Resumo O presente estudo objetivou analisar a percepção da qualidade de vida (QV) dos acadêmicos de uma instituição promotora da saúde, por seriação, verificando o efeito que a experiência ao longo das séries exerce sobre a QV. Delineou-se um estudo de caso transversal, com amostra representativa de 390 universitários da instituição. Para avaliação da QV foi utilizado o instrumento WHOQOL-bref (OMS), juntamente com o questionário sociodemográfico. Os dados foram analisados com estatística descritiva e analítica, utilizando o IBM SPSS Statistics. Os resultados mostraram que o 1º ano da graduação apresentou o maior percentual de alunos que precisavam melhorar a QV e, conforme o avanço da seriação, aumentou gradualmente a percepção positiva da qualidade de vida, com índices estatisticamente significantes entre o 1º e 3º ano (p = 0,044) e 1º e 4º ano (p = 0,010). Verificou-se que, à medida em que o estudante progrediu na seriação, tendo mais tempo de vivência na instituição, ocorreu uma tendência ao aumento dos escores médios da qualidade de vida. Conclui-se que o ambiente universitário, quando promotor da saúde, pode contribuir positivamente para a melhoria da qualidade de vida dos estudantes.

Abstract The present study aimed to analyze the perception of quality of life (QOL) of students at a health-promoting institution, by grade, verifying the effect that experience throughout the grade has on QOL. A cross-sectional case study was designed, with a representative sample of 390 university students from the institution. To assess QoL, the WHOQOL-bref (OMS) instrument was used, together with the sociodemographic questionnaire. Data were analyzed with descriptive and analytical statistics using IBM SPSS Statistics. The results showed that the 1st year of graduation had the highest percentage of students who improved their QOL and, as the series progressed, the positive perception of quality of life gradually increased, with statistically significant rates between the 1st and 3rd year. (p = 0.044) and 1st and 4th year (p = 0.010). It was found that, as the student advanced in grade, having spent more time at the institution, there was a tendency for the average quality of life to increase. It is concluded that the university environment, by promoting health, can contribute positively to improving the quality of life of students.

Abstract Introduction: The incidence of rectal neuroendocrine tumors (r-NETs) is increasing, and most small r-NETs can be treated endoscopically. The optimal endoscopic approach is still debatable. Conventional endoscopic mucosal resection (EMR) leads to frequent incomplete resection. Endoscopic submucosal dissection (ESD) allows higher complete resection rates but is also associated with higher complication rates. According to some studies, capassisted EMR (EMR-C) is an effective and safe alternative for endoscopic resection of r-NETs. Aims: This study aimed to evaluate the efficacy and safety of EMR-C for r-NETs ≤10 mm without muscularis propria invasion or lymphovascular infiltration. Methods: Single-center prospective study including consecutive patients with r-NETs ≤10 mm without muscularis propria invasion or lymphovascular invasion confirmed by endoscopic ultrasound (EUS), submitted to EMR-C between January 2017 and September 2021. Demographic, endoscopic, histopathologic, and follow-up data were retrieved from medical records. Results: A total of 13 patients (male: 54%; n = 7) with a median age of 64 (interquartile range: 54-76) years were included. Most lesions were located at the lower rectum (69.2%, n = 9), and median lesion size was 6 (interquartile range: 4.5-7.5) mm. On EUS evaluation, 69.2% (n = 9) of tumors were limited to muscularis mucosa. EUS accuracy for the depth of invasion was 84.6%. We found a strong correlation between size measurements by histology and EUS (r = 0.83, p < 0.01). Overall, 15.4% (n = 2) were recurrent r-NETs and had been pretreated by conventional EMR. Resection was histologically complete in 92% (n = 12) of cases. Histologic analysis revealed grade 1 tumor in 76.9% (n = 10) of cases. Ki-67 index was inferior to 3% in 84.6% (n = 11) of cases. The median procedure time was 5 (interquartile range: 4-8) min. Only 1 case of intraprocedural bleeding was reported and was successfully controlled endoscopically. Follow-up was available in 92% (n = 12) of cases with a median follow-up of 6 (interquartile range: 12-24) months with no evidence of residual or recurrent lesion on endoscopic or EUS evaluation. Conclusion: EMR-C is fast, safe, and effective for resection of small r-NETs without high-risk features. EUS accurately assesses risk factors. Prospective comparative trials are needed to define the best endoscopic approach.

Resumo Introdução: Os tumores neuroendócrinos do reto (r-NETs) apresentam incidência crescente. A maioria dos tumores de pequenas dimensões pode ser excisada endoscopicamente, no entanto, a abordagem ótima é controversa. A mucosectomia convencional associa-se, frequentemente, a resseção endoscópica incompleta. A disseção endoscópica submucosa (ESD) permite elevadas taxas de resseção completa, mas é tecnicamente complexa e associa-se a maior número de complicações. Alguns estudos sugerem a mucosectomia assistida por cap (EMR-C) como uma alternativa eficaz e segura. Objetivo: Este estudo pretendeu avaliar a eficácia e segurança da mucosectomia com cap na resseção de r-NETs com dimensões ≤10 mm, sem invasão da muscularis própria nem infiltração linfovascular. Material e Métodos: Estudo prospetivo unicêntrico incluindo consecutivamente r-NETs com ≤10 mm, sem invasão da muscularis própria ou linfovascular confirmada em ultrassonografia endoscópica (EUS), submetidos a mucosectomia assistida cap entre janeiro de 2017 e setembro de 2021. Colheita de dados demográficos, clínicos e histopatológicos através de registos médicos eletrónicos. Resultados: Incluídos 13 doentes (género masculino: 54%; n = 7) com idade mediana de 64 (intervalo interquartil [IIQ]: 54-76) anos. A maioria das lesões localizava-se no reto inferior (69.2%; n = 9) e apresentava tamanho mediano de 6 (IIQ: 4.5-7.5) mm. Na avaliação por EUS, 69.2% (n = 9) encontravam-se limitados à muscularis mucosa. A acuidade da EUS na avaliação do envolvimento das camadas da parede retal foi de 84.6% e o tamanho avaliado por EUS correlacionou-se fortemente com o medido na histologia (r = 0.83, p < 0.01). Dois casos (15.4%) corresponderam a recorrências de mucosectomias convencionais prévias. A resseção foi macroscópica e histologicamente completa em 92% (n = 12) dos casos. A análise histológica revelou 76.9% (n = 10) tumores de grau 1. O índice Ki-67 foi inferior a 3% em 84.6% (n = 11) dos casos. O tempo mediano de procedimento foi 5 (IIQ: 4-8) minutos. Verificou-se apenas um caso de hemorragia intraprocedimento resolvida endoscopicamente. O seguimento de 92% dos casos (n = 12) com mediana de 6 (IIQ:12-24) meses não revelou lesão residual ou recorrên-cia em avaliações endoscópica e ultrassonográfica. Discussão/Conclusão: A EMR-C é uma técnica endoscópica segura, rápida e efetiva para a resseção de r-TNEs pequenos sem fatores de alto risco. A EUS apresenta elevada acuidade na avaliação dos fatores de risco. Estudos comparativos prospetivos são necessários para estabelecimento da abordagem endoscópica mais profícua.

Cancer therapy represents a challenge, even with the current scientific developments. Over the years, several studies have shown that the application of antitumor drug nanocarriers is an efficient strategy; however, it requires further improvement. Several nanosystems have been developed, some of which are already in use, including liposomes. Polymer-based nanocarriers are still being adjusted to the peculiarities of the human body due to the biological barriers that were encountered by the first systems that were developed. Among them, the formation of corona proteins, clearance by the endothelial reticulum system and kidneys, activation of the immune system, lack of selectivity, and difficult release have been extensively studied and improved with the development of new devices. In this review, we explore the evolution of primary nanocarriers based on polymeric micelles and highlight the gaps that remain in this field to assist in the research of new systems with superior therapeutic indices. challenge developments years strategy however improvement developed use liposomes Polymerbased Polymer them proteins kidneys selectivity devices review indices

Abstract Social relationships are recognized as a unique element of well-being, having cumulative effects on health. In turn, social support is an important ally of comprehensive health care for the elderly. The objective of this study was to understand the perception of elderly people assisted by a long-stay institution (ILP) about social support and to analyze its relationship with health conditions. This is a descriptive-exploratory, qualitative, cross-sectional study. The sample consisted of 30 elderly people of both sexes of eastern ascent, of the non-probabilistic and intentional type. First, the medical records of the elderly assisted by the ILP were consulted, in order to fill in the Clinical Assessment Form for the Elderly, followed by the application of a semi-structured interview script, containing 10 questions about understanding and access to social supports, organized into three blocks: relationships (family and social), aid and care, and health conditions. From the answers obtained in the interviews, it was found that the institutionalized elderly recognize in the care team an important resource of social support, which reflects positively on their health conditions, configuring a protective factor. It is concluded that social support gives the elderly better conditions to face difficulties in their health condition.

Resumo As relações sociais são reconhecidas como elemento singular ao bem-estar, tendo efeitos cumulativos sobre a saúde. Por sua vez, o suporte social constitui um aliado importante da atenção integral à saúde do idoso. O objetivo deste estudo foi compreender a percepção das pessoas idosas atendidas por uma instituição de longa permanência (ILP), acerca do suporte social e analisar sua relação com as condições de saúde. Trata-se de um estudo descritivo-exploratório, qualitativo, de recorte temporal transversal. A amostra foi composta por 30 idosos, de ambos os sexos, ascendência oriental, do tipo não probabilística e intencional. Primeiramente, procedeu-se a consulta aos prontuários dos idosos atendidos pela ILP, para preenchimento da Ficha de Avaliação Clínica do Idoso, seguida pela aplicação do roteiro de entrevista semiestruturado, contendo 10 questões acerca da compreensão e acesso a suportes sociais, organizadas em três blocos: relacionamentos (familiar e social), auxílio e cuidado, e condições de saúde. A partir das respostas obtidas nas entrevistas, constatou-se que os idosos asilados reconhecem na equipe assistencial um importante recurso de suporte social, o que reflete positivamente em suas condições de saúde, configurando um fator protetivo. Conclui-se que o suporte social dá ao idoso melhores condições para enfrentar dificuldades na condição de saúde.

Abstract Lophius gastrophysus is an exploited deep-sea demersal fishing resource in the Southeast-South region of Brazil, a capture target for the twin trawl multi-specific bottom trawling fleet. Considered a prized fish, it is commonly processed on board, retaining commercial cuts of the tail called colas. Thus it is difficult to recognize the original length of the specimens and, consequently, to assess the dynamics of sources and the impacts of catches. Individual length and weight data were used to generate body predictive models correlated to the monkfish cola. The parameters of growth, mortality and exploitation rate were also estimated from the size structure of Lophius gastrophysus captured by the industrial bottom trawling fleet in Southeast Brazil between May 2013 and April 2015, assessing monkfish stock based on indirect estimates of life history information. All predictive models of body size showed coefficients of determination above 0.9 (P <0.001), indicating good data adjustments. The growth parameters were determined by the minimum residual variance methodology, being: L∞ = 92.4 cm and k = 0.158/year. The size structure tended to increase with depth in the spring. Individuals under the age of sexual maturity contributed significantly to catches. The length of first sexual maturation was estimated at 48.6 cm and the recruitment age was between 6 and 7 years. The coefficients of total, natural, fishing and exploitation rates were estimated at: Z = 0.676; M = 0.241; F = 0.436 and E = 0.644. The fishing mortality rate was higher than the reference value (E > 0.50) indicating a state of overexploitation of the southeast most part of stock. A review of the current Brazilian legislation established for the species on the southeast coast is recommended.

Resumo: O ambiente escolar possui em seu lócus, uma diversidade de culturas, religiões, etnias e características que o fazem propício às discriminações e violências, dentre elas está o bullying. O objetivo desse estudo, consiste em investigar publicações dos anais de eventos em um instituto federal, com intuito de identificar, quais pesquisas têm em seu cerne o bullying no âmbito escolar como objeto de estudo, buscando em suas singularidades novas nuances sobre esse fenômeno. Trata-se de uma pesquisa com abordagem qualitativa, do tipo levantamento bibliográfico. Para a coleta de dados, foi pesquisado o corpus documental nos anais dos eventos disponíveis no site de Publicações de um instituto de ensino. As palavras-chaves utilizadas para a seleção dos trabalhos analisados foram “bullying”, “violência escolar” e “conflitos”. Após selecionados, os manuscritos foram classificados em “resumos expandidos”, “artigos completos” e/ou “dissertações de mestrado” e foram também quantificados o gênero da autoria da pesquisa (masculino ou feminino). À luz dessas características já descritas, foram selecionados oito trabalhos. Desse modo, foi possível observar, a variedade de formas e contextos em que o bullying se apresenta, e como sua prática, fica muitas vezes estereotipada em ações consideradas habituais e comuns.

Abstract: The school environment has in its locus, a diversity of cultures, religions, ethnicities and characteristics that make it conducive to discrimination and violence, among them is bullying. The objective of this study is to investigate publications from the annals of events in a federal institute, in order to identify, which research has at its core bullying at school as an object of study, seeking in its singularities new nuances about this phenomenon. This is a research with a qualitative approach, such as a bibliographic survey. For data collection, the documentary corpus was researched in the annals of the events available on the Publications website of an educational institute. The keywords used to select the analyzed papers were “bullying”, “school violence” and “conflicts”. After being selected, the manuscripts were classified into “expanded abstracts”, “complete articles” and / or “master's dissertations” and the gender of the author of the research (male or female) was also quantified. In light of these characteristics already described, eight works were selected. Thus, it was possible to observe the variety of forms and contexts in which bullying occurs, and as its practice, it is often stereotyped in actions considered habitual and common.

Resumo: Este trabalho é um delineamento das produções e ações do Grupo de Pesquisa Humanidades e Sociedade Contemporânea, do IFMT, com o objetivo de identificar discursos emancipados e também opressores acerca do bullying. Adotou-se a metodologia qualitativa e a coleta de dados foi realizada por meio de um questionário com perguntas objetivas e subjetivas, o qual foi aplicado de forma on-line. Para este estudo, foi feita análise das respostas de uma (01) instituição de ensino em que os alunos responderam: Você tem uma sugestão para acabar com o bullying? Os dados coletados foram analisados por meio da Análise de Discurso Crítica (ADC), evidenciando a que a linguagem é um componente essencial do cotidiano e se conecta dialeticamente a outros elementos sociais. Utilizou-se como aporte teórico as contribuições sobre a banalidade do mal, de Hannah Arendt, para compreender a dinâmica da perpetuação da violência como um ato de despolitização do homem. Como resultados, as respostas dos estudantes traduzem os discursos simbólicos encontrados no contexto escolar, com respostas que sugerem uma visão crítica sobre a ocorrência do bullying em seu cotidiano, mas também com respostas reprodutoras de violência e opressão das vítimas e também dos agressores. Corroborando com o senso crítico da ADC, o conceito da banalidade do mal, de Arendt, complementou a análise do discurso de ódio dos estudantes diante de situações de bullying e oportunizou reflexões no sentido de fomentar diálogos emancipatórios por meio da consciência das mazelas da sociedade.

Abstract: This work is an outline of the productions and actions of the Humanities and Contemporary Society Research Group of IFMT, with the objective of identifying emancipated as well as oppressed speeches about bullying. The qualitative methodology was adopted and the data collection was carried out through a questionnaire with objective and subjective questions, the same was applied online through the use of google forms, it is composed of 13 questions (11 objective and 2 subjective). For this study, an analysis was made of the responses of 01 educational institution, which had the participation of 73 high school students, of this number only 40 students answered the question: Do you have a suggestion to end bullying? The collected data were analyzed through Critical Discourse Analysis (ADC), showing the identification of language as an essential component of everyday life that dialectically connects to other social elements. Hannah Arendt's contributions on the banality of evil were used as a theoretical contribution to understand the dynamics of the perpetuation of violence as an act of depoliticization of man. As a result, the students' responses translate the symbolic discourses found in the school context, with responses that suggest a critical view on the occurrence of bullying in their daily lives, but also with responses that reproduce violence and oppression of victims as well as aggressors. Corroborating with the critical sense of ADC, Arendt's concept of the banality of evil complemented the analysis of students' hate speech in the face of bullying situations and provided opportunities for reflections in order to foster emancipatory dialogues through the awareness of society's problems.

Resumo Fundamentos: Os mecanismos subjacentes pelos quais a doença cardíaca reumática (DCR) levam à disfunção valvar grave não são totalmente compreendidos. Objetivo: O presente estudo avaliou as alterações histopatológicas nas valvas mitrais (VM) buscando uma associação entre o padrão de disfunção valvar predominante e os achados histopatológicos. Métodos: Em 40 pacientes submetidos à troca da VM devido a DCR e em 20 controles submetidos a transplante cardíaco, foram analisados os aspectos histológicos da VM excisada. Dados clínicos e ecocardiográficos também foram coletados. As análises histológicas foram realizadas usando coloração com hematoxilina-eosina. Determinou-se inflamação, fibrose, neoangiogênese, calcificação e metaplasia adiposa. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A idade média dos pacientes com DCR foi de 53±13 anos, sendo 36 (90%) do sexo feminino, enquanto a idade média dos controles foi de 50±12 anos, semelhante aos casos, sendo a maioria do sexo masculino (70%). O endocárdio valvar reumático apresentou espessura maior que os controles (1,3±0,5 mm versus 0,90±0,4 mm, p=0,003, respectivamente), e infiltrado inflamatório mais intenso no endocárdio (78% versus 36%; p=0,004), com predominância de células mononucleares. Ocorreu fibrose moderada a acentuada mais frequentemente em válvulas reumáticas do que em válvulas controle (100% vs. 29%; p<0,001). Ocorreu calcificação em 35% das valvas reumáticas, principalmente entre as valvas estenóticas, associada à área valvar mitral (p=0,003). Conclusões: Apesar do intenso grau de fibrose, o processo inflamatório permanece ativo na valva mitral reumática, mesmo em doença tardia com disfunção valvar. A calcificação predominou em valvas estenóticas e em pacientes com disfunção ventricular direita.

Abstract Background: The underlying mechanisms by which rheumatic heart disease (RHD) lead to severe valve dysfunction are not completely understood. Objective: The present study evaluated the histopathological changes in mitral valves (MV) seeking an association between the pattern of predominant valvular dysfunction and histopathological findings. Methods: In 40 patients who underwent MV replacement due to RHD, and in 20 controls that underwent heart transplant, histological aspects of the excised MV were analyzed. Clinical and echocardiographic data were also collected. Histological analyses were performed using hematoxylin-eosin staining. Inflammation, fibrosis, neoangiogenesis, calcification and adipose metaplasia were determined. A p value<0.05 was considered to be statistically significant. Results: The mean age of RHD patients was 53±13 years, 36 (90%) were female, whereas the mean age of controls was 50±12 years, similar to the cases, with the majority of males (70%). The rheumatic valve endocardium presented greater thickness than the controls (1.3±0.5 mm versus 0.90±0.4 mm, p=0.003, respectively), and a more intense inflammatory infiltrate in the endocardium (78% versus 36%; p=0.004), with predominance of mononuclear cells. Moderate to marked fibrosis occurred more frequently in rheumatic valves than in control valves (100% vs. 29%; p<0.001). Calcification occurred in 35% of rheumatic valves, especially among stenotic valves, which was associated with the mitral valve area (p=0.003). Conclusions: Despite intense degree of fibrosis, the inflammatory process remains active in the rheumatic mitral valve, even at late disease with valve dysfunction. Calcification predominated in stenotic valves and in patients with right ventricular dysfunction.

ABSTRACT The bluefish, Pomatomus saltatrix (Linneus 1766) is captured by industrial, artisanal, and recreational fisheries throughout its distribution range. The reproductive biology of P. saltatrix in the southwestern Atlantic was studied using 1,102 specimens captured by the Brazilian commercial fleet between March 2014 and December 2015. The recruitment period was identified from records of juveniles in experimental beach seine hauls carried out on sandy beaches in the external sector of Guanabara Bay for four years (2012-2015). Based on the reproductive indices and on the macro- and microscopic analyses of the gonads, spawning peaks were identified in autumn and spring. The size at first maturity was estimated at 35.5, 38.3, and 37.4 cm for females, males, and general, respectively. Ovary analyses and measurements of the oocyte diameters indicated that bluefish are multiple spawners with asynchronous oocyte development. The batch fecundity estimate was 202,752.5 eggs and ranged from 9,800.9 to 426,787.0 eggs. The species reproduces throughout the entire study area, but it is more active in the south of Arraial do Cabo. The young-of-the-year were recorded on shallow water in all seasons, with modal peaks in the summer months. The parameters estimated in this study expand and update information on this species, providing important data for the evaluation and fisheries management of the stock of P. saltatrix in the southwestern Atlantic.

ABSTRACT Objectives Evaluate the impact of microscopic extrathyroid extension (MEE) on outcome and therapy response in patients with cT1 and cT2 papillary thyroid carcinoma (PTC). Subjects and methods Retrospective study of 970 consecutive patients, who underwent surgery for PTC between 2000 and 2016. All patients had: tumours ≤ 4 cm, apparent complete tumour resection, without clinically apparent lymph node or distant metastasis at diagnosis and nonaggressive histologic variant. Results Based on the finding of MEE, 175 (18.0%) patients were upstaged to T3. They were older (53.9 versus 50.6 years; P = 0.004) and were more prone to have multifocal tumours (38.2% versus 24.8%; P = 0.001). Radioiodine ablation therapy (RAI) was administered more often to MEE patients (92% versus 40.5%; P < 0.001), as well as prophylactic lymph node resection (35.4% versus 28.6%, P = 0.048). They were more likely to have biochemical incomplete response (4% versus 0.3%; P = 0.03) at the end of the follow-up period. There was no significant association between MEE and recurrence rate, persistence of disease or disease-specific mortality. Conclusion These results support the changes made to the latest edition of the TNM staging system, regarding MEE. Although incomplete biochemical response is more common in these patients, it does not seem to affect their prognosis.

RESUMO Objetivo: Comparar o desempenho da avaliação do processamento fonológico, velocidade de leitura e compreensão de texto antes e depois da aplicação de um programa de remediação fonológica em um grupo restrito de escolares com Transtorno do Déficit de Atenção e Hiperatividade (TDAH) e dislexia. Métodos: Participaram deste estudo 32 escolares do 2º ao 8º ano do Ensino Fundamental, de ambos os sexos, com diagnóstico de TDAH e dislexia de acordo com o DSM-5, atendidos no Ambulatório de Neurologia Infantil do IPPMG/UFRJ. Todos os pacientes foram submetidos ao programa de remediação fonológica, que consistiu em 18 sessões semanais. Resultados: Os resultados, expressos em escore z, indicaram diferença estatisticamente significativa entre as avaliações pré e pós-remediação nas habilidades do processamento fonológico, como em consciência silábica e fonêmica, memória de trabalho e acesso lexical. A tarefa de rima foi analisada separadamente, pois é considerada uma tarefa com nível de segmentação distinto de outros níveis silábicos e, para este resultado não houve significância. Além desses, houve diferença estatisticamente significativa também nos testes que medem velocidade de leitura e compreensão de texto. Conclusão: O programa de remediação fonológica contribui para o desenvolvimento do processamento fonológico, leitura e compreensão textual nesta população.

ABSTRACT Purpose: To compare the performance in phonological processing skills, reading speed and reading comprehension before and after phonological remediation in a restricted group of schoolchildren with Attention Deficit Hyperactivity Disorder (ADHD) and with dyslexia. Methods: Thirty-two schoolchildren from the 2nd to 8th year of Elementary School of both genders, with diagnosis of ADHD and Dyslexia according to the DSM-5, participated in this study. All patients underwent Phonological Remediation Program consisted of 18 weekly sessions. Results: The results, expressed in z scores, showed a statistically significant difference between before and after remediation assessments in phonological processing skills, such as syllabic and phonemic awareness, working memory and lexical access. Rhyming task was analyzed separately because it represents another level of segmentation and, for this result, there was no significance. Besides these results, there was a statistically significant difference in reading speed and reading comprehension. Conclusion: The phonological remediation program contributes to the development of phonological processing, reading speed and reading comprehension in this population.

Introdução: A polineuropatia simétrica distal (PNSD) é uma complicação frequente e catastrófica da diabetes mellitus, mas subdiagnosticada. Os autores colocam a hipótese de o internamento ser uma oportunidade de rastreio da PNSD e pretendem comparar dois métodos de diagnóstico. Material e Métodos:Estudo prospetivo e multicêntrico, que incluiu doentes diabéticos internados nos serviços de medicina interna de dois hospitais, entre maio e outubro de 2015. Foi aplicada a escala MNSI (Michigan Neuropathy Screening Instrument) e o teste SWME (Monofilamento de 10 g-Semmes-Weinstein exam) para despiste de PNSD. Uma pontuação > 2 no exame clínico da MNSI ou ≤ 7 respostas positivas em 10 no teste SWME, foram consideradas diagnósticas de DSPN. Resultados: Foram incluídos 88 pacientes com idade mediana de 77 (13) anos e 45% homens; a maioria com diabetes tipo 2 e 7% tinham diagnóstico prévio de PNSD. A prevalência de PNSD foi de 75% utilizando o MNSI; o teste SWME foi anormal em 38% destes pacientes. A taxa de concordância entre os testes foi de 44,3%. Dos pacientes, 92,4% com diagnóstico de PNSD no estudo não tinham diagnóstico prévio. Discussão: O número de subdiagnósticos de PNSD neste estudo é alarmante. A percentagem de casos subdiagnosticada pode representar um problema de registo ou de escassez de rastreio. Conclusão: Neste estudo concluímos que a PNSD é altamente prevalente entre os pacientes hospitalizados, mas profundamente subdiagnosticada. A escala MNSI poderá ser um instrumento adequado para o rastreio, enquanto o teste SWME não deve ser utilizada isoladamente para este propósito.

Introduction: Distal symmetric polyneuropathy (DSPN) is a frequent, catastrophic and underdiagnosed complication of diabetes mellitus. The authors have hypothesized that hospitalization could be an opportunity to screen DSPN and also pretend to compare two different diagnostic methods. Material and Methods: This was a prospective and multicentre study that enrolled diabetic patients admitted consecutively to internal medicine wards, between May and October 2015. Patients were evaluated using the MNSI (Michigan Neuropathy Screening Instrument) and the SWME (10 g- Semmes-Weinstein monofilament examination). A score > 2 in the clinical examination of MNSI or ≤ 7 positive answers in a total of 10 in SWME were considered diagnostic of DSPN. Results: Eighty-eight patients were included; average age was 77 (13) years and 45% were males; most were type 2 diabetic patients, 7% had a previous diagnosis of DSPN. DSPN prevalence was 75% using MNSI, SWME was abnormal in 38% of these patients. The agreement rate between MNSI and SWME was 44.3%. A percentage of 92.4% of the patients with a diagnosis of DSPN in the study did not have a previous diagnose. Discussion: The number of underdiagnosed cases in this study is alarming but had been previously detected in studies regarding outpatient; it might represent a problem of registry or an omission in the screening of neuropathy. Conclusion: We have concluded that DSPN is a high prevalent disease in hospitalized patients in Portugal, which remains underdiagnosed. MNSI can be a good instrument to screen neuropathy and SWME should not be used exclusively for this purpose.

RESUMO: O objetivo deste estudo foi avaliar e comparar o potencial de redução bacteriana proporcionado peloclorexidinadegermante 2% + álcool 70% eclorexidinadegermante 2% + clorexidinaalcoolica 0,5% e padronizar a antissepsia de pele para colheita de sangue de cães doadores. Foram avaliados 120 zaragatoas de pele da região da jugular de 20 cães, que foram distribuídos em seis tratamentos (T) de acordo com oagente usado para desinfecção, associado, ou não, a tricotomia local: T1 - Tratamento sem tricotomia e sem antissepsia, T2 - Tratamento clorexidinadegermante 2% + clorexidinaalcoolica 0,5% sem tricotomia, T3 - Tratamento clorexidina 2% + álcool 70% sem tricotomia, T4 - Tratamento com tricotomia e sem antissepsia, T5 - Tratamento clorexidina 2% + clorexidina alcoólica 0,5% com tricotomia, T6 - Tratamento clorexidina 2% + álcool 70% com tricotomia. A antissepsia foi feita de forma contínua em um único sentido, totalizando 3 minutos. O uso dos antissépticos se mostraram eficazes nos tratamentos com e sem tricotomia não apresentando crescimento bacteriano. A eficácia de 100% da técnica utilizada no presente trabalho pode ser decorrente do maior tempo de antissepsia. Conclui-se que os protocolos de antissepsia realizados neste estudo podem ser utilizados com segurança para a colheita de sangue de cães, embora ainda o recomendado seja a tricotomia antes da antissepsia.

ABSTRACT: The objective of this study was to evaluate and compare the bactericidal efficacy of2% chlorhexidine surfactant solution + 70% alcohol and 2% chlorhexidine surfactant solution + 0.5% chlorhexidine-alcohol, and standardize skin antisepsis for blood collection from donor dogs. One hundred and twenty skin swabsof the jugular regions of 20 dogs were evaluated. Swabs were distributed into six treatment(T) groups according to the disinfectant used and removal or retention of local hair: T1involved neither antisepsisnorhair removal; T2comprised 2% chlorhexidine + 0.5% chlorhexidine-alcoholwithout hair removal;T3 comprised 2% chlorhexidine + 70% alcohol without hair removal; T4comprised hair removal but no antisepsis;T5comprised 2% chlorhexidine + 0.5% chlorhexidine-alcohol withhair removal; and T6comprised 2% chlorhexidine + 70% alcohol with hair removal. Antiseptic agents were continuously applied in a single direction for a total of 3 min. Use of antiseptics was effective with or without hair removal, resulting in the absence of bacterial growth. Complete efficacy of the technique used in this study may have been due to the increased antiseptic application time. In conclusion,the antisepsis protocols tested in this study can be safely used for the collection of blood from dogs; although,removal of hair prior to antisepsis is still recommended.

Objective: to investigate the association between pharmacological obstetric analgesia and obstetric and neonatal outcomes. Methods: it was a retrospective case-control study conducted with 393 pregnant women comprising 131 cases of pharmacological obstetric analgesia and 262 controls that did not perform this procedure. The sociodemographic and obstetric profile, the circumstances of parturient admission, obstetrical decisions, and obstetric and neonatal outcomes were investigated. Results: pregnant women submitted to pharmacological analgesia during labor presented an increased risk for the use of exogenous oxytocin (p<0.001), episiotomy (p=0.001), Kristeller maneuver (p=0.036), and forceps (p=0.004). Conclusion: pharmacological analgesia does not increase the risk of spontaneous perineal tear, abdominal delivery, and hospitalization in neonatal unit. Nevertheless, it influences the increased risk of synthetic oxytocin use, Kristeller maneuver, episiotomy, forceps, and the occurrence of lower first-minute Apgar scores.

Objetivo: investigar a associação entre a analgesia obstétrica farmacológica e os desfechos obstétricos e neonatais. Métodos: estudo retrospectivo do tipo caso-controle, com 393 parturientes, sendo 131 casos que realizaram analgesia obstétrica farmacológica e 262 controles que não realizaram. Foram investigados o perfil sociodemográfico e obstétrico, as circunstâncias da admissão da parturiente, as condutas obstétricas e os desfechos obstétricos e neonatais. Resultados: parturientes submetidas à analgesia farmacológica durante o trabalho de parto apresentaram risco aumentado para o uso de ocitocina exógena (p<0,001), episiotomia (p=0,001), manobra de Kristeller (p=0,036) e fórceps (p=0,004). Conclusão: a analgesia farmacológica não aumenta o risco de laceração perineal espontânea, parto abdominal e internação em unidade neonatal, contudo influencia no aumento do risco de uso de ocitocina sintética, realização de Manobra de Kristeller, episiotomia, fórceps e ocorrência de escores menores de APGAR no 1° minuto.

Abstract Introduction: The clinical manifestations of sickle cell disease are related to the polymerization of hemoglobin S. The chronic hemolysis caused by this condition often causes the formation of gallstones that can migrate and block the common bile duct leading to acute abdomen. Objective: This study aimed to evaluate the profile of patients with sickle cell disease and cholelithiasis. Methods: Patients with sickle cell disease were separated into groups according to the presence or absence of cholelithiasis. Socioepidemiological and clinical characteristics, such as gender, age, use of hydroxyurea and the presence of other hemoglobinopathies were researched in the medical records of patients. Results: A hundred and seven patients with sickle cell anemia were treated at the institution. Of these, 27 (25.2%) had cholelithiasis. The presence of cholelithiasis was higher in the 11–29 age group than in younger than 11 years and over 29 years. No association was found for the presence of cholelithiasis with gender, use of hydroxyurea or type of hemoglobinopathy (hemoglobin SS, hemoglobin SC or sickle beta-thalassemia). Sixteen of the patients had to be submitted to cholecystectomy with 14 of the surgeries being performed by laparoscopy. Complications were observed in three patients and one patient died for reasons unrelated to the surgery. Conclusion: A quarter of patients with sickle cell disease had gallstones, more commonly in the 11- to 29-year age range. Patients should be monitored from childhood to prevent cholelithiasis with preoperative, intra-operative and postoperative care being crucial to reduce the risk of complications in these patients.