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BACKGROUND: Oral cancer (OC) and oral potentially malignant disorders (OPMD) pose significant challenges to public health in Brazil. This study aimed to estimate the prevalence of oral cancer (OC) and oral potentially malignant disorders (OPMD) among patients who would be treated by Brazilian dentists during their careers. MATERIAL AND METHODS: Data on the number of dentists in Brazil were extracted from the 2022 census data, while incidence rates for OC cases were sourced from the Brazilian National Cancer Institute (INCA). Population estimates for Brazil and data on dental check-up rates were obtained from relevant national sources. RESULTS: Our analysis indicates that a general dentist in Brazil can expect to encounter on average two to three OC patients and on average 675 patients with OPMDs over a 35-year career. Regional disparities were observed, with certain regions showing higher than the average number of encounters due to low density of dentists in some rural districts. CONCLUSIONS: Brazilian dentists are likely to confront a substantial number of OC and OPMD cases during their professional tenure, emphasizing the need for public health policies aimed at enhancing dental surgeons' education in oral cancer prevention and early detection.
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Neoplasias Bucais , Humanos , Brasil/epidemiologia , Neoplasias Bucais/epidemiologia , Prevalência , Efeitos Psicossociais da Doença , Lesões Pré-Cancerosas/epidemiologiaRESUMO
Adaptive behaviors emerge in novel environments through functional changes in neural circuits. While relationships between circuit function and behavior have been well studied, how evolution shapes those circuits and leads to behavioral adpation is poorly understood. The Mexican cavefish, Astyanax mexicanus, provides a unique genetically amendable model system, equipped with above ground eyed surface fish and multiple evolutionarily divergent populations of blind cavefish that have evolved in complete darkness. These differences in environment and vision provide an opprotunity to examine how a neural circuit is functionally influenced by the presence of light. Here, we examine differences in the detection, and behavioral response induced by non visual light reception. Both populations exhibit photokinetic behavior, with surface fish becoming hyperactive following sudden darkness and cavefish becoming hyperactive following sudden illumination. To define these photokinetic neural circuits, we integrated whole brain functional imaging with our Astyanax brain atlas for surface and cavefish responding to light changes. We identified the caudal posterior tuberculum as the central modulator for both light or dark stimulated photokinesis. To unconver how spatiotemporal neuronal activity differed between surface fish and cavefish, we used stable pan-neuronal GCaMP Astyanax transgenics to show that a subpopulation of darkness sensitve neurons in surface fish are now light senstive in cavefish. Further functional analysis revealed that this integrative switch is dependent on dopmane signaling, suggesting a key role for dopamine and a highly conserved dopamine circuit in modulating the evolution of a circuit driving an essential behavior. Together, these data shed light into how neural circuits evolved to adapte to novel settings, and reveal the power of Astyanax as a model to elucidate mechanistic ingiths underlying sensory adaptation.
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INTRODUCTION: Serratia marcescens is an opportunistic pathogen found ubiquitously in the environment and associated with a wide range of nosocomial infections. This multidrug-resistant bacterium has been a cause of concern for hospitals and healthcare facilities due to its ability to spread rapidly and cause outbreaks. Next generation sequencing genotyping of bacterial isolates has proven to be a valuable tool for tracking the spread and transmission of nosocomial infections. This has allowed for the identification of outbreaks and transmission chains, as well as determining whether cases are due to endogenous or exogenous sources. Evidence of nosocomial transmission has been gathered through genotyping methods. The aim of this study was to investigate the genetic diversity of carbapenemase-producing S. marcescens in an outbreak at a public hospital in Cuiaba, MT, Brazil. METHODOLOGY: Ten isolates of S. marcenses were sequenced and antibiotic resistance profiles analyzed over 12 days. RESULTS: The isolates were clonal and multidrug resistant. Gentamycin and tigecycline had sensitivity in 90% and 80% isolates, respectively. Genomic analysis identified several genes that encode ß-lactamases, aminoglycoside-modifying enzymes, efflux pumps, and other virulence factors. CONCLUSIONS: Systematic surveillance is crucial in monitoring the evolution of S. marcescens genotypes, as it can lead to early detection and prevention of outbreaks.
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Antibacterianos , Infecção Hospitalar , Surtos de Doenças , Farmacorresistência Bacteriana Múltipla , Unidades de Terapia Intensiva , Infecções por Serratia , Serratia marcescens , Sequenciamento Completo do Genoma , Serratia marcescens/genética , Serratia marcescens/efeitos dos fármacos , Serratia marcescens/isolamento & purificação , Humanos , Brasil/epidemiologia , Farmacorresistência Bacteriana Múltipla/genética , Infecções por Serratia/microbiologia , Infecções por Serratia/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/epidemiologia , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana , Genótipo , Genoma Bacteriano , beta-Lactamases/genética , Variação GenéticaRESUMO
The effects of short-chain fatty acids (SCFAs) have been explored against cancer due to the crosstalk between gut microbiota alterations and the immune system as a crucial role in cancer development. We evaluated the SCFAs effects in both in vitro and in vivo breast cancer models. In vitro, the SCFAs displayed contrasting effects on viability index, according to the evaluation of breast cancer cells with different phenotypes, human MCF-7, SK-BR-3, MDA-MD-231, or the mouse 4T1 lineage. Acetate displayed minimal effects at concentrations up to 100 mM. Alternatively, propionate increases or reduces cell viability depending on the concentration. Butyrate and valerate showed consistent time- and concentration-dependent effects on the viability of human or mouse breast cancer cells. The selective FFA2 4-CMTB or FFA3 AR420626 receptor agonists failed to overtake the SCFA actions, except by modest inhibitory effects on MDA-MB-231 and 4T1 cell viability. The FFA2 CATPB or FFA3 and ß-hydroxybutyrate receptor antagonists lacked significant activity on human cell lines, although CATPB reduced 4T1 cell viability. Butyrate significantly affected cell morphology, clonogenicity, and migration, according to the evaluation of MDA-MB-231 and 4T1 cells. A preliminary examination of in vivo oral effects of butyrate, propionate, or valerate, dosed in prophylactic or therapeutic regimens, on several parameters evaluated in an orthotopic breast cancer model showed a reduction of lung metastasis in post-tumor induction butyrate-treated mice. Overall, the present results indicate that in vitro effects of SCFAs did not rely on FFA2 or FFA3 receptor activation, and they were not mirrored in vivo, at least at the tested conditions. Overall, the present results indicate potential in vitro inhibitory effects of SCFAs in breast cancer, independent of FFA2 or FFA3 receptor activation, and, in the metastatic breast cancer model, the butyrate-dosed therapeutic regimen reduced the number of lung metastases.
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BACKGROUND: Chemotherapy (CT) is a systemic treatment using a combination of antineoplastic drugs, orally or intravenously, that inhibit tumor growth and fast-growing normal cells. Due to its nonspecificity, chemotherapy can cause a series of adverse effects, such as altered taste (dysgeusia), associated with malnutrition and, consequently, other adverse effects in the gastrointestinal tract and increased mortality risk. This study aimed to evaluate the influence of dysgeusia on the incidence of other adverse effects and overall survival during antineoplastic chemotherapy. MATERIAL AND METHODS: An observational, retrospective, cross-sectional study was conducted using data from the Electronic Health Record system of the Cancer Institute of Ceará over two years. Before the CT session, the multi-professional team evaluated the patient for the presence and severity of adverse effects (AE), using scores from the CTCAE v5.0 scale. Dysgeusia scores were collected and associated with clinical pathological data, with other adverse effects (nausea, vomiting, diarrhea, oral mucositis, anorexia, constipation), and with overall survival. Chi-square and Mantel-Cox log-rank tests were used. RESULTS: Of 5744 patients evaluated, dysgeusia presented a frequency of 50.6%, being directly associated with female gender (p=0.001), overweight (p=0.022), high tumor stages (p=0.009), a combination of adjuvant and neoadjuvant (p=0.010) and four-year survival (p=0.030). Dysgeusia frequency was directly associated with diarrhea (p<0.001), anorexia (p<0.001), oral mucositis (p<0.001), nausea (p<0.001), constipation (p<0.001) and vomiting (p<0.001), and inversely associated with fatigue (p=0.035). CONCLUSIONS: Dysgeusia during CT increases the risk of other adverse effects and negatively impacts prognosis.
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Antineoplásicos , Disgeusia , Neoplasias , Humanos , Disgeusia/induzido quimicamente , Disgeusia/epidemiologia , Estudos Transversais , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Neoplasias/complicações , Idoso , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Adulto , Taxa de Sobrevida , Idoso de 80 Anos ou mais , Adulto Jovem , AdolescenteRESUMO
Problem: The coronavirus disease 2019 (COVID-19) pandemic has highlighted global disparities in accessing essential health products, demonstrating the critical need for low- and middle-income countries to develop local production and innovation capabilities. Approach: The health economic-industrial complex approach changed the values that guided innovation and industrial policies in Brazil. The approach directed health production and innovation to universal access; the health ministry led a whole-of-government approach; and public procurement was strategically applied to stimulate productive public and private investments. The institutional, technological and productive capacities built up by the health economic-industrial complex allowed the country to quickly establish local COVID-19 vaccines production and guarantee access for the population. Local setting: Brazil has a universal health system that guarantees access to health for its 215 million population. Relevant changes: Public policies and actions, based on the health economic-industrial complex, guided investment projects in line with health demands, strengthened local producers, and increased autonomy in the production of health products in areas of greater technological dependence. During the COVID-19 pandemic, the country was able to rapidly scale up local vaccine production. By August 2021, Brazil had produced 74.8% (151 463 502/202 437 516) of the vaccine doses used in the country. Lessons learnt: The Brazilian example shows that low- and middle-income countries can build systemic development policies that increase their capability to produce and innovate in concert with universal health systems. This increased capacity can guarantee access to health products and supplies that are critical during global health emergencies.
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Vacinas contra COVID-19 , COVID-19 , Acessibilidade aos Serviços de Saúde , Brasil , Humanos , COVID-19/epidemiologia , COVID-19/economia , Acessibilidade aos Serviços de Saúde/economia , Vacinas contra COVID-19/economia , Vacinas contra COVID-19/provisão & distribuição , SARS-CoV-2 , Assistência de Saúde Universal , PandemiasRESUMO
BACKGROUND: The Latin American region represents a hotspot for oral cancer incidence and mortality. To reduce oral cancer mortality rates, screening for early detection of subjects with suspicious or innocuous oral lesions has been promoted. A systematic review was performed to assess the outcomes of oral cancer screening in the Latin American region. MATERIAL AND METHODS: An electronic search was conducted in eight databases and grey literature. The eligibility criteria included screening where adult participants underwent any screening test during an organized screening program. Screening programs were assessed to understand trends in oral cancer diagnosis. Rates of oral cancers diagnosed in screening programs were classified as increase, decrease, or stable based on each year assessed. RESULTS: Following our searches, twelve studies conducted in Brazil and Cuba were included. The screening tests reported were visual oral examination (VOE) and in one study in addition light-based fluorescence testing. 13,277,608 individuals were screened and a total of 1,516 oral cancers were detected (0.01%). Only two studies aimed to screen high-risk individuals (smokers and drinkers). Oral cancer cases diagnosed during screening programs were proportionately stable over the years 1997 to 2009 but increased from 2010 to 2021. The fluorescence-associated VOE test demonstrated a sensitivity of 100% and a specificity of 90%. Similarly, the VOE test alone exhibited a sensitivity of 100%, with specificity ranging from 75% to 90%. CONCLUSIONS: Screening studies conducted in Latin American countries had serious limitations both in methodology (lack of examiner training) and in reporting data (lack of description of clinical categories of screen positives). Capacitation of health workers to perform VOE in well-designed screening programs should be implemented.
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Detecção Precoce de Câncer , Neoplasias Bucais , Humanos , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/epidemiologia , Brasil/epidemiologia , Cuba/epidemiologia , América Latina/epidemiologiaRESUMO
The present study investigated the reliability and sensitivity of a wearable near-infrared spectroscopy (wNIRS) device in moderate and heavy exercise intensity domains. On three separate days, eleven males performed an incremental test to exhaustion, and in the following visits, four submaximal constant-load bouts (i.e., test and retest) were performed in the moderate-intensity domain (100 and 130 W) and heavy-intensity domain (160 and 190 W). The local tissue oxygen saturation index (SmO2) and pulmonary oxygen uptake (V̇O2) were measured continuously. The absolute SmO2 and V̇O2 values and the change (Δ) from the 3rd to 6th min of exercise were calculated. There was good reliability for SmO2 measurements, as indicated by the high intraclass correlation coefficient analysis (ICC ≥0.84 for all) and low coefficient of variation between the two trials (CV ≤4.1% for all). Steady-state responses were observed for SmO2 and V̇O2 from the 3rd to the 6th min in the two moderate-intensity bouts (P>0.05), whereas SmO2 decreased and V̇O2 increased from the 3rd to the 6th min in the two heavy-intensity bouts (P<0.05). Together, these findings suggested that the SmO2 measured with a wNIRS device is reliable and sensitive to track local metabolic changes provoked by slight increments in exercise intensity.
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BACKGROUND: Graft-versus-host disease (GVHD) is an immune system reaction that occurs in patients with a history of hematopoietic stem cell transplantation (HSCT), in which the grafted donor's cells attack those of the host. The objective of this systematic review was to present a study on oral squamous cell carcinoma (OSSC) that developed from GVHD areas in patients undergoing HSCT. MATERIAL AND METHODS: An electronic search was conducted in the databases PUBMED, WEB OF SCIENCE, SCOPUS, MEDLINE and SCIENCE DIRECT, according to PRISMA guidelines. RESULTS: Of the 1582 results, 23 articles were included, resulting in 81 cases. The most common underlying disease for performing the transplant was Myeloid Leukemia (55.6%). The mean age was 39 years, with a predilection for males (64.2%). The tongue was the site of GVHD that most frequently underwent transformation to SCC (59.3%). The average time between transplantation and the development of GVHD was of approximately of 8 months, while the average period of development between transplantation and the development of OSCC was of approximately of 111 months. The most common treatment to GVHD was cyclosporine associated with corticosteroids. CONCLUSIONS: OSCCs arising from areas of GVHD present a different evolution from conventional oral carcinomas, since they affect younger patients, smoking and alcohol are not important etiological factors and finally because they present good prognosis, but further studies with larger number cases followed are needed to confirm our findings.
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Carcinoma de Células Escamosas , Doença Enxerto-Hospedeiro , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Masculino , Humanos , Adulto , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Neoplasias Bucais/etiologia , Doença Enxerto-Hospedeiro/complicações , Neoplasias de Cabeça e Pescoço/complicaçõesRESUMO
BACKGROUND: This study aimed to evaluate the profile of antimicrobial consumption in patients assisted by a palliative care (PC) team during the COVID-19 pandemic. METHODS: A retrospective observational study was conducted in a quaternary hospital. Patients assisted by the PC team in 2020 were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records. RESULTS: A total of 181 patients were included in the study, of whom 93.4% had used antimicrobials and 24.3% had had COVID-19. COVID-19 patients were more likely to receive at least one course of antimicrobial therapy. Patients who received polytherapy in the first course of treatment were more likely to die and to be still receiving antimicrobials at death. There was no significant difference in the length of hospital stay, new hospitalization in 12 months, nor the time to death among patients who received monotherapy or polytherapy during the first course of antimicrobial therapy. CONCLUSIONS: There was a large amount of PC patients receiving antimicrobial therapy during the COVID-19 pandemic. SARS-CoV-2-positive patients were more likely to receive antimicrobial therapy.
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RESUMO Os níveis de metabólitos variam de acordo com a região de criação, idade, estado fisiológico e alimentação do animal. Portanto, objetivou-se estimar valores de referência para os perfis energético, hepático e mineral de ovinos adultos nos trópicos. Para isso, foram utilizados dados de ovinos saudáveis, criados em diferentes sistemas de manejo, em instituições brasileiras, de 2006 a 2017. Glicose, colesterol, triglicerídeos, fructosamina, HDL, LDL e VLDL foram determinantes para o perfil energético; para o perfil proteico: proteína total, ácido úrico, ureia, albumina e creatinina; para o perfil mineral: valores de cálcio, fósforo e magnésio; e para o perfil enzimático: AST, GGT e fosfatase alcalina. A estimativa e a determinação dos valores de referência foram realizadas pelo teste Dixon e pelo método não paramétrico bootstrap. O intervalo de confiança definido foi de 95%. A maioria dos metabólitos apresentou intervalos que extrapolaram os limites recomendados na literatura internacional, chamando a atenção para o perfil energético o colesterol, fructosamina, ureia e fósforo e no enzimático, os intervalos de AST, GGT e fosfatase alcalina. Em conclusão, os intervalos definidos com base nos dados nacionais apresentam diferenças em relação aos internacionais, pois estes não distinguem os intervalos quanto à categoria do animal.
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ABSTRACT Brazilian chicken meat is exported to more than 150 countries and consumed by consumer markets that demand high quality and food safety, thus, requiring very strict control of pathogens present in food to guarantee these rigorous safety standards. This study evaluates the reports from the Salmonella spp. Control and Monitoring Program of the Brazilian Ministry of Agriculture, Livestock and Food Supply of seven slaughterhouses inspected by the Federal Inspection Service from the western region of Paraná state, Brazil, from March 2017 to February 2019. The broiler litter swab and carcass analyses revealed a Salmonella spp. positivity ratio of 5.9% (19/319) and 23.5% (75/319), respectively. The concomitant presence of Salmonella spp. in the broiler litter swab and chicken carcasses occurred in 58% of the positive samples. The most frequently isolated serovar in the carcasses was Salmonella Heidelberg (85.3%) followed by Salmonella spp. (10.6%). During slaughter, carcass positivity to Salmonella spp. was significantly different (p=0.047) between the first (19.6%) and the second (29.4%) shifts. The results alert for the possibility of carcass contamination during slaughtering and, therefore, more stringent hygiene measures between shifts must be implemented to mitigate carcass contamination.
RESUMO A carne de frango brasileira é consumida em mais de 150 países, em mercados exigentes com a qualidade e a produção de alimentos seguros, o que justifica o controle de patógenos nesse alimento, a fim de assegurar tais requisitos. O presente estudo analisou dados constantes dos relatórios do Programa de Controle e Monitoramento da Salmonella spp. do Ministério da Agricultura, Pecuária e Abastecimento do Brasil (MAPA), realizado em sete unidades avícolas e frigoríficas da região oeste do estado do Paraná, com Serviço de Inspeção Federal, no período entre março 2017 e fevereiro de 2019. A análise dos dados revelou a presença de Salmonella spp. no suabe de cama de frango em 5,9% dos lotes analisados e em 23,5% das carcaças oriundas desses lotes. A presença concomitante de Salmonella spp. no suabe de cama e nas carcaças de frango do lote ocorreu em 58% das amostras positivas. O sorovar mais frequentemente isolado nas carcaças foi Salmonella Heidelberg (85,3%), seguido de Salmonella spp. (10,6%). Durante o abate, observou-se diferença significativa (P=0,047) na positividade das carcaças para Salmonella spp. entre o primeiro (19,6%) e o segundo turno (29,4%). Os resultados indicam a possibilidade de contaminação das carcaças durante o abate, portanto a adoção de medidas mais rigorosas de higienização entre os turnos deve ser implementada a fim de mitigar a contaminação das carcaças.
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RESUMO A paratuberculose em bovinos de corte já foi diagnosticada no estado do Rio Grande do Sul, mas relatada em apenas um rebanho. Nesse contexto, o objetivo desta pesquisa é verificar se a paratuberculose pode ser detectada em rebanhos de bovinos de corte de diferentes mesorregiões do RS, por meio do teste ELISA. As amostras foram coletadas de bovinos provenientes de seis mesorregiões, entre elas as maiores produtoras de bovinos de corte do RS. Apenas duas amostras foram classificadas como suspeitas no teste de ELISA, as outras 391 amostras foram negativas. Os resultados demonstram baixa detecção da doença nas mesorregiões testadas, com apenas 0,5% das amostras com resultado suspeito. Assim, esses dados demonstram que a enfermidade é pouco frequente nos rebanhos testados e que um programa de controle pode ser implementado de forma viável e economicamente lucrativa.
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SUMMARY OBJECTIVE: Foreign body aspiration is one of the childhood emergencies that thoracic surgeons are interested in, and it can cause morbidity and mortality. Although the relationship between various behavioral problems related to children and foreign body aspiration has been investigated so far, there is no study investigating the relationship between maternal temperament and anxiety sensitivity. This study aimed to investigate the relationship between maternal emotional temperament, anxiety sensitivity, and foreign body aspiration. METHODS: Mothers of 18 children with foreign body aspiration have been evaluated by a thoracic surgeon, and 18 healthy controls have also been included in the study. Maternal emotional temperament has been measured with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Auto questionnaire scale, and anxiety sensitivity has been measured with the Anxiety Sensitivity Index-3. RESULTS: There has been no statistically significant difference between groups in terms of maternal emotional temperament and anxiety sensitivity. In the logistic regression analysis conducted to determine the predictors of foreign body aspiration, it is determined that the mother's anxious temperament has predicted foreign body aspiration significantly. CONCLUSION: As a result of the study, it can be concluded that mothers' anxious temperament can be considered a risk factor for foreign body aspiration because it affects parenting skills and children's ability to manage behavioral problems. Consistent results could be able to be obtained with studies including larger samples on the subject.
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Aim: To evaluate the impact of the first year of the COVID-19 pandemic on antibiotic dispensation in three Brazilian hospitals. Methods: Stock movement was accessed from pharmacy databases and microbiological reports from 2018 to 2021. Results: Reduced antibiotic dispensation occurred during 2020 in all hospitals. The most significant reduction was in April at Hospital Doutor Jayme dos Santos Neves (â¼58%), and in May at Hospital Doutor Roberto Arnizaut Silvares (â¼66%) and Hospital Doutor Dório Silva (â¼29%). However, azithromycin dispensation increased in all hospitals in 2020. Macrolide-resistant bacterial isolates rose from 66.6% in 2019 to 77.1% in 2020 and 88.3% in 2021. Conclusion: Despite reduced antibiotic dispensation, the increase in azithromycin consumption in 2020 highlights the urgency to monitor macrolide resistance after the pandemic and improve stewardship activities.
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Antibacterianos , COVID-19 , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Pandemias , Macrolídeos , Brasil/epidemiologia , COVID-19/epidemiologia , Farmacorresistência Bacteriana , Hospitais PúblicosRESUMO
Objetivo: Avaliar a presença e possíveis correlações entre fadiga, depressão e qualidade de vida relacionada à saúde em mulheres com câncer de mama e ginecológico durante quimioterapia. Metodologia: Estudo exploratório e transversal, realizado com 54 mulheres na Central de Quimioterapia de um hospital universitário, no período de setembro/2017 a dezembro/2019. Instrumentos utilizados: questionário sociodemográfico e clínico-terapêutico, Escala de Fadiga de Piper, Inventário de Depressão de Beck e Quality of Life Questionnaire-Core30. Resultados: Predominaram mulheres com câncer de mama, com fadiga de leve intensidade e sem depressão, contudo destaca-se que nove apresentaram fadiga clinicamente significante e 12 relataram sinais e sintomas indicativos de depressão. Os escores de estado geral de saúde, das funções cognitivas, social, física e desempenho de papel foram considerados satisfatórios, os sintomas prevalentes foram insônia, fadiga, dor e perda de apetite. Houve correlações moderadas entre os itens dos instrumentos, sendo que quanto maiores os escores de fadiga e depressão, maiores foram os sintomas e menores as escalas funcionais de qualidade de vida. Conclusões: A presença de fadiga e depressão correlacionou-se moderadamente com outros sintomas e podem influenciar a qualidade de vida relacionada à saúde destas mulheres.
Objective: To evaluate the presence and possible correlations between fatigue, depression and health-related quality of life in women with breast and gynecological cancer during chemotherapy. Methodology: Exploratory and cross-sectional study, carried out with 54 women at the Chemotherapy Center of a university hospital, from September/2017 to December/ 2019. Instruments used: sociodemographic and clinical-therapeutic questionnaire, Piper's Fatigue Sacale, Beck Depression Inventory, and Quality of Life Questionnaire-Core30. Results: There was a predominance of women with breast cancer, with mild fatigue and without depression, however it is noteworthy that nine had clinically significant fatigue and 12 reported signs and symptoms indicative of depression. The scores of general health status, cognitive, social, physical functions and role performance were considered satisfactory, the prevalent symptoms were insomnia, fatigue, pain and loss of appetite. There were moderate correlations between the instrument items, and the higher the fatigue and depression scores, the greater the symptoms and the lower the quality of life functional scales. Conclusion: The presence of fatigue and depression was moderately correlated with other symptoms and may influence the health-related quality of life of these women.
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Objetivo: descrever os cuidados de enfermagem na assistência prestada ao paciente com estomia intestinal apresentados na literatura. Método: revisão integrativa da literatura baseada em obras secundárias, publicadas no período de 2017 a 2022. Foi realizado o levantamento em ambiente virtual na Biblioteca Virtual de Saúde (BVS), as bases: Lilacs, Medline, BDENF. no Portal de Periódicos CAPES as bases: Cinahl e em uma busca livre de textos completos na Scientific Electronic Library Online (Scielo) Resultados: foram selecionados 14 artigos para a síntese. E esses estudos foram expostos com as informações: autores, ano de publicação e país; objetivo; método, tamanho e tipo de estudo; principais achados; conclusão. Discussão: se tratando da atuação da enfermagem frente a estomia, pode-se afirmar que o enfermeiro possui uma grande responsabilidade. Um dos cuidados com grande importância é o olhar humano e holístico para esse indivíduo ostomizado. focando na pessoa ostomizada, afirma que o enfermeiro deve focar no autocuidado. Tendo em vista que é um conceito amplo, o mesmo está ligado a vários fatores que o indivíduo se relaciona em vida, como: bem-estar, saúde, sobrevivência, autoaprendizagem. o cuidado de educar a pessoa desde a confirmação da confecção do estoma é necessário, dessa forma, o enfermeiro deve planejar seu cuidado desde a confirmação da confecção do estoma até a alta hospitalar. Conclusão: este estudo conseguiu evidenciar os principais cuidados de enfermagem descrito na literatura para serem realizados em pessoas com ostomia. adequado a sua finalidade e útil para a assistência de enfermagem ao paciente internado estomizado.
Objective: to describe the nursing care provided to patients with intestinal ostomy presented in the literature. Method: integrative literature review based on secondary works, published from 2017 to 2022. The survey was carried out in a virtual environment in the Virtual Health Library (BVS), the bases: Lilacs, Medline, BDENF. in the CAPES Periodicals Portal the bases: Cinahl and in a free search of full texts in the Scientific Electronic Library Online (Scielo) Results: 14 articles were selected for the synthesis. And these studies were exposed with the information: authors, year of publication and country; objective; method, size and type of study; main findings; conclusion. Discussion: when it comes to the role of nursing in the face of ostomy, it can be said that the nurse has a great responsibility. One of the most important care is the human and holistic look for this ostomized individual. focusing on the ostomized person, states that nurses should focus on selfcare. Considering that it is a broad concept, it is linked to several factors that the individual relates to in life, such as: well-being, health, survival, self-learning. the care of educating the person from the confirmation of the stoma construction is necessary, in this way, the nurse must plan their care from the confirmation of the stoma construction until hospital discharge. Conclusion: this study was able to highlight the main nursing care described in the literature to be performed in people with ostomy. suitable for its purpose and useful for nursing care for inpatients with a stoma.
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PURPOSE: TRPV1 desensitization or blockade promotes hyperthermia in rodents. Daily changes in core body temperature (Tc), spontaneous locomotor activity (SLA), and glucocorticoids are temporal cues for peripheral clocks. Thus, this study aimed to evaluate the effects of both desensitization and blockade of TRPV1 on Tc, SLA, blood corticosterone, and the clock genes Per1 and Bmal1 in the liver and adrenal. METHODS AND RESULTS: Resiniferatoxin (RTX, 20 µg kg-1) known to desensitize the intra-abdominal TRPV1 channels was i. p. administered in adult male rats. One day after, RTX rats displayed higher Tc than vehicle rats (control) in the light and dark phases. RTX rats showed higher corticosterone at zeitgeber time (ZT) 6 and ZT12 compared to ZT0. Control rats showed a rise in corticosterone at ZT12. RTX abolished the Per1 peak in both the liver and adrenal glands, whereas it enhanced the peak of Bmal1 expression in the liver and decreased it in adrenal glands. Circadian variation in Tc and SLA was unaffected despite higher Tc being found along the light phase up to 5 days after RTX injection. Acute blockade of TRPV1 with the antagonist AMG-517 injected at ZT0 increased Tc and reduced corticosterone without affecting SLA. In the liver, while AMG-517 did not affect Per1, it increased Bmal1 mRNA. In adrenal glands, AMG-517 increased Per1 and did not affect Bmal1 expression. Although rats exposed to a 60-min 34 °C environment showed similar hyperthermia to that observed in AMG-517 rats, neither corticosterone nor liver nor adrenal clock genes changed. CONCLUSIONS: Inactivation of TRPV1 by abdominal desensitization or by antagonism alters the time-of-day changes of clock genes expression in the liver and adrenal, as well as corticosterone. TRPV1 may be necessary for signaling cyclical temporal cues for clock genes in the periphery but less critical for the circadian profile of Tc and SLA.
Assuntos
Fatores de Transcrição ARNTL , Corticosterona , Animais , Masculino , Ratos , Glândulas Suprarrenais/metabolismo , Fatores de Transcrição ARNTL/genética , Fatores de Transcrição ARNTL/metabolismo , Temperatura Corporal , Ritmo Circadiano/fisiologia , Fígado/metabolismoRESUMO
BACKGROUND: Infections by SARS-CoV-2 in liver transplant recipients (LT) patients are of particular concern, notably due to perceived added risks related to immunosuppression and comorbidity burden. Current literature on this topic often relies on small, non-standardized, and geographically limited studies. This manuscript describes COVID-19 presentations and causes for elevated mortality in a large cohort of LT recipients. METHODS: This study was designed as a multicentric historical cohort, including LT recipient patients with COVID-19 in 25 study centers, with the primary endpoint being COVID-related death. We also collected demographic, clinical, and laboratory data regarding presentation and disease progression. RESULTS: Two hundred and thirty-four cases were included. The study population was predominantly male and White and had a median age of 60 years. The median time from transplantation was 2.6 years (IQR 1-6). Most patients had at least one comorbidity (189, 80.8%). Patient age (P = .04), dyspnea (P < .001), intensive care unit admission (P < .001), and mechanical ventilation (P < .001) were associated with increased mortality. Modifications of immunosuppressive therapy (P < .001), specifically the suspension of tacrolimus, maintained significance in multivariable analysis. CONCLUSIONS: Attention to risk factors and the individualization of patient care, especially regarding immunosuppression management, is crucial for delivering more precise interventions to these individuals.