Influence of anaerobic biotransformation process of agro-industrial waste with Lactobacillus acidophilus on the rheological parameters: case of study of pig manure.

This study evaluated the rheological behavior of the pig waste biotransformation process to produce lactic acid (LA) and biomass with Lactobacillus acidophilus in a stirred reactor. In addition, cell growth, carbohydrate consumption, and LA production were measured at three different agitation speeds, 100, 150, and 200 rpm at 37 °C, with a reaction time of 52 h. During the development of the process, the kinetic and rheological parameters were obtained using the logistic, Gompertz, generalized Gompertz, Ostwald de Waele, and Herschel-Bulkley mathematical models, respectively. The substrate used was pig manure, to which molasses was added at 12% v/v to increase the concentration of carbohydrates. The results suggest that mass exchange is favorable at low agitation speeds. Nevertheless, the presence of molasses rich in carbohydrates as a carbon source modifies the characteristics of the fluid, dilatant (n > 1) at the beginning of the process to end up as pseudoplastic (n < 1) due to the addition of exopolysaccharides and the modification of the physical structure of the substrate. This effect was confirmed by the Herschel-Bulkley model, which presented a better fit to the data obtained, in addition to finding a direct relationship between viscosity and pH that can be used as variables for the control of bioconversion processes of pig manure into biomass rich in Lactobacillus acidophilus.

[Communication in Clinical Practice, the Perspective of Patients with Cancer: Translation of the PACE (Patient Assessment of Cancer Communication Experiences) Questionnaire to European Portuguese]. / Comunicação na Prática Clínica, a Perspetiva dos Doentes com Cancro: Tradução do Questionário PACE (Patient Assessment Of Cancer Communication Experiences) para Português.

INTRODUCTION: Communication in clinical practice is essential to healthcare quality, especially in Oncology. The Patient Assessment of Communication Experiences questionnaire evaluates the perspective of cancer patients towards communication and identifies areas that can be improved. This study consists in its translation and validation to European Portuguese, to identify these areas. MATERIAL AND METHODS: We performed a descriptive, observational, cross-sectional study. The translation was conducted according to the World Health Organization's guidelines. We applied the questionnaires to a convenience sample, in patients under systemic antineoplastic treatment at the Day Hospital of Centro Hospitalar Universitário do Porto, between January and March 2020. We calculated the Cronbach's Alpha for each phase of care, the bivariate and multiple correlations and, for each question, the percentage of "non applicable" and most positive answers. RESULTS: We had 100 participants. The instrument we obtained ha good internal consistency, but the classification of some questions does not correlate sufficiently with the global opinion about the experiences with communication in the respective phase. The diagnosis phase revealed a lower proportion of positive experiences, particularly in terms of receiving the bad news. CONCLUSION: This study translates and validates part of the communication assessment instrument PACE to the Portuguese language and elicits the necessity to invest in the phase of diagnosis and disclosure of bad news.

Introdução: A comunicação na prática clínica é essencial para a qualidade dos cuidados de saúde, com particular importância na Oncologia. O questionário Patient Assessment of Cancer Communication Experiences avalia a perspetiva dos doentes oncológicos sobre a comunicação e identifica áreas a melhorar. Este estudo consiste na sua tradução e validação para português, para identificar essas áreas.Material e Métodos: Realizámos um estudo descritivo, observacional e transversal. O processo de tradução seguiu as normas da Organização Mundial de Saúde. Aplicámos os questionários numa amostra de conveniência, em doentes sob tratamento antineoplásico sistémico no Hospital de Dia do Centro Hospitalar Universitário do Porto, entre janeiro e março de 2020. Calculámos o coeficiente de Cronbach para cada fase dos cuidados, as correlações bivariadas e múltiplas e, para cada questão, a percentagem de respostas "não aplicável" e de resposta mais positiva.Resultados: Participaram 100 doentes. O instrumento obtido possui boa consistência interna, mas tem questões cuja classificação não se correlaciona satisfatoriamente com a opinião global das experiências com comunicação na respetiva fase. O diagnóstico foi a fase que revelou menos experiências positivas, especificamente na transmissão da notícia.Conclusão: Este estudo traduziu e validou uma parte do instrumento de avaliação de comunicação PACE, adaptando-o à realidade portuguesa, e demonstra a necessidade de investir na fase de diagnóstico, nomeadamente na transmissão de más notícias.

Psychotic disorders in the diagnostic stability of a Portuguese ward - Diagnostic retrospective analysis / Trastornos psicóticos en la estabilidad diagnóstica de un barrio portugués - Análisis retrospectivo diagnóstico

ABSTRACT Objectives: Psychiatric diagnosis is based on clinical manifestations, resulting from patients' internal state, their life situation, the evolution of their condition and the response to our interventions. There are currently few objective data which help to establish the diagnosis which is why this is based on diagnostic criteria such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM defines entities by their diagnostic stability, however there are several causes of variability as categorised by Spritzer et al. (1987): subjects variance (changing in patients), occasions variance (different episodes), information variance (new information) and observation variance (different interpretations). This paper aims to determine the diagnostic stability of patients with Psychotic Disorders among patients readmitted to our Psychiatric Unit. Methods: Retrospective analysis of the diagnoses of patients with Psychotic Disorders who had been readmitted to our unit. We analysed data from the last 12 years - 5422 admission episodes with 507 patients with a relevant diagnosis in this period. Results: Psychiatric diagnosis does evolve over time, nevertheless some diagnostic groups show a relatively significant stability over time - Bipolar Disorder and Schizophrenia with 69% and 77% stability, respectively. Diagnosis such as Depressive Psychosis and Drug-induced psychosis show a significantly lower stability (8% and 21%, respectively). Conclusions: Knowing our own reality can make us aware that a cross-sectional view of patients can be insufficient and only time can determine a clear diagnosis. This study may help us to understand how psychotic disorders evolve.

RESUMEN Objetivos: El diagnóstico psiquiátrico se basa en las manifestaciones clínicas, consecuencia del estado interno del paciente, de su situación vivencial, de la evolución de su enfermedad y de la respuesta a nuestras intervenciones. Actualmente, existen pocos datos objetivos que ayudan a establecer el diagnóstico por lo que éste se basa en criterios diagnósticos como el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM). La DSM define diagnósticos por su estabilidad, sin embargo, existen varias causas de variabilidad caracterizadas por Spritzer et al. (1987): variación en el sujeto (cambio en el paciente), variación ocasional (diferentes episodios), variación en la información (nueva información) y variación en la observación (diferentes interpretaciones). Este trabajo pretende evaluar la estabilidad diagnóstica de los pacientes con Trastornos Psicóticos reinternados en nuestro internamiento psiquiátrico. Métodos: Análisis retrospectivo de los diagnósticos de los pacientes con Trastornos Psicóticos con reingresos en nuestro servicio. Se analizaron datos de los últimos 12 anos - 5422 admisiones con 507 pacientes con diagnóstico de interés en ese período. Resultados: El diagnóstico psiquiátrico se altera con el tiempo, sin embargo, algunos grupos revelan una mayor estabilidad a lo largo del tiempo - Perturbación Afectiva Bipolar y Esquizofrenia con el 69% y el 77%, respectivamente. Los diagnósticos como la depresión psicótica y la psicosis tóxica, revelan una estabilidad significativamente menor (8% y 21% respectivamente). Conclusiones: Conocer nuestra realidad nos hace conscientes de que una mirada transversal a los enfermos puede ser insuficiente y sólo el tiempo puede determinar un diagnóstico claro. Este trabajo puede ayudarnos a entender cómo evolucionan las enfermedades psicóticas.

Psychotic disorders in the diagnostic stability of a Portuguese ward - Diagnostic retrospective analysis.

OBJECTIVES: Psychiatric diagnosis is based on clinical manifestations, resulting from patients' internal state, their life situation, the evolution of their condition and the response to our interventions. There are currently few objective data which help to establish the diagnosis which is why this is based on diagnostic criteria such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM defines entities by their diagnostic stability, however there are several causes of variability as categorised by Spritzer et al. (1987): subjects variance (changing in patients), occasions variance (different episodes), information variance (new information) and observation variance (different interpretations). This paper aims to determine the diagnostic stability of patients with Psychotic Disorders among patients readmitted to our Psychiatric Unit. METHODS: Retrospective analysis of the diagnoses of patients with Psychotic Disorders who had been readmitted to our unit. We analysed data from the last 12 years - 5422 admission episodes with 507 patients with a relevant diagnosis in this period. RESULTS: Psychiatric diagnosis does evolve over time, nevertheless some diagnostic groups show a relatively significant stability over time - Bipolar Disorder and Schizophrenia with 69% and 77% stability, respectively. Diagnosis such as Depressive Psychosis and Drug-induced psychosis show a significantly lower stability (8% and 21%, respectively). CONCLUSIONS: Knowing our own reality can make us aware that a cross-sectional view of patients can be insufficient and only time can determine a clear diagnosis. This study may help us to understand how psychotic disorders evolve.

Trazodone-induced delirium: case report.

Trazodone is used as an antidepressant in doses between 150 and 600 mg. At lower doses, it is commonly used to treat insomnia. There are few case reports about confusional symptoms as an undesirable side effect of this drug. We report a case of a patient who presented with delirium after prescription of trazodone 100 mg. She required hospitalisation but, shortly after discontinuation of trazodone, the symptoms disappeared without antipsychotic medication. Seven months after the episode, the patient remains asymptomatic.

Trazodone-induced delirium: case report / Delirio inducido por trazodona: reporte de caso

ABSTRACT Trazodone is used as an antidepressant in doses between 150 and 600 mg. At lower doses, it is commonly used to treat insomnia. There are few case reports about confusional symptoms as an undesirable side effect of this drug. We report a case of a patient who presented with delirium after prescription of trazodone 100 mg. She required hospitalisation but, shortly after discontinuation of trazodone, the symptoms disappeared without antipsychotic medication. Seven months after the episode, the patient remains asymptomatic.

RESUMEN La trazodona se usa como antidepresivo en dosis de 150-600 mg. En dosis más bajas, se usa comúnmente para tratar el insomnio. Hay pocos reportes de caso sobre síntomas confusionales como un efecto secundario indeseable de este medicamento. Se presenta el caso de una paciente que acudió con delirio después de la prescripción de trazodona 100 mg. La paciente requirió hospitalización pero, poco después de la interrupción de la trazodona, los síntomas desaparecieron sin medicación antipsicótica. A los 7 meses del episodio, la paciente permanecía asintomática.

"Psychotic Disorders in the Diagnostic Stability of a Portuguese Ward - Diagnostic Retrospective Analysis".

OBJECTIVES: Psychiatric diagnosis is based on clinical manifestations, resulting from patients' internal state, their life situation, the evolution of their condition and the response to our interventions. There are currently few objective data which help to establish the diagnosis which is why this is based on diagnostic criteria such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM defines entities by their diagnostic stability, however there are several causes of variability as categorised by Spritzer et al. (1987): subjects variance (changing in patients), occasions variance (different episodes), information variance (new information) and observation variance (different interpretations). This paper aims to determine the diagnostic stability of patients with Psychotic Disorders among patients readmitted to our Psychiatric Unit. METHODS: Retrospective analysis of the diagnoses of patients with Psychotic Disorders who had been readmitted to our unit. We analysed data from the last 12 years - 5422 admission episodes with 507 patients with a relevant diagnosis in this period. RESULTS: Psychiatric diagnosis does evolve over time, nevertheless some diagnostic groups show a relatively significant stability over time - Bipolar Disorder and Schizophrenia with 69% and 77% stability, respectively. Diagnosis such as Depressive Psychosis and Drug-induced psychosis show a significantly lower stability (8% and 21%, respectively). CONCLUSIONS: Knowing our own reality can make us aware that a cross-sectional view of patients can be insufficient and only time can determine a clear diagnosis. This study may help us to understand how psychotic disorders evolve.

Type 1 diabetes in children is not a predisposing factor for oral yeast colonization.

Type 1 diabetes mellitus (T1D) is considered a risk factor associated with oral yeast infections. The aim of this study was to evaluate the yeast oral carriage (in saliva and mucosal surface) of children with T1D and potential relation with host factors, particularly the subset of CD4+ T cells. Yeasts were quantified and identified in stimulated saliva and in cheek mucosal swabs of 133 diabetic T1D and 72 healthy control subjects. Salivary lymphocytes were quantified using flow cytometry. The presence of yeasts in the oral cavity (60% of total patients) was not affected by diabetes, metabolic control, duration of the disease, salivary flow rate or saliva buffer capacity, by age, sex, place of residence, number of daily meals, consumption of sweets or frequency of tooth brushing. Candida albicans was the most prevalent yeast species, but a higher number of yeast species was isolated in nondiabetics. T1D children with HbA1c ≤ 7.5 (metabolically controlled) presented higher number of CD4+ T salivary subsets when compared with the other groups of children (non-diabetic and nonmetabolically controlled) and also presented the highest number of individuals without oral yeast colonization. In conclusion, T1D does not predisposes for increased oral yeast colonization and a higher number of salivary CD4+T cells seems to result in the absence of oral colonization by yeasts.

Transcultural adaptation procedures for the Dutch Eating Behavior Questionnaire (DEBQ) for Brazil / Procedimentos de tradução da adaptação transcultural do Dutch Eating Behavior Questionnaire (DEBQ) para o Brasil / Procedimientos de traducción de la adaptación transcultural del Dutch Eating Behavior Questionnaire (DEBQ) en Brasil

The objective of this study was to translate the Dutch Eating Behavior Questionnaire (DEBQ) into Brazilian Portuguese and to evaluate the semantic, conceptual, idiomatic and cultural equivalence, content-related validity and level of verbal comprehension as an initial stage of its cross-cultural adaptation. Six stages were conducted: translation, synthesis of translations, back translation, synthesis of back translations; pilot test to evaluate the instrument and verbal comprehension by the target population; and content validity analysis by judges. The differences between the original and translated versions refer to language and culture, as they are very similar in meaning. The content validity index was excellent, with agreement level of 94.50% among specialists, for the entire scale. The items were easily understood by the target population. The Brazilian version of the DEBQ was approved by the original author and is ready to be tested for psychometric properties. (AU)

O objetivo deste estudo foi traduzir o Dutch Eating Behaviour Questionnaire (DEBQ) para a língua portuguesa do Brasil e avaliar as equivalências semântica, conceitual, idiomática e cultural, validade relacionada a conteúdo e nível de compreensão verbal, como um estágio inicial da sua adaptação transcultural. Seis etapas foram conduzidas: tradução, síntese das traduções, retrotradução, síntese das retrotraduções; teste da versão piloto para avaliar o instrumento e a compreensão verbal pela população alvo; e análise da validade de conteúdo por juízes. As diferenças entre as versões original e traduzida referem-se à linguagem e cultura, pois são muito similares em sentido. O índice de validade de conteúdo foi ótimo, com nível de concordância de 94,50% entre os especialistas, para a escala inteira. Os itens foram facilmente compreendidos pela população-alvo. A versão brasileira do DEBQ foi aprovada pelo autor original e está pronta para ser testada em relação às propriedades psicométricas. (AU)

El objetivo de este estudio fue traducir el Dutch Eating Behaviour Questionnaire (DEBQ) para el idioma portugés de Brasil, y evaluar equivalencia semántica, conceptual, idiomática y cultural, validez relacionada con el contenido, y nivel de comprensión verbal como una etapa inicial de adaptación transcultural. Se llevaron a cabo seis etapas: traducción; síntesis de las traducciones; traducción inversa; síntesis de las versiones de traducción inversa; test de la versión piloto para evaluar el instrumento y comprensión verbal por parte de la población objetivo; y análisis de validez de contenido por jueces. Las diferencias entre la versión original y traducida se refieren a lenguaje y cultura ya que son muy similares en significado. El índice de validez de contenido fue óptimo, con nivel de concordancia de 94,50% entre los especialistas, para la totalidad de la escala. Los ítems fueron fácilmente comprendidos por la población objetivo. La versión brasileña del DEBQ fue aprobada por el autor original y está lista para ser testada en relación a las propiedades psicométricas. (AU)

Imagem corporal, ansiedade e depressão em mulheres submetidas à cirurgia bariátrica / Body image, anxiety and depression in women submitted to bariatric surgery / Imagen corporal, ansiedad, depresión en mujeres sometidas a cirugía bariátrica

O impacto do excesso de peso e da cirurgia bariátrica (CB) pode gerar complicações psicológicas, como ansiedade, depressão e distúrbios da imagem corporal (IC). Este trabalho avaliou níveis de sintomas de ansiedade e depressão e a IC em mulheres submetidas à CB. Cinquenta mulheres responderam aos inventários de depressão (BDI) e ansiedade (BAI) de Beck e à escala de figuras de silhuetas (EFS) antes da CB quatro meses após a cirurgia. Foi realizada antropometria para cálculo do índice de massa corporal (IMC). Após a CB, verificou-se a diminuição nas médias de IMC (p < 0,001) e de pontuação do BAI (p < 0,01) e BDI (p = 0,001). A EFS apontou que a maioria das entrevistadas superestimou seu IMC real e 100% estavam insatisfeitas. Apesar da redução de peso e melhora das sintomatologias, as participantes apresentaram distúrbios da IC, justificando a importância de uma avaliação mais criteriosa dessa variável em indivíduos que se submetem à cirurgia.

The impact of overweight and bariatric surgery can lead to psychological complications, such as: anxiety and depression and Body Image disorders. This study evaluated symptoms of anxiety and depression and body image in women submitted to bariatric surgery. Fifty women responded to Beck anxiety inventory (BAI), Beck depression inventory (BDI) and the figure rating scale (FRS) before and four months after bariatric surgery. Anthropometric evaluation was performed to obtain the Body Mass Index (BMI). After the surgery was verified a decrease in mean BMI (p < 0,001) and the average score on the BAI (p < 0,01) and BDI (p = 0,001). The FRS showed that most respondents overestimated their BMI real and 100% were dissatisfied with the self-image. Despite the weight reduction and improvement in symptomatology, the participants had IC disorders, justifying the importance of a more detailed assessment of this variable in individuals who undergo surgical treatment.

El impacto de la cirugía bariátrica y exceso de peso puede llevar a complicaciones psicológicas, tales como trastornos de ansiedad y depresión, y la imagen corporal (IC). Este estudio evaluó los niveles de ansiedad y depresión y IC en mujeres sometidas a cirugía bariátrica. Cincuenta mujeres respondieron al inventario de depresión (BDI) y ansiedad (BAI) Beck y las escala firugas de siluetas (EFS) antes y cuatro meses después de la cirugía bariátrica. Evaluación antropométrica se realizó para obtener el índice de masa corporal (IMC). Después de la cirugía se verificó una disminución en la media del IMC (p < 0,001) y las puntuaciones medias de la BAI (p < 0,01) y el BDI (p = 0,001). La EFS mostró que la mayoría de los encuestados sobrestimaron su IMC real y el 100% no estaban satisfechos con la imagen de sí mismo. A pesar de la reducción de peso y la mejora en la sintomatología, los sujetos tenían trastornos de la IC, lo que justifica la importancia de una evaluación más detallada de esta variable en los individuos que se someten a un tratamiento quirúrgico.