RESUMEN

We employ photothermally driven self-assembly of colloidal particles to design microscopic structures with programmable size and tunable order. The experimental system is based on a binary mixture of "plasmonic heater" gold nanoparticles and "assembly building block" microparticles. Photothermal heating of the gold nanoparticles under visible light causes a natural convection flow that efficiently assembles the microscale building block particles (diameter 1-10 µm) into a monolayer. We identify the onset of active Brownian motion of colloidal particles under this convective flow by varying the conditions of light intensity, gold nanoparticle concentration, and sample height. We realize a crowded assembly of microparticles around the center of illumination and show that the size of the particle crowd can be programmed using patterned light illumination. In a binary mixture of gold nanoparticles and polystyrene microparticles, we demonstrate the formation of rapid and large-scale crystalline monolayers, covering an area of 0.88 mm2 within 10 min. We find that the structural order of the assembly can be tuned by varying the surface charge of the nanoparticles and the size of the microparticles, giving rise to the formation of different phases-colloidal crystals, crowds, and gels. Using Monte Carlo simulations, we explain how the phases emerge from the interplay between hydrodynamic and electrostatic interactions, as well as the assembly kinetics. Our study demonstrates the promise of self-assembly with programmable shapes and structural order under nonequilibrium conditions using an accessible setup comprising only binary mixtures and LED light.

RESUMEN

Introducción: Los rasgos del apetito (RA) forman parte de la conducta alimentaria de la persona, con una serie de respuestas continuas que se relaciona con la elección y consumo de alimentos y, también, con aspectos al momento en que se realiza la alimentación como son la frecuencia de las comidas, el lugar, la compañía con la que se comparten, entre otros. Estos factores pueden tener un impacto significativo en la forma en que se alimenta una persona y en su salud a largo plazo. Objetivo: Analizar la posible asociación entre la conducta alimentaria materna y la composición corporal del adolescente, de una preparatoria de la ciudad de Allende, Nuevo León, en México. Método: Se realizó un estudio cuantitativo, transversal y correlacional. El periodo del presente estudio fue de febrero a agosto de 2022. La población fue de 41 binomios (madre e hijo adolescente entre 15 y 17 años) de una preparatoria del Municipio de Allende, Nuevo León, México. Para probar la hipótesis, se utilizó el coeficiente de correlación de Spearman. Resultados : Al correr la prueba estadística se encontró que no existe una correlación significativa entre el nivel de conducta alimentaria de la madre y la composición corporal del adolescente (rs = -0,174, p = 0,277), por lo cual se rechaza la hipótesis de investigación. Conclusiones : Se encontró que la conducta alimentaria de la madre no se relaciona significativamente con la composición corporal del adolescente, de acuerdo a la muestra considerada en el presente estudio.

RESUMEN

BACKGROUND: The process of capturing and classifying the viability of corneal tissue for corneal transplantation is complex. The biomicroscopic examination is one of the techniques used to evaluate the quality of corneal tissues. The aim of this study was to analyze the relationship between the evaluation criteria used in biomicroscopic examination using a slit lamp and the classification of the quality of corneal tissue. METHODS: This is a longitudinal, retrospective cohort study, performed at the Human Ocular Tissue Bank in the state of Rio Grande do Norte, Brazil. The sample consisted of 419 corneas donated between 2005 to 2016. RESULTS: After the evaluation, the 419 corneas were classified as excellent (8 -1.91%), good (217 - 51.79%), regular (85 - 20.29%), and bad (109 - 26.01%). The classification of corneal quality attributed by ophthalmologists considered 13 criteria: senile arch, scars, epithelial defect, epithelial exposure, stromal infiltrate, subepithelial opacity, pterygium, Descemet's folds, stromal edema, stromal streak, cornea guttata, specular reflex, and cell loss endothelial. The quality of the cornea classified as excellent and good showed a statistically significant association (P value < .05) with senile arch, scar, epithelial defect, epithelial exposure, Descemet's folds, stromal edema, stromal streak, cornea guttata, specular reflex, and losses of endothelial cells; they had evaluated criteria that were absent or slightly present. CONCLUSIONS: The evaluation of the corneal quality for corneal transplantation should involve the implementation of reliable techniques and trained, qualified professionals. There is a need to create evaluation instruments that consider the criteria according to their degree of interference in the quality of corneal tissue.

Asunto(s)

RESUMEN

Los trastornos del sueño son frecuentes en la población y una causa importante de morbilidad. El objetivo de esta revisión es evaluar las alteraciones del sueño en periodos de emergencia y desastres. A lo largo de la historia, la esfera biopsicosocial y el sueño de las personas ha sido abrumada por múltiples eventos a gran escala, tales como desastres naturales, tragedias provocadas por el hombre, conflictos bélicos, crisis sociales y pandemias, cuya experiencia puede derivar en problemas de salud a corto, mediano y/o largo plazo. En los estudios analizados, se ha observado el impacto negativo de las emergencias y desastres en el sueño, por lo que ha cobrado gran relevancia la difusión y promoción de medidas que incentiven el buen dormir. Debido a la llegada del COVID-19 y a la situación de confinamiento por periodos prolongados en el hogar para prevenir su propagación, han surgido importantes consecuencias a nivel social. Ciertos factores ocupacionales y características de los desastres se asocian a mayor comorbilidad, un alto riesgo de experimentar agotamiento físico, trastornos psicológicos e insomnio en grupos altamente vulnerables, como lo son los profesionales de la salud, rescatistas y socorristas. El insomnio es el trastorno de sueño más frecuente en la población general y su empeoramiento en el contexto de pandemia por COVID-19 representa un nuevo problema en salud pública. Es por ello, que es indispensable promover campañas de prevención de salud física y mental orientados a la pesquisa precoz y manejo de patologías de la esfera psicosocial, dentro de las posibilidades socioeconómicas.

Sleep disorders are common in the population and are major cause of morbidity. The objective of this review is to assess sleep disturbances in times of emergency and disasters. Throughout history, the biopsychosocial field and sleep have been affected by multiple large-scale events, such as natural disasters, man-caused tragedies, armed conflicts, social crises and pandemics, the experience of which can lead to short, medium and/or long term health problems. In several studies, the negative impact of emergencies and disasters on sleep have been analyzed, emphasizing the importance of the diffusion and promotion of measures that encourage good sleep. The arrival of COVID-19 and consequent home confinement for prolonged periods caused important social consequences. Certain occupational factors and characteristics of disasters are associated with greater comorbidity: a high risk of experiencing physical exhaustion, psychological disorders and insomnia, especially in highly vulnerable groups, such as health professionals, rescuers and first aids-responders. Insomnia is the most frequent sleep disorder in the general population and its worsening in the context of the COVID-19 pandemic, represents a new public health problem. It is essential to promote physical and mental health prevention campaigns, aimed at early screening and management of pathologies in the psychosocial sphere, within socioeconomic possibilities.

Asunto(s)

RESUMEN

As severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections continue, there is a substantial need for cost-effective and large-scale testing that utilizes specimens that can be readily collected from both symptomatic and asymptomatic individuals in various community settings. Although multiple diagnostic methods utilize nasopharyngeal specimens, saliva specimens represent an attractive alternative as they can rapidly and safely be collected from different populations. While saliva has been described as an acceptable clinical matrix for the detection of SARS-CoV-2, evaluations of analytic performance across platforms for this specimen type are limited. Here, we used a novel sensitive RT-PCR/MALDI-TOF mass spectrometry-based assay (Agena MassARRAY®) to detect SARS-CoV-2 in saliva specimens. The platform demonstrated high diagnostic sensitivity and specificity when compared to matched patient upper respiratory specimens. We also evaluated the analytical sensitivity of the platform and determined the limit of detection of the assay to be 1562.5 copies/ml. Furthermore, across the five individual target components of this assay, there was a range in analytic sensitivities for each target with the N2 target being the most sensitive. Overall, this system also demonstrated comparable performance when compared to the detection of SARS-CoV-2 RNA in saliva by the cobas® 6800/8800 SARS-CoV-2 real-time RT-PCR Test (Roche). Together, we demonstrate that saliva represents an appropriate matrix for SARS-CoV-2 detection on the novel Agena system as well as on a conventional real-time RT-PCR assay. We conclude that the MassARRAY® system is a sensitive and reliable platform for SARS-CoV-2 detection in saliva, offering scalable throughput in a large variety of clinical laboratory settings.

Asunto(s)

RESUMEN

Objectives: To evaluate the profile of the drugs for continuous use prescribed in Primary Health Care (PHC) in Santa Rosa / RS and to identify presence in the official lists of essential drugs. Methods: Cross-sectional, analytical and quantitative study, with analysis of the digital prescriptions of users of primary health care in Santa Rosa. There was no gender restriction and patients who used at least one chronic drug were included. Data were collected through a printed report from users. Results: The study included 642 participants, with a mean age of 60.40±14.48, 64.3% were female and 47.4%, using polypharmacy. A total of 3.009 drugs were identified, with an average of 4.69±2.82 medications/prescription. There was a higher frequency of the cardiovascular system (46.9%), nervous system (16.8%) and digestive tract and metabolism (14.8%). The most commonly used drugs were hydrochlorothiazide, fluoxetine and omeprazole. Regarding the presence of drugs in the official lists, 90.9% are in RENAME and 90.8% in REMUME, and 80% of users have obtained full access to medicines. In the prescriptions, 0.3% contained antibiotics, 1.3% injectable drugs and all drugs were prescribed by the generic name and in a computerized way. Conclusions: The pharmacotherapeutic profile is similar to the national reality and most indicators are as recommended by the WHO, demonstrating the organization of the PA of the city, which facilitates the access of users to essential medicines. However, there was a high number of drugs per prescription and presence of polypharmacy, evidencing the importance of access to it as well as the promotion of the rational use of these drugs.

RESUMEN

The choroid plexus (ChP) epithelium is a source of secreted signaling factors in cerebrospinal fluid (CSF) and a key barrier between blood and brain. Here, we develop imaging tools to interrogate these functions in adult lateral ventricle ChP in whole-mount explants and in awake mice. By imaging epithelial cells in intact ChP explants, we observed calcium activity and secretory events that increased in frequency following delivery of serotonergic agonists. Using chronic two-photon imaging in awake mice, we observed spontaneous subcellular calcium events as well as strong agonist-evoked calcium activation and cytoplasmic secretion into CSF. Three-dimensional imaging of motility and mobility of multiple types of ChP immune cells at baseline and following immune challenge or focal injury revealed a range of surveillance and defensive behaviors. Together, these tools should help illuminate the diverse functions of this understudied body-brain interface.

Asunto(s)

RESUMEN

The urgent need to implement and rapidly expand testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has led to the development of multiple assays. How these tests perform relative to one another is poorly understood. We evaluated the concordance between the Roche Diagnostics cobas 6800 SARS-CoV-2 test and a laboratory-developed test (LDT) real-time reverse transcription-polymerase chain reaction based on a modified Centers for Disease Control and Prevention protocol, for the detection of SARS-CoV-2 in samples submitted to the Clinical Laboratories of the Mount Sinai Health System. A total of 1006 nasopharyngeal swabs in universal transport medium from persons under investigation were tested for SARS-CoV-2 as part of routine clinical care using the cobas SARS-CoV-2 test with subsequent evaluation by the LDT. Cycle threshold values were analyzed and interpreted as either positive ("detected" or "presumptive positive"), negative (not detected), inconclusive, or invalid. Statistical analysis was performed using GraphPad Prism 8. The cobas SARS-CoV-2 test reported 706 positive and 300 negative results. The LDT reported 640 positive, 323 negative, 34 inconclusive, and 9 invalid results. When excluding inconclusive and invalid results, the overall percent agreement between the two platforms was 95.8%. Cohen's κ coefficient was 0.904 (95% confidence interval, 0.875-0.933), suggesting almost perfect agreement between both platforms. An overall discordance rate of 4.2% between the two systems may reflect differences in primer sequences, assay limit of detection, or other factors, highlighting the importance of comparing the performance of different testing platforms.

Asunto(s)

RESUMEN

Interoception, the sense of internal bodily signals, is essential for physiological homeostasis, cognition, and emotions. While human insular cortex (InsCtx) is implicated in interoception, the cellular and circuit mechanisms remain unclear. We imaged mouse InsCtx neurons during two physiological deficiency states: hunger and thirst. InsCtx ongoing activity patterns reliably tracked the gradual return to homeostasis but not changes in behavior. Accordingly, while artificial induction of hunger or thirst in sated mice via activation of specific hypothalamic neurons (AgRP or SFOGLUT) restored cue-evoked food- or water-seeking, InsCtx ongoing activity continued to reflect physiological satiety. During natural hunger or thirst, food or water cues rapidly and transiently shifted InsCtx population activity to the future satiety-related pattern. During artificial hunger or thirst, food or water cues further shifted activity beyond the current satiety-related pattern. Together with circuit-mapping experiments, these findings suggest that InsCtx integrates visceral-sensory signals of current physiological state with hypothalamus-gated amygdala inputs that signal upcoming ingestion of food or water to compute a prediction of future physiological state.

Asunto(s)

RESUMEN

Las necesidades especiales en salud han sido definidas por la Asociación Americana de Odontopediatría como "toda condición o limitación física, del desarrollo, mental, sen- sorial, conductual, cognitiva o deterioro emocional que requiere tratamiento médico, intervención de atención de la salud, y/o el uso de servicios o programas especializados". Actualmente, los pacientes con necesidades especiales en salud presentan una mayor tasa de supervivencia y expectativas de vida mayores. Además, presentan una mayor preva- lencia y severidad de anomalías dento-maxilares que impactan negativamente su salud general y calidad de vida. La creciente preocupación de los padres y profesionales por el aspecto estético y funcional, ha llevado a un aumento en la demanda por tratamiento de ortodoncia, sin embargo, el acceso a él sigue siendo limitado. El objetivo de la presente revisión es describir según la literatura disponible, las consideraciones para el tratamiento ortodóncico en pacientes con necesidades especiales en salud. Se concluye que el tra- tamiento no debe ser denegado solo por presentar una discapacidad; no obstante, el compromiso de los padres y/o cuidadores con el tratamiento es crucial para el éxito. El tratamiento debe ser planificado en etapas, siendo la fase de adaptación a la atención de gran importancia. La longitud de tratamiento en estos pacientes, es similiar a la de individuos sanos, pero se requiere un mayor tiempo-sillón y los resultados obtenidos suelen ser inferiores. El tratamiento de ortodoncia puede mejorar la estética y función en pacientes con situación de discapacidad, facilitando su integración social e impactando positivamente en su calidad de vida

The American Academy of Pediatric Dentistry defines Special Health Care Needs as "any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impair- ment condition or limitation that requires medical management, health care interven- tion, and/or the use of specialized services or programs". Currently, patients with special health needs present a higher survival rate and higher life expectancies. In addition, they present a higher prevalence and severity of malocclusion that negatively impact their general health and quality of life. The growing concern of parents and professionals for the aesthetic and functional aspect, has led to an increase in the demand for orthodontic treatment, however, the health care access still remains limited. A review of the availa- ble literature was performed aiming at describing the considerations in the orthodontic treatment of special health care needs patients. It is concluded that the treatment should not be denied just for presenting a disability. Notwithstanding, it is crucial for the treat- ment success parents and/or caregivers commitment. The treatment should be planned in stages, being of great importance the care adaptation phase. The overall treatment time is similar to those patients without special needs, but still requires longer armchair time and the results obtained are usually lower. Orthodontic treatment can improve aesthetics and function in patients with disabilities, facilitating their social integration and positively impact in their quality of life.

RESUMEN

The Hematopoietic stem cell transplantation (HSCT) is used in children as a definitive treatment for various oncological, immune deficiencies, hemoglobinopathy, and malignancies diseases that involve the hematological system, congenital metabolism disorders, among others. To characterize the clinical and epidemiological profile of children and adolescents submitted to HSCT at a referral service in the state of Rio Grande do Norte. This is a quantitative, retrospective, observational, descriptive and analytical quantitative approach approaching the medical records of children and adolescents submitted to HSCT in a referral hospital service for this type of transplantation in the state of Rio Grande do Sul North (RN). The final sample consisted of 35 records patients aged between 2 and 18 years old who underwent HSCT from February 2008 to December 2015 and who presented the data necessary for the study. The records analyzed showed a littlemajority of male patients (51.42%) and 60.00% of these men were students and 71.42% lived in the state of the Rio Grande do Norte. According to the clinical characteristics, 34.3% of the patients had Acute Lymphoblastic Leukemia and 25.71% had Acute Myeloid Leukemia as the main diagnosis. Gastrointestinal toxicities were the most frequent (97.1%) and all patients received antineoplastic/chemotherapeutic and antiemetic treatment. The allogeneic HSCT was the most frequently performed (57.14%) and the most used source of Hematopoietic progenitor cells (HPC) was the peripheral blood (54.29%) and 5.71% of these patients developed the Graft versus Host Disease (GVHD), of which one was affected by acute GVHD and another by chronic GVHD. Septsis was the most frequent cause of death (60%). The profile of the clinical variables presented by the children and adolescents of this study shows that the most prevalent diagnosis was ALL, the most frequent toxicities were gastrointestinal, cardiac, respiratory and hematological, the most common HSCT was allogeneic peripheral blood and the greatest cause of mortality was sepsis. These data are similar to studies conducted in North America, Europe and Asia.

O Transplante de Células-Tronco Hematopoéticas (TCTH) é utilizado em crianças como um tratamento definitivo para várias doenças oncológicas, imunodeficiências, hemoglobinopatias, malignidades que envolvem o sistema hematológico, distúrbios de metabolismo congênito, entre outros. Caracterizar o perfil clínico e epidemiológico de crianças e adolescentes submetidos ao TCTH em um serviço de referência do estado do Rio Grande do Norte. Trata de um estudo epidemiológico de abordagem quantitativa, do tipo coorte retrospectiva, observacional, descritivo e analítico onde foram abordados os prontuários de crianças eadolescentes submetidos ao TCTH em um serviço hospitalar de referência para esse tipo de transplante no estado do Rio Grande do Norte (RN). A amostra final foi composta por 35 prontuários de pacientes com idade entre dois e 18 anos que realizaram o TCTH no período de fevereiro de 2008 a dezembro de 2015 e que apresentavam os dados necessários ao estudo. Do total de prontuários analisados houve discreta maioria de pacientes do sexo masculino (51,42%). Destes, 60,00% eram estudantes e 71,42% residiam no estado do RN. De acordo com as características clínicas, 34,3% apresentaram como diagnóstico principal a Leucemia Linfoblástica Aguda e 25,71% a Leucemia Mieloide Aguda. As toxicidades gastrointestinais foram as que mais ocorreram (97,1%) e todos receberam tratamento com antineoplásicos/quimioterápicos e antieméticos. O TCTH alogênico foi o mais frequentemente realizado (57,14%) e a fonte de CPH mais utilizada foi o sangue periférico (54,29%) e 5,71% desenvolveram a Doença do Enxerto Contra Hospedeiro (DECH), dos quais um foi acometido por DECH aguda e outro pela forma crônica. A causa de morte com maior frequência foi a sepse (60%). O perfil das variáveis clínicas apresentadas pelas crianças e adolescents desta pesquisa mostram que o diagnóstico mais prevalente foi o de LLA, as toxicidades que mais ocorreram foram as gastrointestinais, cardíacas, respiratórias e hematológicas, o TCTH mais realizado foi o alogênico de sangue periférico e a maior causa de mortalidade foi a sepse. Tais dados se assemelham aos estudos realizados na América do Norte,Europa e Ásia.

Asunto(s)

RESUMEN

Hematopoietic stem cell transplantation (HSCT) affects serious risks for the patient, including death. For this reason, it is considered a treatment that can cure or can present morbidities and lead to death. In this context, patients experience the first psychological conflicts before this transplant. To describe the psychological suffering developed by patients transplanted with hematopoietic stem cells from a referral service in the state of Rio Grande do Norte. This is a cross-sectional study with a quantitative, descriptive, hospital-based approach developed with patients submitted to HSCT at a referral service in the state of Rio Grande do Norte. Data were collected between March and September of 2016, through the evaluation of the medical records of 43 patients who underwent HSCT and developed some type of psychological distress. Among 43 patients with psychological disorders, 51.16% were female, 62.79% developed anxiety 32.56% developed insomnia and 20.93% developed depression. Of these, 27.91% had a main diagnosis indicating the transplantation of Multiple Myeloma (MM), and 58.14 received autologous transplantation. It was observed that the patient had psychological suffering from the diagnosis until the end. The health professional praxis also must go beyond the resolution of physical human responses and, especially in these cases, it should aim at the early identification of signs and symptoms of psychological distress, being possible to achieve the real health needs and treat them with effectiveness.

O Transplante de Células-Tronco Hematopoéticas (TCTH) acarreta sérios riscos para o paciente, inclusive o de morte. Por esse motivo é considerado um tratamento que pode curar ou que pode apresentar morbidades e levar ao óbito. Diante desse contexto, os pacientes vivenciam os primeiros conflitos psicológicos que antecedem o transplante em si. Descrever o sofrimento psicológico desenvolvido por pacientes transplantados com células-tronco hematopoéticas de um serviço de referência do estado do Rio Grande do Norte. Trata de um estudo do tipo transversal, com abordagem quantitativa, descritiva, de base hospitalar, desenvolvida com pacientes submetidos ao TCTH em um serviço de referência do estado do Rio Grande do Norte. Os dados foram coletados entre os meses de março e setembro de 2016, mediante avaliação dos prontuários de 43 pacientes que realizaram o TCTH e desenvolveram algum tipo de sofrimento psicológico. Dentre os 43 pacientes que apresentaram distúrbios psicológicos, 51,16% eram do sexo feminino, 62,79% desenvolveram ansiedade, 32,56% insônia e 20,93% depressão. Destes, 27,91% tinham como diagnóstico principal que indicou o transplante o Mieloma Múltiplo (MM), 58,14 receberam transplante autólogo. Observou-se que o sofrimento psicológico acompanhou o paciente desde o diagnóstico até o desfecho. Ademais, a práxis do profissional de saúde deve ir para além da resolução de respostas humanas físicas e, especialmente para estes casos, deve visar a identificação precoce dos sinais e sintomas de sofrimento psicológico para que seja possível alcançar as reais necessidades de saúde e tratá-las com efetividade.

Asunto(s)

RESUMEN

OBJECTIVE: to identify the main intraoperative complications of patients who underwent keratoplasty and relationship between these complications and clinical and surgical factors. METHOD: cross-sectional observational study. A census of the patients submitted to keratoplasty was carried out, which totaled 258 procedures. RESULTS: twenty-two intraoperative complications were recorded, all in penetrating keratoplasty surgeries, of which 59.09% were performed in male patients with a mean age of 58.5 years. The main intraoperative complication was vitreous loss (36.36%). A statistically significant relationship was found between the variable "intraoperative complication" and the variables "previous surgery", "combined keratoplasty and cataract extraction" and "corneal host button greater than 8.0 mm". CONCLUSION: identifying the main intraoperative complications of keratoplasty enables nurses to understand which factors may interfere with these procedures, point out possible predictors of complications, and seek control measures so that such complications do not occur.

Asunto(s)

RESUMEN

Objetivo: caracterizar epidemiologicamente os transplantes de córneas realizados no estado de Mato Grosso do Sul. Método: trata-se de estudo quantitativo, epidemiológico, de desenho transversal. Compor-se-á a amostra de estudo de forma censitária por todos os pacientes em fila de espera, os submetidos ao transplante de córneas e os doadores desse tipo de tecido no Estado de Mato Grosso do Sul. Realizar-se-á a coleta de dados por meio de três instrumentos elaborados para cada população distinta, com as variáveis de dados clínicos e epidemiológicos. Estabelecer-se-ão estatisticamente os padrões de distribuição e as frequências, bem como as medidas de tendência central, além da análise multivariada com aplicação de medidas de magnitude de efeito e associação, de acordo com a natureza de cada variável, a serem apresentados em forma de gráficos e tabelas. Resultados esperados: espera-se identificar as dificuldades encontradas no sistema estadual de transplante de córneas com foco no desenvolvimento de conceitos técnicos, de planejamento e organização do atendimento aos usuários em fila de espera, doadores e transplantados.(AU)

Objective: to make the clinical and epidemiological characterization of corneal transplants performed in the state of Mato Grosso do Sul. Method: this is a quantitative, epidemiological, cross-sectional study. A sample of the study will be collected in a census form for all patients in queue, those submitted to corneal transplantation and donors of this type of tissue in the State of Mato Grosso do Sul. Data collection will be performed by means of three instruments elaborated for each distinct population, with the variables of clinical and epidemiological data. Distribution patterns and frequencies as well as measures of central tendency will be statistically established, as well as multivariate analysis with application of magnitude of effect and association, according to the nature of each variable, to be presented in charts and tables. Expected results: it is hoped to identify the difficulties found in the state transplant system of corneal aimed at the development of technical concepts, planning and organization of care for waiting users, donors and transplanted patients. Keywords: Corneal Transplantation; Corneal Diseases; Biological Tissue Patchwork; Epidemiology; Health services; Eye Banks.(AU)

Objetivo: caracterizar epidemiológicamente los trasplantes de córneas hechos en el estado de Mato Grosso do Sul. Método: trata-se de un estudio cuantitativo, epidemiológico, de diseño transversal. La muestra de estudio se compondrá de forma censal por todos los pacientes en cola de espera, los sometidos al trasplante de córneas y los donantes de ese tipo de tejido en el Estado de Mato Grosso do Sul. Se realizará la recolección de datos mediante tres instrumentos preparados para cada población distinta, con las variables de datos clínicos y epidemiológicos. Se establecerán .los patrones de distribución y las frecuencias, así como las medidas de tendencia central, además del análisis multivariado con aplicación de medidas de magnitud de efecto y asociación, de acuerdo con la naturaleza de cada variable, que deberán presentarse en forma de gráficos y tablas. Resultados esperados: se espera identificar las dificultades encontradas en el sistema estatal de trasplante de córneas mirando el desarrollo de conceptos técnicos, de planificación y organización de la atención a los usuarios en cola de espera, los donantes y los trasplantados.(AU)

Asunto(s)

RESUMEN

La fisura labio-palatina es la malformación congénita más común entre las anomalías craneofaciales y causa una serie de alteraciones a nivel funcional, fisiológico, estético y social. Una de las características comúnmente asociada a estos pacientes, es la hipoplasia maxilar severa producto de la gran resistencia opuesta por los tejidos cicatrizales de labio y paladar, como consecuencia de la cirugía primaria. Tradicionalmente, el tratamiento ha sido la cirugía ortognática convencional al término del crecimiento, sin embargo, este enfoque ha demostrado tener ciertas limitaciones. La distracción osteogénica mediante un distractor rígido externo ha resultado ser una buena alternativa para el manejo de estos pacientes, ya que permite la distracción gradual del maxilar y de los tejidos asociados, mejorando los resultados a corto y largo plazo. Se realizó una revisión de la literatura actual disponible con el objetivo de describir el alcance del tratamiento de la distracción osteogénica maxilar con distractor rígido externo en los pacientes con fisura labio-pala-tina e hipoplasia maxilar severa. Se concluye que la distracción osteogénica maxilar con distractor rígido externo es un procedimiento efectivo, confiable y relativamente estable, con mínimas complicaciones asociadas y que podría superar a la cirugía convencional en el manejo de pacientes que requieran un avance maxilar severo. Palabras clave: Osteogénesis por distracción; Labio leporino; Fisura del paladar; Maxilar (fuente: DeCS BIREME).

The cleft lip and palate is the most common congenital malformation among craniofacial anomalies and causes a series of functional, physiological, aesthetic and social altera-tions. One commonly characteristic associated with these patients is a severe maxillary hypoplasia as a result of the great resistance opposed by scar lip and palate tissue from a primary surgery. Traditionally, the suggested treatment has been conventional orthogna-thic surgery at the end of skeletal maturity. However, this approach has revealed certain limitations. Distraction osteogenesis using a rigid external distractor has shown to be a good alternative for these patients' treatment, since it allows the gradual distraction of the maxilla and the associated tissues, thereby improving the short and long term results. A review of the available literature was performed to describe the maxillary distraction os-teogenesis treatment scope using a rigid external distractor in cleft lip and palate patients with severe maxillary hypoplasia. It was concluded that maxillary distraction osteogenesis using a rigid external distractor is an effective, reliable and relatively stable procedure, with minimal associated complications. This could be a better alternative compared to conventional surgery for patients' care having severe maxillary hypoplasia. Keywords: Distraction osteogenesis; Cleft lip; Cleft palate; Maxilla (source: MeSH NLM).

RESUMEN

Objetivo identificar as principais complicações intraoperatórias dos pacientes que realizaram ceratoplastias e sua relação com fatores clínicos e cirúrgicos. Método estudo transversal, observacional. Realizou-se um censo dos pacientes submetidos a ceratoplastias que totalizou 258 procedimentos. Resultados foram registradas 22 complicações intraoperatórias, todas em ceratoplastias penetrantes. Do total, 59,09% foram realizadas em pacientes do sexo masculino com idade média de 58,5 anos. A principal complicação intraoperatória notificada foi a perda vítrea (36,36%). Encontrou-se relação estatisticamente significativa entre a variável "complicação intraoperatória" e as variáveis "cirurgia prévia", "ceratoplastia combinada com extração de catarata" e "botão corneano do receptor maior que 8,0 mm". Conclusão identificar as principais complicações intraoperatórias da ceratoplastia possibilita à enfermagem compreender quais fatores podem interferir nesses procedimentos, apontar possíveis fatores preditores das complicações e buscar medidas de controles para que tais complicações não ocorram.

Objective to identify the main intraoperative complications of patients who underwent keratoplasty and relationship between these complications and clinical and surgical factors. Method cross-sectional observational study. A census of the patients submitted to keratoplasty was carried out, which totaled 258 procedures. Results twenty-two intraoperative complications were recorded, all in penetrating keratoplasty surgeries, of which 59.09% were performed in male patients with a mean age of 58.5 years. The main intraoperative complication was vitreous loss (36.36%). A statistically significant relationship was found between the variable "intraoperative complication" and the variables "previous surgery", "combined keratoplasty and cataract extraction" and "corneal host button greater than 8.0 mm". Conclusion identifying the main intraoperative complications of keratoplasty enables nurses to understand which factors may interfere with these procedures, point out possible predictors of complications, and seek control measures so that such complications do not occur.

Objetivo identificar las principales complicaciones intraoperatorias de los pacientes que realizaron queratoplastias y su relación con factores clínicos y quirúrgicos. Método estudio transversal, observacional. Se realizó un censo de los pacientes sometidos a las queratoplastias que tuvo un total de 258 procedimientos. Resultados fueron registradas 22 complicaciones intraoperatorias, todas en queratoplastias penetrantes. Del total, 59,09% fueron realizadas en pacientes del sexo masculino con edad media de 58,5 años. La principal complicación intraoperatoria notificada fue la pérdida vítrea (36,36%). Fue encontrada relación estadísticamente significativa entre la variable "complicación intraoperatoria" y las variables "cirugía previa", "queratoplastia combinada con extracción de catarata" y "botón corneal del receptor mayor que 8,0 mm". Conclusión identificar las principales complicaciones intraoperatorias de la queratoplastia posibilita a la enfermería comprender cuáles factores pueden interferir en estos procedimientos, apuntar posibles factores predictores de las complicaciones y buscar medidas de controles para que tales complicaciones no ocurran.

Asunto(s)

RESUMEN

With the development of new surgical techniques, instrumentation and pharmacological advances, corneal transplant procedures can undergo changes directly in the clinical profile of patients with the indication for penetrating keratoplasty technique. The aim of this study was to identify the clinical profile of patients undergoing penetrating keratoplasty and the main indicating conditions at a university hospital in Northeast Brazil. This is an epidemiological, cross-sectional, descriptive study performed using data from medical records of 241 patients who underwent keratoplasty between January/2010 and December/2014. From the total keratoplasties performed in the hospital during the study period, 88.37% were carried out by penetrating technique. Of these, 50.44% were performed in male patients with an average age of 55.2 years. The main indications were keratoconus, followed by bullous keratopathy and keratitis. Preexisting clinical conditions for penetrating keratoplasty were found, such as changes in vascularization, glaucoma, previous surgery, aphakic and pseudophakic eyes and keratoplasties combined with other types of surgeries. Knowledge of the clinical profile of patients who underwent penetrating keratoplasty enabled identification of the main ocular diagnoses that result in this type of transplant as a therapeutic indication. From this, it is possible to point out the main pre-existing medical conditions of penetrating keratoplasty that may represent potential risk factors for complications in the postoperative period and even lead to graft failure. We suggest that further studies be carried out on a thematic.

Com o desenvolvimento de novas técnicas cirúrgicas, de instrumentação e avanços farmacológicos, os procedimentos de transplantes de córneas podem sofrer mudanças diretamente no perfil clínico dos pacientes com indicação para realização da técnica de ceratoplastia penetrante. O objetivo deste estudo foi identificar o perfil clínico dos pacientes submetidos à ceratoplastia penetrante e principais condições indicadoras em um Hospital Universitário da região nordeste brasileira. Trata de um estudo epidemiológico, transversal, descritivo, realizado com dados de prontuários de 241 pacientes submetidos às Ceratoplastias no período de janeiro/2010 a dezembro/2015. Do total de ceratoplastias realizadas no serviço no período estudado, 88,37% foram realizadas pela técnica penetrante. Destas, 50,44% foram realizadas em pacientes do sexo masculino, com uma média de idade de 55,2 anos. As principais indicações foram o ceratocone, seguido pelas ceratopatia bolhosa e ceratite. Foram encontradas condições clínicas preexistentes às ceratoplastias penetrantes, como alterações de vascularização, glaucoma, cirurgia prévia, olhos afácicos e pseudofácicos e ceratoplastias combinadas com outros tipos de cirurgias. O conhecimento do perfil clínico dos pacientes submetidos às ceratoplastias penetrantes possibilita identificar os principais diagnósticos oculares que resultam nesse tipo de transplante como indicação terapêutica. A partir dele é possível apontar as principais condições clínicas preexistentes à ceratoplastia penetrante que podem representar potenciais fatores de risco para complicações no período pós-operatório e até mesmo levar a falência do enxerto realizado. Novos estudos sobre a temática devem ser considerados

Asunto(s)

RESUMEN

Biofilms are considered important sources of infections on biomedical surfaces, and most infections involving biofilm formation are associated with medical device implants. Therefore, there is an urgent need for new antimicrobial compounds that can combat microbial resistance associated with biofilm formation. In this context, this work aimed to evaluate the antibiofilm action of sulfamethoxazole complexed with Au, Cd, Cu, Ni and Hg on rapidly growing mycobacteria (RGM), as well as to evaluate their safety through cytotoxic assays. The results demonstrate potentiation of the novel compounds in antibiofilm activity, mainly in the complex with Au, which was able to completely inhibit biofilm formation and had the capacity to destroy the biofilm at all the concentrations tested. All cytotoxic data suggest that the majority of sulfamethoxazole metallic derivatives are antimicrobial alternatives, as well as safe molecules, which could be used as potential therapeutic agents for bacterial and biofilm elimination.

Asunto(s)

RESUMEN

The drug-resistant strains of Staphylococcus aureus have been considered as one of the serious health threats, which are related to high patient hospitalization rates. Besides, Staphylococcus aureus biofilm formation exhibits a drug-tolerant nature and shows nonspecific resistance against a broad-spectrum of antibiotics. The emergence of drug-resistant bacteria stimulated the development of novel medicines as a strategy to control infections. In this study, we evaluated the antibacterial and anti-biofilm activity of gold-complexed sulfonamides against Staphylococcus aureus strains such as methicillin-resistant S. aureus and clinical isolates. Our data showed that the exposure of gold-complexed sulfonamides promoted a remarkable reduction in the bacterial adhesion. Also, confocal microscopy displayed the effects of the compounds on in the bacterial cell biofilm, revealed that the compounds decreased the biofilm formation. Our results also demonstrated that gold-complexed sulfonamides exhibited potent antibacterial activity against Staphylococcus aureus strains. Besides, all compounds presented a synergic antibacterial activity when were associated with classical antibiotics. Gold-complexed sulfonamide compounds did not promote toxic effects on Caenorhabditis elegans. Thus, our results showed that the coordination of sulfonamide with gold is a promising alternative in the development of safe and active compounds against methicillin-resistant and clinical isolates S. aureus.

Asunto(s)

RESUMEN

Este estudo teve como objetivo descrever o perfil de consumo de medicamentos e identificar fatores associados entre adultos que aguardavam por atendimento na sala de espera de três unidades de Estratégia de Saúde da Família (ESF) do município de Santa Rosa-RS. Trata-se de um estudo transversal, analítico e descritivo. A coleta de dados foi realizada durante três semanas no mês de agosto de 2014, uma semana em cada unidade. Os dados obtidos foram analisados estatisticamente através do teste Anova, seguido de Test T de Student para as amostras independentes. Identificou-se entre os entrevistados que 58,95% utilizam medicamentos de forma contínua, com média de 2,08 medicamentos/indivíduo. Entre as variáveis relacionadas ao uso contínuo de medicamento observaram-se a faixa etária, acima de 50 anos, presença de doença crônica, escolaridade e frequência de uso dos serviços da unidade de saúde. Entre as variáveis que não apresentaram relação identificaram-se prevalência de mulheres (86,03%), uso correto dos medicamentos (83,84%), o recebimento de orientações para o uso de medicamentos (96,07%), os que referiram cuidar da alimentação (73,36%) e o sedentarismo (71,62%). Garantir acesso a medicamentos encontra- se entre as diretrizes do SUS, porém, é responsabilidade do serviço de saúde promover a utilização desses produtos de forma eficaz e segura. Como estratégia para estes objetivos apresenta-se a sensibilização e capacitação das equipes de saúde e o incentivo à corresponsabilização do usuário de medicamentos sobre o seu tratamento, processo que pode ser desenvolvido através da educação em saúde e do matriciamento, sendo fundamental a participação do farmacêutico nesse processo, apoiando e apoiado pela equipe de saúde de cada unidade.

This study's objective is to describe the medication use profile and identify factors associated with medication use among adults waiting for medical care in the waiting rooms of three units of the Family Health Strategy (FHS) in the city of Santa Rosa, RS. This is a cross-sectional, analytical, and descriptive study. Data collection was carried out over three weeks in August 2014, one week in each unit. Data were statistically analyzed using ANOVA followed by the Student's t-test for the independent samples. It was observed that 58.95% of those interviewed use medication continuously, with a mean use of 2.08 medications/individual. Among the variables correlated with continuous drug use, we observed: the over-50 age group, chronic disease, educational level, and frequency of use of the health unit services. Among the variables with no observed correlation, we identified: a prevalence of women (86.03%), correct use of medications (83.84%), having received guidance on the use of medications (96.07%), those who reported healthy eating (73.36%), and sedentary lifestyle (71.62%). Ensuring access to medications is one of the guidelines of the Brazilian Public Health System, however, it is the health service's responsibility to promote the effective and safe use of these products. A strategy for meeting these objectives includes increased awareness and training of health professionals, and encouraging the co-responsibility of medication users regarding their treatment. This process can be developed through education in health, with participation of the pharmacist in this process, supporting and supported by the health team of each unit.

Asunto(s)