ABSTRACT BACKGROUND: Urinary tract infections (UTI) are highly preventable and have significant clinical and financial impact on the patient and the health care system. OBJECTIVE: To investigate UTIs in critically ill adult patients and the relationship of antimicrobial consumption and multidrug-resistant isolate. DESIGN AND SETTING: A cohort study performed in a Brazilian tertiary-care university hospital in the city of Uberlandia (MG), located at the Federal University of Uberlandia, southeast region of the country. METHODS: We analyzed a cohort of 363 patients with first episode of UTIs from the adult intensive care unit (ICU), from January 2012 to December 2018. The daily doses of antimicrobial administered were calculated. RESULTS: The incidence rate of UTI was 7.2/1000 patient days, with 3.5/1000 patient-days of bacteriuria, and 2.1/1000 patient-days of candiduria. Of 373 microorganisms identified, 69 (18.4%) were Gram-positive cocci, 190 (50.9%) Gram-negative bacilli, and 114 yeasts (30.7%). Escherichia coli and Candida spp. were the most common. Patients with candiduria had higher comorbidity score (Charlson Comorbidity Index ≥ 3), longer length of stay (P = 0.0066), higher mortality (P = < 0.0001) severe sepsis, septic shock, and were immunocompromised when compared with patients with bacteriuria. We observed correlation between antibiotics consumption and multidrug-resistant (MDR) microorganisms. CONCLUSION: The UTIs incidence was high and was mainly caused by Gram-negative bacteria that were resistant to common antibiotics. We observed increase in the consumption of broad-spectrum antibiotics in ICU correlating with MDR microorganisms. In general, ICU-acquired candiduria may be associated with critical illness and poor prognosis.

BACKGROUND There is interest in lingering non-specific symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, referred to as Long coronavirus disease 2019 (Long COVID-19). It remains unknown whether the risk of Long COVID-19 is associated with pre-existing comorbidities or initial COVID-19 severity, including infections due to new Omicron lineages which predominated in 2023. OBJECTIVES The aim of this case report was to characterize the clinical features of acute XBB.1.5 infection followed by Long COVID-19. METHODS We followed a 73-year old female resident of Rio de Janeiro with laboratory-confirmed SARS-CoV-2 during acute infection and subsequent months. The SARS-CoV-2 lineage was determined by genome sequencing. FINDINGS The participant denied comorbidities and had completed a two-dose vaccination schedule followed by two booster doses eight months prior to SARS-CoV-2 infection. Primary infection by viral lineage XBB.1.5. was clinically mild, but the participant subsequently reported persistent fatigue. MAIN CONCLUSIONS This case demonstrates that Long COVID-19 may develop even after mild disease due to SARS-CoV-2 in fully vaccinated and boosted individuals without comorbidities. Continued monitoring of new SARS-CoV-2 lineages and associated clinical outcomes is warranted. Measures to prevent infection should continue to be implemented including development of new vaccines and antivirals effective against novel variants.

Abstract Background Identifying the underlying mechanisms through which adverse childhood experiences affect (ACEs) the mental health of adolescents is of paramount importance for disease prevention in later stages of life. Objective The present study examines the relationship between ACEs and psychopathology in adolescents from northern Chile and how attachment style (abandonment anxiety and intimacy avoidance) may moderate this relationship. A total of 154 schooled adolescents aged 12 to 17 (M = 15.08, SD = 1.64) completed a series of self-report questionnaires including the Adverse Childhood Experience Questionnaire (ACEs), Experiences in Close Relationships-Relationship Structures (ECR-RS), and Youth Self Report (YSR-18). Results The data analysis was carried out using SPSS version 25, which included descriptive analysis, one-way ANOVA, and Spearman correlation analysis. To address moderation analysis, the PROCESS macro extension version 4.1 was employed. In this process, the bootstrap method was applied to construct confidence intervals, and the pick-a-point approach was used to define the levels of the moderating variable. According to the results, 80.3% of the sample experienced one or more ACEs, and 16.4% reported experiencing at least three. Furthermore, the variables under study exhibited significant correlations with each other, except for intimacy avoidance, which showed no correlation with ACEs (rho = −0.10; p = 0.273). When considering abandonment anxiety as a moderating variable, the direct effect of ACEs on externalizing symptoms showed statistically significant changes (β = 0.60, p = 0.03). No other moderating effects were found according to the proposed models. Conclusion In childhood, the accumulation of ACEs is associated with the development of psychopathology in adolescents from northern Chile, specifically with the presence of internalizing and externalizing symptoms. These findings suggest that lower levels of abandonment anxiety could mitigate the effects of ACEs on adolescent psychopathology, while higher levels of abandonment anxiety could exacerbate these effects on psychopathology.

Resumo No artigo analisamos os Planos de Recuperação Social e Ambiental executados pelo Estado do Chile nos municípios denominados zonas de sacrifício. A partir das contribuições da justiça ambiental e os debates em relação à participação e a governança que essa política envolve, damos conta das contradições e dificuldades para a transformação dos territórios degradados pela intensificação de atividades extrativistas, principalmente minero-energéticas. Concluímos mostrando como essas limitações e falhas da política ambiental relacionam-se com a dissociação da dimensão ambiental e social, -através da subvalorização da última-; a compreensão instrumental da participação como uma ferramenta tecno-burocrática para fines estatais; e as tensões provocadas por um modelo de governança ambiental neoliberal. Finalmente, planteamos a necessidade de pensar o conceito de zona de sacrifício vinculado à recuperação socioambiental como proposta desde os territórios para a transição á zonas de recuperação. envolve extrativistas mineroenergéticas. mineroenergéticas minero energéticas. energéticas minero-energéticas relacionamse relacionam se social através última última- tecnoburocrática tecno burocrática estatais neoliberal Finalmente

Resumen En este artículo analizamos los Planes de Recuperación Social y Ambiental implementados por el Estado de Chile en las comunas denominadas zonas de sacrificio. Desde los aportes de la justicia ambiental y los debates respecto a la participación y la gobernanza que esta política involucra, damos cuenta de las contradicciones y dificultades para la transformación de los territorios dañados por la intensificación de actividades extractivistas, principalmente minero-energéticas. Concluimos mostrando cómo estas limitaciones y fallas de la política estatal ambiental se relacionan con la disociación de lo ambiental y social, -a través de la subvaloración de esta última-; la comprensión instrumental de la participación como una herramienta tecno-burocrática para fines estatales; y las tensiones generadas por un modelo de gobernanza ambiental neoliberal. Finalmente planteamos la necesidad de pensar el concepto de zona de sacrificio vinculado a la recuperación socioambiental como propuesta desde los territorios para la transición hacia zonas de recuperación. involucra extractivistas mineroenergéticas. mineroenergéticas minero energéticas. energéticas minero-energéticas social última última- tecnoburocrática tecno burocrática estatales neoliberal

Abstract In this article we analyze the Social and Environmental Recovery Plans implemented by the State of Chile in the communes called sacrifice zones. From the contributions of environmental justice and the debates regarding participation and governance that this policy involves, we account for the contradictions and difficulties for the transformation of territories damaged by the intensification of extractivist activities, mainly mining-energy. We conclude by showing how these limitations and failures of state environmental policy are related to the dissociation of the environmental and social, -through the undervaluation of the latter-; the instrumental understanding of participation as a techno-bureaucratic tool for state purposes; and the tensions generated by a neoliberal environmental governance model. Finally, we propose the need to think about the concept of sacrifice zone linked to socio-environmental recovery as a proposal from the territories for the transition towards recovery zones. zones involves activities miningenergy. miningenergy mining energy. energy mining-energy social through latter latter- technobureaucratic techno bureaucratic purposes model Finally socioenvironmental socio

Resumen Introducción. La infección respiratoria aguda en niños tiene una alta carga de enfermedad. La detección de múltiples microorganismos a través de pruebas moleculares en hisopados nasales podría cambiar el paradigma de patógeno único causal de enfermedad respiratoria en niños y ser de utilidad en la práctica clínica. Objetivo. Caracterizar los patógenos identificados mediante la técnica de reacción en cadena de polimerasa multiplex en tiempo real (RT-PCR) en hisopado nasal, así como las variables clínicas y los resultados de laboratorio en niños <5 años diagnosticados con infección respiratoria aguda baja (IRAB) y hospitalizados en Bogotá D.C., Colombia. Materiales y métodos. Estudio transversal realizado en 81 niños hospitalizados entre septiembre de 2019 y marzo de 2020 en la clínica Cafam y en quienes se hizo hisopado nasal para realizar la identificación microbiològica mediante la prueba RT-PCR multiplex Allplex. Las correlaciones entre el número de patógenos y los niveles de células del hemograma y el nivel de proteína C reactiva se determinaron mediante el coeficiente de correlación de Spearman. Resultados. La edad promedio fue 17.23 meses (±14.44), 54.32% fueron varones y 51.85%, lactantes menores. Se identificaron 149 microorganismos (60.40% virus) en 63 niños (77.78%). Hubo infección mixta en el 48.15% y coinfección en 11.11% de los niños. Respecto a los hallazgos clínicos, la dificultad respiratoria, la obstrucción de la vía respiratoria alta, la tos, la fiebre y la faringitis fueron más comunes en los casos de infección mixta (32.97%), ausencia de microorganismo (16.00%), coinfección (64.40%), infección mixta (29.78%) y ausencia de microorganismo (22.00%), respectivamente. Se observó una correlación negativa entre el número de leucocitos y neutrófilos y el número de microorganismos detectados en preescolares (r=-0.46; p=0.058 y r=-0.51; p=0.033) y una positiva entre el recuento de monocitos y el número de microorganismos detectados (r=0.53; p =0.0096). Conclusión. La prueba RT-PCR multiplex permitió identificar microorganismos en la mayoría de niños, así como casos de infección mixta y coinfección en más de la mitad de la muestra. Además, los hallazgos clínicos fueron altamente heterogéneos entre los niños según el resultado de la prueba.

Abstract Introduction: Acute respiratory infection in children has a high burden of disease. Detection of multiple micro -organisms through molecular testing of nasopharyngeal swab samples could change the paradigm of a single pathogen being the cause of respiratory disease in children and prove its usefulness in clinical practice. Objective: To characterize the pathogens identified in nasopharyngeal swab samples by means of multiplex realtime polymerase chain reaction (RT-PCR), as well as clinical variables and laboratory findings in children <5 years diagnosed with acute lower respiratory tract infection (ALRTI) and hospitalized in Bogotá D.C., Colombia. Materials and methods: Cross-sectional study conducted in 81 children hospitalized between September 2019 and March 2020 at the Clínica Cafam and in whom nasopharyngeal swab samples were collected for microbiological identification using the Allplex™ multiplex RT-PCR assay. Correlations between the number of pathogens and blood cells and C-reactive protein levels were determined by Spearman's rank correlation coefficient. Results: Patients' mean age was 17.23 months (±14.44), 54.32% were males, and 51.85% were young infants. A total of 149 microorganisms (60.40% viruses) were identified in 63 children (77.78%). Mixed infection and coinfection were reported in 48.15% and 11.11% of children, respectively. Regarding clinical findings, shortness of breath, upper airway obstruction, cough, fever and pharyngitis were the most common clinical signs and/or symptoms in patients with mixed infection (32.97%), coinfection (64.40%), mixed infection (29.78%), and absence of microorganism (22.00%), respectively. A negative correlation was observed between the number of leukocytes and the number of neutrophils and the number of microorganisms detected in the preschoolers group (r=-0.46; p =0.058 and r=-0.51; p =0.033, respectively). Furthermore, a positive correlation was found between monocyte count and the number of microorganisms detected (r=0.53; p =0.0096). Conclusion: Multiplex RT-PCR assay allowed the identification of microorganisms in most children, as well as cases of mixed infection and coinfection in more than half of the sample. In addition, clinical findings in these children were highly heterogeneous as per the assay result..

RESUMO: O conhecimento sobre métodos e reagentes apropriados para as avaliações da condição de saúde de exemplares de determinada espécie é fundamental. Este estudo avaliou a eficácia dos anticoagulantes heparina 5.000 U.I. mL-1, Na2EDTA (3% e 5%), e K3EDTA (3 e 5%) em parâmetros sanguíneos de tracajá (Podocnemis unifilis), bem como diferentes soluções para contagem de eritrócitos totais. A coagulação foi eficientemente inibida nas amostras de sangue de P. unifilis com o uso dos diferentes anticoagulantes avaliados após 10 horas de armazenamento. Maior número de eritrócitos com o uso de K3EDTA 5% foi observado quando comparado com a coleta de sangue realizada com heparina. Diferenças, estatisticamente significativas, entre as contagens de eritrócitos com o uso das diferentes soluções de reagentes avaliadas foram verificadas. As soluções contendo citrato de sódio e formol na composição possibilitaram contagens de eritrócitos até 120 horas após a coleta, sem alteração em seus valores. Recomenda-se o uso dos anticoagulantes heparina 5000 U.I. mL-¹, Na2EDTA 3%, Na2EDTA 5%, K3EDTA 3% nas análises hematológicas de tracajá. Assim como o uso da solução de formol-citrato contendo 1,9 g de citrato de sódio e 1,0 mL de formol (em 50 mL de água destilada) para realização das contagens de eritrócitos totais em tracajá.

ABSTRACT: Knowledge of suitable methods and reagents for assessing the health condition of specimens of a given species is essential. The present study evaluated the efficacy of the heparin anticoagulants 5,000 I.U. mL-1, Na2EDTA, and K3EDTA on the blood parameters of yellow-spotted amazon river turtle Podocnemis unifilis, employing different solutions for red blood cells count. The use of the various anticoagulants evaluated after 10 hours of storage efficiently inhibited coagulation in blood samples from P. unifilis. An increased number of erythrocytes was observed with the use of K3EDTA 5% when compared with heparin. Statistically significant changes in the erythrocyte number were observed with the use of the different solutions. Solutions which featured sodium citrate and formaldehyde in their composition, allowed erythrocytes counting up to 120 hours after blood collection, without a change in values. The use of the heparin anticoagulants 5,000 I.U. mL-1, Na2EDTA 3%, Na2EDTA 5%, K3EDTA 3% was recommended in the hematological analysis of P. unifilis. Also recommended was the use of the formaldehyde-citrate solution containing 1.9 g of sodium citrate and 1.0 mL of formaldehyde (in 50 mL of distilled water) to perform red blood cells counts in yellow-spotted amazon river turtle.

ABSTRACT Objective: to understand the meaning of work activities for young women with breast cancer. Method: a qualitative study that used as a theoretical framework the Symbolic Interactionism and, as the methodological framework, the Discourse of the Collective Subject. It was developed in a mastology outpatient clinic and a mastectomized rehabilitation center whose data collection took place between February 2014 and January 2015. Twelve women between 18 and 40 years old with up to one year of diagnosis of breast cancer participated, being excluded those with metastasis; interviewed from the guiding question: how is it for you to be young with breast cancer, in relation to work? Thematic content analysis was applied. Results: the following theoretical categories emerged: young women’s feelings about having to stop working due to breast cancer and its treatments; quitting work meant annoyance and discouragement; change in income and collection by herself raised concern about the financial contribution; physical changes changing work activities, meaning limitation and impairment; work as an opportunity to live a better life, as a meaning of freedom; lack of collaboration of colleagues in the work environment whose significance was difficulties in the work environment; solidarity and positivity at work and family support that provided them with encouragement to cope with the disease. Conclusion: it was difficult to experience and accept changes in work activities. The support of family, friends and coworkers was paramount to cope with this process, which should also be taken into account by the health team, especially nursing.

RESUMO Objetivo: compreender o significado das atividades de trabalho para mulheres jovens com câncer de mama. Método: estudo qualitativo que utilizou como referencial teórico o Interacionismo Simbólico e, metodológico, o Discurso do Sujeito Coletivo. Desenvolvido em um ambulatório de mastologia e em um núcleo de reabilitação de mastectomizadas cuja coleta de dados ocorreu entre fevereiro de 2014 e janeiro de 2015. Participaram 12 mulheres entre 18 e 40 anos com até um ano de diagnóstico do câncer de mama, sendo excluídas aquelas com metástase; entrevistadas a partir da questão norteadora: Como é para você ser jovem com câncer de mama, em relação ao trabalho? Foi aplicada a análise de conteúdo temática. Resultados: emergiram as seguintes categorias teóricas: sentimentos das mulheres jovens por terem que parar de trabalhar devido ao câncer de mama e a seus tratamentos; parar de trabalhar significou chateação e desânimo; modificação na renda e cobrança por parte de si mesma gerou preocupação com o aporte financeiro; modificações físicas mudando as atividades laborais, significando limitação e prejuízo; trabalho como oportunidade de viver uma vida melhor, como significado de liberdade; ausência de colaboração dos colegas no ambiente laboral cujo significado foi dificuldades no ambiente laboral; solidariedade e positividade no trabalho e apoio familiar que lhes forneceram encorajamento para enfrentar a doença. Conclusão: foi difícil vivenciar e aceitar as alterações nas atividades de trabalho. O apoio de familiares, amigos e colegas de trabalho foi primordial para o enfrentamento desse processo, a que também deve atentar-se a equipe de saúde, especialmente, a enfermagem.

RESUMEN La formación de plántulas es una de las fases más importantes para el ciclo de cultivo de la berenjena. El tipo de sustrato utilizado es uno de los factores decisivos para obtener plántulas de calidad y el consiguiente aumento de la productividad. El objetivo de este estudio fue evaluar el crecimiento de las plántulas de berenjena cultivadas en sustratos alternativos con niveles crecientes de "moinha" (residuo del proceso de molienda en seco de café), en sustitución del sustrato comercial. El experimento se realizó en un diseño completamente al azar, con seis tratamientos y diez repeticiones. Los tratamientos fueron: T1: sustrato comercial (control); T2: 0% de moinha (MO) + 40% de cáscara de arroz quemada (CAQ) + 15% de fibra de coco (FC) + 5% de cáscara de huevo (CH) + 40% de sustrato comercial (SC); T3: 10% MO + 40% CAQ + 15% FC + 5% CH + 30% SC; T4: 20% MO + 40% CAQ + 15% FC + 5% CH + 20% SC; T5: 30% MO + 40% CAQ + 15% FC + 5% CH + 10% SC; T6: 40% MO + 40% CAQ + 15% FC + 5% CH + 0% SC. Se evaluó la conductividad eléctrica de los sustratos y la masa seca total de las plántulas, la altura de la planta y el diámetro del tallo. Se recomienda utilizar el sustrato que contiene 20% de MO + 40% de CAQ + 15% de FC + 5% de CH + 20% de SC.

ABSTRACT Seedling formation is one of the most important phases for the eggplant crop cycle. One of the decisive factors for obtaining quality seedlings and the consequent increase in productivity is the type of substrate used. The objective of this research was to evaluate the growth of eggplant seedlings grown in alternative substrates with increasing levels of "moinha" (residue from the coffee dry milling process) replacing the commercial substrate. The experiment was carried out in a completely randomized design, with six treatments and ten replicates. The treatments were: T1: commercial substrate (control); T2: 0% moinha (MO) + 40% burnt rice husk (BRH) + 15% coconut fiber (CF) + 5% eggshell (ES) + 40% commercial substrate (CS); T3: 10% MO + 40% BRH + 15% CF + 5% ES+ 30% CS; T4: 20% MO + 40% BRH + 15% CF+ 5% ES + 20% CS ; T5: 30% MO + 40% BRH + 15% CF + 5% ES + 10% CS; T6: 40% MO + 40% BRH + 15% CF + 5% ES + 0% CS. The electrical conductivity of the substrates and the seedling total dry mass, plant height and stem diameter were evaluated. It is recommended to use the substrate containing 20% MO + 40% BRH + 15% CF + 5% ES + 20% CS.

Abstract Studies about crop residue management have become essential due to the possibility of their use in forest seedlings production. This study evaluated the effect of coffee moinha (MO) on substrates composed of vermiculite (VE), coconut fiber (CF) and carbonized rice husk (CRH) in the development of Eucalyptus seedlings. The experiment was conducted in a completely randomized design, with five treatments of increasing proportions of MO/decreasing proportions of CRH (0/28, 7/21, 14/14, 21/7 and 28/0%) and fixed proportions of VE (36%) and CF (36%) in the substrate. At 85 days after planting, the following parameters were assessed: shoot height, stem diameter, root dry mass, shoot dry mass, emergence percentage and Dickson’s quality index (DQI). The results showed CRH could be fully substituted by MO (28%) in the substrate composition because the assessed variables presented lower values than the control treatment (0% MO + 28% CRH + 36% VE + 36% CF). Moreover, the maximum vegetative development in Eucalyptus seedlings was achieved when CRH was replaced by up to 20% MO. In this way, MO becomes an alternative as a substrate component for Eucalyptus seedlings production.

Abstract INTRODUCTION: The present study aimed to determine the incidence of health care-associated infections (HCAIs) and identify the main resistant microorganisms in intensive care unit (ICU) patients in a Brazilian university hospital. METHODS: A retrospective cohort study was conducted in a Brazilian teaching hospital between 2012 and 2014. RESULTS: Overall, 81.2% of the infections were acquired in the ICU. The most common resistant pathogenic phenotypes in all-site and bloodstream infections were oxacillin-resistant coagulase-negative staphylococci and carbapenem-resistant Acinetobacter spp. (89.9% and 87.4%; 80.6% and 70.0%), respectively. CONCLUSIONS: There is an urgent need to focus on HCAIs in ICUs in Brazil.

ABSTRACT Objective: to identify the conduct of health professionals in managing women with atypias in the cervical cytopathological test who received care in primary healthcare units. Methods: documentary and retrospective study carried out with 175 women who had atypias in their cervical cytopathological tests between 2006 and 2014 in a municipality in the state of São Paulo, Brazil, with descriptive analysis of collected data. Results: 157 (90%) women went back to the unit to check the test result. Among those with atypias, 103 (86%) were properly managed, but 85 (83%) repeated the test within a period shorter than the advocated one. In the group of women who needed a colposcopy, 30 (79%) were properly managed. Conclusion: the management of women with atypias was adequate, but the low positivity rate, the lack of patient records, and the inadequate time to repeat the cervical cytopathological test indicated an opportunistic screening program, which may lead to low coverage of the target population, high late detection rate, and overscreening.

RESUMEN: Objetivo: Determinar la conducta de los profesionales de salud para manejo de mujeres con atipias en examen citopatológico, atendidas en Unidades de Atención Primaria de Salud. Método: Estudio documental, retrospectivo, con 175 mujeres con estudios citopatológicos mostrando atipias, entre 2006 y 2014, en municipio del estado de São Paulo, con análisis descriptivo de datos. Resultados: 157 (90%) mujeres volvieron a la unidad para verificar el resultado del estudio. Entre las que presentaron atipias, 103 (86%) recibieron manejo adecuado, aunque 85 (83%) repitieron el estudio en tiempo inferior al recomendado. De las que precisaron colposcopia, 30 (79%) recibieron manejo adecuado. Conclusión: El manejo de mujeres con atipias resultó adecuado, aunque el bajo índice de positividad, escasez de registros en historias clínicas y temporalidad inadecuada de reiteración del estudio demuestran programación oportuna del seguimiento, determinando potencial baja cobertura de la población objetivo, alto índice de detección tardía y sobreseguimiento.

RESUMO Objetivo: identificar a conduta dos profissionais de saúde no manejo de mulheres com atipias no exame citopatológico, atendidas em Unidades de Atenção Primária à Saúde. Método: estudo documental, retrospectivo, com 175 mulheres que apresentaram exames citopatológicos com atipias, entre 2006 e 2014, num município do estado de São Paulo, com análise descritiva dos dados. Resultados: 157 (90%) mulheres retornaram à unidade para verificar o resultado do exame. Entre as com atipias, 103 (86%) receberam manejo adequado, porém 85 (83%) repetiram o exame em tempo menor que o preconizado. Entre as que precisaram de colposcopia, 30 (79%) receberam manejo adequado. Conclusão: o manejo de mulheres com atipias foi adequado, porém o índice de positividade baixo, escassez de registros em prontuários e temporalidade inadequada para repetição do exame citopatológico demonstram um programa de rastreamento oportunístico, podendo ocasionar baixa cobertura da população alvo, alto índice de detecção tardia, e super-rastreamento.

RESUMO Objetivo: compreender o significado das atividades de trabalho para mulheres jovens com câncer de mama. Método: estudo qualitativo que utilizou como referencial teórico o Interacionismo Simbólico e, metodológico, o Discurso do Sujeito Coletivo. Desenvolvido em um ambulatório de mastologia e em um núcleo de reabilitação de mastectomizadas cuja coleta de dados ocorreu entre fevereiro de 2014 e janeiro de 2015. Participaram 12 mulheres entre 18 e 40 anos com até um ano de diagnóstico do câncer de mama, sendo excluídas aquelas com metástase; entrevistadas a partir da questão norteadora: Como é para você ser jovem com câncer de mama, em relação ao trabalho? Foi aplicada a análise de conteúdo temática. Resultados: emergiram as seguintes categorias teóricas: sentimentos das mulheres jovens por terem que parar de trabalhar devido ao câncer de mama e a seus tratamentos; parar de trabalhar significou chateação e desânimo; modificação na renda e cobrança por parte de si mesma gerou preocupação com o aporte financeiro; modificações físicas mudando as atividades laborais, significando limitação e prejuízo; trabalho como oportunidade de viver uma vida melhor, como significado de liberdade; ausência de colaboração dos colegas no ambiente laboral cujo significado foi dificuldades no ambiente laboral; solidariedade e positividade no trabalho e apoio familiar que lhes forneceram encorajamento para enfrentar a doença. Conclusão: foi difícil vivenciar e aceitar as alterações nas atividades de trabalho. O apoio de familiares, amigos e colegas de trabalho foi primordial para o enfrentamento desse processo, a que também deve atentar-se a equipe de saúde, especialmente, a enfermagem.

ABSTRACT Objective: to understand the meaning of work activities for young women with breast cancer. Method: a qualitative study that used as a theoretical framework the Symbolic Interactionism and, as the methodological framework, the Discourse of the Collective Subject. It was developed in a mastology outpatient clinic and a mastectomized rehabilitation center whose data collection took place between February 2014 and January 2015. Twelve women between 18 and 40 years old with up to one year of diagnosis of breast cancer participated, being excluded those with metastasis; interviewed from the guiding question: how is it for you to be young with breast cancer, in relation to work? Thematic content analysis was applied. Results: the following theoretical categories emerged: young women’s feelings about having to stop working due to breast cancer and its treatments; quitting work meant annoyance and discouragement; change in income and collection by herself raised concern about the financial contribution; physical changes changing work activities, meaning limitation and impairment; work as an opportunity to live a better life, as a meaning of freedom; lack of collaboration of colleagues in the work environment whose significance was difficulties in the work environment; solidarity and positivity at work and family support that provided them with encouragement to cope with the disease. Conclusion: it was difficult to experience and accept changes in work activities. The support of family, friends and coworkers was paramount to cope with this process, which should also be taken into account by the health team, especially nursing.

Resumen Las úlceras abomasales son raras y poco conocidas en los pequeños rumiantes y en los rumiantes, en general. Estas llegan a presentarse por diferentes causas como lo son: la dieta, el estrés, la alteración de los mecanismos protectores de la mucosa gástrica, entre otros. En este artículo, se presenta el caso de un caprino hembra raza criolla de aproximadamente diecisiete años, que presentaba una lesión en la región ventral del abdomen, entre la cicatriz del ombligo y el cartílago xifoides, y, adicionalmente, tenía una enfermedad articular. Como método de diagnóstico se realizaron exámenes paraclínicos como: cuadro hemático, coprológico y toma de rayos x, en donde se determinó el diagnóstico final que fue una úlcera abomasal grado 3 y una enfermedad articular degenerativa. El tratamiento se realizó con penicilina sódica (22 000 UI/kg durante cinco días cada doce horas), gentamicina (6 mg/kg durante tres días cada 24 horas), cuatro aplicaciones de complejo B (2 ml cada 48 horas), omeprazol (10 mg/kg cada doce horas por quince días) y lavados diarios de la herida con solución salina durante quince días. El animal fue dado de alta a los veinte días con cierre total de la herida.

Abstract Abomasum ulcers are rare and quite unknown among small ruminants and, in general, in all ruminants. These are due to different causes such as diet, stress, changes in the gastric mucosa protection mechanisms, among others. This article reports the case of a female criollo-breed goat about 17 years old. It had an injury in the abdominal ventral region, between the navel and the xiphisternum. It also had an articular disease. As a diagnostic method, paraclinical tests were carried out such as blood count, stool test and X-ray. This led to a final diagnosis of a grade 3 abomasum ulcer and degenerative articular disease. The treatment consisted in penicillin sodium (22000 UI/kg for 5 days, every 12 hours), gentamicin (6 mg/kg for 3 days, every 24 hours), 4 doses of B complex (2 ml every 48 hours), Omeprazol (10 mg/kg every 12 hours for 15 days) and daily cleaning of the injury with saline for 15 days. The animal was discharged on day 20 with the injury fully closed.

Resumo As úlceras abomasais são raras e pouco conhecidas em pequenos ruminantes e em ruminantes em geral. Elas chegam a se gerar por diferentes causas como: dieta, estresse, alteração dos mecanismos protetores da mucosa gástrica, entre outros. Neste artigo, apresenta-se o caso de uma cabra fêmea raça Crioula de aproximadamente 17 anos de idade, que apresentava uma lesão na região ventral do abdome, entre a cicatriz do umbigo e a cartilagem xifoide e tinha adicionalmente doença articular. Como método de diagnóstico foi realizado exames paraclínicos como hemograma, coprologia e radiografia, onde foi determinado o diagnostico final de úlcera abomasal grau 3 e doença articular degenerativa. O tratamento foi realizado com penicilina sódica (22000 UI/kg durante 5 dias a cada 12 horas), gentamicina (6 mg/kg durante 3 dias a cada 24 horas), 4 aplicações de complexo B (2 ml a cada 48 horas), Omeprazol (10 mg/kg a cada 12 horas por 15 dias) e lavagens diárias da ferida com solução salina durante 15 dias. O animal recebeu alta aos 20 dias com fechamento total da ferida.

Objective: To describe physical growth features in children with salt-wasting congenital adrenal hyperplasia (CAH) during their first two years of life, in the Endocrinology Service of the Peruvian National Children’s Health Institute (CHI) in Lima, Peru. Materials and Methods: This is a retrospective, observational, and descriptive study. Fifty-five children with CAH underwent follow-up in the Endocrinology Service of the CHI from 2000 to 2016; data such as body weight and height were collected at birth time and every six months, as well as age at diagnosis, hydrocortisone and fludrocortisone doses, and growth velocity. Results: Fifty-five children with salt-wasting CAH were assessed, the diagnosis was more promptly made in females (median: 21 days) compared to males (median: 52 days). At birth, their average length was 0.07 ± 0.75 SD; at 6 months it was -1.67 ± 1.33 SD, and male subjects were more affected (-2.29 ± 1.18 SD; p= 0.022); at 12 months, this parameter was -1.84 ± 1.27 SD, and recovery was observed at 24 months (-1.51 ± 1.10 SD). Growth velocity values were -1.03 ± 1.62 SD and -0.89 ± 1.06 SD in the first and second years of life, respectively. Conclusions: Children with salt-wasting CAH who were followed-up at CHI had shorter length at 6- and 12- months of age, and their recovered at 24-monbths.

Objetivo: Describir el crecimiento físico de niños con hiperplasia suprarrenal congénita (HSC) perdedora de sal durante los dos primeros años de vida, evaluados en el Servicio de Endocrinología del Instituto Nacional de Salud del Niño (INSN), Lima-Perú. Materiales y métodos: Es un estudio observacional, descriptivo y retrospectivo. Se incluyeron 55 niños con HSC que tuvieron seguimiento en el Servicio de Endocrinología del INSN del 2000 al 2016; se recopilaron datos como peso y talla al nacer y cada 6 meses, edad al diagnóstico, dosis de hidrocortisona y fludrocortisona y velocidad de crecimiento. Resultados: Se analizaron 55 niños con HSC perdedora de sal siendo el diagnóstico más precoz en mujeres (mediana: 21 días) que en varones (mediana: 52 días). Al nacimiento, su longitud promedio fue 0,07 + 0,75 DE; a los 6 meses fue -1,67 + 1,33 DE con mayor compromiso en varones (-2,29 + 1,18 DE; p=0,022); a los 12 meses fue -1,84 + 1,27 DE, con recuperación a los 24 meses (-1,51 + 1,10 DE). La velocidad de crecimiento fue -1,03 + 1,62 DE y -0,89 + 1,06 DE en el en el primer y segundo año, respectivamente. Conclusiones: Los niños con HSC perdedora de sal que tuvieron seguimiento en el INSN, tuvieron menor longitud a los 6 y 12 meses de edad y lograron recuperarse a los 24 meses.

Abstract The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1β, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1β levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1β and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1β, IL-6 and IL-8.