NEUROTRAUMA PROJECT: Educate to prevent – the best treatment

Introdução: As lesões neurológicas são as principais causas de deficiência. Os neurotraumas: trauma raquimedular (TRM) e traumatismo cranioencefálico (TCE) além de frequentes, causam, muitas vezes, danos neurológicos permanentes e acometem comumente os jovens que têm a sua vida inteiramente modificada. Os neurotraumas impactam a vida não só do indivíduo que sofre o trauma, mas de toda a sua família, além do sistema de saúde e previdenciário, tornando-se um problema de saúde pública. Objetivos: Promover ações educativas relacionadas aos neurotraumas a alunos do ensino médio das escolas públicas de Diamantina – Minas Gerais e conscientizar sobre a seriedade do TRM e TCE estimulando a prevenção. Métodos: Alunos do ensino médio das escolas públicas da cidade de Diamantina – Minas Gerais formaram o público alvo da intervenção deste projeto de extensão. A atividade extensionista iniciou após autorização da equipe escolar. Um questionário sobre o conhecimento e fatores de risco do TRM e TCE foi entregue para os alunos antes da aula expositiva e ilustrativa sobre os neurotraumas. A aula continha assuntos relacionados à anatomia neurológica, etiologia, incidência, fatores de risco, prognóstico, complicações e prevenção dos neurotraumas. Houve um período para debate e dúvidas, e um folder explicativo sobre o assunto foi entregue aos alunos no final da abordagem. Os dados relacionados ao questionário aplicado foram analisados e relatos dos alunos extensionistas e da equipe escolar foram registrados. Resultados: O número total de estudantes abordados nesta intervenção foi de 451, distribuídos entre os três anos do ensino médio, 32% do primeiro ano, 40% e 28% do segundo e terceiro, respectivamente. A média de idade dos estudantes foi de 16 anos e a maioria do gênero feminino (55%). Um número expressivo de alunos não tinha conhecimento sobre o TRM (41%) e TCE (52%) e vários deles apresentavam atitudes de risco para um possível neurotrauma. Conclusão: A melhor conduta para evitar o número crescente e as consequências dos neurotraumas é a prevenção, pois além da autoproteção, evita acidentes a terceiros e trazem benefícios econômicos para toda a sociedade e menos sofrimento para os indivíduos. Houve interação entre a universidade e as escolas o que proporcionou o aumento do aprendizado.Introducción: Las lesiones neurológicas son las principales causas de discapacidad. Los neurotraumas, trauma raquimedular (TRM) y traumatismo craneoencefálico (TCE), además de frecuentes, muchas veces causan daños neurológicos permanentes y se presentan con frecuencia en los jóvenes que tienen sus vidas completamente modificadas. Los neurotraumas no solo afectan la vida del individuo que lo sufre, sino también su vida familiar, el sistema de salud pública y de seguridad que se convierte en uno problema de salud pública. Objetivos: Promover acciones educativas relacionadas con neurotraumas a los alumnos de bachillerato de las escuelas públicas de Diamantina, Minas Gerais, y concientizar acerca de la seriedad del TRM y TCE estimulando la prevención. Métodos: Alumnos del bachillerato de las escuelas públicas de la ciudad de Diamantina, Minas Gerais, han formado el público objetivo de la intervención de este proyecto de extensión. La actividad extensionista empezó después de la autorización del equipo escolar. Un cuestionario acerca del conocimiento y los factores de riesgo del TRM y TCE fue entregado para los alumnos antes de la clase expositiva y ilustrativa sobre los neurotraumas. La clase contenía temas relacionados con la anatomía neurológica, etiología, incidencia, factores de riesgo, pronóstico, complicaciones y prevención de los neurotraumas. Hubo un período de debate para aclarar las dudas y se entregó un folleto explicativo sobre los contenidos, a los alumnos al final de la actividad. Los datos relacionados al cuestionario aplicado fueron analizados y se registraron informes de los alumnos extensionistas y del equipo escolar. Resultados: El número total de los estudiantes abordados en esta intervención fue de 451 distribuidos entre los tres años del bachillerato, 32% del primer año, 40% y 28% del segundo y tercero, respectivamente. El promedio de las edades de los estudiantes fueron de 16 años y la mayoría fue del género femenino (55%). Un número significativo de alumnos no tenían conocimiento sobre el TRM (41%) y TCE (52%) y varios de ellos presentaban actitudes de riesgo para un posible neurotrauma. Conclusiones: La prevalencia del desconocimiento sobre el TCE y el TRM y sus consecuencias fue alta entre los estudiantes de secundaria y los hábitos de riesgo para un neurotrauma fueron identificados y ampliamente discutidos. La mejor conducta para evitar el número creciente y las consecuencias de los neurotraumas es la prevención, además de la autoprotección, evita accidentes a terceros y traen beneficios económicos para toda la sociedad y menos sufrimiento para las personas. Hubo interacción entre la universidad y las escuelas proporcionando intercambio de saberes, agregando, posiblemente, nuevos conocimientos para todos los involucrados.Introduction: Neurological injuries are the main causes of disability. Neurotraumas, spinal cord injuries (SCI) and traumatic brain injury (TBI), besides being frequent, often cause permanent neurological damage and commonly affect young people whose lives are completely modified. Neurotraumas impact not only the life of the individual who suffers the trauma, but of the whole family, as well as the health and social security system, becoming a public health problem. Objectives: To promote educational actions related to neurotraumas for high school students in the public schools of Diamantina, Minas Gerais, and to raise awareness about the seriousness of SCI and TBI by stimulating prevention. Methods: High school students from the public schools of the city of Diamantina, Minas Gerais, formed the target audience for the intervention of this extension project. The extension activity started after authorization of the school team. A questionnaire about the knowledge and risk factors of SCI and TBI was delivered to students prior to the expository and illustrative class on neurotraumas. The class contained subjects related to the neurological anatomy; etiology, incidence, risk factors, prognosis, complications and prevention of neurotraumas. There was a period for debate and doubts and an explanatory folder on the subject was delivered to the students at the end of the approach. The data related to the applied questionnaire were analyzed and reports of extension students and school staff were recorded. Results: The total number of students broached in this intervention was 451 distributed between the three years of high school, 32% of the first year, 40% and 28% of the second and third respectively. The average age of the students was 16 years and the majority was female (55%). An expressive number of students were not aware of SCI (41%) and TBI (52%) and several of them presented attitudes of risk for a possible neurotrauma. Conclusion: The prevalence of unfamiliarity about SCI and TBI and its consequences was high among high school students and risk habits for neurotrauma were identified and widely discussed. The best conduct to avoid the increasing number and consequences of neurotraumas is prevention, beyond self-protection prevents accidents to third parties and brings economic benefits to the whole society and less suffering for individuals. There was interaction between a university and schools providing knowledge exchange, possibly adding new knowledge to all involved

NEUROTRAUMA PROJECT: Educate to prevent – the best treatment

Introdução: As lesões neurológicas são as principais causas de deficiência. Os neurotraumas: trauma raquimedular (TRM) e traumatismo cranioencefálico (TCE) além de frequentes, causam, muitas vezes, danos neurológicos permanentes e acometem comumente os jovens que têm a sua vida inteiramente modificada. Os neurotraumas impactam a vida não só do indivíduo que sofre o trauma, mas de toda a sua família, além do sistema de saúde e previdenciário, tornando-se um problema de saúde pública. Objetivos: Promover ações educativas relacionadas aos neurotraumas a alunos do ensino médio das escolas públicas de Diamantina – Minas Gerais e conscientizar sobre a seriedade do TRM e TCE estimulando a prevenção. Métodos: Alunos do ensino médio das escolas públicas da cidade de Diamantina – Minas Gerais formaram o público alvo da intervenção deste projeto de extensão. A atividade extensionista iniciou após autorização da equipe escolar. Um questionário sobre o conhecimento e fatores de risco do TRM e TCE foi entregue para os alunos antes da aula expositiva e ilustrativa sobre os neurotraumas. A aula continha assuntos relacionados à anatomia neurológica, etiologia, incidência, fatores de risco, prognóstico, complicações e prevenção dos neurotraumas. Houve um período para debate e dúvidas, e um folder explicativo sobre o assunto foi entregue aos alunos no final da abordagem. Os dados relacionados ao questionário aplicado foram analisados e relatos dos alunos extensionistas e da equipe escolar foram registrados. Resultados: O número total de estudantes abordados nesta intervenção foi de 451, distribuídos entre os três anos do ensino médio, 32% do primeiro ano, 40% e 28% do segundo e terceiro, respectivamente. A média de idade dos estudantes foi de 16 anos e a maioria do gênero feminino (55%). Um número expressivo de alunos não tinha conhecimento sobre o TRM (41%) e TCE (52%) e vários deles apresentavam atitudes de risco para um possível neurotrauma. Conclusão: A melhor conduta para evitar o número crescente e as consequências dos neurotraumas é a prevenção, pois além da autoproteção, evita acidentes a terceiros e trazem benefícios econômicos para toda a sociedade e menos sofrimento para os indivíduos. Houve interação entre a universidade e as escolas o que proporcionou o aumento do aprendizado.Introducción: Las lesiones neurológicas son las principales causas de discapacidad. Los neurotraumas, trauma raquimedular (TRM) y traumatismo craneoencefálico (TCE), además de frecuentes, muchas veces causan daños neurológicos permanentes y se presentan con frecuencia en los jóvenes que tienen sus vidas completamente modificadas. Los neurotraumas no solo afectan la vida del individuo que lo sufre, sino también su vida familiar, el sistema de salud pública y de seguridad que se convierte en uno problema de salud pública. Objetivos: Promover acciones educativas relacionadas con neurotraumas a los alumnos de bachillerato de las escuelas públicas de Diamantina, Minas Gerais, y concientizar acerca de la seriedad del TRM y TCE estimulando la prevención. Métodos: Alumnos del bachillerato de las escuelas públicas de la ciudad de Diamantina, Minas Gerais, han formado el público objetivo de la intervención de este proyecto de extensión. La actividad extensionista empezó después de la autorización del equipo escolar. Un cuestionario acerca del conocimiento y los factores de riesgo del TRM y TCE fue entregado para los alumnos antes de la clase expositiva y ilustrativa sobre los neurotraumas. La clase contenía temas relacionados con la anatomía neurológica, etiología, incidencia, factores de riesgo, pronóstico, complicaciones y prevención de los neurotraumas. Hubo un período de debate para aclarar las dudas y se entregó un folleto explicativo sobre los contenidos, a los alumnos al final de la actividad. Los datos relacionados al cuestionario aplicado fueron analizados y se registraron informes de los alumnos extensionistas y del equipo escolar. Resultados: El número total de los estudiantes abordados en esta intervención fue de 451 distribuidos entre los tres años del bachillerato, 32% del primer año, 40% y 28% del segundo y tercero, respectivamente. El promedio de las edades de los estudiantes fueron de 16 años y la mayoría fue del género femenino (55%). Un número significativo de alumnos no tenían conocimiento sobre el TRM (41%) y TCE (52%) y varios de ellos presentaban actitudes de riesgo para un posible neurotrauma. Conclusiones: La prevalencia del desconocimiento sobre el TCE y el TRM y sus consecuencias fue alta entre los estudiantes de secundaria y los hábitos de riesgo para un neurotrauma fueron identificados y ampliamente discutidos. La mejor conducta para evitar el número creciente y las consecuencias de los neurotraumas es la prevención, además de la autoprotección, evita accidentes a terceros y traen beneficios económicos para toda la sociedad y menos sufrimiento para las personas. Hubo interacción entre la universidad y las escuelas proporcionando intercambio de saberes, agregando, posiblemente, nuevos conocimientos para todos los involucrados.Introduction: Neurological injuries are the main causes of disability. Neurotraumas, spinal cord injuries (SCI) and traumatic brain injury (TBI), besides being frequent, often cause permanent neurological damage and commonly affect young people whose lives are completely modified. Neurotraumas impact not only the life of the individual who suffers the trauma, but of the whole family, as well as the health and social security system, becoming a public health problem. Objectives: To promote educational actions related to neurotraumas for high school students in the public schools of Diamantina, Minas Gerais, and to raise awareness about the seriousness of SCI and TBI by stimulating prevention. Methods: High school students from the public schools of the city of Diamantina, Minas Gerais, formed the target audience for the intervention of this extension project. The extension activity started after authorization of the school team. A questionnaire about the knowledge and risk factors of SCI and TBI was delivered to students prior to the expository and illustrative class on neurotraumas. The class contained subjects related to the neurological anatomy; etiology, incidence, risk factors, prognosis, complications and prevention of neurotraumas. There was a period for debate and doubts and an explanatory folder on the subject was delivered to the students at the end of the approach. The data related to the applied questionnaire were analyzed and reports of extension students and school staff were recorded. Results: The total number of students broached in this intervention was 451 distributed between the three years of high school, 32% of the first year, 40% and 28% of the second and third respectively. The average age of the students was 16 years and the majority was female (55%). An expressive number of students were not aware of SCI (41%) and TBI (52%) and several of them presented attitudes of risk for a possible neurotrauma. Conclusion: The prevalence of unfamiliarity about SCI and TBI and its consequences was high among high school students and risk habits for neurotrauma were identified and widely discussed. The best conduct to avoid the increasing number and consequences of neurotraumas is prevention, beyond self-protection prevents accidents to third parties and brings economic benefits to the whole society and less suffering for individuals. There was interaction between a university and schools providing knowledge exchange, possibly adding new knowledge to all involved

Repercussão da terapia de suplementação de proteína em detrimento das alterações na composição muscular de idosos: uma revisão: Repercussion of protein supplementation therapy to the detriment of changes in muscle composition in the elderly: a review

INTRODUÇÃO: O ato de envelhecer traz consigo inúmeras mudanças fisiológicas, dentre elas, destaca-se a sarcopenia, que por vezes pode levar a perda da capacidade funcional, podendo prejudicar a mobilidade e por fim acarretar em acidentes graves ou mortes. A atual concentração diária recomendada de proteína por quilograma não foi projetada para uma população em fase de envelhecimento, o que pode levar a uma concentração de proteína insuficiente. A suplementação proteica surgiu como forma alternativa de preservar a manutenção muscular. OBJETIVO: Analisar os efeitos da suplementação proteica na manutenção da capacidade funcional muscular na população idosa. METODOLOGIA: Para tanto, foi realizada uma revisão integrativa da literatura de aspecto qualitativo, no qual, a partir de uma pesquisa em bases de dados selecionadas, baseou-se em estudos que apresentaram efeitos da suplementação proteica na manutenção da capacidade funcional muscular de idosos. Ao final foram selecionados seis estudos que contemplavam o tema em questão. RESULTADOS E DISCUSSÃO: A melhora do estado nutricional está relacionada ao desempenho muscular, com base nisso, foram analisados nos estudos os seguintes aspectos: ganho de massa muscular, exercício físico em jejum, membros inferiores, velocidade da marcha e outros parâmetros funcionais e 25-hidroxivitamina D, todos colocando-se em comparação com a suplementação proteica como forma intervencionista e de manutenção da capacidade funcional muscular. Ainda, foi realizada uma análise da suplementação dietética com aminoácidos de cadeia ramificada (BCAAs) em relação a desnutrição. CONCLUSÃO: A análise dos dados supracitados revelou a relevância da busca pela melhoria na qualidade de vida e bem-estar da população senil, de maneira que o consumo diário recomendado de proteína seja preconizado como principal medida para manutenção da massa muscular nesta parcela populacional. Deve-se estimular o consumo diário de alimentos ricos em proteínas, tais como carnes, ovos, leite e derivados e suplementos alimentares, quando sua prescrição se faz necessária. Diante da corroboração da sarcopenia no aumento da incidência de quedas em idosos, se faz necessário orientar e estimular a população senil para a prática regular de exercício físico resistido, além do acompanhamento de equipe multidisciplinar

Evaluation of virulence factors in vitro, resistance to osmotic stress and antifungal susceptibility of Candida tropicalis isolated from the coastal environment of Northeast Brazil

Several studies have been developed regarding human health risks associated with the recreational use of beaches contaminated with domestic sewage. These wastes contain various micro-organisms, including Candida tropicalis. In this context, the objective of this study was to characterize C. tropicalis isolates from the sandy beach of Ponta Negra, Natal, Rio Grande do Norte, Brazil, regarding the expression of in vitro virulence factors, adaptation to osmotic stress and susceptibility to antifungal drugs. We analyzed 62 environmental isolates and observed a great variation among them for the various virulence factors evaluated. In general, environmental isolates were more adherent to human buccal epithelial cells (HBEC) than C. tropicalis ATCC13803 reference strain, besides the fact they were also highly biofilm producers. Most of the isolates presented wrinkled phenotypes on Spider medium (34 isolates, 54.8%). The majority of the isolates also showed higher proteinase production than control strains, but low phospholipase activity. In addition, 35 isolates (56.4%) had high hemolytic activity (hemolysis index > 0.55). With regard to C. tropicalis resistance to osmotic stress, 85.4% of the isolates were able to grow in a liquid medium containing 15% sodium chloride. The strains were highly resistant to the azoles tested (fluconazole, voriconazole and itraconazole). Fifteen strains were resistant to the three azoles tested (24.2%). Some strains were also resistant to amphotericin B (14 isolates; 22.6%), while all of them were susceptible for the echinocandins tested, except for a single strain of intermediate susceptibility to micafungin. Our results demonstrate that C. tropicalis isolated from the sand can fully express virulence attributes and showed a high persistence capacity on the coastal environment; in addition of showing high minimal inhibitory concentrations to several antifungal drugs used in current clinical practice, demonstrating that environmental isolates may have pathogenic potential

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)