Application of ecotoxicological tools to evaluate the quality status of mangroves under restoration in the Yucatán Peninsula, Mexico.

Ecotoxicological tools, namely biomarkers and bioassays, may provide insights on the ecological quality status of mangroves under restoration. We investigated how 1) physicochemical parameters and water bioassays using Artemia franciscana; and 2) quantification of sublethal (osmoregulatory capacity, biochemical, and oxidative stress) and individual biomarkers (density, length-weight relationship [LWR], parasitic prevalence) in the sentinel fiddler crab Minuca rapax, can improve restoration indicators in mangroves from the Yucatán Peninsula, Southern Gulf of Mexico. We showed that water quality was improved with restoration, but still presented toxicity. Regarding sublethal biomarkers, M rapax from restored areas lower osmotic regulatory capacity, higher oxidative stress, and showed lipid peroxidation. As to the individual biomarkers, the density, LWR, and the prevalence of parasites in M. rapax was higher in restored areas. The use of bioassays/biomarkers were useful as early warning indicators to better assess the health of mangroves under restoration.

Metalloproteomic approach to liver tissue of rats exposed to mercury.

The aims of this study were to identify mercury-associated protein spots in the liver tissue of rats exposed to low concentrations of mercury and to elucidate the physiological and functional aspects of the proteins identified in the protein spots. Therefore, proteomic analysis of the liver tissue of Wistar rats exposed to mercury chloride (4.60 µg kg-1 in Hg2+) was performed for thirty days (Hg-30 group) and sixty days (Hg-60 group). The proteomic profile of the liver tissue of the rats was obtained by two-dimensional electrophoresis (2D-PAGE), and the determinations of total mercury in the liver tissue, pellets and protein spots were performed by graphite furnace atomic absorption spectrometry (GFAAS). ImageMaster 2D Platinum 7.0 software was used to identify the differentially expressed mercury-associated protein spots, which were then characterized by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). The determinations by GFAAS indicated a total mercury bioaccumulation of 2812% in the Hg-30 group and 3298% in the Hg-60 group and 10 mercury-associated protein spots with a concentration range of 51 ± 1.0 to 412 ± 6.00 mg kg-1 in the 2D PAGE gels from the liver tissue of the Hg-60 group. The LC-MS/MS analyses allowed the identification of 11 metal binding proteins in mercury-associated protein spots that presented fold change with upregulation >1.5, downregulation < -1.7 or that were expressed only in the Hg-60 group. Using the FASTA sequences of the proteins identified in the mercury-associated protein spots, bioinformatics analyses were performed to elucidate the physiological and functional aspects of the metal binding proteins, allowing us to infer that enzymes such as GSTM2 presented greater mercury concentrations and downregulation < -3; Acaa2 and Bhmt, which showed expression only in the Hg-60 group, among others, may act as potential mercury exposure biomarkers.

Metalloproteomic Investigation of Hg-Binding Proteins in Renal Tissue of Rats Exposed to Mercury Chloride.

Results obtained from rat studies indicate that, even at low concentrations, mercurial species cause harmful effects on the kidneys, by inducing the nephrotic oxidative stress response. In the present work, Hg-associated proteins were identified as possible mercury-exposure biomarkers in rat kidneys exposed to low mercury chloride concentrations for 30 days (Hg-30) and 60 days (Hg-60), using metalloproteomic strategies. The renal proteomic profile was fractioned by two-dimensional electrophoresis and the mercury determinations in kidney samples, protein pellets and protein spots were performed using graphite furnace atomic absorption spectrometry. The characterization of Hg-associated protein spots and the analysis of differentially expressed proteins were performed by liquid chromatography, coupled with tandem mass spectrometry. Eleven Hg-associated protein spots with a concentration range of 79 ± 1 to 750 ± 9 mg kg-1 in the Hg-60 group were identified. The characterization and expression analyses allowed the identification of 53 proteins that were expressed only in the Hg-60 group, 13 "upregulated" proteins (p > 0.95) and 47 "downregulated" proteins (p < 0.05). Actin isoforms and hemoglobin subunits were identified in protein spots of the Hg-60 group, with mercury concentrations in the range of 138 to 750 mg kg-1, which qualifies these proteins as potential mercury-exposure biomarkers.

Severe Intractable Headache as a Presentation of COVID-19 in a 23-Year-Old.

Severe acute respiratory syndrome coronavirus type 2 is a novel betacoronavirus with a new genome sequence that causes coronavirus disease 2019 (COVID-19), which primarily affects the lungs, thus causing pneumonia which can progress to severe acute respiratory distress syndrome. New emerging cases of extrapulmonary manifestations of COVID-19 include gastrointestinal, cardiac, renal, and/or central nervous system involvement. Although an ischemic stroke converting to a hemorrhagic stroke is more commonly seen, spontaneous intracranial hemorrhage (ICH) in hospitalized COVID-19 patients is on the rise. This case report describes a 23-year-old female who tested positive (via a polymerase chain reaction test) for COVID-19 and presented with new onset of severe intractable headache. The investigation suggested COVID-19 as the most probable cause of this patients' spontaneous ICH. This case emphasizes the importance of adding COVID-19 to the differential diagnosis of hemorrhagic cerebrovascular accidents in patients with a spontaneous ICH of unclear etiology and, in the process, performing COVID testing.

Primary Sjögren syndrome and development of another autoimmune rheumatic disease during the follow-up.

BACKGROUND: Primary Sjögren syndrome (pSS) is a chronic autoimmune disease with its main target being exocrine glands, and is the connective tissue disease more frequently associated with other autoimmune diseases. The aim of this study was to assess the frequency of another autoimmune rheumatic disease (ARD) developed in primary Sjögren syndrome (pSS) patients and to describe it's clinical, serological and histologic characteristics. MATERIALS AND METHODS: This is a retrospective cohort study. Data of patients with pSS diagnosis (American-European criteria 2002), included in the GESSAR database (Grupo de Estudio Síndrome de Sjögren, Sociedad Argentina de Reumatología) were analyzed. The development of a second ARD was registered during the follow up. RESULTS: 681 patients were included, 94.8% female. The mean age was 54 (SD 14) years and mean age at diagnosis of 50 (SD 13) years. The mean follow-up was 4.7 (SD 4.9) years; 30 patients (4.41%, CI 95%: 3.1-5.7) developed a second ARD during the follow up, incidence rate was 9.1/1000 patients-year (IR 95%: 5.8-12.4/1000 patients-year), the most frequent being rheumatoid arthritis (RA). 96% out of these 30 patients had xerophthalmia, 86.2% xerostomia, 92% positive Schirmer test, 88.24% positive Rosa Bengala test, lisamine green or Ocular Staining Score, 81.2% positive unstimulated salivary flow, 82.1% Ro(+) and 33.33% La(+). Minor salivary gland biopsy had been performed in 14 of the 30 patients, 12 with positive results. There were no statistically significant differences respect baseline characteristics when comparing the patients who developed another ARD to the ones that did not. CONCLUSIONS: Of all the patients analyzed, 4.4% presented another ARD during their follow-up. It is important to be aware of this, to make an early and proper diagnosis and treatment of our patients.

Primary Sjögren syndrome and development of another autoimmune rheumatic disease during the follow-up

Abstract Background: Primary Sjögren syndrome (pSS) is a chronic autoimmune disease with its main target being exocrine glands, and is the connective tissue disease more frequently associated with other autoimmune diseases. The aim of this study was to assess the frequency of another autoimmune rheumatic disease (ARD) developed in primary Sjögren syndrome (pSS) patients and to describe it's clinical, serological and histologic characteristics. Materials and methods: This is a retrospective cohort study. Data of patients with pSS diagnosis (American-European criteria 2002), included in the GESSAR database (Grupo de Estudio Síndrome de Sjögren, Sociedad Argentina de Reumatología) were analyzed. The development of a second ARD was registered during the follow up. Results: 681 patients were included, 94.8% female. The mean age was 54 (SD 14) years and mean age at diagnosis of 50 (SD 13) years. The mean follow-up was 4.7 (SD 4.9) years; 30 patients (4.41%, CI 95%: 3.1-5.7) developed a second ARD during the follow up, incidence rate was 9.1/1000 patients-year (IR 95%: 5.8-12.4/1000 patients-year), the most frequent being rheumatoid arthritis (RA). 96% out of these 30 patients had xerophthalmia, 86.2% xerostomia, 92% positive Schirmer test, 88.24% positive Rosa Bengala test, lisamine green or Ocular Staining Score, 81.2% positive unstimulated salivary flow, 82.1% Ro(+) and 33.33% La(+). Minor salivary gland biopsy had been performed in 14 of the 30 patients, 12 with positive results. There were no statistically significant differences respect baseline characteristics when comparing the patients who developed another ARD to the ones that did not. Conclusions: Of all the patients analyzed, 4.4% presented another ARD during their follow-up. It is important to be aware of this, to make an early and proper diagnosis and treatment of our patients. Key points Patients with primary Sjögren's Syndrome may develop another connective tissue disease during follow-up. The most frequently connective tissue disease developed during follow-up in the population of patients with primary Sjogren's Syndrome studied was rheumatoid arthritis. It is important to be aware of this to make an early and proper diagnosis.

[Prevalence and repercussions of the locomotor syndrome in patients with chronic obstructive pulmonary disease]. / Prevalencia y repercusión del síndrome locomotor en el perfil clínico de la enfermedad pulmonar obstructiva crónica.

BACKGROUND: Patients with Chronic Obstructive Pulmonary Disease (COPD) suffer a progressive deterioration of functional status and a decrease in independence in activities of daily living. Locomotor Syndrome (SL) is the involvement of the musculoskeletal system due to the deterioration caused by age. AIM: In patients with COPD, to evaluate the prevalence in LS and assess its impact on functional status and quality of life. MATERIAL AND METHODS: Cross sectional assessment of 259 patients with COPD. LS was evaluated with the Geriatric Locomotive Function Scale (GFLS-25). Those with a score < 16 were classified as having LS. Functional status was evaluated with dynamometry, Five Times Sit-to-Stand test, and the Modified Baecke Physical Activity Questionnaire. Functional impairment was measured with the London Chest Activity of Daily Living, and the quality of life was evaluated with EuroQol-5D. RESULTS: LS was found in 139 patients (53%). Activity levels and muscle strength were lower in these patients. Also, they had a higher frequency of functional impairment and a lower quality of life perception. CONCLUSIONS: LS in patients with COPD impacts their functional status and quality of life.

Formação inventiva em psicologia: problematizações à luz dos novos paradigmas da ciência contemporânea / Inventive Formation in psychology: problematizations in the light of the new paradigms of contemporary Science / Formación inventiva en psicología: problematizaciones a la luz de los nuevos paradigmas de la ciencia contemporánea

Este artigo discute a formação acadêmica em Psicologia, lançando luz sobre os múltiplos atravessamentos no domínio da prática clínica. Seu objetivo foi problematizar a concepção de aprendizagem e ensaiar um movimento em defesa da invenção, da consideração dos fluxos heterogêneos e intensivos que operam incessantemente na experiência pessoal do psicólogo clínico. A partir do diálogo com as ideias novo-paradigmáticas de Humberto Maturana, percorremos também os trabalhos de Mony Elkaïm, no campo das terapias familiares, e sua interlocução com Gilles Deleuze e Félix Guattari. A pesquisa de campo consistiu na realização de um grupo de estudos com estudantes da graduação em Psicologia, tomado como um dispositivo de intervenção e conversações intersubjetivas coconstrutoras de novas e impensadas realidades: a consideração das singularidades e das diferenças que se sobrepõem ininterruptamente na prática e que nunca podem ser abarcadas por um conhecimento encerrado em definições absolutas e totalizantes.

This article discusses the academic background in Psychology, shedding light on the multiple crossings in the area of clinical practice. The aim of this study was to problematize the concept of learning and rehearse a movement in defense of the invention, the consideration of heterogeneous and intensive flows operating incessantly on personal experience of the clinical psychologist. From the dialogue with the new paradigmatic ideas of Humberto Maturana, we also cover the work of Mony Elkaïm, in the field of family therapies, and his interlocution with Gilles Deleuze and Félix Guattari. The field research consisted in a group of studies with graduate students in Psychology taked as a space for intersubjective conversations co-constructing of new and unthought realities: the consideration of singularities and differences that overlap uninterruptedly in practice and which can never be encompassed by a knowledge enclosed in absolute and totalizing definitions.

Este artículo discute la formación académica en Psicología, arrojando luz sobre los múltiples atravesamientos en el dominio de la práctica clínica. Su objetivo fue problematizar la concepción de aprendizaje y ensayar un movimiento en defensa de la invención, de la consideración de flujos heterogéneos y intensivos que operan incesantemente en la experiencia personal del psicólogo clínico. A partir del diálogo con ideas nuevo-paradigmáticas de Humberto Maturana, hemos recorrido también trabajos de Mony Elkaïm, en el contexto de las terapias familiares, y su interlocución con Gilles Deleuze y Félix Guattari. La investigación de campo consistió en la realización de un grupo de estudios con estudiantes graduandos en Psicología tomado como dispositivo de intervención y conversaciones intersubjetivas co-constructoras de nuevas y impensadas realidades: la consideración de singularidades y de diferencias que se superponen ininterrumpidamente en la práctica y que nunca pueden ser abarcadas por un conocimiento encerrado en definiciones absolutas y totalizantes.

Digital educational technology for care management of diabetes mellitus people's feet.

OBJECTIVE: to develop and validate a distance learning course aimed at the pillars of care management of diabetes mellitus people's feet. METHOD: a technological production research using Moodle Virtual Learning Environment, based on Andragogy, Constructionism and Instructional Design. Content is based on consensus guidelines on diabetic foot. Validation was carried out by distance education, diabetes and/or diabetic foot experts. RESULTS: the course's content is based on diabetic foot guidelines, and is structured in units with didactic material, videos, forums and questionnaires to assess the participants' learning. The judges considered it appropriate to meet nurses' needs in clinical practice. CONCLUSION: the virtual learning course has been validated, being a promising strategy for training nurses on care management of diabetes mellitus people's feet.

Prevalencia y repercusión del síndrome locomotor en el perfil clínico de la enfermedad pulmonar obstructiva crónica / Prevalence and repercussions of the locomotor syndrome in patients with chronic obstructive pulmonary disease

Background: Patients with Chronic Obstructive Pulmonary Disease (COPD) suffer a progressive deterioration of functional status and a decrease in independence in activities of daily living. Locomotor Syndrome (SL) is the involvement of the musculoskeletal system due to the deterioration caused by age. Aim: In patients with COPD, to evaluate the prevalence in LS and assess its impact on functional status and quality of life. Material and Methods: Cross sectional assessment of 259 patients with COPD. LS was evaluated with the Geriatric Locomotive Function Scale (GFLS-25). Those with a score < 16 were classified as having LS. Functional status was evaluated with dynamometry, Five Times Sit-to-Stand test, and the Modified Baecke Physical Activity Questionnaire. Functional impairment was measured with the London Chest Activity of Daily Living, and the quality of life was evaluated with EuroQol-5D. Results: LS was found in 139 patients (53%). Activity levels and muscle strength were lower in these patients. Also, they had a higher frequency of functional impairment and a lower quality of life perception. Conclusions: LS in patients with COPD impacts their functional status and quality of life.

Digital educational technology for care management of diabetes mellitus people's feet / Tecnología educativa digital para el manejo del cuidado de los pies de personas con diabetes mellitus / Tecnologia educacional digital para a gestão de cuidados dos pés de pessoas com diabetes mellitus

ABSTRACT Objective: to develop and validate a distance learning course aimed at the pillars of care management of diabetes mellitus people's feet. Method: a technological production research using Moodle Virtual Learning Environment, based on Andragogy, Constructionism and Instructional Design. Content is based on consensus guidelines on diabetic foot. Validation was carried out by distance education, diabetes and/or diabetic foot experts. Results: the course's content is based on diabetic foot guidelines, and is structured in units with didactic material, videos, forums and questionnaires to assess the participants' learning. The judges considered it appropriate to meet nurses' needs in clinical practice. Conclusion: the virtual learning course has been validated, being a promising strategy for training nurses on care management of diabetes mellitus people's feet.

RESUMEN Objetivos: desarrollar y validar un curso, en la modalidad a distancia, dirigido a los pilares del manejo del cuidado del pie de personas con diabetes mellitus. Método: investigación de producción tecnológica utilizando el Entorno Virtual de Aprendizaje Moodle, basado en Andragogía, Construccionismo y Modelo de Diseño Instruccional. El contenido se basa en las directrices de Consenso sobre el pie diabético. La validación fue realizada por jueces expertos en el campo de la educación a distancia, diabetes y/o pie diabético. Resultados: el contenido del curso se basa en las directrices sobre pie diabético, estando estructurado en unidades con material didáctico, videos, foros y cuestionarios para evaluar el aprendizaje de los participantes. Los jueces lo consideraron adecuado para satisfacer las necesidades de las enfermeras en la práctica clínica. Conclusión: se ha validado el curso virtual de aprendizaje, siendo una estrategia prometedora para la capacitación de enfermeros en la gestión del cuidado del pie para personas con diabetes

RESUMO Objetivos: desenvolver e validar um curso, na modalidade a distância, voltado para os pilares da gestão dos cuidados com os pés das pessoas com diabetes mellitus. Método: pesquisa de produção tecnológica utilizando o Ambiente Virtual de Aprendizagem Moodle, fundamentado na Andragogia, Construcionismo e Modelo de Design Instrucional. O conteúdo é baseado nas diretrizes do Consenso sobre o pé diabético. A validação foi realizada por juízes especialistas no campo da educação a distância, diabetes e/ou pé diabético. Resultados: o conteúdo do curso é baseado nas diretrizes sobre o pé diabético, sendo estruturado em unidades com material didático, vídeos, fóruns e questionários para avaliar a aprendizagem dos participantes. Os juízes consideraram adequado para atender às necessidades dos enfermeiros na prática clínica. Conclusão: o curso virtual de aprendizagem foi validado, sendo uma estratégia promissora para a qualificação de enfermeiros sobre gerenciamento dos cuidados com os pés de pessoas com diabetes.

Patologías del área oral en los recién nacidos e infantes: frenillos y las aportaciones de los sistemas láser / Pathologies of the oral area in newborns and infants: frenula and contributions of laser systems

El propósito de este artículo es mejorar nuestro conocimiento sobre las estructuras y función de los diferentes elementos presentes en la boca del recién nacido, ya que en ocasiones los odontólogos no recuerdan la importancia de la boca en el desarrollo general del lactante y la necesidad de una intervención temprana con láseres para ayudarles a obtener un buen estado de su sistema oral. Realizamos una exploración clínica integral del paciente con el fin de realizar un diagnóstico más preciso. Cuando la cirugía sea necesaria, recomendamos utilizar láseres de Erbio siempre que sea posible (láser de 2780nm Er, Cr: YSGG o un Er: YAG de 2940nm), ya que es una opción rápida y eficaz para tratar estas lesiones orales, especialmente los frenillos labiales o linguales que pueden poner en riesgo el acto de amamantar; Asimismo podemos utilizar láseres de diodo (810nm, 940nm, 980 nm o un láser Nd: YAG de 1064nm o de CO2 10.600- 9600 nm) con sus gafas de seguridad específicas. Estos sistemas láser utilizados por un profesional certificado, en colaboración con un personal debidamente entrenado, son un factor muy importante durante la cirugía. Al tener un conocimiento adecuado de las estructuras orales y sus patologías, podemos diagnosticar si esos trastornos deben tratarse quirúrgicamente y, de ser así, cómo proceder con los sistemas láser, ya que son procedimientos mínimamente invasivos; o si debiésemos recomendar a los padres que visiten a un terapeuta miofuncional para ayudar a recuperar la función normal. La comprensión de las estructuras orales de los recién nacidos es muy importante para promover el desarrollo del crecimiento craneofacial y para brindar un servicio importante a las madres, dándoles a sus bebés un buen comienzo en la vida desde una etapa muy temprana. Necesitamos mejorar la colaboración entre profesionales de diferentes disciplinas con el fin de mejorar nuestro conocimiento.

The purpose of this article is to improve our knowledge about the structures and function of the different elements present in the mouth of newborns since dentists sometimes do not remember the importance of the mouth in the general development of infants and the need for an early intervention with lasers to help them obtain a good state of their Oral System. We performed a comprehensive clinical exploration of the patient in order to make a more accurate diagnosis. When surgery is necessary, we recommend to use erbium lasers when possible (2780nm Er, Cr: YSGG laser or a 2940nm Er: YAG), as they are a quick and effective option to treat these oral lesions, especially lip or tongue ties which can risk the act of breastfeeding; moreover, we can also use diode lasers (810nm, 940nm, 980nm or a 1064nm Nd:YAG laser or CO2 10.600-9600 nm.) al lof them with their specifical safety goggles. These laser systems used by a certified professional, in collaboration with a properly trained staff, are a very important factor during the surgery.By having proper knowledge of the oral structures and their pathologies, we are able to diagnose whether those disorders should be surgically treated and if so, how to proceed with laser systems as they are minimally invasive procedures; or if we should recommend parents to visit a myofunctional therapist in order to help recover the normal function.The understanding of oral structures of newborns is very important in order to improve the development of craniofacial growth and provide an important service to mothers by giving their babies a right start in life from a very early stage. We need to improve collaboration between professionals from different disciplines in order to enhance our knowledge.

Academias ao ar livre: percepções dos usuários e relação com o serviço de saúde / Outdoor gyms: user perceptions and relationship with the health service

As academias ao ar livre (AAL) surgem como espaço de promoção da saúde e qualidade de vida dos seus usuários. Esse artigo buscou caracterizar o processo de implementação, utilização e referenciamento da população às AAL, pela Atenção Básica em Saúde. Tratou-se de uma pesquisa descritiva, de campo, com delineamento transversal e abordagem quantitativa. O estudo abrangeu as 04 regiões de Teresina-PI, 22 academias e 308 sujeitos e foi utilizado um formulário com questões discursivas e objetivas com os usuários. Em síntese, ressalta-se a importância de se ampliar o incentivo dos homens em participar de espaços onde aconteçam práticas corporais, bem como melhorar a estrutura desses locais, estimulando também o envolvimento participativo da população nos processos decisórios que permeiam as políticas públicas nesse contexto, almejando, uma maior utilização das AAL pela comunidade e pelos serviços de saúde, propiciando assim o empoderamento e a promoção de saúde.

Outdoor Gyms (AAL) are seen as spaces to promote health and quality of life of their users. This article seeks to characterize the process of implementation, use and reference of the population to the AAL by Primary Health Care. It was a descriptive, field research, with cross-sectional design and quantitative approach. The study covered 4 regions of Teresina, in the state of Piauí, consisting of 22 gyms and 308 individuals. A form with open-ended and closed-ended questions was applied to the users. In summary, the importance of expanding or encouraging men to participate in such spaces where corporal practices take place is emphasized, as well as improving the structure of these places, encouraging the involvement of participants in decision-making processes that permeate public policies in this context, aiming at a greater use of AAL by the community and health services, thus enabling both the empowerment of the users and the promotion of their health.

Transcultural adaptation of the EULAR activity index for primary Sjogren's syndrome in Argentine.

OBJECTIVE: To adapt the EULAR Activity Index for primary Sjögren's syndrome (ESSDAI) to the Argentine population. METHODS: observational, cross-sectional study that included patients in a period of ten months. Three Argentine rheumatologists adapted and translated to Spanish the original version in English and the final version was translated back into English by a research associate whose mother language was English. In order to estimate the constructive validity of the index, the visual analogous scale (VAS) of disease activity was used by experts. A subgroup of patients attended a second visit in order to evaluate test-retest reliability. RESULTS: 51 patients were included, 49 (96.1%) were female, the median age was 58 ((interquartile range (IQR): 49-69)). The median global VAS was 10 (IQR: 4-22.25) and the median total ESSDAI score was 5 (IQR: 3-9). The correlation between the global VAS and the total ESSDAI score of the scale was 0.79. The intraclass correlation coefficient was 0.67 (95% CI: 0.32-0.92) for the total score and 0.98 (95% CI: 0.92-0.995) for the global VAS. The results of the correlation coefficient between the VAS and the scale for each domain were: constitutional symptoms: 0.46; lymphadenopathy: 0.76; glandular: 0.78; joint: 0.61; skin: 1; respiratory: 0.83; renal: 1; muscular:- (no patient had myositis); peripheral nervous system: 0.72; central nervous system: 0.67; hematological: 0.96; biomarkers: 0.86. CONCLUSION: The results of this study showed that the ESSDAI is a reliable and valid index for this pSS argentinian population.

Avaliação do conhecimento dos enfermeiros sobre neutropenia febril em crianças com câncer / Evaluación del conocimiento de los enfermeros sobre neutropenia febril en niños con cáncer / Evaluation of nurses knowledge about febrile neutropenia in children with cancer

RESUMO Objetivo: Avaliar o conhecimento dos enfermeiros diante da neutropenia febril em pacientes pediátricos com diagnóstico de neoplasia maligna. Método: Estudo transversal e descritivo com abordagem quantitativa, realizado em dois hospitais referência em oncologia pediátrica de Recife/PE. A amostra contou com 20 enfermeiros. Os dados foram coletados entre setembro e outubro de 2017, por meio da aplicação de um questionário semiestruturado, analisados através do Statistical Package for the Social Sciences (SPSS) e apresentados com recursos de estatística descritiva. Resultados: Verificou-se que 100% (n=20) da amostra foi composta pelo sexo feminino, 60% (n=12) apresentaram faixa etária de 30-39 anos. Em relação ao conhecimento acerca da neutropenia febril, 50% (n=10) participaram de cursos de capacitação/atualização sobre o tema, 25% (n=5) acertaram entre 50-60% das questões aplicadas e apenas 5% (n=1) acertaram 100% do questionário. Conclusão: observou-se um elevado índice de fragilidade no conhecimento dos enfermeiros sobre a neutropenia febril, mostrando-se fundamental a busca de conhecimento para que, assim, os pacientes sejam mais bem assistidos e recebam um tratamento adequado e especializado.

RESUMEN Objetivo: evaluar el conocimiento de los enfermeros delante de la neutropenia febril en pacientes pediátricos con diagnóstico de neoplasia maligna. Método: estudio transversal y descriptivo con abordaje cuantitativo, realizado en dos hospitales referencia en oncología pediátrica de Recife/PE-Brasil. La muestra contó con 20 enfermeros. Los datos fueron recolectados entre septiembre y octubre de 2017, por medio de la aplicación de un cuestionario semiestructurado, analizados a través del Statistical Package for the Social Sciences (SPSS) y presentados con recursos de estadística descriptiva. Resultados: se verificó que el 100% (n=20) de la muestra fue compuesta por el sexo femenino, el 60% (n=12) presentó franja de edad de 30-39 años. Respecto al conocimiento acerca de la neutropenia febril, el 50% (n=10) participó de cursos de capacitación/actualización sobre el tema, el 25% (n=5) acertó entre 50-60% de las cuestiones hechas y solo el 5% (n=1) acertó 100% del cuestionario. Conclusión: se observó un elevado índice de fragilidad en el conocimiento de los enfermeros sobre la neutropenia febril, por lo tanto, es fundamental la búsqueda de conocimiento para que así los pacientes sean mejor asistidos y reciban un tratamiento adecuado y especializado.

ABSTRACT Objective: To evaluate nurses' knowledge regarding febrile neutropenia in pediatric patients diagnosed with malignant neoplasia. Method: Cross-sectional and descriptive study with a quantitative approach, carried out in two reference hospitals in pediatric oncology in Recife/PE. The sample included 20 nurses. The data were collected between September and October 2017, through the application of a semi-structured questionnaire, analyzed using the Statistical Package for the Social Sciences (SPSS) and presented with descriptive statistics resources. Results: It was found that 100% (n=20) of the sample was composed of females, 60% (n=12) had an age range of 30-39 years-old. Regarding knowledge about febrile neutropenia, 50% (n=10) participated in training courses on the topic, 25% (n=5) were correct between 50-60% of the applied questions and only 5% (n=1) got the questionnaire 100% correct. Conclusion: there was a high level of fragility in the nurses' knowledge about febrile neutropenia, showing that the search for knowledge is fundamental so that patients are better assisted and receive adequate and specialized treatment.

[Analysis of unintentional injuries in vulnerable populations, Mexico 2018.] / Análisis de las lesiones accidentales no fatales en población vulnerable, México 2018.

OBJECTIVE: To estimate the prevalence of unintentional injuries (UI) in people residing in localities with <100 000 inhabitants and to analyze its association with different environmental, household and individual characteristics. MATERIALS AND METHODS: Cross-sectional design that analyses the UI component of Ensanut 100k, which is a probabilistic national survey that focused on households beneficiaries of the program Prospera and those with fewer economic capabilities. Prevalence of UI was estimated considering the complex design of the survey. Association with variables of interest was explored using logistic regression analysis. RESULTS: Prevalence of UI was 5.15% (CI95%: 1.43-6.16); probability was higher in male, those living in the region CDMX-EdoMex, and those with hearing and motor disability. CONCLUSIONS: Policies directed to prevent UI need to be strengthened to promote health and quality of life amongst individuals, par- ticularly those with social and economic vulnerability, and to reduce the burden that these conditions impose to public health in Mexico.

OBJETIVO: Estimar la prevalencia de lesiones accidentales en población que reside en localidades con <100 000 habitantes y analizar su asociación con características individuales, ambien­tales y del hoga. MATERIAL Y MÉTODOS: Diseño transversal que analiza el componente de accidentes de la Ensanut 100k, encuesta probabilística, estratificada, por conglomerados que sobrerrepresenta hogares beneficiarios del programa Prospera y aquellos con menos recursos económicos. Su asociación con distintas variables independientes se estableció a partir de un modelo de regresión logística, considerando el muestreo complejo. RESULTADOS: La prevalencia de lesiones acciden­tales fue 5.15% (IC95%: 1.43-6.16) equivalente a cerca de 3.3 millones de personas. La probabilidad fue mayor en hombres, en la región CDMX-EdoMex y en personas con discapacidad auditiva/motora. CONCLUSIONES: Es necesario fortalecer la política de prevención de lesiones accidentales, especialmente la dirigida a grupos con alta vulnerabilidad social y económica, para cuidar su salud y calidad de vida, y reducir la carga que generan para la salud pública.

Análisis de las lesiones accidentales no fatales en población vulnerable, México 2018 / Analysis of unintentional injuries in vulnerable populations, Mexico 2018

Resumen: Objetivo: Estimar la prevalencia de lesiones accidentales en población que reside en localidades con <100 000 habitantes y analizar su asociación con características individuales, ambientales y del hogar. Material y métodos: Diseño transversal que analiza el componente de accidentes de la Ensanut 100k, encuesta probabilística, estratificada, por conglomerados que sobrerrepresenta hogares beneficiarios del programa Prospera y aquellos con menos recursos económicos. Su asociación con distintas variables independientes se estableció a partir de un modelo de regresión logística, considerando el muestreo complejo. Resultados: La prevalencia de lesiones accidentales fue 5.15% (IC95%: 1.43-6.16) equivalente a cerca de 3.3 millones de personas. La probabilidad fue mayor en hombres, en la región CDMX-EdoMex y en personas con discapacidad auditiva/motora. Conclusiones: Es necesario fortalecer la política de prevención de lesiones accidentales, especialmente la dirigida a grupos con alta vulnerabilidad social y económica, para cuidar su salud y calidad de vida, y reducir la carga que generan para la salud pública.

Abstract: Objective: To estimate the prevalence of unintentional injuries (UI) in people residing in localities with <100 000 inhabitants and to analyze its association with different environmental, household and individual characteristics. Materials and methods: Cross-sectional design that analyses the UI component of Ensanut 100k, which is a probabilistic national survey that focused on households beneficiaries of the program Prospera and those with fewer economic capabilities. Prevalence of UI was estimated considering the complex design of the survey. Association with variables of interest was explored using logistic regression analysis. Results: Prevalence of UI was 5.15% (CI95%: 1.43-6.16); probability was higher in male, those living in the region CDMX-EdoMex, and those with hearing and motor disability. Conclusions: Policies directed to prevent UI need to be strengthened to promote health and quality of life amongst individuals, particularly those with social and economic vulnerability, and to reduce the burden that these conditions impose to public health in Mexico.

Reliability of OMERACT ultrasound elementary lesions in gout: results from a multicenter exercise.

The aim of this study was to evaluate the reliability of the outcome measures in rheumatology (OMERACT) definitions for ultrasound (US) elementary lesions in gout through an image reading exercise. Images from patients with gout (static images and videos) were collected. As an initial step, we carried out a image reading exercise within the experts of the Pan-American League of Associations for Rheumatology (PANLAR) US Study Group (n = 16). The following step consisted in a web-based exercise with the participation of larger number of sonographers (n = 63) from different centers. Images were rated evaluating the presence/absence of any US elementary lesion. Inter- and intra-reader reliabilities were analyzed using kappa coefficients. Participants were stratified according to their level of experience. In the first exercise, inter-reader kappa values were 0.45 for aggregates, 0.57 for tophus, 0.69 for erosions, and 0.90 for double contour (DC). Intra-reader kappa values were 0.86, 0.76, 0.80, and 0.90, respectively. The web-based exercise showed inter-reader kappa values for aggregates, tophus, erosions, and DC of 0.42, 0.49, 0.69, and 0.79, respectively. The intra-reader kappa values were 0.62, 0.69, 0.77, and 0.85, respectively. Reliability was not influenced by the sonographer's level of experience. The reliability of the new OMERACT US definitions for elementary lesions in gout ranged from moderate to excellent, depending on the type of lesion.

Preparation and partial characterization of films made with dual-modified (acetylation and crosslinking) potato starch.

BACKGROUND: Starch is an alternative material for the production of biodegradable plastics; however, native starches have drawbacks due to their hydrophilic nature. Chemical modifications such as acetylation and crosslinking are used to broaden the potential end-uses of starch. Dual modification of starches increases their functionality compared to that of starches with similar single modifications. In this study, a dual-modified potato starch (acetylated and crosslinked) was used to produce films by casting. RESULTS: Changes in the arrangement of the amylopectin double helices of dual-modified starch were evident from X-ray diffraction patterns, pasting profiles and thermal properties. The degree of substitution for acetyl groups was low (0.058 ± 0.006) because crosslinking dominated acetylation. Modified starch film had higher elongation percentage (82.81%) than its native counterpart (57.4%), but lower tensile strength (3.51 MPa for native and 2.17 MPa for dual-modified) and lower crystallinity in fresh and stored films. The sorption isotherms indicated that the dual modification decreased the number of reactive sites for binding water, resulting in a reduction in the monolayer value and a decrease in the solubility and water vapor permeability. CONCLUSIONS: Dual modification of starch may be a feasible option for improving the properties of biodegradable starch films. © 2018 Society of Chemical Industry.