Histological aspects of the renal sexual segment of Brazilian snakes of the Boidae family.

Snakes represent a wide and diverse group of species and have anatomical particularities, such as the renal sexual segment (RSS), a structure located in the kidneys and formed from the hypertrophy of the urinary ducts and nephrons. This study aims at describing the histological aspects of the RSS of Boa constrictor, Epicrates cenchria and Corallus hortulanus, all of which are Brazilian snake species from the Boidae family. The reproductive system and kidneys of five male specimens of E. cenchria, three male specimens of C. hortulanus and two male specimens of B. constrictor were obtained. Tissue samples were processed histologically and different stains used (Toluidine Blue, Alcian Blue and Periodic Acid Schiff). The histological evaluation of the RSS of E. cenchria, C. hortulanus and B. constrictor shows that the RSS in these species varies when comparing individuals in the reproductive period with those which are not. It also allows for the observation of the segment's secretory activity in animals in the reproductive stage (mature sperm in the lumen of the seminiferous tubules) as well as in those which are not. Finally, the histological evaluation also reveals the variation of the secretion product in individuals in the reproductive period, in those which are not, and also among individuals within the same reproductive stage.

Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study.

BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

Effectiveness of Multimodal Training Compared to a Uni-Modal Walking Intervention on Postural Control, Strength, Gait Speed and Flexibility in Community-Dwelling Older Adults.

Background: Multimodal training may induce positive effects in different physical domains. Compared to unimodal training, multimodal training allows similar effect sizes at lower overall training volumes. Studies are needed to investigate the potential value of multimodal training with systematic training, especially compared to other exercise-based interventions. This study aimed to compare the effects of a multimodal training with an outdoor walking program, on postural control, muscle strength, and flexibility in community-dwelling older adults. Methods: This study is a pragmatic controlled clinical trial. We compared two real community exercise groups: a multimodal group (n = 53) and an outdoor, overground walking group (n = 45). Both groups participated in 32 sessions of training, twice a week, over 16 weeks. Participants were evaluated using the Mini-Balance Evaluation Systems Test (Mini-BESTest), Handgrip, 5-Times Sit-to-Stand Test, 3-meter Gait Speed Test, and Sit and Reach Test. Results: There was an interaction effect between evaluation and group in the Mini- BESTest with difference between pre and post-intervention only in multimodal group. Regarding gait speed, there was an interaction effect between evaluation and group with difference between pre and post-intervention only in the walking group. In the Sit and Reach Test: there was interaction effect between evaluation and group with difference between pre and post-intervention only in the walking group. Conclusion: The multimodal training improved postural control, while an outdoor walking program improved gait speed and flexibility. Both interventions improved muscle strength without between-group differences.

Key Nanotechnology Breakthroughs in Cardiovascular Disease Therapy

Abstract Background It is justified by the high population's morbidity and mortality rate, as well as the increasing present use of nanoparticles in this pathological context. Objectives To describe the main nanotechnology breakthroughs in the field of cardiovascular disease (CVD) and disseminate pertinent information in the literature. Methods This is a systematic review conducted between September and October 2021. The review was carried out through basic nature, following the initial script for the selective reading of articles in chronological order to collect relevant and consistent data related to the theme. Results It is evidenced the main advances of nanotechnology in the field of CVDs, namely, acute coronary syndromes (ACSs), heart failure (HF), and systemic arterial hypertension (SAH). Conclusion The importance of further and deeper studies in this area is emphasized, in order to make the already approved treatments feasible, so they can reach all publics at a low cost.

Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study

ABSTRACT BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

Sense of mastery in caregivers of people living with dementia: translation and cultural adaptation of the Pearlin Mastery Scale / Senso de domínio de cuidadores de pessoas que vivem com demência: tradução e adaptação cultural da Pearlin Mastery Scale

ABSTRACT The sense of mastery is conceptualized as a positive aspect of care targeted at people living with dementia, a coping mechanism to reduce burden, and may represent a protective factor for caregivers' mental and physical health. Objective: To translate and culturally adapt the Pearlin Mastery Scale for Brazil. Methods: A methodological study was conducted at the Federal University of São Carlos in which the initial translation stages were followed; synthesis; back-translation; review by the committee of judges by analyzing the Content Validity Index (CVI); and test of the pre-final version. Results: Two specialists translated the scale into Brazilian Portuguese and defined a consensus version with the researchers. Subsequently, another two specialists back-translated the consensus version, which was reviewed by three judges who are PhDs in the area, considering all scale items as very equivalent (CVI=1.0), and maintaining them in the pre-final version of the instrument. This was tested in a first group of caregivers for them to point out adjustments. The suggestions were accepted by modifying three items and, afterward, the scale was tested in a second group, which did not present difficulties answering the instrument. Conclusion: The Pearlin Mastery Scale was translated and culturally adapted for Brazil, showing equivalence. However, future psychometric analyses of the instrument are required to make it available for use in this population.

RESUMO O senso de domínio é conceituado como um aspecto positivo do cuidado voltado às pessoas que vivem com demência, um mecanismo de enfrentamento para reduzir a sobrecarga e que pode representar um fator protetor para a saúde mental e física do cuidador. Objetivo: Traduzir e adaptar culturalmente a Pearlin Mastery Scale para o Brasil. Métodos: Estudo metodológico conduzido na Universidade Federal de São Carlos, em que foram seguidas as etapas de tradução inicial; síntese; retrotradução; revisão pelo comitê de juízes pela análise do Índice de Validade de Conteúdo (IVC); e teste da versão pré-final. Resultados: Dois especialistas traduziram a escala para o português brasileiro e definiram uma versão consensual com os pesquisadores. Posteriormente, outros dois especialistas retrotraduziram a versão consensual, que foi revisada por três juízes doutores na área, considerando todos os itens da escala como muito equivalentes (IVC=1,0), mantendo-os na versão pré-final do instrumento. Esta foi testada em um primeiro grupo de cuidadores, a fim de se apontarem adequações. As sugestões foram acatadas mediante a modificação de três itens e, depois, a escala foi testada em um segundo grupo, o qual não apresentou dificuldades em responder ao instrumento. Conclusão: A Pearlin Mastery Scale foi traduzida e adaptada culturalmente para o Brasil, demonstrando equivalência. Entretanto, análises psicométricas futuras do instrumento são necessárias para disponibilizá-lo para uso entre essa população.

Melanoma lentiginoso acral: revisão de literatura / Acral lentiginous melanoma: literature review

O melanoma acral é um subtipo de câncer de pele melanoma que ocorre nas regiões palmoplantar e ungueal. É mais frequente nos indivíduos de fototipos elevados e, além da exposição solar, possui outros fatores de risco envolvidos para a ocorrência, alguns ainda pouco conhecidos. O melanoma acral apresenta padrão de crescimento lentiginoso, no entanto, associa-se a um ruim prognóstico em detrimento do atraso no diagnóstico. Esse atraso pode ser atribuído às características clínicas distintas dos melanomas de outras localizações e à localização peculiar. O tratamento da doença localizada baseia-se na exérese cirúrgica de todo o tumor com margens adequadas, que resulta, por vezes, em grandes defeitos cirúrgicos e com difícil reconstrução. Na doença avançada, a terapia sistêmica é uma alternativa terapêutica e de controle da doença. O advento da imunoterapia e das terapias alvo impactou positivamente na sobrevida global desses pacientes. Este trabalho revisa de forma sucinta o que há na literatura sobre o melanoma acral, com foco principalmente nas peculiaridades clínicas

Acral melanoma is a subtype of melanoma skin cancer that occurs on the hands, feet and nail units. It is more common in individuals with high phototypes and, in addition to sun exposure, there are other risk factors involved in its occurrence, some of which are still unknown. Acral melanoma presents a lentiginous growth pattern; however, it is associated with a poor prognosis at the expense of delayed diagnosis. This delay may be attributed to the distinct clinical characteristics of melanomas from other locations and their peculiar location. Treatment of localized disease is based on surgical excision of the entire tumor with adequate margins, which sometimes results in large surgical defects that are difficult to reconstruct. In advanced disease, systemic therapy is a therapeutic and disease control alternative. The advent of immunotherapy and targeted therapies has positively impacted the overall survival of these patients. This work briefly reviews what is available in the literature on acral melanoma, focusing mainly on clinical peculiarities

Avaliação e intervenção nutricional em transplante cardíaco: relato de caso / Nutritional evaluation and intervention in cardiac transplant: a case report

INTRODUÇÃO: A insuficiência cardíaca (IC) é a via final da maioria das doenças cardíacas. Entre elas, existe a miocardiopatia chagásica, que promove piora do estado nutricional, em virtude da caquexia e desnutrição, que são recorrentes em pacientes com essa doença. O transplante (Tx) cardíaco é uma opção terapêutica para pacientes com IC avançada que é refratária ao tratamento otimizado. A avaliação antropométrica associada com outros instrumentos, como a bioimpedância, permite uma melhor caracterização da evolução desses pacientes. MÉTODO: Foi feito um relato de caso por meio de dados clínicos e nutricionais de prontuários eletrônicos, após consentimento da paciente, que assinou um termo de consentimento. DESCRIÇÃO DO CASO: A paciente de sexo feminino, com 61 anos, hospitalizada com miocardiopatia chagásica, foi admitida com classe funcional III, ortopneia, edema de membros inferiores, ganho recente de peso não intencional, risco nutricional (de acordo com a ferramenta Nutritional Risk Screening 2002) e dados antropométricos com sinais de desnutrição (índice de massa corporal de 21,9 kg/m2, circunferência de braço de 22 cm e circunferência da panturrilha de 31,5 cm). Foi oferecida dieta hospitalar e incluído suplemento nutricional oral (600 Kcal e 24 g de proteína/dia). A aceitação alimentar inicial foi em média de 60% da dieta oferecida. Após implante de balão intra-aórtico, a aceitação atingiu 80%. A avaliação por bioimpedância no período pré-operatório revelou redução do ângulo de fase com elevação após 3 meses da realização do Tx cardíaco, melhora da classe funcional e dos sintomas de IC. CONCLUSÃO: O sucesso da intervenção nutricional em pacientes portadores de IC que são candidatos à Tx cardíaco é desafiado pela condição clínica do paciente e imobilismo prolongado. A intervenção nutricional auxilia a manutenção do estado nutricional na espera pelo órgão. O ângulo de fase obtido pela bioimpedância parece estar associado à condição clínica nesses pacientes.

Efficacy of iSupport-Brasil for unpaid caregivers of people living with dementia: protocol for a randomized and controlled clinical trial.

Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers' mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer's Association, and both groups will be emailed the preliminary version of the "Guia de cuidados para a pessoa idosa" e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions.

Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde.

Use of high frequency electrorotation to identify cytoplasmic changes in cells non-disruptively.

In this paper we demonstrate how the use of frequencies ranging from 50 kHz to 5 GHz in the analysis of cells by electrorotation can open the path to the identification of differences not detectable by conventional set-ups. Earlier works usually reported electrorotation devices operating below 20 MHz, limiting the response obtained to properties associated with the cell membrane. Those devices are thus unable to resolve the physiological properties in the cytoplasm. We used microwave-based technology to extend the frequency operation to 5 GHz. At high frequencies (from tens of MHz to GHz), the electromagnetic signal passes through the membrane and allows probing the cytoplasm. This enables several applications, such as cell classification, and viability analysis. Additionally, the use of conventional microfabrication techniques reduces the cost and complexity of analysis, compared to other non-invasive methods. We demonstrated the potential of this set-up by identifying two different populations of T-lymphocytes not distinguishable through visual assessment. We also assessed the effect of calcein on cell cytoplasmic properties and used it as a controlled experiment to demonstrate the possibility of this method to detect changes happening predominantly in the cytoplasm.

High-risk children and social isolation: the importance of family functioning.

High-risk newborns are exposed to neonatal conditions such as prematurity, very low birth weight, and congenital malformations that can affect development and behavior. Coronavirus disease 2019 (COVID-19) restraint and control measures have been identified as important stressor events and cumulative risk factors for behavioral changes in these children. This study examined social isolation-related factors that contribute to internalizing and externalizing behavior problems in children already at risk for neurodevelopmental disorders. This cross-sectional, multicenter study included 113 children (18 months to 9 years) who were followed in reference services for neonatal follow-up in tertiary units of the public health system in the city of Rio de Janeiro, Brazil. Behavior was assessed using the child behavior checklist, and a structured questionnaire was used to assess sociodemographic aspects. In the bivariate analysis, prematurity was associated with externalizing problems and change in eating habits with internalizing problems. The logistic model indicated that both parents having completed high school and both sharing care of the child were protective factors for behavioral problems; however, reports of sleep problems and living with another child were risk factors. In conclusion, the study identified internalizing and externalizing behavior problems related to prematurity and aspects of family structure and routine in children at risk. The findings confirm the importance of family functioning for child health and family-centered interventions.

iSupport-Brasil: Cross-cultural adaptation of the content included in the iSupport program for caregivers of people who have dementia.

OBJECTIVE: Examine the process of culturally adapting the content of the World Health Organization iSupport program for family caregivers of people living with dementia in Brazil. METHOD: This is a multicenter and methodological study to cross-culturally adapt the iSupport program. Initially, the content of the iSupport program was translated into Brazilian Portuguese by professional translator trained in Psychology, with mastery of the original language of the content (English). Focus groups were then held with caregivers/former caregivers of people who have dementia (n = 24) and health professionals specialized in aging (n = 24). The participants had access to part of the iSupport material for analysis purposes. Semi-structured interviews were conducted between June and September 2019. All the interviews were recorded and transcribed in full for subsequent analysis. All the ethical aspects were respected. RESULTS: The translator implemented some cross-cultural adaptations, such as substituting 69 proper names used in the original version by names of different Brazilian regions. In relation to the analysis of the material and comments from the focus groups, in general, all the participants had positive opinions about the material included in iSupport. Some changes were suggested in relation to the terminology and examples given in the modules to better fit the Brazilian culture and health systems, and links to relevant pages of the local Alzheimer's association were included. All the linguistic and cultural adaptations proposed were systematically documented and duly justified in structured forms provided by the World Health Organization, which approved all of them after verification of fidelity. CONCLUSION: The product of this research is the first version of the iSupport-Brasil program and the inclusion of its content in a digital platform. For the most part, the content offered in iSupport proved to be an important online tool to provide support and diverse information to the caregivers of people who have dementia.

Functional impact on adults and older people after hospitalization by Covid-19.

BACKGROUND AND OBJECTIVES: Hospitalization by Covid-19 can cause persistent functional consequences after hospital discharge due to direct and indirect effects of SARS-COV-2 in several organs and systems of the body added to post-intensive care syndrome and prolonged bed rest. These impacts can lead to dependency in activities of daily living, mainly in older people due to aging process and functional decline. This study aimed to compare the effects of hospitalization by Covid-19 on functional capacity of adults and older people and to identify its associated factors. METHODS: Cross-sectional observational study of 159 survivors of hospitalization by Covid-19 after 1 month from discharge at Hospital das Clínicas of the University of São Paulo, divided into groups: adults (aged < 60 years) and older people (aged ≥ 60 years). Those who did not accept to participate, without availability or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index and patients were classified according to their scores. Data analysis was performed in JASP Statistics program and the sample was compared between the age groups. Wilcoxon test was applied to compare before and after periods, Mann-Whitney test was used for between groups comparison. We adopted alpha = 0.05. RESULTS: The total Barthel Index median score was lower 1 month after hospital discharge than in the pre-Covid-19 period. Older people had worse functional status than adults before and also showed greater impairment after hospital discharge. Both groups showed lower Barthel Index classification than before, and older people presented more functional dependence than adults in both periods. Age, sarcopenia and frailty were associated factors. DISCUSSION: Hospitalization by Covid-19 impacts functional capacity after 1 month from discharge, especially in older people. Age, sarcopenia and frailty are associated factors. These results suggest need for care and rehabilitation of Covid-19 survivors.

Effect of thickness and CAD-CAM material on fatigue resistance of endodontically treated molars restored with occlusal veneers.

PURPOSE: To evaluate the influence of the thickness and type of computer-aided design and computer-aided manufacturing (CAD-CAM) material on the fatigue resistance and failure mode of endodontically treated teeth (ETT) restored with occlusal veneers (OV). MATERIALS AND METHODS: Seventy-five (N = 75) ETT were restored with Herculite XRV in the endodontic access. Five experimental groups (n = 15) were tested. Four groups had two different thicknesses (0.6-0.7 mm or 1.4-1.6 mm) and two different CAD-CAM materials: zirconia-reinforced lithium-silicate (LS/Celtra Duo) and composite resin (RC/Cerasmart). The fifth group (control) did not have occlusal veneers. All the specimens were subjected to accelerated fatigue (5 Hz frequency) with an occlusal load increasing up to 1800 N and 131,000 cycles. The number of cycles was recorded when the machine stopped or at the completion of the test. Fatigue resistance was analyzed using the Kaplan-Meier survival test (95% significance level, log-rank post hoc pairwise comparisons). The samples were categorized according to failure mode. The CAD-CAM materials were examined through scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). RESULTS: No differences were found between the thicknesses, regardless of the type of the CAD-CAM material. The thick LS OV outperformed the RC and control groups. The thin RC OV and control groups showed a higher percentage of repairable and possibly repairable failures than the other groups. LS was more homogeneous under SEM, and the EDS analysis detected Si and Zr, but not Li. CONCLUSIONS: A larger thickness did not improve the resistance of the CAD-CAM materials. Thick LS showed a higher cumulative survival rate to fatigue than the RC and control groups. The direct composite alone (control) survived similarly to the experimental groups, except for the thick LS.

Efficacy of iSupport-Brasil for unpaid caregivers of people living with dementia: protocol for a randomized and controlled clinical trial / Eficácia do iSupport-Brasil para cuidadores informais de pessoas que vivem com demência: protocolo de um ensaio clínico randomizado e controlado

ABSTRACT. Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers' mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer's Association, and both groups will be emailed the preliminary version of the "Guia de cuidados para a pessoa idosa" e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions.

RESUMO. Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde.

ISupport-Brasil: Preliminary results of the usability and acceptability assessment by caregivers of people who have dementia.

Objective: To assess usability and acceptability of iSupport-Brasil (iSupport-BR) to virtually support family caregivers of people who have dementia. Materials and methods: In the first stage, nine caregivers/former caregivers assessed the interface of the platform that hosts iSupport-BR. In the second stage, 10 caregivers assessed acceptability of the platform and answered the System Usability Scale (SUS), which varies from 0 to 100 points. A descriptive analysis of the quantitative data was performed, as well as a thematic analysis on the open questions. All the ethical aspects were respected. Results: The results of the first stage indicated a user-friendly interface of the system and relevant content of the program, with 55.6 and 77.8% of the participants assigning the maximum grade to these questions, respectively. Of the five possible points, the system's mean score was 3.7. In Stage 2, 80% of the caregivers rated the program as very useful and 100% would recommend it to other caregivers. Perception of the program's usability by the SUS scale was excellent (M = 86.5 ± 11.5). Conclusion: This research allowed elaborating the final version of iSupport-BR, considering usability and acceptability of the platform and the program for computers/notebooks, being a pioneer in evaluating it for use in smartphones. Future research studies will have to assess the effects of iSupport-BR on the caregivers' mental health.

Gonococci resistant to current antimicrobial management standards: a new threat to global public health.

Gonorrhea is the second most common sexually transmitted bacterial infection on the planet and is caused by a Gram-negative cocco, Neisseria gonorrhoeae. Currently, the preferred regimen for the management of this disease in Brazil is a combination of antimicrobials, in this case, ceftriaxone and azithromycin. However, over time, the gonococcus developed a decrease in susceptibility to the regimen used, which resulted in frank resistance to antimicrobials, progressively reducing the therapeutic options available. Thus, the study presented here aims to analyze and discuss the current scenario of resistance of N. gonorrhoeae to the antimicrobials used to date, to encourage discussion on the subject in the academic environment. For this purpose, 47 articles indexed in the Bireme, PubMed, Scielo and UpToDate platforms were selected.

Functional Status and Hospital Readmission After Pediatric Critical Disease: A Year Follow-Up.

OBJECTIVES: To evaluate the association between pediatric functional status at hospital discharge after PICU admission and hospital readmission within 1 year. DESIGN: Prospective longitudinal study. SETTING: Two PICUs in tertiary hospitals in South Brazil. PATIENTS: Children and adolescents admitted to the PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the following: clinical and sociodemographic characteristics, functional status using the Functional Status Scale-Brazil (FSS-Brazil) at baseline and at hospital discharge, and hospital readmission within 1 year. Hospital readmission risk was associated with possible related factors using Cox regression to estimate the hazard ratio (HR). A total of 196 patients completed the follow-up. At hospital discharge, 39.3% of children had some degree of decline in FSS-Brazil, and 38.3% had at least one nonelective hospital readmission within 1 year. FSS-Brazil rating at hospital discharge was associated with the risk of hospital readmission within 1 year (HR, 1.698; 95% CI, 1.016-2.838). CONCLUSION: FSS-Brazil rating at hospital discharge, age, and length of stay were associated with greater hazard of nonelective hospital readmission within 1 year of discharge.

Impact of New Complete Dentures on Oral Health-Related Quality of Life: A 12-Month Follow-up.

PURPOSE: To assess oral health-related quality of life (OHRQoL) in edentulous subjects before and after 3, 6, 9, and 12 months of oral rehabilitation with conventional complete dentures (CDs) and to compare their OHRQoL to dentate subjects. MATERIALS AND METHODS: A total of 148 subjects were selected and divided into three groups: G1 = edentulous in maxillary arch (n = 68, mean age = 61.37 ± 8.91 years); G2 = completely edentulous (n = 50, mean age = 65.14 ± 8.91 years); and G3 = control group (dentate, n = 30, mean age = 60.03 ± 6.88 years). OHRQoL was assessed using the Brazilian version of the Oral Health Impact Profile-Edentulous (OHIP-EDENT) questionnaire at four different times: baseline (pretreatment) and 3, 6, 9, and 12 months after oral rehabilitation with a new CD. The data showed nonparametric distribution and were submitted to Kruskal-Wallis test (± = .05). RESULTS: The impact of OHRQoL was higher for the edentulous groups compared to the control group at baseline (P < .05). Treatment significantly improved OHRQoL after 3 months of prosthesis use, and this effect was maintained during all 12 months of evaluation (P > .05). CONCLUSION: Oral rehabilitation with conventional CDs in one or both arches improved OHRQoL in edentulous patients after 3 months of prosthesis use, and its effect was maintained for up to 12 months.

Molecular detection of Toxoplasma gondii and Neospora caninum in neotropical primates.

BACKGROUND: Toxoplasma gondii and Neospora caninum infections in primates are potentially fatal and directly impact the conservation of these animals and public health. MATERIALS AND METHODS: A total of 38 blood/clot samples collected from free-living and captive neotropical primates undergoing clinical care or found dead by environmental authorities in the Mato Grosso State, Brazil, were analyzed by PCR for DNA detection of T. gondii and N. caninum. Furthermore, eight animals were submitted to immunohistochemistry for the detection of T. gondii. RESULTS: DNA of T. gondii and N. caninum was amplified in 11 (28.95%) 10 (26.32%) of samples analyzed, respectively. Coinfection was observed in three individuals. One animal returned a positive result in the immunohistochemistry for the detection of T. gondii. CONCLUSION: These findings reflect a concern for the conservation of these animals, as the pathogen-host interaction is unpredictable and infections by these protozoa can lead to animal mortality, which has a substantial impact on endangered species.