Relato de experiência: enfermeiros que vivenciam o som proveniente da campainha de acionamento e a sirene da ambulância do atendimento móvel de urgência

TCC(especialização) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-graduação em Enfermagem. Linhas de Cuidado em Urgência e EmergênciaEste relato tem como objetivo propor um instrumento aplicado à enfermeiros que identifique os desconfortos e ou danos, gerados pelos sons provenientes da campainha de acioname nto e a sirene da ambulância em um Serviço de Atendimento Móvel de Urgência (SAMU) de uma cidade do Amapá- AP. Utilizou-se como método uma tecnologia de concepção, onde o produto é o próprio plano de ação, direcionado aos enfermeiros do SAMU. O estudo foi realizado no período de Fevereiro a Março de 2014. A construção dessa proposta deu-se através de conversas, durante as trocas de plantões, nos intervalos dos turnos de trabalhos e foi aprofundada com estudos teóricos-científicos. Os profissionais foram incentivados a relatar informalmente sua incomodidade Sonora, ao mesmo tempo buscando uma melhor compreensão da problemática, com possives sugestões de mudanças de hábitos em relação ao toque da campainha de acionamento e o som da sirene da ambulância

Nordic walking training in elderly, a randomized clinical trial. Part II: Biomechanical and metabolic adaptations

BACKGROUND: Nordic walking is an attractive method of endurance training. Nevertheless, the biomechanic response due to the additional contribution of using poles in relation to free walking training has been less explored in the elderly. PURPOSE: This randomized parallel controlled trial aimed to assess the effects of 8 weeks of Nordic walking and free walking training on the walking economy, mechanical work, metabolically optimal speed, and electromyographic activation in elderly. METHODS: Thirty-three sedentary elderly were randomized into Nordic walking (n = 16) and free walking group (n = 17) with equalized loads. Submaximal walking tests were performed from 1 to 5 km h-1 on the treadmill. RESULTS: Walking economy was improved in both free and Nordic walking groups (x2 4.91, p = 0.014) and the metabolically optimal speed was increased by approximately 0.5 km h-1 changing the speed-cost profile. The electromyographic activation in lower and upper limbs, pendular recovery, and total, external, and internal mechanical work remained unchanged (p > 0.05). Interestingly, the internal mechanical work associated with arm movement was higher in the Nordic walking group than in the free walking group after training, while the co-contraction from upper limb muscles was reduced similarly to both groups. CONCLUSIONS: Eight weeks of Nordic walking training effectively improved the walking economy and functionality as well as maintained the gait mechanics, similar to free walking training in elderly people. This enhancement in the metabolic economy may have been mediated by a reduction in the co-contraction from upper limb muscles. TRIAL REGISTRATION: ClinicalTrails.gov NCT03096964

Parcerias para o desenvolvimento: o apoio do BNDES para a Região Sul por meio da Área de Operações Indiretas e instituições financeiras credenciadas, 2008-2013

Bibliografia: p. 179A parceria do BNDES com a rede de instituições financeiras credenciadas, federações de indústria e Serviço Brasileiro de Apoio às Micro e Pequenas Empresas (Sebrae) resultou em 100% de crescimento dos desembolsos para a Região Sul entre os anos 2008 e 2013. Este artigo mostra a participação da Área de Operações Indiretas (AOI) nesse avanço, apresentando números e esforços para simplificação do acesso ao crédito e para divulgação das linhas, sobretudo aquelas voltadas para micro, pequenas e médias empresas (MPME). Conclui-se que a AOI tem papel relevante no apoio do BNDES à Região Sul, caracterizada pela forte presença de empresas com grande potencial empreendedor.The BNDES’ partnership with a network of accredited financial institutions, industry federations, and Brazilian Micro and Small Business Support Service (Sebrae) resulted in a 100% increase in disbursements to the South region of Brazil between 2008 and 2013. The participation of the Indirect Operations Division (AOI) in such an advance is conveyed with numbers and initiatives set up to ease access to credit, particularly for micro, small and mediumsized companies. It concludes that the AOI plays an important role in furthering the BNDES’ support in the Region, characterized by a strong presence of companies with large-scale business potential

Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with po0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (po0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status

Oficinas Participativas na Elaboração do Plano de Manejo da APA-VRT

O presente artigo trata dos processos de participação social e política na produção do Plano de Manejo da Área de Proteção Ambiental da Várzea do Rio Tietê (APA-VRT) localizada no estado de São Paulo, Brasil. Esta APA é composta por doze municípios, foi criada em 1987 e seu plano de manejo foi realizado mais de 20 anos depois. O trabalho de produção deste documento iniciou em 2011 e foi conduzido por pesquisadores da Universidade de São Paulo. Neste artigo descreveremos e analisaremos os processos relativos à organização e implementação da oficina de Diagnóstico Socioambiental nas quais se assentaram os primeiros contatos entre Estado e sociedade civil em torno ao tema do plano de manejo da APA-VRT

Whole genome sequencing of the multidrug-resistant Chryseobacterium indologenes isolated from a patient in Brazil

Chryseobacterium indologenes is a non-glucose-fermenting Gram-negative bacillus. This emerging multidrug resistant opportunistic nosocomial pathogen can cause severe infections in neonates and immunocompromised patients. This study aimed to present the first detailed draft genome sequence of a multidrug-resistant C. indologenes strain isolated from the cerebrospinal fluid of an infant hospitalized at the Neonatal Intensive Care Unit of Brazilian Tertiary Hospital. We first analyzed the susceptibility of C. indologenes strain to different antibiotics using the VITEK 2 system. The strain demonstrated an outstanding resistance to all the antibiotic classes tested, including β-lactams, aminoglycosides, glycylcycline, and polymyxin. Next, C. indologenes was whole-genome-sequenced, annotated using Prokka and Rapid Annotation using Subsystems Technology (RAST), and screened for orthologous groups (EggNOG), gene ontology (GO), resistance genes, virulence genes, and mobile genetic elements using different software tools. The draft genome contained one circular chromosome of 4,836,765 bp with 37.32% GC content. The genomic features of the chromosome present numerous genes related to cellular processes that are essential to bacteria. The MDR C. indologenes revealed the presence of genes that corresponded to the resistance phenotypes, including genes to β-lactamases (blaIND–13, blaCIA–3, blaTEM–116, blaOXA–209, blaVEB–15), quinolone (mcbG), tigecycline (tet(X6)), and genes encoding efflux pumps which confer resistance to aminoglycosides (RanA/RanB), and colistin (HlyD/TolC). Amino acid substitutions related to quinolone resistance were observed in GyrA (S83Y) and GyrB (L425I and K473R). A mutation that may play a role in the development of colistin resistance was detected in lpxA (G68D). Chryseobacterium indologenes isolate harbored 19 virulence factors, most of which were involved in infection pathways. We identified 13 Genomic Islands (GIs) and some elements associated with one integrative and conjugative element (ICEs). Other elements linked to mobile genetic elements (MGEs), such as insertion sequence (ISEIsp1), transposon (Tn5393), and integron (In31), were also present in the C. indologenes genome. Although plasmids were not detected, a ColRNAI replicon type and the most resistance genes detected in singletons were identified in unaligned scaffolds. We provided a wide range of information toward the understanding of the genomic diversity of C. indologenes, which can contribute to controlling the evolution and dissemination of this pathogen in healthcare settings

Molecular Investigation Confirms Myotis Genus Bats as Common Hosts of Polychromophilus in Brazil

Plasmodium spp. and some other blood parasites belonging to the order Haemosporida are the focus of many epidemiological studies worldwide. However, haemosporidian parasites from wild animals are largely neglected in scientific research. For example, Polychromophilus parasites, which are exclusive to bats, are described in Europe, Asia, Africa, and Oceania, but little is known about their presence and genetic diversity in the New World. In this study, 224 samples of bats from remaining fragments of the Atlantic Forest and Pantanal biomes, as well as urbanized areas in southern and southeastern Brazil, were analyzed for the presence of haemosporidian parasites by PCR of the mitochondrial gene that encodes cytochrome b (cytb). The PCR fragments of the positive samples were sequenced and analyzed by the Bayesian inference method to reconstruct the phylogenetic relationships between Polychromophilus parasites from bats in Brazil and other countries. Sequences from Brazilian lineages of Polychromophilus were recovered in a clade with sequences from Polychromophilus murinus and close to the one Polychromophilus sequence obtained in Panama, the only available sequence for the American continent. This clade was restricted to bats of the family Vespertilionidae and distinct from Polychromophilus melanipherus, a parasite species mainly found in bats of the family Miniopteridae. The detection of Polychromophilus and the genetic proximity to P. murinus were further confirmed with the amplification of two other genes (clpc and asl). We also found a Haemosporida parasite sequence in a sample of Noctilio albiventris collected in the Pantanal biome, which presents phylogenetic proximity with avian Haemoproteus sequences. Morphological and molecular studies are still needed to conclude and describe the Polychromophilus species in Brazilian Myotis bats in more detail and to confirm Haemoproteus parasites in bats. Nevertheless, these molecular results in Brazilian bats confirm the importance of studying these neglected genera.Fil: da Silva Mathias, Bruno. Universidade de Sao Paulo; BrasilFil: Minozzo, Guilherme Augusto. No especifíca;Fil: Biondo, Alexander Welker. Universidade Federal do Paraná; BrasilFil: de Oliveira Jorge Costa, Jaciara. Universidade de Sao Paulo; BrasilFil: Sousa Soares, Herbert. Universidade de Santo Amaro; BrasilFil: Marcili, Arlei. Universidade de Sao Paulo; BrasilFil: de Oliveira Guimarães, Lilian. Instituto Pasteur; BrasilFil: a Clares dos Anjos, Carolina. Universidade de Sao Paulo; BrasilFil: Pires Dos Santos, Andrea. Purdue University; Estados UnidosFil: Riediger, Irina Nastassja. No especifíca;Fil: Fecchio, Alan. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagónica. Universidad Nacional de la Patagonia "San Juan Bosco". Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Bueno, Marina Galvão. Fundación Oswaldo Cruz; BrasilFil: Pinho, João Batista. Universidade Federal do Mato Grosso do Sul; BrasilFil: Kirchgatter, Karin. Universidade de Sao Paulo; Brasi

Influence Of Number Of Pregnancies In Peak Expiratory Flow And Body Composition Of Pregnant Women

Objectives: to describe and compare the mean values of the body composition and the peak expiratory flow (PEF) in primigravidae and multigravidae and, to determine its correlation with obstetric, anthropometric and body composition variables. Method: it was performed a cross-sectional study of 120 healthy pregnant women at low risk, including 77 primigravidae and 43 multigravidae. The PEF was measured by spirometry and the body composition by multisegmental electrical impedance. The unpaired t test was used to compare the groups and the Pearson correlation test was used to determine the association between PEF and independent variables. A multiple linear regression was used to estimate the relationship between the dependent variable, the PEF and the independent variables. Results: the body composition variables in multigravidae women showed higher values compared to the primigravidae, being statistically significant, except for fat mass. In primigravidae, the PEF was correlated significantly with maternal age and height. In multigravidae, the PEF was correlated with maternal age, height, pre-pregnancy and current weight, total body water, extracellular water, fat mass, lean mass and fat-free mass. A Multiple linear regression analysis showed that, in primigravidae, height and maternal age were associated with PEF, being responsible for explaining 14.5% of its variability. The current weight and the maternal age explained 42.3% of peak flow variability in multigravidae. Conclusion: The PEF seemed to be influenced by the number of pregnancies. Changes were observed in relation to the body composition, as it was evidenced in correlation with the PEF in multigravidae women. Keywords: Pregnancy. Spirometry. Weight gain

Perfil clínico-epidemiológico da criptococose associada e não associada à infecção pelo HIV na região Centro-Oeste do Brasil / Clinical and epidemiological aspects of cryptococcosis associated and non-associated to HIV infection in Central Western region of Brazil

Objetivo: Analisar as características clínicas-epidemiológicas, segundo a infecção pelo HIV, dos casos de criptococose no estado de Goiás. Métodos: Estudo transversal dos casos de criptococose no período de 2011 a 2014. Utilizou-se registros laboratoriais e prontuários médicos de unidades de saúde referência para a doença. Aplicou testes estatísticos para comparar o grupo HIV positivos e HIV negativos com as variáveis estudadas. Resultados: Identificou 130 casos de criptococose, 116(89,2%) HIV positivos e 14(10,8%) negativos. A meningoencefalite foi a forma clínica predominante em ambos os grupos, assim como a espécie Cryptococcus neoformans. Entre os casos HIV negativos (64,3%) usavam medicamentos imunossupressores. A média da contagem de células TCD4 dos casos HIV positivos foi 58,7 células/mm3e 60,8% foram a óbito, entre os sobreviventes, 43,1% ficaram com sequelas, sendo o déficit visual o mais frequente. Conclusões:  A criptococose é uma doença grave, dada a elevada letalidade e potencial de provocar danos funcionais