Clinical Impact of Assessment of Myocardial Flow Reserve in Identifying the Cause of Chest Discomfort. / Impacto Clínico da Avaliação da Reserva de Fluxo Miocárdico na Identificação da Causa do Desconforto Torácico.

BACKGROUND: Gamma cameras with cadmium-zinc telluride (CZT) detectors allowed the quantification of myocardial flow reserve (MBF), which can increase the accuracy of myocardial perfusion scintigraphy (MPS) to detect the cause of chest discomfort. OBJECTIVE: To assess the clinical impact of MBF to detect the cause of chest discomfort. METHODS: 171 patients with chest discomfort who underwent coronary angiography or coronary CT angiography also underwent MPS and MBF in a time interval of <30 days. The acquisitions of dynamic imaging of rest and stress were initiated simultaneously with the 99mTc injection sestamibi (10 and 30mCi, respectively), both lasting eleven minutes, followed by immediately acquiring perfusion images for 5 minutes. The stress was performed with dipyridamole. A global or per coronary territory MBF <2.0 was classified as abnormal. RESULTS: The average age was 65.9±10 years (60% female). The anatomical evaluation showed that 115 (67.3%) patients had coronary obstruction significant, with 69 having abnormal MPs and 91 having abnormal MBF (60.0% vs 79.1%, p<0.01). Among patients without obstruction (56 - 32.7%), 7 had abnormal MPS, and 23 had reduced global MBF. Performing MBF identified the etiology of the chest discomfort in 114 patients while MPS identified it in 76 (66.7% vs 44.4%, p<0.001). CONCLUSION: MBF is a quantifiable physiological measure that increases the clinical impact of MPS in detecting the cause of chest discomfort through greater accuracy for detecting obstructive CAD, and it also makes it possible to identify the presence of the microvascular disease.

FUNDAMENTO: Gama-câmaras com detectores de telureto-cádmio-zinco (CZT) permitiram a quantificação da reserva de fluxo miocárdico (RFM), podendo aumentar a acurácia da cintilografia miocárdica de perfusão (CMP) para detectar a causa do desconforto torácico. OBJETIVO: Avaliar o impacto clínico da RFM para detectar a causa do desconforto torácico. MÉTODOS: 171 pacientes com desconforto torácico que foram submetidos a coronariografia ou angiotomografia de coronárias também realizaram CMP e RFM num intervalo de tempo <30 dias. As aquisições das imagens dinâmicas de repouso e estresse foram iniciadas simultaneamente à injeção de 99mTc sestamibi (10 e 30mCi, respectivamente), ambas com duração de onze minutos, seguidas imediatamente pela aquisição das imagens de perfusão durante 5 minutos. O estresse foi realizado com dipiridamol. Uma RFM global ou por território coronariano <2,0 foi classificada como anormal. RESULTADOS: A idade média foi de 65,9±10 anos (60% do sexo feminino). A avaliação anatômica mostrou que 115 (67,3%) pacientes apresentavam obstrução coronariana significativa, sendo que, 69 apresentavam CMP anormal e 91 apresentavam RFM anormal (60,0% vs. 79,1%, p<0,01). Dentre os pacientes sem obstrução (56 ­ 32,7%), 7 tinham CMP anormais e 23 tinham RFM global reduzida. A realização da RFM identificou a etiologia do desconforto torácico em 114 pacientes enquanto a CMP identificou em 76 (66,7% vs. 44,4%, p<0,001). CONCLUSÃO: A RFM é uma medida fisiológica quantificável que aumenta o impacto clínico da CMP na detecção da causa do desconforto torácico através de uma maior acurácia para detecção de DAC obstrutiva e ainda possibilita identificar a presença de doença microvascular.

Use of Plant Extracts in Polymeric Scaffolds in the Regeneration of Mandibular Injuries.

Severe loss of bone mass may require grafting, and, among the alternatives available, there are natural biomaterials that can act as scaffolds for the cell growth necessary for tissue regeneration. Collagen and elastin polymers are a good alternative due to their biomimetic properties of bone tissue, and their characteristics can be improved with the addition of polysaccharides such as chitosan and bioactive compounds such as jatoba resin and pomegranate extract due to their antigenic actions. The aim of this experimental protocol was to evaluate bone neoformation in experimentally made defects in the mandible of rats using polymeric scaffolds with plant extracts added. Thirty rats were divided into group 1, with a mandibular defect filled with a clot from the lesion and no graft implant (G1-C, n = 10); group 2, filled with collagen/chitosan/jatoba resin scaffolds (G2-CCJ, n = 10); and group 3, with collagen/nanohydroxyapatite/elastin/pomegranate extract scaffolds (G3-CHER, n = 10). Six weeks after surgery, the animals were euthanized and samples from the surgical areas were submitted to macroscopic, radiological, histological, and morphometric analysis of the mandibular lesion repair process. The results showed no inflammatory infiltrates in the surgical area, indicating good acceptance of the scaffolds in the microenvironment of the host area. In the control group (G1), there was a predominance of reactive connective tissue, while in the grafted groups (G2 and G3), there was bone formation from the margins of the lesion, but it was still insufficient for total bone repair of the defect within the experimental period standardized in this study. The histomorphometric analysis showed that the mean percentage of bone volume formed in the surgical area of groups G1, G2, and G3 was 17.17 ± 2.68, 27.45 ± 1.65, and 34.07 ± 0.64 (mean ± standard deviation), respectively. It can be concluded that these scaffolds with plant extracts added can be a viable alternative for bone repair, as they are easily manipulated, have a low production cost, and stimulate the formation of new bone by osteoconduction.

GIS-FA: an approach to integrating thematic maps, factor-analytic, and envirotyping for cultivar targeting.

KEY MESSAGE: We propose an "enviromics" prediction model for recommending cultivars based on thematic maps aimed at decision-makers. Parsimonious methods that capture genotype-by-environment interaction (GEI) in multi-environment trials (MET) are important in breeding programs. Understanding the causes and factors of GEI allows the utilization of genotype adaptations in the target population of environments through environmental features and factor-analytic (FA) models. Here, we present a novel predictive breeding approach called GIS-FA, which integrates geographic information systems (GIS) techniques, FA models, partial least squares (PLS) regression, and enviromics to predict phenotypic performance in untested environments. The GIS-FA approach enables: (i) the prediction of the phenotypic performance of tested genotypes in untested environments, (ii) the selection of the best-ranking genotypes based on their overall performance and stability using the FA selection tools, and (iii) the creation of thematic maps showing overall or pairwise performance and stability for decision-making. We exemplify the usage of the GIS-FA approach using two datasets of rice [Oryza sativa (L.)] and soybean [Glycine max (L.) Merr.] in MET spread over tropical areas. In summary, our novel predictive method allows the identification of new breeding scenarios by pinpointing groups of environments where genotypes demonstrate superior predicted performance. It also facilitates and optimizes cultivar recommendations by utilizing thematic maps.

Clinical, laboratory, and radiographic aspects of patients with pulmonary tuberculosis and dysglycemia and tuberculosis treatment outcomes.

OBJECTIVE: To analyze the association of dysglycemia with clinical, laboratory, and radiographic characteristics of patients with pulmonary tuberculosis (PTB), as well as with their tuberculosis treatment outcomes. METHODS: This was a longitudinal study involving 140 patients diagnosed with PTB (positive cultures for Mycobacterium tuberculosis or positive Xpert MTB/RIF results from sputum samples). Patients were evaluated at diagnosis (M0), after completing the second month of treatment (M2), and at the end of treatment (MEND). At M0, the patients were classified into three groups: normoglycemia+PTB (NGTB); pre-diabetes mellitus+PTB (PDMTB), and diabetes mellitus+PTB (DMTB), in accordance with glycated hemoglobin levels (< 5.7%, 5.7%-6.4%, and ≥ 6.5%, respectively). Treatment outcomes were classified as favorable (cure or treatment completion) and unfavorable (death, loss to follow-up, or treatment failure). RESULTS: In our sample, 76 patients (61.4%) had dysglycemia, 20 of whom (14.3%) had DM at M0. The patients with dysglycemia, in comparison with those in the NGTB group, more frequently presented with positive sputum smear microscopy (94.2% vs. 75.9%; p = 0.003); cavities (80.2% vs. 63.0%; p = 0.03); bilateral lesions (67.4% vs. 46.0%; p = 0.02); and higher median of affected thirds of the lungs (3.0 vs. 2.0; p = 0.03) on chest radiography. No significant differences regarding outcomes were found among the groups, but tuberculosis lethality was higher in the DMTB group than in the PDMTB and NGTB groups (20% vs. 2.2%). CONCLUSIONS: PTB patients with dysglycemia had laboratory and radiographic manifestations indicative of more advanced disease, and the risk of death was higher in the DMTB group. These findings reinforce the recommendation for early screening for DM in patients with newly diagnosed tuberculosis in order to reduce the risk of death during treatment.

Clinical, laboratory, and radiographic aspects of patients with pulmonary tuberculosis and dysglycemia and tuberculosis treatment outcomes / Aspectos clínicos, laboratoriais e radiográficos de pacientes com tuberculose pulmonar e disglicemia e desfechos do tratamento da tuberculose

ABSTRACT Objective: To analyze the association of dysglycemia with clinical, laboratory, and radiographic characteristics of patients with pulmonary tuberculosis (PTB), as well as with their tuberculosis treatment outcomes. Methods: This was a longitudinal study involving 140 patients diagnosed with PTB (positive cultures for Mycobacterium tuberculosis or positive Xpert MTB/RIF results from sputum samples). Patients were evaluated at diagnosis (M0), after completing the second month of treatment (M2), and at the end of treatment (MEND). At M0, the patients were classified into three groups: normoglycemia+PTB (NGTB); pre-diabetes mellitus+PTB (PDMTB), and diabetes mellitus+PTB (DMTB), in accordance with glycated hemoglobin levels (< 5.7%, 5.7%-6.4%, and ≥ 6.5%, respectively). Treatment outcomes were classified as favorable (cure or treatment completion) and unfavorable (death, loss to follow-up, or treatment failure). Results: In our sample, 76 patients (61.4%) had dysglycemia, 20 of whom (14.3%) had DM at M0. The patients with dysglycemia, in comparison with those in the NGTB group, more frequently presented with positive sputum smear microscopy (94.2% vs. 75.9%; p = 0.003); cavities (80.2% vs. 63.0%; p = 0.03); bilateral lesions (67.4% vs. 46.0%; p = 0.02); and higher median of affected thirds of the lungs (3.0 vs. 2.0; p = 0.03) on chest radiography. No significant differences regarding outcomes were found among the groups, but tuberculosis lethality was higher in the DMTB group than in the PDMTB and NGTB groups (20% vs. 2.2%). Conclusions: PTB patients with dysglycemia had laboratory and radiographic manifestations indicative of more advanced disease, and the risk of death was higher in the DMTB group. These findings reinforce the recommendation for early screening for DM in patients with newly diagnosed tuberculosis in order to reduce the risk of death during treatment.

RESUMO Objetivo: Analisar a associação de disglicemia e características clínicas, laboratoriais e radiográficas em pacientes com tuberculose pulmonar (TBP), bem como a associação de disglicemia e desfechos do tratamento da tuberculose. Métodos: Estudo longitudinal com 140 pacientes com diagnóstico de TBP (culturas de escarro positivas para Mycobacterium tuberculosis ou resultados positivos do teste Xpert MTB/RIF em amostras de escarro). Os pacientes foram avaliados no momento do diagnóstico (M0), após dois meses de tratamento (M2) e no fim do tratamento (MFIM). Em M0, os pacientes foram divididos em três grupos: normoglicemia+TBP (NGTB); pré-diabetes mellitus+TBP (PDMTB) e diabetes mellitus+TBP (DMTB), de acordo com os níveis de hemoglobina glicada (< 5,7%, 5,7%-6,4% e ≥ 6,5%, respectivamente). Os desfechos do tratamento foram classificados em favoráveis (cura ou conclusão do tratamento) e desfavoráveis (óbito, perda de seguimento ou falência do tratamento). Resultados: Em nossa amostra, 76 pacientes (61,4%) apresentavam disglicemia, 20 (14,3%) dos quais apresentavam DM em M0. Os pacientes com disglicemia, em comparação com os do grupo NGTB, apresentaram mais frequentemente baciloscopia de escarro positiva (94,2% vs. 75,9%; p = 0,003); cavidades (80,2% vs. 63,0%; p = 0,03); lesões bilaterais (67,4% vs. 46,0%; p = 0,02) e maior mediana de terços pulmonares acometidos (3,0 vs. 2,0; p = 0,03) na radiografia de tórax. Não foram observadas diferenças significativas entre os grupos quanto aos desfechos, mas a letalidade da tuberculose foi maior no grupo DMTB do que nos grupos PDMTB e NGTB (20% vs. 2,2%). Conclusões: Pacientes com TBP e disglicemia apresentaram manifestações laboratoriais e radiográficas indicativas de doença mais avançada, e o risco de óbito foi maior no grupo DMTB. Esses achados reforçam a recomendação de detecção precoce de DM em pacientes com tuberculose recém-diagnosticada, a fim de reduzir o risco de óbito durante o tratamento.

Trichotillomania-psychopathological correlates and associations with health-related quality of life in a large sample.

BACKGROUND: Relatively few studies have assessed the prevalence, correlates, and independent impact on quality of life (QoL) of trichotillomania (TTM) in large samples. METHODS: Consecutive participants (N = 7639) were recruited from a cross-sectional web-based study. Sociodemographic data were collected and several validated self-reported mental health measures were completed (Minnesota Impulsive Disorders Interview, Hypomania checklist, Fagerström Test for Nicotine Dependence, Alcohol Use Disorders Identification Test, Early Trauma Inventory Self Report-Short Form, and the Symptom Checklist-90-Revised Inventory). Health-related QoL was assessed with the World Health Organization QoL abbreviated scale (WHOQOL-Bref). Multivariable models adjusted associations to potential confounders. RESULTS: The sample was predominantly composed of young females (71.3%; mean age: 27.2 ± 7.9 years). The prevalence of probable TTM was 1.4% (95% confidence intervals [CI]: 1.2-1.7), and was more common among females. Participants with probable TTM had a greater likelihood of having co-occurring probable depression (adjusted odds ratio [ORadj] = 1.744; 95% CI: 1.187-2.560), tobacco (ORadj = 2.250; 95% CI: 1.191-4.250), and alcohol (ORadj = 1.751; 95% CI: 1.169-2.621) use disorders. Probable TTM was also independently associated with suicidal ideation (ORadj = 1.917; 95% CI: 1.224-3.003) and exposure to childhood sexual abuse (ORadj = 1.221; 95% CI: 1.098-1.358). In addition, a positive screen for TTM had more impaired physical and mental QoL. CONCLUSIONS: TTM was associated with a positive screen for several psychiatric comorbidities as well as impaired physical and psychological QoL. Efforts towards the recognition and treatment of TTM across psycho-dermatology services are warranted.

In-Situ Synthesis and Characterization of Nanocomposites in the Si-Ti-N and Si-Ti-C Systems.

The pyrolysis (1000 °C) of a liquid poly(vinylmethyl-co-methyl)silazane modified by tetrakis(dimethylamido)titanium in flowing ammonia, nitrogen and argon followed by the annealing (1000-1800 °C) of as-pyrolyzed ceramic powders have been investigated in detail. We first provide a comprehensive mechanistic study of the polymer-to-ceramic conversion based on TG experiments coupled with in-situ mass spectrometry and ex-situ solid-state NMR and FTIR spectroscopies of both the chemically modified polymer and the pyrolysis intermediates. The pyrolysis leads to X-ray amorphous materials with chemical bonding and ceramic yields controlled by the nature of the atmosphere. Then, the structural evolution of the amorphous network of ammonia-, nitrogen- and argon-treated ceramics has been studied above 1000 °C under nitrogen and argon by X-ray diffraction and electron microscopy. HRTEM images coupled with XRD confirm the formation of nanocomposites after annealing at 1400 °C. Their unique nanostructural feature appears to be the result of both the molecular origin of the materials and the nature of the atmosphere used during pyrolysis. Samples are composed of an amorphous Si-based ceramic matrix in which TiNxCy nanocrystals (x + y = 1) are homogeneously formed "in situ" in the matrix during the process and evolve toward fully crystallized compounds as TiN/Si3N4, TiNxCy (x + y = 1)/SiC and TiC/SiC nanocomposites after annealing to 1800 °C as a function of the atmosphere.

A molecular strategy to optimize bovine tuberculosis post-mortem diagnosis and the exposure to Mycobacterium tuberculosis variant bovis.

Bovine tuberculosis (bTB) is a zoonotic disease caused by Mycobacterium tuberculosis var. bovis, for which the definitive diagnosis is accomplished by bacterial isolation, which has biosafety issues and requires long time. Thus, diagnostic methods with potential to be faster and more efficient can represent an advance in bTB epidemiological knowledge and decrease exposure to M. tuberculosis var. bovis. This study aimed to validate a molecular test for bTB post-mortem diagnosis, as a strategy to reduce waste in bovine production. A total of 185 tissues from animals of infected herds or with suspected lesions at abattoir were evaluated through bacterial isolation, PCR and histopathology. PCR and histopathology showed sensitivities of 45.1% and 71.2%, respectively, and specificities of 83.3% and 83.0%, respectively, when compared to bacterial isolation. The combination of both tests resulted in enhanced specificity and positive predictive values.Therefore, PCR in conjunction with histopathology may be used as screening, in which concordant results can be considered conclusive, and discordant results may be submitted to bacterial isolation.

Pediatric tuberculosis in the metropolitan area of Rio de Janeiro.

AIM: To evaluate the clinical characteristics, diagnostic approach, and treatment outcomes of tuberculosis (TB) in children living in a high-burden metropolitan area. METHODS: This was a retrospective study, based on a medical chart review, involving children under 15 years old treated for TB between 2007 and 2016, in four primary health units (PHU) and three reference centers (RC) in five cities of Rio de Janeiro metropolitan area. Factors associated with TB treatment setting, microbiological diagnosis, and treatment outcomes were evaluated. RESULTS: A total of 544 children were enrolled; 71% were treated in PHU, 36% were under 5 years old, and 72% had pulmonary TB (PTB). The HIV prevalence was 10% (31/322). Fifty-three percent had at least one microbiological test for TB, 68% of them (196/287) had TB confirmed. Among 222 children with previous TB contact, information on LTBI was available for 78 (35%), and only 17% (13/78) were treated. Extrapulmonary TB (56% vs 32%), microbiologically confirmed TB (77% vs 60%), and HIV positivity (18.5% vs 4.0%) were significantly more frequent in RC. Treatment in RC (odds ratio (OR) 3.08, 95% confidence interval (CI) 1.74-5.44) and PTB (OR 2.47, 95% CI 1.34-4.56) were independently associated with a microbiological diagnosis of TB. The treatment success rate was 85%. In the logistic regression analysis, HIV-infected children had a 2.5-fold higher risk of an unfavorable outcome (OR 2.53, 95% CI 1.0-6.38; p = 0.05). CONCLUSIONS: Opportunities for TB prevention and early TB treatment are missed due to suboptimal close contact screening. Microbiological diagnosis of TB and drug susceptibility testing in children should be made available through more sensitive and accessible tests.

Evaluation of quality of life in patients with scoliosis submitted to conservative treatment / Avaliação da qualidade de vida em pacientes portadores de escoliose submetidos ao tratamento conservador / Evaluación de la calidad de vida en pacientes portadores de escoliosis sometidos al tratamiento conservador

ABSTRACT Objective To assess the level of quality of life (QOL) and the most affected dimensions in patients with scoliosis. Methods Original article about a descriptive, quantitative study of 20 individuals diagnosed with scoliosis and undergoing conservative treatment. Data were collected during consultations using two questionnaires, one containing social and demographic data and the Revised Scoliosis Research Society-22 (Brazilian version). The analysis was carried out in the Statistical Package for the Social Sciences (version 25), using descriptive statistics and the nonparametric Mann-Whitney test. The research was submitted to and approved by the Institutional Review Board of the Faculdades Integradas de Patos. Results The sample was composed mostly of female patients (70%), aged between 12 and 16 years (55%), whose most affected QOL domains were activity (10%) and mental health(55%). In addition, patients with moderate scoliosis had a lower quality of life when compared to those with mild scoliosis. Conclusion Scoliosis is an alteration of the spine that affects more female adolescents, negatively impacting their quality of life, and mainly affecting the domains of activity, mental health and appearance. Given this reality, a closer look is needed, seeking to create and encourage strategies that can improve the overall well-being of these patients. Level of Evidence II - Retrospective Study.

RESUMO Objetivo Avaliar o nível da qualidade de vida (QV) em pacientes com escoliose e as dimensões mais afetadas. Métodos Artigo original, com estudo descritivo, quantitativo, realizado com 20 indivíduos com diagnóstico de escoliose submetidos ao tratamento conservador. Os dados foram coletados durante as consultas, a partir de dois questionários, um contendo dados sociais e demográficos e o Revised Scoliosis Research Society-22 (versão brasileira). A análise foi efetivada no Statistical Package for the Social Sciences (versão 25), utilizando estatística descritiva e teste não paramétrico de Mann-Whitney. A pesquisa foi submetida e aprovada pelo Comitê de Ética e Pesquisa das Faculdades Integradas de Patos. Resultados A amostra foi composta na maior parte por pacientes do sexo feminino (70%), com idade entre 12 e 16 anos (55%), que apresentaram como o domínio de QV mais afetado o de atividade (10%) e o de saúde mental (55%). Além disso, os pacientes portadores de escoliose moderada apresentam uma menor qualidade de vida, quando comparados com os de escoliose leve. Conclusão A escoliose é uma alteração da coluna vertebral que acomete mais adolescentes do sexo feminino, trazendo para as mesmas impactos negativos na sua qualidade de vida, afetando principalmente os domínios de atividade, saúde mental e aparência. Diante dessa realidade, é necessário um olhar mais atento, buscando a criação e incentivo de estratégias que possam melhorar o bem-estar global desses pacientes. Nível de Evidência II ­ Estudo Retrospectivo.

RESUMEN Objetivo Evaluar el nivel de calidad de vida (CV) en pacientes con escoliosis y las dimensiones más afectadas. Métodos Artículo original con estudio descriptivo, cuantitativo, realizado con 20 individuos con diagnóstico de escoliosis sometidos al tratamiento conservador. Los datos fueron recolectados, durante las consultas, a partir de dos cuestionarios, uno conteniendo datos sociales y demográficos y el Revised Scoliosis Research Society-22 (versión brasileña). El análisis fue efectuado en el Statistical Package for the Social Sciences (versión 25), utilizando estadística descriptiva y test no paramétrico de Mann-Whitney. La investigación fue enviada y aprobada por el Comité de Ética e Investigación de las Facultades Integradas de Patos. Resultados La muestra fue compuesta en la mayor parte por pacientes del sexo femenino (70%), con edad entre 12 y 16 años (55%) que presentaron como el dominio de CV más afectado el de actividad (١٠٪) y el de salud mental (55%). Además, los pacientes portadores de escoliosis moderada presentan una menor calidad de vida, cuando comparados con los de escoliosis leve. Conclusión La escoliosis es una alteración de la columna vertebral que acomete más a adolescentes femeninas, trayendo para éstas impactos negativos en su calidad de vida, afectando principalmente los dominios de actividad, salud mental y apariencia. Ante esta realidad, es necesario una mirada más atenta, buscando la creación e incentivo de estrategias que puedan mejorar el bienestar global de esos pacientes. Nivel de evidencia II - Estudio retrospectivo.

Correlatos das dimensões de Burnout com características de saúde e demográficas de estudantes de medicina / Correlación de las dimensiones de agotamiento con las características demográficas y de salud de estudiantes de Medicina

Resumo Objetivo: Correlacionar as dimensões da Síndrome de Burnout com características de saúde e demográficas de estudantes de Medicina de uma faculdade do sertão nordestino. Métodos: Estudo descritivo, transversal, correlacional com abordagem quantitativa. Participaram da pesquisa 138 alunos do curso de Medicina do Centro Universitario de Patos (UNIFIP). Foram critérios de inclusão ser estudante de medicina regularmente ma- triculado no curso das UNIFIP e possuir 18 anos ou mais de idade. A coleta de dados foi realizada a partir da aplicação de um questionário social e demográfico e do Maslach Burnout Inventory - Students Survey. Os dados foram analisados no Statistical Package for the Social Sciences a partir de Correlações Bisseriais e de Pearson. Resultados: A maioria dos discentes era do sexo feminino (58,7%), com idades entre 18-24 anos (83,3%) e sol- teiros (96,4%). O estudo evidenciou altas médias de exaustão emocional e eficácia profissional, e baixo índice de descrença. Contudo, na medida em que os discentes evoluem no curso, há aumento da exaustão emocional e da descrença, e redução da realização profissional. Ainda, os estudantes que pensaram em desistir do curso apresentaram tendência a maior pon- tuação em exaustão emocional e descrença, com menor pontuação em realização profissional. Conclusões: Não foram constatados indicativos da Síndrome de Burnout na amostra, entretanto, há risco de desenvolvê-la entre alunos em períodos mais avançados, entre aqueles insatisfeitos com o curso e que pensaram em desistir do mesmo.

Resumen Objetivo: correlacionar las dimensiones del Síndrome de Burnout con las características demográficas y de salud de los estudiantes de Medicina de una universidad del noreste de Brasil. Métodos: Estudio descriptivo, transversal, correlacional con enfoque cuantitativo. Un total de 138 estudiantes de la Facultad de Medicina del Centro Universitario UNIFIP en Patos-PB participaron en la investigación. Los criterios de inclusión fueron ser un estudiante de Medicina matriculado regularmente en el curso FIP y tener 18 años de edad o más. La recolección de datos se realizó mediante la aplicación de un cuestionario social y demográfico y el Inventario de Burnout de Maslach - Encuesta de estudiantes. Los datos se analizaron en SPSS a partir de las correlaciones de Bisserial y Pearson. Resultados: la mayoría de los estudiantes eran mujeres (58,7 %), de 18 a 24 años (83,3 %) y solteras (96,4 %). El estudio mostró altos promedios de agotamiento emocional y efectividad profesional, y un bajo nivel de desconfianza. Sin embargo, a medida que los estudiantes evolucionan con el tiempo, aumenta el agotamiento emocional y la desconfianza, y se reduce el rendimiento profesional. Aun así, los estudiantes que pensaron en abandonar el curso tendieron a obtener puntajes más altos en agotamiento emocional e incredulidad, y puntajes más bajos en logros profesionales. Conclusiones: no hubo indicios de síndrome de Burnout en la muestra; sin embargo, existe el riesgo de desarrollarlo entre los estudiantes en períodos más avanzados, entre aquellos insatisfechos con el curso y los que considerar abandonarlo.

Clinicopathological characteristics and papillomavirus types in cutaneous warts in bovine.

Thirty-one bovine cutaneous warts were submitted to macroscopic and histological analyses and to molecular analyses to partial amplification and sequencing of the L1 gene of bovine papillomavirus (BPV). Viral types detected were BPV1 (52%), BPV2 (29%), BPV6 (16%) and BPV10 (3%). BPV2 had lower frequency in papilloma in comparison to that in fibropapilloma (p = 0.002).

An analytical strategy for the identification of carbamates, toxic alkaloids, phenobarbital and warfarin in stomach contents from suspected poisoned animals by thin-layer chromatography/ultraviolet detection.

In this study, an analytical strategy to identify brucine, strychnine, methomyl, carbofuran (alkaline compounds), phenobarbital, and warfarin (acid compounds) using thin-layer chromatography (TLC) screening with ultraviolet (UV) detection at 254 nm in stomach content is shown. The optimum mobile phase was found to be a chloroform: ethyl acetate: diethylamine (0.5:8.5:1) mixture for alkaline substances while a mixture of chloroform: acetone (9:1) has given better results for acidic substances. As for extraction, an equal proportion between distillated water and crude material (1:1) is required. For alkaline compounds, a filtration system was created in order to avoid any interferences from the biological matrix while for acidic compounds only centrifugation (4000 rpm/10 minutes) was required to obtain an appropriate sample. After the respective pretreatments, a one-step liquid-liquid extraction (LLE) has been employed for alkaline substances using a 3 mL of chloroform: ethyl ether (2:1) mixture for 2 min while acidic analytes used 3 mL of chloroform only during 5 min. For both methodologies described, the respective organic layers were dried down and re-suspended with 50 µL of methanol for further TLC plate application. The methodologies have been developed, successfully validated and applied to gastric contents from real case samples of suspected animal poisoning. Positive results from TLC/UV screening were confronted with HPLC-UV and confirmed by GC-MS.

Laserterapia de baixa intensidade no tratamento de feridas e a atuação da enfermagem / Laser therapy low intensity in wound care and practice nurses

Objetivo: identificar os benefícios da laserterapia no tratamento de feridas e a atuação da enfermagem neste processo. Metodologia: revisão Integrativa da Literatura. A partir das questões >, a amostra foi composta por 12 (doze) artigos científicos. O levantamento bibliográfico foi realizado na Biblioteca Virtual de Saúde. Foram artigos publicados em português, inglês e espanhol, na íntegra nas bases de dados, no período entre 2008 a 2016. Resultados: são evidentes os benefícios da Terapia com Luz de Baixa Intensidade nas feridas, já na primeira sessão com a analgesia, anti-inflamatório e cicatrização. O profissional habilitado realiza a avaliação, desenvolve o plano de cuidados pautado no processo de enfermagem e exerce sua autonomia nesse tipo de tratamento. Conclusão: a literatura mostra os vários benefícios do uso da lasertarapia nas lesões cutâneas agindo de forma intrínseca e extrínseca e a enfermagem é uma profissão capaz de aplicar o recurso terapêutico, desde que obtenha qualificação adequada.

Objective: to identify the benefits of laser therapy in wounds treatment and the nursing role at this process.Methodology: integrative literature review. From the questions >, the sample was formed by 12(twelve) papers. The research was conducted at the Virtual Health Library and included papers published in Portuguese, English and Spanish with full text available at the databases, from 2008 to 2016. Results: the benefits of low-intensity laser at wounds treatments are evident, at the first session with the use of analgesic,anti-inflammatory and at the healing process. The registered nurse performs the evaluation, develops the care plan in accordance with the nursing process and has autonomy throughout the treatment. Conclusion:the literature shows the a variety of benefits of using laser therapy in skin lesions acting intrinsically and extrinsically; and nursing is a profession able of applying the therapeutic resource, as long as obtain proper qualification.

Pathogenic Leptospira spp. in bats: Molecular investigation in Southern Brazil.

The present study aimed to investigate the frequency of pathogenic Leptospira spp. in Brazilian bats and to determine possible risk factors associated to it. Ninety two bats of 12 species were evaluated. Whole genomic DNA from kidneys was extracted and real-time PCR specific to pathogenic Leptospira spp. was applied. Association between the frequency of specimens positive for Leptospira spp. and sex, age, bat species or family, season of collection, geographic localization and feeding habits was evaluated. The results showed that 39.13% of analyzed bats were found positive for Leptospira spp. Nine bat species had at least one positive result. There was no association among the evaluated variables and frequency of pathogenic Leptospira spp. Although the limitations due to lack of Leptospira spp. isolation, leptospiral carriage was demonstrated in bats of different species from southern Brazil, which reinforces the need for surveillance of infectious agents in wild animals.

Perfil epidemiológico dos traumas faciais / Epidemiological profile of facial trauma

Objetivo: identificar os principais tipos de traumas faciais encontrados nas publicações científicas entre os anos de 2005-2017. Metodologia: revisão Integrativa da Literatura. A partir da questão norteadora“Quais são os tipos de traumas faciais mais encontrados nas publicações científicas entre os anos de 2005-2017?”, foram utilizados combinados os Descritores Controlados em Ciências da Saúde “Traumatismos Faciais” e “Epidemiologia” em bases de dados nacionais e latino americanas e o Medical Subject Headings (MeSH) “Facial Injuries” and “Epidemiology” em base de dados internacional. A definição de tais termos auxiliou o processo de pré-seleção (29 trabalhos identificados) e seleção dos estudos (17 publicações). Por fim, realizou-se a categorização dos artigos, permitindo a análise dos resultados para desenvolvimento da discussão e síntese do assunto. Resultados: a maioria dos estudos utilizados foi publicada em 2014 (17,6%), na Literatura Latino-Americana e do Caribe em Ciências da Saúde (47,0%), escritos em inglês (53,0%) e português (47,0%) e divulgados em dez periódicos diferentes. No mais, contemplaram duas temáticas principais: traumas bucomaxilofaciais e traumas por queimadura facial, os quais apresentaram maior prevalência no sexo masculino (88,2%), na faixa etária entre 21 -30 anos (55,0%) e decorrentes de agressão interpessoal (53,0%). Conclusão: os principais tipos encontrados foram os traumas bucomaxilofaciais que envolve lesões mandibulares, maxilares, dentárias, nasais, zigomáticas e orbitais, assim como os traumas por queimadura facial. Desse modo, os resultados sugerem a necessidade de abordagem multidisciplinar, especialmente do bucomaxilofacial para diagnóstico e tratamento, além da prevenção e aprofundamento no assunto.

Objective: toidentify the main types of facial trauma found in the scientific publications between the years of 2005-2017. Methodology: integrative review of literature. From the guiding question > combined were used the Descritores Controlados em Ciências da Saúde "Traumatismos Faciais” and “Epidemiologia” in national databases and Latin American and the Medical Subject Headings "Facial Injuries" and "Epidemiology" in international data base. The definition of such terms assisted pre-selection process (29 publications identified) and selection of the studies (17 publications). Finally, the categorisation of articles, allowing the analysis of the results for the development of the discussion and summary of the subject. Results: the majority of studies used was published in 2014 (17.6%), Latin American literature and Caribbean Health Sciences (47.0%), written in English (53.0%) and Portuguese (47.0%) and published in ten different journals. At most, two main themes included: bucomaxilofaciais trauma and trauma for facial Burns, which presented higher prevalence in males (88.2%), ranging in age between 21-30 years (55.0%) and resulting from interpersonal aggression (53.0%). Conclusion: the main types offacial injuries found were bucomaxilofaciais traumas involving mandibular lesions, jaws, teeth, nasal, orbital and zigomáticas, as well as thetraumas for facial burns. Thus, the results suggest the need for a multidisciplinary approach, especially for oral diagnosis and treatment as well as prevention and deepening in the subject.

Nasal swab real-time PCR is not suitable for in vivo diagnosis of bovine tuberculosis / A PCR em tempo real de swab nasal não é adequada para o diagnóstico in vivo de tuberculose bovina

Bovine tuberculosis (bTB) is a zoonosis causing economic losses and public health risks in many countries. The disease diagnosis in live animals is performed by intradermal tuberculin test, which is based on delayed hypersensitivity reactions. As tuberculosis has complex immune response, this test has limitations in sensitivity and specificity. This study sought to test an alternative approach for in vivo diagnosis of bovine tuberculosis, based on real-time polymerase chain reaction (PCR). DNA samples, extracted from nasal swabs of live cows, were used for SYBR® Green real-time PCR, which is able to differentiate between Mycobacterium tuberculosis and Mycobacterium avium complexes. Statistical analysis was performed to compare the results of tuberculin test, the in vivo gold standard bTB diagnosis method, with real-time PCR, thereby determining the specificity and sensitivity of molecular method. Cervical comparative test (CCT) was performed in 238 animals, of which 193 had suitable DNA from nasal swabs for molecular analysis, as indicated by amplification of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene, and were included in the study. In total, 25 (10.5%) of the animals were CCT reactive, of which none was positive in the molecular test. Of the 168 CCT negative animals, four were positive for M. tuberculosis complex at real time PCR from nasal swabs. The comparison of these results generated values of sensitivity and specificity of 0% and 97.6%, respectively; moreover, low coefficients of agreement and correlation (-0.029 and -0.049, respectively) between the results obtained with both tests were also observed. This study showed that real-time PCR from nasal swabs is not suitable for in vivo diagnosis of bovine tuberculosis; thus tuberculin skin test is still the best option for this purpose.(AU)

A tuberculose bovina (bTB) é uma zoonose que causa perdas econômicas e riscos à saúde pública em muitos países. O diagnóstico da doença em animais vivos é realizado pelo teste intradérmico da tuberculina, que é baseado em reações de hipersensibilidade tardia. Como a tuberculose tem resposta imunológica complexa, este teste tem limitações em termos de sensibilidade e especificidade. Este estudo procurou desenvolver uma abordagem alternativa para o diagnóstico in vivo da tuberculose bovina, com base na reação em cadeia da polimerase (PCR) em tempo real. As amostras de DNA, extraídas de suabes nasais de vacas vivas, foram usadas para PCR em tempo real com SYBR® Green, capaz de diferenciar os complexos Mycobacterium tuberculosis e Mycobacterium avium. A análise estatística foi realizada para comparar os resultados de teste de tuberculina, padrão ouro para o diagnóstico in vivo da bTB, com PCR em tempo real, determinando-se assim a especificidade e sensibilidade do método molecular. O teste cervical comparativo (TCC) foi realizado em 238 animais, dos quais 193 tiveram DNA dos suabes nasais adequados para análise molecular, como indicado pela amplificação do gene gliceraldeído-3-fosfato-desidrogenase (GAPDH), e foram incluídos no estudo. No total, 25 (10,5%) animais foram reativos no TCC, dos quais nenhum foi positivo no teste molecular. Dos 168 animais negativos no TCC, quatro foram positivos para o complexo M. tuberculosis na PCR em tempo real a partir dos suabes nasais. A comparação destes resultados gerou valores de sensibilidade e especificidade de 0% e 97,6%, respectivamente; além disso, baixos coeficientes de concordância e correlação (-0,029 e -0,049, respectivamente) entre os resultados obtidos com ambos os testes também foram observados. Este estudo mostrou que a PCR em tempo real a partir de suabes nasais não é adequada para o diagnóstico in vivo da tuberculose bovina; portanto, o teste da tuberculina ainda é a melhor opção para este fim.(AU)

Atitude religiosa de pessoas com doença renal crônica em tratamento hemodialítico / Religious attitude of people with chronic kidney disease on hemodialysis

Objetivo: analisar a atitude religiosa de pessoas com doença renal crônica em tratamento hemodialítico e a sua interferência no curso terapêutico. Metodologia: pesquisa descritiva, transversal, com abordagem quantitativa. Os dados foram coletados em setembro de 2015 com 58 pacientes da Clínica Nefrológica Santo Amaro localizada em Patos, Paraíba. Para a coleta de dados foi utilizada a Escala de Atitude Religiosa (EAR-20) que avalia quatro fatores atitudinais: afetivo, comportamental, cognitivo e corporeidade. Os dados foram analisados mediante estatística descritiva e inferencial. Resultados: autodenominaram-se católicos 89,7% da amostra. Os fatores conhecimento, corporeidade e comportamento religioso apresentaram valor alfa de Crombach acima de 0,6. Na descrição da atitude religiosa, o fator comportamento apresentou-se como frequente em 39,7% e como sempre em 39,7% dos casos; corporeidade, 41,4% frequentemente; conhecimento,37,9% às vezes; sentimento, 46,6% sempre. Maior relação entre conhecimento e corporeidade com r = 0,71. As pessoas que aceitaram o tratamento sem resistência têm uma mediana significativamente menor do que as que o recusaram no início. Quanto maior o tempo de tratamento maior é o conhecimento religioso.Conclusão: os pacientes apresentam uma atividade religiosa significativa, em que a fé parece contribuir como enfrentamento da situação-problema e assegura o sentimento de proteção.

Objective: to analyze the religious attitude of people with chronic kidney disease on hemodialysis and its interference in the therapeutic course. Methodology: descriptive, cross-sectional study with a quantitative approach. Data were collected in September 2015 with 58 patients Nephrological Santo Amaro Clinic locatedin Patos, Paraíba. For data collection was used the Religious Attitude Scale (EAR-20) that evaluates four attitudinal factors: affective, behavioral, cognitive and corporeality. Data were analyzed using descriptive and inferential statistics. Results: 89.7% of the sample called them selves Catholics. The knowledge factors, corporeality and religious behavior showed Crombach alpha value above 0.6. In describing the religious attitude, behavior factor introduced it as frequent in 39.7% and as always in 39.7% of cases; corporeality,41.4% often; knowledge, 37.9% sometimes; feeling, 46.6% always. Greater relationship between knowledgeand corporeality with r = 0.71. People who accepted the treatment without resistance have a significantly lower median than those that refused at first. The higher the treatment time is religious knowledge. Conclusion: patients have a significant religious activity, and faith seems to contribute to confronti the problem situation and to ensures the feeling of protection.

Prevalência de distúrbios osteomioarticulares e algias em fisioterapeutas / revalence of musculoskeletal disorders and pains in physical therapists

Objetivou-se identificar a prevalência de distúrbios osteomioarticulares e algias em fisioterapeutas decorrentes da atuação profissional. Foi realizada pesquisa do tipo aplicada, descritiva, quantitativa. A amostra foi constituída por 38 fisioterapeutas que atuavam numa instituição de ensino superior em um município do interior da Paraíba. A amostragem foi do tipo não probabilística, por conveniência, com aplicação de instrumento, no período de agosto a setembro de 2012. Os dados foram analisados, utilizando o programa estatístico Statistical Packaget Social Science, versão 18.0. Os resultados indicaram que 92,1% dos participantes da pesquisa possuem uma ou mais queixas de distúrbios osteomioarticulares, 18,4% já se ausentaram do trabalho em decorrência de lesão, 50% afirmaram que sua atividade laborativa é influenciada por uma ou mais das queixas, ainda nesse contexto verificou-se que 26,3% da amostra não praticam exercício físico como forma de prevenção, e as principais queixas dos fisioterapeutas são dor, desconforto e/ou tensão muscular, tendinite, desvio postural, protusão discal, hérnia de disco, bursite, e instabilidade articular. A pesquisa indicou alta prevalência de distúrbios osteomioarticulares e algias em fisioterapeutas decorrentes da atuação profissional. O quadro demanda ações preventivas em prol do autocuidado.

This study aimed to identify the prevalence of musculoskeletal disorders and pains resulting from physical therapists in professional practice. Research the type applied, descriptive and quantitative. The sample was composed of 38 physiotherapists who had ties with an institution of higher education in a city in the interior of Paraíba. Sampling was not probabilistic, for convenience, with a questionnaire in the period August-September 2012. Data analyzed using the statistical software Statistical Packaget Social Science, version 18.0. The results indicated that 92.1% have one or more complaints of musculoskeletal disorders. Only, 18.4% already were absent from work to the detriment of the lesion, 50% said that their labor activity is influenced by one or more of the complaints, even in this context it was found that 26,3% of the sample do not exercise as a form of prevention, and the main complaints of the physiotherapists are pain, discomfort and / or muscle strain, tendonitis, postural deviation, disc protrusion, disc herniation, bursitis, and joint instability. The survey showed a lack of self-care and prevention among physiotherapists, and points out the need for further studies, seeking investigate this issue, while pointing out targets and formulate the development of preventive and control these diseases.

Detection of Mycobacterium tuberculosis and Mycobacterium avium Complexes by Real-Time PCR in Bovine Milk from Brazilian Dairy Farms.

Foodborne diseases are a public health problem worldwide. The consumption of contaminated raw milk has been recognized as a major cause of transmission of bovine tuberculosis to humans. Other mycobacteria that may be present in raw milk and may cause diseases are those belonging to the Mycobacterium avium complex. In this study, molecular biology tools were applied to investigate raw milk contamination with Mycobacterium spp. in family dairy farms from Rio Grande do Sul, southern Brazil. Furthermore, different variables related to the source of the milk, herd characteristics, and management were evaluated for their effect on milk contamination. Five hundred and two samples were analyzed, of which 354 were from the Northwest region (102 farms with samples from 93 bulk tanks and 261 animals) and 148 from the South region of the state (22 farms with samples from 23 bulk tanks and 125 animals). Among them, 10 (1.99%) and 7 (1.39%) were positive for Mycobacterium tuberculosis (9 confirmed as Mycobacterium bovis) and M. avium complexes, respectively. There was no difference in the frequencies of positive samples between the regions or the sample sources. Of the positive samples, 4 were collected from a bulk tank (1 positive for M. avium and 3 for M. tuberculosis). Moreover, 1 sample was positive concomitantly for M. tuberculosis and M. avium complexes. On risk analysis, no variable was associated with raw milk contamination by M. tuberculosis complex species. However, washing the udders of all animals and drying them with paper towels were weakly classified as risk factors for M. avium contamination. Positive samples were obtained from both animals and bulk tanks, which emphasizes the importance of tuberculosis control programs and provides evidence that milk monitoring can be used as a control practice. Moreover, the findings of this study reinforce the need for awareness of the problems of raw milk consumption among the general population.