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This study investigates the tribocorrosion performance of a cast Co-Cr-Mo alloy prepared using casting and electromagnetic stirring (EMS) at specific frequencies. The tribocorrosion behaviour of the alloy was evaluated when exposed to Ringer's lactate solution to optimize the EMS parameters and improve its properties. The research focuses on biomedical implant applications and explores how EMS affects alloy wear and corrosion resistance. As did the friction coefficient and wear volume, the wear rate of samples produced with EMS frequencies of 75 Hz and 150 Hz decreased. These improvements are attributed to the ability of EMS to refine grain size and homogenize the microstructure, thereby increasing the resistance to tribocorrosion. Techniques such as scanning electron microscopy (SEM) and profilometry were used for surface and wear analysis, while mechanical properties were evaluated through instrumented indentation tests. The findings confirm that EMS improves the alloy's durability and tribocorrosion resistance, making it highly suitable for demanding biomedical applications such as joint replacements. This highlights the importance of advanced manufacturing techniques in optimizing biomedical alloys for simulated body conditions.

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Cobalt-chromium-molybdenum (Co-Cr-Mo) alloy is a material recommended for biomedical implants; however, to be suitable for this application, it should have good tribological properties, which are related to grain size. This paper investigates the tribological behaviour of a Co-Cr-Mo alloy produced using investment casting, together with electromagnetic stirring, to reduce its grain size. The samples were subjected to wear and scratch tests in simulated body fluid (Ringer's lactate solution). Since a reduction in grain size can influence the behaviour of the material, in terms of resistance and tribological response, four samples with different grain sizes were produced for use in our investigation of the behaviour of the alloy, in which we considered the friction coefficient, wear, and scratch resistance. The experiments were performed using a tribometer, with mean values for the friction coefficient, normal load, and tangential force acquired and recorded by the software. Spheres of Ti-6Al-4V and 316L steel were used as counterface materials. In addition, to elucidate the influence of grain size on the mechanical properties of the alloy, observations were conducted via scanning electron microscopy (SEM) with electron backscatter diffraction (EBSD). The results showed changes in the structure, with a reduction in grain size from 5.51 to 0.79 mm. Using both spheres, the best results for the friction coefficient and wear volume corresponded to the sample with the smallest grain size of 0.79 mm. The friction coefficients obtained were 0.37 and 0.45, using the Ti-6Al-4V and 316L spheres, respectively. These results confirm that the best surface finish for Co-Cr-Mo alloy used as a biomedical implant is one with a smaller grain size, since this results in a lower friction coefficient and low wear.

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Polyurethane (PU) substrates are biocompatible materials widely used to manufacture endotracheal tubes. However, in common with other biomedical materials, they are liable to the formation of microbial films. The occurrence of pneumonia in intubated patients treated at intensive care units often takes the form of ventilator-associated pneumonia (VAP). The issue relates to the translocation of pathogenic microorganisms that colonize the oropharyngeal mucosa, dental plaque, stomach, and sinuses. New protective materials can provide a more effective therapeutic approach to mitigating bacterial films. This work concerns microcrystalline carbon film containing dispersed silver nanoparticles (µC-Ag) deposited on PU substrates using a physical vapor deposition sputtering process. For the first time, carbon paper was used to produce a carbon target with holes exposing a silver disk positioned under the carbon paper, forming a single target for use in the sputtering system. The silver nanoparticles were well distributed in the carbon film. The adherence characteristics of the µC-Ag film were evaluated using a tape test technique, and electron dispersive x-ray mapping was performed to analyze the residual particles after the tape test. The microbicidal effect of the thin film was also investigated using speciesS. aureus, a pathogenic microorganism responsible for most infections of the lower respiratory tract involving VAP and ventilator-associated tracheobronchitis (VAT). The results demonstrated that µC-Ag films on PU substrates are promising materials for mitigating pathogenic microorganisms on endotracheal tubes.

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Despite functional goat milk products having emerged due to their importance for human nutrition and health, few studies have assessed the safety of consumption of goat dairy products containing potentially probiotic autochthonous lactic acid bacteria supplemented with prebiotic carbohydrates. Aiming this field, this study evaluated the safety of goat's milk fermented with Streptococcus thermophilus QGE, the autochthonous Limosilactobacillus mucosae CNPC007 culture, and the prebiotic inulin, through single- and repeated-dose oral toxicity tests (SDT and RDT, respectively) in animals. Ten female Swiss Webster mice were used for SDT evaluation - 2 groups, SDTc (20 mL/kg of filtered water) and SDTt (20 mL/kg of fermented milk) - and 40 Wistar rats for RDT - RDT3, RDT6, and RDT12 (treated with fermented milk at doses of 3 mL/kg, 6 mL/kg, and 12 mL/kg, respectively) and also RDTc (12 mL/kg of filtered water). For SDT, no signs of mortality or toxicity were observed, and the animals maintained the expected weight gain and feed intake. The RDT trials did not show mortality or signs of toxicity, as well as no change in body weight and organs, in the hematological and biochemical parameters, and also in relation to morphology and histology. Since the fermented milk did not cause any toxic effect in the conditions evaluated, it can be said that its no-adverse effect level (NOAEL) was considered to be higher than 20 mL/kg/day. Thus, the fermented milk with L. mucosae CNPC007 and inulin was considered to be of low toxicity, safe for use in rodents, and allowed for use in further studies.

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In this article, the actions developed by the Hospital Infection Control Service (HICS) and Occupational Medicine (OM) to face the COVID-19 pandemic and track cases of infection among employees of a large hospital in Belo Horizonte, Minas Gerais, Brazil. Training actions, guidelines on how to collect a swab sample, Code 19 (COVID-19) simulation, dressing/undressing, hand hygiene, the definition of flows, and the quantification of cases infected by COVID-19 among employees in care areas were highlighted. The engagement of HICS and OM in the prevention and promotion of health were fundamental to facing the pandemic. It is estimated that SARS-CoV-2 infection rates among staff at the study hospital were similar to those at other hospitals. The experience report is important for expanding knowledge about action planning in the context of a large hospital (AU).

Neste artigo, são relatadas as ações desenvolvidas pelo Serviço de Controle de Infecção Hospitalar (SCIH) e Medicina do Trabalho (MT) para o enfrentamento da pandemia de COVID-19 e rastreamento dos casos de infecção entre funcionários de um hospital de grande porte de Belo Horizonte, Minas Gerais, Brasil. Destacaram-se as ações de treinamentos, orientações de como coletar amostra de swab, simulação Código 19 (COVID-19), paramentação/desparamentação, higiene das mãos, definição de fluxos e quantificação dos casos infectados por COVID-19 entre funcionários de áreas assistenciais. O engajamento do SCIH e da MT na prevenção e promoção da saúde foi fundamental no enfrentamento da pandemia. Estima-se que os índices de infecção pelo SARS-CoV-2 entre os funcionários do hospital em estudo foram similares aos de outros hospitais. O relato de experiência é importante para a ampliação do conhecimento sobre o planejamento de ações no contexto de um hospital de grande porte (AU).

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Here, nanocomposites of high-molecular-weight polyethylene (HMWPE) and HMWPE-UHMWPE (80/20 wt.%) containing a low amount of multilayer graphene oxide (mGO) (≤0.1 wt.%) were produced via twin-screw extrusion to produce materials with a higher tribological performance than UHMWPE. Due to the high viscosity of both polymers, the nanocomposites presented a significant concentration of agglomerates. However, the mechanical (tensile) and tribological (volumetric loss) performances of the nanocomposites were superior to those of UHMWPE. The morphology of the nanocomposites was investigated using differential scanning calorimetry (DSC), microtomography, and transmission electron microscopy (TEM). The explanation for these results is based on the superlubricity phenomenon of mGO agglomerates. It was also shown that the well-exfoliated mGO also contained in the nanocomposite was of fundamental importance as a mechanical reinforcement for the polymer. Even with a high concentration of agglomerates, the nanocomposites displayed tribological properties superior to UHMWPE's (wear resistance up to 27% higher and friction coefficient up to 57% lower). Therefore, this manuscript brings a new exception to the rule, showing that agglomerates can act in a beneficial way to the mechanical properties of polymers, as long as the superlubricity phenomenon is present in the agglomerates contained in the polymer.

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O presente relatório descreve o processo de desenvolvimento das competências inerentes ao enfermeiro especialista à Enfermagem à Pessoa em Situação Crítica. Para uma abordagem qualificada ao doente crítico, é necessário que o enfermeiro especialista detenha competências científicas, éticas, relacionais e técnicas, de modo a operacionalizar as áreas de prestação de cuidados de gestão, formação e investigação. Assim, na primeira parte deste trabalho é feita a análise detalhada das atividades realizadas e das competências especializadas desenvolvidas na prática clínica, que me permitiram cuidar do doente em situação emergente, antecipando a instabilidade e o risco de falência orgânica, gerindo a dor, o bem-estar do doente, a administração de protocolos terapêuticos e a comunicação interpessoal com o doente e família, em diferentes contextos de cuidados de enfermagem à pessoa em situação crítica, dos quais, Serviço de Urgência Geral, Serviço de Medicina Intensiva e Bloco Operatório. O Curso de Mestrado em Enfermagem à Pessoa em Situação Crítica, bem como a análise critico-reflexiva das competências especializadas, tornaram-se muito enriquecedoras e construtivas, contribuindo para o meu crescimento pessoal e sobretudo profissional, levando à melhoria da minha prestação de cuidados em enfermagem na abordagem ao doente crítico. A segunda parte deste trabalho é constituída uma Revisão Sistemática da Literatura que pretende identificar os instrumentos de medida para avaliar o debriefing em estudantes de enfermagem em cenários de simulação clínica.

This report describes the process of developing the competences inherent to the nurse specialising in Critical Care Nursing. For a qualified approach to the critically ill patient, it is necessary for the specialist nurse to have scientific, ethical, relational and technical skills in order to operationalise the areas of care management, training and research. Thus, the first part of this work provides a detailed analysis of the activities carried out and the specialised skills developed in clinical practice, which allowed me to care for the patient in an emergency situation, anticipating instability and the risk of organ failure, managing pain, patient well-being, the administration of therapeutic protocols and interpersonal communication with the patient and family, in different contexts of nursing care for the critically ill person, including the General Emergency Service, Intensive Care Medicine Service and Operating Room. The Master's Degree in Nursing for the Critically Ill Person, as well as the critical-reflective analysis of the specialised competences, became very enriching and constructive, contributing to my personal and above all professional growth, leading to the improvement of my nursing care in the approach to the critically ill patient. The second part of this work is a Systematic Literature Review that aims to identify the measurement instruments to evaluate debriefing in nursing students in clinical simulation scenarios.

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Camphor was incorporated in diamond-like carbon (DLC) films to prevent the Candida albicans yeasts fouling on polyurethane substrates, which is a material commonly used for catheter manufacturing. The camphor:DLC and DLC film for this investigation was produced by plasma enhanced chemical vapor deposition (PECVD), using an apparatus based on the flash evaporation of organic liquid (hexane) containing diluted camphor for camphor:DLC and hexane/methane, mixture for DLC films. The film was deposited at a low temperature of less than 25°C. We obtained very adherent camphor:DLC and DLC films that accompanied the substrate flexibility without delamination. The adherence of camphor:DLC and DLC films on polyurethane segments were evaluated by scratching test and bending polyurethane segments at 180°. The polyurethane samples, with and without camphor:DLC and DLC films were characterized by Raman spectroscopy, scanning electron microscopy, atomic force microscopy, and optical profilometry. Candida albicans biofilm formation on polyurethane, with and without camphor:DLC and DLC, was assessed. The camphor:DLC and DLC films reduced the biofilm growth by 99.0% and 91.0% of Candida albicans, respectively, compared to bare polyurethane. These results open the doors to studies of functionalized DLC coatings with biofilm inhibition properties used in the production of catheters or other biomedical applications.

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RESUMO De acordo com a Lei Arouca (Lei n° 11.794 – 2008), que estabelece critérios para “a criação e a utilização de animais em atividades de ensino e pesquisa científica, em todo o território nacional”, tem-se que, “sempre que possível, as práticas de ensino deverão ser fotografadas, filmadas ou gravadas, de forma a permitir sua reprodução para ilustração de práticas futuras, evitando-se a repetição desnecessária de procedimentos didáticos com animais”. O objetivo deste estudo foi relatar o desenvolvimento de um software (Pharmasoftware®) como método alternativo de ensino em Farmacologia no curso de Medicina da Universidade Federal do Ceará (UFC), Campus Sobral. Para a certificação, foram utilizados dois grupos de alunos, um em aula prática convencional e outro com o Pharmasoftware®. A análise dos resultados revelou que ambas as atividades foram igualmente eficazes em auxiliar na consolidação do tema Vias de Administração dos Fármacos, evidenciando, assim, o Pharmasoftware® como uma ferramenta capaz de auxiliar no ensino da Farmacologia e, ainda, de fomentar a implantação de outros métodos alternativos de ensino de Farmacologia nas Instituições de Ensino Superior.

ABSTRACT The Brazilian Law on scientific and teaching use of animals, Arouca’s Law (n° 11.794 – 2008), clearly states that animals should not be used if an alternative method is available. The aim of this study was to describe the development of a software (Pharmasoftware®) as an alternative method of teaching in pharmacology at a Medical School (Federal University of Ceara, Campus Sobral). To support the development and validation of the Pharmasoftware® as an alternative method, students were allocated into two groups: one attending a conventional practical class and the other employing Pharmasoftware®. The results showed that two activities were equally effective in improving the students’ knowledge of drug administration. Pharmasoftware® may therefore represent a tool capable of supporting pharmacology teaching and it also fostering the establishment of alternative methods for teaching Pharmacology in the undergraduate courses.

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ETHNOPHARMACOLOGICAL RELEVANCE: Species of Chresta genus- are recognized by the population of northeastern Brazil as traditional herbs used to treat gastric diseases and other disorders. AIM OF THE STUDY: This work aimed to find out the action mechanism of Chresta martii hydro alcoholic extract gastro protective effect in the model of ethanol-induced gastropathy. MATERIAL AND METHODS: Gastropathy was assessed by percentual damaged area determination in photographs of mice opened stomachs. Fasted mice treated with ethanol 99.9% (0.2 ml/animal, p.o.) were pre-treated with Chresta martii hydro alcoholic extract (HAE) (50, 100 or 200 mg/kg, p.o.), ranitidine (80 mg/kg, p.o.) or saline (5 ml/kg; p.o.) in different experimental sets, in which pharmacological tools (naloxone, indomethacin, N(ω)-Nitro-L-arginine methyl ester hydrochloride (L-NAME) or yohimbine) were added in order to clarify a possible action mechanism. Animals were sacrificed 30 min after ethanol challenge to stomach analysis. Determination of non-protein sulfhydryl groups and tissue hemoglobin, besides histological assessment (H&E) were taken to fully characterize the HAE gastro protective effect. RESULTS: HAE (100 and 200 mg/kg) was able to protect mucosa against ethanol gastropathy in presence of three (naloxone, indomethacin and L-NAME) of four antagonist/inhibitor tools. The HAE effect was reversed only by yohimbine, showing the alpha-2 adrenoceptors participation on gastro protective effect of this extract. HAE histological characteristics, NP-SH and Hb were compatible with the protective effects. CONCLUSIONS: HAE possesses gastroprotective effects in an ethanol-induced gastropathy model in mice, corroborating the traditional use of this family of plants to treat gastric disorders. This activity is mediated by alpha-2 adrenoceptors activation, but not by nitric oxide release, opioid receptor activation or prostaglandin synthesis. HAE also has antioxidant activity that is thought to either play a role in this biological activity or to be a byproduct of alpha-2 adrenergic complex activation.

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Estudo realizado no Centro Cirúrgico de uma maternidade pública, objetivando identificar a frequência dos diagnósticos de enfermagem mais comuns seguindo a CIPE em emergência obstétrica no período transoperatório de cesárea. Pesquisa do tipo descritivo-exploratória, quantitativa. Utilizou-se um instrumento para a entrevista, exame físico e observação de 30 parturientes....

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Cyclospora cayetanensis adquiriu importância por causar surtos e casos esporádicos de diarréia em todo o mundo, associados a alimentos. No Brasil, até 1999 nenhum surto de ciclosporíase havia sido registrado. O objetivo deste trabalho é apresentar os resultados da investigação do surto de Cyclospora cayetanensis ocorrido no período de setembro a dezembro de 2000, em General Salgado (SP), associado ao sistema de abastecimento público de água da cidade. Um estudo descritivo foi conduzido para identificar a fonte de transmissão, com entrevistas de pacientes, análise dos registros de diarréia dos anos anteriores, inspeções sanitárias dos sistemas de água e esgoto, exames laboratoriais de amostras de fezes dos pacientes, dos alimentos suspeitos e da água do sistema. Caso clínico compatível foi definido como o indivíduo com diarréia líquida e pelo menos mais três dos sintomas gastrintestinais, como náusea, vômito, flatulência, dor abdominal, perda de peso ou diarréia prolongada, residente em General Salgado durante o período do surto. Casos confirmados foram definidos como aqueles com oocistos típicos nas amostras de fezes. Amostras clínicas e de alimentos foram analisadas pelo Instituto Adolfo Lutz. Amostras de água foram testadas pelo CDC/Atlanta por técnica de PCR. Foram identificados 350 casos envolvidos no surto (taxa de incidência = 32,3 casos/1.000 habitantes), dos quais crianças menores de 4 anos constituíram o grupo mais afetado (taxa de incidência = 49,1 casos/1.000 habitantes). Dos 40 casos testados para bactéria, vírus e parasita dez foram positivos para Cyclospora cayetanensis. O sistema público de água era composto de 15 poços artesianos com infiltração de águas pluviais e esgoto. A água do poço de número 7 foi positiva para Cyclospora cayetanensis. Para controlar o surto, mudanças importantes foram necessárias no sistema de abastecimento público de água e esgoto. Medidas educacionais, monitoramento da diarréia aguda, testes laboratoriais...

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Dermoscopy is a non-invasive diagnostic technique for the in vivo observation of pigmented skin lesions used in dermatology. There is currently a great interest in the prospects of automatic image analysis methods for dermoscopy, both to provide quantitative information about a lesion, which can be of relevance for the clinician, and as a stand alone early warning tool. The effective implementation of such a tool could lead to a reduction in the number of cases selected for exeresis, with obvious benefits both to the patients and to the health care system. The standard approach in automatic dermoscopic image analysis has usually three stages: (i) image segmentation, (ii) feature extraction and feature selection, (iii) lesion classification. This paper presents a comparison of segmentation methods applied to 50 dermoscopic image analysis, along with a clinical evaluation of each segmentation result performed by an experienced dermatologist.

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A epidemia da Aids atinge cada vez mais mulheres em idade fértil. A realização do exame anti-HIV no pré-natal é uma importante estratégia para reduzir a morbi-mortalidade por esta causa. O objetivo foi investigar o conhecimento das gestantes quanto à importância da realização do exame anti-HIV no pré-natal. Estudo descritivo com 50 gestantes maiores de 18 anos, que realizavam pré-natal de baixo risco em consulta subseqüente sem diagnóstico firmado para Aids. A idade das gestantes predominou entre 20 a 25 anos; a maioria tinha sido abordada em consultas anteriores a importância sobre o exame anti-HIV e 92% confirmaram ter realizado esse exame após a primeira consulta de pré-natal. Reafirmam-se os benefícios deste exame no pré-natal e a importância da educação em saúde na prevenção e no controle da doença.

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Discontinuation of life-sustaining interventions often raises ethical concerns. In cases of severe child abuse with poor prognosis for recovery, accused parents may have a conflict of interest regarding medical decision-making for their child, because the outcome of such decisions may impact legal charges filed against them. The recently issued American Academy of Pediatrics guidelines for addressing such cases recommended the appointment of a guardian ad litem for medical decision-making. We present the case of an 8-month-old infant who was abused severely by her father, resulting in a persistent vegetative state. We describe our experience with appointing a guardian ad litem and the ethical issues involved.

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No presente estudo clínico, analizou-se os efeitos do uso de goma de mascar, sobre alguns músculos da mastigaçäo (masseter e temporal) e articulaçöes temporomandibulares, em 20 indivíduos (17 do sexo feminino e 03 do sexo masculino), com idades variando entre 20 e 24 anos (idade média de 21,6 anos), portadores de oclusöes normais, sem alteraçöes funcionais do sistema estomatogmático, divididos em quatro grupos com 5 participantes cada, a saber: (1) grupo controle; (2) grupo que utilizou a goma TRIDENT; (3) grupo que utilizou a GOMA BASE e (4) grupo que utilizou a goma PING PONG. Os constituintes da amostra foram orientados a mascar a goma recebida por um período de 20 minutos, após cada uma das refeiçöes principais, sendo avaliados, ao final de cada um dos cinco dias do experimento, através de análise funcional da oclusäo. Consideradas as peculiaridades, a natureza do trabalho, e os resultados obtidos, pareceram pertinentes e relevantes as seguintes conclusöes (1) o exercício da atividade mastigatória na presença de normalidade individual e funcional, nas condiçöes de realizaçäo do presente estudo, näo levou ao aparecimento de sinais e/ou sintomas de desordens craniomandibulares (DCMs); (2) o uso regular de gomas de mascar, após a execuçäo da atividade mastigatória normal, durante um período de tempo pré-estabelecido e sistemático, levou ao aparecimento de manifestaçöes clínicas que poderiam ser consideradas como fatores potenciais de desordens craniomandibulares em indivíduos normais; (3) clinicamente, o aumento no tempo diário de mastigaçäo, resultante do ato de mascar gomas, levou a alteraçöes no tônus muscular dos músculos masseter e temporal, manifestadas como "fadiga" e "dor", (4) os efeitos do ato de mascar gomas, sobre as articulaçöes temporomandibulares, embora mais moderados, sugerem uma relaçäo causa e efeito que indica a necessidade de estudos semelhantes por um período de tempo e com uma amostra maior

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