Abstract Objective To identify the mediating effects of preoperative fear and anxiety on postoperative pain intensity in people undergoing elective surgeries up to six months after surgery. Methods This is an observational and longitudinal study with quantitative analysis, carried out with 172 adult patients admitted to a hospital and undergoing elective surgeries. The instruments used were: form for characterizing sociodemographic, clinical and surgical variables; Hospital Anxiety and Depression Scale; Surgical Fear Questionnaire; and Numeric Rating Scale for pain assessment. The interviews were carried out during the preoperative period, 48 hours after surgery and monthly until six months after surgery. For the descriptive statistical analysis of the explanatory variables, the absolute and relative frequencies, mean, standard deviation, median and minimum and maximum values were used. The relationship between the variables studied was analyzed using measures of correlation and mediating effects (structural equation model, maximum likelihood method). Results During the postoperative period (6 months), the mean pain ranged from 4.86 to 1.19. The means for anxiety (7.62) and fear (25.2) related to surgery were calculated. The analysis of variables showed a positive correlation between both preoperative fear and anxiety with the highest pain levels assessed at different moments in the postoperative period. Furthermore, preoperative anxiety exerted a mediating effect on the relationship between fear related to surgery, manifested in the preoperative period, and postoperative pain in the first 48 hours after surgery. Conclusion Psychological variables, such as preoperative fear and anxiety, influenced postoperative pain intensity in people undergoing elective surgeries. Nursing interventions aimed at anxiety and fear may be useful for surgical patients. 17 sociodemographic Questionnaire assessment 4 frequencies deviation structural model method. method . method) 6 ( months, , months) 486 86 4.8 119 1 19 1.19 7.62 762 7 62 (7.62 25.2 252 25 2 (25.2 calculated Furthermore 8 4. 11 1.1 7.6 76 (7.6 25. (25. 1. 7. (7. (25 (7 (2

Resumen Objetivo Identificar los efectos mediadores de la ansiedad y del miedo preoperatorio sobre la intensidad del dolor posoperatorio en personas que realizaron cirugías electivas hasta los seis meses posteriores a la cirugía. Métodos Se realizó un estudio observacional y longitudinal de análisis cuantitativo con 172 pacientes adultos internados en una institución hospitalaria y sometidos a cirugías electivas. Los instrumentos utilizados fueron: formulario para caracterización de variables sociodemográficas, clínicas y quirúrgicas; Escala Hospitalaria de Ansiedad y Depresión; Escala de Miedos Relacionados con Cirugías y Escala de Categoría Numérica del Dolor. Las entrevistas se realizaron en el período preoperatorio, 48 horas después de la cirugía y mensualmente hasta completar seis meses de posoperatorio. Para el análisis estadístico descriptivo de las variables explicativas, se utilizaron las frecuencias absoluta y relativa, promedio, desviación típica, mediana y valores mínimo y máximo. La relación entre las variables estudiadas se analizó utilizando las medidas de correlación y de los efectos mediadores (modelo de ecuaciones estructurales, método de máxima verosimilitud). Resultados En el período posoperatorio (6 meses), el promedio del dolor varió de 4,86 a 1,19. Se calculó el promedio de ansiedad (7,62) y miedo (25,2) relacionado con la cirugía. El análisis de las variables demostró correlación positiva tanto de la ansiedad como del miedo preoperatorio con niveles de dolor más altos evaluados en distintos momentos del período posoperatorio. Además, la ansiedad preoperatoria tuvo un efecto mediador en la relación entre el miedo relacionado con la cirugía (manifestado en el período preoperatorio) y el dolor posoperatorio en las primeras 48 horas después de la cirugía. Conclusión Las variables psicológicas, ansiedad y miedo preoperatorio, influyeron en la intensidad del dolor posoperatorio en personas que realizaron cirugías electivas. Las intervenciones de enfermería orientadas hacia la ansiedad y el miedo pueden ser útiles para pacientes quirúrgicos. 17 fueron sociodemográficas quirúrgicas Depresión Dolor 4 explicativas relativa típica máximo modelo estructurales verosimilitud. verosimilitud . verosimilitud) 6 ( meses, , meses) 486 86 4,8 119 1 19 1,19 7,62 762 7 62 (7,62 25,2 252 25 2 (25,2 Además manifestado psicológicas quirúrgicos 8 4, 11 1,1 7,6 76 (7,6 25, (25, 1, 7, (7, (25 (7 (2

Resumo Objetivo Identificar os efeitos mediadores do medo e ansiedade pré-operatórios sobre a intensidade da dor pós-operatória em pessoas submetidas a cirurgias eletivas até seis meses após cirurgia. Métodos Estudo observacional e longitudinal de análise quantitativa foi realizado com 172 pacientes adultos internados em uma instituição hospitalar e submetidos a cirurgias eletivas. Os instrumentos usados foram: formulário para caracterização de variáveis sociodemográficas, clínicas e cirúrgicas; Escala Hospitalar de Ansiedade e Depressão; Escala de Medos Relacionados a Cirurgia e Escala de Categoria Numérica para dor. As entrevistas foram realizadas no período pré-operatório, 48 horas após a cirurgia e mensalmente até completar seis meses do pós-operatório. Para a análise estatística descritiva das variáveis explanatórias, foram usadas as frequências absoluta e relativa, média, desvio padrão, mediana e os valores mínimo e máximo. A relação entre as variáveis estudadas foi analisada usando as medidas de correlação e dos efeitos mediadores (modelo de equações estruturais; método de máxima verossimilhança). Resultados No período pós-operatório (6 meses), a média de dor variou de 4,86 a 1,19. As médias de ansiedade (7,62) e medo (25,2) relacionados à cirurgia foram calculadas. A análise das variáveis mostrou correlação positiva tanto do medo como da ansiedade pré-operatórios com os níveis de dor mais elevados avaliados em distintos momentos do período pós-operatório. Além disso, a ansiedade pré-operatória exerceu um efeito mediador na relação entre o medo relacionado à cirurgia, manifestado no período pré-operatório, e a dor pós-operatória nas primeiras 48 h após a cirurgia. Conclusão As variáveis psicológicas, medo e ansiedade pré-operatórios, influenciaram a intensidade da dor pós-operatória em pessoas submetidas a cirurgias eletivas. Intervenções de enfermagem voltadas para ansiedade e medo podem ser úteis aos pacientes cirúrgicos. préoperatórios pré operatórios pósoperatória pós operatória 17 sociodemográficas cirúrgicas Depressão préoperatório, préoperatório operatório, operatório pré-operatório 4 pósoperatório. pósoperatório operatório. explanatórias relativa padrão máximo modelo estruturais verossimilhança. verossimilhança . verossimilhança) 6 ( meses, , meses) 486 86 4,8 119 1 19 1,19 7,62 762 7 62 (7,62 25,2 252 25 2 (25,2 calculadas disso préoperatória psicológicas préoperatórios, operatórios, cirúrgicos 8 4, 11 1,1 7,6 76 (7,6 25, (25, 1, 7, (7, (25 (7 (2

ABSTRACT In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.

Abstract The objective of this research was to analyze the industrial potential of a bacaba powder (Oenocarpus bacaba) obtained by different drying methods, evaluating antioxidant activity, spectroscopic and morphological behavior and addition to the composition of inorganic elements. The content of anthocyanins, flavonoids and carotenoids of each powder were determined as well as the total phenolic compounds. The structure of the granules of the powder were visualized via scanning electron microscopy (SEM) and the elemental composition was attained by the X-ray spectroscopic energy dispersive system (EDS). The data suggest that the freeze-drying method is more efficient in obtaining the bacaba powder material. The increase in temperature applied in the convection drying process caused a reduction in the bioactive compound content and elements with antioxidant activity, it severely damaged the morphology of the plant membrane and influenced the composition of the spectral bands. Thus, this study indicates that the freezer-drying method could be particularly useful for obtaining bacaba powder in off-season periods, and that bacaba itself is a raw material that could be exploited by several industrial segments.

ABSTRACT Monkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.

Abstract The aim of this study was to evaluate the properties of the oil extracted from passion fruit seeds (Passiflora edulis), an agroindustrial residue from juice industries, as a potential source of polyunsaturated fatty acids and bioactive substances. The oil presented low levels of free fatty acids and peroxides, as well a great amount of polyunsaturated fatty acids 58.4%, especially linoleic and linolenic acids, which indicates lower oxidation and good source of lipids. A relevant antioxidant activity as a result of a satisfactory content of bioactive substances, such as polyphenols, flavonoids, carotenoids and ascorbic acid, were determined in the passion fruit seed oil. The thermodegradation behavior of the oil suggested high thermal stability and the infrared spectroscopy exhibited high intensity bands between 1745 cm-1 to 1163 cm-1 correlated to the functional groups of fatty acids. Due to their bioactivity and presence of nutritious substances, the passion fruit seed oil may have beneficial properties to health and to extend the shelf-life foods products when present in dietary foods. Furthermore, the use of this by-product could reduce agroindustrial waste, expand and add value to the production chain when used as an industrial lipid matrix.

Resumen El objetivo de este artículo fue identificar el conocimiento de los profesionales de la salud sobre la Lista de verificación de seguridad quirúrgica, los desafíos y las estrategias para su implementación en un hospital público. Esta es una investigación cuantitativa, descriptiva, transversal. Realizada entre abril y mayo de 2017, incluyó la realización de un cuestionario sobre el conocimiento y las percepciones del Protocolo de cirugía segura por parte de los profesionales que trabajan en el quirófano. Los datos fueron analizados considerando estadística descriptiva. 72 profesionales participaron en el estudio, incluidos técnicos de enfermería, enfermeras, médicos e instructores, la mayoría conocía el Protocolo y los objetivos. La falta de adherencia del equipo fue el principal desafío que encontraron para usar este protocolo. Señalaron estrategias importantes que posiblemente podrían subsidiar la implementación de la herramienta en la institución. Se confirmó la hipótesis del estudio, ya que se descubrió que los profesionales tienen conocimiento sobre la Lista de verificación y la reconocen como una herramienta que garantiza la calidad de la atención durante el período perioperatorio, y enumeran los principales desafíos para su implementación.

Resumo Identificar o conhecimento de profissionais da saúde sobre a Lista de Verificação para Segurança Cirúrgica, os desafios e estratégias para sua implantação em uma instituição pública hospitalar. Trata-se de uma pesquisa quantitativa, de caráter descritivo, transversal. Realizada entre abril e maio de 2017, compreendeu o preenchimento de um questionário sobre o conhecimento e percepções do Protocolo de Cirurgia Segura por profissionais que atuam no centro cirúrgico. Os dados foram analisados considerando a estatística descritiva. 72 profissionais participaram do estudo, entre técnicos de enfermagem, enfermeiros, médicos e instrumentadores, a maioria conhecia o Protocolo e objetivos. A falta de adesão da equipe foi o principal desafio encontrado por esta equipe para utilização deste protocolo. Apontaram estratégias importantes que possivelmente subsidiariam a implantação da ferramenta na instituição. A hipótese do estudo foi confirmada, pois se constatou que os profissionais possuem conhecimento sobre a Lista de Verificação e a reconhecem como uma ferramenta que assegura a qualidade da assistência durante o período perioperatório, além de elencarem os principais desafíos para sua implantação.

Abstract The aim of this study was to identify the knowledge of health professionals about the Surgical Safety Checklist, the challenges and strategies for its implementation in a public hospital. This is a quantitative, descriptive, crosssectional research. Held between April and May 2017, it comprised the completion of a questionnaire about the knowledge and perceptions of the Safe Surgery Protocol by professionals working in the operating room. Data were analyzed considering descriptive statistics. 72 professionals participated in the study, including nursing technicians, nurses, doctors and instructors, most knew the Protocol and objectives. The lack of adherence of the team was the main challenge encountered by this team to use this protocol. They pointed out important strategies that could possibly subsidize the implementation of the tool in the institution. The study hypothesis was confirmed, as it was found that professionals have knowledge about the Checklist and recognize it as a tool that ensures the quality of care during the perioperative period, and list the main challenges for its implementation.

This in vitro and in vivo study compared different topographies of Ti samples (dense, porosity of 30% and 40%) with or not CaP coating, prepared by powder metallurgy. Osteogenic cells from newborn rat calvaria were plated onto the samples and cell adhesion (24 hours), alkaline phosphatase activity (7 and 10 days) and mineralization nodules (14 days) were assessed. Sixteen rabbits were used for in vivo study. Each animal received three non-treated and three treated implants in the right or left tibia, respectively. Histometric evaluation of bone-implant contact (BIC) were assessed at 1, 2, 4 and 8 weeks. Metallographic analysis revealed porosities of 30% and 40%, with pore size ranging from 250 to 350 µm. Cell adhesion test and ALP revealed similar cell behavior, independently of topography and CaP coating (P > 0.05%). However, CaP coating combined with porosity of 40% influenced positively the mineralized matrix formation (P < 0.05%). CaP-coated implants showed higher BIC than non-CaP implants and BIC was different between the short (1 and 2 weeks) and long (4 and 8 weeks) healing periods (P < 0.05%). The results suggest that CaP coating combined with 40% porosity implants allowed greater osteogenesis in vitro and increased BIC in vivo.

ABSTRACT Objective To describe the safety and efficacy of pegvisomant therapy and the predictors of treatment response in acromegaly patients at a single tertiary reference center in Brazil. Materials and methods We retrospectively reviewed the clinical, hormonal and radiological data of acromegaly patients treated with pegvisomant in our center. We also evaluated the presence of the d3 isoform of the growth hormone receptor (d3GHR). Results Twenty-seven patients were included (17 women). Pegvisomant was used in combination with octreotide LAR in 20 patients (74%), in combination with cabergoline in one (4%) and as monotherapy in six (22%). IGF-I normalization was achieved in 23 patients (85%). Mild and transitory elevation of liver enzymes was observed in two patients (7.4%), tumor growth in one (3.4%) and lipodystrophy in two (7.4%). One patient stopped the drug due to headaches. The GHR isoforms were evaluated in 14 patients, and the presence of at least one d3GHR allele was observed in 43% of them, but it was not a predictor of treatment response. Only pre-treatment IGF-I level was a predictor of treatment response. Conclusion Pegvisomant treatment was highly effective and safe in our series of Brazilian patients. A better chance of disease control can be expected in those with lower pre-pegvisomant IGF-I levels.