Ginástica Laboral em Centro Pós-Covid: relato de experiência do PetSaúde Gestão e Assistência / Labor Gymnastics in a Post-Covid Center: experience report of Pet-Saúde Management and Assistance / Gimnasio Laboral en un Centro Post-Covid: informe de experiencia de PetSaúde Gestión y Asistencia

Objetivo: relatar experiência da ginástica laboral por integrantes do Programa de Educação pelo Trabalho para Saúde Gestão e Assistência em Centro de Tratamento Pós-Covid. Método: Relato de experiência sobre a vivência da ginástica laboral por integrantes do programa na implantação do projeto: 'Em Movimento com integrantes do Programa de Educação pelo Trabalho para Saúde Gestão e Assistência em Centro de Tratamento Pós-Covid: contribuição da ginástica laboral', idealizado durante as atividades no cenário no período de agosto de 2022 a julho de 2023. Foi confeccionado um card informativo para guiar as atividades e conduzido pelo bolsista de educação física, sendo as observações relatadas em um diário de campo para avaliação da prática. Resultados: Foram realizados 10 encontros de ginástica laboral com os participantes, sendo aplicada primeiramente a ginástica de aquecimento e nos outros encontros, outras modalidades (relaxamento e compensatória) foram inseridas de acordo com a aceitabilidade dos trabalhadores, que avaliaram como positivo o projeto. Conclusão: A realização da vivência mostrou-se exitosa por possibilitar a socialização dos trabalhadores no momento de pausa durante a ginástica laboral, estimular a prevenção de doenças ocupacionais, possível diminuição dos custos com afastamentos por doenças osteoarticulares, aumento da produtividade e melhora do clima organizacional.

Objective: to report the experience of labor gymnastics by members of Program for Learning Trough Work for Health Management and Assistance in a Post-Covid Treatment Center. Method: Experience report on the experience of labor gymnastics by members of the program in the implementation of the project: 'In Motion with members of the Program for Learning Trough Work for Health Management and Assistance in a Post-Covid Treatment Center: contribution of labor gymnastics', idealized during activities in the scenario in the period from August 2022 to July 2023. An information card was made to guide the activities and conducted by the physical education fellow, and the observations reported in a field diary to evaluate the practice. Results: 10 labor gymnastics meetings were held with the participants, with warm-up gymnastics being applied in the first and during the meetings, other modalities (relaxation and compensatory) were inserted according to the acceptability of the workers, who evaluated the project as positive. Conclusion: The realization of the experience proved to be successful for enabling the socialization of workers at the time of break during the GL, stimulating the prevention of occupational diseases, possible reduction of costs with leaves due to osteoarticular diseases and increased productivity and improvement of the organizational climate.

Objetivo: relatar la experiencia de gimnasia laboral por integrantes del "Programa de Educação pelo Trabalho para Saude" Gestión y Asistencia en un Centro de Tratamiento Post-Covid. Método: Informe de experiencia sobre la experiencia de GL por miembros del programa en la implementación del proyecto: 'En movimiento con miembros de Gestión y Asistencia en un Centro de Tratamiento Post-Covid: contribución"Programa de Educação pelo Trabalho para Saude" de la gimnasia laboral', idealizado durante actividades en el escenario en el período de agosto de 2022 a julio de 2023. Se elaboró una ficha informativa para orientar las actividades y conducida por el becario de educación física, y las observaciones reportadas en un diario de campo como forma de evaluación de la práctica. Resultados: Se realizaron 10 encuentros gimnasia laboral con los participantes, aplicándose gimnasia de calentamiento en el primer momento y durante los encuentros se insertaron otras modalidades (relajación y compensatoria) según la aceptabilidad de los trabajadores, quienes evaluaron el proyecto como positivo. Conclusión: La realización de la experiencia demostró ser exitosa por posibilitar la socialización de los trabajadores en el momento del descanso durante la gimnasia laboral, estimulando la prevención de enfermedades profesionales, posible reducción de costos con bajas por enfermedades osteoarticulares y aumento de la productividad y mejora de la clima organizacional.

Recommendations on robotic-assisted radical prostatectomy: a Brazilian experts' consensus.

Radical prostatectomy is a commonly adopted treatment for localized/locally advanced prostate cancer in men with a life expectancy of ten years or more. Robotic-assisted radical prostatectomy (RARP) is comparable to open radical prostatectomy on cancer control and complication rates; however, new evidence suggests that RARP may have better functional outcomes, especially with respect to urinary incontinence and erectile dysfunction. Some of the surgical steps of RARP are not adequately described in published literature and, as such, may have an impact on the final outcomes of the procedure. We organized a Brazilian experts' panel to evaluate best practices in RARP. The confection of the recommendations broadly involved: selection of the experts; establishment of working groups; systematic review of the literature and elaboration of a questionnaire; and construction of the final text with the approval of all participants. The participants reviewed the publications in English from December 2019 to February 2020. A one-round Delphi technique was employed in 188 questions. Five reviewers worked on the final recommendations using consensual and non-consensual questions. We found 59.9% of questions with greater than 70% agreement that were considered consensual. Non-consensual questions were reported according to the responses. The recommendations were based on evidence-based literature and individual perceptions adapted to the Brazilian reality, although some issues remain controversial. We believe that these recommendations may help urologists involved in RARP and hope that future discussions on this surgical procedure may evolve over the ensuing years.

The effect of the biflavonoid 2″,3″-dihydroochnaflavone on Trypanosoma cruzi Y strain.

Trypanosoma cruzi is the causative agent of Chagas disease which affects 8 million people in Latin America. The parasite possesses high capacity to evade host immune system and the available drugs to treat Chagas disease present low efficacy combined to serious side effects to patients. Therefore, the identification of alternative therapeutics is essential. Brazilian flora exhibits an immense diversity of metabolites with great potential to be developed into new drugs. We investigated the action of 2″,3″-dihydroochnaflavone a biflavonoid extracted from Luxemburgia nobilis Eichler ex Engl. (Ochnaceae) against T. cruzi (Y strain). Our experiments showed that this compound is effective against parasite epimastigote forms, presenting IC50 value of (2.5 ± 0.1) µM after 96 h of treatment. Ultrastructure alterations were also detected in treated epimastigotes especially mitochondrial enlargement at the kinetoplast region. At the concentration of 30 µM, the compound killed (61.6 ± 3.37)% of the parasite in its amastigote form. In addition, at the same concentration, the compound killed all trypamastigotes growing within murine macrophages after 7-9 days of infection. Nonetheless, the biflavonoid concentrations were harmless to murine enriched population of lymphocytes and peritoneal macrophages. These results indicate that 2″,3″- dihydroochnaflavone presents activity against T. cruzi.

O uso da abdominoplastia reversa para o tratamento de queimadura química em região toracoabdominal / The use of reverse abdominoplasty for treatment of chemical burn in the thoracoabdominal region

A queimadura química é um desafio devido à sua agressividade em comparação com as queimaduras térmicas. A profundidade e extensão das lesões em diferentes áreas do corpo nos levam a buscar diferentes possibilidades para auxiliar no melhor tratamento do paciente. Foi proposto, a partir da técnica cirúrgica abdominoplastia reversa, um retalho cutâneo que pudesse reduzir a área exposta de uma paciente vítima de queimadura química. O resultado foi satisfatório, reduziu tempo de tratamento, cirúrgico e de internação da paciente, evidenciando uma ferramenta importante de reconstrução toracoabdominal.

Chemical burn is a challenge owing to its severity compared to thermal burns. The depth and extent of lesions in different areas of the body lead us to look for different possibilities for the best treatment of the patient. A reverse abdominoplasty surgical technique was proposed; this involves a skin flap that could reduce the exposed area of a chemical burn. The result was satisfactory, reducing the patient's treatment, surgical and hospitalization time, highlighting the proposed technique as an important tool for thoracoabdominal reconstruction.

B-1 Cells May Drive Macrophages Susceptibility to Trypanosoma cruzi Infection.

B-1 cells can directly and indirectly influence the immune response. These cells are known to be excellent producers of natural antibodies and can secrete a variety of immunomodulatory molecules. They are also able to differentiate into B-1 cell-derived phagocytes (B-1CDP). B-1 cells can modulate macrophages to become less effective, and B-1CDP cells are more susceptible in infection models. In this work, we investigated the microbicidal ability of these cells in Trypanosoma cruzi infection in vitro. The results show that macrophages from BALB/c mice are more susceptible to infection than macrophages from XID mice. The resistance observed in macrophages from XID mice was abolished in the presence of B-1 cells, and this event seems to be associated with IL-10 production by B-1 cells, which may have contributed to the decrease of NO production. Additionally, B-1CDP cells were more permissive to intracellular T. cruzi infection than peritoneal macrophages. These findings strongly suggest that B-1 cells and B-1CDP cells have a potential role in the persistence of the parasite in host cells.

Anesthesia recovery comparison between remifentanil-propofol and remifentanil-desflurane guided by Bispectral Index® monitoring / Comparação da recuperação pós-anestésica entre remifentanil-propofol e remifentanil-desflurano guiada pela monitoração do Índice Bispectral®

Abstract Background and objectives There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS®). Methods Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES). After the discontinuation of the anesthetics, the times to extubation, to obey commands and to recover the airway protection reflex were recorted. In the post-anesthetic recovery room (PACU) it was recorded the occurrence of nausea and vomiting (PONV), scores of Ramsay sedation scale and of numeric pain scale (NPS), morphine dose and length of stay in the unit. Results Data from 38 patients were analyzed: 18 from REM-PRO and 20 from REM-DES group. Anesthesia times were similar (REM-PRO = 193 min, SD 79.9 vs. 175.7 min, SD 87.9 REM-DES; p = 0.5). REM-DES had shorter times than REM-PRO group: time to follow command (8.5 min; SD 3.0 vs. 5.6 min; SD 2.5; p = 0.0) and extubation time (6.2 min; 3.1-8.5 vs. 9.5 min; 4.9-14.4; p = 0.0). Times to recover airway protective reflex were similar: 16 patients from REM-PRO (88.9%) restored the airway protective reflex 2 min after extubation vs. 17 from REM-DES (89.5%); and 2 patients from REM-PRO (11.1%) vs. 2 from REM-DES (10.5%) 6 min after extubation, p = 1. Ramsay sedation score, NPS, PONV incidents, morphine dose and PACU stay of length PACU were also similar. Conclusion Remifentanil-desflurane-based anesthesia has a faster extubation time and to follow command than remifentanil-propofol-based anesthesia when both guided by BIS®.

Resumo Justificativa e objetivos Há uma forte demanda por recuperação pós-anestésica rápida e previsível com poucos efeitos adversos. A escolha do agente hipnótico pode influenciar isso. Este estudo investigou as diferenças da recuperação no pós-operatório entre as técnicas anestésicas com remifentanil-propofol e com remifentanil-desflurano ambas com monitoração guiada pelo índice bispectral (BIS ®). Métodos Foram randomicamente distribuídos 40 pacientes em dois grupos de acordo com a técnica anestésica aplicada: remifentanil-propofol (REM-PRO) e remifentanil-desflurano (REM-DES). Após a descontinuação dos anestésicos foram registrados os tempos para extubação, obedecer a comandos e recuperar o reflexo de proteção das vias aéreas. Na sala de recuperação pós-anestésica (SRPA) foi registrado a ocorrência de náuseas e vômitos (NVPO), os escores na escala de sedação de Ramsay e na escala numérica de dor (END), a dose de morfina utilizada e o tempo de permanência nesta unidade. Resultados Os dados de 38 pacientes foram analisados: 18 do grupo REM-PRO e 20 do grupo REM-DES. Os tempos de anestesia foram semelhantes (REM-PRO = 193 minutos, DP 79,9 vs. 175,7 minutos, DP 87,9 REM-DES; p = 0,5). O grupo REM-DES apresentou tempos mais curtos do que o grupo REM-PRO: tempo para obedecer a comandos (8,5 minutos; DP 3,0 vs. 5,6 minutos; DP 2,5; p = 0,0) e tempo de extubação (6,2 minutos; 3,1-8,5 vs. 9,5 minutos; 4,9-14,4; p = 0,0). Os tempos para recuperação do reflexo de proteção das vias aéreas foram semelhantes: 16 pacientes do grupo REM-PRO (88,9%) recuperaram o reflexo de proteção das vias aéreas dois minutos após a extubação vs. 17 do grupo REM-DES (89,5%) e dois pacientes do grupo REM-PRO (11,1%) vs. dois do REM-DES (10,5%) seis minutos após a extubação, p = 1. Os escores de Ramsay, NPS, a incidência de NVPO, a dose de morfina e o tempo de permanência na SRPA também foram semelhantes. Conclusão A anestesia com remifentanil-desflurano tem um perfil de recuperação da anestesia pós-anestésica mais rápido do que o da anestesia com remifentanil-propofol quando ambas guiadas pelo BIS®.

Canine Macrophage DH82 Cell Line As a Model to Study Susceptibility to Trypanosoma cruzi Infection.

Trypanosoma cruzi is an obligatory intracellular protozoan parasite, and it is the etiological agent of Chagas' disease that is endemic in the Americas. In addition to humans, a wide spectrum of mammals can be infected by T. cruzi, including dogs. Dogs develop acute and chronic disease, similar to human infection. T. cruzi can infect almost all cell types and after cell invasion, the metacyclics trypomastigotes localize in the cytoplasm, where they transform into amastigotes, the replicative form of T. cruzi in mammals. After amastigote multiplication and differentiation, parasites lyse host cells and spread through the body by blood circulation. In this work, we evaluated the in vitro ability of T. cruzi to infect a canine macrophage cell line DH82 compared with RAW264.7, a murine tissue culture macrophage. Our results have shown that the T. cruzi is able to infect, replicate and differentiate in DH82 cell line. We observed that following treatment with LPS and IFN-γ DH82 cells were more resistant to infection and that resistance was not related reactive oxygen species production in our system. In this study, we also found that DH82 cells became more susceptible to T. cruzi infection when cocultured with apoptotic cells. The analysis of cytokine production has showed elevated levels of the TGF-ß, IL-10, and TNF-α produced by T. cruzi-infected canine macrophages. Additionally, we demonstrated a reduced expression of the MHC class II and CD80 by infected DH82 cell line.

[Anesthesia recovery comparison between remifentanil-propofol and remifentanil-desflurane guided by Bispectral Index® monitoring]. / Comparação da recuperação pós-anestésica entre remifentanil­propofol e remifentanil­desflurano guiada pela monitoração do Índice Bispectral®.

BACKGROUND AND OBJECTIVES: There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS®). METHODS: Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES). After the discontinuation of the anesthetics, the times to extubation, to obey commands and to recover the airway protection reflex were recorted. In the post-anesthetic recovery room (PACU) it was recorded the occurrence of nausea and vomiting (PONV), scores of Ramsay sedation scale and of numeric pain scale (NPS), morphine dose and length of stay in the unit. RESULTS: Data from 38 patients were analyzed: 18 from REM-PRO and 20 from REM-DES group. Anesthesia times were similar (REM-PRO=193min, SD 79.9 vs. 175.7min, SD 87.9 REM-DES; p=0.5). REM-DES had shorter times than REM-PRO group: time to follow command (8.5min; SD 3.0 vs. 5.6min; SD 2.5; p=0.0) and extubation time (6.2 minutes; 3.1-8.5 vs. 9.5 minutes; 4.9-14.4; p=0.0). Times to recover airway protective reflex were similar: 16 patients from REM-PRO (88.9%) restored the airway protective reflex 2min after extubation vs. 17 from REM-DES (89.5%); and 2 patients from REM-PRO (11.1%) vs. 2 from REM-DES (10.5%) 6min after extubation, p=1. Ramsay sedation score, NPS, PONV incidents, morphine dose and PACU stay of length PACU were also similar. CONCLUSION: Remifentanil-desflurane-based anesthesia has a faster extubation time and to follow command than remifentanil-propofol-based anesthesia when both guided by BIS®.

Varizes de ceco não hemorrágicas / Variceal bleending not cecum

Introdução: paciente do sexo masculino, branco, com 54 anos, etilista crônico, assintomático, foi submetido à colonoscopia como método diagnóstico para prevenção de doença neoplásica, evidenciando-se a presença de varizes de ceco de médio e grosso calibre. O encontro de varizes no ceco associado à hipertensão portal é raro, sendo observado em 3,4% e está frequentemente associado ao acometimento difuso dos demais segmentos cólicos, além da esclerose ou trombose das veias mesentéricas ou mesmo à atresia do trato biliar.

Lipoma retal com exteriorização anal aguda / Lipoma rectal with acute anal exteriorization

Introdução: paciente J.F.M.N, masculino, 44 anos, admitido no setor de emergência com uma volumosa tumoração exteriorizada pelo ânus, acompanhado de hemorragia, dor hipogástrica e parada na eliminação de fezes. Encaminhado para procedimento cirúrgico, foi submetido à ressecção fragmentada por via transanal, cujos fragmentos apresentavam dimensões que variavam de 5 a 15 cm de extensão no maior eixo. O exame anatomopatológico demonstrou tratar-se de lipoma submucoso. Os lipomas são neoplasias benignas de origem mesenquimática, acometendo todo o trato gastrointestinal, sendo que os lipomas colorretais são encontrados em uma incidência de 0,2% a 0,6% em necrópsias. Em ordem decrescente, acometem cólon ascendente, ceco, transverso, cólon descendente, sigmoide e reto. Sua incidência é 1,5 a 2 vezes mais frequentes em mulheres, acometendo mais a faixa etária entre a 5ª e 6ª década de vida. Geralmente são assintomáticos, sendo os sintomas diretamente proporcionais ao seu tamanho e às suas complicações, que incluem: a intussuscepção, a enterorragia e a obstrução intestinal. A exteriorização pelo ânus é uma condição extremamente rara.

Robotic-assisted laparoscopic prostatectomy (RALP): a new way to training.

The implementation of RALP program is usually associated with a steep learning curve (LC). Fellows are proctored for few cases, with long operating times, inferior outcomes and an increased number of complications. We report the initial results of 100 RALP procedures performed in Rio de Janeiro, Brazil, with the implementation of a structured program. Our goal was to evaluate if our approach to training would yield a safer outcomes for patients undergoing the procedure during the LC. From October 2012 to January 2014, five surgeons began a training program in RALP. Each surgeon attended a certification course, wet lab, dry lab, didactic course and observed live cases. Each trainee performed 20 cases of RALP under supervision of an experienced preceptor. The median surgical time was 175 min [interquartile range (IQR) 141-180 min]. There were four complications Clavien II (4 %) and three Clavien IIIa (3 %), no conversions nor transfusions. The median estimated blood loss was 200 ml (IQR 150-300 ml). The median hospital stay was 2 days (IQR 1-2 days). The median catheterization time was 7 days (IQR 6-7 days). Overall positive surgical margin rate (PM) was 19 %; stage-specific PSM rates were 12 % in pT2 and 53 % in pT3. The biochemical recidive-free survival rate (PSA < 0.01 ng/ml) was 91 % over an average follow-up of 6 months. The continence rates were (no pad) 74 % within 3 months and 94 % within 6 months. The implementation of a training program with advanced precepting allowed us to overcome the initial LC with reasonable results and with minimal complications.

Ventilação e dificuldades relacionadas à obesidade / Ventilation and difficulties related to obesity

A obesidade é considerada uma epidemia global. O aumento na prevalência tem colocado o anestesista cada vez mais frente às consequências dessa doença. A alteração no sistema respiratório mais proeminente é a redução da capacidade residual funcional que ocorre, principalmente, devido à redução da complacência da caixa torácica e pulmonar. Isso repercute na mecânica respiratória e na troca de gasosa. Há várias estratégias para minimizar esse impacto na anestesia geral. A posição de proclive aumenta o tempo de apneia na indução. Devem-se evitar as posições de Trendelenburg e litotomia, por prejudicarema função respiratória. Merece extremo cuidado o preparo do manejo da via aérea em virtude do alto risco de dificuldades em ventilar e intubar. Antes da intubação, deve-se posicionar adequadamente o paciente. Outra estratégia é o uso de CPAP na pré-oxigenação e de manobras de recrutamento alveolar seguida de PEEP, que aumenta a relação PaO2 /FiO2 e a complacência do sistema respiratório, sem causar alteração significativa na hemodinâmica. Não há diferença substancial comprovada entre os modos ventilatórios, controlados à pressão ou a volume. Ventilação pulmonar protetora (VC<8mL/kg de peso previsto com recrutamento alveolar seguido de PEEP >5 cm de H2 O) tem sido indicada. Antes da extubação, deve-se: elevar o dorso da mesa cirúrgica em 30° ou posicionar a mesa em Trendelenburg reverso; reduzir a FiO2 até 40%, se possível; aspirar a via aérea; fazer manobra de recrutamento alveolar e manter PEEP até a extubação. A extubação deve ser feita quando o paciente estiver acordado. Se necessário, usar CPAP após extubação.

Obesity is considered a global epidemic. It's continuous increase in prevalence places the anesthestist in conflict with consequences of this condition. The most prominent alteration in the respiratory system is the reduction of the residual functional capacity, which occurs mainlydue to the reduction of the chest and lung complacence. This impacts o the mechanic respiratory and on gas exchange. There are several strategies to minimize this impact on general anesthesia. Proclive position increases the apnea time during induction. One should avoid to the maximum the Trendelenburg and lithotomy positions, since they worsen the respiratory function. Maximum caution should be taken in airway management due to the increased risk of difficulties of ventilation and intubation in the obese. Before intubation, the patient should be positioned properly. Another strategy is the use of CPAP during the pre-oxigenation phase and the application of alveolar recruitment maneuver in intraoperative period, followed by PEEP, which increases the PaO2/FiO2 ratio and the system respiratory complacence, without any significant change in hemodynamic. There is no proved substantial difference among ventilatory modes, pressure-control or volume-control. Protective pulmonar ventilation (Volume tidal < 8 mL/Kg of predicted body weight with alveolar recruitment followed by PEEP > 5 cm H20) has been indicated. Before extubation, it should be done: raise the back of the surgery table to 30° or place the table at reverse Trendelenburg; reduce FiO2 by 40%, if feasible; clear the airway; do the alveolar recruitment maneuver and keep PEEP until extubation.Extubation should be done when the patient is awake. If necessary, CPAP could be used after extubation.

Use of alloplastic meshes in abdominal wounds of rats with induced peritonitis.

BACKGROUND: The use of alloplastic meshes has been historically contra-indicated in patients with infection. AIM: To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. METHODS: Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. RESULTS: More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. CONCLUSION: The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse.

Use of alloplastic meshes in abdominal wounds of rats with induced peritonitis / Uso de telas inorganicas em feridas abdominais de ratos com peritonite induzida

Background : The use of alloplastic meshes has been historically contra-indicated in patients with infection. Aim : To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. Methods : Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. Results : More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. Conclusion : The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse. .

Racional: O uso de telas inorgânicas historicamente é contra-indicado em paciente com infecções. Objetivo : Avaliar o comportamento e cicatrização de paredes abdominais com uso de telas de polipropileno após infecções intra-cavitárias. Método : Foram estudadas 20 ratas Wistar aleatoriamente divididas nos grupos Estudo (com peritonite) e Controle (sem peritonite). Um defeito na parede abdominal foi criado em todos os animais, onde foi aplicada tela de polipropileno. Foi feita avaliação da força de tensão com uso de tensiômetro, além de análise histológica da área cicatricial. Resultados : Observou-se maior adesividade da tela às paredes dos animais do grupo Estudo quando comparado ao grupo Controle. A análise histopatológica mostrou prevalência de tecido de granulação de acentuado à moderado em ambos os grupos, sem diferença significativa. Conclusão : O uso de telas inorgânicas nos defeitos da parede abdominal em ratos com peritonite induzida não mostrou resultado pior do que aquele obtido de animais sem infecção, tanto em relação à sua integração quanto ao tecido cicatricial no defeito da parede abdominal. .

Tratamento da esporotricose felina refratária com a associação de iodeto de potássio e itraconazol oral / Treatment of refractory feline sporotrichosis with the association of potassium iodide and oral itraconazole

A esporotricose é uma micose causada por espécies do complexo Sporothrix. Apesar do itraconazol ser o fármaco de escolha devido a sua efetividade e segurança, casos de falência terapêutica em gatos com esta micose têm sido descritos. O iodeto de potássio em cápsulas é uma opção terapêutica nos casos felinos. Adicionalmente, este fármaco é uma alternativa em pacientes humanos não responsivos ao itraconazol. A associação do iodeto de potássio e agentes antifúngicos pode apresentar melhores resultados quando comparada à monoterapia com estes fármacos. Foi realizado um estudo de coorte, o qual teve como objetivo descrever a resposta terapêutica ao iodeto de potássio em cápsulas via oral (5 mg/kg a cada 24 horas) associado ao itraconazol via oral (100 mg/gato a cada 24 horas) em gatos com esporotricose refratária ao itraconazol, assistidos no Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos do Instituto de Pesquisa Clínica Evandro Chagas/Fiocruz no período de 2012 a 2013. Foram incluídos no estudo 38 gatos, dos quais foi observado cura clínica em 24, falência terapêutica em cinco e óbito em três gatosEm seis casos houve abandono do tratamento. O tempo mediano de tratamento até a cura clínica foi 20 semanas. Vinte e nove animais apresentaram efeitos adversos clínicos, sendo 26 classificados como grau leve. Emagrecimento, hiporexia e vômitos foram os efeitos adversos clínicos mais observados. Quatro animais apresentaram efeitos adversos laboratoriais, representado pelo aumento dos valores das enzimas hepáticas. A utilização de iodeto de potássio em cápsulas associado ao itraconazol se mostrou um esquema terapêutico efetivo e seguro, sendo uma opção na esporotricose felina refratária ao itraconazol.

Sporotrichosis is a fungal infection caused by Sporothrix species complex.Itraconazol is the drug of choice for the treatment of the disease due to itseffectiveness and safety. However, cases of treatment failure in cats have beenreported. Potassium iodide capsules are an option for the feline cases.Additionally, the drug is an alternative to human patients unresponsive toitraconazole. The association of potassium iodide and antifungal agents mayprovide better results when compared to the mono therapy with these drugs. A cohort study was conducted, which aimed to describe the therapeutic response oforal potassium iodide (5 mg/kg every 24 hours) associated with oral itraconazole(100 mg/cat every 24 hours) in cats with sporotrichosis refractory to itraconazole,followed up at the Laboratório de Pesquisa Clínica em Dermatozoonoses emAnimais Domésticos do Instituto de Pesquisa Clínica Evandro Chagas/Fiocruz between 2012 and 2013. Of the 38 cats included in the study, 24 were cured,treatment failure ocurred in five and death in three cats. In six cases there wasnon-compliance with treatment. The median time from treatment until clinical curewith the combination was 20 weeks. Twenty-nine animals presented clinical adverse effects, which were classified as mild in 26 animals. Weight loss,hiporexia and vomiting were the most frequently observed. Four animals showed laboratory adverse effects represented by an increase in liver enzymes. The useof potassium iodide associated with itraconazole has proved to be an effective andsafe therapeutic regimen and, therefore, represents an option in the treatment offeline sporotrichosis refractory to itraconazol.

Potassium iodide capsule treatment of feline sporotrichosis.

Sporotrichosis is a mycosis caused by Sporothrix schenckii. The most affected animal is the cat; it has played an important role in the zoonotic transmission of this disease, especially in Rio de Janeiro, Brazil, since 1998. In order to evaluate the treatment of feline sporotrichosis with potassium iodide, an observational cohort was conducted in 48 cats with sporotrichosis at Instituto de Pesquisa Clínica Evandro Chagas, Fiocruz. All cats received potassium iodide capsules, 2.5 mg/kg to 20 mg/kg q24h. The cure rate was 47.9%, treatment failure was 37.5%, treatment abandonment was 10.4% and death was 4.2%. Clinical adverse effects were observed in 52.1% of the cases. Thirteen cats had a mild increase in hepatic transaminase levels during the treatment, six of them presented clinical signs suggestive of hepatotoxicity. Compared to previous studies with itraconazole and iodide in saturated solution, potassium iodide capsules are an alternative for feline sporotrichosis treatment.

Support system for management of shares ergonomic.

This article discusses the development of a computerized support to demands for treatment of a wide spectrum and diverse nature. Developed under SPM platform (Situação, Problema e Melhoria), the practitioner seeks to provide an ergonomic aid from the identification and characterization of the processes of analysis demands. The interest of a technological support the practice of ergonomics is a domestic origin, which already features a wide universe. For purposes of this article will be drawn the line defined by the universe in the Federal Public Service occupations within the guidelines set Subsystem Integrated System for Health Care Workers of the Federal Government. The development of this system initially intended to assist the practitioner in ergonomics mapping situations in which the federal public servant has been undergoing for the second time that can classify and then treat them.