when compared to the control group and the group inoculated at E17. It was found that glycerol inoculation in light eggs at the 18th d of incubation contributed to raise liver glycerol levels and also to improve broilers performance at 7 d.

Trajetórias e narrativas de adolescentes envolvidos com a criminalidade: os objetos e suas formas de aproximação em transdisciplinaridade / Trajectories and narratives from adolescents involved in criminality: objects and approaching procedures in transdisciplinarity / Trayectorias y narrativas de adolescentes involucrados con la criminalidad: los objetos y sus formas de aproximación en transdisciplinariedad

Este trabalho tem por objetivo mapear alguns dos conceitos que servem de fundamentação teórica para a pesquisa Curso de vida e trajetória delinquencial: um estudo exploratório dos eventos e narrativas de jovens em situação de vulnerabilidade (IEAT/UFMG). Partimos de uma breve conceituação dos objetos da pesquisa, a saber, adolescências, violência e criminalidade, para então chegarmos às formas de apreensão escolhidas, tendo como referência os campos da psicanálise, a partir da noção de narrativas, e o da sociologia, a partir da trajetória. Por fim, realizamos uma breve consideração acerca do desafio epistemológico de se construir tais conceitos em uma abordagem transdisciplinar.

This work aims to explore some of the concepts that establish the theoretical foundation for the research "Life course and criminal trajectory: an exploratory study of events and narratives of socially vulnerable adolescents" (IEAT/UFMG). We start from a short description of our research objects, namely, adolescence, violence and criminality so as to reach the chosen approaching methods (narrative and trajectory) having as reference the field of psychoanalysis, based on the idea of narratives and sociology, based on the idea of trajectory. At last, we state brief comments on the epistemological challenge of developing these concepts through a transdisciplinary perspective.

Este trabajo tiene como objetivo mapear algunos de los conceptos que sirven de fundamentación teórica para la investigación "Curso de vida y trayectoria delincuencial: un estudio exploratorio de los eventos y narrativas de jóvenes en situación de vulnerabilidad" (IEAT/UFMG). Partimos de la breve conceptualización de los objetos de la investigación, a saber, adolescencias, violencia y criminalidad, para entonces llegar a las respectivas formas de aprehensión escogidas, teniendo como referencia los campos del psicoanálisis, a partir de la noción de narrativas, y el de la sociología a partir de la trayectoria. Por último, realizamos una breve consideración acerca del desafío epistemológico de construir tales conceptos en un enfoque transdisciplinario.

Transtornos de ansiedade como causa de afastamentos laborais / Anxiety disorders as a cause of work absenteeism

Resumo Introdução: transtornos mentais e comportamentais (TMC) estão entre as principais causas de perda de dias de trabalho. Os transtornos de ansiedade são a segunda causa dos afastamentos laborais. Objetivo: identificar e analisar as evidências disponíveis na literatura sobre afastamentos do trabalho por transtornos de ansiedade. Métodos: revisão integrativa da literatura, sem limite de ano de publicação, com descritores controlados, realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) e Base de Dados em Enfermagem (BDENF). Resultados: a seleção final consistiu em 13 artigos, sendo o mais antigo publicado em 2006 e o mais recente em 2016. Os afastamentos por transtornos de ansiedade tiveram como principais fatores de risco as condições e ambiente de trabalho, com impacto negativo, tanto para a saúde do trabalhador como para o empregador. Discussão: as evidências apontam para uma alta prevalência dos transtornos ansiosos como causa de afastamentos do trabalho e da alta demanda de custos elevados com auxílio-doença. Conhecer o perfil de adoecimento do trabalhador contribui para identificar os fatores de risco para TMC e auxilia na proposição de estratégias de intervenção direcionadas a reduzir o afastamento laboral.

Abstract Introduction: mental and behavioral disorders (MBD) are among the main causes of lost workdays. Anxiety disorders are the second cause of work absenteism. Objective: to identify and analyze evidence available in literature about work absenteism due to anxiety disorders. Methods: integrative literature review, with no publication year limits and with controlled subject headings, using the following databases: Latin American and Caribbean Literature on Health Sciences (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) and Nursing Database (BDENF). Results: the final selection consisted of 13 articles, the oldest published in 2006 and the most recent in 2016. Work absences due to anxiety disorders had as main risk factors the environment and working conditions, with a negative impact for both, the worker's and the employer's health. Discussion: evidence indicates a high prevalence of anxiety disorders as cause of work absenteeism and of the high demand for increasing social security costs. Knowing the worker's illness profile contributes to identify the MBD risk factors, and helps in proposing intervention strategies aimed at reducing work absenteism.

Age-related oxidative stress and antioxidant capacity in heat-stressed broilers.

We aimed to evaluate the effects of acute heat stress (HS) and age on the redox state in broilers aged 21 and 42 days. We evaluated the expression of genes related to antioxidant capacity, the production of hydrogen peroxide (H2O2), and the activity of antioxidant enzymes in the liver, as well as oxidative stress markers in the liver and plasma. The experiment had a completely randomized factorial design with two thermal environments (thermoneutral and HS, 38°C for 24 h) and two ages (21 and 42 days). Twenty-one-day-old animals exposed to HS showed the highest thioredoxin reductase 1 (TrxR1) (P<0.0001) and glutathione synthetase (GSS) (P<0.0001) gene expression levels. Age influenced the expression of the thioredoxin (Trx) (P=0.0090), superoxide dismutase (SOD) (P=0.0194), glutathione reductase (GSR) (P<0.0001) and glutathione peroxidase 7 (GPx7) (P<0.0001) genes; we observed greater expression in birds at 21 days than at 42 days. Forty-two-day-old HS birds showed the highest H2O2 production (222.31 pmol dichlorofluorescein produced/min×mg mitochondrial protein). We also verified the effects of age and environment on the liver content of Glutathione (GSH) (P<0.0001 and P=0.0039, respectively) and catalase (CAT) enzyme activity (P=0.0007 and P=0.0004, respectively). Higher GSH content and lower CAT activity were observed in animals from the thermoneutral environment compared with the HS environment and in animals at 21 days compared with 42 days. Broilers at 42 days of age had higher plasma creatinine content (0.05 v. 0.01 mg/dl) and higher aspartate aminotransferase activity (546.50 v. 230.67 U/l) than chickens at 21 days of age. Our results suggest that under HS conditions, in which there is higher H2O2 production, 21-day-old broilers have greater antioxidant capacity than 42-day-old animals.

Monitoramento e conservação genética de populações naturais de Prochilodus lineatus dos rios Pardo, Mogi-Guaçu e Tietê, São Paulo / Monitoring and conservation genetics of Prochilodus lineatus wild populations of Pardo, Mogi Guaçu and Tiete rivers, São Paulo

O objetivo do presente estudo foi determinar a diversidade e a estrutura genética de seis populações naturais de Prochilodus lineatus em usinas hidrelétricas (UHE) dos rios Pardo (UHE Limoeiro - LMO), Mogi-Guaçu (UHE Mogi-Guaçu - MOG) e Tietê (UHE Promissão - PRO, UHE Barra Bonita - BAB, UHE Nova Avanhandava - NAV e UHE Bariri - BAR). Foi encontrado um total de 47 alelos, com tamanhos entre 118pb e 330pb. Os resultados de heterozigosidade média observada (0,490 a 0,625) refletiram uma alta variabilidade genética intrapopulacional. Os valores de distância genética (0,149 a 0,773), Fst (0,006 a 0,218) e Nm (1,2 a 4,2) mostraram a presença de similaridade genética entre as populações. De acordo com a AMOVA, houve maior variação dentro das populações do que entre elas. O dendograma mostrou a formação de dois agrupamentos (LMO-PRO-MOG e BAR-BAB-NAV). Concluiu-se que as populações naturais apresentaram alta variabilidade genética, com similaridade genética entre elas, possivelmente causada pelo programa de repovoamento realizado nesses rios.(AU)

The aim of this study was to determine the genetic diversity and structure of six wild populations of Prochilodus lineatus in Hydroelectric Power Plants (HPP) of the Pardo (HPP Limoeiro - LMO), Mogi Guacu (HPP Mogi-Guaçu - MOG), and Tiete (HPP Promissão - PRO, HPP Barra Bonita - BAB, HPP Nova Avanhandava - NAV and HPP Bariri - BAR) rivers. A total of 47 alleles, ranging in size from 118bp to 330bp were found. The results of observed heterozygosity average (0.490 to 0.625) reflected a high intra-population genetic variability. The values of genetic distance (0.149 to 0.773), Fst (0.006 to 0.218), and Nm (1.2 to 4.2) showed that between the populations there is genetic similarity. According to AMOVA there was higher variation within populations than between them. The dendrogram demonstrated the formation of two groups (LMO-PRO-MOG and BAR-BAB-NAV). It was concluded that wild populations had high genetic variability with genetic similarity between them, possibly caused by the restocking program performed in these rivers.(AU)

A importância do trabalho em equipe na efetivação do tratamento diretamente observado em tuberculose / The importance of teamwork in the effectiveness of directly observed treatment of tuberculosis / La importancia del trabajo en equipo en la efectuación del tratamiento directamente observado en tuberculosis

Objetivo: analisar a importância do trabalho em equipe na efetivação do tratamento diretamente observado em tuberculose. Método: estudo descritivo e exploratório, com abordagens quantitativa e qualitativa, desenvolvido nas unidades básicas de saúde de Areia Branca/RN, com 28 profissionais: médicos, enfermeiros, técnicos de enfermagem e agentes comunitários de saúde. Para análise dos dados quantitativos, utilizou-se a estatística descritiva e, para os qualitativos, a modalidade técnica de análise temática. Resultados: todos os profissionais reconheceram a importância de trabalhar em equipe na realização do TDO, porém, o cuidado é centralizado pela enfermeira e, posteriormente, outros profissionais são requisitados, compartilhando o cuidado. Conclusão: os profissionais carecem de reconstrução na assistência oferecida, respaldada na interação, no diálogo e na superação da segregação de conhecimentos.(AU)

Objective: to analyze the importance of teamwork in the effectiveness of directly observed treatment for tuberculosis. Method: descriptive and exploratory study with quantitative and qualitative approaches developed in basic health units of Areia Branca/RN with 28 professionals: physicians, nurses, nursing technicians and community health agents. Descriptive statistics were used for analysis of quantitative data and the technique of thematic analysis was used for qualitative data. Results: all professionals recognized the importance of teamwork in achieving the DOT. However, care is centralized in the nurse and, only afterwards, other professionals are called to have a share in the care. Conclusion: the professionals lack reconstruction in the provided assistance, supported by interaction, dialogue and in the overcoming of the segregation of knowledge.(AU)

Objetivo: analizar la importancia del trabajo en equipo en la efectuación del tratamiento directamente observado en tuberculosis. Método: estudio descriptivo y exploratorio, con enfoque cuantitativo y cualitativo, desarrollado en las unidades básicas de salud de Areia Branca/RN, con 28 profesionales: médicos, enfermeros, técnicos de enfermería y agentes comunitarios de salud. Para análisis de los datos cuantitativos, se utilizó la estadística descriptiva y, para los cualitativos, la modalidad técnica de análisis temática. Resultados: todos los profesionales reconocieron la importancia de trabajar en equipo en la realización del TDO, sin embargo, el cuidado es centralizado por la enfermera y, posteriormente, otros profesionales son solicitados, compartiendo el cuidado. Conclusión: los profesionales no tienen reconstrucción en la asistencia ofrecida, respaldada en la interacción, en el diálogo y en la superación de la segregación de conocimientos.(AU)

Quality control of blood irradiation with a teletherapy unit: damage to stored red blood cells after cobalt-60 gamma irradiation.

BACKGROUND: Previous publications have documented the damage caused to red blood cells (RBCs) irradiated with X-rays produced by a linear accelerator and with gamma rays derived from a 137Cs source. The biologic effects on RBCs of gamma rays from a 60Co source, however, have not been characterized. STUDY DESIGN AND METHODS: This study investigated the effect of 3000 and 4000 cGy on the in vitro properties of RBCs preserved with preservative solution and irradiated with a cobalt teletherapy unit. A thermal device equipped with a data acquisition system was used to maintain and monitor the blood temperature during irradiation. The device was rotated at 2 r.p.m. in the irradiation beam by means of an automated system. The spatial distribution of the absorbed dose over the irradiated volume was obtained with phantom and thermoluminescent dosimeters (TLDs). Levels of Hb, K+, and Cl(-) were assessed by spectrophotometric techniques over a period of 45 days. The change in the topology of the RBC membrane was investigated by flow cytometry. RESULTS: Irradiation caused significant changes in the extracellular levels of K+ and Hb and in the organizational structure of the phospholipid bilayer of the RBC membrane. Blood temperature ranged from 2 to 4 degrees C during irradiation. Rotation at 2 r.p.m. distributed the dose homogeneously (92%-104%) and did not damage the RBCs. CONCLUSIONS: The method used to store the blood bags during irradiation guaranteed that all damage caused to the cells was exclusively due to the action of radiation at the doses applied. It was demonstrated that prolonged storage of 60Co-irradiated RBCs results in loss of membrane phospholipids asymmetry, exposing phosphatidylserine (PS) on the cells' surface with a time and dose dependence, which can reduce the in vivo recovery of these cells. A time- and dose-dependence effect on the extracellular K+ and plasma-free Hb levels was also observed. The magnitude of all these effects, however, seems not to be clinically important and can support the storage of irradiated RBC units for at last 28 days.

Prevalência dos fatores trombofílicos em mulheres com infertilidade / Prevalence of thrombophilic factors in infertile women

OBJETIVO: determinar a prevalência dos fatores trombofílicos em mulheres inférteis. MÉTODOS: estudo de corte transversal, no qual foram admitidas mulheres inférteis atendidas em clínica privada e submetidas à investigação de trombofilia, conforme protocolo da referida clínica, no período de março de 2003 a março de 2005, após aprovação do Comitê de Ética e Pesquisa da Universidade Estadual de Campinas (UNICAMP). Foram incluídas mulheres com história de infertilidade, definida como um ano de coito desprotegido sem concepção. Foram excluídas mulheres com hepatopatia e dados incompletos em prontuário, obtendo-se uma amostra de 144 mulheres. Os fatores trombofílicos avaliados foram: o anticorpo anticardiolipina (ACL), o anticoagulante lúpico (ACGL), a deficiência de proteína C (DPC), a deficiência de proteína S (DPS), a deficiência de antitrombina III (DAT), a presença do fator V de Leiden, uma mutação no gene da protrombina e a mutação do metileno tetrahidrofolato redutase (MTHFR). Resultados: os valores de prevalência obtidos para ACL e ACGL foram de 2 por cento. A prevalência dos fatores trombofílicos hereditários foram: DPC=4 por cento, DPS=6 por cento, DAT=5 por cento, fator V de Leiden=3 por cento, mutação da protrombina=3 por cento e mutação MTHFR=57 por cento. CONCLUSÕES: das 144 pacientes selecionadas, 105 mulheres, ou seja, 72,9 por cento apresentavam pelo menos um fator trombofílico presente. Isto reforça a importância e justifica a necessidade da investigação destes fatores neste grupo de mulheres.

PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2 percent. The prevalence of the hereditary thrombophilic factors were: PCD=4 percent, PSD=6 percent, ATD=5 percent, factor V Leiden=3 percent, prothrombin mutation=3 percent, MTHFR mutation=57 percent. Conclusions: of the 144 patients selected, 105 women (72.9 percent) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.

Quality control of blood irradiation: determination T cells radiosensitivity to cobalt-60 gamma rays.

BACKGROUND: To identify the most appropriate dose for the prevention of transfusion-associated graft-versus-host disease, the radiosensitivity of T cells has been determined in blood bags irradiated with X-rays produced by a linear accelerator and gamma rays derived from the cesium-137 source of a specific irradiator. In this study, the influence of doses ranging from 500 to 2500 cGy was investigated on T cells isolated from red blood cell (RBC) units preserved with ADSOL and irradiated with a cobalt teletherapy unit. STUDY DESIGN AND METHODS: A thermal device consisting of acrylic and foam was constructed to store the blood bags during irradiation. Blood temperature was monitored with an automated data acquisition system. Dose distribution in the blood bags was analyzed based on isodose curves obtained with a polystyrene phantom constructed for this purpose. The influence of cobalt-60 gamma radiation on T cells was determined by limiting-dilution analysis, which measures clonable T cells. T-cell content of the mononuclear cell population plated was assessed by flow cytometry with a monoclonal antibody specific for CD3. RESULTS: Blood temperature ranged from 2 to 4.5 degrees C during irradiation. Dosimetry performed on the phantom showed a homogenous dose distribution when the phantom was irradiated with a parallel-opposite field. A radiation dose of 1500 cGy led to the inactivation of T cells by 4 log, but T-cell growth was observed in all experiments. At 2500 cGy, no T-cell growth was detected in any of the experiments and a greater than 5 log reduction in functional T cells was noted. CONCLUSION: The results showed that a dose of 2500 cGy completely inactivates T cells in RBC units irradiated with cobalt-60 source.

Effect of carbohydrate on portal vein blood flow during exercise.

Effects of carbohydrate ingestion and exercise on portal vein blood flow were studied. Flow was measured by pulsed-electronic Doppler. Eight male subjects performed four tests after a standardised breakfast and 5 h fast. Beverages were CHO (10 % glucose, 30 mmol . l (-1) NaCl) and W (water, 30 mmol . l (-1) NaCl). Exercise experiments comprised a resting measurement, 10 min warm-up and 60 min 70 % VO(2)max cycling. Every 10 min subjects stopped cycling briefly (approximately 30 s) for measurements. Beverage was consumed after warm-up (500 ml) and at 20 and 40 min (250 ml). Similar tests were done at rest. Blood samples were taken concurrently with flow measurements for hormonal concentrations. Exercise decreased blood flow (repeated measures ANOVA, p < 0.0001) and carbohydrate ingestion increased flow (p = 0.015). At rest, flow was greater with CHO than with W at 20 (177 +/- 31; 101 +/- 25 %, resp.) (mean +/- SE), 30 (209 +/- 37; 120 +/- 20 %), 40 (188 +/- 32; 108 +/- 12 %), and 60 min (195 +/- 19; 112 +/- 12 %) (1-way ANOVA, Fisher's PLSD, p < 0.05). Flow was similar during exercise with CHO and W, with a tendency for CHO to maintain flow better, at 10 (124 +/- 27; 77 +/- 21 %), 20 (81 +/- 10; 60 +/- 13 %), 30 (106 +/- 26; 56 +/- 10 %), 40 (109 +/- 28; 54 +/- 8 %), 50 (85 +/- 17; 54 +/- 13 %), and 60 min (61 +/- 15; 47 +/- 7 %). A positive correlation between glucagon and flow and an inverse correlation between noradrenaline and flow were observed. Exercise reduces, and carbohydrate increases, portal vein flow. Changes in plasma concentrations suggest that noradrenaline and glucagon, respectively, may play a role in modulating flow.

Quality control system for blood irradiation using a teletherapy unit.

BACKGROUND AND OBJECTIVES: Irradiation of whole blood and blood components before transfusion is currently the only accepted methodology to prevent transfusion-associated graft-vs.-host disease. In the present work, we developed an automated system for blood bag storage during irradiation, using a teletherapy unit. MATERIALS AND METHODS: A device with two thermal compartments was constructed in acrylic and foam, for the storage of blood bags during irradiation. An automatic acquisition system, coupled with an amplifier and a thermal-sensitive probe, were developed to check blood temperature during irradiation. A polystyrene phantom was constructed to simulate the volume of blood routinely irradiated. The dose distribution was measured in the phantom using thermoluminescent dosimeters and represented in terms of isodose curves. RESULTS: The thermal device kept the blood temperature below 6 degrees C for more than 2 h. Our system allowed the simultaneous irradiation of two different blood components while maintaining a constant temperature. The temperature monitoring system remained invariant (0.2 degrees C) over the whole irradiation interval. Phantom dosimetric results showed a homogeneous dose distribution when the phantom was irradiated, using rotational fields with a 2 r.p.m. frequency. CONCLUSIONS: The methodology developed in the present work provides appropriate storage conditions during irradiation of both red blood cells and platelet blood components using a teletherapy unit.