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PURPOSE: Modern pediatric neurosurgery succeeded in reducing ventricle-peritoneal shunt malfunctions and shunt revisions. However, some children may be submitted to many surgeries, posing burden to their caregivers. And most of caregiver assume responsibility for care without emotional preparation. It is up to health professionals to carry out the educational process. The aim of this study was to evaluate the knowledge, attitude, and practice of informal caregivers of children with hydrocephalus before and after intervention with previously developed educational material. METHODS: This is a quasi-experimental, before-and-after study conducted with 32 informal caregivers of children with hydrocephalus. Data collection occurred in three stages: pre-test, educational intervention through educational material, and post-test. The knowledge, attitude, and practice survey was used as a pre-test and post-test assessment tool. RESULTS: The mean score in the three domains (knowledge, attitude, and practice) was lower in the pre-test compared to the post-test. After caregivers read the educational material, the correct answer rate increased by 17% in the knowledge domain and 21.4% in the practice domain, with p values of < 0.01. In the attitude domain, there was a non-significant increase of 0.06 (2.0%, p = 0.161) points in the mean score between the pre-test and the post-test. CONCLUSION: The educational material enables the acquisition of knowledge of informal caregivers of children with hydrocephalus. This can be used by health professionals to strengthen the bond between professional care staff and family, and to facilitate the educational process.

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AIM: To evaluate if a radiochromic film (RF) Gafchromic EBT3 is suitable for surface dose measurements of radiotherapy treatments performed with a 6 MV linear accelerator. Two aspects of RF were analyzed, beam energy dependence and surface dose determination. BACKGROUND: The measurements done at the surface or near the radiation source are done without charged electronic equilibrium and also have contribution of electron contamination. The detectors used for these measurements should not alter the dose to the target. To counteract these dosimetric problems it is proposed to do the measurements with radiochromic films which are thin detectors and have tissue equivalent properties. MATERIALS AND METHODS: The measurements were done using a Novalis linear accelerator (LINAC) with nominal energy of 6 MV. To determine the surface dose, the total scatter factors (TSF) of three different field sizes were measured in a water phantom at 5 cm depth. Energy dependence of EBT3 was studied at three different depths, using a solid water phantom. The surface measurements were done with the RF for the same field sizes of the TSF measurements. The value of the percentage depth dose was calculated normalizing the doses measured in the RF with the LINAC output, at 5 cm depth, and the TSF. RESULTS: The radiochromic films showed almost energy independence, the differences between the curves are 1.7% and 1.8% for the 1.5 cm and 10 cm depth, respectively. The percentage depth doses values at the surface measured for the 10 cm × 10 cm, 5 cm × 5 cm and 1 cm × 1 cm were 26.1 ± 1.3%, 21.3 ± 2.4% and 20.2 ± 2.6%, respectively. CONCLUSIONS: The RF-EBT3 seems to be a detector suitable for measurements of the dose at the surface. This suggests that RF-EBT3 films might be good candidates as detectors for in vivo dosimetry.

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BACKGROUND: Bioengineering aims to develop innovative scaffolds to improve cellular activities for tissue regeneration. OBJECTIVES: To evaluate the biological behavior of human dental pulp stem cells (hDPSCs) seeded onto an experimental polymeric-based scaffold comprising poly-ε-caprolactone/poly (rotaxane). MATERIAL AND METHODS: Adhesion, viability, and proliferation as well as alkaline phosphatase (ALP) activity, mineralized nodule formation (alizarin red assay), and expression of genes related to osteogenic differentiation, including ALP, type 1 collagen alpha 1 (COL1A1), Runt-related transcription factor (Runx-2), and osteocalcin (BGLAP/OCN), were evaluated in hDPSCs seeded onto polymeric scaffolds. RESULTS: hDPSCs expressed typical levels of mesenchymal stem cell surface markers. Cell growth increased upon cultivation on polymeric blend scaffold and the cells gained osteoblast-like appearance. Fourteen days after seeding hDPSCs on the scaffolds, irrespective to the culture medium used (clonogenic or mineralization medium), the cells presented ALP activity higher than that of control cells grown in clonogenic medium. The cells cultivated in mineralization medium on the scaffold showed significantly higher expression of all genes than the control cells, except for BGLAP gene expression. At 21 days, the group cultivated on the scaffold and mineralization medium showed maximum level of mineralization. SIGNIFICANCE: Poly-ε-caprolactone/poly (rotaxane) blend is noncytotoxic to hDPSCs and improved genomic and functional osteogenic differentiation. Thus, poly-ε-caprolactone/poly (rotaxane) blend may serve as a promising bioactive biomaterial for bone tissue bioengineering.

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BACKGROUND: Although aging is considered a risk factor for pelvic floor muscle dysfunction (PFMD), the effect of aging on the function of the pelvic floor muscles (PFM) remains unclear. OBJECTIVE: To compare PFM function and activity in nulliparous women in different age groups. METHODS: This was a cross-sectional study in which 70 women with ages between 18 and 69 years were divided into five age groups for evaluation. Initially, medical histories were taken, and then the PFM function was assessed using digital palpation (Modified Oxford Scale), manometry and surface electromyography (sEMG). The Kruskal-Wallis test was applied to check the differences between the groups. The Spearman correlation coefficient was used to verify the correlations between age and PFM function, manometry values and sEMG. A significance level of 5% was adopted. RESULTS: No significant differences were observed between the different age groups in PFM digital palpation, manometry values and sEMG. There was a low negative correlation between age root mean square and peak of sEMG signals. CONCLUSION: This study found no difference in PFM function and activity between nulliparous women in the five different age groups. Future long-term large prospective studies are required to confirm these findings.

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With the imminence of global climate changes that affect the temperature and the rainfall uniformity, it is growing the concern about the adaptation of crops to the water deficit. Thus, the objective of this study was to evaluate alterations in physiological and enzymatic mechanisms during the germination process of sesame seeds under different water availability. To simulate the water restriction we used PEG6000, a high molecular weight molecule that does not penetrate the seed structure but allows different osmotic potentials. The treatments were -0.1, -0.2, and -0.3 MPa, and the control. Germination, first-count germination, germination velocity index, and length and dry mass of the hypocotyl and radicle were performed. The seeds were weighed before and after treatments every 3 h. After each weighing, 100 seeds were taken for analysis of the enzymes alcohol dehydrogenase (ADH), malate dehydrogenase, esterase, catalase (CAT), superoxide dismutase (SOD), isocitrate lyase (ICL), and glutamate dehydrogenase (GTDH). The statistical design was completely randomized with five replications. PEG6000 prolonged ADH activity during the beginning of germination, maintaining the anaerobic metabolism for longer. Subsequently, their activity was reduced, as well as ICL, favoring the deterioration of the seeds that take the time to germinate. Behavior was evidenced by the appearance of SOD, CAT, and GTDH isoforms after 24 h of imbibition when water restriction was imposed. Therefore, the PEG600 is efficient in simulating water deficit conditions in future scenarios of climate change, offering impotent information regarding the germination behavior of the plants under these conditions.

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Electrospinning is a technique that allows the preparation of nanofibers from various materials. Chitosan is a natural and abundant easily obtained polymer, which, in addition to those features, proved to be biocompatible. This work used nanostructured chitosan and polyoxyethylene membranes as subcutaneous implants in Wistar rats to evaluate the biocompatibility of the material. Samples of the material and tissues adjacent to the implant were collected 7, 15, 30, 45 and 60 days post-implantation. Macroscopic integration of the material to the tissues was observed in the samples and slides for histopathological examination that were prepared. It was noticed that the material does not stimulate the formation of adherences to the surrounding tissues and that there is initial predominance of neutrophilia and lymphocytosis, with a declining trend according to the increase of time, featuring a non-persistent acute inflammatory process. However, the material showed fast degradation, impairing the macroscopic observation after fifteen days of implantation. It was concluded that the material is biocompatible and that new studies should be conducted, modifying the time of degradation by changes in obtaining methods and verifying the biocompatibility in specific tissues for biomedical applications.

A eletrofiação é uma técnica que permite a preparação de nanofibras mediante o uso de diversos materiais. A quitosana é um polímero natural, abundante e de fácil obtenção, que, além dessas características, demonstrou ser biocompatível. Este trabalho utilizou membranas nanoestruturadas de quitosana e polióxido de etileno como implantes subcutâneos em ratos Wistar para avaliar a biocompatibilidade do biomaterial. As amostras do material e de tecidos adjacentes ao implante foram retiradas sete, 15, 30, 45 e 60 dias pós-implantação para a observação da integração macroscópica do material aos tecidos e para a preparação de lâminas para exame histopatológico. Verificou-se que o material não estimula a formação de aderências com os tecidos circunvizinhos e que há predominância inicial de neutrofilia e linfocitose, que tendem a decrescer em razão do aumento do tempo, caracterizando um processo inflamatório agudo não persistente. No entanto, o material apresentou degradação rápida, não sendo possível observá-lo macroscopicamente após 15 dias de implantação. Concluiu-se que o material é biocompatível, o que indica que novos estudos devem ser conduzidos, com modificação do tempo de degradação por alterações nos métodos de obtenção e verificação da biocompatibilidade em tecidos específicos para aplicações biomédicas.

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Electrospinning is a technique that allows the preparation of nanofibers from various materials. Chitosan is a natural and abundant easily obtained polymer, which, in addition to those features, proved to be biocompatible. This work used nanostructured chitosan and polyoxyethylene membranes as subcutaneous implants in Wistar rats to evaluate the biocompatibility of the material. Samples of the material and tissues adjacent to the implant were collected 7, 15, 30, 45 and 60 days post-implantation. Macroscopic integration of the material to the tissues was observed in the samples and slides for histopathological examination that were prepared. It was noticed that the material does not stimulate the formation of adherences to the surrounding tissues and that there is initial predominance of neutrophilia and lymphocytosis, with a declining trend according to the increase of time, featuring a non-persistent acute inflammatory process. However, the material showed fast degradation, impairing the macroscopic observation after fifteen days of implantation. It was concluded that the material is biocompatible and that new studies should be conducted, modifying the time of degradation by changes in obtaining methods and verifying the biocompatibility in specific tissues for biomedical applications.(AU)

A eletrofiação é uma técnica que permite a preparação de nanofibras mediante o uso de diversos materiais. A quitosana é um polímero natural, abundante e de fácil obtenção, que, além dessas características, demonstrou ser biocompatível. Este trabalho utilizou membranas nanoestruturadas de quitosana e polióxido de etileno como implantes subcutâneos em ratos Wistar para avaliar a biocompatibilidade do biomaterial. As amostras do material e de tecidos adjacentes ao implante foram retiradas sete, 15, 30, 45 e 60 dias pós-implantação para a observação da integração macroscópica do material aos tecidos e para a preparação de lâminas para exame histopatológico. Verificou-se que o material não estimula a formação de aderências com os tecidos circunvizinhos e que há predominância inicial de neutrofilia e linfocitose, que tendem a decrescer em razão do aumento do tempo, caracterizando um processo inflamatório agudo não persistente. No entanto, o material apresentou degradação rápida, não sendo possível observá-lo macroscopicamente após 15 dias de implantação. Concluiu-se que o material é biocompatível, o que indica que novos estudos devem ser conduzidos, com modificação do tempo de degradação por alterações nos métodos de obtenção e verificação da biocompatibilidade em tecidos específicos para aplicações biomédicas.(AU)

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Interest in the electronic structure of the intermetallic compound YIn3 has been renewed with the recent discovery of superconductivity at T ∼ 1 K, which may be filamentary in nature. In this work we perform electron spin resonance (ESR) experiments on Gd(3+) doped YIn3 (Y1-xGdxIn3; 0.001 ⪅ x ⩽̸ 0.08), showing that the spin-lattice relaxation of the Gd(3+) ions, due to the exchange interaction between the Gd(3+) localized magnetic moment and the conduction electrons (ce), is processed via the presence of s-, p- and d-type ce at the YIn3 Fermi level. These findings are revealed by the Gd(3+) concentration dependence of the Korringa-like relaxation rate d(ΔH)/dT and g-shift (Δg = g - 1.993), that display bottleneck relaxation behavior for the s-electrons and unbottleneck behavior for the p- and d-electrons. The Korringa-like relaxation rates vary from 22(2) Oe/K for x ⪅ 0.001 to 8(2) Oe/K for x = 0.08 and the g-shift values change, respectively, from a positive Δg = +0.047(10) to a negative Δg = -0.008(4). Analysis in terms of a three-band ce model allows the extraction of the corresponding exchange interaction parameters Jfs, Jfp and Jfd.

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Biomaterials nanofibrous electrospun with biodegradable polymers have the advantage of the similarity to natural extracellular matrices, showing promising as scaffolds for application in tissue engineering. Sedum dendroideum is a phytotherapic drug that stands out for its healing properties and anti-inflammatory. This study presents the efficacy of PLA electrospun membranes used as support S. dendroideum extract releasing on excisional skin lesions of Wistar rats. The PLA porous membranes, which are nonwoven fibrous mats, were obtained by electrospinning using a conventional apparatus with a flat collector. The animals were randomly divided into nine groups: control (C), animals treated with electrospun membranes of PLA (M), animals treated with extract of S. dendroideum dissolved in saline (F), animals treated with membranes of PLA with 10% S. dendroideum (MF10), animals treated with membranes of PLA with 25% S. dendroideum (MF25). Tissue samples were taken after 2, 6 and 10 days after surgery and were subjected to structural analysis and morphology. The experimental observations showed the application of the phytotherapic incorporated in the membrane promoted a significant response regarding the number of inflammatory cells, percentage of mature collagen fibers and epithelium birrefringent in thickness excisional skin lesions in Wistar rats. It was also demonstrated that the application of the PLA membranes without the extract promoted similar responses tissues.

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OBJECTIVE: To assess the effects of neuromuscular electrical stimulation (NMES) associated with an isokinetic training program in healthy young men and women. METHODS: Twenty participants (ten men, ten women; 21±1.5 years) underwent an isokinetic training program for knee extensors of both sides (three sets of ten concentric repetitions at 30°/s) twice a week for four weeks. One limb underwent only the isokinetic strength training (Ex) while the other underwent the same training but with NMES associated with each contraction (Ex+NMES). The current used for NMES was the Russian current (frequency of 2,500Hz, 50 bursts/s and pulse duration of 200µs). Isometric and isokinetic concentric extensor torque at 30°/s were evaluated. RESULTS: The groups increased their peak torque in both test procedures, with no difference between Ex and Ex+NMES. The angle of peak torque increased for the Ex limb, thus showing a change in the tension-length relationship of the muscle group tested, which did not occur for the Ex+NMES limb. There was also a decrease in acceleration time in both limbs, without any effects from NMES on this variable. CONCLUSIONS: These results showed that the association between NMES and isokinetic concentric voluntary strength training did not improve the strength gains and neuromuscular properties of voluntary strength training itself for healthy young participants of both genders.

OBJETIVO: Verificar os efeitos da estimulação elétrica neuromuscular (EENM) associada a um programa de treinamento isocinético em homens e mulheres jovens e sadios. MÉTODOS: Vinte indivíduos (dez homens, dez mulheres, 21±1,5 anos) submeteram-se a um programa de treinamento isocinético de ambos os seus extensores de joelho (três séries de dez repetições concêntricas a 30°/s) duas vezes por semana por quatro semanas. Um membro foi submetido apenas ao treinamento de força isocinético (Ex) enquanto o outro foi submetido ao mesmo treinamento, mas com EENM associada a cada contração (Ex+EENM). A corrente utilizada para a EENM foi a corrente russa (frequência de 2.500Hz, 50 bursts/s, duração de pulso de 200µs). O protocolo de avaliação incluiu o torque extensor isométrico e isocinético concêntrico a 30°/s. RESULTADOS: Os grupos aumentaram seu pico de torque em ambas as modalidades testadas, sem diferença entre Ex e Ex+EENM. O ângulo do pico de torque aumentou para o membro Ex, mostrando uma alteração da relação comprimento-tensão do grupo muscular testado, o que não aconteceu com o membro Ex+EENM. Houve também uma diminuição no tempo de aceleração de ambos os membros, sem efeito da EENM sobre este parâmetro. CONCLUSÕES: Estes resultados mostraram que a associação entre a EENM e o treinamento voluntário isocinético concêntrico não melhorou os ganhos de força e de propriedades neuromusculares do próprio treinamento de força voluntário para sujeitos jovens e sadios de ambos os gêneros.

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Samples of aligned MgB(2) crystallites have been prepared, allowing for the first time the direct identification of an upper critical field anisotropy H(ab)(c2)/H(c)(c2) = xi(ab)/xi(c) approximately 1.7, with xi(o,ab) approximately 70 A, xi(o,c) approximately 40 A, and a mass anisotropy ratio m(ab)/m(c) approximately 0.3. A ferromagnetic background signal was identified, possibly related to the raw materials purity.

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BACKGROUND: Six cases have been reported of reversed end-diastolic umbilical artery (UA) blood flow at 10-14 weeks' gestation. Four were associated with chromosomal anomalies, and one showed congenital heart disease. CASES: This report describes two cases of reversed end-diastolic UA flow at 10 and 12 weeks' gestation with increased nuchal translucency in which cytogenetic analysis by chorionic villus sampling showed triploidy (69,XXX) and trisomy 9, respectively. In second case, the fetus had a ventricular septal defect. CONCLUSION: Reversed end-diastolic UA flow in the first trimester might be an important sign of chromosomal abnormalities in early pregnancy and might be a useful signal for the diagnosis of early cardiac defects.

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The authors consider the possibility of using color Doppler of the ductus venosus and the measurement of nuchal translucency as a screening test for alterations in fetal cardiac functions in the first trimester of gestation. Review of the literature suggests that the combination of the ultrasonographic measurement of nuchal translucency and Doppler at 10 and 14 weeks of gestation can be effective in detecting certain cardiac abnormalities. This conclusion, however, is preliminary and needs to be further investigated.

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This is the fifth case of the Bernard-Soulier syndrome to be described in the literature. The ante-natal period, the delivery and post-partum course without any complications. The platelet concentrations were used ante-natally and after delivery.

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Human chorionic somatomammotropin (HCS), is synthesize and secreted by the syncytiotrophoblast. Its effects on maternal metabolism are significant but the role of this hormone upon fetal development remains unknown. Nonetheless its measurement during final stages of pregnancy has proved to be useful for prediction of outcome. Since HCS serum levels exhibit progressive augmentation throughout gestation and taking into account its site of origin it has been proposed that could be dependent of changes in placental mass. This has not been totally ascertained, due to the lack of precision of studies designed for this purpose. If a correlation between HCS secretion and placental growth cold be established, it might be expected that determination of both indexes would contribute to obtain a more accurate diagnosis of abnormalities in retroplacental of fetal circulating blood volume. Therefore we studied 55 females without complicated pregnancy whose placental volumes were measured through ultrasound scanning. Serum samples were also collected for HCS quantitation by radioimmunoassay. Determinations were made starting on the 12th week of pregnancy. A progressive as well as a parallel increase of placental volume (154.12-825.01 ml) and HCS (0.48-7.0 Ug/ml) was observed during gestation. The correlation coefficient (r = 0.546) was significant (p less than 0.01). Both parameters correlated also with those obtained for fetal biparietal diameters. These findings support the notion that HCS secretion is proportional to the volume/mL of placental tissue which might be related to the amount of syncytiotrophoblast cells. It was not possible to establish causation upon the correlation observed between HCS and fetal parietal diameters.

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An uremic patient with circulating antibodies against HLA Class I antigens and awaiting renal transplantation was treated with plasmapheresis three times weekly for 10 procedures. Prednisone (50 mg/24 h) and azathioprine (1 mg/kg/24 h) were started after the first plasma exchange. Each exchange fluid was replacement with 5% human albumin and frozen plasma. Except for transient leukopenia no complications were observed during the pretransplant treatment. Following treatment the positive crossmatches became negative and she was successfully transplanted with her father kidney. The graft functioned immediately with no hiperacute rejection and a mild episode on day 5 treated methyl prednisolone and three plasma exchange. Our patient is well with plasma creatinine of 0.7 mg/dL and a clearance of 60 mL/min three months after transplantation. This findings must be confirmed by others but identification and removal of anti-HLA antibodies is emerging as a promising method of dealing with the sensitized transplant recipient.

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