Qualidade de vida de pacientes diagnosticados com hanseníase em um município do Piauí / The quality of life of patients diagnosed with leprosy in a city in Piauí

Objetivo: analisar os domínios de qualidade de vida em pacientes com hanseníase em um município de alta endemicidade do Piauí. Métodos: trata-se de um estudo descritivo e transversal, realizado entre fevereiro e novembro de 2019. Para a coleta de dados, foram utilizados um formulário sociodemográficoe o questionário de qualidade de vida SF-36, sendo as informações analisadas por meio dos testes de U Mann-Whitney que visa comparar a diferença entre dois grupos e o de Kruskal-wallis que pretende comparar a média de duas ou mais amostras independentes. Resultados: participaram do estudo 46 pacientes. Quando avaliadas as variáveis socioeconômicas e clínicas relacionadas aos domínios de qualidade de vida, o "Aspecto emocional" obteve maior média (78,25; dp: 39,88) e a dimensão "Saúde mental" apresentou menor média (45,04; dp: 24,95). Já a variável ocupação relacionou-se negativamente com o estado geral de saúde (p-0,002) e saúde mental (p-0,009). Conclusão: a maior parte das dimensões avaliadas obteve boas pontuações, indicando uma boa qualidade de vida na população estudada, exceto as dimensões referentes a "saúde mental" e "estado geral de saúde" relacionados a variável ocupação, obtendo baixo score e indicando má qualidade de vida nesses últimos.

Objective:To analyze the domains of quality of life in patients with leprosy in a city of Piauí where the disease is highly endemic. Methods:This is a descriptive, cross-sectional study, carried out from February to November 2019. For data collection, a sociodemographic form and the SF-36 quality of life questionnaire were used. The information was analyzed using Mann-Whitney's U to compare the difference between two groups and the Kruskal-Wallis test, to compare the mean of two or more independent samples. Results:46 patients participated in the study. When the socioeconomic and clinical variables related with the quality-of-life domains were evaluated, the "Emotional aspect" had the highest mean (78.25; sd: 39.88) while the lowest was found in the "Mental health" dimension (45.04; sd 24.95). The variable occupation had a negative relation with the general state of health (p=0.002) and mental health (p=0.009). Conclusion: Most dimensions evaluated presented a good score, indicating that the quality of life of the population studied was good. The exception were the dimensions "mental health" and "general state of health" when related with the variable occupation, whose score was low, indicating that the quality of life in these dimensions was low.

Perfil microbiológico da carne bovina in natura comercializada no município de Picos, Piauí

A carne bovina in natura constitui um comércio importante e bastante procurado pela população, entretanto está envolvida no aparecimento de inúmeras doenças transmitidas por alimentos. Objetivou-se no presente trabalho avaliar o perfil microbiológico, através da pesquisa de Coliformes totais, Coliformes termotolerantes, Salmonella spp. E Staphylococcus aureus, em amostras de carne bovina in natura comercializada no Município de Picos, Piauí. Coletaram-se 30 amostras de carne (patinho bovino) obtidas em mercados públicos e supermercados, em seguida as amostras foram conduzidas em caixas isotérmicas para o Laboratório de Microbiologia de Alimentos da Universidade Federal do Piauí para análises microbiológicas. Em todas as amostras processadas foi detectada a presença de coliformes totais e Coliformes termotolerantes. Com relação à pesquisa de Salmonella spp, nos supermercados, duas amostras (33,3%) apresentaram Salmonella spp. Nos mercados públicos 14 amostras (58,33%) apresentaram contaminação com Salmonella spp. Com relação à presença de Staphylococcus aureus, 22 amostras (73,33%) apresentaram contaminação acima de 105 UFC/g. De acordo com os resultados obtidos, conclui-se que as elevadas populações dos micro-organismos aqui pesquisados evidenciaram um produto com risco de ocasionar toxinfecções alimentares, necessitando a intervenção dos órgãos de Vigilância Sanitária para implantar medidas de melhorias nas condições de produção, manuseio e de venda deste produto.(AU)

The in natura bovine meat is an important trade and highly sought by the population. However, it is involved in the onset of many food related diseases. The purpose of the present article was to evaluate the microbiological profile in fresh bovine meat samples marketed at the city of Picos, state of Piaui, Brazil. It was done through the detection of total coliforms, fecal coliforms, Salmonella spp. and Staphylococcus aureus presence in the samples. Thirty samples of meat (bovine knuckle) were collected in public markets and supermarkets. The samples were conducted inside of isothermal boxes to the Federal University of Piaui for microbiological analyses. The presence of total coliforms and Escherichia coli were detected in all processed samples. Regarding the detection of Salmonella spp, two samples obtained from the supermarkets (33.3%) showed the presence of Salmonella spp. About the samples obtained from the public markets, 14 of them (58,33%) were contaminated with Salmonella spp. In relation to the presence of Staphylococcus aureus, 22 samples (73,33%) showed a contamination superior to 105 CFU/g. According to the obtained results it was concluded that the high population of microorganisms in the meats investigated in this research were showed as being a product at risk of causing food poisoning. Thus, it requires the intervention of the Sanitary Surveillance agencies to implement measures to improve the production conditions, handling and sale of this product.(AU)

Perfil microbiológico da carne bovina in natura comercializada no município de Picos, Piauí / Microbiological profile of the bovine meat in natura marketed in the municipality of Picos, Piaui

A carne bovina in natura constitui um comércio importante e bastante procurado pela população, entretanto está envolvida no aparecimento de inúmeras doenças transmitidas por alimentos. Objetivou-se no presente trabalho avaliar o perfil microbiológico, através da pesquisa de Coliformes totais, Coliformes termotolerantes, Salmonella spp. e Staphylococcus aureus, em amostras de carne bovina in natura comercializada no Município de Picos, Piauí. Coletaram-se 30 amostras de carne (patinho bovino) obtidas em mercados públicos e supermercados, em seguida as amostras foram conduzidas em caixas isotérmicas para o Laboratório de Microbiologia de Alimentos da Universidade Federal do Piauí para análises microbiológicas. Em todas as amostras processadas foi detectada a presença de coliformes totais e Coliformes termotolerantes. Com relação à pesquisa de Salmonella spp, nos supermercados, duas amostras (33,3%) apresentaram Salmonella spp. Nos mercados públicos 14 amostras (58,33%) apresentaram contaminação com Salmonella spp. Com relação à presença de Staphylococcus aureus, 22 amostras (73,33%) apresentaram contaminação acima de 105 UFC/g. De acordo com os resultados obtidos, conclui- -se que as elevadas populações dos micro-organismos aqui pesquisados evidenciaram um produto com risco de ocasionar toxinfecções alimentares, necessitando a intervenção dos órgãos de Vigilância Sanitária para implantar medidas de melhorias nas condições de produção, manuseio e de venda deste produto.(AU)

Mast cell concentration and skin wound contraction in rats treated with Ximenia americana L.

PURPOSE: To evaluate wound contraction and the concentration of mast cells in skin wounds treated with wild plum (Ximenia americana) essential oil-based ointment in rats. METHODS: Sixty rats were submitted to two cutaneous wounds in the thoracic region, on the right and left antimeres. Thereon, they were divided into three groups: GX (wounds treated once a day with hydro alcoholic branch extract of Ximenia americana), GP (wounds that received vehicle), and GC (wounds without product application). Wounds were measured immediately after the injury as well as 4, 7, 14 and 21 days post-topical application of the extract. At these days, five rats from each group were euthanatized. Thereafter, samples were fixed in 10% formaldehyde and processed for paraffin embedding. Sections were stained with H.E, Masson's Trichrome and toluidine blue for morphological, morphometrical and histopathological analysis, under light microscopy. The degree of epithelial contraction was measured and mast cell concentrations were also evaluated with an image analyzer (Image Pro-plus®software) . RESULTS: The extract treated group showed lower mast cell concentrations in the 4th day of lesion, as compared to GP (GX GP = GC; p<0.05) . CONCLUSION: Ointment containing 10% X. americana induces a decrease in mast cell concentration, at the beginning of the healing process, and promotes early skin wound contraction in rats.

Mast cell concentration and skin wound contraction in rats treated with Ximenia americana L

Abstract Purpose: To evaluate wound contraction and the concentration of mast cells in skin wounds treated with wild plum (Ximenia americana) essential oil-based ointment in rats. Methods: Sixty rats were submitted to two cutaneous wounds in the thoracic region, on the right and left antimeres. Thereon, they were divided into three groups: GX (wounds treated once a day with hydro alcoholic branch extract of Ximenia americana), GP (wounds that received vehicle), and GC (wounds without product application). Wounds were measured immediately after the injury as well as 4, 7, 14 and 21 days post-topical application of the extract. At these days, five rats from each group were euthanatized. Thereafter, samples were fixed in 10% formaldehyde and processed for paraffin embedding. Sections were stained with H.E, Masson's Trichrome and toluidine blue for morphological, morphometrical and histopathological analysis, under light microscopy. The degree of epithelial contraction was measured and mast cell concentrations were also evaluated with an image analyzer (Image Pro-plus®software) . Results: The extract treated group showed lower mast cell concentrations in the 4th day of lesion, as compared to GP (GX<GP=GC, p=0.029), as well as with increased contraction at 7th and 14th days, respectively (7th and 14th days, GX > GP = GC; p<0.05) . Conclusion: Ointment containing 10% X. americana induces a decrease in mast cell concentration, at the beginning of the healing process, and promotes early skin wound contraction in rats.

Mast cell concentration and skin wound contraction in rats treated with Ximenia americana L

Purpose: To evaluate wound contraction and the concentration of mast cells in skin wounds treated with wild plum (Ximenia americana) essential oil-based ointment in rats. Methods: Sixty rats were submitted to two cutaneous wounds in the thoracic region, on the right and left antimeres. Thereon, they were divided into three groups: GX (wounds treated once a day with hydro alcoholic branch extract of Ximenia americana), GP (wounds that received vehicle), and GC (wounds without product application). Wounds were measured immediately after the injury as well as 4, 7, 14 and 21 days post-topical application of the extract. At these days, five rats from each group were euthanatized. Thereafter, samples were fixed in 10% formaldehyde and processed for paraffin embedding. Sections were stained with H.E, Masson's Trichrome and toluidine blue for morphological, morphometrical and histopathological analysis, under light microscopy. The degree of epithelial contraction was measured and mast cell concentrations were also evaluated with an image analyzer (Image Pro-plus®software) . Results: The extract treated group showed lower mast cell concentrations in the 4th day of lesion, as compared to GP (GX GP=GC, p=0.029), as well as with increased contraction at 7th and 14th days, respectively (7th and 14th days, GX > GP = GC; p 0.05) . Conclusion: Ointment containing 10% X. americana induces a decrease in mast cell concentration, at the beginning of the healing process, and promotes early skin wound contraction in rats.(AU)

Fibrogenesis and epithelial coating of skin wounds in rats treated with angico extract (Anadenanthera colubrina var. cebil).

PURPOSE: To evaluate the effects of angico bark extract (Anadenanthera colubrina var. cebil) in the healing process of the skin of rats. METHODS: Twenty adult male rats were divided into four groups of five animals each, according to the respective postoperative days, as follow: G4, G7, G14 and G21. Each group received two incisions on skin and subcutaneous tissue in the right and left antimere of the thoracic region, separated by a distance of 2 cm. The right lesion was treated daily with saline and the left with the angico alcoholic extract (5%). At the end of each experimental period, the animals were euthanized and fragments of the wound area with the edges were removed, fixed in 10% formaldehyde solution and processed for paraffin embedding. Histological sections (5 µm of thickness) were stained with hematoxylin and eosin (HE), Gomori trichromic and picrosisirus red for morphological and morphometric analyses. Statistical analysis was done by ANOVA and Tukey-Kramer test (p<0.05). RESULTS: Morphological analysis showed larger fibroblasts and a higher concentration of collagen fibers in skyn wounds treated with the angico extract. Morphometric analysis demonstrated a significant increase in the number of fibroblasts at 7th and collagen in 7th and 14th days (p<0.01) in wounds treated with the angico extract. CONCLUSION: The angico alcoholic extract (Anadenanthera colubrina var. cebil) induces the acceleration of wound healing in skin wounds of rats.

Fibrogenesis and epithelial coating of skin wounds in rats treated with angico extract (Anadenanthera colubrina var. cebil)

PURPOSE: To evaluate the effects of angico bark extract (Anadenanthera colubrina var. cebil) in the healing process of the skin of rats. METHODS: Twenty adult male rats were divided into four groups of five animals each, according to the respective postoperative days, as follow: G4, G7, G14 and G21. Each group received two incisions on skin and subcutaneous tissue in the right and left antimere of the thoracic region, separated by a distance of 2 cm. The right lesion was treated daily with saline and the left with the angico alcoholic extract (5%). At the end of each experimental period, the animals were euthanized and fragments of the wound area with the edges were removed, fixed in 10% formaldehyde solution and processed for paraffin embedding. Histological sections (5 μm of thickness) were stained with hematoxylin and eosin (HE), Gomori trichromic and picrosisirus red for morphological and morphometric analyses. Statistical analysis was done by ANOVA and Tukey-Kramer test (p<0.05). RESULTS: Morphological analysis showed larger fibroblasts and a higher concentration of collagen fibers in skyn wounds treated with the angico extract. Morphometric analysis demonstrated a significant increase in the number of fibroblasts at 7th and collagen in 7th and 14th days (p<0.01) in wounds treated with the angico extract. CONCLUSION: The angico alcoholic extract (Anadenanthera colubrina var. cebil) induces the acceleration of wound healing in skin wounds of rats. .

Fibrogenesis and epithelial coating of skin wounds in rats treated with angico extract (Anadenanthera colubrina var. cebil)

PURPOSE: To evaluate the effects of angico bark extract (Anadenanthera colubrina var. cebil) in the healing process of the skin of rats.METHODS: Twenty adult male rats were divided into four groups of five animals each, according to the respective postoperative days, as follow: G4, G7, G14 and G21. Each group received two incisions on skin and subcutaneous tissue in the right and left antimere of the thoracic region, separated by a distance of 2 cm. The right lesion was treated daily with saline and the left with the angico alcoholic extract (5%). At the end of each experimental period, the animals were euthanized and fragments of the wound area with the edges were removed, fixed in 10% formaldehyde solution and processed for paraffin embedding. Histological sections (5 m of thickness) were stained with hematoxylin and eosin (HE), Gomori trichromic and picrosisirus red for morphological and morphometric analyses. Statistical analysis was done by ANOVA and Tukey-Kramer test (p 0.05).RESULTS: Morphological analysis showed larger fibroblasts and a higher concentration of collagen fibers in skyn wounds treated with the angico extract. Morphometric analysis demonstrated a significant increase in the number of fibroblasts at 7th and collagen in 7th and 14th days (p 0.01) in wounds treated with the angico extract.CONCLUSION: The angico alcoholic extract (Anadenanthera colubrina var. cebil) induces the acceleration of wound healing in skin wounds of rats.(AU)

Uncomplicated acute cholecystitis: early or delayed laparoscopic cholecystectomy?

Recent meta-analyses suggested that early laparoscopic cholecystectomy (within 1 week of symptom onset) for uncomplicated acute gallbladder disease is safe and feasible. However, surveys on surgical practices indicated that early laparoscopic cholecystectomy is performed by only a minority of surgeons. Furthermore, the exact time-point for performing this procedure as well as its cost-effectiveness remain a matter of debate. The TBE - CiTE Journal Club performed a critical appraisal of the most relevant evidence recently published on timing of laparoscopic cholecystectomy and its cost-effectiveness for the management of uncomplicated acute cholecystitis and provides evidence-based recommendations on the topic. The literature encompasses small trials with high risk of biases. It suggests that early laparoscopic cholecystectomy is safe and shortens hospital stay. There is scarcity of well-designed and large cost-utility analyses. The following main recommendations were generated: (1) Early laparoscopic cholecystectomy should be attempted as the first-line treatment within one week of symptoms onset; and (2) The cost-effectiveness of early laparoscopic cholecystectomy should be evaluated at the individual hospital level, taking into consideration local resources such as the availability of trained personal, operating room and laparoscopic equipment.

Colecistite aguda não-complicada: colecistectomia laparoscópica precoce ou tardia? / Uncomplicated acute cholecystitis: early or delayed laparoscopic cholecystectomy?

Metanálises recentes sugerem que a colecistectomia laparoscópica precoce (dentro de uma semana do início dos sintomas) para a doença aguda, não complicada, da vesícula biliar é segura e viável. No entanto, enquetes sobre as práticas cirúrgicas indicam que a colecistectomia laparoscópica precoce é realizada por apenas uma minoria dos cirurgiões. Além disso, o melhor momento para realização deste procedimento, bem como sua relação custo-eficácia continuam sendo uma questão de debate. A reunião de revista TBE - CiTE realizou uma avaliação crítica dos artigos mais relevantes, publicados recentemente, sobre o momento da colecistectomia laparoscópica e sua relação custo-eficácia para o tratamento da colecistite aguda não complicada e fornece recomendações baseadas em evidências sobre o tema. A literatura engloba pequenos ensaios com alto risco para vieses. Ela sugere que colecistectomia laparoscópica precoce é segura e encurta o período de internação. Há uma escassez de estudos bem desenhados e de grandes séries analisando custo-utilidade. As seguintes recomendações foram geradas: (1) a colecistectomia laparoscópica precoce deve ser tentada como o tratamento de primeira linha dentro de uma semana do início dos sintomas, e (2) O custo-efetividade da colecistectomia laparoscópica precoce deve ser avaliada em cada local, levando-se em consideração os recursos, tais como a disponibilidade de pessoal treinado e de equipamentos laparoscópicos.

Recent meta-analyses suggested that early laparoscopic cholecystectomy (within 1 week of symptom onset) for uncomplicated acute gallbladder disease is safe and feasible. However, surveys on surgical practices indicated that early laparoscopic cholecystectomy is performed by only a minority of surgeons. Furthermore, the exact time-point for performing this procedure as well as its cost-effectiveness remain a matter of debate. The TBE - CiTE Journal Club performed a critical appraisal of the most relevant evidence recently published on timing of laparoscopic cholecystectomy and its cost-effectiveness for the management of uncomplicated acute cholecystitis and provides evidence-based recommendations on the topic. The literature encompasses small trials with high risk of biases. It suggests that early laparoscopic cholecystectomy is safe and shortens hospital stay. There is scarcity of well-designed and large cost-utility analyses. The following main recommendations were generated: (1) Early laparoscopic cholecystectomy should be attempted as the first-line treatment within one week of symptoms onset; and (2) The cost-effectiveness of early laparoscopic cholecystectomy should be evaluated at the individual hospital level, taking into consideration local resources such as the availability of trained personal, operating room and laparoscopic equipment.

Tubo gástrico isoperistáltico no tratamento paliativo do carcinoma irressecável do esôfago / Gastro-esophageal isoperistaltic bypass as palliative treatment of the irresectable esophageal cancer

A meta do tratamento dos pacientes portadores de carcinoma avançado de esôfago é o alívio da disfagia. OBJETIVO: O objetivo deste trabalho é relatar a experiência dos autores na utilização da derivação esofagogástrica através de um tubo gástrico isoperistáltico seguido de radioterapia, no tratamento de doentes portadores de carcinoma irressecável do esôfago. MÉTODO: No período de 1990 a 1999, 30 pacientes foram submetidos à cirurgia de derivação. Vinte e quatro doentes (80 por cento) eram do sexo masculino e seis (20 por cento) do feminino; a idade variou de 27 a 69 anos, média de 49,3 anos. Em todos os casos o diagnóstico foi confirmado por endoscopia digestiva alta e biópsia. Aqueles com tumores maiores que 6cm ao esofagograma ou com sinais de invasão da árvore respiratória à broncoscopia foram considerados irressecáveis. Após avaliação clínica e preparo pré-operatório foram submetidos à operação de derivação. O ato operatório foi realizado por duas equipes, uma na região cervical e outra na abdominal e a duração da intervenção variou entre três a quatro horas. Após a alta hospitalar os pacientes foram encaminhados para a radioterapia. RESULTADOS: Não houve óbito operatório. A mortalidade pós-operatória foi de 10 por cento, um caso de tromboembolismo pulmonar e dois de broncopneumonia. Treze pacientes (43,3 por cento) desenvolveram fístula cervical e em 11 ocorreu o fechamento espontâneo da fístula; um caso necessitou de reoperação e outro veio a falecer no 14º dia pós-operatório com a fístula aberta. Oito pacientes (26,6 por cento) apresentaram estenose da anastomose esôfago-tubo; todos evoluíram bem com dilatação endoscópica. A deglutição foi restabelecida em todos os pacientes até o momento do óbito, excetuando aqueles que faleceram em virtude de complicações pós-operatórias (três casos). O tempo de internação variou de 12 a 45 dias e a sobrevida média foi de 7,9 meses. CONCLUSÕES: Os autores concluíram que nos pacientes portadores...

The goal of the treatment in patients with advanced esophageal carcinoma is to alleviate dysphagia. BACKGROUND: The objective of this study is to report the authors' experience with gastric esophageal bypass using isoperistaltic gastric tube followed by radiotherapy, in the treatment of patients with unresectable esophageal carcinoma. METHOD: From 1990 to 1999, 30 patients underwent bypass surgery. Twenty four patients (80 percent) were male and six (20 percent) female, age ranged from 27 to 69 years, with a mean age of 49.3 years. Diagnosis was confirmed by esophagogastroduodenoscopy and biopsy in all patients. Those with tumors greater than 6 cm at esophagography or with signs of invasion of the respiratory sistem at bronchoscopy were considered unresectable. Bypass surgery was carried out after medical assessment and preoperative evaluation. Surgery was performed by two teams, one at the cervical area and another at the abdominal area. Surgical time ranged from 3 to 4 hours. After hospital discharge, patients were referred to radiotherapy. RESULTS: There was no operative mortality. Postoperative mortality was 10 percent, one case of pulmonary thromboembolism and two cases of pneumonia. Thirteen patients (43.3 percent) developed cervical anastomotic leak and eleven had spontaneous resolution; one required a new operation and another patient died at postoperative day 14, with an open fistula. Eight patients (26.6 percent) had anastomotic stenosis, and all of them had a good outcome with endoscopic dilation. Deglutition was reestablished in all patients until death, excluding those who died as a result of postoperative complications (3 cases). Hospitalization time ranged from 12 to 45 days and mean survival rate was 7.9 months. CONCLUSIONS: We concluded that, in patients with esophageal unresectable carcinoma, obstruction bypass using an isoperistaltic gastric tube alleviates dysphagia symptoms until death. Morbidity is high, even though...