Stroke related sarcopenia in individuals with different physical activity levels: A cross-sectional study.

BACKGROUND AND OBJECTIVE: Individuals after stroke are likely to deal with the possible development of sarcopenia and reduced physical activity levels. The purpose of this study was to compare sarcopenia of individuals with chronic stroke who were stratified according to their physical activity levels, and to evaluate the relationship between sarcopenia and physical activity levels. MATERIALS AND METHODS: This cross-sectional study was conducted with individuals after chronic stroke recruited from the general community. Individuals were submitted to sarcopenia screening (SARC-F questionnaire) and assessment of physical activity levels (Human Activity Profile questionnaire) to classify the individuals as impaired, moderately active, and active according to their Adjusted Activity Status (AAS). ANOVA was used to investigate the sarcopenia between groups and Pearson's coefficient to investigate the association among variables. RESULTS: Fifty-four individuals with a mean age of 56 ± 17.4 years were included. Twenty-one percent of the individuals were screened for sarcopenia. Inactive individuals had higher mean scores in the SARC-F (3.6 ± 2.1 points), whereas moderately active and active individuals presented lower mean scores in the same questionnaire, being 1.2 ± 1.1 points and 0.5 ± 0.7 points, respectively. A statistically significant inverse and high association was found between sarcopenia and physical activity levels (r = -0.716; p < 0.01). CONCLUSION: Sarcopenia was found to be higher in individuals after chronic stroke with lower physical activity levels considered inactive when compared to individuals with higher physical activity levels. Furthermore, there was an inverse relationship between sarcopenia and physical activity level in stroke survivors.

Transtornos de personalidade: história do conceito e controvérsias atuais / Personality disorders: history of the concept and current controversies

Este trabalho tem como objetivo analisar a estruturação do diagnóstico de Transtorno de Personalidade. Inicialmente, o trabalho percorre o território conceitual com o qual, desde sua origem na passagem do século XVIII para o XIX, a psiquiatria procurou nomear, explicar e compreender as personalidades consideradas anormais. Em seguida promove-se uma discussão acerca das concepções de personalidade, normalidade e patologia que circunscrevem a categoria, orientada a partir do estudo de seus diferentes modelos diagnósticos presentes no DSM-5. Por fim busca-se compreender a relevância atual do diagnóstico de transtorno de personalidade através da análise de alguns exemplos de seu uso em contextos médico, legal e literário. O objetivo é o de entrever o lugar ocupado por esse diagnóstico, especialmente o do tipo Antissocial, no imaginário cultural presente

This work analyzes the processes through which the diagnosis of personality disorder has been structured. First, it covers the conceptual territory through which, from its origin in the passage of the eighteenth century to the nineteenth, psychiatry sought to name, to explain and to understand the so called abnormal personalities. This first step is followed by comments on the concepts of personality, normality and pathology that take part in the construction of this psychiatric category as it exists today. In order to do this, the structure of different diagnostic models present in the DSM-5 is analyzed. Finally, we seek to understand the current relevance of the diagnosis of personality disorder by taking into consideration examples of its use in medical, legal and literary contexts, in order to shed some light over the place occupied by this diagnosis, especially the anti-social type, in today's cultural landscape

Antilonomic effects of Brazilian brown seaweed extracts.

The aim of this work was to investigate the hemolysis and blood clotting activity of Lomonia obliqua venom and the ability of some Brazilian marine algal extracts (Canistrocarpus cervicornis, Stypopodium zonale and Dictyota pfaffi) to antagonize such biological activities. L. obliqua caterpillars are dangerous to human beings and envenomation symptoms are characterized by hemorrhagic, hemolytic and blood clotting disorders, and acute renal failure, which sometimes lead to the death of the victims. Through in vitro experiments we have shown that L. obliqua venom is able to clot human plasma and hemolize human erythrocytes and that the coagulation activity of the venom is inhibited by the extracts of C. cervicornis, S. zonale and D. pfaffi. In contrast, C. cervicornis and S. zonale extracts did not inhibit the hemolytic activity of L. oblqua, as did the extract of D. pfaffi. These finding indicate that marine algae may be used as antivenoms or may contribute to the development of compounds with antilonomic effects.

Necessidades de aprendizagem de profissionais de enfermagem na assistência aos pacientes com fístula arteriovenosa / Learning needs of professional nurses to care for patients with arteriovenous fistula / Necesidades de aprendizaje de profesionales de enfermería en la asistencia a pacientes con fístula arteriovenosa

Objetivo: Identificar as necessidades de aprendizagem de profissionais de enfermagem na prestação de assistência aos pacientes portadores de fístula arteriovenosa (FAV) em hemodiálise, a fim de melhorar os cuidados prestados a estes pacientes. Métodos: Trata-se de um estudo transversal, com coleta de dados realizada por meio de questionário semi-estruturado entregue aos profissionais de enfermagem que atuavam na unidade de hemodiálise de um Hospital Base do interior do Estado de São Paulo. Do total de 43 profissionais, 36 (83,7 por cento) responderam a esse questionário. Resultados: Dentre os 36 participantes do estudo, 44,9 por cento apresentaram dificuldades na assistência prestada ao paciente portador de FAV, sendo 47,2 por cento em puncionar a FAV; 19,4 por cento na hemostasia após a retirada das agulhas; 19,4 por cento informaram ter dúvidas na orientação dos pacientes e 13,9 por cento relataram falta de habilidade quando a FAV apresenta hematoma. Conclusão: Foi possível conhecer as necessidades de aprendizagem na assistência de enfermagem ao paciente portador de FAV e elaborar um protocolo para a assistência de enfermagem, a fim de melhor os cuidados prestados a estes pacientes.

Objective: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. Methods: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of São Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7 percent) responded and returned the questionnaires. RESULTS: A great number of nurses (44.9 percent) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2 percent), hemostasis of the site when withdrawing the needle after hemodialysis (19.4 percent) and lack of competency for the management of hematoma (13.9 percent), and patient's instructions and education (19.4 percent). Conclusions: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.

Objetivo: Identificar las necesidades de aprendizaje de profesionales de enfermería en la asistencia a los pacientes portadores de fístula arteriovenosa (FAV) en hemodiálisis a fin de mejorar los cuidados prestados a estos pacientes. Métodos: Se trata de un estudio transversal, cuya recolección de datos fue realizado por medio de un cuestionario semi-estructurado entregado a los profesionales de enfermería que actuaban en la unidad de hemodiálisis de un Hospital Base del interior del Estado de Sao Paulo. Del total de 43 profesionales, 36 (83,7 por ciento) respondieron el cuestionario. Resultados: De los 36 participantes del estudio, el 44,9 por ciento presentaron dificultades en la asistencia prestada al paciente portador de FAV, siendo el 47,2 por ciento en la punción de la FAV; el 19,4 por ciento en la hemostasia después del retiro de las agujas; el 19,4 por ciento informaron tener dudas en la orientación de los pacientes y el 13,9 por ciento relataron falta de habilidad cuando la FAV presenta hematoma. Conclusión: Fue posible conocer las necesidades de aprendizaje en la asistencia de enfermería al paciente portador de FAV y elaborar un protocolo para la asistencia de enfermería, a fin de mejorar los cuidados prestados a estos pacientes.