Surgically retrieved spermatozoa for ICSI cycles in non-azoospermic males with high sperm DNA fragmentation in semen.

Intracytoplasmic sperm injection (ICSI) using surgically retrieved spermatozoa outside the classic context of azoospermia has been increasingly used to overcome infertility. The primary indications include high levels of sperm DNA damage in ejaculated spermatozoa and severe oligozoospermia or cryptozoospermia, particularly in couples with ICSI failure for no apparent reason. Current evidence suggests that surgically retrieved spermatozoa for ICSI in the above context improves  outcomes, mainly concerning pregnancy and miscarriage rates. The reasons are not fully understood but may be related to the lower levels of DNA damage in spermatozoa retrieved from the testis compared with ejaculated counterparts. These findings are consistent with the notion that excessive sperm DNA damage  can be a limiting factor responsible for the failure to conceive. Using testicular in preference of low-quality ejaculated spermatozoa bypasses post-testicular sperm DNA damage caused primarily by oxidative stress, thus increasing the likelihood of oocyte fertilization by genomically intact spermatozoa. Despite the overall favorable results, data remain limited, and mainly concern males with confirmed sperm DNA damage in the ejaculate. Additionally, information regarding the health of ICSI offspring resulting from the use of surgically retrieved spermatoa of non-azoospermic males is still lacking. Efforts should be made to improve the male partner's reproductive health for safer ICSI utilization. A comprehensive andrological evaluation aiming to identify and treat the underlying male infertility factor contributing to sperm DNA damage is essential for achieving this goal.

Slowly progressive invasive rhino-orbito-cerebral aspergillosis: case report and literature review.

This is a report of a patient with aspergillosis infection, which was thought to be a tumoral lesion during its investigation. This is not a common disease in Western countries, and this report should increase our awareness for differential diagnosis of nasal masses. Early diagnosis is desired in order to increase the survival rates.

TRANSPORTING CHILDREN IN CARS AND THE USE OF CHILD SAFETY RESTRAINT SYSTEMS

ABSTRACT Objective: To evaluate the transport of children in automobiles and the use of child restraints systems (CRS). Methods: This is a transversal descriptive study which included 200 vehicle drivers who carried 0-10 year old children in the city of São Luis, MA, Brazil. The drivers' passengers' and children's features were properly identified. The children's transportation using CRS were analyzed according to the Resolution 277/8 of the Brazilian National Traffic Department. Results: The transportation of children was classified as inappropriate in 70.5% of the vehicles analyzed. The most common way for children transportation was free on the back seats (47%) or on the lap of passengers/drivers (17%). The main reasons to justify the improper transportation were either not understanding the importance of CRS use (64.5%) or not having financial resources to buy the devices. The child safety seat was the most used CRS (50.8 %) among vehicles with proper child transportation system. Conclusion: The transportation of children was inappropriate in most of the vehicles analyzed, reflecting the need for creating awareness among automobile drivers, including education, supervision and improvement of policies for health improvement and prevention of accidents involving children transportation. Level of Evidence III, Cross Sectional Study.

TRANSPORTING CHILDREN IN CARS AND THE USE OF CHILD SAFETY RESTRAINT SYSTEMS.

OBJECTIVE: To evaluate the transport of children in automobiles and the use of child restraints systems (CRS). METHODS: This is a transversal descriptive study which included 200 vehicle drivers who carried 0-10 year old children in the city of São Luis, MA, Brazil. The drivers' passengers' and children's features were properly identified. The children's transportation using CRS were analyzed according to the Resolution 277/8 of the Brazilian National Traffic Department. RESULTS: The transportation of children was classified as inappropriate in 70.5% of the vehicles analyzed. The most common way for children transportation was free on the back seats (47%) or on the lap of passengers/drivers (17%). The main reasons to justify the improper transportation were either not understanding the importance of CRS use (64.5%) or not having financial resources to buy the devices. The child safety seat was the most used CRS (50.8 %) among vehicles with proper child transportation system. CONCLUSION: The transportation of children was inappropriate in most of the vehicles analyzed, reflecting the need for creating awareness among automobile drivers, including education, supervision and improvement of policies for health improvement and prevention of accidents involving children transportation. Level of Evidence III, Cross Sectional Study.

Fatores de estresse relacionado ao trabalho: as vozes dos atendentes de telemarketing / Stress factors related to working conditions: what telemarketing attendants have to say

A elevada rotatividade e o crescimento do número de casos de transtornos mentais entre os atendentes de telemarketing é resultado do trabalho penoso a que esses trabalhadores são submetidos. Este artigo teve por objetivo analisar os fatores organizacionais e psicossociais relacionados ao estresse e sofrimento psíquico percebidos pelos atendentes de uma empresa de telemarketing. Foi aplicado um questionário de avaliação do estresse no trabalho e criou-se um grupo focal para a discussão e identificação das principais categorias relacionadas com o sofrimento psíquico desses trabalhadores. A falta de controle e a falta de autonomia foram os principais fatores de estresse e sofrimento psíquico nos dois instrumentos, tanto no quantitativo, quanto nos grupos focais (qualitativo), ambos adotados neste estudo. Na percepção dos atendentes, a falta de transparência nos critérios de promoção e reconhecimento, a precariedade do suporte e o apoio da chefia e os relacionamentos conflitantes na organização pesquisada também influenciam negativamente a saúde mental destes sujeitos.

The high turnover and the increased incidence of mental disorders among telemarketing workers result from the burdensome work they are submitted to. This article evaluated the organizational and psychosocial factors related to stress and psychic suffering perceived by the attendants of a telemarketing company. A questionnaire was used to assess stress at work and a focal group was created for the discussion and identification of key categories related to psychological distress among these workers. The lack of control and autonomy were the main factors related to stress and psychic suffering in both quantitative and qualitative instruments used in this study. In the perception of the attendants, the aspects related to career and recognition, support and leadership, relationships and peer support are relevant to the mental health of these individuals.

Fatores de estresse relacionado ao trabalho: as vozes dos atendentes de telemarketing / Stress factors related to working conditions: what telemarketing attendants have to say

A elevada rotatividade e o crescimento do número de casos de transtornos mentais entre os atendentes de telemarketing é resultado do trabalho penoso a que esses trabalhadores são submetidos. Este artigo teve por objetivo analisar os fatores organizacionais e psicossociais relacionados ao estresse e sofrimento psíquico percebidos pelos atendentes de uma empresa de telemarketing. Foi aplicado um questionário de avaliação do estresse no trabalho e criou-se um grupo focal para a discussão e identificação das principais categorias relacionadas com o sofrimento psíquico desses trabalhadores. A falta de controle e a falta de autonomia foram os principais fatores de estresse e sofrimento psíquico nos dois instrumentos, tanto no quantitativo, quanto nos grupos focais (qualitativo), ambos adotados neste estudo. Na percepção dos atendentes, a falta de transparência nos critérios de promoção e reconhecimento, a precariedade do suporte e o apoio da chefia e os relacionamentos conflitantes na organização pesquisada também influenciam negativamente a saúde mental destes sujeitos.(AU)

The high turnover and the increased incidence of mental disorders among telemarketing workers result from the burdensome work they are submitted to. This article evaluated the organizational and psychosocial factors related to stress and psychic suffering perceived by the attendants of a telemarketing company. A questionnaire was used to assess stress at work and a focal group was created for the discussion and identification of key categories related to psychological distress among these workers. The lack of control and autonomy were the main factors related to stress and psychic suffering in both quantitative and qualitative instruments used in this study. In the perception of the attendants, the aspects related to career and recognition, support and leadership, relationships and peer support are relevant to the mental health of these individuals.(AU)