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Abstract Hypoparathyroidism (HP) is a rare metabolic disorder and causes hypocalcemia because parathyroid hormone secretion is inadequate to mobilize calcium from bone and reabsorb calcium from kidney and gut. Anterior neck surgery is the most common cause of acquired HP and autoimmune HP is the next most common form in adults. The duration, severity, and rate of development of hypocalcemia determine the clinical presentation. A variety of organs can be affected by calcification, more frequently kidneys, but also joints, eyes, skin, vasculature, and other organ systems and, although rarely seen, intracerebral calcifications. We report four cases of bilateral basal ganglia calcifications (BGC) also known as Fahr's syndrome related to hypoparathyroidism. Fahr's syndrome is characterized by bilateral symmetrical calcification of areas of the brain that control movements including basal ganglia, thalamus, and others; it is a rare inherited or sporadic neurological disorder with a prevalence of less than 1/1.000.000. Main symptoms related to bilateral BGC include extra-pyramidal and cerebellar disorders, cognitive impairment, epileptic seizures, and psychiatric changes. BGC has been established as a possible outcome of HP. Its prevalence, demonstrated in the HP cohorts, varied significantly from 12 up to 74%. Currently, computed tomography (CT) is the most valuable method for diagnosis. The treatment include symptomatic support and identification of causes, but there is no specific treatment limiting the progression of calcification in the basal ganglia. Especially in HP, an early treatment can prevent calcification and neurophysiological disorders.

Resumo O hipoparatireoidismo (HP) é um distúrbio metabólico raro e causa hipocalcemia, pois a secreção do paratormônio é inadequada para mobilizar o cálcio dos ossos e reabsorver o cálcio dos rins e intestino. A cirurgia cervical anterior é a causa mais comum de HP adquirido. O HP autoimune é a segunda causa mais comum em adultos. A duração, gravidade e taxa de desenvolvimento da hipocalcemia determinam a apresentação clínica. Diversos órgãos podem ser afetados pela calcificação, mais frequentemente os rins, mas também articulações, olhos, pele, vasculatura e outros órgãos e, embora raramente vista, calcificações intracerebrais. Relatamos quatro casos de calcificações dos gânglios da base (CGB) bilaterais, também conhecidas como síndrome de Fahr relacionadas ao hipoparatireoidismo. A síndrome de Fahr é caracterizada pela calcificação bilateral simétrica de áreas do cérebro que controlam os movimentos incluindo os gânglios da base, tálamo e outros; é um distúrbio neurológico raro, hereditário ou esporádico, com uma prevalência 1/1.000.000. Os principais sintomas relacionados à CGB bilateral incluem distúrbios extrapiramidais e cerebelares, comprometimento cognitivo, convulsões e alterações psiquiátricas. A CGB foi estabelecida como uma possível consequência do HP. Sua prevalência, demonstrada nas coortes de HP, variou significativamente de 12 a 74%. Atualmente, a tomografia computadorizada (TC) é o método mais valioso para o diagnóstico. O tratamento inclui suporte sintomático e identificação de causas, mas não há tratamento específico limitando a progressão da calcificação nos gânglios da base. Especialmente no HP, um tratamento precoce pode prevenir calcificações e distúrbios neurofisiológicos.

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OBJECTIVE: To determine the proportion of patients with asthma with misperception of poor control of their disease. METHODS: A cross-sectional study with a convenience sample of patients with asthma and aged ≥18 years. Asthma control was assessed by the Asthma Control Test and the Global Initiative for Asthma questionnaire. The Kappa coefficient was used to analyze the agreement between the results of these tests and the patients' perception of asthma control, defined by the response to one question of the Asthma Control Test: "How do you evaluate your asthma control during the last 4 weeks?". RESULTS: Among the 71 patients aged 19 to 81 years and a mean of 57.7±13.9 years, there were 27 (38%) controlled, according to the Asthma Control Test, and 18 (25.3%) using the Global Initiative for Asthma questionnaire. The Kappa coefficients of the results of these tests and the perception of control by the patients were 0.4 and 0.29, respectively. Among the 41 (57.7%) patients who considered themselves controlled, 18 (43.9%) had a misperception of their poor control, as per the Asthma Control Test, and 25 (61%) by the Global Initiative for Asthma. CONCLUSION: Applying the Asthma Control Test, it was observed that almost half of the participants had a misperception of their poor control of the disease and, according to the Global Initiative for Asthma questionnaire, more than half of the sample did not notice the lack of asthma control.

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Hypoparathyroidism (HP) is a rare metabolic disorder and causes hypocalcemia because parathyroid hormone secretion is inadequate to mobilize calcium from bone and reabsorb calcium from kidney and gut. Anterior neck surgery is the most common cause of acquired HP and autoimmune HP is the next most common form in adults. The duration, severity, and rate of development of hypocalcemia determine the clinical presentation. A variety of organs can be affected by calcification, more frequently kidneys, but also joints, eyes, skin, vasculature, and other organ systems and, although rarely seen, intracerebral calcifications. We report four cases of bilateral basal ganglia calcifications (BGC) also known as Fahr's syndrome related to hypoparathyroidism. Fahr's syndrome is characterized by bilateral symmetrical calcification of areas of the brain that control movements including basal ganglia, thalamus, and others; it is a rare inherited or sporadic neurological disorder with a prevalence of less than 1/1.000.000. Main symptoms related to bilateral BGC include extra-pyramidal and cerebellar disorders, cognitive impairment, epileptic seizures, and psychiatric changes. BGC has been established as a possible outcome of HP. Its prevalence, demonstrated in the HP cohorts, varied significantly from 12 up to 74%. Currently, computed tomography (CT) is the most valuable method for diagnosis. The treatment include symptomatic support and identification of causes, but there is no specific treatment limiting the progression of calcification in the basal ganglia. Especially in HP, an early treatment can prevent calcification and neurophysiological disorders.

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Introdução: Técnica inalatória (TI) correta é fundamental para o controle da asma. Objetivo: Avaliar TI de pacientes em atendimento de primeira consulta em um ambulatório de asma. Métodos: Estudo observacional transversal com amostra de conveniência de asmáticos com idade ≥ 18 anos, em primeira consulta no ambulatório de asma do Hospital Universitário Antonio Pedro (HUAP) da Universidade Federal Fluminense e em uso de medicamentos disponíveis para uso em aerossol dosimetrado (AD), Aerocaps, Aerolizer ou Diskus. Participantes preencheram questionário com dados sociodemográficos, avaliação de controle da doença segundo o documento GINA, existência de orientações médicas para uso dos dispostivos inalatórios (DI), tempo de uso de DI e especialidade do médico encaminhador. A TI era considerada apropriada quando todas as etapas foram realizadas corretamente baseando-se nas bulas das medicações e foram demonstradas com os DI vazios. Resultados: Entre os 51 pacientes incluídos, 43 (84,3%) tinham TI incorretas e 4 (7,8%) apresentavam asma controlada. Trinta e cinco (70%) referiram orientação prévia quanto ao uso do DI. A TI correta associou-se com tempo de uso maior que 2 anos (p=0,006) e uso de DI de pó seco em detrimento de AD (p=0,019). Conclusão: Somente 16% dos pacientes encaminhados ao ambulatório da pneumologia específico de asma, de um hospital terciário, tinham a TI correta em sua primeira consulta e a quase totalidade não tinha a asma controlada. Atenção deve ser dada sempre a supervisão da qualidade da TI, principalmente dos usuários de AD e dos que usam seus DI há menos de 2 anos.

Introduction: Correct inhalation technique (IT) is essential for asthma control. Objective: To evaluate the IT of patients making their first visit to the asthma outpatient clinic. Methods: Cross-sectional observational study with a convenience sample of asthmatics aged ≥ 18 years, in their first visit to the asthma outpatient clinic of the Hospital Universitário Antonio Pedro (HUAP) of the Universidade Federal Fluminense and using medications available in metered-dose aerosol (DA) , Aerocaps, Aerolizer or Diskus. Participants completed a questionnaire with sociodemographic data, assessment of disease control according to the GINA document, existence of medical guidelines for the use of inhalation devices (IDs), length of ID use, and specialty of the refer-ring clinician. IT was considered appropriate when all steps were performed correctly based on medication package inserts and were demonstrated with empty IDs. Results: Among the 51 patients included, 43 (84.3%) had incorrect IT and 4 (7.8%) had controlled asthma. Thirty-five (70%) reported previous guidance regarding the use of ID. Correct IT was associated with time of use greater than 2 years (p=0.006) and use of dry powder ID rather than DA (p=0.019). Conclusion: Only 16% of the patients referred to the asthma-specific pulmonology outpatient clinic of a tertiary hospital had the correct IT at their first appointment and almost all of them did not have controlled asthma. Attention should always be given to the supervision of IT quality, especially for DA users and those who have been using their ID for less than 2 years.

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ABSTRACT Objective To determine the proportion of patients with asthma with misperception of poor control of their disease. Methods A cross-sectional study with a convenience sample of patients with asthma and aged ≥18 years. Asthma control was assessed by the Asthma Control Test and the Global Initiative for Asthma questionnaire. The Kappa coefficient was used to analyze the agreement between the results of these tests and the patients' perception of asthma control, defined by the response to one question of the Asthma Control Test: "How do you evaluate your asthma control during the last 4 weeks?". Results Among the 71 patients aged 19 to 81 years and a mean of 57.7±13.9 years, there were 27 (38%) controlled, according to the Asthma Control Test, and 18 (25.3%) using the Global Initiative for Asthma questionnaire. The Kappa coefficients of the results of these tests and the perception of control by the patients were 0.4 and 0.29, respectively. Among the 41 (57.7%) patients who considered themselves controlled, 18 (43.9%) had a misperception of their poor control, as per the Asthma Control Test, and 25 (61%) by the Global Initiative for Asthma. Conclusion Applying the Asthma Control Test, it was observed that almost half of the participants had a misperception of their poor control of the disease and, according to the Global Initiative for Asthma questionnaire, more than half of the sample did not notice the lack of asthma control.

RESUMO Objetivo Determinar a proporção de pacientes com asma com percepção inadequada do mau controle de sua doença. Métodos Estudo transversal com amostra de conveniência de pacientes com asma e idade ≥18 anos. Avaliou-se o controle da asma por meio do Asthma Control Test e do questionário do Global Initiative for Asthma. Utilizou-se o coeficiente Kappa para análise da concordância entre os resultados desses testes e a percepção do controle da asma pelo paciente, definida pela resposta a uma questão do Asthma Control Test: "Como você avalia o controle da sua asma durante as últimas 4 semanas?". Resultados Entre os 71 pacientes com idades entre 19 e 81 anos e média de 57,7±13,9 anos, existiam 27 (38%) controlados, segundo o Asthma Control Test, e 18 (25,3%) de acordo com o questionário do Global Initiative for Asthma. Os coeficientes de Kappa entre os resultados desses testes e a percepção do controle pelos pacientes foram, respectivamente, 0,4 e 0,29. Entre os 41 (57,7%) pacientes que se consideravam controlados, 18 (43,9%) tinham percepção inapropriada do seu mau controle, de acordo com o Asthma Control Test, e 25 (61%) segundo o Global Initiative for Asthma. Conclusão Aplicando-se o Asthma Control Test, observou-se que quase metade dos participantes tinha percepção inadequada de seu mau controle da doença e, segundo o questionário da Global Initiative for Asthma, mais da metade da amostra não percebeu o descontrole da asma.

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O controle de tráfego aéreo é um serviço prestado por profissionais que trabalham em terra para orientar e monitorar aeronaves no ar e no solo, a fim de garantir um fluxo de tráfego seguro e ordenado. Os objetivos deste artigo foram conhecer aspectos sociodemográficos dos profissionais de tráfego aéreo lotados no Aeroporto Marechal Hugo da Cunha Machado, em São Luís (MA) e identificar as cargas de trabalho a que estão submetidos. Participaram do estudo 11 controladores, com idade média de 38 anos e 19,64 anos de tempo de serviço na referida função. A carga de trabalho que apresentou maior prevalência foi a psíquica, e a menor, a física. Concluiu-se que a atividade dos pesquisados exige esforços psicológicos intensos quanto às funções atencionais e à tomada de decisão, especialmente diante da rápida necessidade de ações imediatas em idiomas estrangeiros e em meio a procedimentos operacionais estritos.

Air Traffic Control is a service provided by ground professionals to guide and monitor aircraft in the air and on the ground to ensure a safe and orderly flow of traffic. The objectives were to learn about the socio-demographic aspects of air traffic professionals at the Marechal Hugo da Cunha Machado Airport, in São Luís - MA, and to identify the possible workloads to which they are submitted. The study included 11 controllers, with a mean age of 38 years and 19.64 years of service in the profession. The workload that presented the highest prevalence was the psychological, and the lowest was the physical one. It was concluded that the activity of the respondents requires intense psychological efforts regarding attentional functions and decision making, especially in view of the rapid need for immediate actions in international languages, working under strict operational procedures.

El Control de Tráfico Aéreo es un servicio prestado por profesionales que trabajan en tierra para orientar y monitorear aeronaves en el aire y en el suelo, con vistas a garantizar un flujo de tráfico seguro y ordenado. Los objetivos fueron conocer aspectos sociodemográficos de los profesionales de tráfico aéreo del Aeropuerto Marechal Hugo de la Cunha Machado, en São Luís - MA; y, además, identificar las posibles cargas de trabajo a las que están sometidos. Participaron del estudio 11 controladores, con edad media de 38 años y 19,64 años de tiempo de servicio en dicha función. La carga de trabajo que presentó mayor prevalencia fue la psíquica, y la menor la física. Se concluyó que la actividad de los encuestados exige esfuerzos psicológicos intensos en cuanto a las funciones atencionales y toma de decisión, especialmente frente a la rápida necesidad de acciones inmediatas en idiomas internacionales y en medio de procedimientos operacionales estrictos.

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OBJECTIVE: To demonstrate the most frequent errors in inhalation technique in patients with asthma undergoing treatment at a tertiary care hospital. METHODS: A cross-sectional study with a convenience sample of asthma patients aged 18 years or over, treated at a pulmonology outpatient clinic of a tertiary care hospital. The assessment of inhalation technique of users of the dry powder inhalers Aerolizer®, Aerocaps and Diskus®, or metered-dose inhalers was based on the manufacturer's instructions for use of each inhaler device. Patients demonstrated the inhalation technique with empty inhaler devices, and it was considered correct when all stages were performed properly, or when errors probably did not interfere with the treatment outcome. RESULTS: Among 71 participants, 43 (60.5%) performed inhalation technique incorrectly. Among metered-dose inhalers and dry powder inhalers users, inhalation technique errors were found in 84.2% and 51.9%, respectively (p=0.013). Errors were more frequent at the exhalation stage (67.4%), followed by breathing in (58.1%) and apnea (51.2%). In the group using dry powder inhalers, the most common errors occurred during exhalation and, for those using metered-dose inhalers, the most compromised stage was aspiration. CONCLUSION: Errors were more frequent among those using metered-dose inhalers compared with dry powder inhalers. Misconceptions are more common at the expiration stage among users of dry powder inhalers and in aspiration among those on metered-dose inhalers.

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ABSTRACT Objective: To demonstrate the most frequent errors in inhalation technique in patients with asthma undergoing treatment at a tertiary care hospital. Methods: A cross-sectional study with a convenience sample of asthma patients aged 18 years or over, treated at a pulmonology outpatient clinic of a tertiary care hospital. The assessment of inhalation technique of users of the dry powder inhalers Aerolizer®, Aerocaps and Diskus®, or metered-dose inhalers was based on the manufacturer's instructions for use of each inhaler device. Patients demonstrated the inhalation technique with empty inhaler devices, and it was considered correct when all stages were performed properly, or when errors probably did not interfere with the treatment outcome. Results: Among 71 participants, 43 (60.5%) performed inhalation technique incorrectly. Among metered-dose inhalers and dry powder inhalers users, inhalation technique errors were found in 84.2% and 51.9%, respectively (p=0.013). Errors were more frequent at the exhalation stage (67.4%), followed by breathing in (58.1%) and apnea (51.2%). In the group using dry powder inhalers, the most common errors occurred during exhalation and, for those using metered-dose inhalers, the most compromised stage was aspiration. Conclusion: Errors were more frequent among those using metered-dose inhalers compared with dry powder inhalers. Misconceptions are more common at the expiration stage among users of dry powder inhalers and in aspiration among those on metered-dose inhalers.

RESUMO Objetivo: Demonstrar os erros mais frequentes na técnica inalatória de pacientes com asma brônquica em tratamento em hospital terciário. Métodos: Estudo transversal, com amostra de conveniência de pacientes com asma, com 18 anos ou mais, em tratamento em ambulatório de pneumologia de um hospital terciário. A avaliação da técnica inalatória dos usuários dos dispositivos de pó seco Aerolizer ®, Aerocaps® ou Diskus®, ou de aerossóis dosimetrados teve como base as orientações da bula do fabricante de cada dispositivo inalatório. Os pacientes demonstraram a técnica inalatória com dispositivos inalatórios vazios, e ela foi considerada correta quando todas as etapas foram realizadas de forma apropriada, ou quando os equívocos provavelmente não interferiam no resultado do tratamento. Resultados: Entre os 71 participantes, 43 (60,5%) realizaram a técnica inalatória de forma incorreta. Dentre os usuários de aerossóis dosimetrados e dispositivos de pó seco, ocorreram erros de técnica inalatória em 84,2% e 51,9%, respectivamente (p=0,013). Os erros foram mais frequentes na etapa da expiração (67,4%), seguidos da aspiração (58,1%) e da apneia (51,2%). No grupo que usava dispositivos de pó seco, os erros mais comuns aconteceram na expiração e, nos que utilizavam aerossóis dosimetrados, a etapa mais comprometida foi a aspiração. Conclusão: Os erros foram mais frequentes entre os que usavam aerossóis dosimetrados em comparação com dispositivos de pó seco. Os equívocos foram mais comuns na etapa da expiração entre os usuários de dispositivos de pó seco e na aspiração entre os que usavam aerossóis dosimetrados.

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CONTEXT AND OBJECTIVE: Treatment of asthma implies inhalation of specific drugs to reach high concentrations in the respiratory tree and ensure low drug bioavailability and few adverse effects. This study aimed to evaluate the effectiveness of the inhalation technique among outpatients with asthma. DESIGN AND SETTING: Tertiary-care hospital-based cross-sectional study in Rio de Janeiro. METHODS: We evaluated inhalation practices in a convenience sample. A questionnaire was used to investigate sociodemographic data and assess disease control level, duration of use of the inhalation device, length of treatment and previous instructions provided by the prescribing physician. Patients demonstrated their inhalation technique using empty devices, and their technique was considered correct when all steps were appropriately performed or when errors did not interfere with the treatment outcome. RESULTS: Among the 71 participants, 53 (74.7%) had been using the same inhaler device for at least two years and 41 (57.8%) had been under treatment for two years or more. Twelve (17.1%) said that they had been taught once and 57 (81.4%) at least twice, while one (1.4%) reported not having received any guidance regarding use of inhaler devices. Eighteen patients (25.3%) presented controlled asthma and 28 (39.5%) performed the inhalation technique correctly. Incorrect technique was associated with fewer evaluations of the inhalation technique (P =0.04) and uncontrolled asthma (P = 0.01). CONCLUSIONS: Less than half of the sample performed the inhalation technique correctly. Incorrect inhalation technique was related to lower number of evaluations of the use of the inhalation device and uncontrolled asthma.

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ABSTRACT CONTEXT AND OBJECTIVE: Treatment of asthma implies inhalation of specific drugs to reach high concentrations in the respiratory tree and ensure low drug bioavailability and few adverse effects. This study aimed to evaluate the effectiveness of the inhalation technique among outpatients with asthma. DESIGN AND SETTING: Tertiary-care hospital-based cross-sectional study in Rio de Janeiro. METHODS: We evaluated inhalation practices in a convenience sample. A questionnaire was used to investigate sociodemographic data and assess disease control level, duration of use of the inhalation device, length of treatment and previous instructions provided by the prescribing physician. Patients demonstrated their inhalation technique using empty devices, and their technique was considered correct when all steps were appropriately performed or when errors did not interfere with the treatment outcome. RESULTS: Among the 71 participants, 53 (74.7%) had been using the same inhaler device for at least two years and 41 (57.8%) had been under treatment for two years or more. Twelve (17.1%) said that they had been taught once and 57 (81.4%) at least twice, while one (1.4%) reported not having received any guidance regarding use of inhaler devices. Eighteen patients (25.3%) presented controlled asthma and 28 (39.5%) performed the inhalation technique correctly. Incorrect technique was associated with fewer evaluations of the inhalation technique (P =0.04) and uncontrolled asthma (P = 0.01). CONCLUSIONS: Less than half of the sample performed the inhalation technique correctly. Incorrect inhalation technique was related to lower number of evaluations of the use of the inhalation device and uncontrolled asthma.

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DPOC é uma das doenças pulmonares mais prevalentes no mundo. No Brasil, as prevalências de DPOC e de tabagismo são 15,8% e e 10,4%, respectivamente. Entre 30 e 70% dos pacientes com DPOC permanecem tabagistas. O tratamento destes pacientes é um desafio. Frequentemente apresentam baixa motivação e auto eficácia para a interrupção do tabagismo (IT), elevada dependência de nitcotina e associação com depressão. A investigação destes elementos deve preceder o início do tratamento farmacológico, que deve sempre estar associado a terapia cognitivo comportamental (TCC) e ao tratamento da depressão. O paciente com DPOC deve ser informado sobre a relação do tabagismo com sua doença e a importância da interrupção para o controle dos sintomas e mudança do prognóstico. A TCC inclui e sugere a escolha da data de IT, a identificação de situações de alto risco, o desenvolvimento de comportamentos alternativos e o manejo dos sintomas de abstinência, além de proporcionar apoio e incrementar motivação. Todos os fármacos de primeira linha no tratamento do tabagismo podem ser utilizados no tratamento deste grupo, com as doses e períodos clássicos, mas para os mais dependentes, é frequente a necessidade de se estender o período de tratamento, aumentar doses e associar fármacos.

COPD is one of the most prevalent pulmonary diseases in the world. In Brazil, the prevalence of COPD and smoking is 15.8% and 10.4%, respectively. Between 30 and 70% of COPD patients are smokers. The treatment of these patients is a challenge. Frequently they present low motivation and self-efficacy for smoking cessation (SC), high level of nicotine dependence and association with depression. The investigation of these elements should precede the beginning of pharmacological treatment, which should always be associated with cognitive behavioral therapy (CBT) and with the treatment of depression. The patient with COPD should be informed about relationship of smoking with their disease and the importance of discontinuation for symptom control and change of prognosis. CBT includes and suggests the choice of SC date, the identification of high-risk situations, the development of alternative behaviors and the management of withdrawal symptoms, as well as providing support and increasing motivation. All first-line drugs in the smoking treatment can be used in the treatment of this group, with the classic doses and periods, but for the most dependent, it is often necessary to extend the period of treatment, increase doses and associate drugs.

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RESUMOA popularidade de jabutis criados como animais de estimação vem crescendo e tem causado preocupação quanto ao seu impacto na saúde pública e animal. Há uma escassez quanto aos estudos envolvendo o isolamento de bactérias e fungos presentes na cloaca de répteis. Este trabalho teve como objetivos o estudo das microbiotas bacteriana (bactérias aeróbias e anaeróbias facultativas) e fúngica presentes na cloaca de cem jabutis-piranga (Geochelone carbonaria) criados em domicílio bem como a pesquisa de genes de virulência em Escherichia coli e Salmonella spp. utilizando a PCR. Uma grande diversidade de gêneros de bactérias (18) e fungos (9) foi isolada. Os microrganismos mais frequentemente isolados foram: Escherichia sp. (67%), Klebsiella spp. (54%), Bacillus spp. (42%), Candida spp. (42%), Citrobacter spp. (33%), Staphylococcus spp. (29%), Aeromonas spp. (15%) e Salmonella spp. (7%). Todas Salmonella spp. foram positivas para o gene invA. Nenhum dos isolados de E.coli foi positivo para presença de genes de virulência associados com E. coli Enterotoxigênica, Enteropatogênica e Extra-intestinal. Deve-se atentar para os cuidados com jabutis criados como pets, particularmente quanto aos aspectos de higiene, visando assim a prevenção de transmissão inter espécies de diferentes microrganismos alguns dos quais que albergam genes de virulência.

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RESUMOA popularidade de jabutis criados como animais de estimação vem crescendo e tem causado preocupação quanto ao seu impacto na saúde pública e animal. Há uma escassez quanto aos estudos envolvendo o isolamento de bactérias e fungos presentes na cloaca de répteis. Este trabalho teve como objetivos o estudo das microbiotas bacteriana (bactérias aeróbias e anaeróbias facultativas) e fúngica presentes na cloaca de cem jabutis-piranga (Geochelone carbonaria) criados em domicílio bem como a pesquisa de genes de virulência em Escherichia coli e Salmonella spp. utilizando a PCR. Uma grande diversidade de gêneros de bactérias (18) e fungos (9) foi isolada. Os microrganismos mais frequentemente isolados foram: Escherichia sp. (67%), Klebsiella spp. (54%), Bacillus spp. (42%), Candida spp. (42%), Citrobacter spp. (33%), Staphylococcus spp. (29%), Aeromonas spp. (15%) e Salmonella spp. (7%). Todas Salmonella spp. foram positivas para o gene invA. Nenhum dos isolados de E.coli foi positivo para presença de genes de virulência associados com E. coli Enterotoxigênica, Enteropatogênica e Extra-intestinal. Deve-se atentar para os cuidados com jabutis criados como pets, particularmente quanto aos aspectos de higiene, visando assim a prevenção de transmissão inter espécies de diferentes microrganismos alguns dos quais que albergam genes de virulência.

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The discussion in the academy on solid urban waste residues (UWR) is analyzed, with health service waste (HSW) being an integral part of UWR, not necessarily in terms of the amount generated, but due to the risk potential to collective and environmental health. The scope of the study was to verify the vulnerability of UWR handling in primary, secondary and tertiary healthcare units in João Pessoa in the state of Paraíba. This involved a quantitative, exploratory and descriptive investigation of the handling of UWR, using a checklist and analytical evaluation of the vulnerability of HSW handling for data collection. It was detected that 21.05% of the establishments failed to separate hazardous waste, 26.34% did not standardize plastic disposal bags, and 47.37% of the workers responsible for collection were not trained to handle HSW. It was concluded that the vulnerability of HSW handling in João Pessoa in the order of 48.02%, was significant, potentially contributing to the deterioration of environmental and collective health and leading to a public health problem.

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Observa-se na academia a discussão sobre os resíduos sólidos urbanos (RSU), sendo os oriundos de serviços de saúde (RSS) parte integrante dos RSU, não necessariamente pela quantidade gerada, mas pelo potencial de risco que afeta à saúde coletiva e ambiental. Objetivou-se verificar a vulnerabilidade do manejo dos RSS, nos estabelecimentos de atenção primária, secundária e terciária de João Pessoa - PB. Foi uma pesquisa quantitativa, exploratória e descritiva do manejo dos RSS, tendo como instrumentos de coleta de dados checklist e avaliação analítica da vulnerabilidade do manejo dos RSS. Percebeu-se que 21,05 por cento dos estabelecimentos não realizam segregação, 26,34 por cento não padronizam os sacos plásticos e 47,37 por cento dos trabalhadores responsáveis pela coleta não possuem treinamento para o manuseio dos RSS. Conclui-se que a vulnerabilidade do manejo dos RSS de João Pessoa - PB foi significativo 48,02 por cento, podendo contribuir para a deterioração da saúde ambiental e coletiva, acarretando problema de saúde pública.

The discussion in the academy on solid urban waste residues (UWR) is analyzed, with health service waste (HSW) being an integral part of UWR, not necessarily in terms of the amount generated, but due to the risk potential to collective and environmental health. The scope of the study was to verify the vulnerability of UWR handling in primary, secondary and tertiary healthcare units in João Pessoa in the state of Paraíba. This involved a quantitative, exploratory and descriptive investigation of the handling of UWR, using a checklist and analytical evaluation of the vulnerability of HSW handling for data collection. It was detected that 21.05 percent of the establishments failed to separate hazardous waste, 26.34 percent did not standardize plastic disposal bags, and 47.37 percent of the workers responsible for collection were not trained to handle HSW. It was concluded that the vulnerability of HSW handling in João Pessoa in the order of 48.02 percent, was significant, potentially contributing to the deterioration of environmental and collective health and leading to a public health problem.

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RESUMO

A videoendoscopia é um procedimento emergente em medicina veterinária, sendo mais empregadaem países desenvolvidos. Em animais selvagens e exóticos também é pouco utilizada. O presente trabalhoteve por objetivo investigar por endoscopia os aspectos normais da cloaca de cágados de ouvidovermelho. O procedimento utilizado foi minimamente invasivo, sem incisões, realizado apenas comuma sedação. Neste trabalho foi possível localizar as principais estruturas cloacais, progredir facilmentea ótica realizando colonoscopia, cistoscopia, além da visualização do intestino e folículos ovarianosatravés do pleuroperitônio. Em nenhum dos 20 animais examinados, foi observado qualqueralteração compatível com processo patológico. A videoendoscopia se mostrou um procedimento fácilde ser realizado em cágados de ouvido vermelho e importante para observação de várias estruturasinternas mediante a cloacoscopia(AU)

Video-endoscopy is an emerging procedure in veterinary medicine and is more frequently used indeveloped countries. Limited literature is available on the use of video-endoscopy in wild and exoticanimals as this technology is not widely used in these species. The aim of this study was to determineand document the normal cloacal anatomy of red-eared slider using video-endoscopy. Thisminimally invasive procedure was performed using light sedation without any surgical incisions orsuture placement. Visualization of the main cloacal structures was achieved, as well as colonoscopy,cystoscopy, and visualization of intestine and ovarian follicles. None of the twenty patients examinedshowed any abnormalities. Video-endoscopy was easy to perform in red-eared slider and allowedvisualization of several important anatomical landmarks(AU)

Assuntos

RESUMO

A videoendoscopia é um procedimento emergente em medicina veterinária, sendo mais empregadaem países desenvolvidos. Em animais selvagens e exóticos também é pouco utilizada. O presente trabalhoteve por objetivo investigar por endoscopia os aspectos normais da cloaca de cágados de ouvidovermelho. O procedimento utilizado foi minimamente invasivo, sem incisões, realizado apenas comuma sedação. Neste trabalho foi possível localizar as principais estruturas cloacais, progredir facilmentea ótica realizando colonoscopia, cistoscopia, além da visualização do intestino e folículos ovarianosatravés do pleuroperitônio. Em nenhum dos 20 animais examinados, foi observado qualqueralteração compatível com processo patológico. A videoendoscopia se mostrou um procedimento fácilde ser realizado em cágados de ouvido vermelho e importante para observação de várias estruturasinternas mediante a cloacoscopia

Video-endoscopy is an emerging procedure in veterinary medicine and is more frequently used indeveloped countries. Limited literature is available on the use of video-endoscopy in wild and exoticanimals as this technology is not widely used in these species. The aim of this study was to determineand document the normal cloacal anatomy of red-eared slider using video-endoscopy. Thisminimally invasive procedure was performed using light sedation without any surgical incisions orsuture placement. Visualization of the main cloacal structures was achieved, as well as colonoscopy,cystoscopy, and visualization of intestine and ovarian follicles. None of the twenty patients examinedshowed any abnormalities. Video-endoscopy was easy to perform in red-eared slider and allowedvisualization of several important anatomical landmarks

Assuntos

RESUMO

As lesões proliferativas da glândula sebácea abdominal ventral têm sido descritas em gerbil (M. unguiculatus)oriundos de vida livre e laboratórios. Sua prevalência é relativamente baixa, mas aumentaem animais com mais de 2 anos de idade, sendo a neoplasia mais comum em M. unguiculatus machos.Relata-se um caso de adenocarcinoma sebáceo em M. unguiculatus, fêmea, 1 ano e 7 meses, com formaçãonodular, sólida, móvel, não aderida ao tecido subcutâneo, não ulcerada, indolor à palpação e comaproximadamente 2,0cm de diâmetro. Foi realizada a exérese do tumor. O diagnóstico foi confirmadopor exame histopatológico, caracterizado pela proliferação de células epiteliais, com vacuolizaçãointracitoplasmática, organizadas ora em ninhos ora em cordões, apresentando moderados pleomorfismo,atipia e índice mitótico. As células neoplásicas também apresentaram graus variáveis de diferenciaçãosebácea e diferenciação escamosa focal. Também foram encontradas pérolas de queratinadiscretas e multifocais(AU)

Proliferative lesions of the ventral abdominal sebaceous gland have been described in free-living andlaboratory gerbils (M. unguiculatus). Their prevalence is relatively low, but increases in animals withmore than 2 years old, being the most common type of tumor in M. unguiculatus males. This case reportis about a sebaceous gland carcinoma in a female M. unguiculatus, 1 year 7 months old. It was shownas a nodular formation, solid, not adhered to the subcutaneous tissue, no ulcerated surface, painlessto palpation and two centimeters in diameter. The tumor was excised. Diagnosis was confirmed byhistopathologic examination, as the sample was characterized by proliferation of epithelial cells withintracytoplasmic vacuolization, organized in cords or clusters, with moderate pleomorphism, atypiaand mitotic index. The neoplasic cells also showed varying degrees of sebaceous differentiation andfocal squamous differentiation. Mild and multifocal pearls of keratin were noted also(AU)

Assuntos

RESUMO

As lesões proliferativas da glândula sebácea abdominal ventral têm sido descritas em gerbil (M. unguiculatus)oriundos de vida livre e laboratórios. Sua prevalência é relativamente baixa, mas aumentaem animais com mais de 2 anos de idade, sendo a neoplasia mais comum em M. unguiculatus machos.Relata-se um caso de adenocarcinoma sebáceo em M. unguiculatus, fêmea, 1 ano e 7 meses, com formaçãonodular, sólida, móvel, não aderida ao tecido subcutâneo, não ulcerada, indolor à palpação e comaproximadamente 2,0cm de diâmetro. Foi realizada a exérese do tumor. O diagnóstico foi confirmadopor exame histopatológico, caracterizado pela proliferação de células epiteliais, com vacuolizaçãointracitoplasmática, organizadas ora em ninhos ora em cordões, apresentando moderados pleomorfismo,atipia e índice mitótico. As células neoplásicas também apresentaram graus variáveis de diferenciaçãosebácea e diferenciação escamosa focal. Também foram encontradas pérolas de queratinadiscretas e multifocais

Proliferative lesions of the ventral abdominal sebaceous gland have been described in free-living andlaboratory gerbils (M. unguiculatus). Their prevalence is relatively low, but increases in animals withmore than 2 years old, being the most common type of tumor in M. unguiculatus males. This case reportis about a sebaceous gland carcinoma in a female M. unguiculatus, 1 year 7 months old. It was shownas a nodular formation, solid, not adhered to the subcutaneous tissue, no ulcerated surface, painlessto palpation and two centimeters in diameter. The tumor was excised. Diagnosis was confirmed byhistopathologic examination, as the sample was characterized by proliferation of epithelial cells withintracytoplasmic vacuolization, organized in cords or clusters, with moderate pleomorphism, atypiaand mitotic index. The neoplasic cells also showed varying degrees of sebaceous differentiation andfocal squamous differentiation. Mild and multifocal pearls of keratin were noted also

Assuntos

RESUMO

O bico das aves é uma estrutura dinâmica em crescimento constante, constituída pelos ossos maxilares superior e inferior, cobertos por bainhas epidérmicas queratinizadas. Exemplos de problemas adquiridos envolvem malformações, necrose do bico ou traumas incluindo perfurações, lacerações, rachaduras e avulsões. O presente trabalho relata um caso bem sucedido de inserção de prótese homóloga de gnatoteca em um tucano de bico verde (Ramphastos dicolorus), contribuindo assim aos recentes estudos das correções de bico em aves selvagens.(AU)

The avian beak is a dynamic structure in constant growth, constituted by the upper and lower bones, covered by keratin. Examples of problems are malformations, necrosis of the beak or fractures including perforations, lacerations, cracks and avulsions. The present work report a case of gnatotheca homologous prosthesis in a red-breasted toucan(Ramphastos dicolorus), contributing to the recent studies of the beak corrections.(AU)

Assuntos