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INTRODUCTION: This study aimed to validate three age-adjusted versions of a Hearing Screening Questionnaire for Preschoolers, in Brazilian Portuguese, based on parents' perception of their children's hearing and oral language. METHODS: Psychometric validation was conducted on three questionnaires, each comprising nine items with yes/no responses. Three items focused on hearing screening at birth, and six assessed hearing and oral language. The study included 152 parents and their children, who attended daycare centers in Belo Horizonte, Brazil. The children were categorized into three age bands: 12-18 months, 19-35 months, and 36-48 months. Audiological assessments, including tympanometry, transient-evoked otoacoustic emissions (TEOAE), and pure-tone audiometry (when applicable), were performed on the children. In case of abnormal findings in the previous exams, auditory brainstem response (ABR) testing was conducted. Descriptive data, false alarm, and false-negative analyses were carried out. RESULTS: Considering any type of hearing loss, whether unilateral or bilateral, the questionnaires showed a false-negative rate of 41.17% (7/17 children). However, when considering only bilateral hearing loss, the questionnaire showed a false alarm rate of 31.69% (45/142) and a false-negative rate of 30.0% (3/10). When focusing exclusively on sensorineural hearing loss, the questionnaire identified two children (1.31%), with a false-negative rate of 0% but a false-positive rate of 33.33%. CONCLUSION: Language-development-oriented questionnaires allowed quick screening of potential hearing loss in preschoolers. This study found a robust hit rate with these questionnaires. Their validation signifies a promising and cost-effective tool for conducting hearing screenings in preschool children, especially in nations lacking a comprehensive school screening policy. The validated questionnaire affords an easy-to-apply, low-cost, and effective instrument for preschool hearing screening.

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Objetivo: Analisar a atuação do enfermeiro perfusionista na cirurgia cardíaca. Método: Estudo exploratório com abordagem qualitativa, desenvolvida em ambiente virtual no período de 1 a 30 de junho de 2022. Amostra intencional, não probabilística, constituída de 14 enfermeiros perfusionistas. Os dados foram analisados por meio da análise de conteúdo de Bardin. Resultados: Emergiram duas categorias temáticas: Atuação do enfermeiro perfusionista na circulação extracorpórea e A relevância da interação do enfermeiro com os membros da equipe durante a cirurgia cardíaca com circulação extracorpórea. Os relatos identificaram que o enfermeiro perfusionista realiza inúmeras atribuições que vão desde o histórico de enfermagem, até o preparo e a escolha de materiais, circuitos, dispositivos e maquinários para a condução da circulação extracorpórea. Destaca-se a interação desse profissional com os demais membros da equipe no tocante à comunicação a fim de minimizar riscos e obter resultado cirúrgico positivo para o paciente. Conclusão: A atividade do enfermeiro perfusionista é complexa e necessita de um rigoroso preparo teórico-prático, especializações reconhecidas pelos órgãos competentes, bem como frequentes atualizações mesmo já sendo um profissional experiente. (AU)

Objective: To analyze the role of the perfusionist nurse in cardiac surgery. Method: Exploratory study with a qualitative approach, conducted in a virtual environment from June 1st to June 30th, 2022. The sample consisted of 14 perfusionist nurses, selected intentionally and non-probabilistically. Data were analyzed through Bardin's content analysis. Results: Two thematic categories emerged: the role of the perfusionist nurse in extracorporeal circulation and the relevance of the nurse's interaction with team members during cardiac surgery with extracorporeal circulation. The reports identi-fied that the perfusionist nurse performs numerous tasks ranging from nursing history to the preparation and selection of materials, circuits, devices, and machinery for extracorporeal circulation. The interaction of this professional with other team members regarding communication stands out, aiming to minimize risks and achieve positive surgical outcomes for the patient. Conclusion: The activity of the perfusionist nurse is complex and requires rigo-rous theoretical-practical preparation, recognized specializations by competent bodies, as well as frequent updates even for experienced professionals

Objetivo: Analizar el papel del enfermero de perfusión en la cirugía cardíaca. Método: Estudio exploratorio con enfoque cualitativo, desarrol-lado en ambiente virtual durante el período del 1 al 30 de junio de 2022. Muestra intencional, no probabilística, compuesta por 14 enfermeros de perfu-sión. Los datos fueron analizados mediante el análisis de contenido de Bardin. Resultados: Surgieron dos categorías temáticas: El papel del enfermero perfusionista en circulación extracorporea y la relevancia de la interacción del enfermero con los miembros del equipo durante la cirugía cardíaca con circulación extracorporea. Los informes identificaron que el enfermero perfusionista desempeña numerosas atribuciones que van desde el historial de enfermería hasta la preparación y elección de materiales, circuitos, dispositivos y maquinaria para la conducción de la circulación extracorporea. Se des-taca la interacción de este profesional con los demás miembros del equipo en lo que respecta a la comunicación para minimizar riesgos y obtener resulta-dos quirúrgicos positivos para el paciente. Conclusión: La actividad del enfermero de perfusión es compleja y requiere una preparación teórico-práctica rigurosa, especializaciones reconocidas por los órganos competentes, así como actualizaciones frecuentes incluso siendo un profesional experimentado

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ABSTRACT The yellow uxi (Endopleura uchi) is a tree native to the Amazon and its fruits are appreciated in the region. It is rich in total phenols and its bark is known to have high bergenin content, an isocoumarin derivative that presents several pharmacological activities. Yet the nutritional and functional properties of the fruit are still little known. We analyzed the nutritional, centesimal, and mineral properties, and the antioxidant activity and total phenol content of the alcoholic extract of yellow uxi fruit pulp from different locations in the Amazon. The bergenin content was also quantified. Average pulp yield was 45.66 ± 4.44% (w/w), with 60.1 - 89.2 g 100 g-1 of moisture and 1.28 - 1.32 g 100 g-1 of ash (dry basis). Calcium (78.2 - 87.1 mg 100 g-1) and potassium (260.2 - 395 mg 100 g-1) were the most abundant minerals in the pulp. Aluminum concentration was high compared to other Amazonian fruits (23.7 - 28.7 mg 100 g-1). The high caloric value of the pulp (325.3 ± 20.9 Kcal 100 g-1) is attributed to its lipid (32 - 44.9%) and carbohydrate (48.2 - 64.1%) content. The scavenging activity of DPPH was 1.95 - 20.68%, which was highly associated with the total phenolic content (16.91 - 30.07 µg GAE mg-1). Bergenin content was 180.8 ± 55.3 mg 100 g-1. We conclude that E. uchi pulp has high caloric and mineral content, and it is also a source of bergenin, thus this fruit has a potential nutritional and functional value.

RESUMO O uxi amarelo (Endopleura uchi) é uma árvore nativa da região amazônica e suas frutas são apreciadas na região. Ele é rico em fenóis e sua casca tem alto teor de bergenina, um derivado da isocumarina conhecido por apresentar diversas atividades farmacológicas. No entanto, as propriedades nutricionais e funcionais do fruto ainda são pouco conhecidas. Nós analisamos as propriedades nutricionais, centesimais e minerais, e a atividade antioxidante e o teor de fenólicos do extrato alcoólico da polpa do fruto do uxi amarelo de diferentes localidades da Amazônia. O teor de bergenina também foi quantificado. O rendimento médio de polpa foi de 45,66 ± 4,44% (m/m), com 60,1 - 89,2 g 100 g-1 de umidade e 1,28 - 1,32 g 100 g-1 de cinzas (base seca). Cálcio (78,2 - 87,1 mg 100 g-1) e potássio (260,2 - 395 mg 100 g-1) foram os minerais mais abundantes na polpa. A concentração de alumínio foi alta em comparação com outras frutas amazônicas (23,7 - 28,7 mg 100 g-1). O alto valor calórico da polpa (325,3 ± 20,9 Kcal 100 g-1) é atribuído ao seu teor de lipídios (32 - 44,9%) e carboidratos (48,2 - 64,1%). A atividade sequestradora do DPPH foi de 1,95 - 20,68%, altamente associada ao teor de fenólicos totais (16,91 - 30,07 µg GAE mg-1). A quantidade de bergenina na polpa foi de 180,8 ± 55,3 mg 100 g-1. Concluímos que a polpa de E. uchi possui alto teor calórico e mineral, além de ser fonte de bergenina, portanto, este fruto possui valor nutricional e funcional potencial.

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This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

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Resumo Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

Abstract This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

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Patients with cirrhosis and liver transplantation (LT) have a higher risk of infections, complications and death. Vaccines have historically been used to prevent and reduce the risk of complications from viral and bacterial infections. The population with cirrhosis and candidates for LT should be evaluated for immunity against the most relevant immuno-preventable infections, update corresponding immunizations according to the national vaccination program, and inoculate the missing vaccines based on these recommendations. In case of not reaching its inoculation prior to LT, in the post-LT period its vaccination status should be updated. All doctors involved in the health care of these patients must have knowledge about this important topic and be aware of the access and free availability for this population through the presentation of a special form incorporated into the National Immunization Program.

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Patients with cirrhosis and liver transplantation (LT) have a higher risk of infections, complications and death. Vaccines have historically been used to prevent and reduce the risk of complications from viral and bacterial infections. The population with cirrhosis and candidates for LT should be evaluated for immunity against the most relevant immuno-preventable infections, update corresponding immunizations according to the national vaccination program, and inoculate the missing vaccines based on these recommendations. In case of not reaching its inoculation prior to LT, in the post-LT period its vaccination status should be updated. All doctors involved in the health care of these patients must have knowledge about this important topic and be aware of the access and free availability for this population through the presentation of a special form incorporated into the National Immunization Program.

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Schistosoma mansoni is a heteroxenous parasite, meaning that during its life cycle needs the participation of obligatory intermediate and definitive hosts. The larval development occurs in aquatic molluscs belonging to the Biomphalaria genus, leading to the formation of cercariae, which emerge to infect the final vertebrate host. For this reason, studies for control of the diseases caused by digenetic trematodes often focus on combating the snail hosts. Thus, the objective of this study was to evaluate the susceptibility of Biomphalaria tenagophila embryos to the fungus Pochonia chlamydosporia (isolate Pc-10). The entire experiment was conducted in duplicate, with five replicates for each repetition (five egg masses/replicate), utilizing a total of 100 egg masses, with 20-30 eggs/egg mass. At the end of 15 days, the egg masses were evaluated under a stereomicroscope to analyze the hatching of B. tenagophila embryos in both experimental groups. After days of interaction, the exposure to the fungal hyphae bodies significantly impaired the viability of the B. tenagophila eggs, inhibiting the embryogenesis process by 83.7% in relation to the control group. Transmission and scanning electron microscopic images revealed relevant structural alterations in the egg masses exposed to the hyphae action of the fungus, interfering in the development and hatching of the young snails under analysis. These results indicate the susceptibility of B. tenagophila embryos to the fungus P. chlamydosporia (isolate Pc-10) and suggest the potential of Pc-10 to be used in the control of intermediate host, for its ovicidal capacity and for being an ecologically viable option, but in vivo experiments become necessary.

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Biological control is considered one of the most used alternative measures to combat helminths of relevance in veterinary medicine and public health. Among these parasites, Toxocara canis stands out for its high prevalence and worldwide distribution, in addition to being the main cause of visceral larva migrans in man. The present work aimed the fungus Pochonia chlamydosporia (isolate Pc-10) on eggs of T. canis. In order to do this, fertile nematode eggs were obtained by dissection of adult females fertilized specimens. After obtaining the eggs, they were inserted into 24 well plates previously À lled with different concentrations of enzymatic extract of the fungus (100, 200, 400 and 500 µL). In addition, the behavior of P. chlamydosporia hyphae on Toxocara canis eggs was also observed in 2% wateragar medium (2% WA+ fungal isolate) when compared to the control group (2% WA + water). It was veriÀ ed ovicidal activity with the enzymatic extract of P. chlamydosporia at concentrations of 400 and 500 µL. At the same time, after 12 days of exposure of the T. canis eggs to P. chlamydosporia mycelia it was possible to observe the fungus action on eggshells, including penetration of the hyphae and colonization of the egg inside. The results conÀ rm the ovicidal potential of the fungus and suggest its applicability in toxocariasis control programs.(AU)

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Heterorhabditis bacteriophora is an entomopathogenic nematode (EPN) that is mutually associated with Photorhabdus luminescens, utilized globally for biological control of numerous organisms. Freshwater snails of the species Biomphalaria glabrata have been incriminated as the main intermediate hosts of Schistosoma mansoni in Brazil, but virtually nothing is known about the susceptibility of these gastropod to EPNs. Information in this respect is relevant for control of these intermediate hosts, and thus of the helminthiases they transmit. This paper for the first time reports the susceptibility of B. glabrata to infective juveniles of H. bacteriophora (isolate HP88) under laboratory conditions. For that purpose, six groups were formed: three Control groups (not exposed) and three Treated groups, in which the snails were exposed to 300 juveniles infecting the nematode over three weeks. The entire experiment was conducted in triplicate, using a total of 270 snails. Significant physiological alterations in B. glabrata were observed in response to the infection by H. bacteriophora HP88, characterized by decreased levels of hemolymphatic glucose as well as reduced contents of glycogen stored in the host's digestive gland. In parallel, the hemolymphatic activity of lactate dehydrogenase increased in the infected snails, indicating that the infection induces breakdown of carbohydrate homeostasis in B. glabrata. Additionally, all the reproductive parameters analyzed were reduced as a consequence of the infection. The results indicate the occurrence of the phenomenon of parasitic castration in the B. glabrata/H. bacteriophora HP88 interface, probably due to the depletion of galactogen in the parasitized organism. Although the infection did not cause lethality in the population of infected snails, H. bacteriophora HP88 compromised the reproductive performance of B. glabrata, suggesting its applicability in programs for biological control of this planorbid.

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Inflammatory bowel diseases (IBD) are associated with various hepatobiliary disorders. They can occur at any moment in the course of the disease or associated with the treatment. The prevalence of liver dysfunction can reach up to 50% in different studies. Nonalcoholic fatty liver disease is considered the most common hepatobiliary complication in IBD, while primary sclerosing cholangitis is the most specific. Management of hepatic manifestations in IBD involves a multidisciplinary approach that includes a high index of suspicion and joint management with hepatologists. The medical confrontation with abnormal liver tests must include an exhaustive study to determine if these patterns can be related to IBD, associated diseases or to the therapies used.

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Non-alcoholic fatty liver disease (NAFLD) has a high prevalence and risk of progression to cirrhosis and other complications in patients with type 2 diabetes mellitus (T2DM). Likewise, the presence of NAFLD implies a high risk of developing T2DM, determining a bidirectional relationship between them. The diabetology and hepatology societies, developed a joint initiative aiming to unify criteria, reviewing the definitions, diagnostic criteria, risk stratification, treatment, and follow-up of patients with NAFLD and T2DM. The key questions to be discussed were defined by a panel of specialists in diabetology and hepatology. The Delphi methodology was used to reach consensus on the respective recommendations. Based on the discussion generated among the experts, diagnostic and treatment algorithms were proposed, as well as an indication for referral and the role of the different specialists involved in the management of these patients. Strengthening multidisciplinary work with patients with NAFLD and T2DM will allow the early recognition of the disease, the prevention of the progression to cirrhosis, and reducing the associated complications.

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Bacteria of the genus Bacillus have been investigated due to the ability that many species have of accumulating polyhydroxyalkanoates (PHA) via a wide variety of raw materials as their carbon source. Herein, we report the draft whole-genome sequence of the putative PHA-accumulating strain Bacillus paramycoides LB_RP2, isolated from an Amazonian river.

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Hepatitis B virus (HBV) related acute liver failure (ALF) is uncommon in our region, and there is limited HBV literature regarding the optimal management of these cases. In this article, we report two clinical cases of young men who have sex with men (MSM), both developed severe acute hepatitis caused by HBV, progressed to ALF and afterward required liver transplantation. Antiviral post-transplant treatment included entecavir without Hepatitis B Immunoglobulin (HBIG), and immunosuppression therapy with steroids, tacrolimus, and mycophenolate. Serologic follow-up showed early Hepatitis B surface Antigen (HBsAg) seroconversion, undetectable HBV viral load, and positive Anti-HBs titers. During later follow-up, Anti-HBs titers gradually fell (<10mUI/L after six months), with normal liver function. DISCUSSION: In cases of HBV-related ALF, the liver develops a robust immune response, leading to, an early undetectable viral load and seroconversion, with loss of HBsAg, and the appearance of Anti-HBs as a result of the inflammatory response. The management varies depending on whether this is a de novo acute infection or a reactivation of a previous chronic infection. In both cases, the use of antiviral therapy is recommended, with entecavir or tenofovir, among others, but the use of specific HBIG is supported only in ALF related to chronic HBV infection. The optimal length of the antiviral therapy after liver transplantation is still under discussion. CONCLUSION: These cases of HBV related ALF with an early HBsAg seroconversion demonstrates the relevance of requesting IgM antibody against hepatitis B core antigen (anti-HBc IgM) for the etiological study of ALF with negative HBsAg. Usage of HBIG does not seem essential during the post-transplantation period in these cases.

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The actions of resveratrol in brain and plasma of rats with adjuvant-induced arthritis were investigated. Resveratrol was administered orally during a period of 23 days. A major concern of the present work was to explore an ample range of daily doses (10-200 mg/kg). Several oxidative and inflammatory markers were measured. Important effects of resveratrol treatment were the normalization of the plasma myeloperoxidase activity (inflammatory marker), the normalization of the brain xanthine oxidase activity (reactive oxygen species source) and the near-normalization of the catalase activity in the brain (antioxidant defence). These effects presented obvious dose dependencies in the range up to 200 mg/kg. Resveratrol also reduced protein and lipid damage within the lowest dose ranges investigated, and its action as a free radical scavenger activity was enhanced in brain mitochondria of arthritic rats. Resveratrol failed in restoring the diminished albumin levels and plasma protein thiols in arthritic rats. The latter, however, were substantially increased in healthy rats at low doses (up to 50 mg/kg), a sign of antioxidant action. This increase was reversed at higher doses, a sign of pro-oxidant action. The observations agree with the notion that low doses of resveratrol might be useful as an adjuvant to the conventional antirheumatic drugs.

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