ABSTRACT. The objective of this study was to evaluate the productive performance and carcass characteristics of confined Santa Inês sheep, fed different diets, in a Semiarid environment. Twenty whole sheep with 5 ± 0.5 months of age and 27 ± 2.0 kg were used, receiving two different diets for 72 experimental days, one composed of defatted soybean meal and the other of protein-enriched cactus meal. They were evaluated for different diets, consumption, production, carcass characteristics, morphometric measures and edible components. The experimental design was in randomized blocks with two treatments and 10 replications. Performance data and carcass characteristics were evaluated by analysis of variance and means compared by t test at 5% probability level using Statistical Analysis System [SAS]® (1999). Thus, the use of emulsified palm forage protein in the feeding of Santa Inês male lambs proved to be an excellent protein source when compared to the use of defatted soybean meal, since the results of performance and carcass characteristics were similar, being the use of this alternative source advised as it presents the best benefit-cost ratio.

Abstract This study evaluates the economic viability of sheep finishing systems on irrigated Tamani grass pasture under continuous stocking, using castor bean cake. Four production systems were simulated: sheep supplemented with soybean meal on pasture fertilized with urea (SMUR), sheep supplemented with detoxified castor bean cake on pasture fertilized with urea (CCdUR), sheep supplemented with soybean meal on pasture fertilized with in natura castor bean cake (SMCC) and sheep supplemented with detoxified castor bean cake on pasture fertilized with in natura castor bean cake (CCdCC). A minimum unit of 3 hectares and an average slaughter weight of 28 kg were considered. A minimum selling price, at which the least profitable system would become profitable, was stablished: US$ 2.38 and US$ 4.45/kg per kilogram of body weight and carcass weight equivalent, adopting a minimum rate of return of 3.5% per year, based on the Selic rate. The costs for organic fertilization were 46.01% higher than in systems using chemical fertilization. The selling of live animals was not attractive in any of the systems evaluated, and the opposite was observed for the selling of carcasses and non-carcass components. System SMUR proved to be more profitable, with a gain of US$ 0.53 per kg carcass.

Resumo Objetivou-se avaliar a economicidade de sistemas de terminação de ovinos em pastagem irrigada de capim-tamani sob lotação contínua, utilizando torta de mamona. Foram simulados quatro sistemas de produção: ovinos suplementados com farelo de soja e o pasto adubado com ureia (FSUR), ovinos suplementados com torta de mamona destoxificada e o pasto adubado com ureia (TMdUR), ovinos suplementados com farelo de soja e o pasto adubado com torta de mamona in natura (FSTM) e ovinos suplementados com torta de mamona destoxificada e o pasto adubado com torta de mamona in natura (TMdTM). Foi considerada a unidade mínima de 3 hectares e determinado um peso médio ao abate de 28 kg de peso corporal. Estabeleceu-se um preço de venda mínimo, no qual o sistema de criação menos lucrativo se tornasse rentável de 2,38 e 4,45 dólares por quilograma de peso corporal e por equivalente de peso da carcaça, dotando uma taxa mínima de atratividade de 3,5% ao ano, com base na taxa Selic. Os custos com adubação orgânica, em média, são 46,01% superiores aos sistemas que utilizam adubação química. A venda de animais vivos não é atrativa em nenhum dos sistemas avaliados, sendo o contrário observado para a comercialização de carcaças e dos não componentes da carcaça de ovinos. O sistema de produção FSUR se mostrou mais lucrativo, com ganho de US$ 0.53 centavos por kg de carcaça.

Abstract Herlyn-Werner-Wunderlich syndrome (HWW) is a rare congenital anomaly of the female urogenital tract, characterized by the triad of bicorporeal uterus, obstructed hemivagina and ipsilateral renal agenesis. The most common symptoms are pelvic pain, dysmenorrhea and an abdominal mass. Prompt surgical treatment is advisable. If not immediately possible, medical treatment should be initiated to induce amenorrhea. We describe a case of HWW with chronic pelvic pain and mild dysmenorrhea. The ultrasound revealed uterine duplication and a retro-uterine mass contiguous to the cervix. Magnetic resonance imaging (MRI) confirmed a genital tract anomaly. The patient was medicated with continuous oral estroprogestative and was proposed to surgery.

Resumo O Síndrome de Herlyn-Werner-Wunderlich (HWW) é uma anomalia congénita rara do trato urogenital feminino, caraterizada pela tríade de útero bicorporal, hemivagina obstruída e agenesia renal ipsilateral. Os sintomas mais comuns são a dor pélvica, dismenorreia e presença de massa abdominal. É recomendado o tratamento cirúrgico atempado. No caso de impossibilidade, deve ser iniciado tratamento médico para indução da amenorreia. Descreve-se um caso de HWW em doente com dor pélvica crónica e dismenorreia ligeira. Ecograficamente constatada duplicação uterina e a presença de uma massa retro-uterina contigua ao colo uterino. A ressonância magnética confirmou a presença de malformação uterina. A doente foi medicada com estroprogestativo oral contínuo e proposta para cirurgia.

Resumo Muito se tem falado sobre a importância dos indicadores científicos no processo de crescimento e desenvolvimento dos países. Nesse cenário, o presente trabalho buscou analisar o empenho dos bolsistas de pós-doutorado júnior em algumas áreas de Ciências Biológicas (botânica, bioquímica, farmacologia e ecologia) no Brasil. Esta pesquisa classificou-se como descritiva quanto ao seu objetivo e fez uso da bibliometria para analisar os dados encontrados. O desempenho de 97 bolsistas de pós-doutorado júnior com bolsa vigente no site do Conselho Nacional de Desenvolvimento Científico e Tecnológico, foi analisado através do banco de dados Scopus. Os resultados obtidos demonstram que São Paulo é o estado brasileiro que apresenta o maior número de bolsistas (cerca de 20,62%), sendo a Universidade de São Paulo a instituição com a maior predominância de pós-doutorandos (12,37%). A botânica apresenta papel de destaque como área de atuação no campo das Ciências Biológicas, com o maior número de artigos indexados na base Scopus, apresentando uma média de 10,63 artigos por pesquisador. A área de Ecologia apresenta a maior média anual de publicações, com uma média de 1,56 publicações por ano. Observa-se que o pós-doutorado júnior é uma experiência que pode proporcionar avanço do conhecimento e capacitação científica e tecnológica visando à aplicação dos resultados em diversos setores sociais.

Abstract Much has been said about the importance of scientific performance indicators for the growth and development process of countries. Given this scenario, the present work aims to analyze junior postdoctoral fellows’ commitment in some fields of Biological Sciences (botany, biochemistry, pharmacology, and ecology) in Brazil. This research is classified as descriptive for its aim, by using bibliometrics to analyze the data found. The performance of 97 junior postdoctoral fellows with current fellowships on the National Council for Scientific and Technological Development website was analyzed by using the Scopus database. The results obtained show that São Paulo is the Brazilian state that has the largest number of fellows (20.62%), and the University of São Paulo the institution with the largest number of fellows (12.37%). Botany plays an important role as an acting area in the field of Biological Sciences, with the largest number of articles indexed in the Scopus database, with an average of 10.63 articles per researcher. The field of ecology has the highest annual average of publications, representing an average of (1.56) publications per year. We can notice that the junior postdoctoral is an experience that can provide knowledge advancement and scientific and technological training, aiming at the application of results in many social sectors.

Abstract Overview and aims: Cervical cancer (CC) is the fourth leading cause of cancer death in women globally, and accounts around 311,000 deaths annually, being the persistent infection with high-risk Human Papilloma virus the most common cause. The prevention of CC is based on gynecological screening, which allows to classify the degree of existing lesion, as well as to identify other changes which may contribute to the development of these lesions and subsequent neoplasia. We aim to analyze the prevalence of cancerous and pre-cancerous lesions in the Algarve population attending the Private Hospital of Algarve (HPA), through the study of the results of gynecological cytology performed in this Hospital. Study design: Retrospective observational study from the clinical database. Methods: Data collected from the gynecological cytological analysis of female users between 25 up to 65 years old, carried out between January 2013 and December 2017. Results: It was found that the number of samples increased over the five years, making a total of 28346 samples, in which the cytological result with the highest percentage is the negative, with 95.6%. Of the cytology’s with lesions (4.4%), the one with the highest percentage is ASCUS with 2.2%, followed by LSIL with 1.7%. The Algarve municipality with the highest number of injuries identified is Faro 19.7%, followed by Portimão 15.8%. On the other hand, Castro Marim is the county with the lowest frequency of injuries 0.3%, and Alcoutim did not present any detected injuries; the age range with the largest number of samples is from 35 to 40 years old. Conclusion: This study showed that, in Algarve, the adherence to greater female health care increased in the population that uses the HPA, with the negative cytologic result being the most prevalent.

ABSTRACT The consumption of saline water in semiarid regions is a recurrent situation that can affect the ingestive behavior of small ruminants. This study evaluated the ingestive behavior of Santa Inês sheep maintained in a climatic chamber under two air temperatures -25 °C within the thermal comfort zone (TCZ) and 32 °C above the TCZ - and consuming water with three levels of salinity - 2.0, 4.0, and 8.0 dS m-1. The experimental design was completely randomized in 2 × 3 factorial schemes, comprising two air temperatures and drinking water with three levels of salinity, in six replicates (animals). Regardless of air temperature, the consumption of saline water did not affect feed and water intake by the sheep; however, there was a decrease in feed intake and an increase in water intake as air temperature increased. Feed and water intake; feeding, rumination, and idle times; defecation frequency; and fecal production were not affected (P > 0.05) by the water salinity levels, whereas reduction in feed intake, feeding time, and rumination time and an increase in water intake and idle time were observed as air temperature increased. In summary, increasing air temperature negatively affected the ingestive behavior of the animals; however, water with salinity up to 8.0 dS m-1 did not affect their ingestive behavior and hence could be used for drinking.

ABSTRACTObjective: To describe a proposal for making and distributing masks for population in risk, with guidance on the stages of making them and the care in handling them based on the development of educational video and infographic.Method: Experience report on the stages of the process of training people to make fabric masks for the population at risk, between March and June 2020, in a city in the interior of São Paulo. Results: 1,650 masks were made and distributed to vulnerable population groups from different contexts and tutorial video and infographic were elaborated and released to enable people to make their own masks with resources available at home.Final considerations: It was possible to manufacture and distribute masks for the population at risk and develop educational actions to contain the disease, given the advance of confirmed cases and deaths by Covid-19, corroborating the role of nursing in health education.Keywords: Masks. Nursing. Health education. Containment of biohazards. Covid-19.

RESUMENObjetivo: Describir propuesta de confección y distribución de máscaras para población en riesgo, con orientación sobre las etapas de elaboración y cuidados en su manejo con la elaboración de video e infográfico educativos.Método: Relato de experiencia sobre las etapas del proceso de capacitación de personas para la confección de máscaras para poblaciones en riesgo, entre marzo y junio de 2020, en una ciudad del interior de São Paulo.Resultados: Se confeccionaron 1 650 máscaras y se distribuyeron a grupos de riesgo de diferentes contextos, se elaboró y divulgó video tutorial e infográfico para que las personas puedan hacer sus propias máscaras con recursos disponibles en el hogar.Consideraciones finales: Fue posible fabricar y distribuir máscaras para la población en riesgo y desarrollar acciones educativas para contener la enfermedad, dado el avance de casos confirmados y defunciones por Covid-19, confirmando el rol de la enfermería en la educación para la salud.Palabras claves: Máscaras. Enfermería. Educación en salud. Contención de riesgos biológicos. Covid-19.

RESUMOObjetivo: Descrever proposta para confecção e distribuição de máscaras para população de risco, com orientações sobre as etapas de confecção e os cuidados no seu manuseio a partir do desenvolvimento de vídeo e infográfico educativos.Método: Relato de experiência sobre as etapas do processo de capacitação de pessoas para confecção de máscaras de tecido para população de risco, entre março e junho de 2020, em município do interior paulista. Resultados: Foram confeccionadas e distribuídas 1.650 máscaras para grupos populacionais de risco de diferentes contextos, elaborados e divulgados materiais instrucionais, como tutorial com vídeo explicativo e infográfico para capacitar pessoas para confeccionarem suas próprias máscaras com recursos disponíveis no domicílio.Considerações finais: Foi possível confeccionar e distribuir máscaras para população de risco e desenvolver ações educativas para a contenção da doença, dado o avanço dos casos confirmados e de mortes pela Covid-19, corroborando o papel da enfermagem na educação em saúde.Palavras-chave: Máscaras. Enfermagem. Educação em saúde. Contenção de riscos biológicos. Covid-19.

RESUMO Objetivo Descrever proposta para confecção e distribuição de máscaras para população de risco, com orientações sobre as etapas de confecção e os cuidados no seu manuseio a partir do desenvolvimento de vídeo e infográfico educativos. Método Relato de experiência sobre as etapas do processo de capacitação de pessoas para confecção de máscaras de tecido para população de risco, entre março e junho de 2020, em município do interior paulista. Resultados Foram confeccionadas e distribuídas 1.650 máscaras para grupos populacionais de risco de diferentes contextos, elaborados e divulgados materiais instrucionais, como tutorial com vídeo explicativo e infográfico para capacitar pessoas para confeccionarem suas próprias máscaras com recursos disponíveis no domicílio. Considerações finais Foi possível confeccionar e distribuir máscaras para população de risco e desenvolver ações educativas para a contenção da doença, dado o avanço dos casos confirmados e de mortes pela Covid-19, corroborando o papel da enfermagem na educação em saúde.

ABSTRACT Objective To describe a proposal for making and distributing masks for population in risk, with guidance on the stages of making them and the care in handling them based on the development of educational video and infographic. Method Experience report on the stages of the process of training people to make fabric masks for the population at risk, between March and June 2020, in a city in the interior of São Paulo. Results 1,650 masks were made and distributed to vulnerable population groups from different contexts and tutorial video and infographic were elaborated and released to enable people to make their own masks with resources available at home. Final considerations It was possible to manufacture and distribute masks for the population at risk and develop educational actions to contain the disease, given the advance of confirmed cases and deaths by Covid-19, corroborating the role of nursing in health education.

RESUMEN Objetivo Describir propuesta de confección y distribución de máscaras para población en riesgo, con orientación sobre las etapas de elaboración y cuidados en su manejo con la elaboración de video e infográfico educativos. Método Relato de experiencia sobre las etapas del proceso de capacitación de personas para la confección de máscaras para poblaciones en riesgo, entre marzo y junio de 2020, en una ciudad del interior de São Paulo. Resultados Se confeccionaron 1.650 máscaras y se distribuyeron a grupos de riesgo de diferentes contextos, se elaboró y divulgó video tutorial e infográfico para que las personas puedan hacer sus propias máscaras con recursos disponibles en el hogar. Consideraciones finales Fue posible fabricar y distribuir máscaras para la población en riesgo y desarrollar acciones educativas para contener la enfermedad, dado el avance de casos confirmados y defunciones por Covid-19, confirmando el rol de la enfermería en la educación para la salud.

Abstract Obtaining low cost lignocellulolytic enzymes and efficient biomass pretreatment are key to increase the competitiveness of second-generation ethanol in comparison with fossil fuels. The enzymatic cocktail produced by the Chrysoporthe cubensis fungus as well as the mixture prepared with the cocktails of the Chrysoporthe cubensis and Penicillium pinophilum fungi have already proven to be efficient for hydrolyzing biomass pretreated with alkali. In this study, they were evaluated in saccharification of sugarcane bagasse pretreated with dilute acid or hot water at 121°C using an enzyme loading equal to 8 filter paper units per gram of biomass. The most promising results were obtained from the hydrolysis of biomass pretreated with hot water by the C. cubensis-P. pinophilum enzymes blend. In this condition, the glucose and xylose production were 25.2 g.L-1 and 4.6 g.L-1, respectively, that resulted in the conversion of 68% of glucan and 23% of xylan in only 48 hours. This study shows that the hydrothermal pretreatment is a promising alternative to improve the enzymes performance, produced by the fungi C. cubensis and P. pinophilum, in the sugarcane bagasse hydrolysis without the need of chemical compounds, generally used in the acid and alkali pretreatments. Furthermore, the hydrothermal pretreatment for 60 min allowed all cocktails applied to convert the cellulose efficiently with only 24 h of saccharification, which contributes to the energy savings employed in the process.

Abstract Vegetable fibers are widely used as reinforcement in the production of composites. In this work, the photodegradative potential of polymer composites containing babassu fiber was characterized and evaluated. The fibers were extracted manually and immersed in a 10% NaOH solution (Mercerization). After drying, they were crushed and incorporated into the low-density polyethylene matrix in proportions of 5%, 10%, and 20% of the total mass of the composite. The composites were subjected to Scanning Electron Microscopy analysis (showed the incorporation of fibers into the polymeric matrix), Infrared Spectroscopy (the presence of fiber was observed with peaks at 3200-3600 cm-1, and 1596 cm-1-1036 cm-1), Mechanical Tests (with 20% fiber, there is a 44% decrease in tension, 48% in strain and 12% in Young's modulus) and Thermogravimetric Analysis (inicial fiber degradation starts between 220-337 °C, and matrix degradation between 333-550 °C). The composites were subjected to degradation processes by solar radiation and under artificial UV-B. Samples of oxy-biodegradable plastic bags were also degraded under the same degradation conditions of the composites. These results show that the materials used in the research, besides presenting an excellent degree of compatibilization, also reveal an improvement in the photodegradation potential of composites.

Resumo Com a determinação do quanto de biomassa florestal é gerada após as intervenções culturais é possível definir as áreas passíveis de exploração. Com isso, o objetivo do trabalho foi quantificar e estimar a oferta de biomassa de Pinus taeda L. disponível após as intervenções culturais. O experimento foi realizado em reflorestamentos nos municípios dos estados do Paraná e Santa Catarina, com idades de 3 anos (primeira desrama), 5 anos (segunda desrama), 7 anos (terceira desrama), 11 anos (primeiro desbaste) 19 anos (segundo desbaste), 23 e 33 anos (cortes rasos). Para cada idade foram amostradas 10 árvores e quantificados os componentes acículas, galhos, ponteira e casca. Após o corte raso, aos 23 anos houve maior disponibilidade de biomassa individual (372,6 kg.árv-1) e por unidade de área (144,4 t.ha-1), sendo composto principalmente por galhos (69,3%), seguido das acículas (17,9%), casca (11,0%) e ponteira (1,8%) por unidade de área. A correlação entre a massa dos componentes da biomassa por árvore e as variáveis independentes foi significativa e superior a 0,52. A menor correlação foi observada entre estas e a quantidade ofertada de ponteiras. Os modelos de regressão selecionados para estimar a massa de biomassa em função das variáveis independentes tiveram R2aju superiores a 83%, baixos desvios padrões e coeficientes de variação.

Abstract Along with the determination of how much of forest biomass is generated after the cultural interventions, it is possible to define areas that can be exploited. Thus, the objective of this work was to quantify and estimate the biomass supply of Pinus taeda L. available after cultural interventions. The experiment was carried out in populations in the cities of Paraná and Santa Catarina states, with ages of 3 years (first pruning), 5 years (second pruning), 7 years (third pruning), 11 years (first thinning), 19 years (second thinning), 23 and 33 years (harvesting). For each age, 10 trees were sampled and the components of the leaves, twigs, canopy and bark were quantified. After harvesting at 23 years old there was greater availability of individual biomass (372.6 kg. tree-1) and per unit area (144.4 t.ha-1), being composed mainly of twigs (69.3%), followed by leaves (17.9%), bark (11.0%) and canopy (1.8%) per unit area. The correlation between the mass of the components of the biomass per tree and the independent variables was significant and higher to 0.52. The lower correlation was observed between these and the mass of canopy. The regression models selected to estimate the mass of biomass from the independent variables had R2adju higher than 83%, low standard deviations and low coefficients of variation.

RESUMO Objetivo: Caracterizar o nível de deficiência em pacientes com hipertensão pulmonar (HP) com base no World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Método: Estudo prospectivo e observacional em pacientes com HP documentada (N = 46). Os pacientes completaram o questionário WHODAS 2.0 durante uma consulta de rotina, e seus dados demográficos e clínicos foram retirados de prontuários médicos eletrônicos. Nas visitas subsequentes, variáveis clínicas específicas foram registradas para avaliar a progressão da doença. Resultados: a pontuação no WHODAS 2.0 indicaram deficiência leve a moderada para os domínios de mobilidade (22,0 ± 23,2), atividades da vida (23,7 ± 25,5) e participação em sociedade (17,2 ± 15,9), assim como a pontuação total do WHODAS 2.0 (15,3 ± 15,2). Para os domínios de cognição (9,1 ± 14,1), autocuidado (8,3 ± 14,4) e relações interpessoais (11,7 ± 15,7), a pontuação foi mais baixa. Os pontos referentes à deficiência foram, em geral, proporcionais à gravidade da HP. Os principais parâmetros da deficiência foram a classificação de funcionalidade da Organização Mundial da Saúde (OMS), fatiga, dispneia, teste de caminhada de 6 minutos (TC6M), e a porção N-terminal do pró-hormônio do peptídeo natriurético do tipo B (NT-proBNP). Os valores de parâmetro do WHODAS 2.0 mostraram associações significativas com a progressão da doença. Porém, este efeito não foi transversal a todos os domínios; apenas alguns estiveram significativamente associados às variáveis da progressão da doença. Conclusão: Esta população com HP mostra deficiência leve, com níveis mais altos nos domínios de mobilidade e atividades da vida diária. Este estudo é o primeiro a avaliar a deficiência em HP usando o WHODAS 2.0. Outros estudos devem aplicar esta escala em populações maiores com HP, com representações de formas mais graves da HP.

ABSTRACT Objective: To characterise the degree of disability in pulmonary hypertension (PH) patients based on the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). Method: A prospective and observational study of patients with documented PH (N = 46). Patients completed the WHODAS 2.0 questionnaire during a scheduled routine clinical visit, and their demographic and clinical characteristics were retrieved from electronic medical records (EMR). In subsequent visits, selected clinical variables were registered to assess disease progression. Results: WHODAS 2.0 scores were indicative of mild to moderate disability for the domains of mobility (22.0 ± 23.2), life activities (23.7 ± 25.5), and participation in society (17.2 ± 15.9), as well as total WHODAS 2.0 score (15.3 ± 15.2). For the domains of cognition (9.1 ± 14.1), self-care (8.3 ± 14.4), and interpersonal relationships (11.7 ± 15.7), scores were lower. Disability scores were, generally, proportional to the PH severity. The main baseline correlates of disability were World Health Organisation (WHO) functional class, fatigue, dyspnoea, 6-minute walking distance (6MWD), and N-terminal pro b-type natriuretic peptide (NTproBNP). Baseline WHODAS 2.0 scores showed significant associations with disease progression. However, this effect was not transversal to all domains, with only a few domains significantly associated with disease progression variables. Conclusions: This PH population shows mild disability, with higher degree of disability in the domains of mobility and life activities. This study is the first one to assess disability in PH using WHODAS 2.0. Further studies should apply this scale to larger PH populations with suitable representations of more severe PH forms.

ABSTRACT The aim is to characterize and to compare the black (TBG) and gray (TGG) globe temperatures in the production of sheep in the Brazilian semi-arid, using Santa Inês and Doper breeds, distributed in two thermal environments (exposed to the sun and shaded), containing 10 animals in each picket. The experimental design was completely random, 2 x 2 factorial scheme (shaded environment and sun x black and gray globe) in 46 replicates (evaluation days). There was an increase of the TBG in relation to the TGG during the evaluation times, with maximum temperature (48.1°C) at 1p.m. in the environment exposed to the sun, concomitantly with elevation of the black globe temperature and humidity index - BGHI (96.7). The result was distinct for TGG, with a maximum temperature of 37.6°C and BGHI of 86.2 in the same environment. Regardless of the thermometer used, the BGHI values exceeded the considerable comfortable limit for sheep. Under shaded conditions, the globe temperatures showed similar behavior. In sunny conditions, these temperatures diverged, higher in the black, because of the absorption conditions of the thermal radiation of the different colors.

Introdução: A resistência aos antibióticos é uma realidade cada vez mais preocupante na atualidade, nomeadamente pela prevalência crescente de microrganismos multirresistentes, como as bactérias produtoras de betalactamases de espectro alargado (ESBL) e de carbapenamases. Este estudo pretendeu caracterizar os doentes com isolamento de estirpes produtoras de ESBL num hospital central. Material e Métodos: Foi realizado um estudo retrospetivo de 1 de janeiro a 30 de junho de 2014 que incluiu todos os casos de isolamento de bactérias produtoras ESBL ocorridos em adultos internados, em todos os serviços do Centro Hospitalar Universitário do Porto. Foram estudados os fatores de risco, as características clínicas e as opções terapêuticas. Resultados: Foram incluídos 132 isolamentos de estirpes produtoras de ESBL. A maioria dos doentes com bactérias produtoras de ESBL apresentavam um dispositivo invasivo (58,3%, n = 77). O isolamento das bactérias produtoras de ESBL ocorreu, em média, ao 21º dia de internamento. Parte dos doentes (19,7%, n = 26) apresentava história pregressa de isolamento por estes microrganismos e 65,2% (n = 86) já tinham estado ou estavam sob curso de antibiótico na altura do isolamento do agente multirresistente. A Klebsiella pneumoniae foi o agente mais frequentemente isolado (71,2%, n = 94) e a urocultura foi o produto microbiológico com mais alta taxa de isolamentos (62,1%, n = 82). A taxa de mortalidade foi de 6,8% (n = 9). Conclusão: A análise destes dados alerta para a importância da identificação dos doentes colonizados com estirpes produtoras de ESBL e do impacto da antibioterapia inadequada para a disseminação e persistências destes agentes.

Introduction: Resistance to antibiotics is an increasingly worrying reality today, namely by the increasing prevalence of multiresistant microorganisms, such as broad spectrum beta-lactamase (ESBL) and carbapenamase producing bacteria. This study aimed to characterize patients with microbiologic isolation of ESBL-producing strains in a tertiary hospital. Material and Methods:A retrospective study was carried out from the 1st of January to the 30th of June 2014 and included all cases of ESBL producing bacteria isolation in hospitalized adults, in all departments of the Centro Hospitalar Universitário do Porto. Risk factors, clinical characteristics and treatment options were evaluated. Results: A total of 132 isolates of ESBL producing strains were included. Most patients with ESBL-producing bacteria had an invasive device (58.3%, n = 77). Isolation of the ESBL-producing bacteria occurred, on average, at the 21st day of hospitalization. Part of the patients (19.7%, n = 26) had previous history of ESBL producing strain isolation and 65.2% (n = 86) had been or were under antibiotics at the time of isolation. Klebsiella pneumoniae was the most frequently isolated agent (71.2%, n = 94) and uroculture was the microbiological product with the highest isolation rate (62.1%, n = 82). The mortality rate was 6.8% (n = 9). Conclusion: The analysis of these data underlines the importance of identifying colonized patients with ESBL-producing strains and the impact of inadequate antibiotic therapy in the dissemination and persistence of these agents

Resumo Justificativa e objetivo O bloqueio do gânglio esfenopalatino é amplamente aceito em dor crônica; porém, esse bloqueio tem sido subestimado no tratamento de cefaleia pós-punção dural. O bloqueio do gânglio não restaura a dinâmica normal do líquido cefalorraquidiano, mas reduz de modo eficaz os sintomas associados à hipotensão resultante. Quando aplicado corretamente, pode evitar a realização de tampão sanguíneo epidural. A abordagem transnasal é uma técnica simples e minimamente invasiva. Nos casos apresentados, tentamos realizar o bloqueio do gânglio e relatar sua eficácia e duração usando ropivacaína. Características clínicas Apresentamos quatro pacientes de obstetrícia com cefaleia pós-punção dural, após técnica epidural ou técnicas combinadas, com agulha Tuohy (18 G), que foram submetidas ao bloqueio do gânglio esfenopalatino de forma segura e bem-sucedida. Realizamos o bloqueio após 24 a 48 horas da punção dural, com 4 mL de ropivacaína a 0,75% em cada narina. Em três casos, a dor voltou em 1-48 horas, embora menos intensa. Em uma paciente, um segundo bloqueio foi realizado com alívio completo e sem recorrência. Nas outras duas pacientes, um tampão sanguíneo foi feito sem sucesso. Todas as pacientes estavam assintomáticas dentro de sete dias. Conclusão A duração média do efeito analgésico do bloqueio continua mal definida. Nos casos relatados, o bloqueio com ropivacaína foi uma técnica simples, segura e eficaz, com alívio imediato e prolongado da dor durante pelo menos 12-24 horas.

Abstract Purpose Sphenopalatine ganglion block is widely accepted in chronic pain; however it has been underestimated in post dural puncture headache treatment. The ganglion block does not restore normal cerebrospinal fluid dynamics but effectively reduces symptoms associated with resultant hypotension. When correctly applied it may avoid performance of epidural blood patch. The transnasal approach is a simple and minimally invasive technique. In the cases presented, we attempted to perform and report the ganglion block effectiveness and duration, using ropivacaine. Clinical features We present four obstetrics patients with post dural puncture headache, after epidural or combined techniques, with Tuohy needle 18G that underwent a safe and successful sphenopalatine ganglion block. We performed the block 24-48 h after dural puncture, with 4 mL of ropivacaine 0.75% in each nostril. In three cases pain recurred within 12-48 h, although less intense. In one patient a second block was performed with complete relief and without further recurrence. In the other two patients a blood patch was performed without success. All patients were asymptomatic within 7 days. Conclusion The average duration of analgesic effect of the block remains poorly defined. In the cases reported, blocking with ropivacaine was a simple, safe and effective technique, with immediate and sustained pain relief for at least 12-24 h.