Resumen Objetivo Comprender el significado del dolor pélvico crónico bajo la perspectiva de mujeres diagnosticadas y analizar los factores determinantes para el alta ambulatoria. Métodos Investigación de naturaleza cualitativa, que utilizó el marco referencial teórico metodológico de la investigación social estratégica. Participaron en el estudio 14 mujeres, de las cuales siete estaban realizando seguimiento ambulatorio y siete fueron dadas de alta, en consultorios externos de ginecología de un hospital universitario en el municipio de Goiânia, Goiás, Brasil. Se realizaron entrevistas semiestructuradas, con preguntas orientadoras. El análisis de los resultados se basó en la modalidad temática del análisis de contenido, de acuerdo con Bardin. Resultados El análisis de los datos culminó en tres categorías temáticas: Antes del dolor, Convivir con el dolor y Tratar el dolor. El abandono afectivo parental, el duelo, falta de entendimiento con los padres y dificultades en la infancia fueron prominentes antes del inicio del dolor. El surgimiento del dolor se relacionó con el nacimiento de los hijos, menarca, cirugías y conflictos familiares. La convivencia con el dolor causó gran sufrimiento, miedo, perjuicio en las relaciones y en la actividad laboral. La mejora del estado emocional y de las condiciones financieras, la resolución de los conflictos matrimoniales, la oportunidad de poder expresarse y hablar con otras pacientes, el uso de medicamentos y algunos procedimientos quirúrgicos fueron determinantes para el control del dolor y el alta ambulatoria. Conclusión El dolor pélvico crónico se relacionó con el sufrimiento socioeconómico, emocional y físico. La resolución de estos aspectos contribuyó al alta ambulatoria. ambulatoria cualitativa estratégica 1 Goiânia Goiás Brasil semiestructuradas orientadoras contenido Bardin temáticas parental duelo hijos menarca familiares miedo laboral financieras matrimoniales pacientes socioeconómico físico

Abstract Objective To understand the meaning of chronic pelvic pain from the perspective of diagnosed women and analyze the determining factors for outpatient discharge. Methods This is qualitative research, using strategic social research as its theoretical methodological framework. 14 women participated in the study, seven of whom were undergoing outpatient follow-up and seven who were discharged from the gynecology outpatient clinic of a university hospital in the city of Goiânia, Goiás, Brazil. Semi-structured interviews were carried out with guiding questions. The analysis of results was based on the thematic modality of content analysis, according to Bardin. Results Data analysis culminated in three thematic categories: “Before the pain”, “Living with the pain” and “Treating the pain”. Parental emotional abandonment, grief, disagreement with parents and childhood difficulties were prominent before the onset of pain. The onset of pain was related to the birth of children, menarche, surgeries and family conflicts. Living with pain promoted great suffering, fear, harm to relationships and work activity. The improvement in emotional state and financial conditions, the resolution of marital conflicts, the opportunity to express oneself and talk to other patients, the use of medication and some surgical procedures were decisive for pain control and outpatient discharge. Conclusion Chronic pelvic pain was related to socioeconomic, emotional and physical suffering. The resolution of these aspects contributed to outpatient discharge. discharge framework 1 study followup follow up Goiânia Goiás Brazil Semistructured Semi structured questions Bardin categories Before pain, , Treating . abandonment grief children menarche conflicts suffering fear activity conditions patients socioeconomic

Resumo Objetivo Compreender o significado da dor pélvica crônica sob a ótica das mulheres diagnosticadas e analisar os fatores determinantes para a alta ambulatorial. Métodos Pesquisa de natureza qualitativa, tendo como referencial teórico metodológico a Pesquisa Social do tipo Estratégica. Participaram do estudo 14 mulheres, sendo sete em seguimento ambulatorial e sete que receberam alta, no ambulatório de ginecologia de um hospital universitário no município de Goiânia, Goiás, Brasil. Foram realizadas entrevistas semiestruturadas, com questões norteadoras. A análise dos resultados baseou-se na modalidade temática da análise de conteúdo, segundo Bardin. Resultados A análise dos dados culminou em três categorias temáticas: “Antes da dor”, “Convivendo com a dor” e “ Tratando a dor”. O abandono afetivo parental, o luto, o desentendimento com os pais e dificuldades na infância foram proeminentes antes do início da dor. O surgimento da dor relacionou-se ao nascimento dos filhos, menarca, cirurgias e conflitos familiares. A convivência com a dor promoveu grande sofrimento, medo, prejuízo aos relacionamentos e à atividade laboral. A melhora do estado emocional e das condições financeiras, a resolução dos conflitos matrimoniais, a oportunidade de poder expressar-se e conversar com outras pacientes, o uso de medicamentos e alguns procedimentos cirúrgicos foram determinantes para o controle da dor e da alta ambulatorial. Conclusão A dor pélvica crônica relacionou-se a sofrimentos socioeconômicos, emocionais e físicos. A resolução destes aspectos contribuíram para a alta ambulatorial. qualitativa Estratégica 1 Goiânia Goiás Brasil semiestruturadas norteadoras baseouse baseou se conteúdo Bardin temáticas Antes dor, , Convivendo . parental luto relacionouse relacionou filhos menarca familiares sofrimento medo laboral financeiras matrimoniais expressarse expressar pacientes socioeconômicos físicos

ABSTRACT Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown positive renal outcomes in diabetic patients. There is also emerging evidence in non-diabetic patients. This review was conducted to analyse the renal outcomes of SGLT2i in patients without diabetes mellitus (DM). Methods: A systematic review was performed in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant manner. We included only randomized trials that examined the effect of SGLT2i on renal outcomes in non-diabetic patients. Results: A total of ten randomized trials were included with a combined cohort of 26 298 patients. There was a tendency for lesser risk of adverse renal outcomes in heart failure (HF) patients with reduced ejection fraction (EF) (hazard ratio (HR) 0.50-0.71). Lesser effect on adverse renal outcomes was seen in HF patients with preserved EF (HR 0.95). For both preserved and reduced EF HF, there was a statistically significant reduction in the rate of decline in estimated glomerular filtration rate (eGFR) (p<0.001). On a short follow-up, there was a significant reversible reduction in GFR. In the long term, chronic kidney disease (CKD) proteinuric patients had a statistically significant lesser risk of adverse renal outcomes (p<0.001) and a significant reduction in albuminuria (p=0.0016). CKD patients, including non-proteinuric, had a significant reduction in the rate of kidney disease progression (HR = 0.71). Conclusion: Treatment with SGLT2i significantly reduces the rate of kidney disease progression in CKD non-diabetic patients with eGFR ≥ 20 mL/min/1.73 m2. Benefit seems greater in proteinuric patients. Benefit for eGFR < 20 mL/min/1.73 m2, dialysis and kidney transplant patients is yet to be defined.

ABSTRACT Background: The long-term effects of schistosomiasis on the glomerulus may contribute to the development of chronic kidney disease. This study aimed to investigate baseline Schistosoma mansoni-Circulating Anodic Antigen (CAA) levels and their association with kidney biomarkers related to podocyte injury and inflammation in long-term follow-up after praziquantel (PZQ) treatment. Methods: Schistosoma infection was diagnosed by detecting CAA in urine using a quantitative assay based on lateral flow using luminescent up-converting phosphor reporter particles. A cutoff threshold of 0.1 pg/mL CAA was used to diagnose Schistosoma infection (baseline) in a low-prevalence area in Ceará, Northeast, Brazil. Two groups were included: CAA-positive and CAA-negative individuals, both of which received a single dose of PZQ at baseline. Urinary samples from 55 individuals were evaluated before (baseline) and at 1, 2, and 3 years after PZQ treatment. At all time points, kidney biomarkers were quantified in urine and adjusted for urinary creatinine levels. Results: CAA-positive patients had increased baseline albuminuria and proteinuria and showed greater associations between kidney biomarkers. CAA levels correlated only with Vascular Endothelial Growth Factor (VEGF) (podocyte injury) levels. Increasing trends were observed for malondialdehyde (oxidative stress), monocyte chemoattractant protein-1 (inflammation marker), and VEGF. In the follow-up analysis, no relevant differences were observed in kidney biomarkers between the groups and different periods. Conclusions: S. mansoni-infected individuals presented subclinical signs of glomerular damage that may reflect podocyte injury. However, no causal effect on long-term renal function was observed after PZQ treatment. Background longterm long term disease mansoniCirculating mansoni Circulating (CAA followup follow up (PZQ treatment Methods upconverting converting particles 01 0 1 0. pgmL pg mL (baseline lowprevalence low prevalence Ceará Northeast Brazil included CAApositive positive CAAnegative negative 5 2 points Results VEGF (VEGF oxidative stress, stress , stress) protein1 protein protein- marker, marker marker) analysis periods Conclusions S mansoniinfected infected However

Abstract The segment of isotonic beverages has been expanding its market, introducing new flavors and meeting the growing demand for new products. Cajuína, a drink for which Piaui holds a geographical indication certificate, was used in the development of a new sports drink. This work aimed to evaluate the shelf life of isotonic cajuína beverages conditioned at room temperature and under refrigeration, by analyzing the physicochemical, sensorial, and microbiological parameters. The analyzed samples had stable pH (< 3.0), titratable total acidity (0.18 g/100 mL), and °Brix (6.1 °Brix), and presented an acceptable soluble solids total/total titratable acidity (SST/ATT) ratio during storage. There was a vitamin C reduction of 83.3% and 75.27% from the initial amount in the beverage samples stored at room temperature and under refrigeration, respectively. Sensory analysis using the 9-point hedonic scale indicated good acceptance of the sports drink, and good buying intention. The sports drink also demonstrated high microbiological quality, with the absence of total coliforms, E. coli, molds, yeasts and Salmonella sp. The data from the stability study indicated that the isotonic cajuína drink retains its quality and safety, and can thus be consumed, for up to 150 days of storage.

ABSTRACT Dialysate sodium prescription is often standardized. In some patients, this can be hypernatremic compared to serum sodium, causing a positive sodium balance at the end of treatment that will contribute to increased extracellular volume and interdialytic weight gain. A prospective study was carried out to monitor and compare the clinical implications between different prescriptions of sodium dialysate (isonatremic versus hyponatremic hemodialysis). For that purpose, we included hemodialysis patients in treatment for at least 9 months. The individual sodium setpoint was determined through the median of pre-dialysis sodium measurements, carried out for 6 treatments. The prescribed dialysate sodium was equal to the setpoint (isonatremic period) for 4 weeks and then 2 meq/L inferior to the setpoint (hyponatremic period) for another 4 weeks. The main outcome was interdialytic weight gain. Secondary outcomes were ultrafiltration rate, blood pressure at the beginning of treatment, intradialytic complications, and qualitative assessment of symptoms. Twenty patients were included. Pre-dialysis serum sodium assessments in both periods tended to be patient specific with a stable value. The interdialytic weight gain was lower in the hyponatremic period (1.83±0.50 kg versus 2.04±0.58 kg) but without statistical significance (p value=0.387). The same trend was found in mean ultrafiltration and blood pressure. Dialysis complications were low in both periods. The percentage of cramps and hypotension requiring intervention was higher in the hyponatremic period with no statistically significant differences. Concerning thirst, there was a symptomatic improvement with sodium customization. This improvement was even more significant in the hyponatremic period. This study allowed us to reinforce the existence of a “sodium setpoint” for each patient and the importance of an individualized dialysis prescription. Our results suggest the safety of using isonatremic hemodialysis with improving patients’ symptoms. Regarding hyponatremic hemodialysis, despite being beneficial, it seemed to be associated with a higher number of complications.

Resumo: As tecnologias de informação e comunicação (TIC) revolucionaram o quotidiano das sociedades e o desenvolvimento da economia à escala mundial. No turismo, a transformação digital assume um papel central, contribuindo para a divulgação dos produtos e serviços turísticos, permitindo que os stakeholders e turistas usufruam dos benefícios da globalização e das mudanças sociais. O turismo sénior é considerado um sector em forte expansão e, como tal, importa compreender a importância que estes turistas atribuem a estas tecnologias. Através de uma pesquisa na base de dados b-on e ScienceDirect, foram analisados artigos em texto integral, filtrando-os em várias etapas de forma a selecionar somente os que cumpriam os critérios de inclusão. A presente revisão sistemática de literatura ambiciona contribuir para a compreensão da utilização que os turistas seniores fazem das TIC. Em resultado deste processo, foi possível constatar a tendência crescente do recurso às TIC pelos turistas seniores, que se beneficiam de novas experiências. As TIC potenciam o marketing dos stakeholders, melhoram a comunicação com os turistas e promovem destinos turísticos mais sustentáveis e inteligentes, incluindo as mais inovadoras como a realidade aumentada.

Abstract: Information and communication technologies (ICT) have revolutionized the daily lives of society and the global economy development. In tourism, digital transformation takes on a central role, contributing to the promotion of tourism products and services and enabling stakeholders and tourists to enjoy the benefits of globalization and social changes. Senior tourism is considered a growing market niche and, as such, it is important to understand the importance that these tourists address to these technologies, including the most innovative ones such as augmented reality. Through a search in the database b-on and ScienceDirect, articles in full text were analyzed, filtering them in several stages in order to select only those that met the inclusion criteria. As a result of this process, it was possible to verify the growing trend of ICT use by senior tourists, who benefit from new experiences. ICT enhances stakeholder’s marketing, communication with tourists more sustainability and smarter tourist destinations promotion.

Resumen: Las tecnologías de la información y la comunicación (TIC) han revolucionado la vida cotidiana de las sociedades y el desarrollo de la economía en todo el mundo. En el turismo, la transformación digital juega un papel central, contribuyendo a la difusión de los productos y servicios turísticos, permitiendo a los interesados y turistas disfrutar de los beneficios de la globalización y los cambios sociales. El turismo senior es considerado un sector en auge y, como tal, es importante comprender la importancia que estos turistas otorgan a estas tecnologías, incluidas las más innovadoras, como la realidad aumentada. Esta revisión sistemática de la literatura tiene como objetivo contribuir a la comprensión del uso que los turistas mayores hacen de las TIC. Como resultado de este proceso, se pudo ver la tendencia creciente del uso de las TIC por parte de los turistas mayores, quienes se benefician de nuevas experiencias. Las TIC mejoran el marketing de las partes interesadas, mejoran la comunicación con los turistas y promueven destinos turísticos más sostenibles e inteligentes.

ABSTRACT Introduction: Antineutrophil cytoplasmic autoantibodies (ANCAs) are crucial in the pathogenesis of ANCA-associated glomerulonephritis. Although highly specific for this disease, these antibodies can appear in healthy individuals or occur in other settings such as malignance, other inflammatory disease, or drugs. Renal biopsy remains essential for diagnosis and as a prognostic tool. Failing to perform a biopsy risks an incomplete evaluation or misdiagnosis. Clinical case: A 60-year-old male known to have had previous normal kidney function was admitted with generalized pitting edema, nonpruritic erythematous rash, and decreased urine output. He had been recently started on clozapine for depression. Laboratory tests revealed nephrotic syndrome with massive proteinuria (11g/day), hematuria and elevated serum creatinine that reached a maximum of 4.9 mg/dl. The only positive finding was a high titer of myeloperoxidase (MPO) ANCA antibody (111 UI/ml). Clozapine was discontinued, and he was started on conservative management of the nephrotic syndrome. The rash disappeared within one week. Kidney biopsy showed cellular variant focal segmental glomerulosclerosis (FSGS) with mild acute tubular injury. The patient was treated with oral prednisolone with complete remission. Repeat MPO-ANCA was negative after one month. Discussion: We present a challenging case that highlights the importance of kidney biopsy for accurate diagnosis with major impact on treatment and prognosis. This case also underlines the presentation and evolution of FSGS cellular variant, a rare and poorly understood disease. The relationship between skin rash with high MPO titer and the administration of clozapine with clinical remission after its discontinuation favors the hypothesis of drug associated ANCA-vasculitis.

Resumo A formação profissional em Serviço Social demanda a interação com inúmeros fatores da vida cotidiana, sendo a pesquisa científica um dos meios adotados para conhecê-los. Partindo desse pressuposto, objetivamos problematizar o lugar da pesquisa científica em nossa formação profissional, bem como apontar alguns desafios inerentes à esta atividade teórico-prática evidenciando a sua importância no processo de ensino-aprendizagem. A discussão está estruturada em uma breve introdução; depois trataremos sobre o sentido da pesquisa científica; em seguida problematizaremos a importância desta na formação profissional em Serviço Social; por fim, apontaremos algumas reflexões sobre a temática em tela. Fundamentando-se em uma revisão de literatura, sob a luz da teoria social crítica, consideramos que a dimensão investigativa em meio às contradições do sistema econômico e o culto aos estigmas sociais e culturais, é de ímpar relevância para uma profissão comprometida com a ruptura de análises discriminatórias e a construção de uma sociedade humanamente emancipada.

Abstract Professional education in social work entails interaction with many factors of daily life, and scientific research is a way to learn about these factors. Based on this assumption, this study discusses the position of theoretical and practical scientific research regarding professional education, presenting its inherent challenges and highlighting its importance in the teaching-learning process. The discussion is organized in a brief introduction, followed by a debate on the meaning of scientific research. The article reflects on the importance of scientific research in the professional education of social workers and provides final considerations and reflections. Supported by a literature review and guided by the critical social theory, the study recognizes the relevance of the investigative dimension amidst the contradictions of the economic system and the cult of social and cultural stigmas. This dimension is crucial to developing a profession committed to the rupture of discriminatory analyzes and the construction of a humanly emancipated society.

RESUMO Objetivo: analisar a autoeficácia de idosos com Diabetes Mellitus tipo 2 e a relação com as variáveis sociodemográficas, clínicas, de conhecimento e atitude. Método: estudo transversal, quantitativo, realizado com 256 idosos cadastrados em Estratégias Saúde da Família. Obteve-se os dados através de entrevistas. Procedeu-se análise estatística descritiva e modelo de regressão linear múltipla (p<0,05). Resultados: predominou-se sexo feminino, idade média de 69,95 anos, cor da pele branca, 4 a 7 anos de escolaridade, residentes com companheiro, aposentados, baixa renda mensal individual, 6 a 15 anos de doença, católicos, morando com filhos (com ou sem cônjuge). Prevaleceu o baixo conhecimento e atitude negativa dos idosos. A autoeficácia associou-se à atitude e ao conhecimento nos domínios “Nutrição geral e específica”, “Exercício físico” e “Glicose sanguínea”. Conclusão: destaca-se a importância de investigações sobre a autoeficácia no manejo do Diabetes Mellitus tipo 2 em idosos no sentido de incentivar a adesão ao tratamento.

ABSTRACT Objective: to analyze the self-efficacy of elderly with type 2 diabetes mellitus and the relationship with sociodemographic, clinical, knowledge, and attitude variables. Method: a cross-sectional quantitative study conducted with 256 elderly people enrolled in Family Health Strategies. Data were obtained through interviews. Descriptive statistical analysis and multiple linear regression model were performed (p <0.05). Results: female, 69.95-year mean age, white skin color, 4-7 years of schooling, living with a partner, retirees, low individual monthly income, 6 to 15 years of illness, Catholics, living with children (with or without spouse). The elderly’s low knowledge and negative attitude prevailed. Self-efficacy was associated with attitude and knowledge in the domains “General and Specific Diet”, “Physical Exercise” and “Blood Glucose”. Conclusion: self-efficacy investigations in type 2 Diabetes Mellitus management in the elderly are important and encourage treatment adherence.

RESUMEN Objetivo: analizar la auto-eficacia de ancianos con Diabetes Mellitus tipo 2 y la relación con las variables socio-demográficas, clínicos, de conocimiento y actitud. Métodos: estudio transversal, cuantitativo, realizado con 256 ancianos, registrados en Estrategias Salud de la Familia. Los datos fueron obtenidos a través de entrevistas. Se realizó un análisis estadístico descriptivo y un modelo de regresión lineal múltiple (p <0,05). Resultados: se predominó sexo femenino, promedio medio 69,95 años, color de la piel blanca, 4 a 7 años de escolaridad, residentes con compañero, jubilados, baja renta mensual individual, de 6 a 15 años de enfermedad, católicos, viviendo con hijos (con o sin cónyuge). Conclusión: se destaca la importancia de investigaciones sobre la auto-eficacia en el manejo del Diabetes Mellitus tipo 2 en ancianos en el sentido de incentivar la adhesión al tratamiento.

ABSTRACT Objective: to analyze the self-efficacy of elderly with type 2 diabetes mellitus and the relationship with sociodemographic, clinical, knowledge, and attitude variables. Method: a cross-sectional quantitative study conducted with 256 elderly people enrolled in Family Health Strategies. Data were obtained through interviews. Descriptive statistical analysis and multiple linear regression model were performed (p <0.05). Results: female, 69.95-year mean age, white skin color, 4-7 years of schooling, living with a partner, retirees, low individual monthly income, 6 to 15 years of illness, Catholics, living with children (with or without spouse). The elderly’s low knowledge and negative attitude prevailed. Self-efficacy was associated with attitude and knowledge in the domains “General and Specific Diet”, “Physical Exercise” and “Blood Glucose”. Conclusion: self-efficacy investigations in type 2 Diabetes Mellitus management in the elderly are important and encourage treatment adherence.

RESUMEN Objetivo: analizar la auto-eficacia de ancianos con Diabetes Mellitus tipo 2 y la relación con las variables socio-demográficas, clínicos, de conocimiento y actitud. Métodos: estudio transversal, cuantitativo, realizado con 256 ancianos, registrados en Estrategias Salud de la Familia. Los datos fueron obtenidos a través de entrevistas. Se realizó un análisis estadístico descriptivo y un modelo de regresión lineal múltiple (p <0,05). Resultados: se predominó sexo femenino, promedio medio 69,95 años, color de la piel blanca, 4 a 7 años de escolaridad, residentes con compañero, jubilados, baja renta mensual individual, de 6 a 15 años de enfermedad, católicos, viviendo con hijos (con o sin cónyuge). Conclusión: se destaca la importancia de investigaciones sobre la auto-eficacia en el manejo del Diabetes Mellitus tipo 2 en ancianos en el sentido de incentivar la adhesión al tratamiento.

RESUMO Objetivo: analisar a autoeficácia de idosos com Diabetes Mellitus tipo 2 e a relação com as variáveis sociodemográficas, clínicas, de conhecimento e atitude. Método: estudo transversal, quantitativo, realizado com 256 idosos cadastrados em Estratégias Saúde da Família. Obteve-se os dados através de entrevistas. Procedeu-se análise estatística descritiva e modelo de regressão linear múltipla (p<0,05). Resultados: predominou-se sexo feminino, idade média de 69,95 anos, cor da pele branca, 4 a 7 anos de escolaridade, residentes com companheiro, aposentados, baixa renda mensal individual, 6 a 15 anos de doença, católicos, morando com filhos (com ou sem cônjuge). Prevaleceu o baixo conhecimento e atitude negativa dos idosos. A autoeficácia associou-se à atitude e ao conhecimento nos domínios “Nutrição geral e específica”, “Exercício físico” e “Glicose sanguínea”. Conclusão: destaca-se a importância de investigações sobre a autoeficácia no manejo do Diabetes Mellitus tipo 2 em idosos no sentido de incentivar a adesão ao tratamento.

Resumo Introdução A crescente utilização de recursos de terapia intensiva neonatal para manter a vida dos recém-nascidos enfermos pode gerar estímulos dolorosos, causando sofrimento a eles. Porém, nem sempre essa dor é percebida pelos profissionais envolvidos no cuidado, embora já exista um interesse crescente por parte deles nesse sentido. Objetivo Avaliar a percepção de dor do recém-nascido por profissionais de saúde que atuam em unidade neonatal. Método Pesquisa qualitativa do tipo exploratória, realizada em um hospital de referência em cuidado neonatal de uma capital do Nordeste. Foram realizadas entrevistas semiestruturadas com todos os profissionais que atuavam na Unidade de Terapia Intensiva Neonatal e/ou na Unidade de Cuidados Intermediários em cuidado direto com o recém-nascido. Utilizou-se da análise de conteúdo na modalidade temática, e os resultados foram agrupados em categorias. Resultados Foram realizadas 36 entrevistas. Os profissionais entrevistados reconheceram que a dor neonatal foi historicamente negligenciada e que hoje as evidências científicas comprovam sua existência. Foram identificadas carência na formação no tema e fragilidade na aplicação do conhecimento na prática. Conclusão Os profissionais têm conhecimento sobre a dor neonatal, entretanto quase não utilizam os parâmetros fisiológicos e possuem pouco conhecimento sobre a literatura científica atual. O principal desafio diz respeito à necessidade de uso sistemático de escalas que garantam a avaliação da dor.

Abstract Background The increasing use of neonatal intensive care resources to maintain the lives of sick infants can generate painful stimuli and cause distress for them. However, this pain is not always perceived by the professionals involved in the care, although there is already an increasing interest on the part of the professionals involved in care. Objective To evaluate the perception of health professionals, who works in a neonatal unit related to newborn pain. Method Qualitative research of the exploratory type was carried out in a reference hospital in neonatal care of a capital of the Northeast. Semi-structured interviews were conducted with all professionals working in the Neonatal Intensive Care Unit and / or Intermediate Care Unit in direct care of the newborn. Content Analysis was used in the thematic modality and the results were grouped into categories. Results 36 interviews were conducted. The professionals interviewed acknowledged that neonatal pain was historically neglected and that scientific evidence today confirms its existence. It was identified lack in the training in the theme and fragility in the application of the knowledge in the practice. Conclusion The professionals have knowledge about neonatal pain; however they still use little physiological parameters and have little knowledge of current scientific literature. The main challenge is the need for systematic use of scales that guarantee the evaluation of pain.

Resumo Apesar das diversas estratégias perioperatórias empregadas para diminuir a incidência de infecção no sítio cirúrgico (ISS), tais complicações ainda são frequentes, e representam um desafio para os ortopedistas. Por esse motivo, há uma necessidade permanente de buscar métodos cada vez mais eficazes de profilaxia anti-infecciosa, para que sejam reduzidas significativamente as taxas de morbidade pós-operatória, mortalidade, e os custos com os cuidados de saúde. Este estudo teve como objetivo avaliar a eficácia da profilaxia infecciosa com aplicação tópica de vancomicina em pó em cirurgias ortopédicas. Fez-se um estudo de revisão sistemática com metanálise, usando-se o Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). Fez-se uma busca abrangente na literatura por estudos controlados sobre as taxas de ISS com e sem o uso de vancomicina em pó na ferida. Entre os 412 títulos encontrados que preencheram os critérios, foram selecionados 7 estudos, 4 prospectivos e 3 retrospectivos, todos em cirurgia de coluna. A amostra total foi de 6.944 pacientes, que foram divididos em 2 grupos: controle (3.814 pacientes) e intervenção (3.130 pacientes). Observou-se que no grupo intervenção, no qual a vancomicina tópica foi aplicada, 64 (2,04%) pacientes desenvolveram ISS, e, no grupo controle 144 (3,75%) pacientes. Os resultados da metanálise demonstraram que o uso de vancomicina tem efeito protetor contra ISS em cirurgias de coluna, com risco relativo (RR) de 0,59, significância estatística, e intervalo de confiança de 95% (IC95%) entre 0,35-0,98. O uso da vancomicina em pó profilática, no leito da ferida, tem fator protetor contra ISS em cirurgias de coluna; entretanto, mais ensaios prospectivos randomizados são necessários para recomendar seu uso em cirurgias ortopédicas.

Abstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries.

RESUMO Objetivo: Este estudo analisou se a exposição ao ambiente enriquecido durante a fase juvenil da vida interferiria na atividade elétrica do cérebro de ratos adultos. Além disso, a presente pesquisa também investigou se esse provável efeito na atividade elétrica cerebral poderia ser afetado pela hipernutrição durante a lactação. A eletrofisiologia foi medida através da depressão alastrante cortical, um fenômeno relacionado à excitabilidade cerebral. Métodos: Ratos Wistar foram amamentados em ninhadas de nove ou três filhotes, formando os grupos nutridos ou hipernutridos, respectivamente. Aos 36 dias, metade dos animais de cada condição nutricional foram expostos ao ambiente enriquecido. A outra metade foi mantida na condição de ambiente padrão. Aos 90-120 dias de vida, foram obtidos os registros da depressão alastrante cortical. Resultados: A hipernutrição durante a lactação causou incrementos (p < 0,05) nos pesos corporal e cerebral.O Ambiente Enriquecido desacelerou a velocidade de propagação da depressão alastrante cortical independentemente do estado nutricional durante a lactação (p < 0,001). A desaceleração da depressão alastrante cortical no grupo nutrido/ambiente enriquecido foi de 23,8% e no grupo hipernutrido/ambiente enriquecido foi de 15% em comparação com os grupos nutrido/ambiente padrão e hipernutrido/ambiente padrão, respectivamente. Conclusão: Nossos dados demonstram que a exposição ao ambiente enriquecido na fase juvenil da vida do rato reduz a excitabilidade cerebral, e esse efeito pode ser observado mesmo se os animais estiverem hipernutridos durante a lactação. O ambiente enriquecido pode ser considerado um recurso terapêutico adjuvante para modular a excitabilidade cerebral.

ABSTRACT Objective: This study aimed to analyze whether exposure to environmental enrichment (EE) during the juvenile phase of life interferes with the electrical activity of the adult rat brain. In addition, the present research also investigated whether this putative effect on brain electrical activity could be affected by prior overnutrition during lactation. Electrophysiology was measured through cortical spreading depression (CSD), a phenomenon related to brain excitability. Methods: Wistar rats were suckled in litters of either nine or three pups, forming the nourished (N) or overnourished (ON) groups, respectively. At 36 days old, half of the animals from each nutritional condition were exposed to EE. The other half was kept in the standard environment (SE). At 90-120 days of life, each animal was anesthetized for CSD recordings. Results: Overnutrition during lactation caused increases (p < 0.05) in body and brain weights. The EE decelerated CSD propagation velocity regardless of nutritional state during lactation (p < 0.001). The CSD deceleration in the N-EE group was 23.8% and in the ON-EE group was 15% in comparison with the N-SE and ON-SE groups, respectively. Conclusion: Our data demonstrated that EE exposure in the juvenile phase of the rat's life reduced brain excitability, and this effect was observed even if animals were overnourished during lactation. An EE could be considered an adjuvant therapeutic resource to modulate brain excitability.