ABSTRACT Purpose: Acute mesenteric ischemia (AMI) is a condition in pediatric surgery that ranges from intestine necrosis to death. Ischemic postconditioning (IPoC) methods were developed to reduce the damage caused by revascularization. This study aimed to evaluate the efficacy of these methods in an experimental weaning rat model. Methods: Thirty-two 21-day-old Wistar rats were allocated into four groups according to the surgical procedure performed: control, ischemia-reperfusion injury (IRI), local (LIPoC) and remote IPoC (RIPoC). At euthanasia, fragments of the intestine, liver, lungs, and kidneys were submitted to histological, histomorphometric, and molecular analyses. Results: In the duodenum, intestines, and kidneys histological alterations promoted by IRI were reversed by remote postconditioning method. In the distal ileum, the histomorphometric alterations could be reversed by the postconditioning methods with more evident effects promoted by the remote method. The molecular analysis found that the levels of expression of Bax (proapoptotic) and Bcl-XL (antiapoptotic) genes in the intestine were increased by IRI. These alterations were equally reversed by the postconditioning methods, with more evident effects of the remote method. Conclusions: IPoC methods positively reduced the damage caused by IRI in weaning rats.

Abstract Background: Hirschsprung’s Disease (HD) is characterized by intestinal sub-occlusion and the absence of enteric ganglion cells. A rectal biopsy examination is performed to confirm the diagnosis. In a recent study, we demonstrated that the analysis of 60 sections of rectal mucosa and submucosa stained by H&E may ensure a 90% diagnostic accuracy. Although the need to analyze so many sections makes the process of reading the slides more time-consuming, this encouraged us to study their distribution in the healthy rectal submucosa, to simplify the diagnosis. Objectives: To develop a method that facilitates HD diagnosis by studying the distribution of ganglion cells in the submucosal plexus. Methods: Using the calretinin technique, we studied the distribution of plexuses in 60 fragments of rectal submucosa from 19 cadavers. After the study, the reading method created was used for diagnosis in 47 cases of suspected HD, using H&E staining. The accuracy was verified by comparing the results obtained with H&E to those obtained with the acetylcholinesterase technique, the golden standard in our laboratory. Results: The study of submucosal plexus distribution showed that just by examining the submucosal region every 20 µm, approximately, it is possible to locate a ganglionic plexus, and we have already been able to diagnose HD with 93% accuracy. Conclusion: The study of ganglion cell distribution enabled the creation of a simplified method for reading the slides. The method applied achieved good accuracy and it can be used as an alternative method in HD diagnosis.

RESUMO JUSTIFICATIVA E OBJETIVOS: Fatores psicossociais podem estar associados à dor multirregional, caracterizada por sintomas de dor em mais de uma parte do corpo. O objetivo do presente estudo foi determinar associações entre fatores psicossociais e dor multirregional em uma população de trabalhadores. MÉTODOS: Foi realizado um estudo transversal com 195 trabalhadores (professores, técnicos administrativos, profissionais de saúde, faxineiros e funcionários de zoológicos). Os fatores psicossociais foram avaliados por meio da versão abreviada da segunda versão do Copenhagen Psychosocial Questionnaire. A dor multirregional foi identificada por meio do Nordic Musculoskeletal Questionnaire. RESULTADOS: A dor multirregional foi associada com demandas quantitativas (OR=1,31; IC 95%: 1,06-1,63), ritmo de trabalho (OR=1,20; IC 95%: 1,01-1,43), demandas emocionais (OR=1,39; IC 95%: 1,18- 1,63), compromisso com o local de trabalho (OR=0,75; IC 95%: 0,62-0,91), previsibilidade (OR=0,86; IC 95%: 0,76-0,99), satisfação no trabalho (OR=0,53; IC 95%: 0,32-0,88), conflito trabalho-família (OR=1,37; IC 95%: 1,16-1,62), justiça (OR=0,81; IC 95%: 0,69-0,94), percepção geral de saúde (OR=0,54; IC 95%: 0,38-0,76), burnout (OR=1,41; IC 95%: 1,17-1,69) e estresse (OR=1,41; IC 95%: 1,18-1,68). CONCLUSÃO: Vários fatores psicossociais foram associados à dor multirregional, indicando que estes devem ser abordados no manejo da dor.

ABSTRACT BACKGROUND AND OBJECTIVES: Psychosocial factors may be associated with multisite pain, which is characterized by pain symptoms in more than one part of the body. The aim of the present study was to determine associations between psychosocial factors and multisite pain in a population of workers. METHODS: A cross-sectional study was conducted involving 195 workers (educators, administrative technicians, healthcare workers, cleaners, and zookeepers). Psychosocial factors were evaluated using the short form of the second version of the Copenhagen Psychosocial Questionnaire. Multisite pain was identified using the Nordic Musculoskeletal Questionnaire. RESULTS: Multisite pain was associated with quantitative demands (OR=1.31; 95% CI: 1.06-1.63), work pace (OR=1.20; 95% CI: 1.01-1.43), emotional demands (OR=1.39; 95% CI: 1.18-1.63), commitment to the workplace (OR=0.75; 95% CI: 0.62-0.91), predictability (OR=0.86; 95% CI: 0.76-0.99), job satisfaction (OR=0.53; 95% CI: 0.32-0.88), work-family conflict (OR=1.37; 95% CI: 1.16-1.62), justice (OR=0.81; 95% CI: 0.69-0.94), general health perception (OR=0.54; 95% CI: 0.38-0.76), burnout (OR=1.41; 95% CI: 1.17-1.69), and stress (OR=1.41; 95% CI: 1.18-1.68). CONCLUSION: Several psychosocial factors were associated with multisite pain, indicating that these factors could be considered in the multisite pain management.

ABSTRACT Purpose: To evaluate the caliber of an arterial micro-anastomosis in the young growing animal using a continuous suture technique. Additionally, late morphological changes and blood flows distal to the anastomosis were evaluated. Methods: Seventy-four Wistar rats were submitted to laparotomy to access the aorta for blood flow measurement. The aorta was sectioned using microsurgery technique and an end-to-end anastomosis with continuous suture. After a period of six months to one year, the anastomosis was checked. Results: Regarding the size of the aortas, comparing the pre- and postoperative values, there was an increase of 13.33% in adult animals and 25% in young animals, without any difference in the blood flows. Conclusions: The arteries of young rats show signs of growth at the site of the anastomosis performed with continuous suture.

ABSTRACT OBJECTIVES Translate and culturally adapt the short version of Copenhagen Psychosocial Questionnaire II (COPSOQ II) into Brazilian Portuguese (COPSOQ II-Br) and evaluate its psychometric properties. METHODS Translation and cultural adaptation followed the standardized guidelines. Structural validity was assessed using exploratory factorial analysis. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC3,1) and internal consistency by Cronbach’s alpha. Floor and ceiling effect was considered acceptable if less than 15% of participants reported the lowest or highest scores. Measurement error was assessed by standard error of measurement (SEM), while construct validity was tested by correlating the COPSOQ II-Br, the Job Content Questionnaire and the Nordic Musculoskeletal Questionnaire. RESULTS The study evaluated a total of 211 civil servants and service providers in the test and 157 in the retest. After cross-cultural adaptation, the COPSOQ II-Br structure comprised seven domains and 11 dimensions. Most dimensions showed acceptable floor and ceiling effects, excepting “Work family conflicts” (floor effect of 26.1%), and “Meaning and commitment” and “Job satisfaction,” with ceiling floor of 27.5% and 22.3%, respectively. Cronbach’s alpha values reached the recommended levels (varied between 0.70 and 0.87). Test-retest reliability indicated that all dimensions had ICC between 0.71 and 0.81. SEM ranged from 0.6 to 2.2 and the construct validity showed good results with the tested instruments (significant positive and negative correlations). CONCLUSIONS All psychometric properties of the short version COPSOQ II-Br are suitable for use in Brazil. The instrument is thus validated and can be used by occupational health and human resources professionals to evaluate psychosocial working conditions.

ABSTRACT OBJECTIVES Translate and culturally adapt the short version of Copenhagen Psychosocial Questionnaire II (COPSOQ II) into Brazilian Portuguese (COPSOQ II-Br) and evaluate its psychometric properties. METHODS Translation and cultural adaptation followed the standardized guidelines. Structural validity was assessed using exploratory factorial analysis. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC3,1) and internal consistency by Cronbach’s alpha. Floor and ceiling effect was considered acceptable if less than 15% of participants reported the lowest or highest scores. Measurement error was assessed by standard error of measurement (SEM), while construct validity was tested by correlating the COPSOQ II-Br, the Job Content Questionnaire and the Nordic Musculoskeletal Questionnaire. RESULTS The study evaluated a total of 211 civil servants and service providers in the test and 157 in the retest. After cross-cultural adaptation, the COPSOQ II-Br structure comprised seven domains and 11 dimensions. Most dimensions showed acceptable floor and ceiling effects, excepting “Work family conflicts” (floor effect of 26.1%), and “Meaning and commitment” and “Job satisfaction,” with ceiling floor of 27.5% and 22.3%, respectively. Cronbach’s alpha values reached the recommended levels (varied between 0.70 and 0.87). Test-retest reliability indicated that all dimensions had ICC between 0.71 and 0.81. SEM ranged from 0.6 to 2.2 and the construct validity showed good results with the tested instruments (significant positive and negative correlations). CONCLUSIONS All psychometric properties of the short version COPSOQ II-Br are suitable for use in Brazil. The instrument is thus validated and can be used by occupational health and human resources professionals to evaluate psychosocial working conditions.

ABSTRACT Purpose: To assess the biochemical, histological, histomorphometric and molecular effects of biliary duct ligation (BDL) induced liver cirrhosis in the heart and kidneys. Methods: Thirty-two weaning rats (21 days old, 50-70 g) underwent BDL and were divided in four groups (euthanasia after two, four, six, and eight weeks, respectively) and compared to control groups. Results: The animals’ hearts of group 3 were bigger than those of the control group (p=0.042), including thinner right ventricle wall, decreased internal diameter of ventricles, and increased perivascular collagen deposition in left ventricle, as well as increased interstitial collagen in right ventricle after six weeks. In the kidneys of groups 3 and 4, bilirubin impregnation in the tubules, hydropic degeneration, loss of nuclei and lack of plasmatic membrane limits were noted. Nitric oxide synthase (NOS) gene expressions were higher in group 1 (p=0.008), and endothelial nitric oxide synthase (eNOS) gene expressions were elevated in all experimental groups (p=0.008, p=0.001, p=0.022, and p=0.013, respectively). In the heart, a decreased expression of eNOS in group 1 (p=0.04) was observed. Conclusions: Liver cirrhosis leads to histological and histomorphometric alterations in the heart and kidneys, with changes in the NOS and eNOS gene expressions, that may suggest a role in the associated myocardial and renal manifestations.

OBJECTIVES: In cirrhotic children, infection events and sepsis are more frequent and more severe due to immune dysfunction. The objectives of the current study were therefore to develop an experimental model of infection and sepsis in cirrhotic weaning growing rats, by the use of bile duct ligation (BDL) and cecal ligation and puncture (CLP). Additionally, the correlation of the clinico-histopathological data and serial cytokine levels in septic cirrhotic and non-cirrhotic animals was studied. METHODS: Young Wistar rats of age 21 days and of weight between 70-90 g were divided into 12 groups according to the surgical procedure performed: sham (sacrificed after 2 or 4 weeks), BDL (sacrificed after 2 or 4 weeks), CLP (2- or 4-week old animals sacrificed after 12 or 24 hours), BDL+CLP (2- or 4-week old animals sacrificed after 12 hours). Histopathological studies and determination of serum levels of cytokines IL-1 beta, IL-10, and TNF-alpha, for studies of systemic infection, were performed. Murine sepsis scores (MSS) based on the clinical aspects just before euthanasia were also included. RESULTS: A transitory increase in IL-1, IL-10, and TNF-alpha levels was observed, with different patterns according to the groups. Two-hit groups tended to present with higher values of serum cytokines and histopathological scores than their septic non-cirrhotic counterparts. There was a correlation between mortality rate and MSS (p<0.0001). CONCLUSION: The model is feasible and may be utilized in studies on liver cirrhosis and infection in growing animals.

Resumo As correlações entre gênero, diversidade e educação estão presentes na sociedade e na escola. Em geral, na educação infantil quase não existem docentes do gênero masculino, por se entender que essa tarefa é mais adequada às mulheres. No entanto, em algumas culturas indígenas isso é diferente, fato que despertou o interesse em entender essa realidade. Assim, este trabalho tem como objetivo investigar a opinião da comunidade escolar de uma aldeia indígena, localizada no município de Tacuru (MS), acerca do trabalho desenvolvido por professores indígenas do gênero masculino na educação infantil. A pesquisa de campo é de natureza qualitativa e para coleta de dados foi feita a gravação de entrevistas semiestruturadas, realizadas inicialmente com quatro sujeitos: um professor, um gestor escolar, uma mãe de criança, sendo todos indígenas, e uma gestora municipal não índia. Os resultados foram transcritos, analisados e nomeados como dados primários. Este estudo também contou com a participação de um pesquisador da cultura indígena que relatou sua opinião em relação aos resultados obtidos com as entrevistas dos quatro primeiros participantes. Tal participação foi denominada como dados secundários. Os dados da pesquisa evidenciam que na cultura indígena as crianças vivem junto da comunidade onde todos são educadores em potencial, independente do gênero, de modo que o cargo de professor dentro de uma aldeia indígena pode ser considerado um cargo de prestigio. Além disso, para as mulheres indígenas é mais difícil sair da aldeia em busca de uma formação, o que pode explicar a significativa presença masculina na educação infantil na aldeia indígena pesquisada.

Abstract The correlations between gender, diversity and education are present in society and in school. In childhood education, in general, there are almost no male teachers, as the task is believed to be more appropriate for women. However, this view is different in some indigenous cultures, which has aroused the interest in understanding this reality. The aim of this study was to investigate the opinion of the school community of an indigenous village, located in the town of Tacuru (MS), about the work developed by indigenous male teachers in early childhood education. The field research is qualitative in nature and the data were collected by semi-structured interviews, initially conducted with four subjects: a teacher, a school manager, a child´s mother (all of them indigenous), and one non-indigenous municipal manager. The results were transcribed, analyzed and named as primary data. This study also had the participation of a researcher of the indigenous culture who reported his opinion regarding the results obtained from the interviews of the first four participants. Such participation was termed secondary data. The findings show that, in the indigenous culture, children live in a community where everybody is a potential educator, regardless of gender, and the post of a teacher can be considered a prestigious position. In addition, for indigenous women, it is more difficult to leave the village in search of training, which may explain the significant male presence in early childhood education in the indigenous village at issue.

OBJECTIVES: The purpose of this study was to present an experimental model of short bowel syndrome (SBS) in weaning rats and to compare the adaptative mechanisms of the remaining bowel in weaning rats and adult animals by means of morphometric, histologic and molecular methods. METHODS: Twenty-four weaning rats were divided into 3 groups of 8 animals, one control group and two short bowel groups (euthanasia after 4 and 21 days), and were compared with similar adult groups. Morphometric evaluations of the animals and histopathological and molecular studies of the remaining bowel were performed. RESULTS: The weight of young rats increased after enterectomy, whereas that of adult rats decreased after enterectomy (p<0.0001). The ratio of intestinal length/body weight was significantly higher in weaning rats than in adults (p<0.002), showing that intestinal growth was more intense in weaning rats. Intestinal resection promoted increased thickness of the small bowel lamina propria (p=0.001) and reduced thickness of the colon lamina propria (p=0.04) in weaning rats relative to those in adults. In addition, intestinal resection promoted increased expression of the Bcl-xl gene (antiapoptotic) in adult animals compared with that in weaning rats (p=0.001). CONCLUSION: Morphometric, histological and molecular differences were shown in the adaptation processes of growing and mature organisms.

OBJECTIVE: Intestinal ischemia-reperfusion injury occurs in several clinical conditions and after intestinal transplantation. The aim of the present study was to investigate the phenomena of apoptosis and cell proliferation in a previously described intestinal ischemia-reperfusion injury autograft model using immunohistochemical markers. The molecular mechanisms involved in ischemia-reperfusion injury repair were also investigated by measuring the expression of the early activation genes c-fos and c-jun, which induce apoptosis and cell proliferation. MATERIALS AND METHODS: Thirty adult male Wistar rats were subjected to surgery for a previously described ischemia-reperfusion model that preserved the small intestine, the cecum and the ascending colon. Following reperfusion, the cecum was harvested at different time points as a representative segment of the intestine. The rats were allocated to the following four subgroups according to the reperfusion time: subgroup 1: 5 min; subgroup 2: 15 min; subgroup 3: 30 min; and subgroup 4: 60 min. A control group of cecum samples was also collected. The expression of c-fos, c-jun and immunohistochemical markers of cell proliferation and apoptosis (Ki67 and TUNEL, respectively) was studied. RESULTS: The expression of both c-fos and c-jun in the cecum was increased beginning at 5 min after ischemia-reperfusion compared with the control. The expression of c-fos began to increase at 5 min, peaked at 30 min, and exhibited a declining tendency at 60 min after reperfusion. A progressive increase in c-jun expression was observed. Immunohistochemical analyses confirmed these observations. CONCLUSION: The early activation of the c-fos and c-jun genes occurred after intestinal ischemia-reperfusion injury, and these genes can act together to trigger cell proliferation and apoptosis.

OBJECTIVE: In most cases of pediatric liver transplantation, the clinical scenario of large-for-size transplants can lead to hepatic dysfunction and a decreased blood supply to the liver graft. The objective of the present experimental investigation was to evaluate the effects of ischemic preconditioning on this clinical entity. METHODS: Eighteen pigs were divided into three groups and underwent liver transplantation: a control group, in which the weights of the donors were similar to those of the recipients, a large-for-size group, and a large-for-size + ischemic preconditioning group. Blood samples were collected from the recipients to evaluate the pH and the sodium, potassium, aspartate aminotransferase and alanine aminotransferase levels. In addition, hepatic tissue was sampled from the recipients for histological evaluation, immunohistochemical analyses to detect hepatocyte apoptosis and proliferation and molecular analyses to evaluate the gene expression of Bax (pro-apoptotic), Bcl-XL (anti-apoptotic), c-Fos and c-Jun (immediate-early genes), ischemia-reperfusion-related inflammatory cytokines (IL-1, TNF-alpha and IL-6, which is also a stimulator of hepatocyte regeneration), intracellular adhesion molecule, endothelial nitric oxide synthase (a mediator of the protective effect of ischemic preconditioning) and TGF-beta (a pro-fibrogenic cytokine). RESULTS: All animals developed acidosis. At 1 hour and 3 hours after reperfusion, the animals in the large-for-size and large-for-size + ischemic preconditioning groups had decreased serum levels of Na and increased serum levels of K and aspartate aminotransferase compared with the control group. The molecular analysis revealed higher expression of the Bax, TNF-alpha, I-CAM and TGF-beta genes in the large-for-size group compared with the control and large-for-size + ischemic preconditioning groups. Ischemic preconditioning was responsible for an increase in c-Fos, IL-1, IL-6 and e-NOS gene expression. CONCLUSION: Ischemia-reperfusion injury in this model of large-for-size liver transplantation could be partially attenuated by ischemic preconditioning.