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PURPOSE: To assess the test-retest and inter-rater reliability of goniometry and fleximetry in measuring cervical range of motion in individuals with chronic neck pain. METHODS: A reliability study. Thirty individuals with chronic neck pain were selected. Cervical range of motion was measured by goniometry and fleximetry at two time points 7 days apart. To characterize the sample, we used the numerical pain rating scale, Pain-Related Catastrophizing Thoughts Scale, and Neck Disability Index. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) were calculated. Correlations between goniometry and fleximetry measurements were performed using Spearman's correlation coefficient (rho). RESULTS: For goniometry, we found excellent test-retest reliability (ICC ≥ 0.986, SEM ≤ 1.89%, MDC ≤ 5.23%) and inter-rater reliability (ICC ≥ 0.947, SEM ≤ 3.91%, MDC ≤ 10.84%). Similarly, we found excellent test-retest reliability (ICC ≥ 0.969, SEM ≤ 2.71%, MDC ≤ 7.52%) and inter-rater reliability (ICC ≥ 0.981, SEM ≤ 1.88%, MDC ≤ 5.20%) for fleximetry. Finally, we observed a strong correlation between the goniometry and the fleximetry for all cervical movements (rho ≥ 0.993). CONCLUSION: Goniometry and fleximetry measurements are reliable for assessing cervical range of motion in individuals with chronic neck pain.

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Cocaine (COC) and benzoylecgonine (BE), the main COC metabolite, have been detected in aquatic ecosystems. Studies focusing on wild fish are, however, very limited, and no reports concerning elasmobranchs are available. This study investigated COC and BE levels in Brazilian Sharpnose sharks (Rhizoprionodon lalandii) (n = 13) using LC-MS/MS. All samples (13/13) tested positive for COC, with 92 % (12/13) testing positive for BE. COC concentrations (23.0 µg kg-1) were over 3-fold higher than BE (7.0 µg kg-1). COC levels were about three-fold significantly higher in muscle (33.8 ± 33.4 g kg-1) compared to liver (12.2 ± 14.2 µg kg-1). Females presented higher COC concentrations in muscle (40.2 ± 35.8 µg kg-1) compared to males (12.4 ± 5.9 µg kg-1). Several positive statistical correlations were noted between COC and BE (rho = 0.84) in females, indicating systemic COC transport and metabolization, as well as between BE and weight (rho = 0.62), and between COC and the Condition Factor (rho = 0.73). A strong correlation was noted between BE and COC in the muscle of non-pregnant females (rho = 1.00). This study represents the first COC and BE report in free-ranging sharks, and the findings point to the potential impacts of the presence of illicit drugs in environments.

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A síndrome metabólica é um distúrbio metabólico complexo, caraterizada pela associação de fatores de risco cardiovascular e resistência à insulina. Na Atenção Primária à Saúde, algumas condições laborais as quais os profissionais estão expostos podem ser fonte de adoecimento, e a literatura evidencia que aspectos laborais estão associados à síndrome metabólica, ou seja, que o contexto ocupacional é capaz de ser um fator de exposição para o desenvolvimento deste problema. O objetivo deste estudo foi estimar a prevalência de síndrome metabólica e os fatores associados em Agentes Comunitários de Saúde de uma cidade do Norte de Minas Gerais, Brasil. Estudo transversal, no qual coletaram dados sociodemográficos, estilo de vida, laborais, antropométricos, bioquímicos e aspectos emocionais. A variável dependente síndrome metabólica foi definida conforme o critério do National Cholesterol Education Program Adult Treatment Panel III. Realizaram-se análises descritivas e de regressão múltipla de Poisson, com variância robusta, considerando um nível de significância de 5% (p<0,05) para o modelo final. Foram avaliados 673 Agentes Comunitários de Saúde, a prevalência de síndrome metabólica foi de 20,8% e associou-se à faixa etária ≥40 anos, menor escolaridade (Fundamental e/ou Médio), sobrepeso/obesidade, lipoproteína de baixa densidade ≥130 mg/dl e proteína C-reativa >5,0 mg/dl. Constatou-se uma elevada prevalência de síndrome metabólica em Agentes Comunitários de Saúde. Verifica-se a necessidade de estudos para o aprofundamento sobre a temática e o desenvolvimento de ações que visem a promoção de hábitos comportamentais saudáveis, bem como a prevenção de fatores de riscos.

Metabolic syndrome is a complex metabolic disorder, characterized by the association of cardiovascular risk factors and insulin resistance. In Primary Health Care, some work conditions to which professionals are exposed can be a source of illness and the literature shows that work aspects are associated with metabolic syndrome, that is, that the occupational context is capable of being an exposure factor for the development of this problem. The objective of this study was to estimate the prevalence of metabolic syndrome and associated factors among community health workers in a city in the North of Minas Gerais, Brazil. Cross-sectional study, in which sociodemographic, lifestyle, work, anthropometric, biochemical, and emotional aspects of data were collected. The dependent variable metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Descriptive and multiple Poisson regression analyzes were carried out with robust variance, considering a significance level of 5% (p<0.05) for the final model. 673 community health workers were evaluated, the prevalence of metabolic syndrome was 20.8% and was associated with the age group ≥40 years, lower education (elementary and/or secondary), overweight/obesity, low-density lipoprotein ≥130 mg/dl and C-reactive protein >5.0 mg/dl. A high prevalence of metabolic syndrome was found in community health workers. There is a need for studies to delve deeper into the topic and develop actions aimed at promoting healthy behavioral habits, as well as preventing risk factors.

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Past and present habitability of Mars have been intensely studied in the context of the search for signals of life. Despite the harsh conditions observed today on the planet, some ancient Mars environments could have harbored specific characteristics able to mitigate several challenges for the development of microbial life. In such environments, Fe2+ minerals like siderite (already identified on Mars), and vivianite (proposed, but not confirmed) could sustain a chemolithoautotrophic community. In this study, we investigate the ability of the acidophilic iron-oxidizing chemolithoautotrophic bacterium Acidithiobacillus ferrooxidans to use these minerals as its sole energy source. A. ferrooxidans was grown in media containing siderite or vivianite under different conditions and compared to abiotic controls. Our experiments demonstrated that this microorganism was able to grow, obtaining its energy from the oxidation of Fe2+ that came from the solubilization of these minerals under low pH. Additionally, in sealed flasks without CO2, A. ferrooxidans was able to fix carbon directly from the carbonate ion released from siderite for biomass production, indicating that it could be able to colonize subsurface environments with little or no contact with an atmosphere. These previously unexplored abilities broaden our knowledge on the variety of minerals able to sustain life. In the context of astrobiology, this expands the list of geomicrobiological processes that should be taken into account when considering the habitability of environments beyond Earth, and opens for investigation the possible biological traces left on these substrates as biosignatures.

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PURPOSE: To translate and cross-culturally adapt the Spine Functional Index (SFI) into Brazilian Portuguese (SFI-Br) in individuals with musculoskeletal spine disorders. METHODS: Participants (n=194) answered the Numerical Pain Rating Scale (NPRS), 36-item Short-Form Health Survey (SF-36), Roland-Morris Disability Questionnaire for General Pain (RMDQ-g), and SFI-25 incorporating the SFI-10. Structural validity, from confirmatory factor analysis (CFA), used comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). The best structure was considered from the lower values of the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Construct and criterion validity used Spearman's correlation coefficient (rho). Internal consistency used Cronbach's alpha, reliability used intraclass correlation coefficient (ICC2,1), with ceiling and floor effects determined. Error used the standard error of the measurement (SEM) and minimal detectable change, 90% level (MDC90). RESULTS: Adequate fit indices demonstrated an unequivocal one-factor structure only for the SFI-10 (chi-square/DF <3.00, CFI and TLI >0.90, RMSEA <0.08). The SFI-10-Br correlation was high with the SFI-Br (rho=0.914, p<0.001), moderate for the RMDQ-g (rho=-0.78), SF-36 functional capacity domain (rho=0.718) and NPRS (rho=-0.526); and adequate for the remaining SF-36 domains (rho>0.30). Test-retest reliability (ICC2,1=0.826) and internal consistency (alpha=0.864) were high. No ceiling or floor effects were observed, and error was satisfactory (SEM=9.08%, MDC90=25.15%). CONCLUSION: The SFI Brazilian version was successfully produced with the 10-item version showing an unequivocal one-factor structure, high construct and criterion validity, reliability, internal consistency, and satisfactory error. Further research on responsiveness is required.

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INTRODUÇÃO: O aumento crônico da pressão arterial interfere na hemodinâmica do paciente à medida que, com os níveis elevados de pressão, as artérias são prejudicadas e suas paredes danificadas. Ao longo do tempo, o paciente manifesta doença hipertensiva, que pode ter diferentes etiologias; como doença cardíaca hipertensiva ou doença renal hipertensiva. A doença cardíaca hipertensiva, é uma condição clínica multifatorial caracterizada por elevação sustentada dos níveis pressóricos de pressão arterial sistólica - maior ou igual a 140 mmHg, e aumento da pressão arterial diastólica - maior ou igual a 90 mmHg; que se não tratada, a longo prazo provoca danos irreversíveis ao corpo, aumentando riscos cardiovasculares fatais. Enquanto isso, a doença renal hipertensiva pode se manifestar por doença parenquimatosa renal ou por estenose da artéria renal - caracterizada pela doença aterosclerotica degenerativa ou doença inflamatória, que caso progressão, danifica o parênquima renal. MÉTODOS: O estudo elaborado trata-se de uma análise epidemiológica, descritiva e transversal. Os dados expostos foram obtidos através do banco informativo de saúde DATASUS (TABNET) correspondente aos óbitos por doença renal hipertensiva e doença cardíaca hipertensiva entre os anos de 2013 a 2023, do município de São Paulo. A análise utiliza as variáveis: cor, sexo e faixa etária. RESULTADOS: Analisando os dados coletados, é notável a prevalência da incidência de óbitos por doença hipertensiva cardíaca em comparação com a doença hipertensiva renal. Contudo, é perceptivel uma semelhança entre as predominâncias de óbitos entre ambas enfermidades nas variáveis cor e faixa etária, com certa discrepância na variavel sexo. No quesito cor, a predominância foi da cor branca em ambas; representando 61,43% na doença renal hipertensiva e 66,96% na doença cardíaca hipertensiva. Acerca da variável etária os grupos mais afetados foram aqueles com 75 anos ou mais, representando 48,34% na doença renal hipertensiva e 50,61% na doença cardíaca hipertensiva. Quanto ao sexo, a predominancia foi do sexo masculino na doença renal hipertensiva (52,69%) e feminino na doença cardíaca hipertensiva (55,6%). CONCLUSÕES: Diante deste estudo comparativo, com enfoque na etiologia hipertensiva resultando em mortalidade cardiovascular, nota-se a prevalência da enfermidade na população que, embora seja subdiagnosticada, resulte em uma alta taxa de mortalidade à medida em que há progressão de doença sem o tratamento adequado.

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INTRODUÇÃO: A doença cardiovascular continua estabelecida como a principal causa de óbito no Brasil e também em São Paulo, tendo como fator de risco cardinal o crescimento de depósitos gordurosos nas artérias coronárias, as chamadas placas de aterosclerose. O tratamento para doença aterosclerótica coronária (DAC) inclui intervenções bem consolidadas na prática, sendo a cirurgia de revascularização miocárdica (CRM) uma das mais importantes medidas terapêuticas no contexto hospitalar, principalmente em pacientes portadores de lesões triarteriais ou com diabetes associada. Nesse sentido, a CRM vem apresentando importantes avanços em relação à redução da mortalidade e morbidade inerentes ao procedimento cirúrgico, principalmente através das inovações tecnológicas dos últimos anos. Sendo assim, o seguinte trabalho se objetiva a analisar a mortalidade da revascularização miocárdica em pacientes com DAC supracitadas, para uma melhoria da assistência hospitalar e das políticas públicas de saúde, pleiteando uma mortalidade hospitalar cada vez menor. MÉTODOS: Estudo de caráter epidemiológico, descritivo e transversal. Foi realizada coleta de dados através do banco informativo de saúde DATASUS (TABNET), correspondente aos óbitos de pacientes submetidos a revascularização miocárdica entre os anos de 2013 a 2023 no município de São Paulo. As variáveis utilizadas são: raça/cor, sexo e faixa etária. RESULTADOS: Analisando os dados coletados, é notável que o ano de maior incidência de óbitos foi 2014 com 123 óbitos, representando aproximadamente 13,91% do total do período estudado. A raça mais afetada foi a branca, com 65% dos óbitos. Já a faixa etária mais acometida foi entre 65 e 69 anos, totalizando 22,05% dos óbitos. Em relação ao sexo, a prevalência é masculina, caracterizando 58,37% dos óbitos. CONCLUSÕES: Em relação à abordagem terapêutica analisada nos últimos 10 anos no município de São Paulo, foi verificada uma maior mortalidade no sexo masculino, em idades avançadas e na raça branca. Além disso, é importante destacar que houve uma redução significativa nas taxas de desfecho cardiovascular primário nos pacientes submetidos ao procedimento. Esse cenário reforça a projeção da CRM como um tratamento cada vez mais seguro e eficiente no contexto das doenças coronarianas.

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Mining is of great relevance to the global economy, but its activities are challenging due to socio-environmental impacts. In January 2019, an iron ore tailings dam collapsed in Brumadinho (Minas Gerais, Brazil) releasing 12 × 106 m3 of tailings, causing human losses and devastation around 3.13 × 106 m2 of a watershed. In this context, the present study aimed to investigate the potential toxic effects of tailings from the collapsed dam using earthworms Eisenia andrei as a model organism for terrestrial environments. An extensive set of tests was performed, including behavioral (avoidance), acute (mortality and biomass) and chronic tests, such as biomass, reproduction and cytotoxicity (viability and cell density and change in coelomocyte pattern). The physical-chemical characterization revealed a higher density of the tailings in relation to the control soil, which can result in physical changes, such as soil compaction and surface sealing. Aluminum, Ca, Fe, Hg, Mg, Mn, K, Na and P registered higher concentrations in the tailings compared to the control soil, while Total Nitrogen, Total Organic Carbon and Organic Matter were higher in the natural soil. Based on the avoidance test, an EC50 of 27.18 ± 2.83% was estimated. No lethality was observed in the acute exposure, nor variations in biomass in the acute and chronic assays. However, there was a tendency to reduce the number of juveniles in relation to cocoons in the proportions of 3125; 12.5 and 25%. Significant changes in viability, cell density and pattern of amebocytes and eleocytes were observed up to the 35th day of exposure. A multi-biomarker approach (Integrated Biological Response version 2) indicated concentration-dependent effects and attenuation of cellular changes over time. These are the first results of chronic effects on earthworms exposed to tailings from the B1 dam. Despite being conclusive, we highlight the possible heterogeneity of the tailings and the necessary care in extrapolating the results.

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Water body contamination by leachate originated from dumpsites is a concern for municipal solid waste (MSW) management. In this context, this study aimed to evaluate antioxidant system alterations and oxidative and genotoxic effects in Danio rerio (zebrafish) exposed to leachate from a closed dumpsite. Groups comprising 50 fish were exposed (96 h) to different leachate concentrations (5, 15, 30, and 50%) to evaluate effects on liver and brain superoxide dismutase (SOD), catalase (CAT), and glutathione-S-transferase (GST) activities and reduced glutathione (GSH) and metallothionein (MT) concentrations, as well as malondialdehyde (MDA) and protein carbonylation (PTC) levels. Blood genotoxicity was evaluated by the comet assay. The investigated dumpsite leachate pond presented high chloride concentrations (Cl-; 2288.4 ± 69.5 mg L-1) and high electrical conductivity (EC; 8434.0 mS cm-1), indicating the presence of leachate. Concerning Danio rerio exposure, higher SOD (37%), CAT (67%), and GST (39%) activities and higher GSH (57%) concentrations were observed in liver following exposure to 50% leachate, while decreased brain GST (42%) activities and GSH (90%) levels were observed at the same leachate concentration. A significant increase in the olive tail moment (OTM; 280%) indicative of genotoxicity in blood was observed. A principal component analysis indicated that increased enzymatic activities and high levels of both GSH and MT were not sufficient to prevent the accumulation of reactive oxygen species, resulting in PTC and genotoxicity. Therefore, leachate exposure causes sublethal Danio rerio effects, altering the antioxidant system, increasing ROS production, and leading to PTC and genotoxicity. The findings demonstrate the need to further develop sublethal level assessments in zebrafish using leachate from different sources to subsidize risk assessments regarding MSW management.

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Background: Leishmaniasis, caused by the protozoan Leishmania sp., infects phagocyte cells present in lymphatic organs. This study demonstrates the influence of nanostructured lipid carrier-loaded hydroxymethylnitrofurazone (NLC-NFOH) on lymphatic uptake using a chylomicron-blocking flow model in rats. Method: Lymphatic uptake of NFOH was assessed 1 h after oral administration of dimethyl sulfoxide with NFOH or NLC-NFOH with and without cycloheximide pretreatment. Result: Dimethyl sulfoxide with NFOH and NLC-NFOH showed NFOH serum concentrations of 0.0316 and 0.0291 µg/ml, respectively. After chylomicron blocking, NFOH was not detected. Conclusion: Despite log P below 5, NFOH was successfully taken up by the lymphatic system. Long-chain fatty acids and particle size might be main factors in these findings. NLC-NFOH is a promising and convenient platform for treating leishmaniasis via oral administration.

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The aim of this study was to evaluate the dietary supplementation of organic selenium (Se) and vitamin E for sows from 1st and 2nd parity order, without adiabatic cooling on physiological parameters, reproductive performance, milk composition, litter performance and blood concentrations of antioxidant enzymes. A total of 96 sows were allotted in a 4 × 2 completely factorial design, with 4 experimental groups and 2 parity orders (1st and 2nd). The experimental groups consisted of: ACCon-sows receiving adiabatic cooling and no dietary supplementation of organic Se and vitamin E; WACCon-sows without adiabatic cooling and no dietary supplementation of organic Se and vitamin E; WACSe-sows without adiabatic cooling with dietary supplementation of 0.3 mg/kg organic Se; WACSeE-sows without adiabatic cooling with dietary supplementation of 0.3 mg/kg organic Se and 90 UI of vitamin E. ACCon Sows had lower respiratory rate, rectal temperature and body surface temperature when compared to the others sows (p < 0.05). Sows without evaporative cooling had lower daily milk production and weaned litters with lower weight and average daily gain when compared to the other groups (p < 0.05). ACCon sows presented higher weaned piglets to WACSeE sows. WACSeE Sows had higher concentrations of GSH-Px when compared to other experimental groups and higher levels of SOD than sows from ACCon and WACSe. Piglets of sows from WACSeE group presented higher levels of GSH-Px and SOD when compared to the other experimental groups. ACCon sows have higher milk yield and higher litter weight than others groups. Under equatorial climate conditions, dietary supplementation of organic Se and vitamin E from first and second parity order sows does not respond efficiently on thermoregulatory physiology and performance compared to adiabatic cooling, but modulates the enzymatic antioxidant balance of sows and piglets.

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In 2022, the International League Against Epilepsy revised their classification of epilepsy syndromes for clinicians to better understand the relationships between different epilepsy syndromes, their underlying causes, and their associated developmental and behavioral features. This review highlights portions of the current classification with an emphasis on epilepsy syndromes that readily present with developmental challenges and provides a unique framework, based on electroencephalography, to easily identify and understand these syndromes. Included in this review are a helpful categorization scheme with visual aid, descriptions of updated epilepsy syndromes, figures of relevant identifiers of syndrome and information regarding future directions toward treatment and research. Covered syndromes include developmental and epileptic encephalopathy, Dravet syndrome, Rasmussen syndrome, and infantile epileptic spasm syndrome, among others. WHAT THIS PAPER ADDS: The revised epilepsy syndrome classification by the International League Against Epilepsy aims to improve the outcomes for children with epilepsy. The electroencephalography features of epilepsy syndromes are grouped based on a categorization model. This model allows clinicians to understand overlapping phenotypes and aid with both identification and diagnosis.

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The rapid fetal development and the increased demand for milk result in a catabolic state and oxidative stress in hyperprolific sows. Despite animal defense mechanisms, the dietary supplementation of antioxidants is being evaluated to reduce the impacts of excess free radicals. The aim of this study was to evaluate the short- and long-term effects of beta-carotene supplementation for sows on the reproductive response and performance of suckling piglets. A total of 120 sows were distributed in a 3 × 4 factorial arrangement of three supplementation levels (B0-no supplementation, B200-200 mg beta-carotene/day and B400-400 mg beta-carotene/day) and four groups of parity order (1st, 2nd, 3rd, above 4th). Beta-carotene supplementation during lactation resulted in a higher litter weight at weaning. A higher average weight of piglets and litter weight at birth were observed, as well as a greater number of piglets weaned and litter weight at weaning in sows supplemented with 400 mg of beta-carotene during gestation and lactation periods. Supplementation with 200 and 400 mg of beta-carotene resulted in a greater weight at weaning and daily weight gain in piglets. Daily supplementation with 400 mg of beta-carotene in the prepartum and lactation phases provides a greater litter weight at weaning and, when supplemented in the pre-gestation and gestation periods, results in a greater litter weight at birth and at weaning.

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The objective of this study was to assess the impact of increasing levels of heat-treated soybean in the diet of crossbred cattle during the finishing phase on nutrient intake and digestibility, ruminal parameters, digesta passage rate, nitrogen balance, and microbial protein synthesis. Five steers, crossbred 7/8 Jersey x Zebu, fitted with rumen cannulas and with an average weight of 350 ± 50 kg, were utilized. The experimental treatments consisted of 0, 7, 14, 21, and 28% inclusion of heat-treated soybean in the total diet dry matter. The animals were randomly allocated in a 5 × 5 Latin square design. Evaluation of the animals took place over five experimental periods, each lasting 20 days. During each experimental period, the first 15 days were allocated for animal adaptation to the experimental diets, followed by five days of data collection. No significant differences were observed among the diets in terms of dry matter intake (average of 6.57 kg day-1; P = 0.615) and organic matter intake (average of 6.23 kg day-1; P = 0.832). However, heat-treated soybean had a significant impact on the digestibility of dry matter (P = 0.02), organic matter (P = 0.01), crude protein (P < 0.01), and neutral detergent fiber (P < 0.01). There was no observed change on microbial protein synthesis (average of 409.6 g day-1) in animals with the inclusion of heat-treated soybean in the diets. With each 1% inclusion of heat-treated soybean in the cattle diet, there was an increase of 0.00754 units in ruminal pH values and a reduction of 0.75839 mg dL-1 in ruminal ammoniacal nitrogen values. This study suggests that heat-treated soybean can be included in up to 15% of the dry matter in diets for finishing feedlot cattle.

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Lung cancer is the leading cause of cancer-related death. In addition to new innovative approaches, practical strategies that improve the efficacy of already available drugs are urgently needed. In this study, an inhalable dry powder formulation is used to repurpose flubendazole, a poorly soluble anthelmintic drug with potential against a variety of cancer lineages. Flubendazole nanocrystals were obtained through nanoprecipitation, and dry powder was produced by spray drying. Through fractional factorial design, the spray drying parameters were optimized and the impact of formulation on aerolization properties was clarified. The loading limitations were clarified through response surface methodology, and a 15% flubendazole loading was feasible through the addition of 20% L-leucine, leading to a flubendazole particle size of 388.6 nm, median mass aerodynamic diameter of 2.9 µm, 50.3% FPF, emitted dose of 83.2% and triple the initial solubility. Although the cytotoxicity of this formulation in A549 cells was limited, the formulation showed a synergistic effect when associated with paclitaxel, leading to a surprising 1000-fold reduction in the IC50. Compared to 3 cycles of paclitaxel alone, a 3-cycle model combined treatment increased the threshold of cytotoxicity by 25% for the same dose. Our study suggests, for the first time, that orally inhaled flubendazole nanocrystals show high potential as adjuvants to increase cytotoxic agents' potency and reduce adverse effects.

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Hourglass-like constriction (HLC) is an uncommon spontaneous mononeuropathy that is typically characterised by a sudden onset of pain followed by palsy, affecting branches of the radial (posterior interosseous nerve) and median nerves (anterior interosseous nerve). HLC of the radial nerve (RN) is rare, with only a few reported cases. Here, we report a case of a man who presented with acute wrist and finger drop due to the HLC of the RN. Surgery was recommended 5 months after clinical observation, when the lesion was resected and primarily repaired, resulting in satisfactory recovery. There is still much that remains unknown about HLC, especially for RN. The current understanding points out an inflammatory disease that should be treated conservatively for 3-7 months. The surgical technique depends mostly on the severity and extent of constriction; however, considering only RN constrictions, primary repair by neurorrhaphy or nerve grafts resulted in better functional outcomes.

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Currently, more than 100,000 papers had been published studying the placenta in both physiological and pathological contexts. However, relevant health conditions affecting placental function, mostly found in low-income countries, should be evaluated deeper. This review will raise some - of what we think necessary - points of discussion regarding challenging topics not fully understood, including the paternal versus maternal contribution on placental genes imprinting, placenta-brain communication, and some environmental conditions affecting the placenta. The discussions are parts of an international effort to fulfil some gaps observed in this area, and Latin-American research groups currently evaluate that.

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OBJECTIVES: The aim of this study was to characterise a broad-spectrum cephalosporin-resistant AmpC-positive Enterobacter huaxiensis colonising the skin of a Neotropical frog (Phyllomedusa distincta) inhabiting the Brazilian Atlantic Forest. METHODS: During a genomic surveillance study of antimicrobial resistance, we screened skin samples from P. distincta. Gram-negative bacteria growing on MacConkey agar plates supplemented with 2 µg/mL ceftriaxone were identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. A cephalosporin-resistant E. huaxiensis was sequenced using the Illumina NextSeq platform. Genomic data were analysed using bioinformatics tools, whereas AmpC ß-lactamase was characterised in depth by comparative analysis of amino acids, in silico modelling, and analysis of susceptibility to ß-lactam antibiotics and combinations of ß-lactamase inhibitors. RESULTS: Whole-genome sequencing analysis revealed a novel variant of AmpC ß-lactamase belonging to the ACT family, designated ACT-107 by NCBI. This variant contains 12 novel amino acid mutations within the ACT family, 5 in the signal peptide sequence (Ile2, Met14, Tyr16, Gly18 and Thr20), and 7 in the mature protein (Gln22, His43, Cys60, Thr157, Glu225, Ala252 and Asn310). In silico modelling showed that substitutions occurring in the mature chain are localised in the solvent-accessible surface of the protein, where they are not expected to affect the ß-lactamase activity, as observed in the resistance profile. Strikingly, 'not designated' ACT variants from E. huaxiensis were clustered (> 96% identity) with ACT-107. CONCLUSION: Since E. huaxiensis has been isolated from human infection, ACT-107 requires surveillance and the attention of clinicians.

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INTRODUÇÃO: A terapia com anticoagulantes orais é o esquema terapêutico complexo para a prevenção de eventos tromboembólicos. Atualmente, com todas as exigências para melhoria da qualidade assistencial e diminuição de custos na atual demanda de desenvolvimento de pesquisa, faz necessário intervenções multiprofissionais com componentes educativos para auxiliar no manejo da TACO. No âmbito da contribuição da enfermagem, a utilização de linguagem padronizada pode auxiliar enfermeiros de diferentes contextos e nacionalidades para que assim possam atuar respaldados em evidências. OBJETIVOS: identificar na literatura as intervenções em saúde dentro da terapia e estratificá-las com nível de evidência e mapear as ações de enfermagem encontradas na literatura as intervenções/atividades propostas pela Nursing Interventions Classification. MÉTODOS: Trata-se de um estudo de revisão integrativa, seguido de mapeamento cruzado, através da Biblioteca Virtual em Saúde, que trará artigos do IBECS, LILACS, BDENF e MEDLINE. Para realização do mapeamento cruzado foram utilizadas as regras adaptadas, baseadas em Lucena e Barros (2005). RESULTADOS: Foram selecionados 16 artigos conforme fluxograma PRISMA, com dados sociodemográficos e nível de evidência. As intervenções para adesão foram agrupadas em grupos: educação, autogestão e tratamento diretamente observados, com o mapeamento realizado de acordo com o Nursing Interventions Classification. CONCLUSÃO: As intervenções incluem questões educacionais, de autogerenciamento e tratamento diretamente observado a fim de promover a adesão do paciente dentro da terapia, para isso as evidências apontam para o tratamento em centros especializados que por sua vez despendem da utilização de mhealth, pill boxes, recursos áudio visuais, cartilhas, consultas voltadas para as particularidades do paciente.

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