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Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation.
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Febre Maculosa das Montanhas Rochosas , Criança , Humanos , Febre Maculosa das Montanhas Rochosas/complicações , Febre Maculosa das Montanhas Rochosas/diagnóstico , Febre Maculosa das Montanhas Rochosas/microbiologia , Rickettsia rickettsii , Brasil , FebreRESUMO
ABSTRACT Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation.
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RESUMO Objetivo: Elaborar e validar o conteúdo de um protocolo de pontos de acupuntura auricular para o tratamento de cefaleia. Método: Estudo metodológico, realizado em junho de 2023, em Montes Claros, Minas Gerais, Brasil. Estruturando em três etapas: planejamento (levantamento bibliográfico e identificação das variáveis de estudo), construção dos instrumentos (caracterização dos experts, protocolo de pontos e regime de tratamento) e validação de conteúdo por 15 experts. Na análise de dados utilizou-se a porcentagem de concordância absoluta igual ou superior a 80%. Resultados: O protocolo de acupuntura auricular para o tratamento de cefaleia, validado pelos experts, foi composto pelos seguintes pontos: "Porta da Mente" (93,3%), Rim (86,7%), Simpático (86,7%), Ansiedade (86,7%), Subcórtex (86,7%), Tronco Cerebral (86,7%), Frontal (86,7%), Occipital (86,7%), Temporal (86,7%) e Fígado (80%). Conclusão: o protocolo de acupuntura auricular para o tratamento de cefaleia foi considerado válido, o que permitirá sua utilização na prática clínica e em pesquisas.
ABSTRACT Objective: To develop and validate the content of an auricular acupuncture point protocol for the treatment of headaches. Method: A methodological study, carried out in June 2023 in Montes Claros, Minas Gerais, Brazil. It was structured in three stages: Planning (bibliographic survey and identification of the study variables); Construction of the instruments (characterization of the experts, point protocol and treatment regime); and Content validation in charge of 15 experts. In the data analysis, an absolute agreement percentage equal to or greater than 80% was used. Results: The auricular acupuncture protocol for the treatment of headaches that was validated by experts consisted of the following points: "Door of the Mind" (93.3%), Kidney (86.7%), Sympathetic (86.7%), Anxiety (86.7%), Subcortex (86.7%), Brainstem (86.7%), Frontal (86.7%), Occipital (86.7%), Temporal (86.7%) and Liver (80%). Conclusion: the auricular acupuncture protocol for the treatment of headaches was considered valid, which will allow its use in the clinical practice and research studies.
RESUMEN Objetivo: Elaborar y validar el contenido de un protocolo de puntos de acupuntura auricular para el tratamiento de la cefalea. Método: Estudio metodológico, realizado en junio de 2023, en Montes Claros, Minas Gerais, Brasil. Estructurado en tres etapas: planificación (relevamiento bibliográfico e identificación de variables de estudio), elaboración de instrumentos (caracterización de expertos, protocolo de puntos y régimen de tratamiento) y validación de contenido por 15 expertos. En el análisis de los datos se utilizó un porcentaje de concordancia absoluta igual o mayor al 80%. Resultados: El protocolo de acupuntura auricular para el tratamiento de la cefalea, validado por expertos, estuvo compuesto por los siguientes puntos: "Puerta de la Mente" (93,3%), Riñón (86,7%), Simpático (86,7%), Ansiedad (86,7%), Subcórtex (86,7%), Tronco Encefálico (86,7%), Frontal (86,7%), Occipital (86,7%), Temporal (86,7%) e Hígado (80%). Conclusión: Se consideró válido el protocolo de acupuntura auricular para el tratamiento de la cefalea, lo que permitirá su uso en la práctica clínica y en la investigación.
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O objetivo deste estudo é relatar a experiência da construção e divulgação de um podcast como ferramenta para promoção a saúde de gestantes e puérperas. Trata-se de estudo descritivo, na modalidade de relato de experiência sobre o podcast "Saber para nascer.cast". O desenvolvimento dessa ferramenta ocorreu em 03 etapas: referencial teórico; criação e desenvolvimento do podcast e divulgação dos episódios. O Saber para Nascer.cast contou com a produção de onze episódios que contemplaram: apresentação dos projetos que deram origem ao podcast; pré-natal; imagem corporal; saúde mental; alimentação; exercícios físicos; apego materno-fetal; aleitamento materno; violência obstétrica; trabalho de parto e relato de experiência de uma gestante. O Saber para Nascer.cast como prática educativa complementar às consultas de pré-natal permitiu a divulgação de informações de cunho científico e de fácil acesso, com intuito de construir conhecimentos e aprendizados acerca dos temas disponibilizados com ênfase nos cuidados à saúde das gestantes e puérperas.
The objective of this study is to report the experience of building and disseminating a podcast as a tool to promote the health of pregnant and postpartum women. This is a descriptive study, in the form of an experience report on the podcast "Saber para Nascer.cast". The development of the podcast took place in three stages: theoretical framework, creation and development of the podcast, and dissemination of the episodes. Saber para Nascer.cast The study examined the production of 11 episodes which featured the following topics: presentation of the projects that gave rise to the podcast, prenatal, body image, mental health, food, physical exercises, maternal-fetal attachment, breastfeeding, obstetric violence, labor, and a woman's account of her overall pregnancy experience. Saber para Nascer.cast. The podcast aims to provide a complementary educational practice to prenatal consultations through the dissemination of scientific and easily accessible information. The aim is to build knowledge and learn about the topics available, with an emphasis on health care for pregnant and postpartum women.
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Atenção Primária à Saúde , Gravidez , Educação em Saúde , WebcastRESUMO
Snake venoms have a complex mixture of compounds that are conserved across species and act synergistically, triggering severe local and systemic effects. Identification of the toxin classes that are most damaging to cell homeostasis would be a powerful approach to focus on the main activities that underpin envenomation. Here, we focus on the venom of Bothrops atrox, snake responsible for most of the accidents in Amazon region of South America. We identified the key cytotoxic toxin fractions from B. atrox venom and mapped their biochemical properties, protein composition and cell damage. Five fractions were obtained by mass exclusion chromatography and contained either a single class of enzymatic activity (i.e., L-amino acid oxidases or Hyaluronidases) or different activities co-distributed in two or more protein fractions (e.g., Metalloproteinases, Serine Proteases, or Phospholipases A2). Only three protein fractions reduced cell viability of primary human cells. Strikingly, such activity is accompanied by disruption of cell attachment to substratum and to neighbouring cells. Such strong perturbation of morphological cell features indicates likely defects in tissue integrity in vivo. Mass spectrometry identified the main classes of toxins that contribute to these phenotypes. We provide here a strategy for the selection of key cytotoxic proteins for targeted investigation of their mechanism of action and potential synergism during snakebite envenomation. Our data highlights putative toxins (or combinations of) that may be the focus of future therapeutic interference.
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Bothrops , Mordeduras de Serpentes , Animais , Humanos , Antivenenos/análise , Antivenenos/metabolismo , Antivenenos/farmacologia , Bothrops/metabolismo , Mordeduras de Serpentes/terapia , Espectrometria de Massas , Metaloproteases/análise , Metaloproteases/química , Metaloproteases/metabolismoRESUMO
The coinfections by some microorganisms have been related to severe diseases in humans and animals, where immunosuppressive agents favor opportunistic behavior of other pathogens. A 4-month-old, female mixed-breed dog with a two-week history of inappetence, prostration, emaciation, and respiratory distress was admitted at a veterinary hospital in Brazil. Tachycardia, pale mucous membranes, severe respiratory distress, and a large number of ticks (Rhipicephalus sanguineus s.l.) in different body regions were observed at clinical examination. Hematological examination of dog showed leukocytosis, neutrophilia, mild anemia, and thrombocytopenia, whereas unremarkable values in biochemical tests. Thoracic radiography revealed a pleural effusion image. Blood and the pleural fluid (purulent aspect) samples were subjected to qPCR (16S rRNA and dsb genes) and sequencing, which identified Ehrlichia canis and Anaplasma platys coinfection. An aggregate of coccoid-to-branching or long filamentous microorganisms, surrounded by pyogranulomatous inflammatory reaction was seen at the cytology of the pleural fluid. Bacteriological culture of pleural effusion showed colonies compatible with the genus Nocardia, which revealed gram-positive filamentous organisms with a tendency of fragmentation and were identified as Nocardia otitidiscaviarum in mass spectrometry (MALDI-TOF MS). Therapy of N. otitidiscaviarum isolate using levofloxacin (supported by a previous in vitro susceptibility testing) and doxycycline for E. canis and A. platys resulted in complete resolution of the clinical picture. Here, we report for the first time a triple coinfection by Nocardia otitidiscaviarum, A. platys, and E. canis in a dog with pleural effusion, where debilitating or immunosuppressive conditions induced by A. platys and E. canis coinfection probably contributed to the opportunistic behavior of N. otitidiscaviarum.
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Anaplasmose , Coinfecção , Doenças do Cão , Ehrlichiose , Nocardia , Derrame Pleural , Síndrome do Desconforto Respiratório , Humanos , Cães , Feminino , Animais , Lactente , Ehrlichia canis/genética , Anaplasmose/microbiologia , Coinfecção/veterinária , Coinfecção/microbiologia , Ehrlichiose/veterinária , Ehrlichiose/microbiologia , RNA Ribossômico 16S/genética , Nocardia/genética , Derrame Pleural/veterinária , Doenças do Cão/microbiologiaRESUMO
Staphylococcus spp. have been associated with cases of healthcare associated infections due to their high incidence in isolates from the hospital environment and their ability to cause infections in immunocompromised patients; synthesize biofilms on medical instruments, in the case of negative coagulase species; and change in genetic material, thus making it possible to disseminate genes that code for the acquisition of resistance mechanisms against the action of antibiotics. This study evaluated the presence of blaZ, femA, and mecA chromosomal and plasmid genes of Staphylococcus spp. using the qPCR technique. The results were associated with the phenotypic expression of resistance to oxacillin and penicillin G. We found that the chromosomal femA gene was present in a greater proportion in S. intermedius when compared with the other species analyzed, while the plasmid-borne mecA gene was prevalent in the S. aureus samples. The binary logistic regression performed to verify the association among the expression of the genes analyzed and the acquisition of resistance to oxacillin and penicillin G were not significant in any of the analyses, p > 0.05.
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Central nervous system (CNS) infections comprise life-threatening clinical conditions in domestic species, and are commonly related to severe sequelae, disability, or high fatality rates. A set of bacterial pathogens have been identified in central nervous infections in livestock and companion animals, although the most of descriptions are restricted to case reports and a lack of comprehensive studies involving CNS-related bacterial infections have been focused on a great number of domestic species. In this scenario, we retrospectively investigated selected epidemiological data, clinical findings, bacteriological culture, and in vitro susceptibility patterns of 136 nonrepetitive neurologic cases in domestic species (2005-2021). Bacterial isolates were recovered from 25% (34/136) of the cerebrospinal fluid (CSF) sampled. The isolates were obtained from cattle (9/136 = 6.6%), dogs (7/136 = 5.1%), horses (6/136 = 4.4%), goats (3/136 = 2.2%), pigs (3/136 = 2.2%), sheep (3/136 = 2.2%), cats (2/136 = 1.5%), and asinine (1/136 = 0.7%). Among animals with bacterial isolation, Staphylococcus aureus (6/34 = 17.6%), Escherichia coli (5/34 = 14.7%), Staphylococcus beta-hemolytic (5/34 = 14.7%), and Trueperella pyogenes (3/34 = 8.8%) were predominant, in addition to a miscellaneous of other bacteria isolated in minor frequency, e.g., Corynebacterium pseudotuberculosis, Enterobacter cloacae, Mannheimia haemolytica, Pseudomonas aeruginosa, and Streptococcus equi subsp. equi. In vitro susceptibility tests of isolates revealed that amoxicillin/clavulanic acid (11/13 = 84.6%), cephalexin (9/11 = 81.8%), and florfenicol (9/12 = 75%) were the most effective antimicrobials. Conversely, isolates exhibited resistance mainly to tetracycline (6/10 = 60%), penicillin (6/11 = 54.5%), and trimethoprim/sulfamethoxazole (5/11 = 45.5%). Also, multidrug resistance to ≥ 3 classes of antimicrobials was found in 23.5% (8/34) strains. Data relative to the outcome was available in 79.4% (27/34) of animals that had bacterial isolation, and from these, the lethality rate was 92.6% (25/27). Incoordination (14/34 = 41.2%), recumbency (11/34 = 32.4%), apathy (10/34 = 29.4%), anorexia (9/34 = 26.5%), blindness (7/34 = 20.6%), seizure (6/34 = 17.6%), limb paresis (5/34 = 14.7%), head-pressing (4/34 = 11.8%), and nystagmus (3/34 = 8.8%) were the most frequent clinical signs. A variety of bacterial pathogens were identified in the CSF of domestic species showing neurologic signs, with a predominance of staphylococci, streptococci, and enterobacteria. High lethality of cases, poor in vitro efficacy of conventional antimicrobials, and a high in vitro multidrug resistance pattern of isolates were seen. Our results contribute to etiological characterization, antimicrobial resistance patterns, and clinical-epidemiological findings of bacterial infections in domestic species with neurological signs.
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Farmacorresistência Bacteriana , Infecções Estafilocócicas , Animais , Cães , Bovinos , Cavalos , Suínos , Ovinos , Estudos Retrospectivos , Antibacterianos/farmacologia , Bactérias , Escherichia coli , Staphylococcus , Cabras , Testes de Sensibilidade MicrobianaRESUMO
Abstract Objective: To compare the performance of anthropometric indicators that identify excess body fat (BF) in adolescents. Methods: This is a methodological study that used probability cluster sampling through school and class draws. Data collection included sociodemographic characteristics and anthropometric measures. Body mass index (BMI), waist-to-height ratio (WtHR), conicity index (C index), and waist circumference (WC) were calculated. Body fat percentage (BF%) was calculated from skinfold thickness and used as the gold standard. To analyze the data, descriptive statistics, Student's t-test, Receiver Operating Characteristic (ROC) curve, and Youden's index were used, in addition to correlation coefficient calculation between the indicators and BF%. Results: A total of 997 adolescents enrolled in municipal secondary schools participated in the study. By calculating the BMI, we found that 10.6% of adolescents were overweight, and 4.7% were obese. BMI, WC, and WtHR had the highest accuracy to predict body fatness. All the anthropometric indicators had higher specificity than sensitivity to diagnose excess BF in males. WC had the highest sensitivity in both genders. C index had the smallest area under the ROC curve and the lowest sensitivity in both genders, but its specificity was equivalent to that of the other indicators. Conclusions: BMI, WtHR, and WC were the best anthropometric indicators to predict excess BF in adolescents and had the best correlation coefficients. These tools can be considered in the screening to detect excess BF in adolescents.
RESUMO Objetivo: Comparar o desempenho de indicadores antropométricos para identificar o excesso de gordura corporal (GC) em adolescentes. Métodos: Estudo metodológico com amostragem probabilística por conglomerados, por sorteio das escolas e turmas. A coleta de dados incluiu características sociodemográficas e medidas antropométricas. O índice de massa corporal (IMC), a relação cintura-estatura (RCE), o índice de conicidade (IC) e a circunferência da cintura (CC) foram calculados. O percentual de gordura corporal (%GC) foi calculado com base na espessura das dobras cutâneas e utilizado como padrão-ouro. Para analisar os dados, foram utilizadas estatísticas descritivas, teste t de Student, curva Receiver Operating Characteristic (ROC) e índice de Youden. Foi calculado o coeficiente de correlação entre os indicadores e o %GC. Resultados: Participaram do estudo 997 adolescentes de escolas municipais. Identificou-se, pelo IMC, que 10,6% dos adolescentes apresentavam sobrepeso e 4,7%, obesidade. O IMC, a CC e a RCE apresentaram a maior acurácia para predizer a gordura corporal. Todos os indicadores antropométricos apresentaram especificidade superior à sensibilidade para diagnosticar excesso de GC no sexo masculino. A CC apresentou a maior sensibilidade em ambos os sexos. O IC apresentou a menor área sob a curva ROC e a menor sensibilidade em ambos os sexos, mas especificidade equivalente aos demais indicadores. Conclusões: IMC, RCE e CC apresentaram a melhor capacidade de predizer excesso de GC em adolescentes e os melhores coeficientes de correlação. Essas ferramentas podem ser consideradas formas de rastreamento na identificação do excesso de GC em adolescentes.
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Abstract Objectives: to analyze the consumption of ultra-processed food and its association with body image, physical activity, nutritional status and self-assessment on food of pregnant women enrolled in the Primary Health Care. Methods: this is a cross-sectional study carried out with pregnant women enrolled in the Family Health Strategy in the city of Montes Claros, Minas Gerais. Data were collected through a questionnaire. The dependent variable was the consumption of ultra-processed food, and the independent ones addressed body appearance, physical activity, nutritional status, self-assessment on food and food consumption. Descriptive analysis was carried out and for association of analysis, the linear regression model was used with crude and adjusted associations. Results: 1,185 pregnant women participated in the study. Caloric intake from ultra-processed food represented 32.0% of these women's daily diet. There was an association between consumption of ultra-processed food and physical activity (β=-0.08; p<0.01), pre-gestional nutritional status (β=-0,12; p<0.01) and body image (β =0.08; p=0.01). Conclusion: the pregnant women presented high consumption of ultra-processed food. Having a negative body image, the lowest level of physical activity, and high pre-gestational nutritional status are conditions that influenced the consumption of these food.
Resumo Objetivos: analisar o consumo de alimentos ultraprocessados e sua associação com imagem corporal, atividade física, estado nutricional e autoavaliação alimentar de gestantes cadastradas na Atenção Primária à Saúde. Métodos: trata-se de um estudo transversal, realizado com gestantes cadastradas na Estratégia Saúde da Família do município de Montes Claros, Minas Gerais. Os dados foram coletados por meio de um questionário. A variável dependente foi consumo de alimentos ultraprocessados, e as independentes abordaram aspecto corporal, atividade física, estado nutricional, autoavaliação alimentar e consumo alimentar. Realizou-se análise descritiva e para análise de associação, utilizou-se o modelo de regressão linear com associações brutas e ajustadas. Resultados: participaram do estudo 1.185 gestantes. O consumo calórico proveniente dos ultraprocessados representou 32,0% da dieta diária dessas mulheres. Verificou-se associação entre consumo de ultraprocessados com atividade física (β=-0,08; p<0,01), estado nutricional pré-gestacional (β=-0,12; p<0,01) e imagem corporal (β=0,08; p=0,01). Conclusão: as gestantes apresentaram alto consumo de alimentos ultraprocessados. Ter imagem corporal negativa, menor nível de atividade física, estado nutricional pré-gestacional elevado são condições que influenciaram o consumo desses alimentos.
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Humanos , Feminino , Gravidez , Imagem Corporal , Exercício Físico , Estado Nutricional , Gestantes , Ingestão de Alimentos , Comportamento Alimentar , Alimento Processado/estatística & dados numéricos , Comportamento Materno , Atenção Primária à Saúde , Brasil , Estudos Transversais , Inquéritos e Questionários , Epidemiologia Nutricional , Nutrição MaternaRESUMO
OBJECTIVE: To compare the performance of anthropometric indicators that identify excess body fat (BF) in adolescents. METHODS: This is a methodological study that used probability cluster sampling through school and class draws. Data collection included sociodemographic characteristics and anthropometric measures. Body mass index (BMI), waist-to-height ratio (WtHR), conicity index (C index), and waist circumference (WC) were calculated. Body fat percentage (BF%) was calculated from skinfold thickness and used as the gold standard. To analyze the data, descriptive statistics, Student's t-test, Receiver Operating Characteristic (ROC) curve, and Youden's index were used, in addition to correlation coefficient calculation between the indicators and BF%. RESULTS: A total of 997 adolescents enrolled in municipal secondary schools participated in the study. By calculating the BMI, we found that 10.6% of adolescents were overweight, and 4.7% were obese. BMI, WC, and WtHR had the highest accuracy to predict body fatness. All the anthropometric indicators had higher specificity than sensitivity to diagnose excess BF in males. WC had the highest sensitivity in both genders. C index had the smallest area under the ROC curve and the lowest sensitivity in both genders, but its specificity was equivalent to that of the other indicators. CONCLUSIONS: BMI, WtHR, and WC were the best anthropometric indicators to predict excess BF in adolescents and had the best correlation coefficients. These tools can be considered in the screening to detect excess BF in adolescents.
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Tecido Adiposo , Razão Cintura-Estatura , Adolescente , Antropometria , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Circunferência da CinturaRESUMO
Klebsiella species, particularly K. pneumoniae, are well-known opportunistic enterobacteria related to complexity of clinical infections in humans and animals, commonly refractory to conventional therapy. The domestic animals may represent a source of the pathogenic and multidrug-resistant Klebsiella species to humans. Nevertheless, most studies involving Klebsiella-induced infections in domestic animals are restricted to case reports or outbreaks. We retrospectively investigated selected epidemiological data, clinical aspects, and in vitro susceptibility pattern of 697 non-repetitive Klebsiella infections in livestock and companion species (1997-2019). The isolates were obtained from different clinical disorders from dogs (n = 393), cattle (n = 149), horses (n = 98), cats (n = 27), pigs (n = 22), sheep (n = 5), goats (n = 2), and buffalo (n = 1), except four isolates from subclinical bovine mastitis. Urinary (223/697 = 32%), enteric (117/697 = 16.8%), mammary (85/697 = 12.2%), reproductive (85/697 = 12.2%), and respiratory disorders (67/697 = 9.6%) were the most common clinical manifestations. Other miscellaneous clinical pictures (116/697 = 16.6%) included abscesses, otitis, hepatitis, conjunctivitis, pyodermitis, sepsis, and encephalitis. Norfloxacin (183/245 = 74.7%) and gentamicin (226/330 = 68.5%) were the most effective antimicrobials. High in vitro resistance of the isolates was seen to ampicillin (326/355 = 91.8%), amoxicillin/clavulanic acid (25/62 = 40.3%), and trimethoprim/sulfamethoxazole (100/252 = 39.7), and multidrug resistance to ≥ 3 classes of antimicrobials was found in 20.4% (142/697) isolates. Wide variety of clinical manifestations of Klebsiella-induced infections was observed, with a predominance of urinary, enteric, mammary, reproductive, and respiratory tract disorders, reinforcing opportunistic behavior of agent. Poor in vitro efficacy was observed to some conventional antimicrobials and ~ 20% of isolates exhibited resistance pattern, reinforcing the need for proper use of drugs on therapy approaches in domestic animals to avoid multidrug-resistant bacteria, an emergent global concern.
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Infecções por Klebsiella , Klebsiella , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Gatos , Bovinos , Cães , Farmacorresistência Bacteriana Múltipla , Feminino , Cabras , Cavalos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/veterinária , Klebsiella pneumoniae , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Ovinos , SuínosRESUMO
The Peruvian rattlesnake Crotalus durissus is a venomous species that is restricted to the Peruvian Departments of Puno and Madre de Dios. Although clinically meaningful in this region, Crotalus durissus venom composition remains largely elusive. In this sense, this work aimed to provide a primary description of Peruvian C. durissus venom (PCdV). The enzymatic activities (SVMP, SVSP, LAAO, Hyaluronidase and PLA2) of PCdV were analyzed and compared to Brazilian Crotalus durissus terrificus venom (BCdtV). PCdV showed higher PLA2 activity when compared to the Brazilian venom. PCdV also showed cytotoxicity in VERO cells. For proteomic analysis, PCdV proteins were separated by HPLC, followed by SDS-PAGE. Gel bands were excised and tryptic digested for MALDI-TOF/TOF identification. Approximately 21 proteins were identified, belonging to 7 families. Phospholipases A2 (PLA2, 66.63%) were the most abundant proteins of the venom, followed by snake venom serine proteinases (SVSPs, 13.37%), C-type lectins (Snaclec, 8.98%) and snake venom metalloproteinases (SVMPs, 7.13%), crotamine (2.98%) and phosphodiesterase (PDE, 0.87%). Moreover, antivenom recognition assays indicated that both Brazilian and Peruvian antivenoms recognize PCdV, indicating the presence of antigenically related proteins in crotalic venoms. The results reported here, may impact in the venom selection for the production of effective Pan-American crotalic antivenom.
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Venenos de Crotalídeos , Crotalus , Animais , Antivenenos , Chlorocebus aethiops , Venenos de Crotalídeos/toxicidade , Humanos , Peru , Proteômica , Células VeroRESUMO
The present study aimed to analyze changes in food consumption among teachers of state schools in Minas Gerais in the context of the pandemic of coronavirus disease 2019 (COVID-19). This is a cross-sectional study of teachers at elementary, middle, and high schools in Minas Gerais. An online questionnaire was made available to all participants through the Google Forms platform. For the analysis, sociodemographic, economic, occupational profile, health conditions, and behavioral/habitual variables were used. Food consumption was assessed through the weekly frequency of eating foods considered healthy and unhealthy before and during the pandemic. The changes observed in the frequency were classified as: decreased intake, no change in intake, and increased intake during the pandemic. Statistical analysis was performed using bivariate and multiple analysis using the Multinomial Logistics Regression model. The data were tabulated with the aid of the Statistical Package for Social Sciences (SPSS), version 18.0. A total of 15,641 teachers participated in this study, with an average age of 42.96 (±9.27) years, and most of them were female (81.9%). During the pandemic, approximately 40% reported altered sleep quality and alcohol consumption, and lack of physical activity with 60.4% of the professionals categorized as overweight. During this period, there was an increase in the consumption of sweets (19.5%), soft drinks (13.3%), sausages (12.0%), frozen foods (8.9%), salty foods (6.3%), vegetables (13.1%), fruits (12.6%), and wholegrain products (8.3%). In the regression analysis, several factors were found to be associated with changes in teachers' food consumption in a bidirectional way when associated with variables related to sociodemographic characteristics, occupational profile, general health, and lifestyle.
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The study aimed to assess the psychometric properties of the Brazilian Portuguese version of the Internet Addiction Test (IAT) in students. The methodological study population consisted of secondary and university students from Montes Claros, Minas Gerais State, Brazil. The following parameters were assessed: psychometric sensitivity, construct validity (factor, convergent, discriminant, and test of hypothesis), criterion validity (concurrent), and reliability (internal consistency and reproducibility). A total of 2,519 students participated, 29.6% of whom were secondary school enrollees. A three-factor measurement model was adjusted ("emotional and cognitive preoccupation with the Internet", "problems in managing time", and "performance problems"), which obtained satisfactory adequacy indices and stable structure in the independent subsamples. Convergent validity was close to the recommended level (mean extracted variation = 0.32, 0.41, and 0.45 and compound reliability values = 0.84, 0.81, and 0.71), and discriminant and concurrent validities were adequate. Internal consistency was adequate (alpha = 0.906), as was reproducibility (kappa = 0.73 and intraclass correlation coefficient = 0.90). The Portuguese-language version of the IAT presented satisfactory levels of validity, reliability, and stability in independent samples of students.
O objetivo foi avaliar as propriedades psicométricas da versão traduzida para o português do Internet Addiction Test (IAT) em estudantes. Estudo metodológico, cuja população foi constituída por estudantes dos ensinos Médio e Superior de Montes Claros, Minas Gerais, Brasil. Foram avaliadas sensibilidade psicométrica, validade de construto (fatorial, convergente, discriminante e teste de hipótese), validade de critério (concorrente) e confiabilidade (consistência interna e reprodutibilidade). Participaram 2.519 estudantes, sendo 29,6% do Ensino Médio. Foi ajustado um modelo de medida trifatorial - "preocupação emocional e cognitiva com a Internet", "problemas de gerenciamento de tempo" e "problemas de desempenho" -, o qual obteve índices satisfatórios de adequação e estrutura estável nas subamostras independentes. A validade convergente foi próxima ao recomendado (variância extraída média = 0,32, 0,41 e 0,45 e valores de confiabilidade composta iguais 0,84, 0,81 e 0,71); as validades discriminante e concorrente foram adequadas. Foram igualmente adequadas a consistência interna (alfa = 0,906) e a reprodutibilidade (kappa = 0,73 e coeficiente de correlação intraclasse = 0,90). A versão traduzida para o português do IAT apresentou níveis satisfatórios de validade, confiabilidade e estabilidade em amostras independentes de estudantes.
El objetivo fue evaluar las propiedades psicométricas de la versión traducida al portugués del Internet Addiction Test (IAT) en estudiantes. Estudio metodológico, cuya población estuvo constituida por estudiantes de enseñanza media y superior de Montes Claros, Minas Gerais, Brasil. Se evaluaron: sensibilidad psicométrica, validez del constructo (factorial, convergente, discriminante y test de hipótesis), validez de criterio (concurrente) y confiabilidad (consistencia interna y reproducibilidad). Participaron 2.519 estudiantes, siendo un 29,6% de enseñanza media. Se ajustó un modelo de medida trifactorial: "preocupación emocional y cognitiva con Internet", "problemas de gestión de tiempo" y "problemas de desempeño", con el que se obtuvieron índices satisfactorios de adecuación y estructura estable en las submuestras independientes. La validez convergente estuvo cercana a lo recomendado (variancia extraída media = 0,32, 0,41 y 0,45 y valores de confiabilidad compuesta = 0,84, 0,81 y 0,71), la validez, tanto discriminante como concurrente, fueron adecuadas. La consistencia interna fue adecuada (alfa = 0,906), así como la reproducibilidad (kappa = 0,73 y coeficiente de correlación intraclase = 0,90). La versión traducida al portugués del IAT presentó niveles satisfactorios de validez, confiabilidad y estabilidad en muestras independientes de estudiantes.
Assuntos
Transtorno de Adição à Internet , Estudantes , Brasil , Humanos , Internet , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Based on the work-family enrichment theory, this study analyzes the contribution of work-family and family-work enrichment to explain the military's well-being during a peacekeeping mission. The data used were collected in a sample of 306 Brazilian soldiers, who were married and/or had children, during the phase named "employment of troops" (i.e., when peacekeepers had been in the Haitian territory and, as a result, away from their families, for between three to five months). Data analysis was performed using the Structural Equations Model. It was observed that the military's perception of their spouses' support for their participation during the mission had a positive relationship with both family-to-work enrichment and work-to-family enrichment, and the work-to-family enrichment mediated the relationship between the perception of the spouses' support and the military's health perception and general satisfaction with life. Theoretical and practical implications were discussed and limitations and suggestions for future research were presented.
Assuntos
Militares , Brasil , Criança , Emprego , Haiti , Humanos , Psicologia Positiva , CônjugesRESUMO
Caseous lymphadenitis (CL) in sheep is a chronic contagious disease caused by Corynebacterium pseudotuberculosis, commonly characterized by abscess formation in peripheral lymph nodes and disseminated infections. Nonetheless, other microorganisms, including with zoonotic relevance, can be isolated from CL-resembling lymph nodes. Currently, mycobacteria have been reported in visceral granulomatous lesions in small ruminants, a fact that poses a public health issue, particularly in slaughtered sheep intended for human consumption. Cytology using fine needle aspiration and microbiological culturing are suitable tests for routine diagnostic, whereas present drawbacks and molecular methods have been confirmatory. Data about the occurrence of mycobacteria in both lymph nodes with aspect of CL and apparently healthy visceral nodes of sheep slaughtered for human consumption are scarce. In this study, 197 visceral lymph nodes of sheep showed lymphadenitis and 202 healthy visceral lymph nodes of slaughtered sheep intended for human consumption were submitted to conventional bacteriological diagnosis, mycobacteria culturing, and cytological evaluation. Compatible Corynebacterium isolates were subjected to multiplex PCR targeting 16S rRNA, rpoB, and pld genes to detect C. pseudotuberculosis. Based on microbiological identification, C. pseudotuberculosis (86/197; 43.7%), streptococci γ-hemolytic (17/197; 8.6%), and Trueperella pyogenes (12/197; 6.1%) were prevalent in lymph nodes with abscesses, as opposed to staphylococci (53/202; 26.2%) in apparently healthy lymph nodes. No mycobacteria were isolated. Cytology identified 49.2% (97/197) Gram-positive pleomorphic organisms (coryneform aspect). Multiplex PCR confirmed genetic material of C. pseudotuberculosis in 74.4% (64/86) of the samples with C. pseudotuberculosis isolation and 66% (64/97) samples with cytological coryneform aspect (κ = 86.78%; 95% CI = 79.87-93.68%). These findings emphasize the prevalence of C. pseudotuberculosis in abscess formation among peripheral lymph nodes of sheep. Other bacteria were also identified in lymph nodes sampled that resembling C. pseudotuberculosis-induced infections that may difficult the diagnosis. Multiplex PCR revealed a valuable assay to detect C. pseudotuberculosis, in addition to routine methods applied to CL-diagnosis. No mycobacteria were identified in lymph nodes sampled, with and without apparent lesions. Nonetheless, due to public health impacts, this pathogen should be considered as a differential diagnosis of C. pseudotuberculosis-induced infections during inspection procedures of slaughtered sheep intended for human consumption.
Assuntos
Bactérias/genética , Coinfecção/veterinária , Corynebacterium pseudotuberculosis/genética , Linfonodos/citologia , Linfonodos/microbiologia , Linfadenite/microbiologia , Linfadenite/veterinária , Mycobacterium/genética , Matadouros , Animais , Bactérias/classificação , Brasil/epidemiologia , Coinfecção/microbiologia , Estudos Transversais , Fazendas , Feminino , Masculino , Prevalência , RNA Ribossômico 16S/genética , Distribuição Aleatória , Ovinos/microbiologia , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/microbiologiaRESUMO
Resumo: O objetivo foi avaliar as propriedades psicométricas da versão traduzida para o português do Internet Addiction Test (IAT) em estudantes. Estudo metodológico, cuja população foi constituída por estudantes dos ensinos Médio e Superior de Montes Claros, Minas Gerais, Brasil. Foram avaliadas sensibilidade psicométrica, validade de construto (fatorial, convergente, discriminante e teste de hipótese), validade de critério (concorrente) e confiabilidade (consistência interna e reprodutibilidade). Participaram 2.519 estudantes, sendo 29,6% do Ensino Médio. Foi ajustado um modelo de medida trifatorial - "preocupação emocional e cognitiva com a Internet", "problemas de gerenciamento de tempo" e "problemas de desempenho" -, o qual obteve índices satisfatórios de adequação e estrutura estável nas subamostras independentes. A validade convergente foi próxima ao recomendado (variância extraída média = 0,32, 0,41 e 0,45 e valores de confiabilidade composta iguais 0,84, 0,81 e 0,71); as validades discriminante e concorrente foram adequadas. Foram igualmente adequadas a consistência interna (alfa = 0,906) e a reprodutibilidade (kappa = 0,73 e coeficiente de correlação intraclasse = 0,90). A versão traduzida para o português do IAT apresentou níveis satisfatórios de validade, confiabilidade e estabilidade em amostras independentes de estudantes.
Abstract: The study aimed to assess the psychometric properties of the Brazilian Portuguese version of the Internet Addiction Test (IAT) in students. The methodological study population consisted of secondary and university students from Montes Claros, Minas Gerais State, Brazil. The following parameters were assessed: psychometric sensitivity, construct validity (factor, convergent, discriminant, and test of hypothesis), criterion validity (concurrent), and reliability (internal consistency and reproducibility). A total of 2,519 students participated, 29.6% of whom were secondary school enrollees. A three-factor measurement model was adjusted ("emotional and cognitive preoccupation with the Internet", "problems in managing time", and "performance problems"), which obtained satisfactory adequacy indices and stable structure in the independent subsamples. Convergent validity was close to the recommended level (mean extracted variation = 0.32, 0.41, and 0.45 and compound reliability values = 0.84, 0.81, and 0.71), and discriminant and concurrent validities were adequate. Internal consistency was adequate (alpha = 0.906), as was reproducibility (kappa = 0.73 and intraclass correlation coefficient = 0.90). The Portuguese-language version of the IAT presented satisfactory levels of validity, reliability, and stability in independent samples of students.
Resumen: El objetivo fue evaluar las propiedades psicométricas de la versión traducida al portugués del Internet Addiction Test (IAT) en estudiantes. Estudio metodológico, cuya población estuvo constituida por estudiantes de enseñanza media y superior de Montes Claros, Minas Gerais, Brasil. Se evaluaron: sensibilidad psicométrica, validez del constructo (factorial, convergente, discriminante y test de hipótesis), validez de criterio (concurrente) y confiabilidad (consistencia interna y reproducibilidad). Participaron 2.519 estudiantes, siendo un 29,6% de enseñanza media. Se ajustó un modelo de medida trifactorial: "preocupación emocional y cognitiva con Internet", "problemas de gestión de tiempo" y "problemas de desempeño", con el que se obtuvieron índices satisfactorios de adecuación y estructura estable en las submuestras independientes. La validez convergente estuvo cercana a lo recomendado (variancia extraída media = 0,32, 0,41 y 0,45 y valores de confiabilidad compuesta = 0,84, 0,81 y 0,71), la validez, tanto discriminante como concurrente, fueron adecuadas. La consistencia interna fue adecuada (alfa = 0,906), así como la reproducibilidad (kappa = 0,73 y coeficiente de correlación intraclase = 0,90). La versión traducida al portugués del IAT presentó niveles satisfactorios de validez, confiabilidad y estabilidad en muestras independientes de estudiantes.
Assuntos
Humanos , Estudantes , Transtorno de Adição à Internet , Psicometria , Brasil , Inquéritos e Questionários , Reprodutibilidade dos Testes , InternetRESUMO
Resumo: Introdução: Afecções otorrinolaringológicas são destaques entre as enfermidades mais frequentes na atenção primária. Acredita-se que a sobrecarga na atenção secundária seja consequência da baixa resolução dos problemas na atenção primária. Uma possível explicação para esse fato seria a deficiência na capacitação médica durante a graduação. Estima-se que a carga horária média de otorrinolaringologia seja 0,6% da carga horaria média total, após análise de 141 matrizes curriculares, correspondendo a aproximadamente 70,5% do total das escolas médicas em funcionamento em 2013. Nessa área, poucos estudos têm sido realizados em relação ao ensino e à necessidade de reavaliação curricular. Objetivo: O presente estudo tem o intuito de buscar um consenso sobre as competências necessárias ao generalista na especialidade de otorrinolaringologia. Métodos: Criou-se um questionário inicial que abordava as competências otorrinolaringológicas pertinentes à prática clínica dos médicos da atenção primária. Por meio da metodologia Delphi, no formato eletrônico, o questionário foi enviado para 20 especialistas com formações distintas: médicos generalistas, otorrinolaringologistas e médicos de família e comunidade. Essa heterogeneidade entre os especialistas contribuiu para garantir a confiabilidade dos resultados. Os resultados obtidos após cada rodada eram analisados pelos pesquisadores, que observavam as tendências e as opiniões dissonantes, bem como suas justificativas. Ao final da sistematização e compilação dos resultados, um novo questionário era elaborado e reenviado, iniciando uma nova rodada até que o consenso fosse estabelecido em todas competências. Resultados: Realizaram-se cinco rodadas para o estabelecimento do consenso em todas as 17 competências otorrinolaringológicas avaliadas pelas proposições, o possibilitou a definição do nível de competência dos conteúdos e procedimentos otorrinolaringológicos preconizados ao egresso de Medicina. Conclusão: Os dados obtidos neste trabalho podem servir para o embasamento, direcionamento e desenvolvimento do currículo otorrinolaringológico nos cursos de graduação de Medicina, visto que não se encontrou na literatura consenso estabelecendo as competências mínimas otorrinolaringológicas na formação curricular da graduação.
Abstract: Introduction: Otorhinolaryngological disorders are amongst the most prominent frequent diseases in primary care. The overload in secondary care is thought to be a consequence of the low resolution of these problems in primary care. A deficiency in undergraduate medical training may explain this fact. The average estimated time spent studying otorhinolaryngological practice is estimated to be 0.6% of the total average practice hours after analysis of data from 141 medical course syllabuses in Brazil, corresponding to approximately 70.5% of all the medical schools in operation in 2013. Few studies have been conducted in this area and regarding teaching and the need for curriculum reassessment. Objectives: This study seeks to ascertain a consensus on the skills required by the general practitioner in the specialty of otorhinolaryngology. Methods: An initial questionnaire was devised addressing the otorhinolaryngological skills relevant to primary care clinical practice. Using the Delphi method, the questionnaire was sent in electronic format to 20 specialists with training in three different specialties; this heterogeneity of the survey sample helped ensure the reliability of the results. The results obtained after each round were analyzed by one researcher and validated by another, observing any discrepant trends and opinions, as well as their justifications. Once the results had all been compiled and systematized, a new questionnaire was devised and sent out, starting a new round until consensus had been established for all the skills. Results: Five rounds were completed until a consensus was established for all 17 otorhinolaryngological skills evaluated by the propositions. Conclusions: The data obtained by this work can serve as a basis and guideline for developing an otorhinolaryngological curriculum for undergraduate medical training since no consensus was found in the literature establishing such a minimum skill set.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Otolaringologia/educação , Técnica Delphi , Educação Baseada em Competências , CurrículoRESUMO
Introdução: Afecções otorrinolaringológicas são destaques entre as enfermidades mais frequentes na atenção primária. Acredita-se que a sobrecarga na atenção secundária seja consequência da baixa resolução dos problemas na atenção primária. Uma possível explicação para esse fato seria a deficiência na capacitação médica durante a graduação. Estima-se que a carga horária média de otorrinolaringologia seja 0,6% da carga horaria média total, após análise de 141 matrizes curriculares de cursos de medicina do Brasil, correspondendo a, aproximadamente, 70,5% do total das escolas médicas em funcionamento em 2013. Objetivo: O presente estudo tem o intuito de buscar um consenso sobre as competências na especialidade de otorrinolaringologia para generalistas com ênfase na formação para a atenção primária. Métodos: Foi criado um questionário inicial, abordando as habilidades otorrinolaringológicas pertinentes à prática clínica dos médicos da atenção primária, fundamentado no currículo baseado em competências para medicina de família e comunidade (2015). Usando a metodologia Delphi, no formato eletrônico, o questionário foi enviado para 20 especialistas, sendo 7 otorrinolaringologistas, 7 médicos da família e comunidade e 6 generalistas, essa heterogeneidade teve como finalidade aumentar a confiabilidade dos resultados. Os resultados obtidos após cada rodada foram analisados por um pesquisador e validados por outro pesquisador, observando as tendências e as opiniões dissonantes, bem como suas justificativas. O fato de a convergência das respostas nos números 1 e 2 na escala de valoração tipo Likert ser igual ou maior que 75% foi utilizado como critério de exclusão da referida proposição. Quando a convergência das respostas nos números 5 e 6, da mesma escala, foram igual ou superior a 75%, tomou-se esse dado como fator de inclusão da proposição em análise. Ao final da sistematização e da compilação dos resultados, um novo questionário foi elaborado e reenviado, iniciando uma nova rodada, até que o consenso em todas competências foram estabelecidos. Resultados: Foram realizadas cinco rodadas para estabelecimento do consenso em todas as 17 competências otorrinolaringológicas avaliadas pelas proposições iniciais. Conclusão: Os dados obtidos nesse trabalho podem servir no embasamento e direcionamento para o desenvolvimento do currículo otorrinolaringológico nos cursos de graduação de medicina, visto que não se encontrou, na literatura, consenso estabelecendo as competências mínimas otorrinolaringológicas na formação curricular da graduação e também não houve o estabelecimento de um modelo curricular de medicina nas diretrizes curriculares nacionais
Introduction: Otorhinolaryngological disorders are amongst the most prominent frequent diseases in primary care. The overload in secondary care could be a consequence of the low resolution of these problems in primary care. A deficiency in medical training during graduation could be a possible explanation for this fact. The average estimated hour spent in otolaryngology practice is 0.6% of the total average practice hours. Data acquired after analyzing 141 matrices of medical courses in Brazil, corresponding to approximately 70.5% of the medical schools in operation in 2013. Objectives: The present study aims to reach a consensus about the competencies in otorhinolaryngology specialty for generalists whose formation emphasis primary attention Methods: A questionnaire was created addressing the otorhinolaryngological skills relevant to the clinical practice of primary care physicians based on the competency-based curriculum for family and community medicine (2015). The electronic format of Delphi methodology was used, later on the questionnaire was sent to 20 specialists trained in three distinct specialties, the heterogeneity among the specialists contributed to ensure the results reliability. The results obtained after each round were analyzed by one researcher and validated by another researcher, observing the dissonant trends and opinions, as well as their justifications. The proposition exclusion criterion was used when the convergence of the answers in numbers 1 and 2 on the Likert-type rating scale was equal or greater than 75% and the proposition inclusion when the convergence in answers in numbers 5 and 6 of the same scale equal or greater than 75%. By the end of the results systematization and compilation, a new questionnaire was elaborated and resent, starting a new round until a consensus in all competencies were established. Results: Five rounds were performed until a consensus was establish in all 17 otorhinolaryngological competencies evaluated by the propositions. Conclusions: The data obtained by this work can serve as basis and guidelines for developing an otorhinolaryngological curriculum in undergraduate medical courses since there was no consensus in the literature about establishing the minimum otorhinolaryngological competences in the undergraduate curriculum formation. In Brazil, there is no curriculum model recommended by national guidelines