Robust, maintainable, emergency invasive mechanical ventilator. / Ventilador mecânico invasivo de emergência resistente e de fácil manutenção.

OBJECTIVE: To develop a simple, robust, safe and efficient invasive mechanical ventilator that can be used in remote areas of the world or war zones where the practical utility of more sophisticated equipment is limited by considerations of maintainability, availability of parts, transportation and/or cost. METHODS: The device implements the pressure-controlled continuous mandatory ventilation mode, complemented by a simple assist-control mode. Continuous positive airway pressure is also possible. The consumption of compressed gases is minimized by avoiding a continuous flow of oxygen or air. Respiratory rates and inspiration/expiration time ratios are electronically determined, and an apnea/power loss alarm is provided. RESULTS: The pressure profiles were measured for a range of conditions and found to be adjustable within a ± 2.5cmH2O error margin and stable well within this range over a 41-hour period. Respiratory cycle timing parameters were precise within a few percentage points over the same period. The device was tested for durability for an equivalent period of four months. Chemical and biological tests failed to identify any contamination of the gas by volatile organic compounds or microorganisms. A ventilation test on a large animal, in comparison with a well established ventilator, showed that the animal could be adequately ventilated over a period of 60 minutes, without any noticeable negative aftereffects during the subsequent 24-hour period. CONCLUSION: This ventilator design may be viable, after further animal tests and formal approval by the competent authorities, for clinical application in the abovementioned atypical circumstances.

OBJETIVO: Desenvolver um ventilador mecânico invasivo simples, resistente, seguro e eficiente que possa ser utilizado em áreas remotas do mundo ou zonas de guerra, em que a utilidade prática de equipamentos mais sofisticados é limitada por questões de manutenção, disponibilidade de peças, transporte e/ou custo. MÉTODOS: O dispositivo implementa o modo de ventilação mandatória contínua com pressão controlada, complementado por um simples modo assisto-controlado. Pode-se também utilizar a pressão positiva contínua nas vias aéreas. Ao se evitar o fluxo contínuo de oxigênio ou ar, minimiza-se o consumo de gases comprimidos. As taxas respiratórias e as relações de tempo de inspiração e expiração são determinadas eletronicamente. Além disso, conta com um alarme de apneia/falta de energia. RESULTADOS: Os perfis de pressão foram medidos para uma série de condições, sendo considerados ajustáveis dentro de uma margem de erro de ± 2,5cmH2O, e foram considerados bem estáveis dentro dessa variação durante um período de 41 horas. Os parâmetros de tempo do ciclo respiratório foram precisos dentro de alguns pontos percentuais durante o mesmo período. O dispositivo foi testado quanto à durabilidade por um período equivalente a 4 meses. Os testes químicos e biológicos não conseguiram identificar qualquer contaminação do gás por compostos orgânicos voláteis ou micro-organismos. Em comparação com um ventilador bem estabelecido, o teste de ventilação em um animal de grande porte mostrou que este poderia ser ventilado adequadamente durante um período de 60 minutos, sem quaisquer efeitos negativos perceptíveis durante o período subsequente de 24 horas. CONCLUSÃO: Este projeto de ventilador pode ser viável após novos testes em animais e aprovação formal pelas autoridades competentes, para aplicação clínica nas circunstâncias atípicas anteriormente mencionadas.

Ventilador mecânico invasivo de emergência resistente e de fácil manutenção / Robust, maintainable, emergency invasive mechanical ventilator

RESUMO Objetivo: Desenvolver um ventilador mecânico invasivo simples, resistente, seguro e eficiente que possa ser utilizado em áreas remotas do mundo ou zonas de guerra, em que a utilidade prática de equipamentos mais sofisticados é limitada por questões de manutenção, disponibilidade de peças, transporte e/ou custo. Métodos: O dispositivo implementa o modo de ventilação mandatória contínua com pressão controlada, complementado por um simples modo assisto-controlado. Pode-se também utilizar a pressão positiva contínua nas vias aéreas. Ao se evitar o fluxo contínuo de oxigênio ou ar, minimiza-se o consumo de gases comprimidos. As taxas respiratórias e as relações de tempo de inspiração e expiração são determinadas eletronicamente. Além disso, conta com um alarme de apneia/falta de energia. Resultados: Os perfis de pressão foram medidos para uma série de condições, sendo considerados ajustáveis dentro de uma margem de erro de ± 2,5cmH2O, e foram considerados bem estáveis dentro dessa variação durante um período de 41 horas. Os parâmetros de tempo do ciclo respiratório foram precisos dentro de alguns pontos percentuais durante o mesmo período. O dispositivo foi testado quanto à durabilidade por um período equivalente a 4 meses. Os testes químicos e biológicos não conseguiram identificar qualquer contaminação do gás por compostos orgânicos voláteis ou micro-organismos. Em comparação com um ventilador bem estabelecido, o teste de ventilação em um animal de grande porte mostrou que este poderia ser ventilado adequadamente durante um período de 60 minutos, sem quaisquer efeitos negativos perceptíveis durante o período subsequente de 24 horas. Conclusão: Este projeto de ventilador pode ser viável após novos testes em animais e aprovação formal pelas autoridades competentes, para aplicação clínica nas circunstâncias atípicas anteriormente mencionadas.

ABSTRACT Objective: To develop a simple, robust, safe and efficient invasive mechanical ventilator that can be used in remote areas of the world or war zones where the practical utility of more sophisticated equipment is limited by considerations of maintainability, availability of parts, transportation and/or cost. Methods: The device implements the pressure-controlled continuous mandatory ventilation mode, complemented by a simple assist-control mode. Continuous positive airway pressure is also possible. The consumption of compressed gases is minimized by avoiding a continuous flow of oxygen or air. Respiratory rates and inspiration/expiration time ratios are electronically determined, and an apnea/power loss alarm is provided. Results: The pressure profiles were measured for a range of conditions and found to be adjustable within a ± 2.5cmH2O error margin and stable well within this range over a 41-hour period. Respiratory cycle timing parameters were precise within a few percentage points over the same period. The device was tested for durability for an equivalent period of four months. Chemical and biological tests failed to identify any contamination of the gas by volatile organic compounds or microorganisms. A ventilation test on a large animal, in comparison with a well established ventilator, showed that the animal could be adequately ventilated over a period of 60 minutes, without any noticeable negative aftereffects during the subsequent 24-hour period. Conclusion: This ventilator design may be viable, after further animal tests and formal approval by the competent authorities, for clinical application in the abovementioned atypical circumstances.

Assessment of the Transmission Dynamics of Clostridioides difficile in a Farm Environment Reveals the Presence of a New Toxigenic Strain Connected to Swine Production.

The recent increase in community-acquired Clostridioides difficile infections discloses the shift in this bacterium epidemiology. This study aimed at establishing a transmission network involving One Health components, as well as assessing the zoonotic potential and genomic features of dominant clones. Samples were collected from different compartments of animal, human and environmental origin, from an animal production unit. C. difficile isolates were characterized for toxigenic profile by multiplex-PCR, while genetic diversity was evaluated by PCR-ribotyping and whole genome-based analysis. The overall C. difficile prevalence was 37.2% (70/188), and included samples from environmental (58.3%, 35/60) and animal (31.5%, 35/111) compartments; human samples (n = 17) taken from healthy workers were negative. A predominant clone from RT033 was found in almost 90% of the positive samples, including samples from all compartments connected to the pig production unit, with core-genome single nucleotide variant (SNV)-based Analysis supporting a clonal transmission between them (mean distance of 0.1 ± 0.1 core-SNVs). The isolates from this clone (herein designated PT RT033) were positive for all C. difficile toxin genes (tcdA, tcdB, cdtA/cdtB). The phyloGenetic positioning of this clone was clearly distinct from the classical RT033 cluster, suggesting a different evolutionary route. This new clone shares genomic features with several RTs from the clade 5 Sequence Type (ST) 11, including a complete pathogenicity locus (PaLoc) that is more similar to the one found in toxigenic strains and contrasting to the less virulent classical RT033 (tcdA-, tcdB-, cdtA + /cdtB +). The presence of a tcdA gene truncated into two ORFs, not previously described, requires further evaluation concerning toxin functionality. We hypothesize that the unique combination of genetic elements found in the PT RT033 clone may contribute to host tropism and environmental dissemination and maintenance. This study constitutes the first report of a toxigenic RT033 clone and adds to the overall knowledge on Clade 5 sequence type 11, considered the C. difficile evolutionary lineage with the highest zoonotic potential. The presence of this clone in all compartments associated with the pig production unit suggests a transmission chain involving these animals and contributes to unveil the role played by animal and environmental reservoirs in this pathogen epidemiology.

Effect of dietary incorporation of Chlorella vulgaris and CAZyme supplementation on the hepatic proteome of finishing pigs.

The combination of several factors, including an increase in world population and living standards in developing countries and world dependency on conventional crop imports drive a search for alternative feedstuffs for poultry and pig diets. This would reduce the environmental impact associated with the foreseeable increase in the demand for animal products. One of such alternatives are microalgae, a diverse group of aquatic organisms with interesting nutritional properties. Chlorella vulgaris is a green microalga with a crude protein content comparable to that of soybean meal. However, its recalcitrant cell wall prevents it from being used as a nutrient source in monogastric diets. CAZyme supplementation is a putative strategy to increase its nutritional value, aiming at disrupting the cell wall and make intracellular nutrients available for digestion. The impact of these dietary strategies on the hepatic metabolism is currently unknown. The objective of this study was to evaluate the hepatic proteome of pigs fed with 5% C. vulgaris with or without CAZyme supplementation. Microalga inclusion has affected lipid metabolism and oxidative stress. CAZyme supplementation has caused higher oxidative stress in the liver, possibly caused by the higher digestive availability and consequent hepatic oxidation of fatty acids. SIGNIFICANCE: C. vulgaris, a microalga, is a novel feedstuff that is an alternative to conventional crops such as maize and soybean meal. Its recalcitrant cell wall may cause antinutritional effects when included in monogastric diets. This can be prevented by using exogenous enzyme supplementation, namely CAZymes, aimed at degrading this cell wall during digestion. Liver proteomics was used to identify the impact of these diets in finishing pig metabolism.

Impact of Chlorella vulgaris as feed ingredient and carbohydrases on the health status and hepatic lipid metabolism of finishing pigs.

The implication of high dietary level of Chlorella vulgaris, individually and supplemented with two carbohydrase mixtures, on pigs' health and liver metabolism was assessed in this study. Forty crossbred (Large White × Landrace sows crossed with Pietrain boars) entire male pigs were randomly allocated to the following feeding treatments (n = 10): cereal-soybean meal basal diet (control); basal diet with 5% C. vulgaris; basal diet with 5% C. vulgaris supplemented with 0.005% Rovabio® Excel AP; and basal diet with 5% C. vulgaris supplemented with 0.01% of a preselected four-CAZyme mixture. The trial lasted from 59.1 ± 5.69 kg of initial live weight to 101 ± 1.9 kg of slaughter weight. Data indicate that this high dietary level of C. vulgaris has impact on several blood parameters of finishing pigs. However, the most relevant health outcome observed was a strong immunosuppressive effect promoted by the microalga, which increases pigs' susceptibility to infection diseases. In addition, the dietary incorporation of C. vulgaris reduced the systemic antioxidant capacity of pigs. In turn, the dietary supplementation with the four-CAZyme mixture promoted a clear decrease on some blood parameters compared with the control group. Regarding hepatic lipids, pigs fed C. vulgaris diets, had an increased hepatic content of n-3 PUFA, with a consequent decrease on the n-6/n-3 ratio. In conclusion, the use of C. vulgaris as feed ingredient appears to be safe under controlled experimental conditions. However, it is imperative test it in industrial production systems, with more stressful and less hygienic environments.

Desenvolvimento de aplicativo móvel para o acompanhamento pré-natal e validação de conteúdo / Desarrollo de aplicación móvil para el seguimiento de la atención prenatal y validación de contenido / Development of a mobile application for prenatal care and content validation

Resumo Objetivo Desenvolver aplicativo móvel para gestantes em acompanhamento pré-natal e validar o conteúdo. Métodos Estudo metodológico, tecnológico de abordagem quantitativa realizado em três etapas: revisão integrativa de literatura, validação de conteúdo e construção do aplicativo. A revisão foi realizada em Bases de Dados Bibliográficas; em seguida, um instrumento guia foi elaborado abarcando assuntos sobre pré-natal, parto e puerpério, o qual passou por uma validação inicial, por meio de um grupo focal. Para a construção do aplicativo seguiram-se as fases: análise, design, desenvolvimento, implementação e avaliação de especialistas. A construção do aplicativo e validação do conteúdo foi realizada por 21 especialistas, sendo 14 enfermeiros obstetras e 7 profissionais da área de tecnologia da informação e comunicação. Utilizou-se o Índice de Validade de Conteúdo (IVC), considerando como taxa de concordância valores acima de 80%, Concordância interavaliadores e teste não paramétrico de Mann-Whitney para verificação da fase Delphi 1 e 2. Resultados O aplicativo possui 111 telas sobre o pré-natal, parto, puerpério e aleitamento materno, caderneta virtual da gestante, despertador como lembrete de consultas e o menu fale conosco. Após duas rodadas da técnica Delphi, obteve-se concordância entre os especialistas, com índice de validade de conteúdo médio de 0,89. Conclusão O aplicativo obteve IVC geral adequado entre os especialistas, evidenciando que as informações abordadas e a parte técnica do sistema são confiáveis, sendo validado quanto ao conteúdo. Este apresenta-se como uma potencial ferramenta para promoção da saúde, no que concerne ao cuidado no período gravídico-puerperal.

Resumen Objetivo Desarrollar aplicación móvil para gestantes para el seguimiento de la atención prenatal y validar el contenido. Métodos Estudio metodológico, tecnológico de enfoque cuantitativo realizado en tres etapas: revisión integradora de literatura, validación de contenido y elaboración de la aplicación. La revisión fue realizada en bases de datos bibliográficas. Luego, se elaboró un instrumento guía sobre temas relacionados con control prenatal, parto y puerperio, que pasó por una validación inicial, por medio de un grupo focal. Para elaborar la aplicación, se siguieron las siguientes fases: análisis, diseño, desarrollo, implementación y evaluación de especialistas. La elaboración de la aplicación y la validación del contenido fueron realizadas por 21 especialistas, de los cuales 14 eran enfermeros obstetras y siete profesionales del área de tecnologías de la información y la comunicación. Se utilizó el Índice de Validez de Contenido (IVC), considerando como índice de concordancia valores superiores a 80 %, concordancia interevaluadores y prueba no paramétrica de Mann-Whitney para verificación de la fase Delphi 1 y 2. Resultados La aplicación posee 111 pantallas sobre control prenatal, parto, puerperio y lactancia materna, libreta virtual de gestante, alarma como recordatorio de consultas y el menú "contáctenos". Luego de dos rondas del método Delphi, se obtuvo concordancia entre los especialistas, con un índice de validez de contenido promedio de 0,89. Conclusión La aplicación obtuvo un IVC general adecuado entre los especialistas, lo que deja en evidencia que la información abordada y la parte técnica del sistema son confiables y, de esta forma, el contenido es validado. Se presenta como una herramienta potencial para la promoción de la salud, en lo que respecta al cuidado durante el embarazo y el puerperio.

Abstract Objective To develop a mobile application for pregnant women in prenatal care and validate its content. Methods This is a methodological and technological study with a quantitative approach, carried out in three stages: integrative literature review, content validation, and application construction. The review was carried out in bibliographic databases; then, a guide instrument was elaborated covering subjects about prenatal care, childbirth and the puerperium, which underwent an initial validation through a focus group. For the application construction, the following phases were followed: analysis, design, development, implementation and expert assessment. The application construction and content validation were carried out by 21 experts, being 14 obstetric nurses and 7 Information and Communication Technology professionals. Content Validity Index (CVI) was used, considering as an agreement rate values above 80%, inter-rater agreement and Mann-Whitney non-parametric test to verify Delphi 1 and 2 phases. Results The application has 111 screens about prenatal care, childbirth, puerperium and breastfeeding, the pregnant woman's virtual notebook, an alarm clock as a reminder of appointments and the contact us menu. After two rounds Delphi technique rounds, agreement was reached between the experts, with an average Content Validity Index of 0.89. Conclusion The application obtained an adequate general CVI among experts, showing that the information covered and the system's technical part are reliable, being validated in terms of content. This presents itself as a potential instrument for health promotion with regard to care in the pregnancy-puerperal period.

Agricultural value of Black Soldier Fly larvae frass as organic fertilizer on ryegrass.

Hermetia illucens L., known as Black Soldier Fly (BSF) appear as an opportunity to reuse vegetable by-products, as it is easy to reproduce and can be reared in agricultural side streams, allowing the production of both, animal feed (the larvae, after recycling of the vegetal debris) and soil organic fertilizer (insect frass). Although several organic fertilizers, from long ago, have been used in agriculture, there is yet a paucity of experimental data on the evaluation of the fertilization potential of BSF larvae frass (BSFF). The present study is a contribution to access the agronomic and environmental potential of the BSFF as an organic fertilizer. Within this aim, it was conducted a greenhouse experiment with ryegrass, using seven treatments of BSFF. Under the experimental conditions, the results showed a significant effect of BSFF on the overall ryegrass production, with a steady increase (significant at p ≤ 0.05, as accessed through the Tukey test) up to the treatment with a greater rate of application. In what concerns sustainability of soil productivity, at the end of the experiment, there was also positive indications, namely, a significant increase of OM, P and K, for treatments with higher N endowments, together with a constant increase of dehydrogenase activity, from the control to the higher treatment, which was significant for treatments receiving the higher dose of BSFF.

Terminologia especializada de enfermagem no cuidado às pessoas vivendo com aids / Terminología especializada de enfermería en el cuidado de personas que viven con sida / Specialized nursing terminology in care of people infected with AIDS

Resumo Objetivo: Construir e validar quanto ao conteúdo uma terminologia especializada de Enfermagem, no cuidado a adultos vivendo com aids, fundamentado no Modelo de Sete Eixos da Classificação Internacional para a Prática de Enfermagem. Métodos: Estudo metodológico, realizado em um Hospital Escola no Nordeste do Brasil. Seguiram-se as seguintes etapas: extração dos termos de prontuários de pessoas vivendo com aids; normalização; mapeamento cruzado entre os extraídos e os constantes na Classificação Internacional para a Prática de Enfermagem; distribuição destes nos sete eixos e validação de conteúdo por meio de índice de concordância entre enfermeiros peritos. Resultados: Extraíram-se 2.000 termos. A normalização resultou em 557 termos pertinentes, estando 319 constantes e 238 não constantes na Classificação Internacional para a Prática de Enfermagem. Foram validados pelos peritos 522 termos, sendo 319 constantes e 203 não constantes, os quais atingiram um índice de concordância ≥ 0,80. Conclusão: O estudo permitiu identificar e validar os termos utilizados por enfermeiros na assistência às pessoas vivendo com aids, o qual subsidiará as etapas subsequentes à construção de um subconjunto terminológico para informação e comunicação à prática de Enfermagem.

Resumen Objetivo: Elaborar y validar, en cuanto al contenido, una terminología especializada de enfermería en el cuidado de adultos que viven con sida, fundamentada en el Modelo de Siete Ejes de la Clasificación Internacional de la Práctica de Enfermería. Métodos: Estudio metodológico, realizado en un hospital universitario en la región nordeste de Brasil. Se llevaron a cabo las siguientes etapas: extracción de los términos de historias clínicas de personas que viven con sida; normalización; mapeo cruzado entre los términos extraídos y los que constan en la Clasificación Internacional de la Práctica de Enfermería; distribución de estos en los siete ejes y validación de contenido mediante el índice de concordancia por enfermeros peritos. Resultados: Se extrajeron 2.000 términos. La normalización dio como resultado 557 términos pertinentes, de los cuales 319 constaban en la Clasificación Internacional de la Práctica de Enfermería y 238 no. Los peritos validaron 522 términos, de los cuales 319 constaban y 203 no constaban, que alcanzaron un índice de concordancia ≥ 0,80. Conclusión: El estudio permitió identificar y validar los términos utilizados por enfermeros en la atención a personas que viven con sida y contribuirá con las etapas subsiguientes de la construcción de un subconjunto terminológico para información y comunicación en la práctica de enfermería.

Abstract Objective: To build and validate, in terms of content, a specialized nursing terminology in care of adults infected with AIDS, based on the Seven-Axis Model of the International Classification for Nursing Practice. Method: A methodological study carried out at a teaching hospital in northeastern Brazil. The following steps followed extraction of terms from the medical records of people infected with AIDS; normalization; cross-mapping between extracted and constant in the International Classification for Nursing Practice; distribution in seven axes and content validation through a concordance index among expert nurses. Results: Two thousand terms have been extracted. Normalization resulted in 557 pertinent terms, 319 of which were constant and 238 not included in the International Classification for Nursing Practice. Five hundred and twenty-two terms were validated by experts, of which 319 were constant and 203 were not constant, which reached a concordance index ≥ 0.80. Conclusion: This study allowed to identify and validate the terms used by nurses in assisting people infected with AIDS, which will subsidize the steps subsequent to the construction of a terminological subset for information and communication to nursing practice.

A High Dietary Incorporation Level of Chlorella vulgaris Improves the Nutritional Value of Pork Fat without Impairing the Performance of Finishing Pigs.

The influence of a high inclusion level of Chlorella vulgaris, individually and supplemented with two carbohydrase mixtures, in finishing pig diets was assessed on zootechnical performance, carcass characteristics, pork quality traits and nutritional value of pork fat. Forty crossbred entire male pigs, sons of Large White × Landrace sows crossed with Pietrain boars, with an initial live weight of 59.1 ± 5.69 kg were used in this trial. Swines were randomly assigned to one of four dietary treatments (n = 10): cereal and soybean meal-based diet (control), control diet with 5% C. vulgaris (CV), CV diet supplemented with 0.005% Rovabio® Excel AP (CV + R) and CV diet supplemented with 0.01% of a four-CAZyme mixture (CV + M). Animals were slaughtered, after the finishing period, with a BW of 101 ± 1.9 kg. Growth performance, carcass characteristics and meat quality traits were not influenced (p > 0.05) by the incorporation of C. vulgaris in the diets. However, the inclusion of the microalga in finishing pig diets increased some lipid-soluble antioxidant pigments and n-3 PUFA, and decreased the n-6:n-3 ratio of fatty acids, thus ameliorating the nutritional value of pork fat. Moreover, the supplementation of diets with the carbohydrase mixtures did not change (p > 0.05) neither animal performance nor meat quality traits, indicating their inefficacy in the increase of digestive utilization of C. vulgaris by pigs under these experimental conditions. It is concluded that the use of C. vulgaris in finishing pig diets, at this high incorporation level, improves the nutritional value of pork fat without compromising pig performance.

Quantitative Proteomics Identifies Metabolic Pathways Affected by Babesia Infection and Blood Feeding in the Sialoproteome of the Vector Rhipicephalus bursa.

The negative impact of ticks and tick-borne diseases on animals and human health is driving research to discover novel targets affecting both vectors and pathogens. The salivary glands are involved in feeding and pathogen transmission, thus are considered as a compelling target to focus research. In this study, proteomics approach was used to characterize Rhipicephalus bursa sialoproteome in response to Babesia ovis infection and blood feeding. Two potential tick protective antigens were identified and its influence in tick biological parameters and pathogen infection was evaluated. Results demonstrate that the R. bursa sialoproteome is highly affected by feeding but infection is well tolerated by tick cells. The combination of both stimuli shifts the previous scenario and a more evident pathogen manipulation can be suggested. Knockdown of ub2n led to a significative increase of infection in tick salivary glands but a brusque decrease in the progeny, revealing its importance in the cellular response to pathogen infection, which is worth pursuing in future studies. Additionally, an impact in the recovery rate of adults (62%), the egg production efficiency (45.75%), and the hatching rate (88.57 %) was detected. Building knowledge on vector and/or pathogen interplay bridges the identification of protective antigens and the development of novel control strategies.

Prevalência do diagnóstico de enfermagem Mobilidade Física Prejudicada em pessoas com esclerose múltipla / Prevalence of nursing diagnosis Impaired Physical Mobility in people with multiple sclerosis / Prevalencia del diagnóstico de enfermería Movilidad Física Deteriorada en personas con esclerosis múltiple

Objetivo: identificar a prevalência do diagnóstico de enfermagem Mobilidade Física Prejudicada, suas características definidoras e fatores relacionados em pessoas com Esclerose múltipla e verificar a associação entre ambos e suas razões de prevalência. Métodos: estudo transversal com 113 pacientes em um hospital da região Nordeste do Brasil. Para a análise dos dados utilizou-se os testes de qui-quadrado de Pearson e exato de Fisher, sendo calculadas também as razões de prevalência. Resultados: o diagnóstico esteve presente em 89% da amostra e as características e fatores que apresentaram associação foram: alterações na marcha; instabilidade postural; movimentos descoordenados; redução nas habilidades motoras finas e grossas; depressão; força muscular diminuída e prejuízo músculo esquelético. Conclusão: o diagnóstico apresentou-se com elevada frequência na amostra, o que permite identificar as necessidades de intervenções que diz respeito à capacidade funcional do indivíduo, potencializando seu rendimento funcional e pessoal, através do planejamento do cuidado e da assistência qualificada

Objective: to identify the prevalence of the nursing diagnosis Impaired Physical Mobility, its defining characteristics and related factors in people with multiple sclerosis, and to verify the association between both and their prevalence ratios. Methods: cross-sectional study, with 113 patients in a hospital in the Northeast region of Brazil. Pearson's chi-square test and Fisher's exact test were used to perform data analysis, and the prevalence ratios were calculated. Results: the diagnosis was present in 89% of the sample and the characteristics and factors that presented association were: changes in gait; postural instability; uncoordinated movements; reduction in fine and gross motor skills; depression; decreased muscle strength and skeletal muscle injury. Conclusion: the diagnosis was presented with high frequency in the sample, which allows identifying the needs of interventions that relate to the functional capacity of the individual, enhancing their functional and personal income through the planning of care and qualified care.

Objetivo: identificar la prevalencia del diagnóstico de enfermería Movilidad Física Deteriorada, sus características definitorias y factores relacionados en personas con esclerosis múltiple, y verificar la asociación entre ambos y sus razones de prevalencia. Métodos: estudio transversal, con 113 pacientes en un hospital de la región noreste de Brasil. La prueba de chi-cuadrado de Pearson y la prueba exacta de Fisher se usaron para realizar el análisis de datos, y se calcularon las razones de prevalencia. Resultados: el diagnóstico estuvo presente en el 89% de la muestra y las características y factores que presentaron asociación fueron: cambios en la marcha; inestabilidad postural; movimientos descoordinados; reducción de las habilidades motoras fina y gruesa; depresión; disminución de la fuerza muscular y lesión del esqueleto muscular. Conclusión: el diagnóstico se presentó con alta frecuencia en la muestra, lo que permite identificar las necesidades de las intervenciones que se relacionan con la capacidad funcional del individuo, mejorando sus ingresos funcionales y personales a través de la planificación de la atención y la atención calificada.

Distinct fatty acid composition of some edible by-products from bovines fed high or low silage diets.

In the present study, it was hypothesized that the incorporation of fatty acids is distinct among ruminant tissues and that it could be modulated by diet composition. To test this hypothesis, fatty acid composition, including conjugated linoleic acid isomers, of the most relevant beef by-products (brain, heart, kidney, liver, pancreas and tongue) from young bulls those fed distinct silage levels was assessed. Data indicated a large variation in fatty acid profile and conjugated linoleic acid composition among edible by-products. The most abundant fatty acids were C16:0 (kidney), C18:0 (heart and liver) and C18:1 c9 (brain, pancreas and tongue) followed by C20:4 n-6, except in brain (C22:6 n-3 predominates). Brain, as shown by principal component analysis, presents a distinct fatty acid composition compared to the other beef by-products analysed. In addition, high silage diet relative to low silage diet promoted an increase of n-3 polyunsaturated fatty acid, t11, t13 and t11, c13 conjugated linoleic acid in heart, kidney, liver and pancreas. Overall, the data suggested that beef by-products had, in general, high contents of cholesterol, saturated fatty acid and trans fatty acid, as well as high levels of conjugated linoleic acid. Therefore, from a nutritional point of view they are recommended only in small amounts as part of a balanced diet.

Proposta de plano de cuidados de enfermagem para paciente queimado: estudo de caso / Proposal for a nursing care plan for burned patient: case study

A Sistematização da Assistência de Enfermagem é caracterizada por ser uma ferramenta utilizada pelo enfermeiro para aprimorar os saberes da prática, otimizando, aperfeiçoando e aprimorando as técnicas assistenciais a partir das novas evidências científicas. O estudo teve como objetivo elaborar e validar um plano de cuidados para paciente queimado. Trata-se de um estudo de caso realizado no Centro de Tratamento de Queimados de um hospital público no nordeste do Brasil, no período de abril a maio de 2016. As etapas metodológicas do estudo foram estas: coleta de dados; elaboração dos diagnósticos, resultados e intervenções de enfermagem; elaboração e validação do plano de cuidados. Após a análise dos dados, foi realizada a elaboração e a validação de um plano de cuidados com quatro diagnósticos, resultados e 24 intervenções de enfermagem. Diante disso, o estudo permitiu identificar os diagnósticos, resultados e intervenções de enfermagem para a aplicação na prática clínica, corroborando para o cuidado científico e direcionado as necessidades prioritárias

The Systematization of Nursing Care is characterized by being a tool that nurses use to improve the practical knowledge, optimizing, enhancing and improving the technical assistance will from the new scientific evidence. The study aimed to develop and validate a plan of care for burn patients. This is a case study in the Burn Treatment Center of a public hospital in northeastern Brazil, from April to May 2016. The methodological stages of the study were these: data collection; preparation of diagnoses / outcomes and nursing interventions; preparation and care plan validation. After analyzing the data produced and validated a care plan with four diagnostic / 24 results and nursing interventions. Thus, the study identified the diagnoses / outcomes and nursing interventions to implement in clinical practice