RESUMO

BACKGROUND: The Confusion, Hubbub, and Order Scale (CHAOS in English Version) was originally developed in the USA by Matheny et al (Bringing order out of chaos: psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology 16(3):429-444, 1995) to measure chaos in the family environment, characterized by confusion, lack of routine, and organization. OBJECTIVE: To present evidence of content validity, internal structure validity, and validity based on relationships with external measures of an adapted version of the CHAOS into Brasilian Portuguese with adolescents sample in São Paulo - Brasil. METHOD: Study 1 involved the translation/back-translation and adaptation of the scale into Brazilian Portuguese [here named "Escala de Confusão, Alvoroço e Ordem no Sistema familiar" (CAOS)], assessed by 5 judges. In Study 2, we conducted an exploratory factor analyses (EFA) to determine the scale's factor structure (N = 180 adults). In Study 3, we carried out confirmatory factor analyses (CFA) to confirm the internal validity of the scale, along with complete structural equation modeling to explore convergent validity in another sample (N = 239 adolescents). RESULTS: The CAOS scale displayed content validity, and the EFA and CFA showed a unifactorial structure (with some scale adjustments) with an acceptable fit. The family chaos latent factor was associated with externalizing symptoms and perceived stress in adolescents. CONCLUSION: Overall, the Brazilian version of the scale presented evidence of construct, internal, and concurrent validity that indicate its usefulness in Brazil.

RESUMO

OBJECTIVES: To investigate the transdentinal effects of surface reaction-type pre-reacted glass-ionomer (S-PRG) fillers on odontoblast-like cells. METHODS: An eluate of S-PRG fillers was obtained by dissolving the particles in distilled water (1:1 m/v). Dentin discs with similar permeability were mounted into artificial pulp chambers and MDPC-23 cells were seeded on their pulpal surface. The occlusal surface was treated with (n = 10): ultrapure water (negative control - NC), hydrogen peroxide (positive control - PC), S-PRG eluate exposure for 1 min (S-PRG 1 min), or S-PRG filler eluate exposure for 30 min (S-PRG 30 min). After 24 h, cell viability (alamarBlue) and morphology (SEM) were evaluated. The extract obtained from transdentinal diffusion was applied to MDPC-23 pre-cultured in plates for another 24 h to evaluate viability (alamarBlue, 1, 3, and 7 days), gene expression of Col1a1, Alpl, Dspp, and Dmp1 (RT-qPCR, 1 and 7 days), and mineralization (Alizarin Red, 7 days). Data were analyzed with ANOVA (α = 5 %). RESULTS: While S-PRG 1 min did not differ from NC, S-PRG 30 min reduced 17.9 % viability of cells from discs. S-PRG treatments resulted in low cell detaching from dentin, and the remaining cells exhibited typical morphology or minor cytoplasmic contraction. S-PRG 30 min slightly increased cell viability (6 %) 1 day after contact with the extract. S-PRG treatments upregulated the expression of the investigated genes, especially after 1 day. S-PRG 30 min stimulated mineralization activity by 39.7 %. CONCLUSIONS: S-PRG filler eluate does not cause transdentinal cytotoxicity on odontoblast-like cells, and long-term exposure can stimulate their dentinogenic-related mineralization activity. SIGNIFICANCE: The transdentinal elution of ions from S-PRG fillers is not expected to be harmful to the dental pulp and may exert bioactive effects by inducing dentin matrix deposition through the metabolism of underlying odontoblasts.

Assuntos

RESUMO

Amphibians are often recognized as bioindicators of healthy ecosystems. The persistence of amphibian populations in heavily contaminated environments provides an excellent opportunity to investigate rapid vertebrate adaptations to harmful contaminants. Using a combination of culture-based challenge assays and a skin permeability assay, we tested whether the skin-associated microbiota may confer adaptive tolerance to tropical amphibians in regions heavily contaminated with arsenic, thus supporting the adaptive microbiome principle and immune interactions of the amphibian mucus. At lower arsenic concentrations (1 and 5 mM As3+), we found a significantly higher number of bacterial isolates tolerant to arsenic from amphibians sampled at an arsenic contaminated region (TES) than from amphibians sampled at an arsenic free region (JN). Strikingly, none of the bacterial isolates from our arsenic free region tolerated high concentrations of arsenic. In our skin permeability experiment, where we tested whether a subset of arsenic-tolerant bacterial isolates could reduce skin permeability to arsenic, we found that isolates known to tolerate high concentrations of arsenic significantly reduced amphibian skin permeability to this metalloid. This pattern did not hold true for bacterial isolates with low arsenic tolerance. Our results describe a pattern of environmental selection of arsenic-tolerant skin bacteria capable of protecting amphibians from intoxication, which helps explain the persistence of amphibian populations in water bodies heavily contaminated with arsenic.

Assuntos

RESUMO

BACKGROUND: Malnutrition/sarcopenia is frequent in patients with inflammatory bowel diseases (IBD), and results in muscle catabolism, impacting treatment response, postoperative complications, and quality of life. OBJECTIVE: This study aims to assess whether the phase angle (PhA) is a parameter for predicting reduced muscle mass in patients with IBD. METHODS: Adult patients with IBD were included in this cross-sectional study. For the estimation of muscle mass and the calculation of the PhA, we used bioelectrical impedance analysis (BIA). Crohn's disease (CD) and ulcerative colitis (UC) activity scores were defined using the Harvey-Bradshaw index and partial Mayo score, respectively. The area under the ROC curve was calculated to identify the PhA cut-off point for reduced muscle mass. RESULTS: The sample consisted of 145 patients, with 39 (26.9%) with IBD in the active phase. There was a correlation of the PhA with skeletal muscle mass (SMM) (rs 0.35, P<0.001) and with the skeletal muscle mass index (SMI) (rs 0.427, P<0.001), and the associations remained in the most active form (moderate or severe) of IBD. The ROC curve analysis indicated that the cut-offs points of the PhA ≤5.042 for female and PhA ≤6.079 for male can be used to predict muscle mass reduction. CONCLUSION: The PhA can be considered a predictor of muscle mass reduction in IBD patients, and we can use it for screening and monitoring the evolution of malnutrition. BACKGROUND: • This study aims to assess whether the phase angle is a parameter for predicting reduced muscle mass in patients with inflammatory bowel disease. BACKGROUND: • There was a correlation of the phase angle with skeletal muscle mass and the associations remained in disease activity. BACKGROUND: • The ROC curve analysis indicated that the cut-off point of the PhA ≤5.042° for women and PhA ≤6,079° for men can be used to predict muscle mass reduction. BACKGROUND: • The phase angle can be considered a predictor of muscle mass reduction in inflammatory bowel disease.

Assuntos

RESUMO

This study aimed to measure the consumption of different types of plant waste by the diplopod species Trigoniulus corallinus, in order to determine which would be the most suitable for the millicomposting process. To this end, a waste consumption experiment was carried out in the laboratory, using a completely randomized experimental design with 15 replicates and 13 organic residues from different sources. After 10 days, the following parameters were evaluated: dry mass of the waste used to feed the diplopods, dry mass of the fecal pellets, and diplopod mortality. Significant differences were observed in the consumption rates of the diplopods in the different treatments, with the highest rates being observed for Mimosa caesalpiniifolia, with 44.49%, followed by Gliricidia sepium chips, with 38.24%. The highest values for pellet mass were obtained from the decomposition of Mimosa caesalpiniifolia litter (0.891 g). The treatment with Syngonium auritum shavings showed 93% mortality after consumption, followed by the treatment with Heliconia psittacorum shavings, which showed 53%. Both species are ornamental and widely found in gardens and backyards. The diplopods have a preference for Mimosa caesalpiniifolia litter and Gliricidia sepium shavings. There is limited consumption of ornamental plant waste, with reports of toxicity to other organisms. Based on these results, a mixture of waste will be tested for millicomposting in urban farming areas that excludes toxic plants.

Assuntos

RESUMO

OBJECTIVE: To evaluate whether coating enamel with a polymeric primer (PPol) containing titanium tetrafluoride (TiF4) before applying a bleaching gel with 35% H2O2 (35% BG) increases esthetic efficacy, prevents changes in morphology and hardness of enamel, as well as reduces the cytotoxicity from conventional in-office bleaching. MATERIALS AND METHODS: Standardized enamel/dentin discs were stained and bleached for 45 min (one session) with 35% BG. Groups 2TiF4, 6TiF4, and 10TiF4 received the gel on the enamel previously coated with PPol containing 2 mg/mL, 6 mg/mL, or 10 mg/mL, respectively. No treatment or application of 35% BG directly on enamel were used as negative control (NC), and positive control (PC), respectively. UV-reflectance spectrophotometry (CIE L*a*b* system, ΔE00, and ΔWI, n = 8) determined the bleaching efficacy of treatments. Enamel microhardness (Knoop, n = 8), morphology, and composition (SEM/EDS, n = 4) were also evaluated. Enamel/dentin discs adapted to artificial pulp chambers (n = 8) were used for trans-amelodentinal cytotoxicity tests. Following the treatments, the extracts (culture medium + bleaching gel components diffused through the discs) were collected and applied to odontoblast-like MDPC-23 cells, which were assessed concerning their viability (alamarBlue, n = 8; Live/Dead, n = 4), oxidative stress (n = 8), and morphology (SEM). The amount of H2O2 in the extracts was also determined (leuco crystal violet/peroxidase, n = 8). The numerical data underwent one-criterion variance analysis (one-way ANOVA), followed by Tukey's test, at a 5% significance level. RESULTS: Regarding the ΔE00, no difference was observed among groups 2TiF4, 6TiF4, and PC (p > 0.05). The ΔWI was similar between groups 2TiF4 and PC (p > 0.05). The ΔWI of group 6TiF4 was superior to PC (p < 0.05), and group 10TiF4 achieved the highest ΔE00 and ΔWI values (p < 0.05). Besides limiting enamel microstructural changes compared to PC, group 10TiF4 significantly increased the hardness of this mineralized dental tissue. The highest cellular viability occurred in 10TiF4 compared to the other bleached groups (p < 0.05). Trans-amelodentinal H2O2 diffusion decreased in groups 2TiF4, 6TiF4, and 10TiF4 in comparison with PC (p < 0.05). CONCLUSION: Coating enamel with a PPol containing TiF4 before applying a 35% BG may increase enamel microhardness and esthetic efficacy and reduce the trans-amelodentinal cytotoxicity of conventional in-office tooth bleaching. The PPol containing 10 mg/mL of TiF4 promoted the best outcomes.

Assuntos

RESUMO

ABSTRACT Malnutrition/sarcopenia is frequent in patients with inflammatory bowel diseases (IBD), and results in muscle catabolism, impacting treatment response, postoperative complications, and quality of life. Objective: This study aims to assess whether the phase angle (PhA) is a parameter for predicting reduced muscle mass in patients with IBD. Methods: Adult patients with IBD were included in this cross-sectional study. For the estimation of muscle mass and the calculation of the PhA, we used bioelectrical impedance analysis (BIA). Crohn's disease (CD) and ulcerative colitis (UC) activity scores were defined using the Harvey-Bradshaw index and partial Mayo score, respectively. The area under the ROC curve was calculated to identify the PhA cut-off point for reduced muscle mass. Results: The sample consisted of 145 patients, with 39 (26.9%) with IBD in the active phase. There was a correlation of the PhA with skeletal muscle mass (SMM) (rs 0.35, P<0.001) and with the skeletal muscle mass index (SMI) (rs 0.427, P<0.001), and the associations remained in the most active form (moderate or severe) of IBD. The ROC curve analysis indicated that the cut-offs points of the PhA ≤5.042 for female and PhA ≤6.079 for male can be used to predict muscle mass reduction. Conclusion: The PhA can be considered a predictor of muscle mass reduction in IBD patients, and we can use it for screening and monitoring the evolution of malnutrition.

RESUMO A desnutrição/sarcopenia é frequente em pacientes com doenças inflamatórias intestinais (DII), resultando em catabolismo muscular, com impacto nas respostas aos tratamentos, complicações cirúrgicas e na qualidade de vida. Objetivo: Este estudo tem como objetivo, avaliar se o ângulo de fase (AF) é um parâmetro para a predição de redução de massa muscular em pacientes com DII. Métodos: Pacientes adultos com DII foram incluídos neste estudo transversal. A estimativa da massa muscular e o cálculo do AF foram realizados a partir do exame de bioimpedância elétrica (BIA). As atividades da doença de Crohn e retocolite ulcerativa foram definidas pelo índice Harvey-Bradshaw e escore parcial de Mayo, respectivamente. A área de curva ROC foi calculada para identificar o ponto de corte do AF para a massa muscular reduzida. Resultados: A amostra foi composta por 145 pacientes, sendo 39 (26.9%) com DII em fase ativa. Houve correlação do AF com massa muscular esquelética (MME) (rs 0.35, P<0.001) e com o índice de massa muscular esquelética (IMME) (rs 0.427, P<0.001), mantendo-se as associações na forma mais ativa (moderada ou grave) da DII. A análise da curva ROC indicou que os pontos de corte de AF ≤5.042 para mulheres e ≤6.079 para homens podem ser usados para prever a redução da massa muscular. Conclusão: O AF pode ser considerado um preditor de redução de massa muscular nos pacientes com DII e ser utilizado para triagem e acompanhamento da evolução da desnutrição.

RESUMO

OBJECTIVE: to analyze care transition in hospital discharge planning for patients with chronic noncommunicable diseases. METHOD: a qualitative study, based on the Care Transitions Intervention theoretical model, with four pillars of intervention, to ensure a safe transition. Twelve professionals participated in a public hospital in the countryside of São Paulo. Data were collected through observation, document analysis and semi-structured interviews. RESULTS: there was a commitment of a multidisciplinary team to comprehensive care and involvement of family members in patient care. The documents facilitated communication between professionals and/or levels of care. However, the lack of time to prepare for discharge can lead to fragmented care, impairing communication and jeopardizing a safe transition. FINAL CONSIDERATIONS: they were shown to be important elements in discharge planning composition, aiming to ensure a safe care transition, team participation with nurses as main actors, early discharge planning and family involvement.

Assuntos

RESUMO

To discuss, based on Adorno's philosophy, the negativity of care in confronting the "natural caregiver" discourse in the profession and exercise discursive analysis of this stereotype based on the negative trihedron of care (deny, confront, shiver). Theoretical study that articulates negative dialectic with the biopolitics of caring for the body. Negativity of care, as an immanent criticism that emerges from the dialectic between help and power, aims to shiver at bodily suffering, a residue of nature violated by cultural discursive practices. We applied the methodological framework of care to deny, confront, and shiver in label analysis to highlight non-identity between nursing reality and natural caregiver affirmation. We confronted the injustices made invisible in the prejudice that women are naturally predestined to provide for others' well-being. We reflected on the contradictions and suffering of women, nurses or not, invisible in the vaunted loving care. We proposed shiver as a metaphor for deny, a critical negativity that opens to the strange coerced and mutilated in the human body.

Assuntos

RESUMO

The stormwater runoff may act as a nonpoint pollutant source and contributes to aquatic ecosystem quality decay in urban environments. The aim of this work was to evaluate the runoff characteristics on the transport of total solids and total metals, as well as pH and conductivity responses during the rainfall evolution. During 2017 and 2018, 12 rain events were monitored in 4 sampling stations at a car parking lot located at Nuclear and Energy Research Institute (IPEN/CNEN) in São Paulo/Brazil. A 4-chamber integrated collector allowed the sequential/temporal runoff evolution assessment. The runoff composition, in decreasing order of quantities, was Ca > K > Mg > Si > Al > Fe > Na > Zn > Mn > Sr > Ti > Mo > V > Cu > B > Pb > Ni > Ce > Sb > Cr > La > U > Th > Cd. The amount of total solids, Al, and Fe exceeded the Brazilian water quality standards. Principal component analysis (PCA) identified the elemental clusters linked to the facility activity, soil, and traffic/atmospheric-related deposition. The results show that the runoff characteristics could be differentiated by pollutant source. Factors such as seasonal variation, rain event intensity, air mass from oceanic or continental origin, spatial distribution inside the monitoring area, and the intensity of the first flush must be considered in order to disentangle the elemental clusters and pollution source contributions. In winter, continental air masses were associated with higher concentrations of heavy metals in the surface runoff. Spatial changes with no seasonal variation were observed for U, Th, La, and Ce.

Assuntos

RESUMO

OBJECTIVES: To investigate the response of pulp cells to the application of silver diamine fluoride (SDF) and potassium iodide (KI) on demineralized dentin. MATERIALS AND METHODS: The occlusal surfaces of human dentin discs (0.4 mm thick) with similar permeability were subjected to an artificial caries protocol, and then the discs were adapted into artificial pulp chambers. MDPC-23 cells were seeded on the healthy pulp dentin surface, while the demineralized surface was treated with SDF, KI, SDF + KI, or hydrogen peroxide (positive control-PC) (n = 8). The negative control (NC) received ultrapure water. After 24 h, cell viability (alamarBlue) and morphology (SEM) were evaluated. The extracts were then applied to new MDPC-23 cells seeded in culture plates to assess their viability and the formation of mineralized nodules (MN; Alizarin Red) after seven days. The data were analyzed using one-way analysis of variance/Tukey or Games-Howell tests (α = 5%). RESULTS: SDF and PC significantly reduced the viability of cells seeded on discs (45.6% and 71.0%, respectively). Only cells treated with SDF or PC detached from the dentin substrate, while the remaining cells showed altered morphology. Cells in contact with extracts showed less reduction in viability, but it was still more toxic compared to NC. Only PC reduced MN deposition. SDF + KI or KI alone did not affect the cell response. CONCLUSIONS: SDF applied alone showed a mild to moderate transdentinal cytotoxic effect on pulp cells. However, the combination of SDF + KI reduced the cytotoxic effects. Both materials used alone or in combination did not affect the mineralization ability of pulp cells. CLINICAL RELEVANCE: Besides improving esthetic results, associating potassium iodide with silver diamine fluoride may reduce the transdentinal cytotoxic effects of this cariostatic agent on pulp cells.

Assuntos

RESUMO

Leishmaniasis is a neglected tropical disease with a wide spectrum of clinical manifestations, ranging from visceral to cutaneous, with millions of new cases and thousands of deaths reported each year. The species of Leishmania and the immune response of the host determine the severity of the disease. Leishmaniasis remains challenging to diagnose and treat, and there is no vaccine available. Several studies have been conducted on the use of herbal medicines for the treatment of leishmaniasis. Natural products can provide an inexhaustible source of chemical diversity with therapeutic potential. Terpenes are a class of natural products derived from a single isoprene unit, a five-carbon compound that forms the basic structure of isoprenoids. This review focuses on the most important and recent advances in the treatment of parasites of the genus Leishmania with different subclasses of terpenes. Several mechanisms have been proposed in the literature, including increased oxidative stress, immunomodulatory role, and induction of different types of parasite cell death. However, this information needs to be brought together to provide an overview of how these compounds can be used as therapeutic tools for drug development and as a successful adjuvant strategy against Leishmania sp.

Assuntos

RESUMO

Background: Human cysticercosis (CC) is a global public health problem, especially in Latin America, including Brazil. We aimed to analyze the seroprevalence of CC among school-age children and adolescents. Methods: We analyzed the presence of specific IgG antibodies against Taenia solium metacestodes in 500 serum samples from elementary school children and adolescents in Jataí City, state of Goiás, Brazil. IgG antibodies against the antigenic extract of the parasite were detected and analyzed by ELISA, and specific peptides were identified by confirmatory Western Blotting test. Results: Of the 500 study participants, 205 (41%) were male, and 295 (59%) were female. Participants aged between 4 and 18 years (mean age 8.4 years). The percentage of serum samples reactive by ELISA was 37.2%. These samples were analyzed by Western Blotting, which confirmed that the seropositivity rate was 6.2% (95% CI 2.4-14.7) in 31 samples reactive for CC-specific bands, determined in serum samples from 18 male (5-11 years old) and 13 female (4-12 years old) students. Conclusion: The CC seroprevalence demonstrated in schoolchildren suggests that this parasitosis is endemic in the study area. Further investigations are necessary to clarify the local epidemiology of this parasitosis.

RESUMO

BACKGROUND: Simulating a bacterial-induced pulpitis environment in vitro may contribute to exploring mechanisms and bioactive molecules to counteract these adverse effects. OBJECTIVE: To investigate the chronic exposure of human dental pulp cells (HDPCs) to lipopolysaccharides (LPS) aiming to establish a cell culture protocol to simulate the impaired odontogenic potential under pulpitis conditions. METHODOLOGY: HDPCs were isolated from four healthy molars of different donors and seeded in culture plates in a growth medium. After 24 h, the medium was changed to an odontogenic differentiation medium (DM) supplemented or not with E. coli LPS (0 - control, 0.1, 1, or 10 µg/mL) (n=8). The medium was renewed every two days for up to seven days, then replaced with LPS-free DM for up to 21 days. The activation of NF-κB and F-actin expression were assessed (immunofluorescence) after one and seven days. On day 7, cells were evaluated for both the gene expression (RT-qPCR) of odontogenic markers (COL1A1, ALPL, DSPP, and DMP1) and cytokines (TNF, IL1B, IL8, and IL6) and the production of reactive nitrogen (Griess) and oxygen species (Carboxy-H2DCFDA). Cell viability (alamarBlue) was evaluated weekly, and mineralization was assessed (Alizarin Red) at 14 and 21 days. Data were analyzed with ANOVA and post-hoc tests (α=5%). RESULTS: After one and seven days of exposure to LPS, NF-κB was activated in a dose-dependent fashion. LPS at 1 and 10 µg/mL concentrations down-regulated the gene expression of odontogenic markers and up-regulated cytokines. LPS at 10 µg/mL increased both the production of reactive nitrogen and oxygen species. LPS decreased cell viability seven days after the end of exposure. LPS at 1 and 10 µg/mL decreased hDPCs mineralization in a dose-dependent fashion. CONCLUSION: The exposure to 10 µg/mL LPS for seven days creates an inflammatory environment that is able to impair by more than half the odontogenic potential of HDPCs in vitro, simulating a pulpitis-like condition.

Assuntos

RESUMO

To compare the quality of life (QoL) of children with and without atopic dermatitis (AD) and that of their caregivers and to assess their QoL according to different degrees of AD. This is a cross-sectional, case-control study conducted with patients aged between 4 and 12 years with and without AD and their caregivers. Patients were treated at the Pediatric Dermatology Outpatient Center and the Childcare Center of the Joana de Gusmão Children's Hospital, respectively, from June 2021 to March 2022. The QoL Assessment Scale Autoquestionnaire Qualité de Vie Infant Imagé (AUQEI) was applied to children and adolescents with AD and the control group while the World Health Organization Quality of Life assessment instrument was administered to their caregivers. Fifty cases and fifty controls were included in this study. When assessing the QoL of the case and control groups, statistically significant differences were found in the domains of the AUQUEI instrument. Regarding QoL and AD severity, a statistically significant difference was seen (p = 0.027) when comparing moderate and severe SCORAD scores. When comparing the QoL of children with and without AD, a difference was seen between the two groups. The QoL of AD patients was worse and related to the severity of the disease. A better QoL was found among the caregivers in the control group. In the case group, the higher the SCORAD score, the worse the QoL. No relationship was found between AD severity and the QoL of the caregivers in the case group.

Assuntos

RESUMO

INTRODUCTION AND HYPOTHESIS: A prospective clinical, preliminary study was performed in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) who were nonresponders to conventional treatment and received intravesical ozone as a therapeutic alternative. METHODS: Sixteen patients received six applications of intravesical ozone at a concentration of 41 µg/mL. We evaluated therapeutic efficacy by the percentage reduction of Interstitial Cystitis Symptom and Problem Index scores (ICSI/ICPI-the O'Leary-Sant symptom index), recurrence rate, nonresponse, and side effects in scores collected on admission (pre-treatment), at the end of the therapeutic protocol (post-treatment), and 180 days (follow-up) after the last ozone application. RESULTS: The mean age of women was 52.9 years (SD: 15.5), and the duration of symptoms was 5.7 years (SD: 7.1). The median ICSI on admission was 17 (IQR: 14.25-19.5) and at follow-up was 0.5 (IQR: 0-2), with a reduction of 97.5% (CI: 85.7-100). The median ICSI/ICPI on admission was 31.5 (IQR: 29-35.2) and at follow-up was 2.0 (IQR: 0-3.75), with a reduction of 92.3% (CI: 88.8-100). The recurrence rate was only 6.25%, and no patients were nonresponders to the treatment. CONCLUSIONS: The application of intravesical ozone was effective in the treatment of patients with IC/BPS who were nonresponders to conventional therapy, showing a progressive and safe effect, at least in the short term.

Assuntos

RESUMO

ABSTRACT Objective: to analyze care transition in hospital discharge planning for patients with chronic noncommunicable diseases. Method: a qualitative study, based on the Care Transitions Intervention theoretical model, with four pillars of intervention, to ensure a safe transition. Twelve professionals participated in a public hospital in the countryside of São Paulo. Data were collected through observation, document analysis and semi-structured interviews. Results: there was a commitment of a multidisciplinary team to comprehensive care and involvement of family members in patient care. The documents facilitated communication between professionals and/or levels of care. However, the lack of time to prepare for discharge can lead to fragmented care, impairing communication and jeopardizing a safe transition. Final considerations: they were shown to be important elements in discharge planning composition, aiming to ensure a safe care transition, team participation with nurses as main actors, early discharge planning and family involvement.

RESUMEN Objetivo: analizar la transición de la atención en la planificación del alta hospitalaria de pacientes con enfermedades crónicas no transmisibles. Método: estudio cualitativo, basado en el modelo teórico Care Transitions Intervention, con cuatro pilares de intervención, para garantizar una transición segura. Doce profesionales participaron en un hospital público del interior de São Paulo. Los datos fueron recolectados a través de observación, análisis de documentos y entrevistas semiestructuradas. Resultados: el equipo multidisciplinario se comprometió a brindar una atención integral e involucrar a los familiares en el cuidado del paciente. Los documentos facilitaron la comunicación entre profesionales y/o niveles de atención. Sin embargo, la falta de tiempo para prepararse para el alta puede dar lugar a una atención fragmentada, perjudicando la comunicación y poniendo en peligro la transición segura. Consideraciones finales: se mostraron elementos importantes en la composición de la planificación del alta, con el objetivo de garantizar una transición segura de la atención, la participación del equipo con los enfermeros como protagonistas, la planificación del alta temprana y la participación de la familia.

RESUMO Objetivo: analisar a transição do cuidado no planejamento de alta hospitalar de pacientes com doenças crônicas não transmissíveis. Método: estudo qualitativo, fundamentado no modelo teórico Care Transitions Intervention, com quatro pilares de intervenção, para garantir uma transição segura. Participaram 12 profissionais, em hospital público, no interior paulista. Os dados foram coletados por meio de observação, análise documental e entrevistas semiestruturadas. Resultados: houve comprometimento da equipe multiprofissional para a integralidade da assistência e envolvimento de familiares nos cuidados ao paciente. Os documentos facilitaram a comunicação entre profissionais e/ou níveis de atenção. Todavia, a falta de tempo hábil para preparação da alta pode ocasionar um cuidado fragmentado, prejudicando a comunicação e colocando em risco a transição segura. Considerações finais: evidenciaram-se como elementos importantes na composição do planejamento de alta, visando garantir a transição do cuidado segura, participação da equipe com protagonismo do enfermeiro, planejamento precoce de alta e envolvimento da família.

RESUMO

ABSTRACT: This study evaluated if the milk ring test (MRT) used to the brucellosis diagnostic at dairy herd level can be done in milk samples with conservative (Bronopol®) collected to the somatic cell count (SCC) that is used to mastitis monitoring. It were analyzed 38 bulk tank milk samples (BTMS) from 19 dairy herds artisanal cheese producers and 36 BTMS from a brucellosis free dairy herd, used as negative control (NC) and positive control (PC), when was added serum from vaccinated animals. The milk samples were collected in two different bottles (with or without Bronopol®). All the 38 BTMS from artisanal cheese producers (samples with and without Bronopol®) were non-reagent to MRT, as all NC. All PC were reagent to MRT, without interference of Bronopol®. Results showed that the milk sample used to SCC presented the proportion of agreement of results in all milk samples (100%), that is, false positive and false negative results were not observed. Results indicated that Bronopol® did not interfere with the color in the time of MRT reading suggesting that the same milk samples could be used to monitoring mastitis and brucellosis.

RESUMO: O objetivo deste estudo foi avaliar se o teste do anel do leite (TAL), utilizado para o diagnóstico da brucelose em nível de rebanho leiteiro, pode ser realizado em amostras de leite com conservador (Bronopol®) coletado para contagem de células somáticas (CCS) que é utilizado para monitoramento de mastite. Foram analisadas 38 amostras de leite de tanques de expansão (ALTE) de 19 rebanhos leiteiros produtores de queijo artesanal e 36 ALTE de rebanho leiteiro livre de brucelose, utilizadas como controle negativo (CN) e controle positivo (CP), quando foi adicionado soro de animais vacinados. As amostras de leite foram coletadas em dois frascos diferentes (com e sem Bronopol®). Todos as 38 ALTE de produtores artesanais de queijo (amostras com e sem Bronopol®) foram não reagentes ao TAL, como todos os CN. Todos os CP foram reagentes ao TAL, sem interferência do Bronopol®. Os resultados mostraram que a amostra de leite utilizada para CCS apresentaram a proporção de concordância dos resultados em todas as amostras de leite (100%), ou seja, não foram observados resultados falso-positivos e falso-negativos. Os resultados indicam que o Bronopol® não interferiu na cor no momento da leitura do TAL, sugerindo que as mesmas amostras de leite poderiam ser usadas para monitorar mastite e brucelose.

RESUMO

This study evaluated if the milk ring test (MRT) used to the brucellosis diagnostic at dairy herd level can be done in milk samples with conservative (Bronopol®) collected to the somatic cell count (SCC) that is used to mastitis monitoring. It were analyzed 38 bulk tank milk samples (BTMS) from 19 dairy herds artisanal cheese producers and 36 BTMS from a brucellosis free dairy herd, used as negative control (NC) and positive control (PC), when was added serum from vaccinated animals. The milk samples were collected in two different bottles (with or without Bronopol®). All the 38 BTMS from artisanal cheese producers (samples with and without Bronopol®) were non-reagent to MRT, as all NC. All PC were reagent to MRT, without interference of Bronopol®. Results showed that the milk sample used to SCC presented the proportion of agreement of results in all milk samples (100%), that is, false positive and false negative results were not observed. Results indicated that Bronopol® did not interfere with the color in the time of MRT reading suggesting that the same milk samples could be used to monitoring mastitis and brucellosis.

O objetivo deste estudo foi avaliar se o teste do anel do leite (TAL), utilizado para o diagnóstico da brucelose em nível de rebanho leiteiro, pode ser realizado em amostras de leite com conservador (Bronopol®) coletado para contagem de células somáticas (CCS) que é utilizado para monitoramento de mastite. Foram analisadas 38 amostras de leite de tanques de expansão (ALTE) de 19 rebanhos leiteiros produtores de queijo artesanal e 36 ALTE de rebanho leiteiro livre de brucelose, utilizadas como controle negativo (CN) e controle positivo (CP), quando foi adicionado soro de animais vacinados. As amostras de leite foram coletadas em dois frascos diferentes (com e sem Bronopol®). Todos as 38 ALTE de produtores artesanais de queijo (amostras com e sem Bronopol®) foram não reagentes ao TAL, como todos os CN. Todos os CP foram reagentes ao TAL, sem interferência do Bronopol®. Os resultados mostraram que a amostra de leite utilizada para CCS apresentaram a proporção de concordância dos resultados em todas as amostras de leite (100%), ou seja, não foram observados resultados falso-positivos e falso-negativos. Os resultados indicam que o Bronopol® não interferiu na cor no momento da leitura do TAL, sugerindo que as mesmas amostras de leite poderiam ser usadas para monitorar mastite e brucelose.

Assuntos

RESUMO

Introdução: Com a emergência do SARS-CoV-2 foi disponibilizado uma grande quantidade de ferramentas de diagnóstico. Neste contexto, a falta de vacina, de tratamento e o grande número de casos graves e morte, possibilitou a aprovação emergencial de diversos testes, que ainda necessitam de estudos populacionais para seu registro definitivo. Objetivo: Realizar uma revisão de literatura para avaliar as metodologias de diagnóstico disponíveis no Brasil, de acordo com a realidade local de saúde, explorando o momento epidemiológico a complexidade do teste e a finalidade da sua aplicação. Metodologia: Trata-se de um estudo bibliográfico, descritivo do tipo revisão de literatura. Foram utilizadas as seguintes bases de dados científicos para buscas: PUBMED, MEDLINE, LILACS E COCHRANE LIBRARY, através de descritores selecionados na plataforma DECS. Resultados: O cenário de diversos ensaios, baseados em diferentes metodologias, como os testes baseados em RNA viral, em detecção de antígenos virais ou de anticorpos, associados ao conhecimento da história natural do vírus, possibilita uma análise crítica do melhor diagnóstico de acordo com a clínica do paciente, os epidemiológicos, o objetivo do diagnóstico e a acurácia do ensaio. Atualmente, há mudança no padrão imunológico da população e a descrição de tipos e subtipos de SARS-CoV-2 com mudanças gênicas, que podem levar a mudanças na acurácia diagnóstica ou a re-emergência em surtos de doença grave. Conclusão: Ainda é incerto o caminho evolutivo da história natural da Covid-19 e os ensaios diagnósticos estão em diferentes estágios de desenvolvimento, validação e produção e cada tipo de teste tem suas próprias vantagens e desvantagens distintas inerentes a plataforma tecnológica de origem e uma combinação de tipos de testes usados em momentos diferentes pode ser útil para a condução clínica dos pacientes e no controle da pandemia por SARS-CoV-2.

Introduction: With the emergence of SARS-CoV-2, a large number of diagnostic tools were made available. In this context, the lack of vaccine, treatment and the large number of severe cases and death, allowed the emergency approval of several tests, which still require population studies for their definitive registration. Objective: To carry out a literature review to evaluate the diagnostic methodologies available in Brazil, according to the local health reality, exploring the epidemiological moment, the complexity of the test and the purpose of its application. Methodology: This is a bibliographic, descriptive study of the literature review type. The following scientific databases were used for searches: PUBMED, MEDLINE, LILACS AND COCHRANE LIBRARY, through selected descriptors on the DECS platform. Results: The scenario of several tests, based on different methodologies, such as tests based on viral RNA, on detection of viral antigens or antibodies, associated with knowledge of the natural history of the virus, allows a critical analysis of the best diagnosis according to the patient's clinical, epidemiological, diagnostic objective and assay accuracy. Currently, there is a change in the immune pattern of the population and the description of types and subtypes of SARS-CoV-2 with genetic changes, which can lead to changes in diagnostic accuracy or the re-emergence in outbreaks of severe disease. Conclusion: The evolutionary path of the natural history of Covid-19 is still uncertain and diagnostic assays are at different stages of development, validation and production and each type of test has its own distinct advantages and disadvantages inherent in the technology platform of origin and a combination of types of tests used at different times can be useful for the clinical management of patients and in the control of the SARS-CoV-2 pandemic.

Introducción: Con la aparición del SARS-CoV-2, se dispuso de un gran número de herramientas diagnósticas. En este contexto, la falta de vacuna, tratamiento y el gran número de casos graves y muerte, permitieron la aprobación de urgencia de varias pruebas, que aún requieren estudios poblacionales para su registro definitivo. Objetivo: Realizar una revisión bibliográfica para evaluar las metodologías diagnósticas disponibles en Brasil, de acuerdo con la realidad sanitaria local, explorando el momento epidemiológico, la complejidad de la prueba y la finalidad de su aplicación. Metodología: Se trata de un estudio bibliográfico, descriptivo, del tipo revisión de literatura. Para las búsquedas se utilizaron las siguientes bases de datos científicas PUBMED, MEDLINE, LILACS Y COCHRANE LIBRARY, a través de descriptores seleccionados en la plataforma DECS. Resultados: El escenario de varias pruebas, basadas en diferentes metodologías, como pruebas basadas en el ARN viral, en la detección de antígenos virales o anticuerpos, asociado al conocimiento de la historia natural del virus, permite un análisis crítico del mejor diagnóstico de acuerdo con la clínica del paciente, epidemiológica, objetivo diagnóstico y precisión de la prueba. Actualmente, hay un cambio en el patrón inmunológico de la población y la descripción de tipos y subtipos de SARS-CoV-2 con cambios genéticos, que pueden conducir a cambios en la precisión diagnóstica o la reaparición en brotes de enfermedad grave. Conclusiones: El camino evolutivo de la historia natural del Covid-19 es aún incierto y los ensayos de diagnóstico se encuentran en diferentes etapas de desarrollo, validación y producción y cada tipo de prueba tiene sus propias ventajas y desventajas distintas inherentes a la plataforma tecnológica de origen y una combinación de tipos de pruebas utilizadas en diferentes momentos puede ser útil para el manejo clínico de los pacientes y en el control de la pandemia de SARS- CoV-2.

Assuntos