O estresse e a discriminação afetam negativamente a qualidade de vida, mas o apoio social pode amortecer seus efeitos. Os objetivos deste estudo são: (1) examinar as associações entre estresse psicológico, discriminação e qualidade de vida relacionada à saúde bucal (QVRSB); e (2) avaliar se apoio social, estresse e discriminação interagem para modificar suas associações com QVRSB. Os dados são de uma pesquisa transversal de base domiciliar de um estudo que incluiu 396 indivíduos com 14 anos ou mais de famílias registradas para benefícios federais em uma cidade no sul do Brasil. A QVRSB foi mensurada pelo Impactos Orais no Desempenho Diário (OIDP), enquanto o estresse psicológico foi avaliado pela Escala de Estresse Percebido (PSS). Além disso, o apoio social foi avaliado pelo número de parentes ou amigos próximos e a discriminação por meio da Escala de Discriminação Diária (EDS). As interações foram estimadas por meio do excesso relativo de risco devido à interação (RERI). Os efeitos ajustados foram calculados por meio de regressão logística. A prevalência de impactos bucais entre as pessoas com maior e menor escores de PSS foi de 81,6% e 65,5%, respectivamente (p < 0,01). O apoio social mostra interações inclusivas com níveis de estresse e discriminação. A associação entre discriminação social e QVRSB (escore OIDP > 0) foi OR = 2,03 (IC95%: 1,23; 3,34) dentre pessoas com baixo nível de estresse, mas foi de OR = 12,6 (IC95%: 1,31; 120,9) dentre aqueles com níveis mais altos (p = 0,09, para interação). Indivíduos que relataram níveis mais elevados de estresse psicológico e discriminação apresentaram pior QVRSB; o efeito sinérgico com o apoio social não foi evidente.

Stress and discrimination negatively affect quality of life, but social support may buffer their effects. This study aims: (1) to examine the associations between psychological stress, discrimination, and oral health-related quality of life (OHRQoL); and (2) to assess whether social support, stress and discrimination interact to modify their associations with OHRQoL. We used cross-sectional household-based data from a study including 396 individuals aged 14 years and over from families registered for government social benefits in a city in Southern Brazil. OHRQoL was measured with the Oral Impacts on Daily Performance (OIDP) scale; psychological stress was assessed with the Perceived Stress Scale (PSS); social support was assessed based on the number of close relatives or friends of the participant, and discrimination was assessed with a short version of the Everyday Discrimination Scale. Interactions were estimated using the relative excess of risk due to interaction (RERI). Adjusted effects were calculated with logistic regression. The prevalence of oral impacts among people with higher and lower PSS scores was 81.6% and 65.5%, respectively (p < 0.01). Social support was found to have no interactions with stress levels and discrimination. The association between social discrimination and OHRQoL (OIDP score > 0) was OR = 2.03 (95%CI: 1.23; 3.34) among people with a low level of stress, but was OR = 12.6 (95%CI: 1.31; 120.9) among those with higher levels (p = 0.09, for interaction). Individuals who reported experiencing higher levels of psychological stress and discrimination had worse OHRQoL; a synergistic effect with social support was not clear.

El estrés y la discriminación afectan negativamente a la calidad de vida, pero el apoyo social puede mitigar sus efectos. Los objetivos de este estudio son: (1) examinar las asociaciones entre el estrés psicológico, la discriminación y la calidad de vida relacionada con la salud bucal (CVRSB); y (2) evaluar si el apoyo social, el estrés y la discriminación interactúan para modificar sus asociaciones con la CVRSB. Los datos provienen de una encuesta transversal de hogares cuyo estudio incluyó a 396 individuos de 14 años o más de familias registradas en beneficios del gobierno en una ciudad del Sur de Brasil. La CVRSB se midió mediante el Impactos Orales en el Rendimiento Diario (OIDP), mientras que el estrés psicológico se evaluó mediante la Escala de Estrés Percibido (PSS). El apoyo social se basó en el número de familiares o amigos cercanos, y la discriminación en la Escala de Discriminación Cotidiana (EDS). Las interacciones se estimaron mediante el excesivo de riesgo relativo debido a la interacción (RERI). Los efectos ajustados se calcularon mediante regresión logística. La prevalencia de impactos orales entre las personas con puntajes de PSS más altas y más bajas fue del 81,6% y del 65,5%, respectivamente (p < 0,01). El apoyo social presenta interacciones inclusivas con niveles de estrés y discriminación. La asociación entre discriminación social y OHRQoL (puntuación OIDP > 0) fue OR = 2,03 (IC95%: 1,23; 3,34) entre personas con un nivel bajo de estrés, pero fue OR = 12,6 (IC95%: 1,31; 120,9) entre aquellos con niveles más altos (p = 0,09, para interacción). Las personas que informaron tener niveles más elevados de estrés psicológico y discriminación tuvieron una peor CVRSB; el efecto sinérgico con el apoyo social no estaba claro.

RESUMEN Introducción y objetivos: El tratamiento de los pacientes con fibrilación auricular no valvular (FANV) que requieren implante de stents coronarios es un desafío. El objetivo del estudio fue investigar si el cierre de la orejuela izquierda (COI) podría ser una opción posible y beneficiosa para estos pacientes. Para ello, se analiza el impacto del COI más tratamiento antiagregante plaquetario (AP) en comparación con la combinación de anticoagulantes orales (ACO), incluidos los ACO directos, y tratamiento AP en los resultados a largo plazo de estos pacientes Métodos: Se analizaron los resultados de 207 pacientes con FANV sometidos consecutivamente a implante de stents coronarios. Recibieron ACO 146 pacientes (74 acenocumarol, 71 ACO de acción directa) y en 61 se realizó COI. La mediana de seguimiento fue de 35 meses. Los pacientes también recibieron tratamiento AP por prescripción de su cardiólogo. El estudio recibió la debida supervisión ética. Resultados: La edad (media: 75,7 años) y el antecedente de accidente vascular cerebral fueron similares en ambos grupos, aunque el grupo de COI presentó más características desfavorables (antecedente de enfermedad de las arterias coronarias [CHA2DS2-VASc], antecedente de hemorragias significativas [BARC ≥ 2] y HAS-BLED). La aparición de acontecimientos adversos graves (muerte, accidente vascular cerebral, accidente isquémico transitorio, hemorragia grave) y cardiovasculares graves (muerte de causa cardiaca, accidente vascular cerebral, accidente isquémico transitorio, infarto de miocardio) fue significativamente mayor en el grupo de ACO que en el de COI: 19,75 frente a 9,06% (HR = 2,18; p = 0,008) y 6,37 frente a 1,91% (HR = 3,34; p = 0,037), respectivamente. Conclusiones: La combinación de COI y tratamiento AP en pacientes con FANV conlleva mejor pronóstico clínico a largo plazo que el tratamiento con ACO y terapia AP, a pesar de las características basales desfavorables del grupo de COI.

ABSTRACT Introduction and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients' long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Abstract This case-control study evaluated the gene expression levels of interleukin (IL)-4, macrophage inflammatory protein type 1 alpha (MIP-1α), and metalloproteinase (MMP)-9, factors involved in the formation of giant cells in healthy peri-implant tissue and peri-implantitis. Thirty-five subjects (15 healthy and 20 with peri-implantitis), who met the inclusion and exclusion criteria, were included in this study. The peri-implant tissue biopsies were subjected to total RNA extraction, DNAse treatment, and cDNA synthesis. Subsequently, the reaction of real-time PCR was performed to evaluate the gene expression levels of IL-4, MIP-1α, and MMP-9 concerning the reference gene. IL-4 gene expression showed higher (18-fold) values in the Peri-Implantitis Group of Patients when compared with the Healthy (Control) Group (p<0.0001). Although MIP- 1α and MMP-9 gene expression levels were higher in diseased implants, they showed no significant differences (p=0.06 and p=0.2337), respectively. Within the limitations of this study, the results showed that in tissues affected by peri-implantitis, only levels of Il-4 were increased when compared with tissues in the control group.

Resumo Este estudo caso-controle teve como objetivo avaliar a expressão gênica dos níveis de interleucina (IL)-4, proteína inflamatória de macrófagos tipo alfa 1 (MIP-1α) e metalopreoteinase (MMP)-9, todos fatores envolvidos na formação de células gigantes em tecidos peri-implantares saudáveis e com peri-implantite. Trinta e cinco indivíduos (15 saudáveis e 20 com peri-implantite) foram incluídos nesse estudo seguindo os critérios de inclusão e exclusão. Os tecidos peri-implantares foram submetidos a extração do RNA total, tratamento de DNAse e síntese de cDNA. Subsequentemente, a reação de PCR em tempo real foi realizada para avaliar os níveis da expressão de IL-4, MIP-1α, e MMP-9 em relação ao gene de referência. O nível de expressão de IL-4 foi estatisticamwente maior (18 vezes) nos tecidos de pacientes com peri-implantite quando comparados aos pacientes saudáveis (grupo controle) (p<0,0001). Embora os níveis de expressão de MIP- 1α e MMP-9 apresentassem maiores valores nos implantes doentes, esses níveis não foram estatisticamente significantes (p=0.06 and p=0.2337) respectivamente. Dentro das limitações desse estudo, os resultados mostraram que nos tecidos afetados pela peri-implantite, apenas os nívies de IL-4 estavam aumentados quando comparados ao grupo controle.

ABSTRACT BACKGROUND: Peritoneal carcinomatosis in gastric cancer is considered a fatal disease, without expectation of definitive cure. As systemic chemotherapy is not sufficient to contain the disease, a multimodal approach associating intraperitoneal chemotherapy with surgery may represent an alternative for these cases. AIMS: The aim of this study was to investigate the role of intraperitoneal chemotherapy in stage IV gastric cancer patients with peritoneal metastasis. METHODS: This study is a single institutional single-arm prospective clinical trial phase II (NCT05541146). Patients with the following inclusion criteria undergo implantation of a peritoneal catheter for intraperitoneal chemotherapy: Stage IV gastric adenocarcinoma; age 18–75 years; Peritoneal carcinomatosis with peritoneal cancer index<12; Eastern Cooperative Oncology Group 0/1; good clinical status; and lab exams within normal limits. The study protocol consists of four cycles of intraperitoneal chemotherapy with paclitaxel associated with systemic chemotherapy. After treatment, patients with peritoneal response assessed by staging laparoscopy undergo conversion gastrectomy. RESULTS: The primary outcome is the rate of complete peritoneal response. Progression-free and overall survivals are other outcomes evaluated. The study started in July 2022, and patients will be screened for inclusion until 30 are enrolled. CONCLUSIONS: Therapies for advanced gastric cancer patients have been evaluated in clinical trials but without success in patients with peritoneal metastasis. The treatment proposed in this trial can be promising, with easy catheter implantation and ambulatory intraperitoneal chemotherapy regime. Verifying the efficacy and safety of paclitaxel with systemic chemotherapy is an important progress that this study intends to investigate.

RESUMO RACIONAL: A carcinomatose peritoneal no câncer gástrico é considerada uma doença fatal, sem expectativa de cura definitiva. Como a quimioterapia sistêmica não é suficiente para conter a doença, uma abordagem multimodal associando a quimioterapia intraperitoneal à cirurgia pode representar uma alternativa para esses casos. OBJETIVOS: Investigar o papel da quimioterapia intraperitoneal em pacientes com câncer gástrico estágio IV com metástases peritoneais. MÉTODOS: Trata-se de um ensaio clínico prospectivo unicêntrico, braço único, fase II (NCT05541146). Pacientes com os seguintes critérios de inclusão serão submetidos à implantação de cateter peritoneal para quimioterapia intraperitoneal: adenocarcinoma gástrico estágio IV; idade 18-75 anos; carcinomatose peritoneal com índice de câncer peritoneal<12; ECOG 0/1; bom estado clínico e exames laboratoriais dentro da normalidade. O protocolo do estudo consiste em 4 ciclos de quimioterapia intraperitoneal com Paclitaxel associado à quimioterapia sistêmica. Após o tratamento, os pacientes com resposta peritoneal avaliada por laparoscopia serão submetidos à gastrectomia de conversão. RESULTADOS: O desfecho primário é a taxa de resposta peritoneal completa. A sobrevida livre de progressão e global são outros desfechos avaliados. O estudo foi iniciado em julho de 2022 e os pacientes serão selecionados para inclusão até que 30 sejam inscritos. CONCLUSIONS: Terapias para pacientes com câncer gástrico avançado foram avaliadas em ensaios clínicos, mas sem sucesso em pacientes com metástase peritoneal. O tratamento proposto neste estudo pode ser promissor, com fácil implantação do cateter e regime de quimioterapia intraperitoneal ambulatorial. Verificar a eficácia e segurança do Paclitaxel associado à quimioterapia sistêmica é um progresso importante que o presente estudo pretende investigar.

Abstract Prolonged overexposure to catecholamines causes toxicity, usually credited to continuous adrenoceptor stimulation, autoxidation, and the formation of reactive pro-oxidant species. Non-differentiated SH-SY5Y cells were used to study the possible contribution of oxidative stress in adrenaline (ADR)-induced neurotoxicity, as a model to predict the toxicity of this catecholamine to peripheral nerves. Cells were exposed to several concentrations of ADR (0.1, 0.25, 0.5 and 1mM) and two cytotoxicity assays [lactate dehydrogenase (LDH) release and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazolium bromide (MTT) reduction] were performed at several time-points (24, 48, and 96h). The cytotoxicity of ADR was concentration- and time-dependent in both assays, since the lowest concentration tested (0.1mM) also caused significant cytotoxicity at 96h. N-acetyl-cysteine (1mM), a precursor of glutathione synthesis, prevented ADR-induced toxicity elicited by 0.5mM and 0.25mM ADR following a 96-h exposure, while the antioxidant Tiron (100µM) was non-protective. In conclusion, ADR led to mitochondrial distress and ultimately cell death in non-differentiated SH-SY5Y cells, possibly because of ADR oxidation products. The involvement of such processes in the catecholamine-induced peripheral neuropathy requires further analysis.

ABSTRACT Objective: To describe the functional results, recurrence rate, postoperative radiographic appearance, and complications of patients undergoing the Latarjet procedure over 24 months. Methods: Retrospective case series, including adult patients with recurrent traumatic anterior glenohumeral dislocation undergoing the Latarjet procedure. We clinically evaluated patients preoperatively by the Rowe score and at six, 12, and 24 months after the procedure. The positioning, consolidation, and resorption of the graft were analyzed by plain radiography. The recurrence rates and other complications were also described. Results: We analyzed 40 patients (41 shoulders). The Rowe score median increased from 25 before surgery to 95 at 24 months after surgery (p < 0.001). We observed graft resorption in three cases (7.3%) and consolidation in 39 (95.1%). Most grafts presented adequate placement. We observed two recurrences (4.8%), one case of dislocation and one of subluxation. Seven patients (17.1%) had a positive apprehension test. The study had no cases of infection, neuropraxia, or graft breakage. Conclusion: Latarjet surgery is a safe and effective procedure in the treatment of recurrent anterior dislocation of the shoulder. This surgery enables a statistically significant improvement according to the Rowe score, with a low number of recurrences. Level of Evidence IV, Case Series.

RESUMO Objetivo: Descrever os resultados funcionais, a taxa de recidiva, o aspecto radiográfico pós-operatório e as complicações de pacientes submetidos ao procedimento de Latarjet ao longo de 24 meses. Métodos: Série de casos retrospectiva que inclui pacientes adultos com luxação glenoumeral recidivante anterior traumática submetidos ao procedimento de Latarjet. Avaliamos clinicamente os pacientes pela escala de Rowe pré-operatória e aos 6, 12 e 24 meses após o procedimento. O posicionamento, a consolidação e a reabsorção do enxerto foram analisados por radiografia simples. Descrevemos ainda as taxas de recidiva e as demais complicações. Resultados: Analisamos 40 pacientes (41 ombros). A mediana da escala de Rowe evoluiu de 25,0 antes da cirurgia para 95,0 passados 24 meses desde a cirurgia (p < 0,001). Foi observada reabsorção do enxerto em três casos (7,3%), e consolidação em 39 (95,1%). A maioria dos enxertos apresentava posicionamento adequado. Ocorreram duas recidivas (4,8%), sendo um caso de luxação e outro de subluxação. Sete pacientes (17,1%) referiam sensação de apreensão. Não ocorreram casos de infecção, neuropraxia ou quebra do enxerto. Conclusão: A cirurgia de Latarjet é um procedimento seguro e eficaz no tratamento da luxação anterior recidivante do ombro, possibilitando melhora funcional significativa de acordo com a escala de Rowe, com baixo número de recidivas. Nível de Evidência IV, Série de Casos.

Abstract Parasitism by gastrointestinal nematodes is a challenge for small ruminant farming worldwide. It causes productive and economic losses, especially due to parasite resistance to conventional anthelmintics. Natural compounds with antiparasitic activity are a potential alternative for controlling these parasites especially when considering the widespread occurrence of anthelmintic resistance. Our objective was to evaluate the activity of anacardic acid, geraniol, cinnamaldehyde and citronellal on Haemonchus contortus isolates with different levels of anthelmintic resistance profiles. These compounds were tested using egg hatch assays (EHAs), larval development tests (LDTs) as well as LDTs on mini-fecal cultures, on the Haemonchus contortus isolates Kokstad (KOK-resistant to all anthelmintics), Inbred-Strain-Edinburgh (ISE-susceptible to all anthelmintics) and Echevarria (ECH-susceptible to all anthelmintics). Effective concentrations to inhibit 50% (EC50) and 95% (EC95) of egg hatching and larval development were calculated. Results for EHA and LDT for all tested compounds, considering EC50 and EC95 values, showed low variation among the studied isolates with most RF values below 2x. All studied compounds showed efficacy against egg hatching and larval development of H. contortus isolates regardless of anthelmintic resistance profiles. The compounds with the smallest EC50 and EC95 values were cinnamaldehyde and anacardic acid making them promising candidates for future in vivo studies.

Resumo A infecção por nematoides gastrintestinais é um dos principais desafios na produção de pequenos ruminantes e ocasiona perdas produtivas, principalmente, devido à resistência anti-helmíntica. Bioativos com atividade anti-helmíntica são potencial alternativa para o controle desses parasitos em especial, considerando-se a ampla incidência de resistência anti-helmíntica nos rebanhos. O objetivo deste estudo foi avaliar a atividade biológica do ácido anacárdico, geraniol, cinamaldeído e citronelal em isolados de Haemonchus contortus com diferentes perfis de resistência anti-helmíntica. Foram realizados testes de eclosão de ovos (TEO), testes de desenvolvimento larvar (TDL) e TDLs em minicoproculturas, utilizando-se o isolado Kokstad (resistente a todos os anti-helmínticos), o isolado Inbred-Strain-Edinburgh (suscetível) e o isolado Echevarria (suscetível). Foram calculadas as concentrações efetivas para inibir 50% (CE50) e 95% (CE95) da eclodibilidade dos ovos e do desenvolvimento larvar. Resultados de TEO e TDL apresentaram baixa variação entre os diferentes isolados para um mesmo composto testado com fatores de resistência geralmente abaixo de 2x. Todos os compostos estudados mostraram eficácia contra a eclosão de ovos e desenvolvimento larvar de isolados de H. contortus independente do perfil de resistência anti-helmíntica dos mesmos. Os compostos que apresentaram atividade nas menores concentrações foram cinamaldeído e ácido anacárdico, sendo estes os componentes mais promissores para futuros estudos in vivo.

Abstract Based on the theoretical framework offered by the Narrative Analysis, this work seeks to analyze narratives of the life histories of poor women who have experienced violent marital relationships, describing the ways in which these women operate discursively with certain normative aspects socially established, linked to “gender” crossings, “race” and “social class”. We also observe how such crossings are articulated with contemporary social elements and systems, such as romantic love, religiosity, the value of work, meritocracy. In this way, especially in the “evaluations” of the narratives analyzed, we observe certain gender-based norms competing with new elements - such as the narrators' agency - characterized by establishing cracks on normative aspects, ratifying the position taken by Butler (2014) according which, although the category “gender” refers to the mechanism by which the notions of masculine and feminine are produced and naturalized, also puts these aspects in question, producing transformations in the generalized social conventions.

Resumen Partiendo del marco teórico proporcionado por el Análisis Narrativo, este trabajo examina las narrativas de historias de vida de mujeres pobres que experimentaron relaciones conyugales violentas, describiendo cómo estas mujeres operan discursivamente con ciertos aspectos normativos socialmente establecidos relacionados con las intersecciones de “género”, “raza” y “clase social”. También observamos cómo estas intersecciones se entrelazan con elementos y sistemas sociales contemporáneos, como el amor romántico, la religiosidad, el valor del trabajo y la meritocracia. En este camino, especialmente en las “evaluaciones” de las narrativas analizadas, observamos que ciertas normas de género establecidas compiten con nuevos elementos, como la agencia de las narradoras, que se caracterizan por abrir fisuras en aspectos normativos, ratificando la posición asumida por Butler (2014), según la cual, aunque la categoría “género” se refiere al mecanismo mediante el cual se producen y naturalizan las nociones de masculinidad y feminidad, también cuestiona estos aspectos, generando cambios en las convenciones sociales relacionadas con el género.

Resumo Partindo do quadro teórico oferecido pela Análise da Narrativa, este trabalho analisa narrativas de histórias de vida de mulheres pobres que vivenciaram relacionamentos conjugais violentos, descrevendo como essas mulheres operam discursivamente com determinados aspectos normativos estabelecidos socialmente, atrelados aos atravessamentos de “gênero”, “raça” e “classe social”. Observa-se também como os atravessamentos se articulam com elementos e sistemas sociais contemporâneos - o amor romântico, a religiosidade, o valor do trabalho, a meritocracia. Nesse caminho, sobretudo nas “avaliações” das narrativas analisadas, observamos determinadas normas instituídas de gênero concorrendo com novos elementos - tais como a agência das narradoras - caracterizados por estabelecer fissuras sobre aspectos normativos, ratificando a posição assumida por Butler (2014), segundo a qual, embora a categoria “gênero” faça referência ao mecanismo pelo qual as noções de masculino e feminino são produzidas e naturalizadas, também coloca esses aspectos em questão, produzindo transformações nas convenções sociais generificadas.

ABSTRACT Objective: To establish the implementation of nursing diagnoses and care for the spiritual dimension of people with cancer. Method: Action research in a university hospital in the north-east of Brazil. Nine nurses and thirteen nursing technicians from the Onco-hematology and Bone Marrow Transplant Unit of this hospital took part. Data collection took place in four phases and involved the talking map technique, pedagogical workshops and a logbook. The groups’ speeches were coded using Maxqda software, subjected to Braun and Clarke’s thematic analysis and interpreted in the light of Paulo Freire’s constructs. Results: Phase 1 sought to apprehend the participants’ prior knowledge on the subject; in phase 2, proposals emerged for spiritual care organized in the Nursing Process; in phase 3, the diagnoses and care plan for the spiritual dimension for clinical practice were contemplated; and in phase 4, through the final evaluation, it was possible to see the transformations that occurred in the nursing team’s practice with the proposed implementation. Conclusion: The educational actions provided significant learning for the nursing team and the implementation of diagnoses and nursing care for the spiritual dimension of people with cancer.

RESUMEN Objetivo: Establecer la implementación de diagnósticos y cuidados de enfermería para la dimensión espiritual de personas con cáncer. Método: Investigación-acción en un hospital universitario del nordeste de Brasil. Participaron nueve enfermeros y trece técnicos de enfermería de la Unidad de Oncohematología y Trasplante de Médula Ósea de este hospital. La recogida de datos se realizó en cuatro fases e incluyó la técnica del mapa parlante, talleres pedagógicos y un cuaderno de bitácora. Los discursos de los grupos se codificaron con el programa Maxqda, se sometieron al análisis temático de Braun y Clarke y se interpretaron a la luz de los constructos de Paulo Freire. Resultados: La fase 1 buscó captar los conocimientos previos de los participantes sobre el tema; en la fase 2, surgieron propuestas de cuidados espirituales organizados en el Proceso de Enfermería; en la fase 3, se contemplaron los diagnósticos y el plan de cuidados de la dimensión espiritual para la práctica clínica; y en la fase 4, a través de la evaluación final, fue posible ver las transformaciones ocurridas en la práctica del equipo de enfermería con la implementación propuesta. Conclusión: Las acciones educativas proporcionaron aprendizajes significativos para el equipo de enfermería y la implementación de diagnósticos y cuidados de enfermería para la dimensión espiritual de las personas con cáncer.

RESUMO Objetivo: Estabelecer a implementação de diagnósticos e cuidados de enfermagem à dimensão espiritual da pessoa com câncer. Método: Pesquisa-ação, em um hospital universitário do Nordeste do Brasil. Participaram nove enfermeiros e treze técnicos de enfermagem da Unidade de Oncohematologia e Transplante de Medula Óssea do referido hospital. A coleta de dados aconteceu em quatro fases e envolveu a técnica do mapa falante, oficinas pedagógicas e o diário de bordo. As falas dos grupos foram codificadas com auxílio do software Maxqda, submetidas à análise temática de Braun e Clarke e interpretadas à luz dos construtos de Paulo Freire. Resultados: A fase 1 buscou apreender o saber prévio dos participantes sobre a temática; na fase 2, surgiram propostas para o cuidado espiritual organizado no Processo de Enfermagem; na fase 3, contemplou-se os diagnósticos e plano de cuidados à dimensão espiritual para a prática clínica; e na fase 4, através da avaliação final, foi possível constatar as transformações ocorridas na prática da equipe de enfermagem com a implementação proposta. Conclusão: As ações educativas proporcionaram a aprendizagem significativa da equipe de enfermagem e implementação dos diagnósticos e cuidados de enfermagem à dimensão espiritual da pessoa com câncer.

Abstract Resolution 658/2022 of the Brazilian Regulatory Agency requires the determination of the permitted daily exposure (PDE) of pharmaceutical agents. Ginkgo biloba L. is used therapeutically to treat memory deficits and other brain diseases. However, published results indicate that more studies are needed to confirm the safety of Ginkgo biloba. This study aimed to evaluate the dry extract of Ginkgo biloba L. leaves PDE as an ingredient in an oral pharmaceutical product in preclinical studies using mice. Acute oral toxicity and repeated dose experiments were performed based on OECD guidelines, as well as genotoxicity tests. The results indicate that Ginkgo biloba L. has low acute toxicity, no liver toxicity, and does not alter blood glucose levels. No changes in weight gain were observed, but food intake decreased in males during the first week of treatment at the highest dose. Hematological parameters were not altered in males, whereas females presented lower leukocyte and lymphocyte counts and higher neutrophil counts at the highest dose. The lipid profile was not altered in males, whereas total cholesterol was increased in females. The estimated PDE was 0.1 mg/day and, when related to the maximum residual concentration, indicates that the cleaning process used is safe and does not require reassessment.

Resumo O pseudoaneurisma do arco palmar é uma entidade rara, cujo diagnóstico depende de alta suspeição clínica. Apresentamos o caso de um paciente encaminhado ao pronto-socorro com história de traumatismo penetrante por vidro na face palmar, com massa pulsátil e sangramento em jato. A ultrassonografia com Doppler evidenciou pseudoaneurisma parcialmente trombosado, e a angiotomografia demonstrou formação sacular originada do arco palmar superficial. Uma abordagem cirúrgica convencional foi indicada. Para prosseguir com o diagnóstico correto, essa suspeita clínica deve ser aventada. Modalidades de imagem são necessárias para identificar o pseudoaneurisma e planejar o curso do tratamento. No entanto, a sequência diagnóstica é individual, pois uma avaliação mais aprofundada, com diferentes métodos de imagem, pode não alterar o racional da intervenção. Em nossa experiência, a remoção cirúrgica convencional é preferível, visto sua segurança e seus resultados bem estabelecidos. rara prontosocorro pronto socorro jato trombosado superficial indicada correto aventada tratamento entanto individual aprofundada intervenção experiência preferível estabelecidos

Abstract Pseudoaneurysm of the palmar arch is a rare entity. Diagnosis is dependent on high clinical suspicion. We present a case referred to the emergency department, with a history of glass penetrating trauma to the palmar surface with a pulsatile mass and jet bleeding. Doppler ultrasound evidenced a partially thrombosed pseudoaneurysm. A CT angiography examination showed a saccular formation arising from the superficial palmar arch. A conventional surgical approach was indicated. A clinical suspicion must be ventured to arrive at the correct diagnosis. Imaging modalities are needed to identify the pseudoaneurysm and plan the treatment course. Nonetheless, the sequence of diagnosis is individual, because further evaluation with different imaging methods may not change the rationale for the intervention. In our experience, conventional surgical removal is preferable, due to its safety and well-established outcomes. entity department bleeding indicated course Nonetheless individual intervention experience preferable wellestablished well established outcomes

Abstract Enzymes are biological catalysts that play a key role in the food industry, responsible for desirable and undesirable chemical reactions. These compounds can occur spontaneously in food products or even be incorporated on purpose. The main enzyme classes (oxidoreductase, transferase, hydrolase, lyase, isomerase, and ligase) and their subclasses can be obtained from several sources, presenting numerous applications in foods such as inhibition of microorganisms, insertion of aromas, improvement of physico-chemical properties, decreased candy crystallization, meat tenderization, antioxidants, indicators of heat treatment, and so on. Each enzyme acts effectively under specific conditions of pH, temperature, concentration, and water activity. Enzymatic immobilization techniques have been studied to minimize adverse conditions that enzymes are subjected to during food processing. Among the immobilization technique, the enzymes can be immobilized to the packages, being known as enzymatic active packages, the packages allow the enzymes to be migrated to the product or trapped, increasing the shelf life of the products, this technique being innovative both for the packaging market and for the enzyme market. Thus, the main enzymes and their applications in food were briefly discussed in this review article, as well as the main techniques of immobilization and insertion of these compounds in active packaging. industry reactions purpose oxidoreductase, oxidoreductase (oxidoreductase transferase hydrolase lyase isomerase ligase sources microorganisms aromas physicochemical physico properties crystallization tenderization antioxidants treatment pH temperature concentration activity processing trapped Thus article

Abstract Soils are particulate materials, which often stand out for their low shear strength. In most cases, this aspect justifies adapting the geotechnical project for this characteristic, which can be even more problematic in the case of soft sands, since it often occurs in superficial layers in various parts of the metropolitan region of Fortaleza. Therefore, the soil improvement procedure with the addition of small cement fractions can be crucial. The content to be adopted should be such as to bring a more economically viable alternative to the geotechnical design of a shallow foundation, for example. The present research aims to propose a modified Mohr-Coulomb envelope for artificially cemented soils. The proposal is based on the development of two functions that relate shear strength parameters (cohesion and friction angle) with the cement content. In order to assess the proposed functions, triaxial shear tests were performed on the sand with different cement contents. The adjustments presented consistent results. In addition, the proposed envelope was validated using published results encountered in literature.

Abstract Objectives: To detect RSV or other thirteen respiratory viruses as possible causer agent of bronchiolitis in infants. Method: This is an epidemiological analytical study, conducted using a nasopharyngeal aspirate of 173 hospitalized children younger than two years old with severe bronchiolitis in three hospitals in the Campinas Metropolitan Region (CMR) during 2013-14. The data was statically evaluated by Pearson’s chi-squared test with statistical significance of 0.05 and 95% confidence level. Results: As expected, the most prevalent viruses detected were RSV A and B in 47% and 16% of the samples, respectively. However, almost a third of severe bronchiolitis cases there were no detection of RSV, and the viruses more commonly detected were rhinoviruses, which were identified in almost a quarter of all positive samples for at least a viral agent. Conclusions: Although nothing could be concluded from the disease severity and clinicalepidemiological data, the present study’s results indicate that severe bronchiolitis is not always related to RSV infections in children younger than two years old, and the rhinoviruses were more prevalent in these cases. These findings reinforce the need to carry out a

Abstract Given the polysemic and multidimensional nature of the notion of quality and its centrality and growing relevance in higher education, it is necessary to lay the foundations for conceptualizing it in terms of its context of application, in order to provide support and consistency to the design of specific policies. This paper presents the main methodological guidelines and findings of an exhaustive literature review focused on identifying the conceptions of quality in higher education in papers published in high-impact international journals between 2016-2020. Following the axial guidelines of the PRISMA-P method, 186 articles were selected out of 53,290 identified as part of the initial universe. Using open deductive coding, prevailing conceptions of the quality of higher education and its valued components were identified. Another noteworthy finding is the relevance of grouping these conceptions into two categories –“quality en soi” and “quality pour soi”– which are very similar to the positions taken in two very influential publications in Latin America. A crucial question arose as a consequence of the analysis of the articles submitted for review: who is responsible for determining the quality of a product or service in higher education? The answer to this question gave rise to the emergence of an alternative theoretical and conceptual positioning to those underlying the two categories: “quality pour qui” (quality for whom).

Resumen Dado el carácter polisémico y multidimensional de la noción calidad y de su centralidad y relevancia creciente en la educación superior, resulta necesario sentar bases que permitan conceptualizarla en función de su contexto de aplicación, de modo de dar sustento y consistencia al diseño de políticas focalizadas. El artículo expone los principales lineamientos metodológicos y resultados de una exhaustiva revisión bibliográfica orientada a esos efectos, centrada en la identificación de las concepciones sobre calidad de la educación superior en artículos publicados entre 2016 y 2020 en revistas de alto impacto internacional. Una vez finalizada la revisión, que siguió los lineamientos axiales del método PRISMA-P, quedaron seleccionados 186 artículos del universo inicial de 53 290. Un análisis por codificación abierta deductiva permitió identificar las concepciones predominantes de la calidad de la educación superior y sus componentes valorados como sustantivos. Otro de los resultados destacables es la pertinencia de agrupar esas concepciones en dos categorías —“calidad en soi” y “calidad pour soi”—, muy afines con las posiciones asumidas en dos textos muy influyentes en Hispanoamérica. Del análisis de los artículos seleccionados surgió una interrogante crucial: ¿a quién le corresponde determinar la calidad de un producto o servicio en educación superior? La respuesta a esta pregunta dio lugar a la emergencia de un posicionamiento teórico-conceptual alternativo a los subyacentes en esas categorías: “calidad pour qui” (calidad para quién, calidad para quiénes).