Impact of different fermentation times on the microbiological, chemical, and sensorial profile of coffees processed by self-induced anaerobiosis fermentation.

Variation in fermentation time may be an essential alternative to provide coffee beverages with different and unique sensory profiles. This work investigated the microbiological, chemical, and sensory changes in coffees submitted to different fermentation durations (0, 24, 48, 72, and 96 h). Self-induced anaerobiosis fermentation (SIAF) was used, and two treatments were performed: spontaneous fermentation and inoculation with S. cerevisiae CCMA0543. Microbiological analyses were performed, and the permanence of the inoculum was monitored. Chromatography (sugars, organic acids, and volatile compounds) was analyzed, and sensory analysis (temporal dominance of sensations - TDS) was performed. A total of 228 isolates were identified during spontaneous fermentation. The dominant bacteria and yeasts were Leuconostoc mesenteroides, Lactiplantibacillus plantarum, Staphylococcus warneri, Bacillus sp., Torulaspora delbrueckii, Hanseniaspora uvarum, and Meyerozyma caribbica. High concentrations of citric (18.67 mg.g- 1) and succinic (5.04 mg.g- 1) acids were detected at 96 h in SIAF fermentation. One hundred twenty-one volatile compounds were detected, but 22 were detected only in inoculated coffees. In spontaneous fermentation, 48 h of fermentation showed woody notes, while 72 h showed chestnuts. However, in the inoculated coffee, 72 h of fermentation showed high fruity dominance, and 96 h of fermentation was the only one with herbaceous notes. In addition, yeast inoculation increased the intensity of caramel notes in the first 48 h and increased the fruity flavor after 72 h of fermentation. Therefore, the type of fermentation (with or without inoculation) and the chosen fermentation time will depend on the sensorial profile the producer intends to obtain.

Use of microencapsulated starter cultures by spray drying in coffee under self-induced anaerobiosis fermentation (SIAF).

Using starter culture in liquid form is not economically viable in the coffee fermentation process. This work aimed to compare the fermentative performances of fresh and microencapsulated yeasts in coffee under self-induced anaerobic fermentation (SIAF). The inoculum permanence was monitored, and sugars, alcohols, acids, and volatile compounds were analyzed by chromatography. In addition, sensory analysis was performed on roasted beans. After 180 h of fermentation in the natural process, microencapsulated Torulaspora delbrueckii (MT) (7.97 × 107 cells/g) showed a higher population thanfresh Torulaspora delbrueckii (FT) (1.76 × 107 cells/g). The same acids and volatile compounds were detected in coffees with fresh and microencapsulated yeast. However, the yeast state influenced the concentration of the compounds. In pulped coffee, the coffee inoculated withmicroencapsulated Saccharomyces cerevisiae (MS) obtained the highest concentration of alcohols, esters, pyrazines, and others compared with fresh Saccharomyces cerevisiae (FS), with an increase of up to 47%. Furthermore, the coffee inoculated with MT obtained the highest concentration in almost all chemical classes in both processes compared with FT. These differences ranged up to 55%. Regarding sensory analysis, coffees inoculated with MS showed dominant notes of fruity, caramel, and nuts in the natural process. Otherwise, in pulped process, coffees inoculated with MT showed caramel, honey, and nuts. Therefore, the microencapsulated yeasts were metabolically active and may be considered with commercial potential. Considering the parameters analyzed, the most suitable yeast for natural and pulped processing would be MS and MT, respectively.

Consequences of oxygen deprivation on myelination and sex-dependent alterations.

Oxygen deprivation is one of the main causes of morbidity and mortality in newborns, occurring with a higher prevalence in preterm infants, reaching 20 % to 50 % mortality in newborns in the perinatal period. When they survive, 25 % exhibit neuropsychological pathologies, such as learning difficulties, epilepsy, and cerebral palsy. White matter injury is one of the main features found in oxygen deprivation injury, which can lead to long-term functional impairments, including cognitive delay and motor deficits. The myelin sheath accounts for much of the white matter in the brain by surrounding axons and enabling the efficient conduction of action potentials. Mature oligodendrocytes, which synthesize and maintain myelination, also comprise a significant proportion of the brain's white matter. In recent years, oligodendrocytes and the myelination process have become potential therapeutic targets to minimize the effects of oxygen deprivation on the central nervous system. Moreover, evidence indicate that neuroinflammation and apoptotic pathways activated during oxygen deprivation may be influenced by sexual dimorphism. To summarize the most recent research about the impact of sexual dimorphism on the neuroinflammatory state and white matter injury after oxygen deprivation, this review presents an overview of the oligodendrocyte lineage development and myelination, the impact of oxygen deprivation and neuroinflammation on oligodendrocytes in neurodevelopmental disorders, and recent reports about sexual dimorphism regarding the neuroinflammation and white matter injury after neonatal oxygen deprivation.

Microencapsulation of epiphytic coffee yeasts by spray drying using different wall materials: Implementation in coffee medium.

The storage of microorganisms in liquid form is the main drawback of commercializing epiphytic coffee yeasts. This work aimed to evaluate the fermentative performance of microencapsulated yeasts by spray drying in a coffee peel and pulp media (CPM). The yeasts, Saccharomyces cerevisiae CCMA 0543, Torulaspora delbrueckii CCMA 0684, and Meyerozyma caribbica CCMA 1738, were microencapsulated using maltodextrin DE10 (MD), high maltose (MA), and whey powder (WP) as wall materials. A Central Composite Rotational Design (CCRD) was used to investigate the effect of operating parameters on the microcapsules' cell viability, drying yield, and water activity. Yeasts reached cell viability and drying yields above 90 and 50 %, respectively. WP maintained the cell viability of the three yeasts over 90 days of storage at room temperature (25 °C) and was selected as a wall material for the three yeasts. M. caribbica showed to be more sensitive to spray drying and less resistant to storage. Some differences were found in the fermentation of the CPM medium, but the microencapsulated yeasts maintained their biotechnological characteristics. Therefore, the microencapsulation of epiphytic coffee yeasts by spray drying was promising to be used in the coffee fermentation process.

Microencapsulation by spray drying of coffee epiphytic yeasts Saccharomyces cerevisiae CCMA 0543 and Torulaspora delbrueckii CCMA 0684.

The objective of this work was to evaluate the microencapsulation feasibility of Saccharomyces cerevisiae CCMA 0543 and Torulaspora delbrueckii CCMA 0684 in three different compositions of wall material by spray-dryer. The yeasts (109 CFU mL-1) were microencapsulated separately using maltodextrin (15%), maltodextrin (15%) with sucrose (2%), or maltose (2%) as wall material. The viability was evaluated for 6 months at two different temperatures (7 and 25 °C). The yield, cell viability after spray drying, and characterization of the microcapsules were performed. Results indicate that cell viability ranged between 94.06 and 97.97%. After 6 months, both yeasts stored at 7 °C and 25 °C presented 107 and 102 CFU mL-1, respectively. Regarding Fourier-transform infrared spectroscopy analysis, all microencapsulated yeasts presented typical spectra footprints of maltodextrin. After 6 months of storage, S. cerevisiae CCMA 0543 obtained a 10.8% increase in cell viability using maltodextrin with maltose as wall material compared to maltodextrin and maltodextrin with sucrose. However, T. delbrueckii CCMA 0684 obtained a 13.5% increase in cell viability using only maltodextrin. The study showed that maltodextrin as a wall material was efficient in the microencapsulation of yeasts. It is possible to assume that maltose incorporation increased the cell viability of S. cerevisiae CCMA 0543 during storage.

Hip muscle strength, dynamic balance and functional capacity of community-dwelling older adults aged 60 and older: A cross-sectional study.

The objective of the present study was to evaluate the association of hip muscle strength, dynamic balance and functional capacity in the older adults aged 60 to 79 years and older adults aged 80 years and older. A total of 191 community-dwelling older adults participated in this study. Isometric muscle strength was quantified as the peak torque (PT), measured using an isokinetic dynamometer. Functional capacity was determined by the forward step test (ST) and the dynamic balance by the tandem gait (TG) test. The hip flexor, extensor, abductor and adductor PT in the older adults aged 60 to 79 years had a positive influence on the execution of the step test (p < 0.05). The peak adductor torque did not show a significant association with tandem gait (p = 0.649). In older adults aged 80 years and older, the peak adductor torque was the only one that showed an association with the performance of the ST (p = 0.001) and TG (p = 0.024) tests. The hip adductors may have a higher contribution in adults aged 80 years and older during the execution of clinical tests. These findings are relevant to clinical practice as they can help in the development of appropriate physical exercise programs targeting older adults of different age groups.

Impact of neonatal anoxia and hypothermic treatment on development and memory of rats.

Therapeutic hypothermia (TH) is well established as a standard treatment for term and near-term infants. However, therapeutic effects of hypothermia following neonatal anoxia in very premature babies remains inconclusive. The present rodent model of preterm neonatal anoxia has been shown to alter developmental milestones and hippocampal neurogenesis, and to disrupt spatial learning and memory in adulthood. These effects seem to be reduced by post-insult hypothermia. Epigenetic-related mechanisms have been postulated as valuable tools for developing new therapies. Dentate gyrus neurogenesis is regulated by epigenetic factors. This study evaluated whether TH effects in a rodent model of preterm oxygen deprivation are based on epigenetic alterations. The effects of TH on both developmental features (somatic growth, maturation of physical characteristics and early neurological reflexes) and performance of behavioral tasks at adulthood (spatial reference and working memory, and fear conditioning) were investigated in association with the possible involvement of the epigenetic operator Enhancer of zeste homolog 2 (Ezh2), possibly related to long-lasting effects on hippocampal neurogenesis. Results showed that TH reduced both anoxia-induced hippocampal neurodegeneration and anoxia-induced impairments on risk assessment behavior, acquisition of spatial memory, and extinction of auditory and contextual fear conditioning. In contrast, TH did not prevent developmental alterations caused by neonatal anoxia and did not restore hippocampal neurogenesis or cause changes in EZH2 levels. In conclusion, despite the beneficial effects of TH in hippocampal neurodegeneration and in reversing disruption of performance of behavioral tasks following oxygen deprivation in prematurity, these effects seem not related to developmental alterations and hippocampal neurogenesis and, apparently, is not caused by Ezh2-mediated epigenetic alteration.

The effect of unilateral muscle fatigue of hip abductor muscles on balance and functional capacity in community-dwelling older women.

BACKGROUND: Hip abductor muscles are important for the maintenance of postural stability, mainly on the mediolateral direction and unipodal support conditions. The objective of the present study was to evaluate the effect of unilateral induced fatigue of hip abductor muscles on balance and functional capacity of older women. METHODS: The study included physically independent women aged 60-75 years. We assessed static balance with the single limb stance test (SLS) and evaluated functional capacity with the maximum gait speed (MGS) and step test (ST). We ran the protocol of hip abductor muscle fatigue with a Biodex isokinetic dynamometer. Assessment of balance and functional capacity happened before and after the muscle fatigue protocol. We applied the t-test for repeated measures to determine whether unilateral hip abductor muscle fatigue influences the performance in the tests (SLS, MGS and ST). RESULTS: The protocol of hip abductor muscle fatigue negatively affected all three evaluated tasks: SLS (p = 0.000), ST (p = 0.000) and MGS (p = 0.000). However, the single limb stance test was the most task affected (effect size = 0.51, pre- and post-fatigue difference = 28.1 %). CONCLUSION: After the unilateral muscle fatigue of hip abductors, we observed the worst performance on clinical tests, mainly regarding the SLS test, which shows the involvement of hip abductors during usual motor tasks. However, the small magnitude of the limitation of functional tests (MGS and ST) suggests the presence of postural compensations.

Diagnostic Accuracy of Clinical Tests for the Indirect Assessment of Hip Abductor Muscle Strength in Community-Dwelling Older Women.

OBJECTIVE: The objective of this study was to determine the accuracy of 3 clinical tests (lateral step [LS], tandem gait [TG], and single-leg stance [SS]) in identifying older women with reduced hip abductor muscle strength and to determine the post-test probability of each test and of their combination in changing the certainty of diagnosis. METHODS: In this cross-sectional study, a total of 123 older women received clinical testing to obtain the variables LS height, time for TG execution, percentage of errors in TG, and time of permanence on SS and were tested for isometric hip abductor peak torque using an isokinetic dynamometer. Only the dominant lower limb was evaluated. Multiple linear regression analysis with adjustment was performed to determine the association among variables, followed by the receiver operating characteristic curve to identify clinical variables that can discriminate older women with reduced abductor muscle strength. Post-test probability was then calculated based on the receiver operating characteristic curve data. RESULTS: Although the 4 clinical variables showed correlation with abductor peak torque, only LS and TG time were able to discriminate reduced abductor muscle strength with low accuracy (area under the curve was between 0.5 and 0.7). However, the combination of LS and TG time increased post-test probability from 47% (prevalence of weakness in the population) to 76% when both tests were positive and reduced it from 47% to 18% when both tests were negative. CONCLUSION: The combination of the LS test and TG time is useful for the indirect assessment of hip abductor strength in community-dwelling older women. IMPACT: Hip abductor muscle strength is extremely important for function in older women. This study presents clinicians with simple, fast, and inexpensive methods for assessing hip abductor muscle strength.

Desenvolvimento de instrumental para a padronização do volume e da forma dos incrementos de resina composta direta e relato de caso clínico / Development of instruments for the standardization of volume and shape of direct composite resin increments and clinical case report

Objetivo: O presente trabalho teve por objetivo desenvolver um protótipo de instrumental clínico que possibilita a padronização do volume e forma da massa de resina composta para o uso em procedimentos restauradores direto, além de relato de caso demonstrando a aplicabilidade do protótipo. Para isso, foi selecionada uma empresa produtora de instrumentos odontológicos e ativa no mercado nacional com registro na ANVISA. Tendo como base um calcador de Holemback número 6, esse, foi reconfigurado geometricamente afim de atingir os requisitos necessários para o desenho pretendido. Após a etapa de desenvolvimento, esse novo instrumento foi utilizado para o relato de um caso clínico de restauração direta de resina composta envolvendo esmalte e dentina das superfícies ocluso-distal do dente 15 e oclusal do dente 16. Os tecidos dentais foram hibridizados pela técnica adesiva associada de condicionamento seletivo do esmalte com ácido fosfórico e aplicação de sistema adesivo auto-condicionate (Clearfil SE Bond, Kuraray, Japão) em esmalte e dentina. A restauração foi realizada com a resina composta Z350 XT (3M ESPE, USA) nas cores A1 e A2B. Conclusão: A utilização do protótipo de instrumental auxilia na execução de restaurações direta de resina composta com o favorecimento ao controle das tensões geradas pela contração de polimerização e poderá ter papel importante no treinamento restaurador dos profissionais(AU)

Objective: The objective of this work was to develop a prototype of clinical instruments that allows the standardization of the volume and shape of the composite resin mass for use in direct restorative procedures, besides a case report demonstrating the applicability of the prototype. For this, a company was selected to produce dental instruments and active in the national market with ANVISA registration. Based on a Holemback number 6 presser foot, it was geometrically reconfigured to meet the requirements for the intended design. After the development stage, this new instrument was used to report a clinical case of direct restoration of composite resin involving enamel and dentin of the occlusal-distal surfaces of the tooth 15 and occlusal of the tooth 16. The dental tissues were hybridized by the adhesive technique associated with the selective conditioning of the enamel with phosphoric acid and the application of auto-conditioning adhesive system (Clearfil SE Bond, Kuraray, Japan) in enamel and dentin. The restoration was performed with the composite resin Z350 XT (3M ESPE, USA) in colors A1 and A2B. Conclusion: The use of the prototype of auxiliary instruments in the execution of direct restorations of composite resin with the favoring to control the tensions generated by the polymerization contraction and may play an important role in the restorative training of professional(AU)

Coffee growing altitude influences the microbiota, chemical compounds and the quality of fermented coffees.

The objective of this work was to evaluate the influence of different altitudes on the epiphytic microbiota of coffee beans and on sensorial and chemical quality of coffees grown at 800, 1000, 1200, and 1400 m in Serra do Caparaó, Espírito Santo, Brazil. For microbiological analysis, the population counts of mesophilic bacteria, lactic acid bacteria (LAB), and yeasts were performed from the surface plating. The isolates were grouped and identified from the Matrix Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) and sequencing of the ribosomal region was used. The chemical composition of the green grains was evaluated by Raman spectroscopy, and the sensory analysis of the roasted grains was performed using temporal dominance of sensations (TDS). During fermentation, there was a decrease in the LAB in pulped coffee from 800 and 1000 m altitude, while an increase was observed at 1200 and 1400 m. In natural coffee, there was an increase of LAB population at all altitudes. The highest diversity of mesophilic bacteria and yeast were identified in natural 1400 m and 1000 m, respectively. However pulped coffee treatments it was at 1200 m and 800 m. The chlorogenic acid and fatty acids in the green bean changed with altitude variation and processing. The floral attribute was detected only at altitude 1400 m. Caramel, chocolate and almond attributes were most frequently detected in coffees at different altitudes and processing. Therefore, pulped coffee processing was most suitable at low altitude while at high altitudes, both processes can be conducted to obtain a beverage with unusual sensory profile.

Advances in the Management of Perioperative Patients' Thirst.

In response to an increase in osmolarity or a decrease in plasma volume, surgical patients often experience thirst during the perioperative period. Thirst causes intense discomfort for patients, but perioperative nurses and health care providers have received minimal direction on how to address this concern. This article presents evidence related to the advances in the management of patients' thirst and discusses clinical strategies that perioperative personnel can safely implement for their patients during the preoperative and postoperative periods. The Thirst Study and Research Group at Londrina State University, Brazil, developed the Thirst Management Model to provide a standardized method for perioperative personnel. Four pillars comprise this model: identification of thirst, measurement of thirst, safety assessment for the management of thirst, and application of relief strategies. This evidence-based model should assist perioperative nurses with translating knowledge and scientific evidence into clinical practice to provide safe patient care.

Production of coffee (Coffea arabica) inoculated with yeasts: impact on quality.

BACKGROUND: The aim of this study was to evaluate the performance of yeasts Saccharomyces cerevisiae CCMA 0200 and Torulaspora delbrueckii CCMA 0684 in Mundo Novo and Catuaí varieties processed by the wet method and the impact on sensory quality and compounds profile. The microbiota was evaluated by surface plating, and the compounds were evaluated by high-performance liquid chromatography and gas chromatography-mass spectrometry. Sensorial analysis was performed using the cupping test (Specialty Coffee Association). RESULTS: T. delbrueckii CCMA 0684 was better adapted to the process and remained for up to 72 h of drying. Eighteen volatile compounds were detected in green coffee and 75 in roasted coffee. 2-Furanmethanol propanoate and 2-ethyl-3,5-dimethylpyrazine were identified only in the inoculated treatments, and these are important contributors to the coffee aroma. All treatments received scores greater than 80 in the sensory analysis. CONCLUSION: T. delbrueckii CCMA 0684 presented better results in relation to the sensorial analysis and is preferable for the varieties and processing method studied. The use of starter cultures is a viable method with which to obtain high-quality coffees with a distinct flavor and thus add to value to the product. © 2019 Society of Chemical Industry.

Developing and validating the Perioperative Thirst Discomfort Scale.

OBJECTIVE: Developing and validating a scale to assess perioperative thirst discomfort. METHOD: A methodological research conducted in 2014 and 2015 at the surgical center of a public hospital in the north of Paraná, Brazil. The scale was developed after literature review, followed by face and content validation, and reliability assessment through its internal consistency and inter-observer equivalence. RESULTS: Seven items make up the scale: dry mouth; dry lips; thick tongue; thick saliva; dry throat, bad taste and desire to drink water. The content validity index for attributes and items was 0.98, and the reliability index was 1 for the scale attributes and items. Internal consistency assessed by Cronbach's alpha was 0.91 and inter-rater equivalence was 1, as measured by weighted kappa coefficient. CONCLUSION: ThePerioperative Thirst Discomfort Scaleshowed high content and reliability indexes. OBJETIVO: Elaborar e validar uma escala para avaliação do desconforto da sede perioperatória. MÉTODO: Pesquisa metodológica realizada em 2014 e 2015, no centro cirúrgico de um hospital público do norte do Paraná. A escala foi elaborada após revisão bibliográfica, seguida de validação aparente e de conteúdo e avaliação da fidedignidade através de sua consistência interna e da equivalência inter observadores. RESULTADOS: Sete itens compuseram a escala: boca seca; lábios ressecados; língua grossa; saliva grossa; garganta seca; gosto ruim e vontade de beber água. O índice de validade de conteúdo para atributos e itens foi de 0,98, e o índice de fidedignidade foi de 1 para os atributos e itens da escala. A consistência interna avaliada pelo alfa de Cronbach foi de 0,91, e a equivalência interobservadores foi de 1, medida pelo coeficiente de kappa ponderado. CONCLUSÃO: A escala de desconforto da sede perioperatóriademonstrou altos índices de validade de conteúdo e fidedignidade.

[Conicity index as a predictor of changes in the lipid profile of adolescents in a city in Northeast Brazil]. / Índice de conicidade como preditor de alterações no perfil lipídico em adolescentes de uma cidade do Nordeste do Brasil.

The objective was to evaluate the conicity index (C Index) as a predictor of changes in the lipid profile of adolescents and to establish its cutoff points. This was a cross-sectional study in 774 adolescents of both sexes (55% girls), 10 to 14 years of age. C Index was calculated according to the formula proposed by Valdez, considering body mass, height, and waist circumference (WC). Changes in the adolescents' lipid profile were defined according to one of the following conditions: elevated levels of total cholesterol, low-density lipoprotein (LDL), and triglycerides and low levels of high-density lipoprotein (HDL). The predictive power of the conicity index for altered lipid profile and its cutoff points were determined by Receiver Operating Characteristic (ROC) curves. The C Index was a good predictor of lipid alterations in adolescents, emphasizing triglycerides in boys 10 to 11 years of age (ROC = 0.67; 95%CI: 0.50-0.85) and 12 to 14 (ROC = 0.69; 95%CI: 0.59-0.80), and in girls 10 to 11 years (ROC = 0.65; 95%CI: 0.50-0.79); and LDL in girls 10 to 11 years (ROC = 0.70; 95%CI: 0.59-0.80) and boys (ROC = 0.65; 95%CI: 0.55-0.75) and girls (ROC = 0.62; 95%CI: 0.50-0.75) 12 to 14 years. The cutoff points for the C Index varied from 1.12 to 1.16 between boys and girls. The C Index can be used to predict lipid alterations, and its cutoff points can be used to screen adolescents for risk of alterations in lipid profile.

Behavior of yeast inoculated during semi-dry coffee fermentation and the effect on chemical and sensorial properties of the final beverage.

Pulped Mundo Novo and Ouro Amarelo coffee beans were inoculated with Saccharomyces cerevisiae (CCMA 0200 and CCMA 0543) during semi-dry coffee fermentation and compared with a non-inoculated control. Samples were collected throughout the fermentation process (12days) to evaluate the persistence of the inoculum by Real-Time quantitative PCR (qPCR). Also, the chemical composition of the beans was determined by HPLC and GC-MS and the roasted beans were sensorial evaluated using the cupping test. S. cerevisiae CCMA 0543 had an average population of 5.6logcell/g (Ouro Amarelo cultivar) and 5.5logcell/g (Mundo Novo cultivar). Citric, malic, succinic and acetic acid were found in all samples, along with sucrose, fructose, and glucose. There were 104 volatile compounds detected: 49 and 55 in green and roasted coffee, respectively. All coffee samples scored over 80 points in the cupping test, indicating they were specialty-grade. Inoculation with the CCMA 0543 strain performed better than the CCMA 0200 strain. This is the first time that qPCR has been used to assess the persistence of the inoculated strains populations during coffee processing. Strain CCMA 0543 was the most suitable as an inoculant due to its enhanced persistence during the process and number of volatile compounds produced.

Avaliação das dimensões da sede: revisão integrativa / Assessment of the thirst dimension: integrative review

A sede é um sintoma multifatorial e subjetivo cuja mensuração requer múltiplos instrumentos. O objetivo deste estudo foi identificar as dimensões de avaliação da sede e os instrumentos de mensuração utilizados. Incluíram-se artigos publicados entre 2005 a 2015 das bases de dados Lilacs, PubMed e SciELO. A amostra final foi de 18 artigos que evidenciaram as dimensões da sede: intensidade, frequência e desconforto. Também se avaliou a xerostomia e sua intensidade. Essas dimensões foram identificadas por Escalas Visuais Analógicas, Escalas Verbais Numéricas, Escalas de Faces e Escalas Likert, empregadas no Inventário de Sede, Inventário de Xerostomia e Escala de Desconforto da Sede. Avaliou-se a sede principalmente em pacientes dialíticos e internados em unidade de terapia intensiva. Embora a sede seja um sintoma, sua avaliação concentra-se sobretudo na intensidade e é realizada em populações específicas.

Thirst is a multifactorial and subjective symptom that request multiple measuring instruments. The objective of this study was to identify the assessment dimensions of thirst and the measurement tools used. We included studies published between 2005 and 2015 from the databases Lilacs, PubMed and SciELO. Eighteen articles composed the final sample that showed thirst dimensions: intensity, frequency, and discomfort. We also assessed the xerostomia and its intensity. These dimensions were identified by Visual Analogic Scales, Verbal Numeric Scales, Face's Scales and Likert-type Scales, used in the Thirst Inventory, Xerostomia Inventory, and Thirst Discomfort Scale. We assessed thirst especially in dialytic patients and the ones admitted to the intensive care unit. Although thirst is a symptom, in general, its assessment concentrates in its intensity, and it is conducted in specific populations

Índice de conicidade como preditor de alterações no perfil lipídico em adolescentes de uma cidade do Nordeste do Brasil / Conicity index as a predictor of changes in the lipid profile of adolescents in a city in Northeast Brazil / Índice de conicidad como predictor de alteraciones en el perfil lipídico en adolescentes de una ciudad del nordeste de Brasil

Resumo: O objetivo foi avaliar o indice de conicidade (Índice C) como preditor de alterações no perfil lipídico em adolescentes e estabelecer seus pontos de corte. Estudo transversal com 774 adolescentes de ambos os sexos (55% do sexo feminino), de 10 a 14 anos de idade. O Índice C foi calculado de acordo com a fórmula proposta por Valdez, considerando as medidas de massa corporal, estatura e circunferência da cintura (CC). As alterações no perfil lipídico dos adolescentes foram definidas segundo uma das seguintes condições: elevados níveis de colesterol total, lipoproteína de alta densidade (LDL), triglicerídeos e níveis baixos de lipoproteína de baixa densidade (HDL). O poder preditivo do Índice C para alterações no perfil lipídico, assim como seus pontos de corte, foi determinado por meio das curvas ROC (Receiver Operating Characteristic). O Índice C foi um bom preditor para alterações lipídicas em adolescentes, com destaque para os níveis de triglicerídeos em adolescentes do sexo masculino de 10 a 11 anos (ROC = 0,67; IC95%: 0,50-0,85) e de 12 a 14 anos (ROC = 0,69; IC95%: 0,59-0,80), assim como em adolescentes do sexo feminino de 10 a 11 anos (ROC = 0,65; IC95%: 0,50-0,79); e LDL em adolescentes do sexo feminino de 10 a 11 anos (ROC = 0,70; IC95%: 0,59-0,80) e adolescentes do sexo masculino (ROC = 0,65; IC95%: 0,55-0,75) e adolescentes do sexo feminino (ROC = 0,62; IC95%: 0,50-0,75) de 12 a 14 anos. Os pontos de corte do Índice C variaram de 1,12 a 1,16 entre meninos e meninas. O Índice C pode ser utilizado para predizer alterações lipídicas, bem como seus pontos de corte podem ser utilizados para triagem de adolescentes em risco de alterações no perfil lipídico.

Abstract: The objective was to evaluate the conicity index (C Index) as a predictor of changes in the lipid profile of adolescents and to establish its cutoff points. This was a cross-sectional study in 774 adolescents of both sexes (55% girls), 10 to 14 years of age. C Index was calculated according to the formula proposed by Valdez, considering body mass, height, and waist circumference (WC). Changes in the adolescents' lipid profile were defined according to one of the following conditions: elevated levels of total cholesterol, low-density lipoprotein (LDL), and triglycerides and low levels of high-density lipoprotein (HDL). The predictive power of the conicity index for altered lipid profile and its cutoff points were determined by Receiver Operating Characteristic (ROC) curves. The C Index was a good predictor of lipid alterations in adolescents, emphasizing triglycerides in boys 10 to 11 years of age (ROC = 0.67; 95%CI: 0.50-0.85) and 12 to 14 (ROC = 0.69; 95%CI: 0.59-0.80), and in girls 10 to 11 years (ROC = 0.65; 95%CI: 0.50-0.79); and LDL in girls 10 to 11 years (ROC = 0.70; 95%CI: 0.59-0.80) and boys (ROC = 0.65; 95%CI: 0.55-0.75) and girls (ROC = 0.62; 95%CI: 0.50-0.75) 12 to 14 years. The cutoff points for the C Index varied from 1.12 to 1.16 between boys and girls. The C Index can be used to predict lipid alterations, and its cutoff points can be used to screen adolescents for risk of alterations in lipid profile.

Resumen: El objetivo fue evaluar el índice de conicidad (Índice C), como predictor de alteraciones en el perfil lipídico en adolescentes y establecer sus puntos de corte. Métodos: estudio transversal con 774 adolescentes de ambos sexos (55% del sexo femenino), de 10 a 14 años de edad. El Índice C fue calculado de acuerdo con la fórmula propuesta por Valdez, considerando las medidas de masa corporal, estatura y circunferencia de la cintura (CC). Las alteraciones en el perfil lipídico de los adolescentes fueron definidas según una de las siguientes condiciones: elevados niveles de colesterol total, lipoproteína de alta densidad (LDL), triglicéridos y niveles bajos de lipoproteína de baja densidad (HDL). El poder predictivo del Índice C para alteraciones en el perfil lipídico, así como sus puntos de corte, fue determinado mediante las curvas ROC (Receiver Operating Characteristic). El Índice C fue un buen predictor para alteraciones lipídicas en adolescentes, destacando los niveles de triglicéridos en niños de 10 a 11 años (ROC = 0,67; IC95%: 0,50-0,85) y de 12 a 14 años (ROC = 0,69; IC95%: 0,59-0,80), así como en niñas de 10 a 11 años (ROC = 0,65; IC95%: 0,50-0,79); y LDL en niñas de 10 a 11 años (ROC = 0,70; IC95%: 0,59-0,80) y niños (ROC = 0,65; IC95%: 0,55-0,75) y niñas (ROC = 0,62; IC95%: 0,50-0,75) de 12 a 14 años. Los puntos de corte del Índice C variaron de 1,12 a 1,16 entre niños y niñas. El Índice C puede ser utilizado para predecir alteraciones lipídicas, así como sus puntos de corte pueden ser utilizados para el cribado de adolescentes en riesgo de alteraciones en su perfil lipídico.

Developing and validating the Perioperative Thirst Discomfort Scale / Elaboración y validación de escala de incomodidad de la sed perioperatoria / Elaboração e validação de Escala de Desconforto da Sede Perioperatória

Abstract OBJECTIVE Developing and validating a scale to assess perioperative thirst discomfort. METHOD A methodological research conducted in 2014 and 2015 at the surgical center of a public hospital in the north of Paraná, Brazil. The scale was developed after literature review, followed by face and content validation, and reliability assessment through its internal consistency and inter-observer equivalence. RESULTS Seven items make up the scale: dry mouth; dry lips; thick tongue; thick saliva; dry throat, bad taste and desire to drink water. The content validity index for attributes and items was 0.98, and the reliability index was 1 for the scale attributes and items. Internal consistency assessed by Cronbach's alpha was 0.91 and inter-rater equivalence was 1, as measured by weighted kappa coefficient. CONCLUSION ThePerioperative Thirst Discomfort Scaleshowed high content and reliability indexes.

Resumen OBJETIVO Elaborar y validar una escala para evaluación de la incomodidad de la sed perioperatoria. MÉTODO Investigación metodológica realizada en 2014 y 2015, en el quirófano de un hospital público del norte de Paraná. La escala fue elaborada tras revisión bibliográfica, seguida de validación aparente y de contenido y evaluación de la credibilidad mediante su consistencia interna y la equivalencia entre los observadores. RESULTADOS Siete puntos compusieron la escala: boca seca; labios resecos; lengua gruesa; saliva gruesa; garganta seca; gusto malo y deseo de beber agua. El índice de validez de contenido para atributos indicadores fue de 0,98 y el índice de credibilidad fue de 1 para los atributos y puntos de la escala. La consistencia interna evaluada por el alfa de Cronbach fue de 0,91 y la equivalencia entre observadores fue de 1, medida por el coeficiente de kappa ponderado. CONCLUSIÓN La escala de incomodidad de la sed perioperatoria demostró altos índices de validez de contenido y credibilidad.

Resumo OBJETIVO Elaborar e validar uma escala para avaliação do desconforto da sede perioperatória. MÉTODO Pesquisa metodológica realizada em 2014 e 2015, no centro cirúrgico de um hospital público do norte do Paraná. A escala foi elaborada após revisão bibliográfica, seguida de validação aparente e de conteúdo e avaliação da fidedignidade através de sua consistência interna e da equivalência inter observadores. RESULTADOS Sete itens compuseram a escala: boca seca; lábios ressecados; língua grossa; saliva grossa; garganta seca; gosto ruim e vontade de beber água. O índice de validade de conteúdo para atributos e itens foi de 0,98, e o índice de fidedignidade foi de 1 para os atributos e itens da escala. A consistência interna avaliada pelo alfa de Cronbach foi de 0,91, e a equivalência interobservadores foi de 1, medida pelo coeficiente de kappa ponderado. CONCLUSÃO A escala de desconforto da sede perioperatóriademonstrou altos índices de validade de conteúdo e fidedignidade.

Percepção dos cuidadores quanto à sede da criança cirúrgica / Percepción de los cuidadores cuanto a la sed del niño quirúrgico / Perceptions of caregivers about surgical children's thirst

Objetivo compreender como o cuidador vivencia o jejum da criança cirúrgica e percebe sua sede no período perioperatório. Métodos pesquisa descritiva de natureza qualitativa, realizada com 15 acompanhantes de crianças entre 1 e 12 anos no pós-operatório em um hospital-escola. Para análise, utilizou-se o método do Discurso do Sujeito Coletivo. Resultados emergiram quatro unidades temáticas: A criança cirúrgica em face do jejum e da sede; Percebendo a sede na criança cirúrgica; Vivenciando e enfrentando o período de jejum e a sede junto da criança; Percebendo a ação da equipe em face da sede da criança. Para os familiares, a vivência do jejum é permeada de sentimentos, como impotência e angústia. A presença da sede, detectada pelo autorrelato e por sinais físicos, agrava esse sofrimento. Conclusão o manejo da sede amenizaria o sofrimento da criança e dos familiares. Por conseguinte, é necessário desenvolver estratégias de manejo da sede na criança.

Objetivo comprender cómo el cuidador experimenta el ayuno del niño quirúrgico y percibe su sed en el perioperatorio. Métodos estudio descriptivo, cualitativo, con 15 cuidadores de niños entre 1 y 12 años en postoperatoria en un hospital universitario. Para el análisis, se utilizó el método del Discurso del Sujeto Colectivo. Resultados surgieron cuatro unidades temáticas: Niño quirúrgico delante del ayuno y de la sed; Percibiendo la sed en el niño quirúrgico; Experimentar y enfrentarse el ayuno y sed con el niño; Percibiéndose la acción del equipo delante de la sed del niño. Para la familia, la experiencia del ayuno está llena de sentimientos, como impotencia y angustia. La presencia de la sed, detectada por auto-informe y signos físicos, exacerba ese sufrimiento. Conclusión el manejo de la sed aliviaría el sufrimiento del niño y familias. Por lo tanto, es necesario desarrollar estrategias de manejo de la sed en niño.

Objective to understand how caregivers experience surgical children's fasting and how they realize their thirst in the perioperative period. Methods descriptive study of qualitative nature, carried out with 15 caregivers of children between 1 and 12 years old after surgery in a teaching hospital. For analysis, the Collective Subject Discourse method was used. Results four thematic units emerged: surgical children in the presence of fasting and thirst; realizing thirst in surgical children; experiencing and facing the period of fasting and thirst with children; realizing the action of the health team in the presence of children's thirst. For families, the experience of fasting is permeated with feelings like helplessness and distress. The presence of thirst, detected by self-report and physical signs, exacerbates their suffering. Conclusion thirst management alleviates the suffering of children and families. It is therefore necessary to develop strategies for children's thirst management.