RESUMEN

Abstract Objective: To develop growth charts for weight-for-age, height-for-age, and body mass index (BMI)-for-age for both genders aged 2 to 18 years for Brazilian patients with Williams-Beuren Syndrome (WBS). Methods: This is a multicenter, retrospective, and longitudinal study, data were collected from the medical records of boys and girls with a confirmed diagnosis of WBS in three large university centers in the state of Sao Paulo, Brazil. Growth charts stratified by gender and age in years were developed using LMSchartmaker Pro software. The LMS (Lambda Mu Sigma) method was used to model the charts. The quality of the settings was checked by worm plots. Results: The first Brazilian growth charts for weight-for-age, height-for-age, and BMI-for-age stratified by gender were constructed for WBS patients aged 2 to 18 years. Conclusion: The growth charts developed in this study can help to guide family members and to improve the health care offered by health professionals.

RESUMEN

Synthetic dyes are persistent organic environmental pollutants that can cause extensive damage to living beings and to the ecosystem as a whole. Cost-effective, sustainable, and efficient strategies to deal with this type of pollution are necessary as it commonly resists conventional water treatment methods. Silver nanoparticles (AgNPs) synthesized using the aqueous extract from the leaves, stem, and fruits of Leucaena leucocephala (Leucena) were produced and characterized through UV-vis, TEM, EDS, SDL, XPS, XRD, and zeta potential, and they proved to be able to promote adsorption to remediate methylene blue and tartrazine pollution in water. The nanoremediation was performed and did not require direct exposure to sunlight or any special lamp or a specific reduction agent. The AgNPs produced using the extract from the leaves exhibited the best performance in nanoremediation and also presented antioxidant activity that surpassed the one from butylated hydroxytoluene (BHT). Consequently, it is an interesting nanotool to use in dye nanoremediation and/or as an antioxidant nanostructure.

Asunto(s)

RESUMEN

OBJECTIVE: To investigate the association between mortality and masticatory function in older adults living in long-term care facilities (LTCFs), controlling for demographic and health covariates. BACKGROUND: Poor oral health has been associated with mortality; however, no previous study investigated whether objective and self-reported poor masticatory function is a predictor of early mortality in LTCFs. MATERIALS AND METHODS: Baseline characteristics of 295 participants were collected, including age, sex, polypharmacy, mobility, activities of daily living, frailty, nutritional status, and objective (masticatory performance - chewing gum) and self-reported masticatory function. The participants were followed-up with for 4 years to record the mortality data. Cox regression models were run to analyse the data (α = .05). RESULTS: During the 4-year follow-up, 124 (42.0%) participants died. Older adults with poor masticatory performance (hazard ratio [HR] = 1.59, 95% confidence interval [95% CI] = 1.07-2.36) and those who self-reported masticatory dysfunction (HR = 1.48, 95% CI = 1.01-2.16) were at higher risk of early death than those with good mastication. However, in a multivariate model including both objective and self-reported masticatory function, only the objective measurement remained associated with early death (HR = 1.52, 95% CI = 1.02-2.27). CONCLUSION: Poor masticatory performance seems to be associated with early death in older adults living in LTCFs, but they may have shared risk factors accumulated throughout life that were not covered by the study period.

RESUMEN

OBJECTIVE: To develop growth charts for weight-for-age, height-for-age, and body mass index (BMI)-for-age for both genders aged 2 to 18 years for Brazilian patients with Williams-Beuren Syndrome (WBS). METHODS: This is a multicenter, retrospective, and longitudinal study, data were collected from the medical records of boys and girls with a confirmed diagnosis of WBS in three large university centers in the state of Sao Paulo, Brazil. Growth charts stratified by gender and age in years were developed using LMSchartmaker Pro software. The LMS (Lambda Mu Sigma) method was used to model the charts . The quality of the settings was checked by worm plots. RESULTS: The first Brazilian growth charts for weight-for-age, height-for-age, and BMI-for-age stratified by gender were constructed for WBS patients aged 2 to 18 years. CONCLUSION: The growth charts developed in this study can help to guide family members and to improve the health care offered by health professionals.

Asunto(s)

Asunto(s)

RESUMEN

Abstract Introduction Chronic obstructive pulmonary disease (COPD) not only restricts airflow but also induces sys-temic manifestations in individuals with the disease. Objective To evaluate the effect of a water-based aero-bic exercise program on respiratory muscle strength, thoracic mobility, dyspnea, and functional capacity in patients with COPD. Methods We conducted a blind randomized controlled trial with 22 patients with COPD, dividing them into a control group (CG) and a training group (TG). The TG participated in 24 sessions of a water aerobic exercise program, while the CG only partici-pated in the evaluations. Maximal respiratory pressure (MRP), dyspnea, and functional capacity were measured. Results When comparing the MRP values (cmH2O) in the pre- and post-training conditions, the results revealed a significant improvement in the TG [maximal inspiratory pressure (MIP): 74.8 ± 15.3 vs. 83.9 ± 17.2; maximal expi-ratory pressure (MEP): 141.5 ± 30.7 vs. 157.6 ± 32.9], whereas no difference was observed for the CG (MIP: 55.5 ± 21.8 vs. 54.4 ± 18.4; MEP: 116.2 ± 40.3 vs. 109.3 ± 38.9). Regarding thoracic mobility in the pre- and post-training conditions, no significant difference was found for the CG, whilst for the TG there was a significant in-crease at the axillary level (cm) (5.9 ± 1.8 vs. 7.7 ± 1.1). With respect to functional capacity, there was a signifi-cant increase in walking distance during the six-minute walking test only in the TG when comparing pre- and post-training conditions (462.1 ± 62.9 vs. 538.5 ± 63.7). Lastly, the dyspnea results demonstrated that after the training period there was a major reduction in the scores of Medical Research Council (3.1 ± 0.8 vs. 1.9 ± 0.7) and Borg CR-10 scales (5.2 ± 0.8 vs. 3.7 ± 0.3) only for the TG. Conclusion The water aerobic exercise training promoted beneficial changes in respiratory mus-cle strength, thoracic mobility, functional capacity and dyspnea among patients with COPD.

Resumo Introdução A doença pulmonar obstrutiva crônica (DPOC) não apenas restringe o fluxo aéreo, mas também induz mani-festações sistêmicas em indivíduos com a doença. Objetivo Avaliar o efeito de um programa de exercícios aeróbicos aquáticos na força muscular respiratória (FMR), mobilidade torácica, dispneia e capacidade funcional em pacientes com DPOC. Métodos Realizou-se um ensaio clínico randomizado cego com 22 pacientes com DPOC, divi-dindo-os em grupo controle (GC) e grupo treinamento (GT). O GT participou de 24 sessões de um programa de exercícios aeróbicos aquáticos, enquanto o GC participou somente das avaliações. Foram me-didas a pressão respiratória máxima, (PRM) dispneia e capa-cidade funcional. Resultados Ao comparar os valores da PRM (cmH2O) nas condições pré e pós-treinamento, os resultados revelaram melhora significativa no GT [pressão inspiratória má-xima (PImáx): 74,8 ± 15,3 vs. 83,9 ± 17,2; pressão expiratória máxima (PEmáx): 141,5 ± 30,7 vs. 157,6 ± 32,9], enquanto não observou-se diferença para o GC (PImáx: 55,5 ± 21,8; vs. 54,4 ± 18,4; PEmáx: 116,2 ± 40,3 vs. 109,3 ± 38,9). Em relação à mobilidade torácica nas condições pré e pós-treinamento, não foi encontrada diferença significativa para o GC, enquanto para o GT houve um aumento significante no nível axilar (cm) (5,9 ± 1,8 vs. 7,7 ± 1,1). Com relação à capacidade funcional, houve aumento significativo da distância percorrida durante o teste de caminhada de 6 minutos apenas no GT quando comparadas as condições pré e pós-treinamento (462,1 ± 62,9 vs. 538,5 ± 63,7). Por fim, os resultados da dispneia demonstraram que após o período de treinamento houve uma redução importante nas pontuações do Medical Research Council (3,1 ± 0,8 vs. 1,9 ± 0,7) e nas escalas Borg CR-10 (5,2 ± 0,8 vs. 3,7 ± 0,3) apenas para o GT. Conclusão O trei-namento físico aquático promoveu alterações benéficas na força muscular respiratória, mobilidade torácica, capacidade funcional e dispneia em pacientes com DPOC.

RESUMEN

A Paraíba conta com a segunda maior cobertura de Atenção Básica (AB) do país, todavia ainda enfrenta a tendência nacional da disparidade na concentração de médicos entre as macrorregiões de saúde. A ampliação no provimento destes profissionais ao longo dos anos, rendeu ao Estado um incremento quantitativo, entre 2012 e 2015, de 21%, dos quais 3% decorreram do Programa Mais Médicos (PMM). O objetivo deste artigo é avaliar a percepção dos médicos e gestores participantes do programa na Paraíba, apontando potencialidades e fragilidades. Trata-se de um estudo exploratório-descritivo, qualitativo, no qual foram entrevistados médicos e gestores de 13 municípios da Paraíba. Realizaram-se entrevistas com roteiro semiestruturado, as quais foram gravadas, transcritas e analisadas através da análise de conteúdo, com a classificação sistemática dos relatos. Médicos e gestores concordaram quanto ao impacto positivo do programa no acesso ao serviço e na qualidade do cuidado da AB. Os gestores relataram diferenciais dos médicos participantes em relação aos não participantes do programa: maior comprometimento profissional, perfil mais voltado à AB e uma relação com a comunidade marcada pela proximidade e pelo vínculo. Os médicos destacaram como incentivos relevantes a maior autonomia, estabilidade contratual e boa remuneração. Ambos grupos se queixaram de problemas no deslocamento, alta demanda de atendimento e dificuldade na fixação de médico no interior. Os médicos cubanos foram descritos como profissionais de alta dedicação e humanização, porém, houve críticas quanto à linguagem e às condutas terapêuticas. As entrevistas analisadas permitem inferir que o Mais Médicos trouxe mudanças que ultrapassam a presença do médico na Unidade de Saúde da Família, pois levou a impactos na qualidade do cuidado, no vínculo com a comunidade, bem como na relação da equipe.

The Paraíbahas the second largest coverage of Primary Care (AB) in the country, however it still faces the national trend of disparity in the concentration of physicians between health macro-regions. The expansion in the provision of these professionals over the years, gave the State a quantitative increase, between 2012 and 2015, of 21%, of which 3% resulted from the More Doctors Program (PMM). The objective of this article is to evaluate the perception of doctors and managers participating in the programin the Paraíba, pointing out strengths and weaknesses. This is an exploratory-descriptive, qualitative study, in which physicians and managers from 13 municipalities of the 20th century were interviewed. Interviews were carried out with a semi-structured script, which were recorded, transcribed and analyzed through content analysis, with the systematic classification of reports. Physicians and managers agreed on the positive impact of the program on access to the service and quality of PC care. Managers reported differences between participating physicians and non-participants in the program: greater professional commitment, a profile more focused on PC and a relationship with the community marked by proximity and bonding. Physicians highlighted greater autonomy, contractual stability and good remuneration as relevant incentives. Both groups complained of problems with commuting, high demand for care and difficulty finding a doctor in the countryside. Cuban doctors were described as professionals of high dedication and humanization, however, there was criticism regarding the language and therapeutic approaches. The interviews analyzed allow us to infer that Mais Médicos brought about changes that go beyond the presence of the doctor in the Family Health Unit,as it led to impacts on the quality of care, on the bond with the community, as well as on the team's relationship.

Asunto(s)

RESUMEN

BACKGROUND: Aneurysms of the posterior communicating segment of carotid artery (PcomA) have a high risk of rupture; when these nonruptured aneurysms are associated with oculomotor nerve palsy (ONP), the risk of rupture increases compared with asymptomatic nonruptured PcomA. OBJECTIVE: To retrospectively analyze the risk factors involved in ONP secondary to PcomA aneurysm and to study the factors involved in the recovery time of ONP once it is established. METHODS: This was a retrospective study of patients from 10 neurosurgery centers from October 2008 to December 2020. We analyzed age at diagnosis, presence of compressive neuropathy of the oculomotor nerve, presence of aneurysm rupture, largest aneurysm diameter, aneurysm projection, smoking, hypertension, diabetes, time between diagnosis and surgical treatment, as well as the outcome. RESULTS: Approximately 1 in 5 patients (119/511 23.3%) with a PcomA presented with ONP. We found that patients with aneurysms measuring greater than or equal to 7.5 mm were 1.6 times more likely to have ONP than those with aneurysms smaller than 7.5 mm. In our study, the prevalence of smoking in the PcomA + ONP group was 57.76%, and we also found that smokers were 2.51 times more likely to develop ONP. A total of 80.7% showed some degree of improvement, and 45.4% showed complete improvement with a median recovery time of 90 days. CONCLUSION: This study showed that 80.7% of patients with PcomA aneurysms undergoing surgical treatment with aneurysm clipping showed some degree of improvement of the ONP, with a median time to recovery between 90 and 120 days.

Asunto(s)

RESUMEN

OBJECTIVES: Test the hypothesis the type of enamel caries (natural, artificial induced by gel, and artificial induced by acid solutions) affect the organic volume and the permeability of the surface layer in enamel caries lesions. DESIGN: Artificial enamel caries, induced by either acidic solution (organic-poor; Group 1) or acidic gel (organic-rich; Group 2), and natural non-cavitated inactive approximal enamel caries lesions (NEC; Group 3) were obtained, from which longitudinal ground sections were prepared. Measurements of the mineral (Vmin) (by microradiography), and water (α) and organic (ß) volumes (by optical birefringence) were obtained at three points in the surface layer (n = 30/group). RESULTS: The main outcomes were the ratio between experimental ß by predicted ß (ß Ratio) and the ratio between experimental and predicted permeabilities (αd Ratio). ß Ratio in Group 1 was lower than in Groups 2 (Cohen's d: -1.81; 95% CI:-1.45,-2.32; p < 0.001) and 3 (Cohen's d: -0.71; 95% CI:-0.27,-1.18; p = 0.004), and Group 2 surpassed Group 3 (Cohen's d: 0.49; 95% CI:0.07,0.94; p = 0.03). αd Ratio in Group 1 was higher than in Groups 2 (Cohen's d: 1.86; 95% CI:1.49,2.33; p < 0.001) and 3 (Cohen's d: 0.60; 95% CI:0.18,1.14; p = 0.01), and Group 3 surpassed Group 2 (Cohen's d: 0.61; 95% CI:0.23,1.07; p = 0.01). CONCLUSIONS: The highest organic volume and the lowest permeability occurred at the surface layer of gel-induced artificial enamel caries lesions, which should be preferred in in vitro studies on de- and remineralization and resin infiltration.

Asunto(s)

RESUMEN

ABSTRACT Purpose: to identify the impact of wearing protective face masks on reporters' communicative performance during the COVID-19 pandemic and verify whether there was an association between these aspects. Methods: a quantitative, descriptive, cross-sectional study with a sample of 32 reporters (16 females and 16 males) who worked, during the pandemic. Most participants had a bachelor's degree (n = 28; 87.5%). The sample's mean age was 35.09 years (SD = 9.41), and they had been working in the area for a mean of 10.09 years (SD = 7.62). Reporters answered an online form with 26 questions, developed by the researchers, on their self-perception of voice and communicative performance when wearing a mask, during the pandemic. Data were descriptively analyzed, and the chi-square test was applied with the Statistical Package for the Social Sciences 20 (SPSS). Results: most reporters (n = 20; 62.5%) classified their voices and speech articulation as good (n = 19; 59.4%) and reported difficulties hearing and/or being heard by interviewees in noisy places and perceived their voices were lower, muffled, or with a low volume (n = 28; 87.5%). Also, 22 (68.8%) reported having to speak louder than usually to be heard. Lastly, the questions on reporters' communicative performance were associated with wearing masks while reporting. Conclusion: wearing protective face masks, during reportage, negatively impacted reporters and was associated with their communicative performance.

RESUMO Objetivo: identificar o impacto do uso de máscara de proteção facial na performance comunicativa dos repórteres durante a pandemia da COVID-19, bem como verificar se existe associação entre esses aspectos. Métodos: trata-se de um estudo transversal, de caráter descritivo, com abordagem quantitativa. Participaram 32 repórteres que atuaram durante a pandemia, sendo 16 do sexo feminino e 16 do sexo masculino. A maioria dos participantes tinha ensino superior (n = 28; 87,5%). A amostra apresentou média de idade de 35,09 anos (DP = 9,41) e tempo de atuação na área de 10,09 anos (DP = 7,62). Os repórteres responderam a um formulário online composto por 26 questões, elaborado pelos próprios pesquisadores, sobre a autopercepção vocal e performance comunicativa do repórter com o uso de máscara durante a pandemia. Foi realizada análise descritiva dos dados e aplicado o teste Qui-quadrado por meio do software Statistical Package for Social Sciences 20 (SPSS). Resultados: a maioria dos repórteres (n = 20; 62,5%) classificou sua voz e articulação de fala como boas (n = 19; 59,4%). A maioria dos participantes relatou sentir dificuldade de ouvir e/ou ser ouvido pelo entrevistado em locais com ruído e perceber a sua voz mais baixa, com pouco volume ou abafada (n= 28; 87,5%), bem como 22 (68,8%) relataram ter que falar mais alto do que o normal para ser ouvido. Por fim, verificou-se a presença de associações entre as questões sobre a performance comunicativa dos repórteres e o uso de máscaras durante as reportagens. Conclusão: os repórteres apresentaram impactos negativos com uso das máscaras de proteção facial durante as reportagens, bem como verificou-se associação entre o uso destas com a performance comunicativa.

RESUMEN

The expansion of the sheep model in research represents an attractive and economically beneficial academic reason for investigations in sheep echocardiography. The present study aimed to evaluate the clinical and echocardiographic parameters in Dorper lambs during the developmental period. Emphasis was placed on the use of the species in translational research for the echocardiographic diagnosis of congenital heart diseases, which can contribute to improvements in interventionist techniques. Ten Dorper lambs were evaluated at the following time points: 24 h after birth and 7, 14, 21, 30, 60, 90 and 120 days of age. Clinical parameters were compiled, and echocardiogram records were obtained without sedation. Rectal temperature was lower on the first day compared to the others. From 21 days of life, there was a reduction in HR, with differences between time points. Mean and systolic blood pressure differed, with the highest values at 90 and 120 days of age. The thickness of the interventricular septum in diastole (IVSd) increased as age progressed, with the highest value at 120 days of age, and the same occurred for LVIDd (left ventricle internal diameter in diastole), LVFWd (left ventricular free wall thickness in diastole), IVSs (interventricular septum thickness in systole), LVIDs (left ventricle internal diameter in systole) and LVFWs (left ventricular free wall thickness in systole). There were differences in the size of the LA, Ao and LA/Ao ratio, which were greater at 90 days and 120 days of age. Echocardiographic changes accompany the development of lambs, where changes in echocardiographic parameters are evident with advancing age. The echocardiographic measurements in lambs obtained in the present study are similar to those in newborns.

Asunto(s)

RESUMEN

The experiment was conducted at Araí & Zumbi farm on sixty healthy Dorper ewes to compare blood glucose, hormonal profile, and insulin resistance evaluation in sheep from conception until 48 h postpartum in single and twin pregnancies. All experimental ewes raised under semi-intensive management system. Sixty animals were selected from 150 estrous synchronized and pregnant ewes. The animals were divided into two groups based on single (G1, n = 30) and twin pregnancies (G2, n = 30). Blood samples were collected at nine time points: immediately after fixed-time artificial insemination (D0); at 30 days (D30), 90 days (D90), 120 days (D120), 130 days (D130), and 140 days (D140) of pregnancy; on the delivery day (DD); and at 24 h (PD1) and 48 h (PD2) postpartum. The results of blood glucose, insulin, glucagon, cortisol, and thyroid hormones (T3 and T4) levels showed significant differences over the analyzed sample times; however, only cortisol showed differences within groups, with the G1 having higher values than the G2 group. The interaction of the groups × nine sample times showed a significant result (P = 0.001) only for glucagon. The number of fetuses directly interfered with the glucagon profile throughout gestation. The glucose, cortisol, glucagon, and the homeostatic model assessment for insulin resistance (HOMA IR) concentrations increased at DD and decreased at PD1 and PD2. T3 and T4 showed different behaviors among the sample times. T3 values presented a decrease from D0 to D90, followed by an increase from D90 to DD. Otherwise, for T4 values, a decrease from D90 to D130 was observed, followed by an increase from D130 to D140. Despite the changes found in the endocrine system and metabolism in Dorper ewes throughout pregnancy, the nutritional management ensured a healthy status during pregnancy, delivery, and postpartum in single and twin gestation, whose HOMA IR profiles remained identical.

Asunto(s)

RESUMEN

Diante do quadro pandêmico em decorrência da COVID-19, as unidades de saúde tiveram que readequar os seus fluxos para garantir o atendimento dos pacientes com síndrome gripal sem negligenciar ações prioritárias como o planejamento reprodutivo. Diante disso, esse trabalho tem como objetivo relatar a experiência na ampliação do acesso das mulheres ao dispositivo intrauterino através das redes sociais e da Telemedicina no município de João Pessoa, Paraíba. A divulgação do novo fluxograma foi realizada através do Instagram. Nesta plataforma, a mulher tinha acesso a um formulário do Google Forms, pelo qual poderia demonstrar interesse em inserir o DIU. Em seguida, era realizado contato telefônico via WhatsApp para marcar uma consulta remota, na qual era feita a avaliação inicial da mulher interessada frente aos critérios de elegibilidade do DIU. Após avaliar esses critérios, a mulher também era orientada sobre os efeitos adversos e as possíveis complicações. Concluída essa etapa, agendava-se o procedimento de inserção na unidade de saúde. Portanto, as redes sociais podem ser aliadas no acesso a informações compartilhadas por profissionais de saúde, além de facilitar o acesso a alguns serviços oferecidos, como a pré-consulta, antes da avaliação e inserção do dispositivo intrauterino.

Due to COVID-19 pandemic, health centers had to readjust their workflows to provide care to patients with flu-like syndrome without neglecting priority actions such as reproductive planning. Therefore, this work aims to report the experience in expanding women's access an intrauterine device through social media and telemedicine in the city of João Pessoa, Paraíba. The dissemination of the new workflow was released by Instagram. On this platform, the woman had access to a Google Forms form, through which she could show interest in inserting the IUD. Then, telephone contact was made via WhatsApp to arrange a remote consultation, in which the interested woman was initially assessed according to IUD medical eligibility criteria. After this, the woman was also instructed about adverse effects and possible complications. Thereby, the IUD insertion at the health centers was scheduled. Therefore, social networks can be allied in accessing information shared by health professionals, in addition to facilitating access to some services offered, such as previous consultation, before the evaluationand intrauterine device insertion.

Asunto(s)

RESUMEN

ABSTRACT: The hematopoietic system changes during the pregnancy to carry fetal development and maternal needs. This study compared the hematological parameters between ewes with single and twin pregnancies during gestation, delivery, and postpartum. The experiment was conducted on 60 healthy pregnant Dorper ewes that were divided into two experimental groups: Group 1 (G1), with single pregnancies (n=30), and Group 2 (G2), with twin pregnancies (n=30). Blood samples were collected from all ewes at different times: immediately before fixed-time artificial insemination (AI); on day 30, 90, 120, 130, and 140 of pregnancy; immediately after delivery; and at 24h and 48h postpartum. Statistical analysis compared the two groups at different times (P<0.05). Mild, normocytic, and hypochromic anemia was detected in all ewes from AI time and throughout pregnancy from both groups, but did not prove to be of clinical relevance. In the peripartum stage (from the 140th day of pregnancy to 48h postpartum), the ewes with twin pregnancies (G2) exhibited higher erythrogram values and neutrophil:lymphocyte ratio than did ewes with single pregnancies (G1). This indicated a greater hematopoietic adaptation in the body during the development of two fetuses. Except for the eosinophil numbers, all leukogram parameters were influenced by pregnancy in a similar way in both groups, and was characterized mainly by leukocytosis with neutrophilia during peripartum due to the high presence of endogenous cortisol at delivery. Thus, these findings showed that pregnancy was a stressful physiological event that increased the leukocyte count with a slight alteration in the erythrogram of Dorper ewes.

RESUMO: O sistema hematopoiético sofre mudanças durante a gestação para atender o desenvolvimento fetal e as necessidades maternas. Este estudo comparou os parâmetros hematológicos entre ovelhas com gestação simples e gemelar durante a prenhez, parto e pós-parto. O estudo foi realizado em 60 ovelhas Dorper prenhes, saudáveis, divididas em dois grupos experimentais: Grupo 1 (G1) com gestação simples (n = 30); e Grupo 2 (G2) com gestação gemelar (n = 30). Amostras de sangue foram colhidos de todas as ovelhas em diferentes momentos: imediatamente antes da inseminação artificial em tempo fixo (IA); nos dias 30, 90, 120, 130 e 140 de gestação; imediatamente após o parto; e às 24h e 48h pós-parto. A análise estatística comparou os dois grupos nos diferentes momentos (P < 0,05). Anemia leve, normocítica e hipocrômica foi detectada desde a IA e ao longo da gestação, nas ovelhas de ambos os grupos, mas não houve relevância clínica. Na fase periparto (do 140º dia de gestação às 48h pós-parto), as ovelhas com gestação gemelar (G2) mostraram valores do eritrograma e proporção neutrófilos: linfócitos mais elevados do que as ovelhas com gestação simples (G1). Isso indicou maior adaptação hematopoiética da ovelha para o desenvolvimento de dois fetos. Com exceção do número de eosinófilos, todos os parâmetros do leucograma foram influenciados pela gestação de forma semelhante em ambos os grupos, e foi caracterizada principalmente por leucocitose com neutrofilia no periparto devido ao alto nível de cortisol endógeno no parto. Assim, os achados mostraram que a gestação foi um evento fisiológico estressante que aumentou a contagem de leucócitos com leve alteração no eritrograma de ovelhas Dorper.

RESUMEN

INTRODUCTION: Diagnosis of Achilles insertional tendinopathies (AIT) is based on pain by tendon palpation. However, there is no consensus or standard with regard to the amount of force to be used during the evaluation. Algometry is a method of measuring the pressure applied in a specific region and can be a method for determining diagnosis values. GOAL: To determine a cutoff value for pain threshold (PT) in the assessment of AIT. DESIGN: This is a prospective case-control study of diagnostic accuracy, to develop a diagnostic criterion. METHODS: Forty asymptomatic individuals and forty patients with AIT, matched by age and sex, were evaluated and submitted to algometry for PT and for visual analog scale (VAS) levels with 3 kgf at the insertion of the calcaneal tendon by two different evaluators. Inter-observer reproducibility was assessed through the interclass correlation coefficient (ICC). Sensitivity and specificity calculations of PT and of VAS were calculated and plotted on a receiver operating characteristic curve. RESULTS: The lowest ICC found was 0.788. With regard to the diagnosis through PT , the 4.08-kgf value showed the best relation between sensitivity and specificity (92.5% and 92.5%, respectively). Algometry values lower than 4.08 were considered positive for disease. For the diagnosis of AIT through VAS with 3 kgf, the value of 2.98 was estabilished (sensitivity of 92.5% and specificity of 97.5%). CONCLUSION: Algometry was shown to be a simple and reliable method for diagnosing AIT. Values of PT less than 4.08 kgf were found to be predictors of the disease.

Asunto(s)

RESUMEN

A new fluorimetric method for copper(II) determination in wines was developed combining functionalized magnetic nanoparticles (FMNP) and fluorescent carbon dots (FCD). To produce FMNP, Fe3O4 was coated with Al2O3 forming Fe3O4@Al2O3 core-shell magnetic nanoparticles and functionalized with PAN and SDS. FCD was synthesized from pineapple juice through hydrothermal carbonization. For copper determination, aliquots of wine, the FMNP dispersion, and Britton-Robinson buffer (pH = 4.0) were mixed under stirring to allow the adsorption of copper by FMNP. Cu-FMNP complex was attracted by a niobium magnet and, after discarding the non-magnetic material, the copper(II) ions were eluted with an FCD dispersion before fluorescence quenching measurements. The proposed method presented a linear range from 0.020 to 0.100 mg L-1 (r2 = 0.9953), RSD (intraday) < 3.0%, and recovery rates from 96 to 105 %. FMNP and FCD properties permitted extraction/preconcentration/determination of copper within 1 min with an enrichment factor of nine and without prior sample treatment.

Asunto(s)

RESUMEN

Patients with unbalanced X-autosome translocations are rare and usually present a skewed X-chromosome inactivation (XCI) pattern, with the derivative chromosome being preferentially inactivated, and with a possible spread of XCI into the autosomal regions attached to it, which can inactivate autosomal genes and affect the patients' phenotype. We describe three patients carrying different unbalanced X-autosome translocations, confirmed by G-banding karyotype and array techniques. We analyzed their XCI pattern and inactivation spread into autosomal regions, through HUMARA, ZDHHC15 gene assay and the novel 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay, and identified an extremely skewed XCI pattern toward the derivative chromosomes for all the patients, and a variable pattern of late-replication on the autosomal regions of the derivative chromosomes. All patients showed phenotypical overlap with patients presenting deletions of the autosomal late-replicating regions, suggesting that the inactivation of autosomal segments may be responsible for their phenotype. Our data highlight the importance of the XCI spread into autosomal regions for establishing the clinical picture in patients carrying unbalanced X-autosome translocations, and the incorporation of EdU as a novel and precise tool to evaluate the inactivation status in such patients.

Asunto(s)

RESUMEN

The evaluation of the autonomic cardiac functions may be performed through the analysis of the heart rate variability. Heart rate variability is defined as the fluctuations in the heart rhythm or rate, and represents a useful tool in the evaluation of the autonomic nervous system through the sympathetic and parasympathetic components, as well as its balance and its reflexes on the cardiorespiratory control system. Fetal electrocardiography provides important information regarding the well-being of the fetus since, in human fetuses, there are changes in the behavior of the fetal heart rate during the second and third trimesters of pregnancy due to an increase in parasympathetic activity. Therefore, considering the importance of evaluating fetal viability, this study aims at evaluating the behavior of fetal heart rate and heart rate variability in Dorper sheep, as well as the activity of the autonomic nervous system during fetal life and in newborn lambs. The species is often used in experimental studies and autonomic nervous system activity is a prognostic index, therefore, the diagnosis of modifications in the sympathovagal balance may represent an early index for fetal viability and well-being in lambs. The analyses were performed in 10 Dorper sheep during pregnancy and in 10 lambs after birth until 120 days of age. There was a decrease in the fetal heart rate and heart rate variability indexes during the fifth month of pregnancy, but without statistical significance for the period evaluated. The heart rate of the lambs decreased gradually until they were 21 days old. The indexes SDNN (standard deviation of RR intervals) and RMSSD (square root of the mean of successive differences between adjacent RR intervals) diverged according to age, being high at day 60. Fetal viability is relevant in sheep fetuses to avoid losses during pregnancy and risks to the health of the mother. In the species, there seems to be a predominance of parasympathetic activity starting from the 21st day of age. Heart rate variability may be employed as a tool in the evaluation of the fetus and development of lambs, since changes in its behavior may represent an adverse effect to fetal and neonatal health.

Asunto(s)

RESUMEN

In this study we aim to show the application of ultrasound evaluation of the fetal heart in the ovine species, as well as its limitations in the field. Ten Dorper sheep, without any sedation, were evaluated starting from the second month of pregnancy through transabdominal ultrasound with an ultrasound device equipped with a convex transducer. Images of the fetal heart were obtained through maternal abdominal ultrasound by identifying the position of the fetus and conducting the following measurements: length and diameter of the heart, dimensions of the right and left ventricles and dimensions of the right and left atria. The measurements could only be conducted with acceptable precision starting from the third month of pregnancy. There was a significant difference only for left ventricle diameter, which was larger in the fifth month of pregnancy. The echocardiographic evaluation of the fetus enables monitoring the heart development identifying early fetal viability, assessing inadequate events that could put the pregnancy at risk, especially for production animals. For the experimental design of research employing production animals, it is important to consider, among other factors, the limitations of the evaluation on the field, such as restraining the animals, the stress caused by handling and environmental conditions, temperature, luminosity, facilities available and the qualifications of the team.

Asunto(s)

RESUMEN

OBJECTIVE: Anterior clinoidectomy is an important and essential skill for skull base and cerebrovascular neurosurgeons. We present a 1-piece intradural anterior clinoidectomy, providing a step-by-step description of the technique, independently of anatomic variations. METHODS: Between 2014 and 2020, 128 patients (119 women and 9 men; average age, 54.6 years) underwent intradural anterior clinoidectomy during microsurgical clipping of carotid-ophthalmic aneurysms. RESULTS: The anterior clinoid process continues medially with the planum sphenoidale, over the optic nerve, laterally with the lesser wing of the sphenoid bone, and inferiorly with the optic strut, which is always found anteriorly to the clinoid segment of the internal carotid artery, and separates the optic canal from the superior orbital fissure. The proposed anterior clinoidectomy followed, one after the other, these 3 fixation points for the detachment of the anterior clinoid process. The main indication for intradural anterior clinoidectomy was the management of vascular lesions around paraclinoid (clinoidal and ophthalmic) segments of the internal carotid artery. Complications of the procedure included injury to the internal carotid artery or the ophthalmic artery, thermal damage to the optic nerve, and invasion of the sphenoid sinus or a pneumatized anterior clinoid process, which could lead to postoperative cerebrospinal fluid leakage. CONCLUSIONS: The anterior clinoidectomy technique described here minimizes the drilling surface for detachment of the anterior clinoid process and reduces operative time as well as the amount of bone dust produced by drilling. It also precisely delineates the localization of the optic strut, preventing carotid or optic nerve damage.

Asunto(s)