DELIRIUM E TEMPO DE PERMANÊNCIA EM UNIDADE DE TERAPIA INTENSIVA

Objetivo: analisar a associação entre delirium e tempo de permanência na Unidade de Terapia Intensiva. Método: estudo de coorte prospectivo conduzido na terapia intensiva de um hospital universitário de São Paulo, Brasil, entre outubro e dezembro de 2017. Participaram todos os pacientes acima de 18 anos. As variáveis independentes foram os dados clínicos, demográficos e o tempo de permanência. A variável dependente foi o delirium, medido pelo instrumento Confusion Assessment Method (ICU). Na análise dos dados, foi realizada a estatística descritiva, correlação de Spearman, teste V Cramer e o modelo de regressão logística para o teste de associação. Resultados: o delirium foi identificado em 48,5% dos pacientes graves e correlacionado com número de doses de medicamento e tempo de permanência. A condição de saída apresentou diferença significativa entre pacientes com e sem delirium. Conclusão: o tempo de permanência aumentou em quase 10,0% a chance de delirium na Unidade de Terapia Intensiva.Descritores: Enfermagem. Unidades de Terapia Intensiva. Cuidados Críticos. Delirium. Tempo de Internação. Avaliação em Enfermagem

Determination of Doppler velocimetric measurements of the median artery in horses: Determinação das medidas dopplervelocimétricas da artéria mediana em equinos

Considering the importance of equine culture for the northeast region, the objective was to determine the median artery Doppler velocimetry measurements in horses through Doppler ultrasonography and to correlate changes in these measurements with possible risk factors for laminitis and / or other foot diseases. The project was approved for its execution through protocol N°. 3769100419 granted by the UFPB Ethics Committee. The analyzes were performed at Horse Training Centers and at the Veterinary Hospital - CCA / UFPB, in Areia, Paraíba State. Fourteen animals were used, which were trichotomized at the time of the third metacarpal bone, medial face of both thoracic limbs. The sonoscape S2V ultrasound device with color Doppler coupled to a 7 MHz linear probe was placed at the height of the median artery, in which B was measured. Then, the color Doppler mode was used to determine the doppler velocimeter measurements. Thus, with a 95% confidence interval in mode B 0,509 ± 0,133 of the median artery diameter was determined and in Doppler mode 2,198 ± 1,451 of the pulsatility index and 0,734 ± 0,906 of the resistivity index (non-parametric data). as reference values ​​for normality of median artery vascularization. It is concluded that more studies need to be developed to attest to the reliability of these values. Moreover, they may help in the early diagnosis, improving the prognosis of these animals prone to laminitis and other foot diseases

Florações de Cianobactérias tóxicas no Reservatório do Funil: dinâmica sazonal e consequências para o zooplâncton

revista vol 13 nº 2.indd The Funil water reservoir, located in the Paraíba do Sul River Valley in the municipality of Resende (Rio de Janeiro State, Brazil), has become eutrophic during the last two decades and undergone recurrent blooms of cyanobacteria. This study presents temporal series of physical, chemical and biological data from the reservoir encompassing an overall period of four years (from June/02 to March/06). Monthly, measurements of conductivity, transparency, temperature, pH, dissolved oxygen, and water samples for the analyses of nutrients (N and P), chlorophyll-a, phytoplankton and zooplankton composition and cyanotoxins in seston and in net plankton were performed. Toxicity tests with native and temperate cladocerans species were also performed. The results showed that the high input of N and P favored the persistent dominance of cyanobacteria. A temporal pattern was observed mainly related to changes in water temperature, characterizing two distinct periods: a warm-wet period with cyanobacterial bloom, and a cold-dry period with general reduced biomass. Cyanobacteria included potential hepatotoxins (microcystins) producers like Microcystis spp., and potential neurotoxins (saxitoxins) producers like Anabaena circinalis and Cylindrospermopsis raciborskii. In fact, elevated concentrations of microcystins and saxitoxins were found in the phytoplankton, and high levels of microcystins in the zooplankton, suggesting that these toxins may be transferred through the food chain. The toxicity tests revealed that the cyanobacterial blooms had toxic effects on cladocerans, causing death, reduction in the rate of population increase (r), and paralysis, in agreement with the mechanism of action of the cyanotoxins present.revista vol 13 nº 2.indd El Embalse de Funil, localizado en el valle del Río Paraíba do Sul, municipio de Resende (RJ), se convirtió en un ambiente eutrófico a lo largo de las últimas dos décadas, con floraciones recurrentes de cianobacterias. Este estudio presenta una serie temporal de datos físicos, químicos y biológicos del embalse abarcando un período de cuatro años (Junio/02 a Marzo/06). Durante dicho período, se tomaron mensualmente medidas de conductividad eléctrica, transparencia de la columna de agua, temperatura, pH, oxigeno disolvido, muestras de agua para análisis de nutrientes (N y P), clorofila-a, de la composición de la comunidad fitoplanctônica y zooplanctónica y cianotoxinas en el seston y colectas en red de plancton. También fueron realizados ensayos de toxicidad con cladóceros nativos así como también con una especie de zonas templada. Los resultados encontrados evidencian que el elevado y constante aporte de N y P favorece la ocurrencia de cianobacterias durante todo el año. Sin embargo, los patrones temporales están principalmente relacionados con el cambio en la temperatura, caracterizando dos períodos diferentes: cálido-húmedo, con floraciones de cianobacterias, y frío-seco, con una biomasa reducida. Entre las cianobacterias presentes están las especies potencialmente productoras de hepatotoxinas (microcistinas), como Microcystis spp., y de neurotoxinas (saxitoxinas), como Anabaena circinalis e Cylindrospermopsis raciborskii. Fueron encontradas concentraciones elevadas de microcistinas y saxitoxinas en el fitoplancton y microcistinas en el zooplancton, sugiriendo que puede existir transferencia trófica de dichas toxinas en la cadena alimenticia. Los ensayos de toxicidad revelaron que las floraciones de cianobacterias ejercieron efectos tóxicos sobre los cladóceros, como alta mortalidad, reducción de la tasa de crecimiento poblacional (r) y parálisis de los movimientos natatorios, que parecen estar relacionados con el mecanismo de acción de las cianotoxinas presentes.O Reservatório do Funil, situado no vale do Rio Paraíba do Sul, município de Resende (RJ), tornou-se ao longo das últimas duas décadas um ambiente eutrófico, com florações recorrentes de cianobactérias. Este estudo apresenta uma série temporal de dados físicos, químicos e biológicos do reservatório, abrangendo um período amostral de quatro anos (junho/02 a março/06). Mensalmente, foram realizadas medidas de condutividade elétrica, transparência da coluna d'água, temperatura, pH, oxigênio dissolvido, e coletas de água para análise de nutrientes (N e P), clorofila-a, cianotoxinas do seston e do plâncton de rede, e da composição da comunidade fitoplanctônica e zooplanctônica. Foram também realizados testes de toxicidade com cladóceros nativos e de origem temperada. Os resultados mostraram que o elevado e constante aporte de N e P favorece a ocorrência de cianobactérias durante todo ano. Entretanto, a variabilidade temporal está principalmente relacionada às alterações de temperatura, caracterizando dois períodos distintos: quente-chuvoso, com floração de cianobactérias e frio-seco, com reduzidas biomassas. Entre as cianobactérias presentes estão espécies potencialmente produtoras de hepatotoxinas (microcistinas), como Microcystis spp., e de neurotoxinas (saxitoxinas), como Anabaena circinalis e Cylindrospermopsis raciborskii. Foram encontradas concentrações elevadas de microcistinas e saxitoxinas no fitoplâncton e microcistinas no zooplâncton, sugerindo que pode haver transferência trófica destas toxinas na cadeia alimentar. Os testes de toxicidade revelaram que as florações de cianobactérias exerceram efeitos tóxicos para os cladóceros, como alta mortalidade, redução da taxa de crescimento populacional (r) e paralisia dos movimentos natatórios, que parecem estar relacionados ao mecanismo de ação das cianotoxinas presentes

Effect of Polydextrose on the Growth of Pediococcus pentosaceus as Well as Lactic Acid and Bacteriocin-like Inhibitory Substances (BLIS) Production

Pediococcus pentosaceus was cultivated in MRS medium supplemented or not with polydextrose under different conditions in order to evaluate its effect on cell growth, lactic acid and bacteriocin-like inhibitory substance (BLIS) production. Independent variables were pH (4.0, 5.0, 6.0), rotational speed (50, 100, 150 rpm), polydextrose concentration (0.5, 1.0, 1.5%) and temperature (25, 30, 35 °C), while cell concentration and productivity after 24 h, maximum specific growth rate, specific rate of substrate (glucose) consumption, volumetric and specific lactic acid productivities, yields of biomass and lactic acid on consumed substrate were the dependent . The maximum cell concentration (10.24 ± 0.16 gX L−1) and productivity (0.42 ± 0.01gX L−1 h−1) were achieved at pH 6.0, 35 °C, 150 rpm using 1.5% polydextrose, while the maximum specific growth rate (0.99 ± 0.01 h−1) and yield of biomass (2.96 ± 0.34gX gS−1) were achieved at the same pH and polydextrose concentration, but at 25 °C and 50 rpm. The specific substrate consumption rate (0.09 ± 0.02 gS gX−1 h−1) and the volumetric lactic acid productivity (0.44 ± 0.02 gP L−1 h−1) were maximized at pH 6.0, 35 °C, 50 rpm and 0.5% polydextrose. BLIS produced in this last run displayed the highest antibacterial activity against Escherichia coli, while the same activity was displayed against Enterococcus faecium using 1.5% polydextrose. These results appear to be quite promising in view of possible production of this BLIS as an antibacterial agent in the food industr

Mapping the morbidity and mortality of Chagas disease in an endemic area in Brazil

Chagas disease is among the 21 neglected diseases according to the World Health Organization. This study aimed to investigate the morbidity and mortality distribution of Chagas disease for identifying areas with greater prevalences and deaths of the disease in Northeast Brazil. A population-based ecological study was performed from 2016 to 2018 using data on acute Chagas disease patients from the Disease Notification Information System, chronic cases from the Chagas Disease and the referral Heart Failure Outpatient Clinic in Pernambuco, and Chagas disease-related mortality from the Mortality Information System. The unit of analysis were Pernambuco State mesoregions. The indicators were spatialized into thematic maps on the occurrence and mortality of the disease per 100,000 inhabitants. No cases of acute disease were reported in the period analyzed. Data on 801 chronic Chagas disease patients were analyzed. The population showed an average age of 62 years, with female predominance. The most prevalent comorbidity was systemic arterial hypertension and cardiologic involvement without ventricular dysfunction. The average chronic disease occurrence rate was 3.2/ 100,000 people/ year. As for deaths in the mortality system; in total, 350 deaths were recorded, showing male predominance, age ≥ 60 years, and chronic disease with cardiac involvement as the main mortality cause. The annual average mortality proportion was 1.6/100,000 people. The chronic case distribution showed spatial heterogeneity, with the highest rates of chronic disease and deaths observed in two mesoregions, with the main cause of death being heart-related. This highlights the need for more specialized services in areas with higher burden of the disease to avoid delay in the patients’ care

Effects of low-level laser therapy on stem cells from human exfoliated deciduous teeth

Low-Level Laser Therapy stimulates the proliferation of a variety of types of cells. However, very little is known about its effect on stem cells from human exfoliated deciduous teeth (SHED). Objective This study aimed to evaluate the influence of different laser therapy energy densities on SHED viability and proliferation. Material and Methods SHED were irradiated according to the groups: I (1.2 J/cm2 - 0.5 mW – 10 s), II (2.5 J/cm2 – 10 mW – 10 s), III (3.7 J/cm2 – 15 mW – 10 s), IV (5.0 J/cm2 – 20 mW – 10 s), V (6.2 J/cm2 – 25 mW – 10 s), and VI (not irradiated – control group). Cell viability was assessed 6 and 24 h after irradiation measuring the mitochondrial activity and using the Crystal Violet assay. Cell proliferation was assessed after 24, 48, and 72 h of irradiation by SRB assay. Results MTT assay demonstrated differences from 6 to 24 hours after irradiation. After 24 h, groups I and IV showed higher absorbance values than those of control group. Crystal Violet assay showed statistically differences in the absorbance rate from 6 to 24 h after irradiation for groups III and VI. At 24 h after irradiation, Group III absorbance rate was greater than that of groups I, II, and IV. Group VI absorbance rate was greater than that of groups I and IV. SRB assay showed that the group I had higher rates than those of groups II, III, V, and VI, at 24 h after irradiation. After 48 h, group I exhibited the greatest cell proliferation rate followed by groups III, V, and VI. After 72 h, group III exhibited the lowest cell proliferation rate than those of groups II, IV, and V. Conclusions The Low-Level Laser Therapy energy densities used in this study did not cause loss of cell viability and stimulated SHED proliferation within the parameters described in this study

Modulação dos receptores de hormônio tireoidiano, TRα e TRβ, utilizando diferentes doses de triiodotironina (T3) em diferentes tempos

OBJECTIVE: To examine the effect of different doses of triiodothyronine (T3) on mRNA levels of thyroid hormone receptors, TRα and TRβ, at different times. MATERIALS AND METHODS: 3T3-L1 adipocytes were incubated with T3 (physiological dose: F; supraphysiological doses: SI or SII), or without T3 (control, C) for 0.5, 1, 6, or 24h. TRα and TRβ mRNA was detected using real-time polymerase chain reaction. RESULTS: F increased TRβ mRNA levels at 0.5h. After 1h, TRα levels increased with F and SI and TRβ levels decreased with SII compared with C, F, and SI. After 6h, both genes were suppressed at all concentrations. In 24h, TRα and TRβ levels were similar to those of C group. CONCLUSIONS: T3 action with F began at 1h for TRα and at 0.5h for TRβ. These results suggest the importance of knowing the times and doses that activate T3 receptors in adipocytes.OBJETIVO: Examinar o efeito de diferentes doses de triiodotironina (T3) sobre a expressão gênica dos receptores TRα e TRβ em diferentes tempos. MATERIAIS E MÉTODOS: Adipócitos, 3T3-L1, foram incubados com T3 nas doses fisiológica (F, 10nM) e suprafisiológicas (SI, 100nM ou SII, 1000nM) ou veículo (controle, C) durante 0,5, 1, 6 ou 24h. mRNA dos TRs foram detectados utilizando PCR em tempo real. RESULTADOS: Níveis de TRβ aumentaram em F em 0,5h. Após 1h, níveis de TRα aumentaram em F e SI comparado ao C, enquanto TRβ diminuiu no SII comparado com C, F, e SI. Após 6h, ambos os genes foram suprimidos em todas concentrações. Em 24h, níveis de TRα e TRβ retornaram aos do C. CONCLUSÕES: Ação do T3 em F iniciou-se em 1h para TRα e 0,5h para TRβ. Esses resultados são importantes para determinar tempo inicial e dose de T3 em que os receptores de HT são ativados em adipócitos.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Unesp Botucatu Medicine School Department of Internal ClinicUniversidade Federal de São Paulo (UNIFESP) Department of PhysiologyUnesp Biosciences Institute Department of BiostatisticsUNIFESP, Department of PhysiologySciEL

Construction and validation of educational booklet about spirometry for users: Construção e validação de cartilha educativa sobre espirometria para usuários

Spirometry should be performed to diagnose ventilatory changes and measure their severity in patients with signs and symptoms. The objective was to develop a booklet to guide users on spirometry. This is a methodological study that was carried out in the pulmonary function laboratory of the Walter Cantídio hospital, located in Fortaleza-Ceará-Brazil, after institutional consent. Ten users of the spirometry exam, who were present at the pulmonary function outpatient clinic of the referred hospital, were interviewed, and those who agreed to participate in the study, who had or did not perform the spirometry exam previously and aged> 18 years, were selected. For validation of the booklet, six judges issued their opinion. The results revealed that most users have performed the exam before, but do not know the precautions that must be taken before, during and after the exam. Therefore, the content of the booklet was constructed based on these considerations of the users, as well as the validation of the courts and was adapted. The technology built will facilitate the service of the multiprofessional team that will have more time to assist in the health problem situation. Therefore, the use of this educational resource opens the way for the management of care and approximation of these data to the process of planning care actions by the team