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BACKGROUND: Von Hippel-Lindau (VHL) disease is a rare autosomal dominant disorder that predisposes patients to develop multiple cysts and tumors, such as hemangioblastomas (HBs) and clear cell renal cell carcinoma (ccRCC), due to mutations in the VHL tumor suppressor gene. While treatment of HBs varies based on their characteristics and has improved patient survival, it still involves high morbidity and mortality, leading to ongoing debates and studies to refine therapy strategies. Recent developments include the emergence of Belzutifan, a novel inhibitor targeting hypoxia-inducible factor 2α (HIF-2α), which has shown promising results in ongoing trials, particularly for patients not immediately requiring surgery. METHODS: This systematic review and meta-analysis aimed to comprehensively evaluate the efficacy and safety of Belzutifan for treating HBs associated with VHL disease. Search was conducted across Medline, Embase, Cochrane, and Web of Science databases. Statistical Analysis was performed, with proportions and 95 % confidence intervals. Statistical analyses were carried out using R Studio. RESULTS: Ten studies were selected, comprising 553 patients. The population mean age was 40 (24-65), and 50 % of the population was formed by males. In terms of proportion, 6 analyses were performed: Disease Stability of 31 % [95 %CI:14 %-47 %; I2 = 2 %]; Disease Progression of 2 %[95 %CI:0 %-9 %; I2 = 0 %]; Partial Response of 75 % [95 %CI:54 %-96 %; I2 = 58 %]. Complete response of 1 % [95 %CI:0 %-7 %; I2 = 0 %];and Side effects, anemia 81 % rate [95 % CI:54 %-100 %; I2 = 94 %], and fatigue rate of 79 % [95 % CI:54 %-100 %;I2 = 94 %]. CONCLUSION: Results indicate that Belzutifan effectively stabilizes disease, reduces tumor progression, and achieves significant therapeutic responses, although side effects like anemia and fatigue were noted.

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BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach. OBJECTIVE: To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom. METHODS: Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA). RESULTS: Among the 65 individuals evaluated, 44.6% (n = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex (p = 0.049), pain intensity (p = 0.026), functioning (p = 0.004), disease severity (p = 0.029), and QoL (p = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p = 0.001), muscle strength (r = - 0.356; p = 0.004), functioning (r = - 0.363; p = 0.003), and QoL (r = 0.481; p = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters. CONCLUSIONS: Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS.

ANTECEDENTES: Esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa fatal que leva à fraqueza muscular e paralisia. Fadiga é um sintoma incapacitante, frequentemente relatado na ELA, mas permanece pouco investigado nessa população. Assim, uma investigação acurada deste sintoma e dos possíveis fatores associados é necessária para auxiliar em uma abordagem terapêutica adequada. OBJETIVO: Investigar a presença de fadiga em indivíduos com ELA e possíveis fatores correlacionados a este sintoma. MéTODOS: Participaram 65 indivíduos com ELA esporádica. Aspectos demográficos, clínicos e funcionais foram investigados. Foram utilizadas: Escala de Severidade de Fadiga (FSS, na sigla em inglês), Escala Funcional de ELA (ALSRFS-R, na sigla em inglês) e questionário de Qualidade de Vida (QV) (ALSAQ-40, na sigla em inglês). Análises descritivas e de correlação foram realizadas no programa SPSS para Windows versão 19.0 (IBM Corp., Armonk, NY, USA). RESULTADOS: Dos 65 indivíduos avaliados, 44,6% (n = 29) apresentaram fadiga pela FSS. A intensidade da fadiga foi 5,4 ± 1,2 e apenas 10,4% usavam medicamento específico para fadiga. Diferenças entre os grupos com e sem fadiga foram encontradas em relação ao sexo (p = 0,049), intensidade da dor (p = 0,026), funcionalidade (p = 0,004), gravidade da doença (p = 0,029) e QV (p = 0,000). A fadiga foi correlacionada com a intensidade da dor (r = 0,425; p = 0,001), força muscular (r = - 0,356; p = 0,004), funcionalidade (r = - 0,363; p = 0,003) e QV (r = 0,481; p = 0,000). Não foram encontradas correlações com idade, tempo de diagnóstico, cãibras ou outros parâmetros de mobilidade. CONCLUSõES: A fadiga é um sintoma comum entre os indivíduos com ELA e pode estar presente em todos os estágios da doença. Este sintoma estava correlacionado à pior funcionalidade, pior QV, gravidade, intensidade da dor, fraqueza muscular e sexo feminino em indivíduos com ELA.

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Abstract Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach. Objective To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom. Methods Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA). Results Among the 65 individuals evaluated, 44.6% (n = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex (p = 0.049), pain intensity (p = 0.026), functioning (p = 0.004), disease severity (p = 0.029), and QoL (p = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p = 0.001), muscle strength (r = - 0.356; p = 0.004), functioning (r = - 0.363; p = 0.003), and QoL (r = 0.481; p = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters. Conclusions Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS.

Resumo Antecedentes Esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa fatal que leva à fraqueza muscular e paralisia. Fadiga é um sintoma incapacitante, frequentemente relatado na ELA, mas permanece pouco investigado nessa população. Assim, uma investigação acurada deste sintoma e dos possíveis fatores associados é necessária para auxiliar em uma abordagem terapêutica adequada. Objetivo Investigar a presença de fadiga em indivíduos com ELA e possíveis fatores correlacionados a este sintoma. Métodos Participaram 65 indivíduos com ELA esporádica. Aspectos demográficos, clínicos e funcionais foram investigados. Foram utilizadas: Escala de Severidade de Fadiga (FSS, na sigla em inglês), Escala Funcional de ELA (ALSRFS-R, na sigla em inglês) e questionário de Qualidade de Vida (QV) (ALSAQ-40, na sigla em inglês). Análises descritivas e de correlação foram realizadas no programa SPSS para Windows versão 19.0 (IBM Corp., Armonk, NY, USA). Resultados Dos 65 indivíduos avaliados, 44,6% (n = 29) apresentaram fadiga pela FSS. A intensidade da fadiga foi 5,4 ± 1,2 e apenas 10,4% usavam medicamento específico para fadiga. Diferenças entre os grupos com e sem fadiga foram encontradas em relação ao sexo (p = 0,049), intensidade da dor (p = 0,026), funcionalidade (p = 0,004), gravidade da doença (p = 0,029) e QV (p = 0,000). A fadiga foi correlacionada com a intensidade da dor (r = 0,425; p = 0,001), força muscular (r = - 0,356; p = 0,004), funcionalidade (r = - 0,363; p = 0,003) e QV (r = 0,481; p = 0,000). Não foram encontradas correlações com idade, tempo de diagnóstico, cãibras ou outros parâmetros de mobilidade. Conclusões A fadiga é um sintoma comum entre os indivíduos com ELA e pode estar presente em todos os estágios da doença. Este sintoma estava correlacionado à pior funcionalidade, pior QV, gravidade, intensidade da dor, fraqueza muscular e sexo feminino em indivíduos com ELA.

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AIM: The aim was to characterize cold-adapted bacteria by testing their PGP features and antagonistic activity against Macrophomina phaseolina, both in vitro and coating soybean seeds (Glycine max [L.] Merr.). METHODS AND RESULTS: Burkholderia gladioli MB39, Serratia proteamaculans 136 and Serratia proteamaculans 137 were evaluated. In vitro tests showed that S. proteamaculans 136 and 137 produce siderophore and indole-acetic acid (IAA), solubilize phosphate and fix nitrogen. Additionally, B. gladioli MB39 and S. proteamaculans 137 showed hydrolase activity and potent antifungal effects. The biocontrol efficacy over soybean seeds was evaluated using in vitro and greenhouse methods by immersing seeds into each bacterial suspension. As a result, S. proteamaculans 136 has improved the performance in all the seed germination evaluated parameters. In addition, S. proteamaculans 137 and B. gladioli MB39 strongly inhibited M. phaseolina, reducing the infection index values to 10% and 0%, respectively. CONCLUSION: Serratia proteamaculans 136, 137 and Burkholderia gladioli MB39 showed plant growth promotion features and inhibition of Macrophomina phaseolina infection by producing different antifungal compounds. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results reinforce the application of cold-adapted Serratia proteamaculans and Burkholderia gladioli bacterial strains as candidates for developing microbial formulation to promote plant growth and guarantee antifungal protection in soybean crops.

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PURPOSE: (a) to investigate the test-retest and inter-rater reliabilities and the criterion-related validity of the modified sphygmomanometer test (MST) for the assessment of muscle strength in community-dwelling older adults, (b) to calculate the standard error of measurement (SEM) and the smallest real difference (SRD); (c) to verify whether the number of trials affect the results. METHODS: Bilateral strength of lower limbs (LL) and grip muscles were evaluated with the MST and with portable dynamometers in 50 older adults (69.92 ± 5.52 years). Intra-class Correlation Coefficients (ICC) was used to evaluate the inter-rater and test-retest reliabilities and Pearson Correlations was used to investigate the criterion-related validity of the MST. SEM and SRD were also calculated. Analysis of variance was used to investigate whether the number of trials affects the results. RESULTS: Significant correlations with high to very high magnitude were found for all muscle groups evaluated for test-retest and inter-rater reliabilities (0.80 ≤ ICC ≤ 0.99; p < 0.001) and validity (0.80 ≤ r ≤ 0.91; p < 0.001). Moreover, the values provided by different numbers of trials were similar. The SEM (3.66 ≤ SEM ≤ 20.46) and the SRD (10.15 ≤ SRD95% ≤ 56.70) were considered low for all outcome measures. CONCLUSION: The MST showed adequate results for all the measurement properties evaluated for the assessment of the muscle strength of older adults.Implications for rehabilitationOlder adults often develop sarcopenia and dynapenia that are associated with an increased number of falls and fractures and loss of independence.Portable dynamometer is the standard instrument to evaluate isometric muscle strength, however this instrument is expensive and it is not readily available in the underdeveloped or in developed countries.The Modified Sphygmomanometer Test is an alternative method for the clinical measurement of muscle strength, is portable, has a low-cost and provides an objective measurement.In this study the Modified Sphygmomanometer Test showed adequate results for all the measurement properties evaluated for the assessment of the muscle strength in community-dwelling older adults and a single trial after test familiarization can be used to measure the muscle strength in this population.

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Resumo Objetivo Investigar a influência da escolaridade nos ganhos de função executiva após o treinamento com dupla tarefa (DT). Método Estudo exploratório realizado com 31 idosas, com escolaridade ≥3 anos e sem alterações das funções cognitivas rastreadas pelo Miniexame do Estado Mental (MEEM). As participantes foram distribuídas em dois grupos a partir do critério escolaridade, sendo o Grupo 1 com escolaridade de três a sete anos (n=17) e o Grupo 2 com escolaridade igual e superior a oito anos (n=14). Foram avaliadas as funções executivas antes e após o treinamento através dos testes Stroop, Exame Cognitivo de Addenbrooke - Revisado (ACE-R) e Trilhas B. O protocolo de intervenção consistiu em três sessões semanais, duração de 50 minutos cada, com a realização de atividades de DT cognitiva e motora, associadas à caminhada, por 12 semanas. Resultados A ANOVA indicou que o treinamento de DT melhorou significativamente o desempenho nos testes Stroop (F=5,95; p=0,02) e ACE-R (F=18,33; p<0,0001), independentemente da escolaridade. Foi verificado efeito do grupo nos testes ACE-R (F=14,65; p<0,001) e Trilhas B (F=18,74; p<0,001). Em nenhum dos testes analisados, foi observado efeito da interação grupo x tempo (0,04<F<2,14; 0,15<p<0,95). Conclusão O treinamento de DT pode melhorar significativamente a função executiva de idosas, independente do nível de escolaridade, podendo ser utilizado na prática clínica como uma proposta de intervenção, visando o ganho de função executiva.

Abstract Objective Investigate the influence of education levels on gains in executive function after dual-task (DT) training. Method Exploratory study carried-out with 31 old women, who had ≥3 years of education and without cognitive deficits, as screened by the Mini-Mental State (MMS). The participants were distributed in two groups: group 1: 3 to 7 years of education (n=17) and group 2: ≥8 years of education (n=14). Measures of executive function (Stroop, Addenbrooke's Cognitive Examination - Revised (ACE-R), and Trail Making Test - B (B-Trails)) were obtained before and after training. The intervention protocol consisted of three weekly sessions of 50 minutes each and included cognitive and motor DT training, associated with walking, over 12 weeks. Results ANOVA indicates that DT training improved the performance of Stroop (F=5.95; p=0.02) and ACE-R (F=18.33; p<0.0001) tests, regardless of the education level. The effect of the ACE-R test group (F=14.65; p<0.001) and B-Trails (F=18.74; p<0.001) was verified. In none of the investigated tests, the interaction effects between groups and time (0.04<F<2.14; 0.15<p<0.95) was observed. Conclusion DT training has the potential to generate effects and can positively improve the executive function of older women, regardless of educational level and may be used within clinical practice, aiming at improving executive function.

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Abstract Introduction: Depressive and anxiety disorders are considered the main cause of emotional suffering and decrease of quality of life among older adults. It has been suggested that the practice of physical exercise can be a treatment option for anxiety and depression. Alternative approaches such serious games show promise for reducing depression symptoms. Objective: To compare the effect of virtual reality, in the form of commercially available interactive Kinect Adventures video games, compared to a standard physical exercise program on depressive symptoms of older adults. Method: This is a pilot study, parallel group, single-blind randomized controlled pilot trial that recruited two intervention groups: Interactive Video Game Kinect Adventures (IVG, n=8) versus usual physical exercise program (PEP, n=6). The two groups completed a seven week program with a total of fourteen 60-minute sessions divided into two sessions a week. The IVG completed individual training sessions using the Microsoft Xbox Kinect Adventures games and the PEP performed a group exercise program. Depression symptoms were measured using the Geriatric Depression Scale (GDS-15). This measure was assessed pre-intervention, post intervention and at 30-day follow-up. Results: There was a significant effect of assessment without group effect or interaction between factors, in the GDS-15 (RM-ANOVA, P < 0.0001). Both groups showed improvement in the GDS-15 post intervention assessment that was maintained after 30-day follow-up (Bonferroni post hoc test, P < 0.05). Conclusion: The results of this study suggest that both Interactive Kinect Adventures video games and physical exercise provide beneficial effects on depressive symptoms of older adults.

Resumo Introdução: Os transtornos depressivos e de ansiedade são considerados a principal causa de sofrimento emocional e diminuição da qualidade de vida de idosos. Foi sugerido que a prática de exercício físico pode ser um tratamento para depressão. Abordagens alternativas, como jogos interativos, podem reduzir sintomas depressivos. Objetivo: Comparar o efeito da realidade virtual, na forma de videogames interativos Kinect Adventures disponíveis comercialmente, em comparação com um programa de exercícios físicos padrão sobre sintomas depressivos de idosos. Método: Trata-se de um estudo piloto, grupos paralelos, experimental, controlado, randomizado, cego através de dois grupos de intervenção: Interactive Video Game Kinect Adventures (IVG, n = 8) versus programa de exercício físico (PEF, n = 6). Os dois grupos completaram um programa de sete semanas com um total de 14 sessões de 60 minutos divididas em duas sessões por semana. O IVG concluiu sessões de treinamento individuais usando os jogos Microsoft Xbox Kinect Adventures e o PEF realizou um programa de exercícios em grupo. Os sintomas de depressão foram mensurados através da Escala de Depressão Geriátrica (GDS-15). Essas medidas foram avaliadas pré-intervenção, pós-intervenção e no seguimento de 30 dias. Resultados: Houve um efeito significativo da avaliação sem efeito grupo ou interação entre fatores, no GDS-15 (RM-ANOVA, P <0,0001). Ambos os grupos apresentaram melhora na avaliação pós-intervenção GDS-15, que foi mantida após 30 dias de acompanhamento (teste post hoc de Bonferroni, P <0,05). Conclusão: Os resultados deste estudo sugerem que os jogos interativos Kinect Adventures e o exercício físico proporcionam efeitos positivos nos sintomas depressivos de idosos.

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O presente estudo busca conhecer aspectos da saúde sexual e reprodutiva de homens e mulheres haitianos, residentes na Vila Esperança Cordeiro, localizada na zona norte de Porto Alegre. Os principais aspectos a serem explorados nessa pesquisa compreendem a descrição de conhecimentos, atitudes e práticas, referentes ao tema, levando em conta as questões de gênero dos migrantes e identificando elementos facilitadores e barreiras no acesso e utilização dos serviços da Atenção Básica de Porto Alegre. O procedimento metodológico alinha-se à perspectiva qualitativa e foi realizada uma intervenção por meio de oficinas. Os sujeitos de estudo foram usuários da unidade de saúde Esperança Cordeiro, contatados e convidados por meio de visitas domiciliares. Participaram das oficinas 42 haitianos residentes em Porto Alegre, mulheres e homens. A maioria deles e delas demonstrou pouco ou nenhum conhecimento sobre IST's, saúde sexual e reprodutiva e sobre condicionantes e acesso ao sistema de saúde brasileiro. Ao término das oficinas constatou-se a necessidade de estabelecer políticas de atenção à saúde dos migrantes e melhoria da informação referente à promoção da saúde, incluindo a sexual e reprodutiva. Os processos migratórios aproximam usuários e trabalhadores de saúde pertencentes a sistemas culturais distintos, com barreiras linguísticas, comunicacionais e diferentes percepções dos processos de saúde e adoecimento humanos, exigindo dos trabalhadores de saúde flexibilidade, aceitação e proposição de ações eficientes dirigidas a essa população.

The present study aims to know certain aspects of the sexual and Reproductive Health (SRH) of Haitians from Vila Esperança Cordeiro, located north of Porto Alegre (Brazil). The main aspects to explore in this research are the description of knowledge, attitudes, and practices related to the theme, considering gender issues of immigrants, and identifying the elements that facilitate and prevent access and use of services of primary care in Porto Alegre. The methodological approach refers to the qualitative perspective and the intervention was carried out through workshops. The study subjects were users of the health center Esperance Cordeiro, contacted and invited through home visits. 42 Haitians (men and women) living in Porto Alegre participated in the research. Most of them showed little or no knowledge about STIs, sexual and reproductive health, and about conditions of access to the Brazilian health system. At the end of the study, there was a need to establish policies to provide health care to migrants and improve information on health promotion, including sexual and reproductive health. The migratory processes bring together users and health workers belonging to different cultural systems, with linguistic, communicational barriers and different perceptions of human health and illness processes, demanding from health workers flexibility, acceptance, and proposition of efficient actions directed at this population.

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BACKGROUND AND PURPOSE: In any given year, 28% to 35% of older adults experience falls. In nursing home environments, the annual rate of falls increases to 30% to 50%. Our objective was to verify and compare the reliability, validity, and ability to identify falls of the Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest for older adults who live in nursing homes. METHODS: This was a cross-sectional study. Older adults (n = 49; aged 62-90 years; mean = 77.8; standard deviation = 7.2) were recruited from a nonprofit nursing home. All participants were assessed by 2 physiotherapists using the BBS, BESTest, Mini-BESTest, and Brief-BESTest. The interrater and test-retest (7-14 days) reliability were assessed using intraclass correlation coefficients (ICCs [2, 1]). Minimal detectable changes at the 95% confidence level were established. To analyze each test's ability to identify fall status, we used receiver operating characteristic (ROC) curves, whose statistical significance we verified using the area under the ROC curve (AUC) and respective 95% confidence intervals (CIs). The diagnostic likelihood ratios (positive and negative) and 95% CI were used to verify posttest probability. We used Fagan's nomogram to show the posttest probability of each balance test. Validity was assessed using kappa coefficients and the prevalence-adjusted bias-adjusted kappa (PABAK). RESULTS: Interrater and test-retest reliability for the total scores were good to excellent across all 4 tests (ICC interrater value = 0.992-0.994 and ICC test-retest value = 0.886-0.945). All tests were also able to identify fall status (AUC = 0.712-0.762) and were in good agreement with each other (kappa coefficient for individuals with fall risk = 0.679-0.957 and individuals with no fall risk = 0.135-0.143; PABAK = 83.7%-98%). CONCLUSION: All balance tests presented similar reliability, reproducibility, and validity. This suggests that any of these tests can be used in clinical practice. However, the Brief-BESTest is the quickest and easiest test to perform.

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Background:Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the ac-cumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detec-tion of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact.Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 h with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocyto-sis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the pres-ence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis. Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog...

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Background:Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the ac-cumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detec-tion of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact.Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 h with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocyto-sis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the pres-ence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis. Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog...(AU)

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Este artigo tem como proposta relatar a experiência de estágio. A prática embasou-se no uso das técnicas do psicodrama, com oito encontros temáticos com a participação de oito pacientes e uma sessão pública de psicodrama com 15 pessoas. O relato objetiva narrar a vivência da prática da intervenção psicodramática no estágio de Psicologia e Promoção da Saúde, bem como apresentar as percepções do atendimento psicológico com abordagem psicodramática como técnica eficaz de trabalho de grupo para promover a saúde.

This article proposes to report the internship experience. The practice was based on the use of psychodrama techniques, with eight thematic meetings with the participation of eight patients, and a public session of psychodrama with 15 persons. The report aims to describe the experience of the practice of psychodramatic intervention in the Psychology and Health Promotion intern program, as well as to present the perceptions of psychological care using a psychodramatic approach as an effective group work technique to promote health.

Este artículo tiene como propuesta relatar la experiencia de pasantía. La práctica se basó en el uso de las técnicas del psicodrama, con ocho encuentros temáticos con la participación de ocho pacientes y una sesión pública de psicodrama con 15 personas. El relato objetiva narrar la vivencia de la práctica de la intervención psicodramática en la pasantía de Psicología y Promoción de la Salud, así como presentar las percepciones de la atención psicológica con abordaje psicodramático como técnica eficaz de trabajo de grupo para promover la salud.

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OBJECTIVE: To compare the effectiveness of Kinect Adventures games versus conventional physiotherapy to improve postural control (PC), gait, cardiorespiratory fitness, and cognition of the elderly. In addition, we evaluated the safety, acceptability, and adherence to the interventions. MATERIALS AND METHODS: The study was a randomized clinical trial in which 46 elderly individuals were selected, mean age 69.3 (5.34) years. Participants were allocated to the Kinect Adventures Training Group (KATG) or the Conventional Physical Therapy Group (CPTG), 23 individuals in each group. Participants of both groups participated in 14 training sessions lasting 1 hour each, twice a week. The KATG practiced four Kinect Adventures games. The CPTG participated in conventional physiotherapy. The primary outcome was PC: Mini-Balance Evaluation Systems Test (Mini-BESTest), and secondary outcomes were gait: Functional Gait Assessment (FGA), cardiorespiratory fitness: Six-minute step test (6MST), and cognition: Montreal Cognitive Assessment (MoCA). Acceptability was assessed through a questionnaire created by the researchers themselves. Adherence was assessed by the "frequency of the number of elderly individuals who completed the interventions and safety through the presence of adverse effects." Participants were assessed immediately pre- and posttreatment and fourth week after the end of the treatment. Statistical analysis was done through repeated-measures analysis of variance and Tukey post hoc test. RESULTS: Both groups presented a significant improvement in the PC (Mini-BEST), gait (FGA), and cognition (MoCA) posttreatment that was maintained at fourth week after treatment (post hoc Tukey test; P < 0.05). Regarding cardiorespiratory fitness (6MST), the KATG presented improvement posttreatment and maintenance of the results in the fourth week after treatment. CPTG showed improvement only in fourth week after treatment (post hoc Tukey tests; P < 0.05). Regarding the acceptability, the questionnaire showed that both groups were satisfied with regard to the proposed interventions. There was 91% adherence in both training sessions. Regarding the safety, 34% and 26% of the individuals of the KATG and CPTG, respectively, presented adverse effects of delayed muscle pain in the lower limbs after the first session only. CONCLUSION: There were no significant differences between the KATG and CPTG; both interventions provided positive effects on PC, gait, cardiorespiratory fitness, and cognition of the elderly.

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Abstract Introduction: Aging is associated with loss of muscle mass, immunosenescence and increased production of inflammatory mediators, high levels being predictors of a decline in functional capacity in the elderly. Objective: To assess the association between inflammatory mediators, interleukin 6 (IL-6) and C-reactive protein (CRP) and functional capacity in the elderly. Methods: Cross-sectional study with 308 community-dwelling elderly. The study was approved by the Research Ethics Committee, under protocol number 067/2010. Grip strength (GS) was measured using a JAMAR® dynamometer and functional capacity by the Timed Up and Go (TUG) test. Blood tests were performed and serum levels of C-reactive protein and interleukin 6 assessed. Spearman's coefficient was applied to analyze the correlation between variables and the Mann-Whitney for intergroup comparison. Significance was set at 0.05. Results: There was no significant correlation between GS, the TUG and inflammatory mediators (CRP and IL-6). However, by adjusting for variables such as age, sex and muscle mass, a significant and inverse correlation (p = 0.023) was observed between GS and CPR. Conclusion: Elderly subjects with low C-reactive protein levels performed better in the grip strength test. It is important to investigate the adverse effects on functional capacity that can be influenced by inflammatory cytokines in the elderly during aging.

Resumo Introdução: O envelhecimento está relacionado a perda de massa muscular, imunossenescência e o aumento da produção de mediadores inflamatórios, cujos níveis elevados são preditores do declínio da capacidade funcional na população idosa. Objetivo: Avaliar a associação entre mediadores inflamatórios, interleucina-6 (IL-6) e proteína C-reativa (PCR) e capacidade funcional no idoso. Métodos: Estudo transversal com 308 idosos da comunidade. O estudo foi aprovado pelo Comitê de Ética e Pesquisa, 067/2010. A força de preensão manual (FPM) foi avaliada através do dinamômetro de JAMAR® e a capacidade funcional pelo teste Timed Up and Go. Foi realizado um exame de sangue e analisados os níveis séricos de proteína C-reativa e interleucina-6. Utilizou-se o coeficiente de Spearman para verificar a correlação entre as variáveis e o teste de Mann-Whitney para comparação entre os grupos. O nível de significância utilizado foi de 0,05. Resultados: Não houve correlação significativa entre a FPM e o Timed Up and Go e os mediadores inflamatórios (PCR e IL-6). Porém, ao controlar as variáveis como idade, gênero e índice de massa muscular encontrou-se uma associação significativa e inversa (p = 0,023) entre a FPM e os níveis de PCR. Conclusão: Idosos com baixos índices de proteína C-reativa apresentaram melhor desempenho no teste de força muscular manual. É destacável a importância da investigação dos desfechos adversos que podem ser influenciados pela citocinas inflamatórias na capacidade funcional dos idosos durante o envelhecimento.

Resumen Introducción: El envejecimiento se relaciona con una pérdida de masa muscular, inmunosenescencia, tanto el aumento de la producción de mediadores inflamatorios, cuyos niveles elevados son predictores de disminución de la capacidad funcional en la población de edad avanzada. Objetivo: Investigar la asociación entre mediadores inflamatorios, interleucina-6 (IL-6) y proteína C reactiva (CRP) y capacidad funcional en los ancianos. Métodos: Estudio transversal con 308 ancianos de la comunidad. El estudio fue aprobado por el Comité de Ética e Investigación, 067/2010. La fuerza de la empuñadura (GS) se evaluó utilizando el dinamómetro JAMAR® y la capacidad funcional mediante la prueba Timed Up and Go. Se realizó un análisis de sangre y se analizaron los niveles séricos de proteína C reactiva e interleucina-6. El coeficiente de Spearman se utilizó para verificar la correlación entre las variables y la prueba de Mann-Whitney para la comparación entre los grupos. El nivel de significancia fue 0,05. Resultados: No hubo correlación significativa entre GS y Timed Up and Go y mediadores inflamatorios (CRP e IL-6). Sin embargo, cuando se controlaron variables como la edad, el sexo y el índice de masa muscular, hubo una asociación significativa (p = 0,023) entre los niveles de GS y CRP, es decir, los individuos que obtuvieron buenos resultados en el GS obtuvieron niveles más bajos de PCR circulante. Conclusión: Los pacientes ancianos con bajos niveles de proteína C reactiva, presentaron mejor desempeño en la prueba de fuerza muscular manual. Es importante investigar los efectos adversos que pueden estar influenciados por las citosinas inflamatorias sobre la capacidad funcional de los ancianos durante el envejecimiento.

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Introduction The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway(r) system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.

Introdução Declínios fisiológicos decorrentes da idade comprometem habilidades motoras, expondo os idosos a maiores riscos de quedas, principalmente durante a realização de tarefas simultâneas à marcha. Objetivos Avaliar o efeito da execução da dupla tarefa (DT) nos parâmetros espaço-temporais da marcha de idosos e identificar os instrumentos e tarefas mais utilizados para avaliar o desempenho da DT em idosos. Método As buscas foram realizadas nas bases de dados MEDLINE, PsycINFO, CINAHL e SciELO. Foram selecionados estudos observacionais que avaliaram as alterações no desempenho da marcha durante a realização da DT em idosos, publicados até abril de 2014. Resultados Foi encontrado um total de 385 artigos, dos quais 28 foram incluídos. Quanto aos efeitos da DT na marcha de idosos, foram observados redução da velocidade e aumento da variabilidade da passada, do tempo da passada, da largura do passo e do tempo de apoio duplo. Os sistemas de análise do movimento - passarelas ou tapetes de captação de pressão utilizados para análise cinemática -, como o GaitRite(r) system, foram os instrumentos mais frequentemente utilizados em 16 estudos. A DT mais avaliada foi o cálculo aritmético, usado em 20 estudos, seguido pela de fluência verbal, em nove deles. Os parâmetros da marcha mais avaliados foram a velocidade de marcha, em 19 estudos, seguida por parâmetros relacionados à passada, em 14 trabalhos. Conclusão : Idosos apresentam alterações nos parâmetros espaço-temporais em situações de DT. A velocidade de marcha e a variabilidade da passada foram bastante utilizadas e, juntas, são consideradas ótimos indicadores para risco de quedas.

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Gait variability is related to functional decline in the elderly. The dual-task Timed Up and Go Test (TUG-DT) reflects the performance in daily activities. Objective To evaluate the differences in time to perform the TUG with and without DT in elderly women with different ages and levels of education and physical activity. Method Ninety-two elderly women perfomed the TUG at usual and fast speeds, with and without motor and cognitive DT. Results Increases in the time to perform the TUG-DT were observed at older ages and lower educational levels, but not at different levels of physical activity. More educated women performed the test faster with and without DT at both speeds. When age was considered, significant differences were found only for the TUG-DT at both speeds. Conclusion Younger women with higher education levels demonstrated better performances on the TUG-DT.

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Gait variability is related to functional decline in the elderly. The dual-task Timed Up and Go Test (TUG-DT) reflects the performance in daily activities. Objective To evaluate the differences in time to perform the TUG with and without DT in elderly women with different ages and levels of education and physical activity. Method Ninety-two elderly women perfomed the TUG at usual and fast speeds, with and without motor and cognitive DT. Results Increases in the time to perform the TUG-DT were observed at older ages and lower educational levels, but not at different levels of physical activity. More educated women performed the test faster with and without DT at both speeds. When age was considered, significant differences were found only for the TUG-DT at both speeds. Conclusion Younger women with higher education levels demonstrated better performances on the TUG-DT. .

Alterações da marcha são indícios de declínio funcional em idosos. O TUG com dupla tarefa (TUG-DT) reflete o desempenho das atividades do cotidiano. Objetivo Avaliar as diferenças no tempo de execução do TUG com e sem DT em idosas com diferentes faixas etárias, e níveis de escolaridade e atividade física. Método Noventa e duas idosas foram avaliadas pelo TUG nas velocidades usual e máxima, sem e com DT cognitiva e motora. Resultados Houve aumento no tempo de execução do TUG-DT em idosas com maior faixa etária e menor escolaridade, mas não para diferentes níveis de atividade física. Aquelas com maior escolaridade realizaram o teste mais rápido com e sem DT nas duas velocidades. Com relação à faixa etária, foram obervadas diferenças apenas nos testes com DT nas duas velocidades. Conclusão Idosas mais jovens com maior escolaridade demonstraram um melhor desempenho no TUG com DT. .

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O ambiente laboral organizado na perspectiva do princípio da integralidade pode induzir o profissional da saúde a se proteger e a se preocupar com a proteção do outro, contribuindo para um comportamento preventivo diante dos riscos. Realizar uma reflexão teórica sobre a segurança ocupacional do trabalhador em saúde na perspectiva da integralidade constitui-se objetivo desse ensaio. Os resultados são apresentados em dois temas: integralidade como fundamento da segurança no trabalho e a educação permanente como estratégia para o alcance da integralidade da segurança no trabalho. Conclui-se que a adesão dos profissionais da saúde às medidas de proteção necessita ser compreendida na perspectiva da integralidade. Deve permear um olhar sobre a gestão e a organização do trabalho e a proatividade individual do trabalhador para o agir coletivo na transformação da realidade do serviço. Exige-se uma articulação entre os profissionais do ensino e da prática para a formação, capacitação em saúde e segurança dos trabalhadores.

The work environment organized under the integrality principle ́s perspective can induce the healthcare worker to protect yourself and to worry about the protection of others, contributing to preventive behavior at the risks. Perform a theoretical reflection about the occupational safety health worker in integrality perspective constitutes the objective of this essay. The results presented in two themes: integrality as the foundation of the work safety and permanent education like strategy to reach the safety ́s integrality at work. We conclude that adherence of healthcare workers on protective measures need to understand in the integrality perspective. Must permeate the collective thinking on the work's management and organization and the individual proactivity of worker to collective action to transform the reality service. It requires coordination between professionals of teaching and practice for the formation, health training and workers safety.

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Objetivo: Conhecer a percepção da equipe de enfermagem sobre o Método Mãe-Canguru da maternidade de um hospital de ensino. Métodos: Pesquisa qualitativa, realizada entre setembro e outubro de 2010, na Maternidade Maria Barbosa do Hospital Universitário Clemente de Faria, Montes Claros-MG, Brasil, com cinco profissionais de enfermagem. Utilizaram-se entrevistas não diretivas para coleta dos dados, os quais foram analisados por meio da análise de conteúdo, emergindo duas categorias de análise: ?Percebendo o Método Mãe-Canguru como um estímulo de ligação entre a mãe e o filho? e ?Compreendendo o Método Mãe-Canguru como benefício para o desenvolvimento do recém-nascido?. Resultados: Os profissionais enxergam o Método Mãe-Canguru como estímulo para o estabelecimento do vínculo e apego mãe-filho, permitindo que esse binômio mantenha a união que foi construída desde a vida intrauterina. O Método Mãe-Canguru é considerado um fator relevante na recuperação do recém-nascido, pois propicia aumento de peso, estabilidade dos dados vitais e estímulo à amamentação. Destaca-se ainda que, para os entrevistados, a capacitação dos profissionais, por meio da educação continuada, quanto à realização da técnica é essencial para ofertar o cuidado humanizado na assistência neonatal. Conclusão: Os profissionais de enfermagem entrevistados compreendem o Método Mãe-Canguru aplicado na sua assistência diária como uma busca pela humanização do cuidado ao recém-nascido, uma forma de estímulo da ligação entre mãe e filho, apresentando-se como fator de relevância na recuperação do recém-nascido e proporcionando melhoria na saúde do neonato.

Objective: To know about the perception of the nursing staff about the Kangaroo-Mother Method in the maternity ward of a teaching hospital. Methods: Qualitative research, conducted in September and October 2010, in Maria Barbosa Maternity of Clemente de Faria University Hospital, Montes Claros, Minas Gerais, Brazil, with five nursing professionals. Non-directive interviews were used for data collection, which were analyzed by means of the content analysis, emerging two categories of analysis: ?Realizing the Kangaroo-Mother Method as a stimulus to the connection between the mother and the child? and ?Understanding the Kangaroo-Mother Method as a benefit to the newborn?s development?. Results: The professionals see the Kangaroo-Mother Method as a stimulus to the establishment of the mother-child bond, allowing this binomial to keep the union that was built since the intrauterine life. The Kangaroo-Mother Method is regarded as a relevant factor in the newborn?s recovery, given that it encourages weight gain, stability of vital data and stimulus to breastfeeding. It is also noticeable that, for the interviewees, professional training through continuing education on the performance of the technique is essential for providing humanized care in neonatal assistance. Conclusion: The nursing professionals interviewed understand the Kangaroo-Mother Method applied in their daily assistance as a search for humanization of care to the newborn, as a form of stimulation of the connection between mother and son, being presented as a relevant factor in the newborn?s recovery, providing improvement in the health of the neonate.

Objetivo: Conocer la percepción del equipo de enfermería sobre el Método Madre-Canguru de la maternidad de un hospital universitario. Métodos: Investigación cualitativa realizada em septiembre y octubre de 2010 en la maternidad María Barbosa Del Hospital Universitario Clemente de Faria, Montes Claros-MG, Brasil, con cinco profesionales de la enfermería. Para la recogida de datos se utilizó entrevistas no directivas las cuales fueron analizadas a través del análisis de contenido, identificándose dos categorías de análisis: ?La percepción del Método Madre- Canguru como un estímulo de relación entre madre e hijo? y ?La comprensión del Método Madre-Canguru como beneficio para el desarrollo del recién-nacido?. Resultados: Los profesionales identifican el Método Madre-Canguru como estímulo para El establecimiento de la relación y apego madre-hijo, permitiendo que ese binomio mantenga la unión que fue construida en la vida intra-uterina. El Método Madre-Canguru es considerado un factor relevante en la recuperación del recién-nacido porque conlleva al aumento de peso, estabilidad de datos vitales y estímulo al amamantamiento. Se destaca, todavía, que para los entrevistados, la capacitación de los profesionales sobre la realización de la técnica a través de la educación continuada es fundamental para ofrecer el cuidado humanizado en la asistencia neonatal. Conclusión: Los profesionales de enfermería entrevistados comprenden que el Método Madre-Canguru aplicado en La asistencia a diario como una búsqueda de la humanización del cuidado al recién-nacido, una forma de estímulo de La relación madre-hijo presentándose como factor relevante en La recuperación del recién-nacido y promoviendo la mejoría de su salud.

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O reconhecimento da importância do elemento dental como órgão humano é um fato muitas vezes negligenciado ou desconsiderado pela maioria dos odontólogos e por alguns profissionais vinculados à pesquisa científica, que utilizam grandes quantidades de dentes humanos em seus trabalhos, e por acadêmicos dos cursos de Odontologia. O presente estudo tem como propósito rever os aspectos éticos e legais envolvidos na utilização de dentes humanos por todos os envolvidos, sejam eles pesquisadores, professores e/ou alunos, promovendo assim um uso racional desses órgãos, o que vem sendo possível com a criação de Bancos de Dentes nas universidades. Diante do exposto, torna-se necessária a existência de um vínculo entre o Banco de Dentes e o Comitê de Ética da Instituição em que este se encontra, a fim de que se estabeleçam, desde o início de sua organização, diretrizes e normas de funcionamento conjuntas, visando ao cumprimento da legislação vigente.

The perception of the dental element as a human organ is neglected and disregarded many times by most of the dentists that use a great amount of human teeth in their works, by some of the professionals linked to scientific research, by professors and also by academics of dentistry courses. The main goal of this study is to review in the literature, the ethical and legal aspects involved in the use of human teeth in universities, demonstrating that that perception should be implicit in all its users, whether researchers, professors and/or students, resulting in a rational use of those organs, such as is possible with the creation of Bank of Teeth in universities. Facing the foregoing, it is necessary the existence of a link between the Bank of Teeth and the Ethics Institutional Committee of the university, in order to be establish guidelines, rules, standards and mode operations since the beginning of the bank organization, aimed at compliance with current legislation.