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Many aspects of the impact of childhood trauma remain unknown, such as the age at which individuals are most vulnerable to trauma, whether traumatic experiences have more severe and lasting effects when experienced early in life, and whether early life trauma causes psychiatric conditions such as anxiety and major depressive disorder (MDD) that persist over time or evolve into other disorders. Thus, this study aimed to investigate the impact of traumatic experiences in childhood on susceptibility to mood disorders in adulthood, particularly MDD. Animal models were used to address these questions, and different stressor protocols at various stages of the offspring's life were used. Three-hit starting with injections of Poly: IC was performed on the 9th day of gestation and then considered the first stressor. After birth, the animals were exposed to the maternal deprivation (MD) protocol, which separated the pups from the mother 3 h a day during the first ten days of life. From the 60th day of life, the animals were divided to receive the chronic mild stress (CMS) protocol over 21 days. The stressors can induce anxiety-like behaviors, such as increased locomotor activity through a maternal immune activation protocol using Poly: IC and demonstrating depressive-like behaviors through the MD and CMS protocols. It also showed changes in brain structures for pro-inflammatory parameters, IL-1ß and TNF-α, and alterations in anti-inflammatory parameters, IL-4 and IL-10, at different ages of life. The study also found that regulating pro- and anti-inflammatory cytokines is necessary for appropriate neuronal behavior, and stress responses can be both friendly and enemy, with costs and benefits balanced to provide the best-fit result. In conclusion, phenotypic characteristics of animals' life history are shaped by signals transmitted directly or indirectly to developing animals, known as "predictive adaptive responses."

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O envelhecimento é um processo de modificações corporais progressivo, que promove alterações morfofisiológicas e dificulta a realização de tarefas funcionais, podendo ocasionar aumento de lesões e influencia diretamente na qualidade de vida. Objetivo: Avaliar a funcionalidade e qualidade de vida dos idosos em reabilitação de membros superiores. Métodos: Estudo transversal e descritivo envolvendo idosos em reabilitação de membros superiores. Para realização da coleta dos dados foram aplicados três questionários na forma de entrevista, um questionário socioeconômico clínico elaborado pelos autores, o questionário Disabilities of the arm, shoulder and hand (DASH) e o questionário Item Short Form Health Survey (SF-12). Resultados: A amostra foi composta por 30 idosos, com média de idade de 69,53 ± 6.62 anos, predominantemente do sexo feminino (66,7%), ensino superior completo (46,7%), trabalhadores autônomos (46,7%), com renda mensal de 5 ou mais salário-mínimo. (53,3%). Quanto a qualidade de vida do questionário SF-12 obtivemos 40,53% no componente físico (PCS), 52,74% componente mental (MCS). Quanto a funcionalidade do questionário DASH o score de 40,68% classifica como incapacidade leve. Conclusão: Os idosos em reabilitação de membros superiores apresentaram melhor qualidade de vida no componente mental e incapacidade leve nos membros superiores

Aging is a process of progressive body changes, which promotes morphophysiological changes and makes it difficult to perform functional tasks, leading to an increase in injuries and directly influencing the quality of life. Objective: To evaluate the functionality and quality of life of elderly people undergoing rehabilitation of upper limbs. Methods: Cross-sectional and descriptive study involving elderly people undergoing upper limb rehabilitation. To perform the data collection, three questionnaires were applied in the form of an interview. The first was a socioeconomic clinical questionnaire prepared by the authors. Then, the "arm, shoulder, and hand" (DASH) impairments. Last but not least was the Item Short Form Health Survey (SF-12). Results: The sample consisted of 30 elderly people, with a mean age of 69.53 ± 6.62 years, predominantly female (66.7%), complete higher education (46.7%), self-employed (46.7 %), with a monthly income of 5 or more minimum wages. (53.3%). As for the quality of life of the SF-12 questionnaire, we obtained 40.53% in the physical component (PCS) and 52.74% in the mental part (MCS). As for the functionality of the DASH questionnaire, the score of 40.68% classifies it as a mild disability. Conclusion: The elderly undergoing rehabilitation of upper limbs had a better quality of life in the mental component and mild disability in the upper limbs.

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ABSTRACT Objectives: Evaluate the treatment outcome and the performance of the uCentum spinal fixation system in treating traumatic, degenerative, and tumoral diseases of the spine. Methods: This is a therapeutic study to investigate treatment outcomes and level of evidence III, including twenty-three adult patients of both sexes undergoing surgical treatment of degenerative (13 patients), traumatic (04 patients), or tumor diseases (06 patients). Patients were prospectively evaluated using clinical parameters: pain (visual analog scale), clinical and functional assessment questionnaires (SF-36, Oswestry and Roland-Morris), and radiological criteria (arthrodesis consolidation, loosening, breakage or deformation of the implants). Results: Twenty patients were followed for a period of 01 month to 12 month (mean 6,5±7,77). Three patients died due to complications unrelated to the primary disease (traumatic brain injury, septicemia, and lung tumor). Improvements were observed in clinical parameters and scores of the evaluation questionnaires used. No implant-related complications (breakage, loosening, deformation) were observed. Conclusion: the uCentum fixation system showed great versatility for performing the surgical treatment, allowing the performance of open, percutaneous procedures, the introduction of acrylic cement inside the implants, and conversion of polyaxial screws into monoaxial screws intraoperatively. Level of Evidence III; Therapeutic Studies - Investigating the Results of Treatment.

Resumo: Objetivos: Avaliar o resultado do tratamento e o desempenho do sistema uCentum de fixação vertebral no tratamento de doenças traumáticas, degenerativas e tumorais da coluna vertebral. Métodos: Trata-se de um estudo terapêutico de investigação dos resultados do tratamento e nível de evidência III, incluindo vinte e três pacientes adultos de ambos os sexos submetidos ao tratamento cirúrgico de doenças degenerativas (13 pacientes), traumáticas (04 pacientes) ou tumorais (06 pacientes). Os pacientes foram prospectivamente avaliados por meio de parâmetros clínicos: dor (escala visual analógica), questionários de avaliação clínica e funcional (SF-36, Oswestry e Roland-Morris), e critérios radiológicos (consolidação da artrodese, soltura, quebra ou deformação dos implantes). Resultados: vinte pacientes foram seguidos por um período de 01 a 12 meses (média 6,5 ± 7,77). Três pacientes foram a óbito devido a complicações não relacionadas com a doença primária (trauma cranioencefálico, septicemia e tumor pulmonar). Foi observada melhora dos parâmetros clínicos e escores dos questionários de avaliação utilizados. Não foram observadas complicações relacionadas com os implantes (quebra, soltura, deformação). Conclusão: o sistema de fixação uCentum apresentou grande versatilidade para a realização do tratamento cirúrgico, permitindo a realização de procedimentos abertos, percutâneos, introdução de cimento acrílico no interior dos implantes e conversão dos parafusos poliaxiais em monoaxiais no intra-operatório. Nível de Evidencia III; Estudos terapêuticos - Investigação dos resultados do tratamento.

Resumen: Objetivos: Evaluar el resultado del tratamiento y el desempeño del sistema de fijación vertebral uCentum en el tratamiento de enfermedades traumáticas, degenerativas y tumorales de la columna vertebral. Métodos: Este es un estudio terapéutico para investigar los resultados del tratamiento y el nivel de evidencia III, que incluye veintitrés pacientes adultos de ambos sexos sometidos a tratamiento quirúrgico de enfermedades degenerativas (13 pacientes), traumáticas (04 pacientes) o tumorales (06 pacientes). Los pacientes fueron evaluados prospectivamente mediante parámetros clínicos: dolor (escala analógica visual), cuestionarios de evaluación clínica y funcional (SF-36, Oswestry y Roland-Morris) y criterios radiológicos (consolidación de artrodesis, aflojamiento, rotura o deformación de los implantes). Resultados: veinte pacientes fueron seguidos durante un período de 1 a 12 meses (media 6,5 + 7,77). Tres pacientes fallecieron por complicaciones no relacionadas con la enfermedad primaria (lesión cerebral traumática, septicemia y tumor pulmonar). Se observaron mejoras en los parámetros clínicos y puntuaciones de los cuestionarios de evaluación utilizados. No se observaron complicaciones relacionadas con el implante (rotura, aflojamiento, deformación). Conclusión: el sistema de fijación uCentum mostró una gran versatilidad para realizar el tratamiento quirúrgico, permitiendo la realización de procedimientos abiertos, percutáneos, introducción de cemento acrílico en el interior de los implantes y conversión de los tornillos poliaxiales en tornillos monoaxiales en el intraoperatorio. Nivel de Evidencia III; Estudios terapéuticos - Investigación de los resultados del tratamiento.

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ABSTRACT Objectives: Evaluate the reliability and reproducibility of the kyphosis measurement in thoracolumbar spine traumatic fractures by different assessment methods in different types of fractures. Methods: Fifteen fractures of the thoracolumbar spine, previously classified into types A, B, and C according to Magerl's classification, were evaluated. The value of kyphosis was measured using five different methods: (1) Cobb angle; (2) Gardner's method; (3) back wall method; (4) angle of adjacent endplates; and (5) wedge angle. The measurements were performed by five independent observers and repeated five times with a minimum interval of two weeks between each evaluation. Results: Intraobserver reliability was excellent among the five observers, evidencing good reproducibility of the methods. The five methods used also showed great intraobserver reliability in the global analysis, with methods one and four being more consistent. Conclusion: Although there is no universal agreement on measuring kyphosis in thoracolumbar fractures, our study concluded that method 1 (Cobb angle) and method 4 (adjacent endplate angle) presented the best interobserver reliabilities. Furthermore, the use of digitized radiographs and a simple computer program allowed the performance of highly reliable and reproducible measurements by all methods, given the high intraobserver reliability. Level of Evidence II; Comparative study.

Resumo: Objetivos: Avaliar a confiabilidade e reprodutibilidade da mensuração da cifose nas fraturas traumáticas da coluna toracolombar por diferentes métodos de avaliação nos diferentes tipos de fraturas. Métodos: Foram avaliadas 15 fraturas na coluna toracolombar previamente classificadas em tipo A, B e C de acordo com a classificação de Magerl. Em cada caso, foi medido o valor da cifose através de cinco diferentes métodos: (1) ângulo de Cobb; (2) método de Gardner; (3) método das paredes posteriores; (4) ângulo das placas terminais adjacentes; e (5) ângulo de cunha. As mensurações foram realizadas por cinco avaliadores independentes e repetidas cinco vezes com intervalo mínimo de duas semanas entre cada avaliação. Resultados: A confiabilidade intraobservador mostrou-se excelente entre os cinco avaliadores, evidenciando boa reprodutibilidade dos métodos. Os cinco métodos utilizados também apresentaram grande confiabilidade intraobservador na análise global, sendo mais consistentes o método 1 e o método 4. Conclusão: Apesar de não haver concordância universal em como medir a cifose nas fraturas toracolombares, nosso estudo concluiu que o método 1 (ângulo de Cobb) e o método 4 (ângulo das placas terminais adjacentes) apresentaram as melhores confiabilidades interobservadores. Além disso, o uso de radiografias digitalizadas e um programa computadorizado simples permitiram a realização de medidas altamente confiáveis e reprodutíveis por todos os métodos, visto pela elevada confiabilidade intraobservador. Nível de evidência II; Estudo Comparativo.

Resumen: Objetivos: Evaluar la fiabilidad y reproducibilidad de mensuración de cifosis en fracturas traumáticas de la columna toracolumbar por diferentes métodos de valoración en diferentes tipos de fracturas. Métodos: Se evaluaron quince fracturas de columna toracolumbar, previamente clasificadas en los tipos A, B y C según la clasificación de Magerl. En cada caso, el valor de la cifosis se midió utilizando cinco métodos diferentes: (1) ángulo de Cobb; (2) método de Gardner; (3) método de la pared posterior; (4) ángulo de placas de extremo adyacentes; y (5) ángulo de cuña. Las mediciones fueron realizadas por cinco evaluadores independientes y repetidas cinco veces con un intervalo mínimo de dos semanas entre cada evaluación. Resultados: La confiabilidad intraobservador fue excelente entre los cinco evaluadores, evidenciando una buena reproducibilidad de los métodos. Los cinco métodos utilizados también mostraron una gran fiabilidad intraobservador en el análisis global, siendo el método 1 y el método 4 más consistentes. Conclusión: Aunque no existe un acuerdo universal sobre cómo medir la cifosis en las fracturas toracolumbares, nuestro estudio concluyó que el método 1 (ángulo de Cobb) y el método 4 (ángulo de la placa terminal adyacente) presentaron las mejores confiabilidades entre observadores. Además, el uso de radiografías digitalizadas y un programa informático simple permitieron realizar mediciones altamente fiables y reproducibles por todos los métodos, dada la alta fiabilidad intraobservador. Nivel de evidencia II; Estudio Comparativo.

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Idosos são suscetíveis a formas graves da Covid-19, o que resultou em medidas de isolamento social que intensificaram o estilo de vida sedentário, com comprometimento emocional e funcional. A atenção primária deve preparar-se para lidar com as repercussões desse período. Risco de quedas, rastreio de sintomas depressivos e vulnerabilidade são preditores de redução da capacidade funcional em idosos. Objetivo: Comparar o índice de vulnerabilidade, equilíbrio, depressão em idosos praticantes e não praticantes de atividade física após o período de isolamento social na pandemia da Covid-19. Casuística e Métodos: Estudo analítico transversal comparativo, com amostragem não probabilística voluntária de 56 idosos vinculados a um programa comunitário de saúde de uma capital brasileira, sendo 28 participantes do Grupo Fisioterapia (GF) e 28 do Grupo Sedentários (GS), com período de coleta de dados entre agosto a novembro de 2022. Utilizou-se questionários sociodemográficos de autopercepção de saúde e do estado emocional pela Geriatric Depression Scale (GDS-30), de classificação do nível de vulnerabilidade pelo Índice de vulnerabilidade Clínico-Funcional-20 (IVCF-20) e de risco de quedas e avaliação do equilíbrio pelo Timed Up and Go Test (TUG). Resultados: Média de idade de 69,36 ± 6,97 anos com predominância feminina (76,8%). Significância estatística entre grupos para escores GDS-30 e TUG (p=0,03; p<0,01) que evidenciaram depressão moderada em ambos os grupos e risco para quedas no GS. A média do IVCF-20 dos grupos revelou baixo comprometimento quanto à vulnerabilidade. O GF apresentou menores índices em todos os casos. Conclusão: A atividade física mostrou-se um modelo de intervenção que impacta na autonomia e bem-estar dos idosos, com melhores escores de vulnerabilidade, mobilidade funcional e depressão

Elderly are susceptible to severe forms of Covid-19 and this led to social isolation measures that intensified a sedentary lifestyle, with emotional and functional impairment. Primary care must prepare to deal with the repercussions of this period. Risk of falls, screening for depressive symptoms and vulnerability are predictors of reduced functional capacity in the elderly. Objective: To compare the vulnerability index, balance, depression in elderly practitioners and non-practitioners of physical activity after the period of social isolation of the Covid-19 pandemic. Casuistic and Methods: Comparative cross-sectional analytical study, with voluntary nonprobabilistic sampling of 56 elderly people linked to a community health program in a Brazilian capital, with 28 participants in the Physical Therapy Group (GF) and 28 in the Sedentary Group (GS), with a collection period between August and November 2022. Socio-demographic questionnaires were used to assess self-perception of health and emotional state using the Geriatric Depression Scale (GDS-30), classification of vulnerability level using the Clinical-Functional Vulnerability Index-20 (IVCF-20) and risk of falls and assessment of balance by the Timed Up and Go Test (TUG). Results: Mean age of 69.36 ± 6.97 years, with female predominance (76.8%). Statistical significance between groups for GDS-30 and TUG scores (p=0.03; p<0.01), which showed moderate depression in both groups and risk for falls in the GS. The IVCF-20 average of the groups revealed low impairment in terms of vulnerability. The GF had lower rates in all cases. Conclusion: Physical activity proved to be an intervention model that impacts the autonomy and well-being of the elderly, with better vulnerability scores, functional mobility and depression

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ABSTRACT BACKGROUND AND OBJECTIVES: Erector spinae plane block is an interfascial plane block used as a tool for management of pain resulting from thoracic and abdominal surgical procedures described in the literature since 2016 and widely used in clinical practice. In the context of the pandemic caused by Sars-CoV-2, multiple pulmonary complications arising from severe viral pneumonia and respiratory failure that required surgical approaches for their investigation and/or treatment were observed. The present study's objective was to present a series of three cases of patients affected by COVID-19 who had pulmonary complications due to infection or exacerbation of previous pulmonary diseases caused by the new coronavirus, in which the continuous fascial plane block was successfully used for postoperative pain management. CASE REPORTS: Three cases of patients with COVID-19 viral pneumonia requiring diagnostic or therapeutic thoracic surgery who underwent erector spinae plane block for perioperative pain management were presented. CONCLUSION: The use of a catheter with continuous infusion of local anesthetic was useful for reducing analgesic rescue and maintaining good postoperative analgesia with no evidence of adverse effects in the presented patients, also allowing acceleration of postoperative recovery and a better outcome for the patients.

RESUMO JUSTIFICATIVA E OBJETIVOS: O bloqueio do plano dos músculos eretores da espinha é um bloqueio do plano interfascial usado como ferramenta para manejo de dor consequente a procedimentos cirúrgicos torácicos e abdominais descrito na literatura desde 2016 e amplamente utilizado na prática clínica. No contexto da pandemia causada pelo Sars-CoV-2, foram observadas múltiplas complicações pulmonares decorrentes de pneumonia viral grave e insuficiência respiratória que demandaram abordagens cirúrgicas para sua investigação e/ou tratamento. O objetivo deste estudo foi apresentar uma série de três casos de pacientes acometidos pela COVID-19 que tiveram complicações pulmonares pela infecção ou exacerbação de doença pulmonar prévia causada pelo novo coronavírus, nos quais o recurso do bloqueio do plano fascial contínuo foi utilizado para manejo de dor pós-operatória com sucesso. RELATO DOS CASOS: Foram apresentados três casos de pacientes acometidos pelo COVID-19 em sua forma de pneumonia viral, para os quais houve necessidade de cirurgia torácica diagnóstica ou terapêutica, e que foram submetidos ao bloqueio do plano dos músculos eretores da espinha para manejo da dor perioperatória. CONCLUSÃO: O uso de cateter com infusão contínua de anestésico local foi útil para a diminuição dos resgates analgésicos e manutenção de boa analgesia pós-operatória sem evidência de efeitos adversos nos pacientes apresentados, possibilitando ainda a aceleração da recuperação pós-operatória e um melhor desfecho para os pacientes.

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BACKGROUND: Weight stigma is a phenomenon associated with adverse behavioural and psychological consequences. Although experts suggest that its increase during the COVID-19 pandemic may be associated with worse health outcomes for people with obesity, a thorough analysis of the main findings and gaps is still needed when relating to this subject. OBJECTIVE: We aim to answer three questions: (1) How does weight stigma manifest in the COVID-19 pandemic? (2) How can weight stigma affect people with overweight or obesity in times of COVID-19? (3) What are the perceptions and experiences of weight stigma during the pandemic in individuals who experience overweight or obesity? METHODS: We conducted a scoping review of studies addressing weight stigma and the COVID-19 pandemic in electronic databases (Medline/PubMed, CINAHL, Embase, PsycInfo, BVS/Lilacs, Scopus, Web of Science, Google Scholar, and OpenGrey) published until 10th August 2021. All relevant studies were reviewed in full by two researchers. In addition, a narrative synthesis of the data was performed. RESULTS: The results included 35 studies out of 8,090 records and identified 13 original research publications, 14 text and opinion papers, and 6 narrative reviews. The results revealed the presence of weight stigma in the media, healthcare settings, interpersonal relationships, and public campaigns during the COVID-19 pandemic. The evidence of increasing weight stigma in the COVID-19 outbreak is limited, though. Many weight discrimination consequences were described during this time, such as impairment in accessing healthcare, worst COVID-19 outcomes, and maladaptive eating. However, only maladaptive behaviours and decline in mental health outcomes were demonstrated empirically in all age groups. This effect occurred regardless of body mass index, but people with high body weight were more likely to experience weight stigma. For some people with obesity, weight stigma in the pandemic has made activities of daily routine difficult. CONCLUSIONS: The results suggest that weight stigma in the COVID-19 pandemic occurs in several settings; moreover, although weight discrimination impacts mental health, whether before or during the pandemic, this influence between the pandemic and pre-pandemic scenario is still unclear. Therefore, more research is required in this field while the pandemic lasts, especially with people with obesity. Overall, people with overweight or obesity are more vulnerable to weight stigma than individuals without overweight. In addition, weight stigma refers to discrimination or prejudice based on a person's weight and relates to several consequences, for instance, poor healthcare treatment and mental health problems. In the COVID-19 outbreak, these weight stigma effects tend to become even more critical because they may be associated with unfavourable COVID-19 outcomes and eating disorder risks. Thus, it is crucial to investigate how weight stigma occurs during the pandemic and its impact on health, mainly for the most affected people. We investigated 35 studies published between 2019 and 2021 to map and explore how weight stigma was manifested and the related consequences for people with overweight or obesity in the COVID-19 pandemic. Only about a third of them were quantitative or qualitative, limiting the evidence of weight stigma in the COVID-19 context. The available evidence suggests that weight stigma manifests in several settings such as media, healthcare, public campaigns, and is more common in people with excess weight. However, weight discrimination experiences before or during the pandemic were associated with adverse psychological and behavioural consequences across all age groups, regardless of body weight. For some people with obesity, for instance, weight stigma made it difficult to accomplish their activities of daily routine. Nevertheless, it remains unclear whether weight stigma has increased in the pandemic, thus, more studies are required, especially about people with overweight or obesity.

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OBJECTIVES: This study aimed to evaluate the efficacy of hyaluronic acid in the viability and proliferation profile of human femoral-tibial joint cartilage affected by osteoarthritis using in vitro models of chondrocytes in a 2-dimensional (2D)- and 3-dimensional (3D)-based culture model by spheroids. DESIGN: In vitro study of knee cartilage affected by osteoarthritis that required surgical treatment. Samples were cultured and exposed to hyaluronic acid (100 and 500 µM; intervention group) or vehicle solution. In monolayer or 2D culture, proliferation and cell viability were measured, and nuclear morphometry was analyzed by 4',6'-diamino-2-fenil-indol (DAPI) staining. The 3D-based culture established from the culture of articular cartilage of patients submitted to total knee arthroplasty evaluated the diameter, viability, and fusion ability of the chondrospheres created. RESULTS: Samples from 3 patients resulted in viable cultures, with chondrocyte cells exhibiting a potential for cell proliferation and viability to establish a culture. Hyaluronic acid (100 and 500 µM) improved chondrocyte viability and proliferation up to 72 hours in contact when compared with the control group, and no nuclear irregularities in morphology cell characteristics were observed by DAPI. In the 3D evaluation, hyaluronic acid (500 µM) improved the cellular feedback mechanisms, increasing the survival and maintenance of the chondrospheres after 7 days of analysis, showing the intrinsic capacity of chondrospheres grouped in the attempt to rearrange and reestablish new articular tissue. CONCLUSIONS: The 2D- and 3D-based culture models with hyaluronic acid improved chondrocyte viability and proliferation and demonstrated the ability of freshly formed chondrospheres to undergo fusion when placed together in the presence of hyaluronic acid.

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Resumo Objetivo Apresentar um panorama da imagem social da enfermeira divulgada na Mídia Impressa brasileira no período de 1970 a 1999. Métodos Estudo exploratório, documental, quantitativo que utilizou como fonte de dados as edições publicadas pelo Jornal Estado de São Paulo nos 30 anos compreendidos entre 1970 e 1999, que mencionaram o termo "enfermeira" ou "enfermeiro", identificadas por meio de webscraping. O tratamento e a análise das notícias foram realizados com auxílio do software Sphinx. Resultados Foram identificadas 10.950 edições do jornal e 2.528 notícias que mencionavam os termos "enfermeiro" ou "enfermeira". Identificamos uma média de sete notícias por mês a respeito da enfermeira. Entretanto, em 90,3%, a enfermeira foi apenas mencionada no texto, sem nenhum destaque ou relação com a notícia principal. Além disso, a maior parte das matérias foi veiculada na seção classificados, no formato de artigo ou coluna, que, por característica constitutiva, traz a opinião do autor sobre determinado tema. Conclusão Podemos inferir, com base nos dados analisados, que apesar do significativo quantitativo de notícias publicadas a respeito do tema durante o período analisado, isso pouco contribuiu para a construção da imagem da enfermeira enquanto profissional de saúde na sociedade brasileira porque a maior parte das notícias apenas mencionou a enfermeira no texto ou utilizou o termo para caracterizar um objeto ou situação.

Resumen Objetivo Presentar cómo es la situación de la imagen social de la enfermera divulgada en los medios de comunicación impresos brasileños de 1970 a 1999. Métodos Estudio exploratorio, documental, cuantitativo que utilizó como fuente de datos las ediciones publicadas por el periódico Estado de São Paulo durante los 30 años comprendidos entre 1970 y 1999, que mencionaron el término "enfermera" o "enfermero", identificadas mediante webscraping. Las noticias fueron tratadas y analizadas con ayuda del software Sphinx. Resultados Se identificaron 10.950 ediciones del periódico y 2.528 noticias que mencionaron los términos "enfermero" o "enfermera". Identificamos un promedio de siete noticias por mes relacionadas con enfermeras. Sin embargo, en el 90,3 % de los casos, la enfermera solo fue mencionada en el texto, sin ningún tipo de énfasis o relación con la noticia principal. Además, la mayor parte de las notas fue publicada en la sección de clasificados, en formato de artículo o columna, que, por característica constitutiva, expone la opinión del autor sobre determinado tema. Conclusión Con base en los datos analizados, podemos deducir que, a pesar de la cantidad significativa de noticias publicadas sobre el tema durante el período estudiado, contribuyó poco en la construcción de la imagen de la enfermera como profesional de la salud en la sociedad brasileña, porque en la mayoría de las noticias solo se mencionó a la enfermera en el texto o se utilizó el término para caracterizar un objeto o situación.

Abstract Objective to present an overview of nurses' social image published in the Brazilian Printed Media from 1970 to 1999. Methods this is an exploratory, documentary, quantitative study, which used as a data source the editions published by Estado de São Paulo in the 30 years between 1970 and 1999, which mentioned the term "nurses", identified through web scraping. News processing and analysis carried out using the Sphinx software. Results 10,950 issues of the newspaper and 2,528 news items that mentioned the term "nurses" were identified. We identified an average of seven news a month about nurses. However, in 90.3%, nurses were only mentioned in the text, without any highlight or relationship with the main news. Furthermore, most articles were published in the classified section, in the form of an article or column, which, by constitutive characteristic, brings the opinion of the author on a given topic. Conclusion we can infer, based on the analyzed data, that despite the significant amount of news published on the subject during the analyzed period, this contributed little to constructing the image of nurses as health professionals in Brazilian society because most of the news only mentioned nurses in the text or used the term to characterize an object or situation.

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BACKGROUND AND OBJECTIVES: Postoperative pain is still a major concern in several surgical procedures. Multimodal analgesia is best for postoperative pain management; however, opioid therapy is still the main treatment for pain after surgical procedures. Transdermal buprenorphine is a partial µ agonist opioid widely used for chronic pain syndromes, with limited evidence for acute postoperative pain. A systematic review of studies examining transdermal buprenorphine for acute pain management after surgery was conducted. CONTENTS: Data from PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL via EBSCOhost, and LILACS were reviewed, including randomized clinical trials that evaluated total postoperative pain, postoperative analgesic consumption, drug-related side effects and patient satisfaction with analgesia regimen. Data from nine studies (615 patients) were included in this review. Most studies initiated transdermal buprenorphine use 6 to 48 hours before surgery, maintaining use from 1 to 8 days after the procedure. Most studies showed lower or similar postoperative pain scores, postoperative analgesic consumption and patient satisfaction comparing buprenorphine to placebo, tramadol, celecoxib, flurbiprofen and parecoxib. The incidence of side effects varied between studies, with most showing no increase in drug-related side effects with buprenorphine use, except one study, which compared buprenorphine to oral tramadol, and one to transdermal fentanyl. However, most results were derived from evidence with an overall high or unclear risk of bias. CONCLUSIONS: Although more studies are necessary, initial results show that transdermal buprenorphine seems to be an effective and safe opioid choice for management of acute postoperative pain.

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Background and objectives: Postoperative pain is still a major concern in several surgical procedures. Multimodal analgesia is best for postoperative pain management; however, opioid therapy is still the main treatment for pain after surgical procedures. Transdermal buprenorphine is a partial µ-agonist opioid widely used for chronic pain syndromes, with limited evidence for acute postoperative pain. A systematic review of studies examining transdermal buprenorphine for acute pain management after surgery was conducted. Contents: Data from PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL via EBSCOhost, and LILACS were reviewed, including randomized clinical trials that evaluated total postoperative pain, postoperative analgesic consumption, drug-related side effects and patient satisfaction with analgesia regimen. Data from nine studies (615 patients) were included in this review. Most studies initiated transdermal buprenorphine use 6 to 48 hours before surgery, maintaining use from 1 to 28 days after the procedure. Most studies showed lower or similar postoperative pain scores, postoperative analgesic consumption and patient satisfaction comparing buprenorphine to placebo, tramadol, celecoxib, flurbiprofen and parecoxib. The incidence of side effects varied between studies, with most showing no increase in drug-related side effects with buprenorphine use, except one study, which compared buprenorphine to oral tramadol, and one to transdermal fentanyl. However, most results were derived from evidence with an overall high or unclear risk of bias. Conclusions: Although more studies are necessary, initial results show that transdermal buprenorphine seems to be an effective and safe opioid choice for management of acute postoperative pain

Justificativa e objetivos: A dor pós-operatória ainda é uma queixa importante em vários procedimentos cirúrgicos. A analgesia multimodal é a melhor conduta para a dor pós-operatória, embora a terapia com opioides ainda seja o principal tratamento para a dor após procedimentos cirúrgicos. A buprenorfina transdérmica é um opioide agonista µ amplamente prescrito nas síndromes de dor crônica, mas com limitada evidência do seu uso para dor aguda no pós-operatório. Realizamos revisão sistemática de estudos que examinaram o papel da buprenorfina transdérmica no tratamento da dor aguda pós-operatória. Conteúdo: Revisamos os dados de PubMed, Embase, Registro Central de Ensaios Controlados Cochrane (CENTRAL), CINAHL via EBSCOhost e LILACS, incluindo estudos clínicos randomizados que avaliaram a dor pós-operatória total, consumo de analgésicos pós-operatórios, efeitos colaterais relacionados a medicamentos e satisfação do paciente com esquema de analgesia. Dados de nove estudos (615 pacientes) foram incluídos nesta revisão. A maioria dos estudos iniciou o uso transdérmico de buprenorfina 6 a 48 horas antes da cirurgia, mantendo o uso de 1 a 28 dias após o procedimento. A maioria dos estudos encontrou valores semelhantes ou menores para o escore de dor pós-operatória, consumo pós-operatório de analgésicos e satisfação do paciente quando a buprenorfina foi comparada ao placebo, tramadol, celecoxibe, flurbiprofeno e parecoxibe. A incidência de efeitos colaterais oscilou nos estudos, e a maioria não mostrou aumento de efeito colateral relacionado ao uso de buprenorfina, exceto em dois estudos, um que comparou buprenorfina ao tramadol oral e outro ao fentanil transdérmico. No entanto, a maioria dos resultados foi obtida a partir de evidências com um risco geral alto ou risco de viés impreciso. Conclusões: Embora sejam necessários mais estudos, os resultados iniciais mostram que a buprenorfina transdérmica parece ser uma forma de administração segura e efetiva de opioide no tratamento da dor aguda pós-operatória

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QUESTION: In people with chronic low back pain, what is the average effect of directing manipulation at the most painful lumbar level compared with generic manipulation of the spine? DESIGN: Randomised controlled trial with concealed allocation, a blinded assessor and intention-to-treat analysis. PARTICIPANTS: 148 people with non-specific chronic low back pain with a minimum level of pain intensity of 3 points (measured from 0 to 10 on the Pain Numerical Rating Scale). INTERVENTIONS: All participants received 10 spinal manipulation sessions over a 4-week period. The experimental group received treatment to the most painful segment of the lower back. The control group received treatment to the thoracic spine. OUTCOME MEASURES: The primary outcome was pain intensity, measured at the end of the intervention (Week 4). Secondary outcomes were: pain intensity at Weeks 12 and 26; pressure pain threshold at Week 4; and global perceived change since onset and disability, both measured at Weeks 4, 12 and 26. RESULTS: Each group was randomly allocated 74 participants. Data were collected at all time points for 71 participants (96%) in the experimental group and 72 (97%) in the control group. There were no clinically important between-group differences for pain intensity, disability or global perceived effect at any time point. The estimate of the effect of directing manipulation at the most painful lumbar level, as compared with generic manipulation, on pain intensity was too small to be considered clinically important: MD 0 (95% CI -0.9 to 0.9) at Week 4 and -0.1 (95% CI -1.0 to 0.8) at Week 26. CONCLUSION: No clinically important differences were observed between directed manipulation and generic manipulation in people with chronic low back pain. TRIAL REGISTRATION: NCT02883634.

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BACKGROUND: Most of our understanding on the social behavior and genomics of bees and other social insects is centered on the Western honey bee, Apis mellifera. The genus Apis, however, is a highly derived branch comprising less than a dozen species, four of which genomically characterized. In contrast, for the equally highly eusocial, yet taxonomically and biologically more diverse Meliponini, a full genome sequence was so far available for a single Melipona species only. We present here the genome sequence of Frieseomelitta varia, a stingless bee that has, as a peculiarity, a completely sterile worker caste. RESULTS: The assembly of 243,974,526 high quality Illumina reads resulted in a predicted assembled genome size of 275 Mb composed of 2173 scaffolds. A BUSCO analysis for the 10,526 predicted genes showed that these represent 96.6% of the expected hymenopteran orthologs. We also predicted 169,371 repetitive genomic components, 2083 putative transposable elements, and 1946 genes for non-coding RNAs, largely long non-coding RNAs. The mitochondrial genome comprises 15,144 bp, encoding 13 proteins, 22 tRNAs and 2 rRNAs. We observed considerable rearrangement in the mitochondrial gene order compared to other bees. For an in-depth analysis of genes related to social biology, we manually checked the annotations for 533 automatically predicted gene models, including 127 genes related to reproductive processes, 104 to development, and 174 immunity-related genes. We also performed specific searches for genes containing transcription factor domains and genes related to neurogenesis and chemosensory communication. CONCLUSIONS: The total genome size for F. varia is similar to the sequenced genomes of other bees. Using specific prediction methods, we identified a large number of repetitive genome components and long non-coding RNAs, which could provide the molecular basis for gene regulatory plasticity, including worker reproduction. The remarkable reshuffling in gene order in the mitochondrial genome suggests that stingless bees may be a hotspot for mtDNA evolution. Hence, while being just the second stingless bee genome sequenced, we expect that subsequent targeting of a selected set of species from this diverse clade of highly eusocial bees will reveal relevant evolutionary signals and trends related to eusociality in these important pollinators.

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OBJECTIVE: The objective of this study was to evaluate the effects of intake of Brazil nut extract (BN) or sodium selenite solution on reproductive parameters of male diabetic animals. METHODS: A total of 48 Wistar rats were distributed into six groups: diabetes (n = 8); diabetes and Brazil nut extract (n = 8); diabetes and sodium selenite (Na2SeO3) (n = 8); Brazil nut extract (n = 8); sodium selenite (n = 8) and control (n = 8). A single dose of streptozotocin (65 mg/kg) was injected intravenously to the rats to induce diabetes. BN or Na2SeO3 were administered by gavage for 56 days. RESULTS: The diabetes caused critical alterations on body mass gain, reproductive parameters and antioxidant capacity. Treatments with both BN or Na2SeO3 were able to increase significantly the glutathione peroxidase and the daily sperm production, both in diabetic (p < 0.01 and p < 0.05) and in healthy animals (p < 0.01 and p < 0.05). CONCLUSION: The Brazil nut extract and sodium selenite were able to improve some reproductive parameters of diabetic rats. Moreover, we could infer that this effect is probably due to the natural selenium content of the BN.

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Studies related to ants found in hospital environments have aroused interest in their role as mechanical vectors of pathogenic microorganisms. The objective of the current research was to determine the species composition and bacterial contamination of ant species found in a public hospital in the eastern Amazonian region. Ants were captured using bait containing honey and sterilized sardines in 15 locations within the Macapá Emergency Hospital, Amapá. Ants were identified morphologically using specific keys. Bacteria were first inoculed in a Brain Heart Infusion broth and then plated on 5% Agar with blood or MacConkey media. Bacterial species were identified through biochemical procedures. In total, 9,687 ants were collected, with 69.8% from the dry season and 30.2% from the rainy season. Nine species of ants were identified belonging to three subfamilies: the Monomorium pharaonis (Linnaeus 1758) being the most common, comprising 39.2% of the total specimens. Only one ant species was found in each bait, facilitating microbiological analyses. In total, 92 bacteria isolates were identified comprising 12 species. Pseudomonas aeruginosa Schroeter 1872 (Pseudomonadales: Pseudomonadaceae) was pathogenic bacteria, most frequently isolated, comprising 10.9% of the positive samples. The most contaminated ant in the study was M. pharaonis with 38.3%. It was the dominant ant species in this hospital environment. Its wide prevalence, forage day and night of this vector in hospital facilitated bacterial contamination. The presence of bacteria on ants may be associated with the dissemination of pathogens which cause hospital infections, making pest control a necessity in these institutions.

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Relato de caso: apresentamos um caso de diagnóstico ecográfico pré-natal de ictiose de Arlequim, que evoluiu com óbito intrauterino. Conclusão: esse distúrbio caracteriza-se por um neonato envolto por uma membrana espessa de material córneo com fissuras generalizadas, comprometendo as funções básicas da pele e predispondo o recém-nascido a infecções e a alterações metabólicas. Com prognóstico desfavorável, o diagnóstico precoce e o tratamento de suporte visam aumentar a sobrevida e melhorar a qualidade de vida ao neonato.

Case report: we present a case of prenatal ultrasound diagnosis of ichthyosis of Harlequin, which evolved with intrauterine decease. Conclusion: this disorder is characterized by a neonate wrapped in a thick membrane off horny material with generalized fissures that compromise the basic functions of the skin, predisposing the newborn to infections and metabolic alterations. With a reserved prognosis, early diagnosis and supportive care aim to increase survival and improve the quality of life of the newborn.

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Organophosphates (OPs) constitute many toxic agrochemicals and warfare and can undergo a wide spectrum of mechanisms, some which are fairly unexplored. In this sense, concise mechanistic elucidation stands out as a strategic tool for achieving efficient detoxification and for monitoring processes. Particularly intriguing is the effect of substituting the oxygen atom of the phosphoryl moiety (P=O) in OPs with a sulfur atom to give the thio-derived OPs (i.e., OTPs, P=S). In general, imidazole (IMZ) reacts very efficiently with OPs by targeting the phosphorus atom, although herein we evidence a thio-driven shift with OTPs: IMZ undergoes unusual nucleophilic attack at the aliphatic carbon atom of methyl parathion. Alkylation of IMZ under mild conditions (aqueous weakly basic medium) is also novel and should be applicable to other novel IMZ-based architectures, and thereby, it can be a great ally for organic synthesis. Overall, a broader understanding of the mechanistic trend involved in such highly toxic agents is provided.

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Justificativa e Objetivos: É essencial conhecer os microrganismos presentes em hemoculturas de pacientes pediátricos internados para uma melhor escolha da terapêutica antibiótica. Dessa forma, este trabalho tem como objetivo verificar a associação entre parâmetros clínicos e epidemiológicos com o desenvolvimento de sepse neonatal tardia em pacientes internados em um serviço de pediatria de um hospital do sul do Brasil. Métodos: Estudo transversal, descritivo, retrospectivo e qualiquantitativo que utilizou dados secundários oriundos dos prontuários de pacientes que apresentaram critérios clínicos para sepse neonatal, internados na Unidade de Tratamento Intensivo Neonatal (UTIN) do Hospital Santa Cruz. Resultados: Dos 588 pacientes internados na UTIN do Hospital Santa Cruz no período de 01/01/2013 a 31/12/2015, 123 recém-nascidos (RNs) preencheram os critérios para sepse neonatal tardia. Destes, 59 (47,97%) apresentaram hemocultura positiva, o que foi mais frequente em RNs prematuros (39,84%) e de baixo peso (43,90%), embora não tenha havido associação estatisticamente significativa entre estes fatores e hemocultura positiva. Dentre os possíveis fatores de risco para o desenvolvimento de sepse neonatal, o uso de ventilação mecânica (p=0,005), realização de cirurgia (p=0,019) e permanência no hospital por mais de um mês (p=0,001) apresentaram associação estatística com hemocultura positiva. Os microrganismos presentes em maior frequência nas hemoculturas foram os estafilococos coagulase-negativa (S. epidermidis, S. saprophyticus e S. haemolyticus), encontrados em 35,71% das hemoculturas analisadas. Conclusão: O estudo evidenciou maior prevalência de sepse neonatal tardia em RNs prematuros e de baixo peso, que necessitaram de maiores cuidados e foram submetidos a maior manipulação durante a permanência na UTIN. Procedimentos invasivos e longa permanência hospitalar se associaram significativamente com hemocultura positiva, corroborando com o descrito na literatura.(AU)

Background and Objectives: It is essential recognize the microorganisms present in hemoculture in pediatric patients internees for a better choice of antibiotic therapy. In this way, this work aims assess the association between clinical and epidemiological parameters with the onset of late neonatal sepsis in hospitalized patients, in a pediatric service of the south of Brazil. Methods: A cross-sectional, descriptive, retrospective, qualitative and quantitative study that used secondary data from the files of patients which presented clinical criteria indicating neonatal sepsis, that were hospitalized in the Neonatal Intensive Care Unit (NICU) at Hospital Santa Cruz. Results: Out of the 588 patients hospitalized in the NICU from 01/01/2013 to 12/31/2015, 123 newborns (NBs) filled the criteria for late neonatal sepsis. Out of these, 59 (47,97%) presented with positive hemoculture, which was more frequent in preterms NBs (39,84%) and low birth weight (43,90%), although there was no statistically significant associantion between these factors and positive hemoculture. From the possible risk factors for the onset of neonatal sepsis, mechanical ventilation (p=0,005), having performed surgery (p=0,019) and in-hospital stay longer than a month (p=0,001) showed statistic association with positive hemoculture. The microrganisms that were the most frequent were the coagulase-negative staphylococci (S. epidermidis, S. saprophyticu and S. haemolyticus), found in 37,71% of the analyzed hemocultures. Conclusion: This study showed higher prevalence of neonatal sepsis on premature NBs and on low-weight NBs that required higher care and suffered invasive procedures during the stay in the NICU. Invasive procedures and long hospital stay were significantly associated with positive hemoculture, corroborating with tah described in the literature.(AU)

Justificación y objetivos: Es esencial conocer los microorganismos presentes em las hemoculturas de pacientes pediátricos internados para una mejor elección de la terapia antibiótica. De esta forma, este trabajo tiene como objetivo verificar la asociación entre parámetros clínicos y epidemiológicos con el desarrollo de sepsis neonatal tardía en pacientes internados en un servicio de pediatría de un hospital del sur de Brasil. Métodos: Estudio transversal, descriptivo, retrospectivo y cualiquantitativo que utilizó datos secundarios oriundos de los prontuarios de pacientes que presentaron criterios clínicos para sepsis neonatal, internados en la Unidad de Tratamiento Intensivo Neonatal (UTIN) del Hospital Santa Cruz. Resultados: De los 588 pacientes internados en la UTIN del Hospital Santa Cruz en el período de 01/01/2013 a 31/12/2015, 123 recién nacidos (RNs) cumplieron los criterios para sepsis neonatal tardía. De estos, 59 (47,97%) presentaron hemocultura positiva, lo que fue más frecuente en RNs prematuros (39,84%) y de bajo peso (43,90%), aunque no hubo asociación estadísticamente significativa entre estos factores y hemocultura positiva. Entre los posibles factores de riesgo para el desarrollo de sepsis neonatal, el uso de ventilación mecánica (p=0,005), realización de cirugía (p=0,019) y permanencia en el hospital por más de un mês (p=0,001) presentaron asociación estadística con hemocultura positiva. Los microorganismos presentes en mayor frecuencia en los hemocultivos fueron los estafilococos coagulasa-negativos (S. epidermidis, S. saprophyticus y S. haemolyticus), encontrados en el 35,71% de los hemocultivos analizados. Conclusión: El estudio evidenció mayor prevalencia de sepsis neonatal tardía en RNs prematuros y de bajo peso, que requirieron mayores cuidados y fueron sometidos a mayor manipulación durante la permanencia en la UTIN. Los procedimientos invasivos y larga permanencia hospitalaria se asociaron significativamente con hemocultura positiva, corroborando con lo descrito en la literatura.(AU)

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A new mathematical model was developed for the kinetics of α-, ß- and γ-cyclodextrin production, expanding an existing model that only included the production of ß- and γ-cyclodextrins, because a detailed kinetic modelling of the reactions involved allows the manipulation of the process yields. The kinetic behaviour of the commercial enzyme Toruzyme® was studied with maltodextrin as substrate at different concentrations and for CGTase from Bacillus firmus strain 37 at a concentration of 100 g L-1. The mathematical model showed a proper fit to the experimental data, within the 24-h period studied, confirming that the considered hypotheses represent the kinetic behaviour of the enzymes in the reaction medium. The kinetic parameters generated by the model allowed reproducing previous observed qualitative tendencies as it can be seen that changing experimental conditions in the reaction process such as enzyme and substrate concentrations results in large changes in the enzyme kinetics and using high substrate concentrations does not guarantee the highest conversion rates due to enzyme inhibition and reverse reactions. In addition, this new mathematical model complements previous qualitative observations enabling the manipulation of the direct and reverse reactions catalysed by the enzyme by adjusting the reaction conditions, to target quantitative results of increased productivity and better efficiency in the production of a desired cyclodextrin.

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