Recomendações nutricionais na Distrofia Muscular de Duchenne

OBJETIVO: Pesquisar as recomendações nutricionais para pacientes com Distrofia Muscular de Duchenne (DMD). MÉTODO: Trata- se de uma revisão integrativa da literatura, através de levantamento bibliográfico nas bases cientificas PubMed e Scielo, foram utilizadas as palavras chaves: Distrofia Muscular de Duchenne em combinação com os termos Nutrição, Nutrientes, Nutracêuticos, Vitaminas e Antioxidantes. Foi realizada a busca dos artigos publicados nos últimos 10 anos. RESULTADOS: Foram selecionados 102 artigos, dos quais após análise dos critérios de exclusão e inclusão, resultaram em 31 artigos referentes a 31,62% da amostra inicial que foram utilizados para a produção dessa revisão. CONCLUSÃO: O acompanhamento nutricional do paciente com DMD é fundamental, de forma a garantir a manutenção do estado nutricional, além de contribuir de forma significativa para a desaceleração dos sintomas da doença e melhora da qualidade de vida

A POSSIBILIDADE DE IMPLANTAÇÃO DO ICMS-ECOLÓGICO NO ESTADO DO AMAZONAS

RESUMOA temática da preservação ambiental é recorrente na preocupação internacional a respeito dos impactos climáticos que a humanidade tem enfrentado. O aumento gradativo da temperatura global é fator importante a ser considerado quando se analisa qualquer aspecto do meio-ambiente, principalmente no que tange à sadia qualidade de vida. Neste sentido, o objetivo desta pesquisa verificar a possibilidade do direito tributário auxiliar no instituto da sustentabilidade Ambiental e abordando o tributo ICMS sob o viés ecológico, no âmbito do Estado do Amazonas. Conclui-se que o ICMS-Ecológico exorta comportamentos positivos por parte do Poder municipal que poderá, através da Educação Ambiental, estimular comportamentos positivos dos munícipes do Estado do Amazonas, gerando proteção ambiental e, consequentemente, melhoria da qualidade de vida no Estado. Utilizou-se do método dedutivo sendo que, quantos aos meios a pesquisa foi a bibliográfica e, quantos aos fins, qualitativa. PALAVRAS-CHAVES: ICMS-Ecológico; Sustentabilidade; Município ABSTRACT The theme of environmental preservation is recurrent in international concern about the climatic impacts that humanity has faced. The gradual increase of the global temperature is an important factor to be considered when analyzing any aspect of the environment, especially with regard to the healthy quality of life. In this sense, the objective of this research is to verify the possibility of the auxiliary tax law in the institute of Environmental sustainability and addressing the ICMS tax under the ecological bias, within the scope of the State of Amazonas. It is concluded that the ICMS-Ecological calls for positive behaviors on the part of the municipal power that can, through Environmental Education, stimulate positive behaviors of the citizens of the State of Amazonas, generating environmental protection and, consequently, improvement of the quality of life in the State. The deductive method was used, how many to the means the research was the bibliographical and, how many to the ends, qualitative. KEYWORDS: ICMS-Ecological; Stainability; Municipality

A EXTRAFISCALIDADE DO IPTU COMO FORMA DE INDUÇÃO AO DESENVOLVIMENTO DE UM MEIO AMBIENTE MAIS SAUDÁVEL

RESUMO O meio ambiente saudável é essencial para a vida, e tem-se como um dos principais poluidores o dióxido de carbono (CO2). Em contrapartida, o principal combatente ao CO2 as árvores. O objetivo desta pesquisa foi o de demonstrar como a extrafiscalidade do IPTU pode incentivar o cidadão na construção de um meio ambiente saudável, garantindo-o para as futuras gerações. Conclui-se que o estímulo dado pelo Poder Público, através de exemplos, é fundamental para o cidadão participar efetivamente da criação de um meio ambiente mais equilibrado. A metodologia utilizada foi a dedutiva e qualitativa, na qual usa-se a revisão bibliográfica, pesquisas legislativas e jurisprudências. PALAVRAS-CHAVES: IPTU verde; meio ambiente saudável; extrafiscalidade do IPTU. ABSTRACTThe healthy environment is essential for life, and carbon dioxide (CO2) is a major polluter. In contrast, the main combatant to CO2 the trees. The objective of this research was to demonstrate how the IPTU's extrafiscality can encourage the citizen in the construction of a healthy environment, guaranteeing it for future generations. It is concluded that the stimulus given by the Public Power, through examples, is fundamental for the citizen to participate effectively in the creation of a more balanced environment. The methodology used was deductive and qualitative, in which the bibliographic review, legislative searches, comun law. KEYWORDS: IPTU green; healthy environment; IPTU extrafiscality

ARTIFICIAL PRUNING OF FOREST TREE SPECIES IN RESPONSE TO CULTIVATION METHOD

This study aimed to quantify the artificial pruning of forest species sabia (Mimosa caesalpiniaefolia Benth.), acacia (Acacia mangium Willd.) and neem (Azadirachta indica A. Juss), at 12 months of age, in response to the cultivation method. The experimental design was in randomized block design in a factorial scheme (2x3), corresponding tosix treatments distributed in plots in tracks with four blocks. Being the main factor two methods of cultivation (less intensive - CA and more intensive - CB) and the secondary factor the forest species, totaling six treatments with four replicates each. The growth of each tree was obtained with the measurement of the total height and diameter at breast height. For the quantification of biomass pruned selected is a tree in the surrounds of each parcel with average height and diameter. The pruning was performed until the height equivalent to 40% of the crown height of the tree. The three variables studied (leaf, branch and total) showed significant differences between the types of cultivation and between the species. Only the parameter leaf for the sabia treatment didn’t show differences in relation to the cultivation types. We concluded that the cultivation method and the species types have influency in the total biomass production and consequently in the pruned plant amount

Eventos científicos e a educação médica durante a pandemia: uma revisão integrativa da literatura / Scientific events and medical education during pandemia: an integrative literature review

Este estudo teve o objetivo de buscar evidências sobre possíveis contribuições e/ou limitações que a adaptação de eventos científicos para a modalidade virtual esteja trazendo para a educação médica (EM). Realizou-se uma busca nas bases de dados Biblioteca Virtual em Saúde (BVS), US National Library of Medicine (PUBMED) e PubCovid-19, utilizando os descritores “educação à distância”, “educação médica”, “pandemia” e “coronavírus, com filtro de 1 ano (julho de 2019 – julho de 2020). Destacaram-se como possíveis contribuições a hiperconectividade digital e o preparo da geração atual para integrar a tecnologia no compartilhamento dos conhecimentos em ambientes on-line. As possíveis limitações relacionam-se às habilidades interpessoais e ao aumento orçamentário. Os achados são suficientes para trazer inovação e contribuição para avanços no campo da EM, bem como para estimular estudos que investiguem o papel das tecnologias na integração da tríade ensino- pesquisa-extensão

Canine Cystitis - Biofilm Formation by Bacterial Isolates

Background: Biofilms have been reported as important virulent markers associated with drug resistance in urinary tract infections (UTIs) in humans and dogs. However, in veterinary medicine, researches involving biofilm formation, treatments and preventions have been limited; yet, it is still possible to find few studies demonstrating biofilm-forming bacteria associated with different comorbidities such as otitis, wound infections, UTIs, and endometritis. These studies generally select dogs with chronic and recurrent infections, which could be an important factor in antibiotic resistance. We aimed to evaluate biofilms in sporadic cystitis regarding prevalence and drug resistance.Materials, Methods & Results: Urine samples were collected by cystocentesis from 36 client-owned dogs under clinical and laboratory suspicion of non-recurrent urinary bladder infection (cystitis). Urine was aseptically plated onto blood agar, MacConkey, and CLED, followed by incubation for 24 to 48 h. Definitive identification of a potential pathogen was made by subculture collected from an isolated colony to obtain a pure culture. The gram staining method and specific biochemical tests (phenol red fermentation, lysine, phenylalanine, citrate, sulfide-indole-motility, and urease) were used to distinguish and classify the bacteria. After identification, the bacteria were tested for antimicrobial susceptibility by a standard disk diffusion method, using the following antimicrobials: amoxicillin with clavulanic acid, ampicillin, ceftriaxone, ciprofloxacin, clindamycin, cefazolin, cephalothin, erythromycin, gentamicin, norfloxacin, and sulfamethoxazole-trimethoprim. The biofilm-forming ability was determined based on a culture in Congo red agar (CRA), where biofilm producer strains formed black colonies with a dry crystalline surface, while non-biofilm producer strains formed red colonies with a smooth surface. A crystal violet dye assay was used to confirm the CRA results. Of the 36 urine samples collected from dogs with suspected cystitis, a total of 37 isolates were obtained, from mixed or pure cultures. The most prevalent bacteria were Escherichia coli (11/37), followed by Staphylococcus spp. (8/37), Proteus spp. (7/37), and Enterococcus spp. (5/37). Other less prevalent bacteria were Klebsiella spp., Streptococcus spp., and Enterobacter spp. As for biofilm-forming ability, 67.6% (25/37) of the 37 bacterial isolates had biofilm formation in CRA and 54.05% (20/37) on the microplates containing crystal violet dye. There was no statistical difference in antimicrobial susceptibility between biofilm producer and non-biofilm producer bacteria.Discussion: We found a high proportion (> 54%) of in vitro biofilm-forming ability by different bacteria, which may indicate that biofilms may also be formed in vivo, in simple cystitis. Antimicrobial resistance was not noticed in bacteria capable of forming a biofilm; however, in a future study it is important to evaluate bacterial resistance in vivo, considering the possibility of having a different response than in vitro. In addition, the problem of the presence of a biofilm in vivo is that it can nullify the antimicrobial efficacy of therapeutic agents even with in vitro susceptibility. Besides the possibility of slow or incomplete diffusion of antibiotics through the extracellular matrix of the biofilm, aspects like hydration level, pCO2, pO2, pH, pyrimidine, and divalent cation concentration that negatively influence antimicrobial activity in vitro can also cause undesirable effects at the profound layers of the biofilm. In conclusion, all of the genera of bacteria isolated from dog’s sporadic cystitis in this study were able to form a biofilm in vitro. The pathogenicity and antibiotic resistance of bacteria appears unrelated to biofilm formation in vitro.Keywords: sessile bacteria, urine, simple cystitis, antibiotic resistance

AVALIANDO O NÍVEL DE CONHECIMENTO EM PRIMEIROS SOCORROS DOS ACADÊMICOS DE ENFERMAGEM EM UM CENTRO UNIVERSITÁRIO DO SERTÃO CENTRAL

Primeiros socorros são ações iniciais à vítima, realizadas no local onde ocorreu a situação de emergência, tendo como finalidade manter a vida, sem provocar mais lesões ou agravar as já existentes, é importante que graduandos de Enfermagem sejam incentivados e treinados em suporte básico de vida (SBV) para prestar socorros adequados e de qualidade. Este estudo teve como objetivo geral avaliar o nível de conhecimento em primeiros socorros dos acadêmicos de enfermagem em um Centro Universitário do Sertão Central. Assim desenvolveu-se um estudo de caráter exploratório descritivo com abordagem quantitativa, como amostra tivemos 43 acadêmicos de enfermagem, a coleta de dados foi realizada em novembro de 2016, por meio de um jogo educativo o “Aprender brincando” acompanhado por um questionário com perguntas diversas, através das respostas desse questionário foram formulados gráficos e tabelas discutidas junto com a literatura. Como resultados tivemos que a maioria dos estudantes apresentam um conhecimento “bom” sobre primeiros socorros, porém, ainda existe uma carência imensa para aprimorar este conhecimento. Diante dos resultados, concluímos que ainda é alto o número de pessoas que não saberiam atuar em situações de emergência, e nos preocupa o fato de acadêmicos de enfermagem que também não saberia agir de maneira adequada nessas situações, contudo, nos tranquilizamos, pois, essa grande maioria pertence ao primeiro semestre onde os mesmos relatam não terem feito a cadeira optativa de Primeiros Socorros, assim não possuem tanto embasamento sobre o assunto.

INTESTINAL AND PULMONARY INFECTION BY Cryptosporidium parvum IN TWO PATIENTS WITH HIV/AIDS

We describe two patients with HIV/AIDS who presented pulmonary and intestinal infection caused by Cryptosporidium parvum, with a fatal outcome. The lack of available description of changes in clinical signs and radiographic characteristics of this disease when it is located in the extra-intestinal region causes low prevalence of early diagnosis and a subsequent lack of treatment

A general methodology for adaptative planning of urban water systems under deep uncertainty

ABSTRACT Urban Water Systems (UWS) operate under a broad list of uncertainties. They usually depend on large amount of investments requiring long-term planning for a future full of changes with high degree of uncertainties (climate, social and economic). Many of these uncertainties do not have analytical representation neither they count on agreement among experts or decision makers concerning their influence in the performance of the UWS. The literature has named these changes as deep uncertainties (DU). This work presents a general approach to incorporate the influence of DU on planning and management processes of three types of UWS: 1) Water Supply Systems; 2) Drainage Systems and 3) Rainwater Harvesting Systems. The proposed framework defines steps toward the selection of the best policies and their evaluation in a broad set of scenarios. The particularities of each urban system led to adjustments in some steps of the general methodology. The approach proposed in this work was applied to a practical case, the Rainwater Harvesting Systems in the city of Ipameri, located in the State of Goiás, Brazil. The results highlight the impacts of DU factors on the system performance and reinforce this type of approach as a contribution towards adaptive planning for UWS

Early Childhood Caries Experience of Children from Poor Families Living Below and Above Poverty Line

Objective: To evaluate the role of poverty and its related factors on early childhood caries (ECC) experience among deprived children. Material and Methods: This population-based cross-sectional study surveyed 418 children aged one to six years enrolled in Brazilian public preschools from an area of the country known for its high social deprivation. Intraoral examination of children evaluated dental caries experience (dmft). Parents/caregivers answered a questionnaire with sociodemographic indicators. Family income was dichotomized into below or above poverty line. Data analysis used Chi-square test, Mann-Whitney test, and Multivariate Logistic Regression analysis (p<0.05). Results: Predisposing variables for an increased chance of ECC were: age group 3-4 years (OR: 4.89; 95% CI: 2.32-10.31), age group 5-6-years (OR: 5.60; 95% CI: 2.60-12.04), being part of families living below poverty line (OR: 1.88; 95% CI: 1.04-3.38) and having mothers with less than nine years of schooling (OR: 2.86; 95% CI: 2.77-7.14). Children from families living below poverty line presented higher dmft (2.9 +3.8; p=0.001) and untreated dental caries (d component) (2.7 +3.7; p=0.002). Conclusion: ECC in a poor population was influenced by indicators of social deprivation. The poorest of poor children from mothers with less years of schooling were at higher risk