Health literacy (HL) is defined as a cognitive and social skill that determines the motivation and ability of individuals to understand and use information to promote and maintain proper health. Inadequate HL has been associated with worse outcomes in diabetes control, poor self-care, and higher hospitalization rates for some chronic diseases. We hypothesized that HL influences the prevalence of diabetic retinopathy (DR) among individuals with type 2 diabetes mellitus (T2DM) and that inadequate glycemic control would mediate this association. This was a cross-sectional study carried out with 288 participants of the “Brazilian Diabetes Study” cohort. Inclusion criteria were people diagnosed with T2DM aged between 40 and 70 years and ability to read and write. In the adequate HL group, DR was found in 16.5% of participants and in the inadequate HL group, it was found in 32.8% (P=0.0081). Individuals with inadequate HL had a higher risk of having DR, and this association was still statistically significant after adjusting for HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure. In conclusion, HL is related to DR without the mediation of classical clinical variables.

This experiment aimed at evaluating the effect of the dietary inclusion of caffeinated and decaffeinated coffee on the performance and internal and external egg quality of commercial layers. One hundred and twenty 25-week-old Hy-line Brown layers, with 1575 ± 91 average body weight, were distributed according to a completely randomized experimental design with three treatments (control, 1.2% caffeinated coffee, or 1.2% decaffeinated coffee) of five replicates of eight birds each. The inclusion of 1.2% caffeinated coffee was calculated to supply 6mg caffeine per kg body weight, which is considered a moderate dose. The applied treatments did not influence (p>0.05) feed intake, egg production, egg weight, egg mass, feed conversion ratio, Haugh units, yolk color or albumen and yolk percentages. The eggs of hens fed 1.2% caffeinated coffee presented lower (p<0.05) eggshell thickness and egg specific density. The eggs of layers fed 1.2% caffeinated coffee tended (p=0.0637) to present lower eggshell percentage. It was concluded that feeding caffeinated coffee to commercial layers does not affect their performance or internal egg quality; however, eggshell quality is impaired.

Background: In postoperative critically-ill patients who develop Acute Kidney Injury (AKI) it is important to focus on survival and quality of life beyond hospital discharge. The aim of the study was to evaluate outcome and quality of life in patients that develop AKI after major surgery. Methods: This retrospective study was carried out in a Post- Anaesthesia Care Unit with five intensive care beds during 2 years. Patients were followed for the development of AKI. Preoperative characteristics, intra-operative management and outcome were evaluated. Six months after discharge, these patients were contacted to complete a Short Form-36 questionnaire (SF-36) and to have their dependency in Activities of Daily Living (ADL) evaluated. Chi-square or Fischer's exact test were used to compare proportions between groups. A "t test" and a paired "t test" for independent groups was used for comparisons. Results: Of 1597 patients admitted to the PACU, 1200 patients met the inclusion criteria. One hundred-fourteen patients (9.6%) met AKI criteria. Patients with AKI were more severely ill, stayed longer at the PACU. Among 71 hospital survivors at 6 months follow-up, 50 completed the questionnaires. Fifty-two percent of patients reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients that met AKI criteria after surgery had worse SF-36 scores for physical function, role physical and role emotional domains. Six months after PACU discharge, patients that met AKI criteria were more dependent in Instrumental-ADL but not in Personal-ADL. Conclusions: Patients that develop AKI improved selfperception of quality of life despite having high rate of dependency in ADL tasks. For physical function and role physical domains they had worse scores than PACU patients that did not develop AKI.

Antecedentes: En pacientes posoperatorios críticamente enfermos que desarrollan insuficiencia renal aguda (IRA), es importante centrarse en la supervivencia y la calidad de vida una vez que se haya obtenido el alta. El objetivo del estudio era evaluar el resultado y la calidad de vida de los pacientes que desarrollan IRA tras haber experimentado una cirugía mayor. Métodos: este estudio retrospectivo se llevó a cabo en una Unidad de recuperación Posanestésica (URPA), con cinco camas de cuidado intensivo, durante 2 años. Se hizo un seguimiento de los pacientes para detectar el desarrollo de IRA, evaluando las características preoperatorias, la gestión de la operación y el resultado. Seis meses después de recibir el alta se contactó con estos pacientes para realizar un cuestionario SF-36 y para evaluar su grado de dependencia en actividades de la vida diaria (AVD). Para comparar proporciones entre grupos, se utilizó el test de Chi-cuadrado o test exacto de Fischer. Para realizar comparaciones se usó un test T y un test T para datos emparejados para grupos independientes. Resultados: De los 1597 pacientes ingresados en la URPA, 1.200 cumplían con el criterio de inclusión. Ciento catorce pacientes (9,6%) cumplían el criterio de IRA. Los pacientes con IRA padecían la enfermedad con un nivel de gravedad mayor, y su estancia en la URPA fue más prolongada. Durante una revisión realizada pasados 6 meses de los 71 supervivientes, 50 realizaron los cuestionarios. El 52% de los pacientes opinaron que su estado de salud el día del cuestionario era mejor que 12 meses antes. Los pacientes que cumplían con los criterios de IRA posquirúrgica obtuvieron una puntuación más negativa en los cuestionarios SF-36 en las áreas de funciones físicas, rol físico y rol emocional. Seis meses después de recibir el alta de la URPA, los pacientes que cumplían con los criterios de IRA eran más dependientes en lo que se refiere a las AVD instrumentales, pero no a las AVD personales. Conclusiones: los pacientes que desarrollaron IRA mejoraron su percepción de su calidad de vida, a pesar de tener una mayor dependencia en las tareas de la AVD. En las áreas de funciones físicas y rol físico, obtuvieron una puntuación más negativa que los pacientes en la URPA que no habían desarrollado IRA.

Introdução: A hepatite C é um importante problema de saúde pública. Em Portugal desconhece-se a verdadeira magnitude do problema e dispomos de poucos dados caracterizadores da doença, o que limita a eficácia de potenciais medidas preventivas. Objectivos: Caracterização da população seguida na consulta de hepatologia com o diagnóstico de hepatite C. Avaliação da eficácia terapêutica. Doentes e Métodos: Análise retrospectiva dos doentes com o diagnóstico de hepatite C seguidos na consulta de hepatologia, por um período de 10 anos (1995 - 2004). Resultados: Dos 618 doentes avaliados com idade média de 36,7 anos, 74% eram do sexo masculino, em 74% a via de transmissão foi a parentérica e 60,8% apresentavam genótipo 1. A associação Peginterferon e Ribavirina obteve taxas de resposta sustentada de 38% e 85% para os genótipos 1 e 3a, respectivamente. Foram observados 13 doentes com hepatite aguda C; em 83% dos casos em que se efectuou terapêutica houve negativação do ARN do vírus da hepatite C. Conclusão: A nossa série é composta maioritariamente por adultos jovens com hábitos toxicofílicos. Os genótipos predominantes foram os 1a/1b. A eficácia terapêutica foi semelhante à descrita na literatura. A terapêutica da hepatite C aguda acompanhou-se de uma elevada taxa de resposta sustentada.

Introduction: Hepatitis C is an important public health problem. Very limited data is available on Portuguese Hepatitis C patient population, which limits the effectiveness of potentials preventive measures. Aims: Characterization of the hepatitis C outpatients. Evaluation of the therapeutic effectiveness. Patients and Methods: Retrospective analysis of outpatients with hepatitis C diagnosis between January 1995 and December 2004. Results: A total of 618 patients were evaluated with a mean age of 36,7 years, 74% was male, in 74 % the transmission route was the parenteric and 60,8% was genotype 1. With the association Peginterferon and Ribavirin the sustained virologic response rates were 38% and 85% for genotypes 1 and 3a, respectively. Acute hepatitis C was observed in 13 patients; 83% of the treated patients achieved sustained virologic response. Conclusion: Our study group is composed mainly by young adults with history of intravenous drug use. Genotypes 1a/1b were the most prevalent. The therapeutic effectiveness was similar to other series. The treatment of acute hepatitis C had a high sustained virologic response rate.

Objectivos: Analisar a evolução da prática da colonoscopia na Unidade de Endoscopia do Hospital São Bernardo. Metodologia: Análise retrospectiva das colonoscopias efectuadas em 1997 (ano que precedeu o lançamento da Campanha de Rastreio do Cancro Colorrectal pela Sociedade Portuguesa de Endoscopia Digestiva) e 2003 (ano da inauguração das novas instalações da Unidade de Endoscopia). Foram considerados: sexo, idade, proveniência dos doentes, indicações para o exame, uso de sedação, nível do cólon atingido, qualidade da preparação intestinal, diagnósticos e tratamentos efectuados. Resultados: Em 1997 e em 2003 foram efectuadas, respectivamente, 917 e 1207 colonoscopias. Em 2003, os doentes foram referenciados mais frequentemente pelo Serviço de Gastrenterologia (60% vs. 40%, em 1997, p<0,001); um maior número foi sedado (25% vs. 5%, p<0,001) e apresentavam uma melhor qualidade da preparação intestinal (boa qualidade: 54% vs. 40%, p<0,001); também se verificou uma maior frequência de colonoscopias com indicação correcta (70% vs. 64%, p<0,01) e menos doentes submetidos a colonoscopia em regime de internamento (21% vs. 34%, p<0,001) e de urgência (18% vs. 26%, p<0,001). A frequência do rastreio aumentou significativamente, passando de 1,3% para 8,8% dos exames (p<0,001). Em contrapartida, não foram encontradas diferenças na percentagem de colonoscopias totais (73% vs. 71% em 1997), normais (37% em ambos os anos) ou nos motivos para colonoscopia incompleta. Conclusões: O lançamento da Campanha de Rastreio do cancro colorrectal e as mudanças introduzidas na organização e funcionamento da Unidade de Endoscopia, após a inauguração das novas instalações, tiveram um impacto benéfico na prática da colonoscopia no Serviço de Gastrenterologia do Hospital São Bernardo.

Objective: To characterise the evolution of colonoscopy practice in the Endoscopy Unit of Hospital São Bernardo. Methods: A retrospective study in patients who underwent colonoscopy in 1997 (the year prior to the launch of the Portuguese Society of Digestive Endoscopy’s colorectal cancer screening campaign) and in 2003 (the year the Endoscopy Unit’s new facilities were inaugurated). Data collected included: patient gender, age and geographical origin; whether the procedure was ambulatory or inpatient, routine or emergency, the quality of the bowel prep, whether or not sedation was used, informed consent, indication, extent of the visualization of the colon and final outcome (endoscopic and histological). The indications were also compared with ASGE recommendations. Results: In 1997 and in 2003, 917 and 1207 colonoscopies, respectively, were performed. In 2003, the patients were more often referred from the Gastroenterology Department (60% vs. 40%, in 1997, p < 0.001); a greater number of patients were sedated in 2003 (25% vs. 5%, p < 0.001). In 2003 the patients had better intestinal preparation good quality: 54% vs. 40%, p < 0.001). In addition, a greater number of the colonoscopies were done based on a correct indication according to ASGE (70% vs. 64%, p < 0.01) and fewer patients underwent colonoscopy as inpatients (21% vs. 34%, p < 0.001) and fewer exams were urgent (18% vs. 26%, p < 0.001). The frequency of the screening increased significantly, accounting for 1,3% of exams in 1997 and 8,8% in 2003 (p < 0.001). However, we found no differences in the percentage of total colonoscopies (73% vs. 71% in 1997), normal exams (37% in both years) or the reasons for incomplete colonoscopy. Conclusions: The start of the colorectal screening campaign and changes made in the organization of the Endoscopy Unit, after the inauguration of the new facilities, had a positive impact on colonoscopy practice in the Gastrenterology Department of Hospital São Bernardo.

Scorpionism is a common problem that occurs in tropical and subtropical countries and assumes great medical-sanitary importance due to its fatal effect on sensitive individuals, being able to lead children and aged people to death. The envenomation lethal potential is responsible for the serious cardiopulmonary alterations the scorpion toxin produces in its victims. The present research evaluated the effects of Tityus serrulatus venom on dogs, using two distinct doses: a dose that simulates natural envenomation (0.4 mg/total dose), and an experimental dose (0.25 mg/kg). General clinical signs were observed at different moments after envenomation, and specific data related to the cardiopulmonary system were evaluated by systemic arterial pressure measurement, CK-MB enzymatic activity dosage, and radiographic, electrocardiographic and echocardiographic examinations. Results demonstrated that the scorpion venom, in experimental doses, was able to cause acute and reversible cardiac injury in few days, and, in the dose that simulated natural accident, it produced clinical signs of light envenomation, such as local pain, hyperesthesia, sialorrhea, vomiting, diarrhea, sneeze and prostration.

Índices biológicos baseados na biomassa (peso seco, conteúdo de cinzas e clorofila a) do perifíton em substrato natural (folhas submersas de Typha domingensis Pers) e artificial (mangueiras plásticas) foram comparados, em experimentos realizados durante o verão e o inverno, em duas estações de amostragem da lagoa Imboassica, Macaé, Rio de Janeiro. A comunidade perifítica apresentou baixa biomassa nas fases iniciais e finais dos experimentos e biomassa média nas fases intermediárias, independente do tipo de substrato, estação de amostragem e período estudado. Em ambos os períodos, houve variação espacial com relação ao grau de trofia do perifíton em razão da diferença de disponibilidade de nutrientes entre as estações de amostragem. As alternâncias do perifíton inorgânico e orgânico, heterotrófico, hetero-autotrófico, auto-heterotrófico e autotrófico se deveram a mudanças nos fatores abióticos nas estações de amostragem nos períodos estudados. O índice de Lakatos mostrou-se mais sensível às variações na composição da comunidade perifítica do que o Indíce Autotrófico.

Biological indices based on the biomass (dry weight, ash content, and chlorophyll-a) of the periphyton in a natural (submersed leaves of Typha domingensis Pers) and in an artificial (plastic hoses) substrate were compared, in experiments performed in summer and winter, in two sampling stations of Imboassica Lagoon, Macaé, Rio de Janeiro. The periphytic community exhibited low biomass at the beginning and end of the experiments, and moderate biomass in the intermediate period of the experiment, whatever the kind of substrate, sampling station, and season. In both seasons, there was a spatial variation regarding the degree of trophy of the periphyton, due to the difference of nutrient availability among the sampling stations. The alternation of inorganic and organic periphyton, as well as of their heterotrophic, hetero-autotrophic, auto-heterotrophic and, autotrophic character was due to changes in the abiotic factors of the sampling periods. The Lakatos index proved more sensitive than the Autotrophic Index to variations in the composition of the periphytic community.