Meeting Complex Needs of Sexually Assaulted Incarcerated Individuals: Impact of Expert Sexual Assault Nurse Examiner Care via Telehealth.

Sexual violence within prisons is a complex issue. The Prison Rape Elimination Act identifies standards to guide the provision of care to meet the medical and forensic needs of individuals who experience sexual assault (SA) while incarcerated. The standards include access to care by a Sexual Assault Nurse Examiner (SANE) whenever possible. Telehealth is one solution to ensure expert SANE access. This brief report addresses the pre-examination concerns/worries and immediate post-examination perceptions and experiences of six individuals who experienced SA while incarcerated. Findings show resolution of pre-examination worries, high satisfaction with care, high telehealth acceptability rates, and universal endorsement that examinations should occur outside of correctional facilities. Although not generalizable, this report provides preliminary insight into care in an understudied population with unique health care needs.

Towards low carbon demand and highly efficient nutrient removal: Establishing denitrifying phosphorus removal in anaerobic/anoxic/oxic + nitrification system.

A two-sludge anaerobic/anoxic/oxic + nitrification system with simultaneous nitrogen and phosphorus removal was studied for enhanced low-strength wastewater treatment. After 158 days of operation, excellent NH4+-N, chemical oxygen demand (COD) and PO43--P removal (99.0 %, 90.0 % and 92.0 %, respectively) were attained under a low carbon/nitrogen ratio of 5, resulting in effluent NH4+-N, COD and PO43--P concentrations of 0.3, 30.0 and 0.5 mg/L, respectively. The results demonstrate that the anaerobic/anoxic/oxic sequencing batch reactor (A2-SBR) and nitrification sequencing batch reactor (N-SBR) had favorable denitrifying phosphorus removal and nitrification performance, respectively. High-throughput sequencing results indicate that the phosphate-accumulating organisms Dechloromonas (1.1 %) and Tetrasphaera (1.2 %) were enriched in the A2-SBR, while the ammonia-oxidizing bacteria Nitrosomonas (7.8 %) and the nitrite-oxidizing bacteria Nitrospira (18.1 %) showed excellent accumulation in the N-SBR. Further analysis via functional prediction revealed that denitrification is the primary pathway of nitrogen metabolism throughout the system. Overall, the system achieved low carbon and high efficiency nutrient removal.

Evaluation of FDA Labeling Changes Related to PREA Safety-Waivers.

PURPOSE: The Pediatric Research Equity Act (PREA) gives the US Food and Drug Administration (FDA) authority to require pediatric studies for drug and biologics products under certain circumstances and to waive this requirement in some, or all, pediatric ages. When studies are waived for safety, PREA stipulates the safety issue must be described in labeling. This study assessed the rate of including waiver-related safety information in labeling. METHODS: FDA databases were reviewed to determine the number of safety-related pediatric study waivers and issued from December 2003 through August 2020, and corresponding labeling to establish when relevant safety information was included. Descriptive comparisons were conducted across Cohort 1: December 2003-2007, Cohort 2: 2008-2011, Cohort 3: 2012-2015, and Cohort 4: 2016-August 2020. RESULTS: One hundred sixteen safety waivers were issued [Cohort 1 (n = 1); Cohort 2 (n = 38), Cohort 3 (n = 37), and Cohort 4 (n = 40)] for 84 unique drugs or biologics. Most (106 of 116; 91%) waiver-related safety issues were described in labeling [Cohort 1 (1 of 1), Cohort 2 (33 of 38), Cohort 3 (33 of 37), and Cohort 4 (39 of 40)]. Safety waivers were most common in patients ≤ 17 years (n = 40) and least common in patients ≤ 6 months (n = 15). Products for infections (n = 32) were the most common group receiving safety waivers; 17 for non-antiviral anti-infective products including treatments for dermatologic infestations/infections, and 15 for antiviral products. CONCLUSION: The data confirm that FDA consistently describes waiver-related safety information in drug/biologic product labeling since the inception of PREA in December of 2003.

Detection of human Mastadenovirus C in wild guinea pigs (Cavia aperea aperea) feces.

The Adenoviridae family is composed by a high diversity of viruses that are extremely resistant in environment and are frequently excreted in animal reservoir feces for long periods. The knowledge of adenovirus (AdV) diversity among wild species may be important for the understanding of the epidemiology of putative emerging diseases. Cavia aperea aperea, commonly known as wild guinea pigs, wild cavies, or preas, are small herbivorous rodents widely distributed throughout South America and classified in Caviidae family, as well as domestic guinea pigs and capybaras. In order to investigate their potential role as reservoir of zoonotic agents, the present study aimed to verify the presence of AdV in fecal samples of 14 preas from Northeast Brazil. When submitted to nested PCR, two out of 14 samples (14.28%) were positive for AdV and classified as human Mastadenovirus C (HAdV-C) using DNA sequencing and phylogenetic analysis. Wild guinea pigs are synanthropic rodents that live in close contact with humans. The investigation of viral agents in rodents is important due to their potential role as reservoirs of human and animal pathogens. Moreover, the present work presents the first known evidence of HAdV in wild guinea pig stool samples, which may represent both the impact of anthropogenic pollution to wild animals and an important knowledge in terms of human health.

Dermatology Drugs for Children-U.S. Food and Drug Administration Perspective.

Drug development regulation needs of the pediatric population were not addressed until later in the twentieth century. Because of legislation including the Best Pharmaceuticals for Children Act (BPCA) and Pediatric Research Equity Act (PREA), clinical trials and data analysis targeting the pediatric population have resulted in drug product labeling. Drug products with pediatric dermatology indications benefit from BPCA, PREA, exclusivity incentives, newer analytical methods, and Food and Drug Administration team review. Although legislation, clinical and pharmacological research, and analytical methods have evolved, problems remain. Collaborative and targeted strategies are needed to allow timely drug labeling for pediatric dermatology populations.

EVALUATING THE IMPLEMENTATION OF THE PRISON RAPE ELIMINATION ACT (PREA): A "LESSONS LEARNED" APPROACH.

The Prison Rape Elimination Act (PREA) was designed to address sexual violence in prison. While previous has focused on sexual violence occurring in correctional facilities, there has been a dearth of studies that document the expertise, experience, or reflections of program following the cimplementation of PREA- within a correctional system. The current study utilizes a "lessons learned" approach to discuss the impact of the PREA Demonstration Project on a state prison system that includes 19 correctional institutions. Results indicate the benefits of merging the philosophical orientation of key stakeholders, establishing benchmarks, and the need for partnerships with prosecutors. A comparison of the perceptions of correctional administrators, inmates, and front-line correctional officers regarding PREA is included. Also featured are the "lessons learned" from the implementation of PREA into four prison sites, along with the concept of building trust and the impact of lockdowns due to staff shortages.

Functional Analysis of preA in Aeromonas veronii TH0426 Reveals a Key Role in the Regulation of Virulence and Resistance to Oxidative Stress.

Aeromonas veronii is one of the main pathogens causing freshwater fish sepsis and ulcer syndrome. This bacterium has caused serious economic losses in the aquaculture industry worldwide, and it has become an important zoonotic and aquatic agent. However, little is known about the molecular mechanism of pathogenesis of A. veronii. In this study, we first constructed an unmarked mutant strain (ΔpreA) by generating an in-frame deletion of the preA gene, which encodes a periplasmic binding protein, to investigate its role in A. veronii TH0426. Our results showed that the motility and biofilm formation ability of ΔpreA were similar to those of the wild-type strain. However, the adhesion and invasion ability in epithelioma papulosum cyprini (EPC) cells were significantly enhanced (2.0-fold). Furthermore, the median lethal dose (LD50) of ΔpreA was 7.6-fold higher than that of the wild-type strain, which illustrates that the virulence of the mutant was significantly enhanced. This finding is also supported by the cytotoxicity test results, which showed that the toxicity of ΔpreA to EPC cells was enhanced 1.3-fold relative to the wild type. Conversely, tolerance test results showed that oxidative stress resistance of ΔpreA decreased 5.9-fold compared to with the wild-type strain. The results suggest that preA may negatively regulate the virulence of A. veronii TH0426 through the regulation of resistance to oxidative stress. These insights will help to further elucidate the function of preA and understand the pathogenesis of A. veronii.

Global Harmonization of Pediatric Drug Development: Critical for Progress for Developing Safe and Effective Therapeutic Agents for Children.

The article, "Questionable Industry-Sponsored Studies in Children and Adolescents in Slovenia" provides an opportunity to discuss evolving US and EU legislative measures to improve the available clinical trial-derived pediatric data and provide coherent labeling for pediatric providers in dosing of drugs for children.

Subplacental development in Galea spixii / Desenvolvimento subplacentário do preá (Galea spixii)

Animal models are essential to understand healthy human placentation. Guinea pig related rodents became on focus for such purposes. In particular, processes of trophoblast invasion are similar. The latter is associated with a specialized area, the subplacenta. Since previous results showed differences between the guinea pig and its close relative Galea spixii, we aimed to study subplacental development with more detail. We investigated 16 pregnant females of 14 to 55 days of gestation by means of histology, morphometrics, immunohistochemistry and electron microscopy. The overlap between the fetomaternal blood systems resulted as intimate, suggesting some exchange processes. Proliferation was revealed by three independent methods, being most active in early and mid-gestation, which was in accordance to former results. Though degeneration of tissues took place, the subplacenta was maintained towards term with access to the fetal vascularization, supporting a hypothesis about the release of substances to the fetal unit in advanced gestation. In contrast to other species, the extraplacental trophoblast showed a shift from syncytial streamers to giant cells during mid-gestation. Views on placentation in caviomorphs were influenced by the guinea pig, but our data supported recent studies that the subplacenta had a much greater placidity. In regard to subplacental grow, degeneration and likely also exchange processes, Galea and other species showed a more basal pattern of caviomorphs than the guinea pig. Such differences should be considered, when choosing most adequate animal models for special purposes in comparison to human placentation.(AU)

Modelos animais são essenciais para entender a placenta humana sadia. Neste sentido os roedores relacionados ao porquinho da índia tornaram-se foco para tal entendimento. Em particular, os processos de invasão trofoblástica são semelhantes. O último está associado a uma área especializada, a subplacenta. Uma vez que os resultados anteriores mostraram diferenças entre o porquinho da índia e seu relativo o preá, buscamos estudar o desenvolvimento subplacentário com mais detalhes. Pesquisamos 16 fêmeas gestantes de 14 a 55 dias de gestação por meio de histologia, morfometria, imuno-histoquímica e microscopia eletrônica. A sobreposição entre os sistemas sanguíneos materno e fetal apresentou-se com íntima relação, sugerindo alguns processos de troca. A proliferação foi revelada por três métodos independentes, sendo mais ativos no início e metade da gestação, o que corroborou com os resultados anteriores. Embora a degeneração dos tecidos tenha ocorrido, a subplacenta foi mantida até o termo gestacional com acesso à vascularização fetal, apoiando uma hipótese sobre a liberação de substâncias para a unidade fetal em gestação avançada. Em contraste com outras espécies, o trofoblasto extraplacentário mostrou uma mudança de flâmulas sinciciais para células gigantes durante a metade da gestação. As visualizações sobre a placentação em caviomorfos foram influenciadas pelo porquinho da índia, mas nossos dados apoiaram estudos recentes de que a subplacenta apresentava uma plasticidade muito maior. Em relação ao crescimento subplacentário, a degeneração e provavelmente também os processos de troca, o preá e outras espécies apresentaram um padrão mais basal de caviomorfos do que o porquinho da índia. Tais diferenças devem ser consideradas, ao escolher os modelos animais mais adequados para fins especiais em comparação com a placentação humana.(AU)

Imunolocalização de receptores de leptina no ovário de preás (Galea spixii Wagler, 1831) / Immunolocalization of leptin receptor of Spix's Yellow-toothed Cavy (Galea spixii Wagler, 1831) ovary

A leptina, uma citocina produzida pelas células adiposas, é alvo da comunidade científica por acreditarem que ela apresente impacto sobre a reprodução dos animais promovendo a puberdade, foliculogênese e oogênese, ciclo estral e auxiliando na fecundação. A compreensão dos mecanismos que controlam a atividade reprodutiva de preás (Galea spixii) possui papel relevante para a preservação da espécie. Desta forma, o presente trabalho propôs analisar a imunolocalização dos receptores de leptina (Ob-R) no ovário de preás. Coletaram-se os ovários de 20 fêmeas adultas, não prenhes e saudáveis. As amostras foram fixadas em paraformaldeído a 4% em tampão fosfato, incluídas em parafina e seccionadas para a realização de imunohistoquímica (IHC). As secções foram fotomicrografadas e avaliadas quanto à intensidade da reação. Observou-se forte imunorreação no oócito e nas células da teca, moderada nas células do estroma ovariano e nas células luteínicas grandes e fracamente coradas nas células da granulosa, endoteliais, perivasculares e células luteínicas pequenas. Quando comparado a expressão de receptores ao longo do desenvolvimento folicular foi observado que o oócito e as células da teca se mantiveram com expressão na mesma intensidade. Entretanto, as células da granulosa apresentaram forte marcação nos estádios pré-antrais enquanto que nos folículos antrais apresentou fraca intensidade. Concluímos que em ovários de Galea spixii existe a presença de Ob-R nas principais estruturas do ovário sugerindo que este hormônio desempenhe papel fundamental na reprodução desta espécie.

Leptin, a cytokine produced by adipose cells, is the target of the scientific community for believing that it has an impact on the reproduction of the animals promoting puberty, folliculogenesis and oogenesis, estrous cycle and aiding in fertilization. The understanding of the mechanisms controlling the reproductive activity of Spix's Yellow-toothed Cavy (Galea spixii) plays a relevant role in the preservation of the species. Thus, the present study proposed to analyze the immunolocalization of leptin receptors (Ob-R) in the ovary of cavies. Ovaries from 20 adult, non-pregnant, healthy females were collected. The samples were fixed in 4% phosphate buffered paraformaldehyde, embedded in paraffin and sectioned for immunohistochemistry. The sections were photomicrographs and intensity of the reaction was measured. Strong immunoreaction was observed in oocyte and theca cells, moderate in ovarian stromal cells and large luteal cells and weak stained in granulosa, endothelial, perivascular and small luteal cells. When compared to receptor expression along follicular development it was observed that the oocyte and the theca cells remained with expression at the same intensity. However, the granulosa cells presented strong stained in the preantral stages, whereas in the antral follicles it presented low intensity. We conclude that in the ovaries of Galea spixii there is the presence of Ob-R in the main structures of the ovary sugesting that this hormone plays a fundamental role in the reproduction of this species.

Pediatric Medicine Development: An Overview and Comparison of Regulatory Processes in the European Union and United States.

Pediatric legislation in the US and the EU is driving pediatric product development on an international scale. To facilitate harmonization and global development of pediatric medicines, it is important to understand the legislative requirements that must be met along with incentives that exist in the US and the EU to include pediatric patients in therapeutic clinical trials. Although there are many similarities, differences exist. This review is an effort to enhance understanding of the pediatric legislation in both regions. It is intended as an overview to supplement the region-specific legislation and guidance documents that are available on the websites of the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Despite differences, the goal of the legislation in both the EU and the US is to incentivize and require timely, ethical, and sound scientific development of pharmaceutical products for the pediatric population and to provide information for their safe and effective use.

Transgender Inmates in Prisons.

Transgender inmates provide a conundrum for correctional staff, particularly when it comes to classification, victimization, and medical and health issues. Using LexisNexis and WestLaw and state Department of Corrections (DOC) information, we collected state statutes and DOC policies concerning transgender inmates. We utilized academic legal research with content analysis to determine whether a statute or policy addressed issues concerning classification procedures, access to counseling services, the initiation and continuation of hormone therapy, and sex reassignment surgery. We found that while more states are providing either statutory or policy guidelines for transgender inmates, a number of states are lagging behind and there is a shortage of guidance dealing with the medical issues related to being transgender.

Ramos colaterais do Arco aórtico do preá (Galea spixii Wagler, 1831) / Collateral branches of the aortic arch of galea (Galea spixii Wagler, 1831)

O preá é um roedor típico da caatinga pertencente à família Caviidae. Considerando a inexistência de dados sobre o arco aórtico do preá, foi realizado este estudo tendo como objetivo descrever os ramos colaterais do arco aórtico neste cavídeo, e dessa forma, contribuir com dados para biologia da espécie. Foram utilizados vinte preás machos provenientes de estudos anteriores e encontravam-se armazenados em freezer no Centro de Multiplicação de Animais Silvestres (CEMAS/UFERSA). Os animais foram descongelados, a cavidade torácica foi aberta, a aorta canulada e o sistema vascular lavado com solução salina e em seguida, injetado látex Neoprene corado com pigmento vermelho, amarelo ou branco. Posteriormente, os animais foram fixados em formol e depois de 72 horas, dissecados e analisados, sendo obtidos desenhos esquemáticos e os exemplares mais representativos fotografados. O arco aórtico do preá emitiu como ramos colaterais, o tronco braquiocefálico e a artéria subclávia esquerda. O tronco braquiocefálico originou na maioria das peças estudadas, a artéria carótida comum esquerda e o tronco braquiocarotídeo, do qual surgem as artérias subclávia direita e carótida comum direita. As artérias subclávias direita e esquerda em todos os animais estudados emitiram a artéria vertebral, a artéria torácica interna, a artéria cervical superficial, o tronco costocervical e a artéria axilar. O padrão da formação do arco aórtico do preá assemelhou-se ao observado em outros roedores, tais como no mocó, no porquinho-da-índia e na chinchila...

Galea spixii is a typical rodent of the caatinga belonging to the Caviidae family. Considering the lack of data on the aortic arch of the galea, this study aimed to describe the collateral branches of the aortic arch in this specie and to contributes to knowledge of its biology. Twenty males from previous studies were used which had been stored in a freezer at Multiplication Center of Wild Animals (CEMAS/UFERSA). The animals were thawed, the thoracic cavity was opened and the aorta cannulated vasculature was washed with saline and then injected with Neoprene latex colored with red pigment, yellow or white. Subsequently, the animals were fixed in formalin and after 72 hours dissected and analyzed, to obtain schematic drawings and the most representative samples were photographed. The cavy aortic arch issued as collateral branches, the brachiocephalic trunk and the left subclavian artery. The brachiocephalic trunk afforded in most of the specimens the left common carotid artery and the brachiocarotid trunk, where the right subclavian and right common carotid arteries arise. The right and left subclavian arteries in all animals studied issued the vertebral artery, internal thoracic artery, superficial cervical artery costocervical trunk and axillary artery. The pattern of formation of the aortic arch of galea was similar to that observed in other rodents, such as the kerodon, the guinea pig and chinchilla....

Dinâmica da inversão do saco vitelino em preás (Galea spixii Wagler, 1831) / Dynamics of yolk sac inversion in galea (Galea spixii Wagler, 1831)

O objetivo deste trabalho foi estudar o período de inversão do saco vitelino bem como a dinâmica resultante deste processo na gestação inicial em preás, utilizando-se microscopia de luz, microscopia eletrônica de varredura e de transmissão. No décimo segundo dia de gestação observou-se o desenvolvimento dos endodermas parietal e visceral delimitando a cavidade do saco vitelino. O endoderma parietal foi evidenciado revestindo a superfície fetal da placenta corioalantoidea bem como contornando o espaço delimitado pela decídua capsular. Estes endodermas apresentaram formato prismático e encontraram-se separados do trofoblasto por uma desenvolvida membrana de Reichert. Já o endoderma visceral continha vasos vitelínicos e possuía vilosidades apenas em determinadas áreas. No décimo quarto dia de gestação verificou-se a inversão do saco vitelino, caracterizada pela degeneração do endoderma parietal e trofoblasto mural, associado ao desaparecimento gradual da membrana de Reichert. Como consequência deste fenômeno, o endoderma visceral passou a constituir uma interface com o epitélio uterino. Após a inversão, o endoderma parietal que permaneceu íntegro foi aquele que se apoiava na superfície da placenta corioalantóidea, apresentando células em formato colunar alto e característica de epitélio pseudoestratificado. O endoderma visceral apresentou numerosas vilosidades apicais principalmente em regiões próximas a placenta corioalantóidea. Com o contínuo desenvolvimento do embrião e placenta corioalantóidea, observou-se o surgimento de importante área de aposição entre os endodermas visceral e parietal. A inversão do saco vitelino representou uma disposição anatômica favorável ao desenvolvimento embrionário, além de ser uma característica evolutiva nesta espécie de roedor.

The aim of this study was to study the time of yolk sac inversion as well as the dynamics resulting from this process in galea throughout pregnancy. For this, conventional histological techniques, scanning electron microscopy and transmission electron microscopy were used. Parietal and visceral endoderm delimiting the yolk sac cavity was observed at 12 days of pregnancy. The parietal endoderm was coating the fetal surface of the chorioallantoic placenta as well as delimiting the decidua capsularis area. This endoderm had prismatic format and were apart from the trophoblast by an enlarged Reichert's membrane. The visceral endoderm had vitelline vessels and there were villi only in certain areas. At 14 days of pregnancy the yolk sac inversion was characterized by the degeneration of parietal endoderm and mural trophoblast, and also the gradual disappearance of the Reichert's membrane. So it made the visceral endoderm establish an interface with the uterine epithelium. After the inversion, the parietal endoderm which remained intact was the one that rested on the chorioallantoic placenta surface. It presented cells with high columnar format and pseudostratified epithelium featured. The visceral endoderm presented many apical villi, especially in areas close to the chorioallantoic placenta. The continued development of the embryo and chorioallantoic placenta evidenced the emergence of an important apposition area between visceral and parietal endoderm. The yolk sac inversion represented an anatomical arrangement in favor of the embryo development as well as an evolutionary trait in this rodent species.

Sedação consciente para endoscopia digestiva alta realizada por médicos endoscopistas / Conscious sedation for upper digestive endoscopy performed by endoscopists / Sedación consciente para la endoscopia digestiva alta realizada por médicos endoscopistas

JUSTIFICATIVA E OBJETIVOS: A sedação consciente na prática ambulatorial, embora comum, não é isenta de riscos. Este trabalho teve por objetivo avaliar a pressão arterial, a frequência cardíaca e a saturação periférica de oxigênio em pacientes submetidos à sedação consciente para endoscopia digestiva alta, realizada por médicos endoscopistas. MÉTODOS: Foram selecionados 105 pacientes de ambos os sexos, com idade mínima de 18 anos, estado físico ASA I a III, submetidos a endoscopia digestiva alta sob sedação consciente. Os pacientes foram monitorados com medidas de pressão arterial não invasiva, oximetria de pulso e frequência cardíaca, registradas antes, durante e após o exame. A sedação foi administrada com os fármacos midazolam e/ou meperidina. RESULTADOS: As variações de saturação de oxigênio, pressão arterial e frequência cardíaca ao longo do tempo não foram estatisticamente significativas. Entretanto, observou-se incidência de hipóxia de 41,9 por cento; em 53,3 por cento dos casos, houve hipotensão arterial e taquicardia em 25,6 por cento. Os pacientes obesos demonstraram-se mais suscetíveis à hipóxia e à hipotensão que aqueles não obesos. CONCLUSÕES: A ocorrência de hipóxia e hipotensão arterial é comum nos exames de endoscopia digestiva alta sob sedação consciente quando utilizados midazolam e meperidina associados. Pacientes obesos demonstraram-se mais suscetíveis à hipoxemia e à hipotensão arterial.

BACKGROUND AND OBJECTIVES: Conscious sedation in the ambulatory setting albeit common is not risk-free. The present study aimed at evaluating the blood pressure, heart rate and peripheral oxygen saturation in patients submitted to conscious sedation for upper digestive endoscopy performed by endoscopists. METHODS: A total of 105 patients of both sexes were selected, aged 18 and older, physical status ASA I to III, submitted to upper digestive endoscopy under conscious sedation. The patients were monitored through noninvasive blood pressure measurements, pulse oximetry and heart rate recorded before, during and after the examination. The sedation was carried out with midazolam or meperidine. RESULTS: The variations in oxygen saturation, blood pressure and heart rate throughout time were not statistically significant. However, an incidence of hypoxia of 41.9 percent was observed; 53.3 percent of the cases presented arterial hypotension and 25.6 percent presented tachycardia. Obese patients were more prone to hypoxia and hypotension than those non obese. CONCLUSIONS: The occurrence of hypoxia and arterial hypotension is common in upper digestive endoscopic examinations under conscious sedation when midazolam and meperidine are associated. Obese patients demonstrated to be more susceptible to hypoxemia and arterial hypotension.

JUSTIFICATIVA Y OBJETIVOS: La sedación consciente en la práctica ambulatorial, aunque sea algo común, no está exenta de riesgos. Este trabajo tuvo el objetivo de evaluar la presión arterial, la frecuencia cardíaca y la saturación periférica del oxígeno en pacientes sometidos a la sedación consciente para la endoscopia digestiva alta, realizada por médicos endoscopistas. MÉTODOS: Se seleccionaron 105 pacientes de los dos sexos, con una edad mínima de 18 años, estado físico ASA I a III, sometidos a la endoscopia digestiva alta bajo sedación consciente. Los pacientes fueron monitorizados con medidas de presión arterial no invasiva, oximetría de pulso y frecuencia cardíaca registradas anteriormente, durante y después del examen. La sedación fue administrada con los fármacos midazolam y/o meperidina. RESULTADOS: Las variaciones de saturación de oxígeno, presión arterial y frecuencia cardíaca a lo largo del procedimiento, no fueron estadísticamente significativas, pero se observó la incidencia de hipoxia en un 41,9 por ciento. En un 53,3 por ciento de los casos, se registró hipotensión arterial y en un 25,6 por ciento, taquicardia. Los pacientes obesos fueron más susceptibles a la hipoxia y a la hipotensión que los pacientes no obesos. CONCLUSIONES: La incidencia de hipoxia e hipotensión arterial es algo común en los exámenes de endoscopia digestiva alta bajo sedación consciente cuando están asociados al midazolam y a la meperidina. Los pacientes obesos fueron más susceptibles a la hipoxemia y a la hipotensión arterial.

Origem e distribuição dos nervos isquiáticos do preá / Origin and distribuition of sciatic nerves of the Galea

O preá do semiárido nordestino (Galea spixii Wagler, 1831) é um roedor pertencente à família Caviidae. Pouca literatura é encontrada sobre essa espécie em relação a sua morfologia e seu comportamento ambiental e reprodutivo. Com o objetivo de entender a morfologia geral, em foco, na inervação do membro pélvico dessa espécie, neste trabalho, foi explorado o nervo isquiático, o qual é o maior de todos os nervos do organismo. Foram utilizados 10 preás (cinco machos e cinco fêmeas) que vieram a óbito por causas naturais, oriundos do Centro de Multiplicação de Animais Silvestres da Universidade Federal Rural do Semiárido (CEMAS/UFERSA). Os animais foram fixados após o óbito em solução aquosa de formaldeído 10 por cento e, após 48 horas de imersão nessa solução, foram dissecados para exposição do nervo isquiático. Dessa forma, os dados obtidos foram compilados em tabelas e expressos em desenhos esquemáticos e fotografias. Os pares de nervos isquiáticos originaram-se de raízes ventrais de L6L7S1 (70 por cento) e de L7S1S2 (30 por cento) e distribuíram-se pelos músculos glúteo profundo, bíceps femural, semitendinoso e semimembranoso.

The Galea of the semi-arid northeast (Galea spixii Wagler, 1831) is a rodent belonging to the family Caviidae. Little literature is found on this species in relation to morphology, environmental and reproductive behavior. With a view to understanding the general morphology, particularly, in the innervation of the pelvic limb of this species, ponder the sciatic nerve, which is the largest of all the nerves of the body. 10 cavies were used (five males, five females) that they had died of natural causes, originating from breeders scientific, legally licensed by IBAMA, the UFRSA, Mossoró, RN. The animals were fixed after the death in an aqueous solution of formaldehyde 10 percent and after 48 hours of immersion in it, were dissected to expose the sciatic nerve. Thus, the data were compiled in tables and expressed in drawings and photographs. The pairs of sciatic nerves were derived from ventral roots L6L7S1 (70 percent) and L7S1S2 (30 percent) and were distributed by the deep gluteal muscles, biceps femural, semitendinosus and semimembranosus muscles.