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Resumen (Introducción): Los parques naturales con vocación recreativa desempeñan un papel fundamental para fomentar acciones proambientales entre sus visitantes. Sin embargo, para la región de América Latina los programas dirigidos a estos propósitos no han tenido resultados esperados, por lo contrario, una de las causas que han intensificado el deterioro ambiental de los parques son las actividades recreativas. Entre los mayores retos para favorecer la conservación en estas áreas se encuentra el desarrollo de la conciencia ambiental de los visitantes. (Objetivo): Para sustentar una gestión que fortalezca la conservación y genere actitudes e involucre a los visitantes en prácticas proambientales, este estudio analiza la conciencia ambiental de 190 visitantes al Parque Estatal Sierra Morelos, área natural protegida, ubicada en el municipio de Toluca, Estado de México. (Metodología): Para recolectar los datos se diseñó un cuestionario estructurado, a partir de las cuatro dimensiones de la conciencia ambiental (cognitiva, afectiva, conativa y activa). Se realizó un análisis factorial, un análisis de conglomerados y una prueba de Kruskal-Wallis para identificar las diferencias entre grupos. (Resultados): Fueron 11 factores identificados, explicando el 70.88 % de la varianza acumulada. El análisis de conglomerados identificó tres grupos; Estadio 1: discursivo-intencional pasivo; Estadio 2: predisposición ambiental y; Estadio 3: afectivo de acciones convenidas. (Conclusiones): Los resultados muestran que no existe un número definido de estadios que explique una o varias realidades y que las experiencias humanas con la naturaleza son la clave de la conciencia ambiental.

Abstract (Introduction): Natural parks with a recreational vocation play a fundamental role in promoting pro-environmental actions among their visitors. However, for the Latin American region, the programs aimed at these purposes have not had the expected results; on the contrary, one of the causes that have intensified the environmental deterioration of the parks are recreational activities. One of the major challenges to promote conservation in these areas is the development of environmental awareness among visitors. (Objective): To analyze the stages of environmental awareness of 190 visitors to Sierra Morelos State Park, a natural protected area in the municipality of Toluca, State of Mexico, to support a management that strengthens conservation and generates attitudes and involves visitors in pro-environmental practices. (Methodology): In order to collect data, a structured questionnaire was designed based on the four dimensions of environmental awareness (cognitive, affective, conative and active). A factor analysis, a cluster analysis and to identify differences between groups a Kruskal-Wallis test was applied. (Results): Eleven factors were identified explaining 70.88 % of the cumulative variance. The cluster analysis identified three groups; Stage 1: passive discursive-intentional; Stage 2: environmental predisposition and Stage 3: affective of agreed actions. (Conclusions): The results show that there is no definite number of stages that explain one or several realities for which the human experiences are the key to environmental awareness.

https://doi.org/10.15359/rca.58-1.8

Detection of anti-Trypanosoma spp. antibodies in cattle from southern Brazil
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Samoel, Gisele Vaz Aguirre

; Fernandes, Fagner D’ambroso

; Roman, Isac Junior

; Rodrigues, Bibiana Teixeira

; Miletti, Luiz Claudio

; Bräunig, Patrícia

; Guerra, Renata Rojas

; Sangioni, Luís Antônio

; Cargnelutti, Juliana Felipetto

; Vogel, Fernanda Silveira Flores

Revista Brasileira de Parasitologia Veterinária

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2024, Volume 33 N. 1 elocation e013723

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Bovine trypanosomosis, caused by Trypanosoma vivax, is a disease that originated in Africa and currently affects cattle in several South American countries, including almost all Brazilian states. Despite the reports on T. vivax infection in southern Brazil, data on its circulation status is currently unavailable. In this study, we aimed to detect anti-Trypanosoma spp. IgG antibodies in cattle from Rio Grande do Sul and suggest areas with T. vivax transmission risk. A total of 691 serum samples from cattle in the intermediate regions of Rio Grande do Sul were analyzed using indirect immunofluorescence assay (IFA). The overall seroprevalence of anti-Trypanosoma antibodies in cattle was 24.6% (170/691). The detection rate ranged from 0-37.3%, with a high prevalence in the intermediate regions of Ijuí (37.3%), Uruguaiana (30.7%), and Passo Fundo (28.9%). Thus, these regions were suggested as possible bovine trypanosomosis risk areas due to the high seroprevalence. This is the first serological study to determine Trypanosoma spp. infection status in cattle from Rio Grande do Sul, providing data on the epidemiology of trypanosomosis in the state.

Resumo A tripanossomose bovina, causada por Trypanosoma vivax, é uma doença que teve origem na África, e atualmente, afeta bovinos em diversos países da América do Sul, incluindo quase todos os estados brasileiros. Apesar dos relatos de infecção por T. vivax, no sul do Brasil, dados sobre seu status de circulação não estão disponíveis atualmente. Neste estudo, o objetivo foi detectar anticorpos IgG anti-Trypanosoma spp. em bovinos do Rio Grande do Sul e sugerir possíveis áreas de risco de transmissão de T. vivax. Foi analisado um total de 691 amostras de soro de bovinos, das regiões intermediárias do Rio Grande do Sul, usando-se o ensaio de imunofluorescência indireta (IFA). A soroprevalência geral de anticorpos anti-Trypanosoma em bovinos foi de 24,6% (170/691). A taxa de detecção variou de 0 a 37,3%, com uma alta prevalência nas regiões intermediárias de Ijuí (37,3%), Uruguaiana (30,7%) e Passo Fundo (28,9%). Portanto, essas regiões foram sugeridas como possíveis áreas de risco para a tripanossomose bovina, devido à alta soroprevalência. Este é o primeiro estudo sorológico a determinar o status de infecção por Trypanosoma spp., em bovinos do Rio Grande do Sul, fornecendo dados sobre a epidemiologia da tripanossomose no estado.

https://doi.org/10.1590/s1984-29612024002

Banco de semillas del suelo bajo individuos aislados de especies arbóreas del Matorral Espinoso Tamaulipeco
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Valdes-Alameda, Renata

; Jurado, Enrique

; Flores, Joel

; Estrada, Eduardo

Revista mexicana de ciencias forestales

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oct 2023, Volume 14 N. 79 Pages 31 - 57

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Estudiar el banco de semillas permite interpretar el estado de sitios perturbados, la respuesta a cambios impulsados por disturbios y la consecuente dinámica de una comunidad vegetal. La heterogeneidad en la formación del banco de semillas está influida por la latencia de estas, su tipo de dispersión y componentes del paisaje como topografía o vegetación. El número de semillas en el suelo depende, en parte, de la vegetación presente, sin embargo, en paisajes deforestados y fragmentados, los árboles aislados representan los únicos reservorios potenciales para la regeneración de la vegetación. En este trabajo se exploró, durante dos años, la variación espacial y temporal en la abundancia, densidad y número de especies de semillas germinables en el suelo bajo cinco especies arbóreas aisladas comunes en áreas abiertas del Matorral Espinoso Tamaulipeco. Las características del banco de semillas se calcularon para cada especie de árbol aislado y se compararon entre ellas, estaciones y año de colecta. El banco de semillas bajo las copas de dos árboles zoócoros (Neltuma laevigata y Diospyros texana) fue más rico y denso que bajo otras tres especies (Yucca filifera, zoócora; Parkinsonia aculeata y Vachellia farnesiana dispersión no asistida). También se registraron más especies y semillas germinadas en otoño que en primavera, y más herbáceas que arbóreas.

Abstract Studying the seed bank makes it possible to interpret the status of disturbed sites, the response to disturbance-driven changes, and the subsequent dynamics of a plant community. Heterogeneity in seed bank formation is influenced by seed dormancy, seed dispersal type, and such landscape components as topography or vegetation. The number of seeds in the soil depends, in part, on the vegetation present, however, in deforested and fragmented landscapes, isolated trees are the only potential reservoirs for vegetation regeneration. In this work, the spatial and temporal variation in abundance, density, and number of germinable seed species on the ground was explored during two years, under five common isolated tree species in open areas of the Tamaulipan Thorny Scrub. Seed bank characteristics were calculated for each isolated tree species and compared between species, seasons, and years of collection. The seed bank under the canopy of two zoochorous trees (Neltuma laevigata and Diospyros texana) was richer and denser than under the other three species (Yucca filifera, zoochorous; Parkinsonia aculeata and Vachellia farnesiana, unassisted dispersal). Also, more species and seeds germinated in Fall than in Spring, and more herbaceous than arboreal species were recorded.

https://doi.org/10.29298/rmcf.v14i79.1344

O MODELO SOCIAL DA DEFICIÊNCIA E AS DECISÕES DO TJ/SP: ANÁLISE A PARTIR DE DEMANDAS POR PROFISSIONAL DE APOIO1
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TIBYRIÇÁ, Renata Flores

; MENDES, Enicéia Gonçalves

Revista Brasileira de Educação Especial

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2023, Volume 29 elocation e0052

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT This article deals with a qualitative research of content analysis, based on the Grounded Theory, that aimed to analyze the content of judicial decisions in demands of teachers and support professionals, in order to verify their adequacy to the new paradigm of the concept of disability adopted in Brazil: the social model of disability. A sample of 16 judgments was selected from a database that aimed to outline the profile of the judicialization of Special Education in the state of São Paulo, Brazil. The selection criteria were processes with demands for a support professional for school inclusion (SPSI), from 2019, and avoiding the repetition of the Judge Rapporteur in the sample to guarantee heterogeneity. The 16 judgments found were read and their contents were coded, categorized, and co-occurrences were analyzed using the ATLAS.ti software. The results indicated that the State Court of São Paulo especially used medical reports and diagnoses and learning difficulty in its decisions to provide the SPSI. This evidence is explained by the lack of instruments for biopsychosocial assessment in Brazil or by the structural ableism resulting from the vision ingrained in society about the form of treatment of those considered “abnormal”, due to atypical development who need control and are submitted to medical treatment, or the conception of disability as a personal tragedy that must necessarily be compensated with this type of support.

RESUMO Este artigo trata de uma pesquisa qualitativa de análise de conteúdo, a partir da teoria fundamentada (Grounded Theory), que teve por objetivo analisar o conteúdo das decisões judiciais em demandas de professores e profissionais de apoio, no intuito de verificar sua adequação ao novo paradigma do conceito de deficiência adotado pelo Brasil: o modelo social de deficiência. Foi selecionada uma amostra de 16 acórdãos de uma base de dados que visou traçar o perfil da judicialização da Educação Especial no Estado de São Paulo. O critério de seleção foram processos com demandas de profissional de apoio à inclusão escolar (PAIE), do ano de 2019, e evitando-se a repetição de Desembargador relator na amostra para garantir heterogeneidade. Os 16 acórdãos encontrados foram lidos e seus teores foram codificados, categorizados, realizando-se análises de coocorrência com o software ATLAS.ti. Os resultados indicaram que o Tribunal de Justiça do Estado de São Paulo (TJ/SP) utilizou especialmente laudos médicos e diagnósticos e a dificuldade de aprendizagem em suas decisões para disponibilizar o PAIE. Explica-se essa evidência pela falta de instrumentos para avaliação biopsicossocial no Brasil ou pelo capacitismo estrutural decorrente da visão arraigada na sociedade sobre a forma de tratamento daqueles considerados “anormais”, em razão de desenvolvimento atípico que necessitam de controle e são submetidos a tratamento médico, ou da concepção de deficiência como tragédia pessoal que deve ser necessariamente compensada com esse tipo de suporte.

https://doi.org/10.1590/1980-54702023v29e0052

The Role of Digital Technology and New Strategies in Engagement and Adherence Among Patients With Cardiometabolic Disease
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Krakauer, Márcio

; Flores, Marcella

; Lima, Renata Vital do Nascimento

; Sachetti, Lara Abrão

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20230126

Abstract: En | Text: En | PDF: En

Abstract This article explores challenges and barriers to managing cardiometabolic conditions, highlighting strategies and technologies for improving patient adherence. Approaches such as simplifying prescriptions, patient empowerment, health education, setting short-term goals, understanding social context, self-monitoring, and gamification have been effective in promoting adherence. The use of health apps for chronic diseases has also been increasing, facilitating medication adherence and self-monitoring. Integrating these approaches into clinical practice can lead to consistent outcomes and reduce care-associated costs. conditions prescriptions empowerment education shortterm short term goals context selfmonitoring, selfmonitoring self monitoring, monitoring self-monitoring increasing selfmonitoring. monitoring. careassociated care associated costs

https://doi.org/10.36660/ijcs.20230126

Satisfaction with orthodontic treatment: cross-cultural adaptation and validation of an instrument for the Brazilian Portuguese language
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ALVARENGA, Renata Negreiros

; PAIVA, Saul Martins

; FLORES-MIR, Carlos

; BERNABÉ, Eduardo

; ABREU, Lucas Guimarães

Dental Press Journal of Orthodontics

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2022, Volume 27 N. 6 elocation e2220471

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To cross-culturally adapt into the Brazilian Portuguese and evaluate the psychometric properties of an instrument for assessing the satisfaction of parents/guardians regarding their sons’/daughters’ orthodontic treatment. Methods: Translations of the instrument from English, pre-test and evaluation of validity and reliability of the Brazilian Portuguese version were performed. The questionnaire has 25 items distributed across 3 subscales (process, psychosocial effect and outcome). Eighty-three parents/guardians of children/adolescents who had completed orthodontic treatment participated. Descriptive statistics and floor and ceiling effects were calculated. Internal consistency, stability (interval of three weeks), convergent construct validity and discriminant construct validity were determined. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed dimensionality. Results: Among the 83 parents/guardians, 58 (69.9%) were mothers and 25 (30.1%) were fathers of children/adolescents. In the questionnaire’s total score and the three subscales scores, an acceptable percentage (≤15%) of participants achieved the maximum score (ceiling effect). In the total questionnaire score and in the three subscales scores, no participant achieved the minimum score (floor effect). Cronbach’s α coefficient for the total score was 0.72 (internal consistency). Intra-class correlation coefficient for the total score was 0.71 (stability). The questionnaire’s total score presented large Pearson correlation coefficient (>0.50) with the three subscales too (construct validity). Female parents/guardians had significantly higher scores in the psychosocial effect (p=0.013) and in the treatment outcome (p=0.037) subscales, compared to male parents/guardians (discriminant validity). EFA and CFA confirmed dimensionality in a three-factor solution. Conclusions: The final obtained version is valid and reliable to be used in Brazilian populations.

RESUMO Objetivo: Adaptar transculturalmente para a língua portuguesa do Brasil e avaliar as propriedades psicométricas de um questionário que avalia a satisfação de pais e responsáveis com relação ao tratamento ortodôntico recebido por seus filhos. Métodos: Tradução do questionário em inglês, pré-teste e avaliação da validade e confiabilidade da versão em português obtida. O questionário consistiu de 25 itens distribuídos em três subescalas (processo durante o tratamento, efeito psicossocial e resultado geral do tratamento). Participaram 83 pais/responsáveis de crianças/adolescentes que concluíram o tratamento ortodôntico. Estatística descritiva foi realizada e foi calculado valor máximo e valor mínimo. Foram determinadas a consistência interna, a estabilidade (intervalo de três semanas), a validade de constructo convergente e a validade de constructo discriminante. A análise fatorial exploratória (AFE) e a análise fatorial confirmatória (AFC) avaliaram a dimensionalidade. Resultados: dos 83 pais/responsáveis que participaram do estudo, 58 (69,9%) eram mães e 25 (30,1%) eram pais das crianças/adolescentes. No escore total do questionário e no escore das três subescalas, uma porcentagem aceitável (≤15%) dos participantes atingiu o escore máximo (ceiling effect). No escore total do questionário e no escore das três subescalas, nenhum participante atingiu o escore mínimo (floor effect). O coeficiente α de Cronbach para o escore total foi 0,72 (consistência interna). O coeficiente de correlação intraclasse para o escore total foi 0,71 (estabilidade). O escore total do questionário apresentou um coeficiente de correlação de Person alto (>0,50) com as três subescalas (validade de constructo). Pais/responsáveis do sexo feminino apresentaram escores significativamente maiores nas subescalas efeito psicossocial (p=0,013) e desfecho do tratamento (p=0,037), em comparação aos pais/responsáveis do sexo masculino (validade discriminante). AFE e AFC confirmaram a dimensionalidade em uma solução de três fatores. Conclusões: A versão do questionário obtida no presente estudo mostrou-se válida e confiável para o uso na população brasileira.

https://doi.org/10.1590/2177-6709.27.6.e2220471.oar

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF CROHN’S DISEASE IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN’S DISEASE AND COLITIS (GEDIIB)
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IMBRIZI, Marcello

; BAIMA, Júlio Pinheiro

; AZEVEDO, Matheus Freitas Cardoso de

; ANDRADE, Adriana Ribas

; QUEIROZ, Natália Souza Freitas

; CHEBLI, Júlio Maria Fonseca

; CHEBLI, Liliane Andrade

; ARGOLLO, Marjorie Costa

; SASSAKI, Ligia Yukie

; PARRA, Rogerio Serafim

; QUARESMA, Abel Botelho

; VIEIRA, Andrea

; DAMIÃO, Adérson Omar Mourão Cintra

; MORAES, Antonio Carlos da Silva

; FLORES, Cristina

; ZALTMAN, Cyrla

; VILELA, Eduardo Garcia

; MORSOLETTO, Eloá Marussi

; GONÇALVES FILHO, Francisco de Assis

; PENNA, Francisco Guilherme Cancela e

; SANTANA, Genoile Oliveira

; ZABOT, Gilmara Pandolfo

; PARENTE, José Miguel Luz

; COSTA, Marcia Henriques de Magalhães

; ZERÔNCIO, Marco Antonio

; MACHADO, Marta Brenner

; CASSOL, Ornella Sari

; KOTZE, Paulo Gustavo

; FRÓES, Renata de Sá Brito

; MISZPUTEN, Sender Jankiel

; AMBROGINI JUNIOR, Orlando

; SAAD-HOSSNE, Rogério

; COY, Cláudio Saddy Rodrigues

Arquivos de Gastroenterologia

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2022, Volume 59 Suppl. 1 Pages 20 - 50

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Background: Inflammatory bowel disease (IBD) is an immune-mediated disorder that includes Crohn’s disease (CD) and ulcerative colitis. CD is characterized by a transmural intestinal involvement from the mouth to the anus with recurrent and remitting symptoms that can lead to progressive bowel damage and disability over time. Objective: To guide the safest and effective medical treatments of adults with CD. Methods: This consensus was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn's disease and Colitis (GEDIIB)). A systematic review of the most recent evidence was conducted to support the recommendations/statements. All included recommendations and statements were endorsed in a modified Delphi panel by the stakeholders and experts in IBD with an agreement of at least 80% or greater consensus rate. Results and conclusion: The medical recommendations (pharmacological and non-pharmacological interventions) were mapped according to the stage of treatment and severity of the disease in three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus is targeted towards general practitioners, gastroenterologists, and surgeons interested in treating and managing adults with CD and supports the decision-making of health insurance companies, regulatory agencies, and health institutional leaders or administrators.

RESUMO Contexto: A doença inflamatória intestinal (DII) é uma doença imunomediada que inclui a doença de Crohn (DC) e a retocolite ulcerativa. A DC é caracterizada por um envolvimento intestinal transmural da boca ao ânus com sintomas recorrentes e remitentes que podem levar a danos intestinais progressivos e incapacidade ao longo do tempo. Objetivo: Orientar os tratamentos médicos mais seguros e eficazes de adultos com DC. Métodos: Este consenso foi desenvolvido por autores que representam gastroenterologistas e cirurgiões brasileiros especialistas em doenças colorretais (GEDIIB, Organização Brasileira de Doença de Crohn e Colite). Uma revisão sistemática das evidências mais recentes foi realizada para apoiar as recomendações/declarações. Todas as recomendações e declarações incluídas foram endossadas em um painel Delphi modificado pelas partes interessadas e especialistas em DII com uma concordância de pelo menos 80% ou mais. Resultados e conclusão: As recomendações médicas (intervenções farmacológicas e não farmacológicas) foram mapeadas de acordo com o estágio de tratamento e gravidade da doença em três domínios: manejo e tratamento (intervenções medicamentosas e cirúrgicas), critérios para avaliar a eficácia do tratamento médico, e acompanhamento/monitoramento do paciente após o tratamento inicial. O consenso é direcionado a clínicos gerais, gastroenterologistas e cirurgiões interessados em tratar e gerenciar adultos com DC e apoia a tomada de decisões de companhias de seguro de saúde, agências reguladoras e líderes ou administradores de instituições de saúde.

https://doi.org/10.1590/s0004-2803.2022005s1-02

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF ULCERATIVE COLITIS IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN’S DISEASE AND COLITIS (GEDIIB)
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BAIMA, Júlio Pinheiro

; IMBRIZI, Marcello

; ANDRADE, Adriana Ribas

; CHEBLI, Liliane Andrade

; ARGOLLO, Marjorie Costa

; QUEIROZ, Natália Sousa Freitas

; AZEVEDO, Matheus Freitas Cardoso de

; VIEIRA, Andrea

; COSTA, Marcia Henriques de Magalhães

; FRÓES, Renata de Sá Brito

; PENNA, Francisco Guilherme Cancela e

; QUARESMA, Abel Botelho

; DAMIÃO, Aderson Omar Mourão Cintra

; MORAES, Antonio Carlos da Silva

; SANTOS, Carlos Henrique Marques dos

; FLORES, Cristina

; ZALTMAN, Cyrla

; VILELA, Eduardo Garcia

; MORSOLETTO, Eloá

; GONÇALVES FILHO, Francisco de Assis

; SANTANA, Genoile Oliveira

; ZABOT, Gilmara Pandolfo

; PARENTE, José Miguel Luz

; SASSAKI, Ligia Yukie

; ZERÔNCIO, Marco Antonio

; MACHADO, Marta Brenner

; CASSOL, Ornella Sari

; KOTZE, Paulo Gustavo

; PARRA, Rogerio Serafim

; MISZPUTEN, Sender Jankiel

; COY, Cláudio Saddy Rodrigues

; AMBROGINI JUNIOR, Orlando

; CHEBLI, Júlio Maria Fonseca

; SAAD-HOSSNE, Rogério

Arquivos de Gastroenterologia

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2022, Volume 59 Suppl. 1 Pages 51 - 84

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Background: Inflammatory bowel diseases are immune-mediated disorders that include Crohn’s disease (CD) and ulcerative colitis (UC). UC is a progressive disease that affects the colorectal mucosa causing debilitating symptoms leading to high morbidity and work disability. As a consequence of chronic colonic inflammation, UC is also associated with an increased risk of colorectal cancer. Objective: This consensus aims to provide guidance on the most effective medical management of adult patients with UC. Methods: A consensus statement was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn’s Disease and Colitis [GEDIIB]). A systematic review including the most recent evidence was conducted to support the recommendations and statements. All recommendations/statements were endorsed using a modified Delphi Panel by the stakeholders/experts in inflammatory bowel disease with at least 80% or greater consensus. Results and conclusion: The medical recommendations (pharmacological and non-pharmacological) were mapped according to the stage of treatment and severity of the disease onto three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus targeted general practitioners, gastroenterologists and surgeons who manage patients with UC, and supports decision-making processes by health insurance companies, regulatory agencies, health institutional leaders, and administrators.

RESUMO Contexto: As doenças inflamatórias intestinais são doenças imunomediadas que incluem a doença de Crohn (DC) e a retocolite ulcerativa (RCU). A RCU é uma doença progressiva que acomete a mucosa colorretal causando sintomas debilitantes levando a alta morbidade e incapacidade laboral. Como consequência da inflamação crônica do cólon, a RCU também está associada a um risco aumentado de câncer colorretal. Objetivo: Este consenso visa fornecer orientações sobre o manejo médico mais eficaz de pacientes adultos com RCU. Métodos: As recomendações do consenso foram desenvolvidas por gastroenterologistas e cirurgiões colorretais referências no Brasil (membros da Organização Brasileira para Doença de Crohn e Colite [GEDIIB]). Uma revisão sistemática, incluindo as evidências mais recentes, foi conduzida para apoiar as recomendações. Todas as recomendações foram endossadas pelas partes interessadas/especialistas em doença inflamatória intestinal usando um Painel Delphi modificado. O nível de concordância para alcançar consenso foi de 80% ou mais. Resultados e conclus ão: As recomendações médicas (farmacológicas e não farmacológicas) foram mapeadas de acordo com o estágio de tratamento e gravidade da doença em três domínios: manejo e tratamento (intervenções medicamentosas e cirúrgicas), critérios para avaliar a eficácia do tratamento médico, e acompanhamento/monitoramento do paciente após o tratamento inicial. O consenso foi direcionado a clínicos gerais, gastroenterologistas e cirurgiões que tratam pacientes com RCU e apoia os processos de tomada de decisão por companhias de seguro de saúde, agências reguladoras, líderes institucionais de saúde e administradores.

https://doi.org/10.1590/s0004-2803.2022005s1-03

Densidad de semillas y plántulas de Zanthoxylum fagara en México y Zanthoxylum coco en Argentina: influencia de plantas bajo las cuales ocurren y borde de la vegetación
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Valdes-Alameda, Renata

; Jurado, Enrique

; Flores, Joel

; Pando-Moreno, Marisela

; Estrada, Eduardo

; Gurvich, Diego E.

Botanical Sciences

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mar 2021, Volume 99 N. 1 Pages 67 - 79

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Background: Plant distribution depends, partially on dispersers that transport seeds to suitable habitats and the presence of other plants that facilitate or inhibit germination and establishment. It is important to determine how these factors influence plant distribution in vegetation and include such information in management plans. Hypotheses: Seeds and seedlings of the studied species will differ under tree species and position with respect to the vegetation edge. Higher seed and seedling density is expected under species of animal dispersed trees and in the edges of fragments. Methods: We carried out a direct count of seeds and seedlings of Zanthoxylum fagara (L.) Sarg. in North America and Zanthoxylum coco Gillies ex Hook.f. & Arn. in South America under the canopy of shrubs inside and at the edge of remnant vegetation. Results: For both species, seed density was similar at the edge and inside vegetation fragments. Z. fagara seedling density was higher at the edge than 40 m inside the scrub, also higher under trees dispersed by animals. For Z. coco no seedling density differences were found at edge or inside vegetation fragments. Conclusions: For both species, seed dispersers do not appear to be important, as seeds had similar seed density in edge and inside vegetation. However, they might have an effect on Z. fagara regeneration, as there was higher seedlings density at the edge than inside. Higher light at edge might promote regeneration of this species. For Z. coco there does not appear to be an effect of dispersers on regeneration.

Resumen Antecedentes: La distribución de plantas depende de dispersores que transportan semillas a hábitats adecuados y de plantas que faciliten o inhiban germinación y establecimiento. Es importante conocer cómo estos factores influyen en la distribución de la vegetación y contemplar esta información en planes de manejo. Hipótesis: Las semillas y plántulas de las especies estudiadas diferirán en abundancia bajo diferentes especies de árboles y posición respecto al borde de la vegetación. Se espera una mayor densidad de semillas y plántulas bajo especies de árboles dispersos por animales y en los bordes de los fragmentos. Método: Se realizó conteo directo de semillas y plántulas de Zanthoxylum fagara (L.) Sarg. en México y Zanthoxylum coco Gillies ex Hook.f. & Arn. en Argentina, en fragmentos de vegetación remanente bajo copas de árboles, en borde e interior de vegetación. Resultados: Para ambas especies, la densidad de semillas fue similar en borde y en interior. La densidad de plántulas de Z. fagara fue mayor en el borde que 40 m al interior, así como bajo las copas de árboles dispersados por fauna. Para Z. coco no se encontraron diferencias. Conclusiones: Para ambas especies los dispersores de semillas no parecen importantes, se presenta similar densidad de semillas en borde e interior. Quizá tengan efecto en regeneración de Z. fagara, con mayor densidad de plántulas en borde que al interior. Es probable que mayor disponibilidad de luz en borde promueva regeneración de esta especie. Para Z. coco no parece existir un efecto de los dispersores en la regeneración.

https://doi.org/10.17129/botsci.2636 391 downloads

10.

Primer consenso nacional de edema macular diabético
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Jiménez-Sierra, Juan Manuel

; Cano-Hidalgo, René

; Flores-Peredo, Vanessa

; Fromow-Guerra, Jans

; García-Aguirre, Gerardo

; García-Franco, Renata

; González-Cortés, Jesús

; Hernández-Da Mota, Sergio

; Hernández-Núñez, Fabiola

; Hernández-Vázquez, Ángela

; Lopezcarasa-Hernández, Gabriela

; Lozano-Rechy, David

; Mira-Lorenzo, Ximena

; Pérez-Montaño, Carla

; Ramírez-Estudillo, Abel

; Rodríguez-Valdéz, Patricio

; Roig-Melo, Enrique

; Sánchez-Buenfil, Ermilo

Revista mexicana de oftalmología

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2021, Volume 95 Suppl. 1 Pages 1 - 118

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El edema macular diabético (EMD) representa la causa principal de pérdida de la visión en pacientes con diabetes mellitus. Se trata de una enfermedad compleja que demanda a los oftalmólogos y retinólogos una amplia experiencia para lograr una oportuna detección, un certero diagnóstico y un adecuado tratamiento. En la actualidad se cuenta con diversas y novedosas alternativas de tratamiento que deben ser evaluadas a la par que las características y las necesidades de cada paciente para brindarle los mayores beneficios. En este documento se describen las características y la evidencia científica que respaldan algunos de estos tratamientos, así como la propuesta del Grupo de Consenso para el tratamiento más apropiado de los pacientes con EMD de acuerdo con sus características y perfiles.

Abstract Diabetic macular edema (DME) represents the leading cause of vision loss in patients with diabetes mellitus. It is a complex disease that demands extensive experience from ophthalmologists and retinologists to achieve a timely detection, an accurate diagnosis and adequate treatment. At present, there are various and innovative treatment alternatives that must be evaluated along with the characteristics and needs of each patient to provide the greatest benefits. This document describes the characteristics and scientific evidence that support some of these treatments, as well as the Consensus Group's proposal for the most appropriate treatment of patients with DME according to their characteristics and profiles.

https://doi.org/10.24875/rmo.m21000206 200 downloads

11.

Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol: a randomized clinical trial
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Xavier, Alice C.M.

; de Souza, Camila M.B.

; Flores, Luís H.F.

; Bermudez, Mariane B.

; Silva, Renata M.F.

; de Oliveira, Ariadne C.

; Dreher, Carolina B.

Brazilian Journal of Psychiatry

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oct 2020, Volume 42 N. 5 Pages 510 - 518

Abstract: En | Text: En | PDF: En

Introduction: Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. This trial aimed to adapt the Rothbaum trichotillomania protocol to SPD (Study 1) and test its efficacy for treating SPD and comorbidities in individual and group formats (Study 2). Methods: The adapted protocol was applied to 16 SPD patients, who were allocated to group or individual treatment (Study 1). Afterwards, 54 patients were randomly allocated to treatment in an individual (n=27) or group format (n=27) (Study 2). In both studies, assessments of SPD severity, anxiety, depression, clinical status and skin lesion severity were performed at baseline and the endpoint. Results: The adapted protocol was feasible in both treatment modalities (Study 1) and led to high SPD remission rates (individual 63%; group 52%), with no significant difference between intervention types (p = 0.4) (Study 2). SPD, anxiety, and depression symptoms and objective patient lesion measures improved after treatment. There was large effect size for SPD symptom improvement in both treatment types (Cohen’s d: group = 0.88; individual = 1.15) (Study 2). Conclusion: The adapted Rothbaum protocol was effective for SPD remission, comorbidities, and skin lesions, both in individual and group formats. Clinical trial registration: NCT03182478

https://doi.org/10.1590/1516-4446-2019-0636 983 downloads

12.

Prevalence of mental disorders among elderly men: a systematic review and meta-analysis
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Ribeiro, Genef Caroline Andrade

; Vieira, Walbert de Andrade

; Herval, Álex Moreira

; Rodrigues, Renata Prata Cunha Bernardes

; Agostini, Bernardo Antonio

; Flores-Mir, Carlos

; Repeke, Carlos Eduardo Palanch

; Paranhos, Luiz Renato

Sao Paulo Medical Journal

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jun 2020, Volume 138 N. 3 Pages 190 - 200

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Elderly men have been characterized as a group vulnerable to suicide, motivated by loneliness, loss of loved ones and feelings of uselessness to family members. OBJECTIVES: To ascertain the prevalence of different mental disorders among elderly men who attempted suicide. DESIGN AND SETTING: Systematic review of observational studies developed as a result of a partnership between two postgraduate schools (Lagarto and Uberlândia). METHODS: An electronic search was performed in eight electronic databases, including “grey literature”, in January 2019. Observational studies that assessed mental disorders among men older than 60 years who attempted suicide were eligible for inclusion. RESULTS: Among the disorders evaluated, mood disorders had the highest prevalence (42.0%; 95% confidence interval, CI: 31.0-74.0%; I2: 0.0%; P = 0.763), followed by substance use-related disorders (41.0%; 95% CI: 8.0-74.0%; I2: 96.4; P < 0.001) and, lastly, schizophrenic disorders (5.0%; 95% CI: 0.0%-14.0%; I2: 80.3%; P = 0.024). CONCLUSIONS: It seems that mood disorders and substance use-related disorders are quite prevalent among elderly men with mental disorders who attempted suicide. It is important to consider the role of healthcare services in making early diagnoses of mental disorders among elderly men, in order to diminish the chances of suicide attempts among them. SYSTEMATIC REVIEW REGISTRATION: CRD42018105981.

https://doi.org/10.1590/1516-3180.2019.0454.r1.16012020 846 downloads

13.

Feasibility of ultrasound-assisted optimized process of high purity rice bran protein extraction
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Bernardi, Sílvia

; Kalschne, Daneysa Lahis

; Menegotto, Anne Luize Lupatini

; Flores, Eder Lisandro Moraes

; Barin, Juliano Smanioto

; Fuchs, Renata Hernandez Barros

; Colla, Eliane

; Canan, Cristiane

Ciência Rural

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2020, Volume 50 N. 12 elocation e20200012

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: O farelo de arroz é um subproduto do processo de moagem do arroz, encontrado em abundância em todo o mundo e destacado devido ao seu teor de proteínas. Este estudo otimizou as condições para a extração assistida por ultrassom da proteína do farelo de arroz desengordurado (DRB) e caracterizou o concentrado de proteína do farelo de arroz (RBPC). Uma estratégia sequencial de desenho experimental foi empregada; o efeito do pH, temperatura, tempo de exposição ao ultrassom e amplitude foram avaliados em relação à porcentagem de extração proteica por um Delineamento Fatorial Completo (FFD) com frequências fixas (FFD -A: 37 kHz; FFD-B: 80 kHz). Posteriormente, a porcentagem de proteína extraída foi otimizada empregando um Planejamento Composto Central (variáveis: pH e tempo de exposição ao ultrassom) e o RBPC obtido foi caracterizado quanto às propriedades químicas e funcionais. O pH e o tempo de exposição ao ultrassom tiveram efeito positivo (P ≤ 0,05) na porcentagem de extração proteica. Além disso, a frequência de 37 kHz foi mais eficaz na extração de proteínas. A condição otimizada (frequência: 37 kHz; temperatura: 30 °C; pH: 10; tempo de exposição ao ultrassom: 30 min; e amplitude: 100%) permitiu 15,07% de recuperação de proteínas e o RBPC apresentou 84,76 g 100 g-1 de proteína. Magnésio e cobre foram os principais minerais da RBPC (34,4 e 25,5 µg g-1, respectivamente), enquanto a leucina foi o aminoácido limitante (0,42) e a treonina apresentou o maior escore químico (1,0). A solubilidade do RBPC foi mínima em pH 4 e superior em pH 6-10; a capacidade de absorção de água e óleo foi maior que a albumina sérica bovina (BSA) e a capacidade de emulsificação foi comparável à BSA, com uma estabilidade adequada. Assim, foi possível obter um RBPC com elevada pureza, maior do que o descrito na literatura, devido à otimização nas etapas do processo de extração, com propriedades funcionais adequadas para aplicação em produtos alimentícios, principalmente emulsificados.

ABSTRACT: Rice bran is a by-product of the rice milling process, found worldwide in abundance and highlighted due its protein content. This study optimized the conditions for ultrasonic-assisted extraction of protein from defatted rice bran (DRB) and characterized the rice bran protein concentrate (RBPC). A sequential strategy of experimental design was employed; the effect of pH, temperature, ultrasound exposure time, and amplitude were evaluated regarding the percentage of protein extraction by a Full factorial design (FFD) with a fixed frequencies (FFD-A: 37 kHz; FFD-B: 80 kHz). Subsequently, the percentage of protein extracted was optimized employing a Central composite rotatable design (variables: pH and ultrasound exposure time) and RBPC obtained was characterized regarding chemical and functional properties. The pH and ultrasound exposure time had positive effect (P ≤ 0.05) on percentage of protein extraction; moreover, 37 kHz frequency was more effective in protein extraction. The optimized condition (frequency: 37 kHz; temperature: 30 °C; pH: 10; ultrasound exposure time: 30 min; and amplitude: 100%) allowed 15.07% of protein recovery and the RBPC presented 84.76 g 100 g-1 of protein. Magnesium and copper were the main mineral in RBPC (34.4 and 25.5 µg g-1, respectively), while leucine was the limiting amino acid (0.42) and threonine presented the highest chemical score (1.0). The RBPC solubility was minimal at pH 4 and higher at pHs 6-10; the water and oil absorption capacity were higher than bovine serum albumin (BSA) and the emulsifying capacity was comparable to BSA, with a suitable stability. It was possible to obtain a higher purity RBPC than described in the literature, due to the optimization in the extraction process steps, with functional properties suitable for application in food products, especially emulsified ones.

https://doi.org/10.1590/0103-8478cr20200012 532 downloads

14.

Tongue function and swallowing in individuals with temporomandibular disorders
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Rosa, Raquel Rodrigues

; Bueno, Mariana da Rocha Salles

; Migliorucci, Renata Resina

; Brasolotto, Alcione Ghedini

; Genaro, Katia Flores

; Berretin-Felix, Giédre

Journal of Applied Oral Science

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2020, Volume 28 elocation e20190355

Abstract: En | Text: En | PDF: En

Abstract The tongue participates in the oral phase of swallowing by pushing the food bolus toward the oropharynx. This relationship between tongue function and swallowing is little addressed addressed in individuals with temporomandibular dysfunction (TMD). Objective: To analyze the association of functional tongue conditions on swallowing in individuals with TMD. Methodology: After approval by the Institutional Review Board, the study was conducted on 30 individuals of both sexes, aged 18 to 28 years, with TMD, and not treated for the disorder. Tongue function was assessed as to the mobility, pressure, and oral motor control. Swallowing was analyzed by clinical assessment during ingestion of solid (wafer biscuit) and liquid (water). Data regarding mobility and swallowing were collected using the orofacial myofunctional evaluation protocol. Tongue pressure was measured by the Iowa Oral Performance Instrument, during elevation, protrusion, swallowing, and resistance test. The oral motor control was assessed by the oral diadochokinesis (DDK) test by rapid and repeated emissions of syllables “ta” and “ka”. Data were statistically analyzed by the Spearman correlation coefficient, at a significance level of 5%. Results: Relationships were found between tongue function and swallowing for the following aspects: mobility (r=0.741), pressure in protrusion (r=-0.366), swallowing of saliva (r=-0.499), mean DDK rate in emissions “ta” (r=-0.424) and “ka” (r=-0.446), and mean DDK period in emissions “ta” (r=0.424) and “ka” (r=0.446). Thus, the greater the change in tongue mobility, the lower the tongue pressure in protrusion and swallowing of saliva, the lower the emissions per second, the longer the mean time between vocalizations, and the worse the swallowing of individuals with TMD. Conclusion: The functional conditions of the tongue regarding mobility, pressure, and oral DDK were associated with swallowing in individuals with TMD.

https://doi.org/10.1590/1678-7757-2019-0355 1517 downloads

15.

Responsividade dos Centros de Saúde Auditiva de Maceió: Avaliação dos Usuários
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Flores, Nayyara Glicia Calheiros

; Jesus, Renata Patrícia Freitas Soares de

; Vidal, Suely Arruda

CoDAS

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2020, Volume 32 N. 5 elocation e20190029

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Avaliar responsividade dos serviços de saúde auditiva como medida da satisfação dos usuários. Método: Estudo de corte transversal em quatro Centros Especializados de Reabilitação (CER) em Maceió-AL, nomeados aqui A, B, C e D, habilitados no Sistema Único de Saúde (SUS). Amostra calculada proporcional ao número de usuários maiores de 18 anos que receberam próteses auditivas por Centro. Aplicou-se o Multi-Country Survey Study, com os domínios: dignidade/ respeito profissional; autonomia; comunicação; confidencialidade; agilidade/pronto atendimento; escolha profissional, e serviços básicos/amenidades. Respostas em escala Likert, variando de um (1) a quatro (4) pontos, apresentadas em gráficos, tabelas e percentuais. Classificação: responsividade baixa/muito baixa (somatório respostas um e dois) e boa/muito boa (três e quatro). Resultados: “Dignidade/respeito” avaliado com boa responsividade por mais de 90 % e “Confidencialidade” com 80 %, exceto em um CER. “Autonomia” foi classificada como boa responsividade por 66,5 % (CER C) e 55,5 % (CER A). “Escolha profissional” julgada com pobre responsividade, 27,5% no CER B e 35,9% no D. “Agilidade” na concessão da prótese auditiva, 41,2% esperaram seis a nove meses no CER D, e nos demais, três a seis meses (41,8-48,5%). Conclusão: A maioria avaliou a responsividade dos serviços de saúde auditiva como boa, mas há domínios que necessitam melhorar. Estudos dessa natureza fornecem resultados úteis ao planejamento e à reorganização dos serviços, visando melhorar o processo de assistência.

ABSTRACT Purpose: To evaluate the responsiveness of hearing health services as a measure of user satisfaction. Method: Cross-sectional study conducted in four Specialized Hearing Rehabilitation Centers (SHRC), accredited by the National Health System (SUS) in Maceió, state of Alagoas, Brazil, henceforth named SHRC-A, -B, -C and -D. The sample size was calculated proportional to the number of users aged >18 years who received hearing aids by SHRC. The Multi-country Survey Study (MCSS) was applied with assessment of seven domains: dignity, autonomy, clear communication, confidentiality, prompt attention, choice of health care provider, and quality basic amenities, using a Likert scale ranging from 1 to 4 points, with results presented in graphs and tables (in number and percentage). Responsiveness classification was as follows: very low/low (sum of responses one and two) and good/very good (sum of responses three and four). Results: “Dignity” was evaluated as good by over 90% of the respondents, and “confidentiality” was assessed as good by 80% of them, except for one SHRC. “Autonomy” was classified as good by 66.5% of the respondents in SHRC-C and 55.5% in SHRC-A. “Choice of health care provider” was considered poor responsiveness by 27.5% of the respondents in SHRC-B and 35.9% in SHRC-D. Regarding “prompt attention” in receiving hearing aids, 41.2% of the respondents reported that they had to wait six to nine months in SHRC-D and three to six months in the other SHRC 41.8-48.5%. Conclusion: Most users evaluated the responsiveness of hearing health services as good, but some MCSS domains need improvement. Studies of this nature provide useful results for the planning and reorganization of services, aiming to improve the assistance process.

https://doi.org/10.1590/2317-1782/20202019029 470 downloads

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