Budd–Chiari Syndrome: an unnoticed diagnosis

Budd–Chiari syndrome (BCS) encompasses a group of disorders caused by the obstruction to the hepatic venous outflow at the level of the small or large hepatic veins, the inferior vena cava, or any combination thereof. Clinical manifestation of the subacute form is characterized by supramesocolic abdominal discomfort, abdominal distension, fever, and lower limbs edema. Imaging work-up with hepatic Doppler ultrasound and abdominal computed tomography (CT) enables the diagnosis in the majority of cases. Treatment comprises long-term anticoagulation associated with measures that attempt to re-establish the flow in the thrombosed vessel (thrombolysis or angioplasty) or through the venous blood flow bypasses (transjugular intrahepatic portosystemic shunt or surgical bypass); however, the outcome is often dismal. The authors report the case of a 37-year-old woman presenting a 2-month history of dyspeptic complaints and abdominal distention. Fever was present at the beginning of symptoms. The laboratory work-up disclosed mild hepatic dysfunction, and the ultrasound showed evidence of chronic liver disease. Despite a thorough etiologic investigation, diagnosis was missed and, therefore, management could not be directed towards the physiopathogenetic process. The outcome was characterized by portal hypertension and esophageal varices bleeding. The patient died and the autopsy findings were characteristic of BCS, although an abdominal CT, close to death, had showed signs consistent with this diagnosis. The authors highlight the importance of knowledge of this entity, the diagnostic methods, and the multidisciplinary approach. BCS should be considered whenever investigating etiology for chronic or acute hepatopathy

Qualidade microbiológica de queijos coloniais comercializados em Porto Alegre-RS

Colonial cheese is a traditional dairy product in southern Brazil and is commonly purchased by the citizens of Porto Alegre. However, there is still a lack of technical regulation of colonial cheese, and there is little information about the microbiological quality of this product at the retail level. Thus, the objectives of this study were to (i) evaluate compliance with the legal microbiological standards of colonial cheese sampled from street fairs and the central market of the city of Porto Alegre; (ii) statistically test the hypothesis of an association between noncompliance with the standards and local purchasing (street fairs or central market); (iii) estimate the number of Listeria spp. and Listeria monocytogenes in the positive samples; and (iv) characterize the L. monocytogenes strains by serotyping and macrorestriction (PFGE). For this purpose, 205 cheese samples belonging to 17 different brands were analyzed. The microbiological analyses were conducted according to ISO standardized protocols for the detection of L. monocytogenes and Salmonella spp. or by enumeration of coagulase-positive Staphylococcus and coliforms at 45°C. Among the samples, 47.31% did not comply with at least one of the microbiological standards established by the Brazilian legislation and were thus unsuitable for human consumption. Regarding the coliforms at 45ºC and coagulase-positive Staphylococcus, 10.73% and 40.48% of the samples presented higher counts than the legal parameter, respectively. There was no association between the frequency of samples with coagulase-positive Staphylococcus counts above the legal parameter and local of purchasing; however, the commercial brand influenced the frequency of unsuitable samples This may indicate failures of hygiene during cheese production. Salmonella spp. were not detected. Listeria monocytogenes was isolated from 2.9% of the samples. The estimated average populations of Listeria spp. and L. monocytogenes were low in the positive cheese samples at -3.3 log CFU g‾1 and -2.26 log CFU g‾¹, respectively. The strains of L. monocytogenes belonged to serovars 1/2a, 1/2b and 1/2c and could be grouped into five pulsotypes with no evident epidemiological relation among them. The results demonstrate the need to improve the hygiene procedures during colonial cheese production and to strengthen monitoring at the dairy plants and retail levels.O queijo colonial é um derivado lácteo típico do sul do Brasil, e amplamente adquirido pela população da cidade de Porto Alegre. Porém, esse produto lácteo ainda não conta com regulamento técnico específico e ainda há poucos dados sobre a qualidade microbiológica dos queijos ofertados à população. Sendo assim, os objetivos do estudo foram: (i) avaliar os parâmetros microbiológicos previstos na legislação em queijos coloniais comercializados em Feiras Modelo e Mercado Público de Porto Alegre; (ii) testar hipóteses estatísticas de associação entre violação do padrão microbiológico estabelecido na legislação com o ponto de comercialização; (iii) estimar a distribuição de contagem de Listeria sp. e L. monocytogenes nos queijos em que esta bactéria foi detectada e (iv) caracterizar as cepas de L. monocytogenes por sorotipificação e macro-restrição. Para tanto, foram analisadas 205 amostras de queijo, compreendendo 17 marcas distintas. As análises microbiológicas foram conduzidas conforme protocolos padronizados de análise de alimentos e evidenciaram que 47,31% dos queijos estavam não conformes com pelo menos um dos parâmetros microbiológicos estabelecidos na RDC nº12/2001, portanto impróprios ao consumo humano. Com relação à quantificação de coliformes a 45ºC e Staphylococcus coagulase positiva, respectivamente, 10,73% e 40,48% das amostras apresentaram contagens superiores ao estabelecido na legislação A distribuição das amostras não conformes com o parâmetro Staphylococcus coagulase positiva não esteve associada ao ponto de comercialização, mas foi influenciada pela marca comercial do queijo, indicando possíveis falhas na elaboração dos mesmos. Não houve detecção de Salmonella sp. e em 2,9% das amostras havia presença de L. monocytogenes. A população média estimada nos queijos positivos para Listeria sp. e L. monocytogenes foi baixa, respectivamente, -3,3 log UFC g-1 e -2,26 log UFC g-1. As cepas de L. monocytogenes pertenciam aos sorovares 1/2a, 1/2b e 1/2c e a macro-restrição demonstrou a presença de cinco pulsotipos sem relação epidemiológica evidente. Os resultados demonstram a necessidade de melhorar a qualidade higiênica da elaboração do queijo colonial e aumentar a fiscalização sanitária desse produto

Mapeamento dos atributos químicos do solo a partir de amostragem para fins de agricultura de precisão e tradicional

O aumento da demanda mundial por alimento, aliado à redução na expansão das áreas agrícolas evidencia a necessidade da correção da fertilidade dos solos para obtenção de altas produtividades e rentabilidade satisfatória. O presente estudo objetivou comparar as técnicas de amostragem de solo tradicional e agricultura de precisão. Os níveis de fertilidade, observados a partir de amostras coletadas em áreas de manejo tradicional e nos grids da agricultura de precisão, foram analisados e interpretados por meio de software Farms Work® para verificação do melhor sistema de análise e recomendação. Os resultados demonstraram que na agricultura tradicional, áreas de baixa e alta fertilidade são mascaradas, em função de a área ser representada por amostras compostas de diversos pontos amostrais. Na agricultura de precisão, a área é subdividida por classes de fertilidade, ficando evidentes os locais de alta e baixa fertilidade, o que as tornam aptas para receber as devidas correções de fertilidade. A agricultura de precisão mostrou ser mais viável à recuperação de áreas degradadas, manutenção da fertilidade do solo e utilização de insumos de maneira correta e eficiente

Difficulties Reported by Hiv-Infected Patients Using Antiretroviral Therapy in Brazil

OBJECTIVE: To describe the degree of difficulty that HIV-infected patients have with therapy treatment. INTRODUCTION: Patients’ perceptions about their treatment are a determinant factor for improved adherence and a better quality of life. METHODS: Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis. RESULTS: Among 406 patients initiating treatment, 350 (86.2%) and 209 (51.5%) returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm³) and high (> 4) adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills), use of other medications, high (> 4) adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit. CONCLUSIONS: A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol

ACÚMULO E PARTIÇÃO DE BIOMASSA E MACRONUTRIENTES DE CULTIVARES DE FEIJÃO-VAGEM EM CULTIVO PROTEGIDO FERTIRRIGADO

For a better management of fertigation in protected cultivation of vegetables such as snap beans, it is important to know the nutritional requirements of the plants. Thus, we aimed to characterize the biomass and nutrients accumulation of bush snap beans genotypes. For that, an experiment was carried out in greenhouse, where the genotypes UEL-1 and Alessa were grown in plastic pots with coarse sand as substrate and fertigation by micro sprinklers. Each ten days, plants were sampled and measured the dry matter and the concentrations of elements such as nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg) and sulfur (S), adjusting their accumulation over time by the gaussian model. The fresh pods yield (kg m-2) was also evaluated. The accumulation of biomass and macronutrients are intensified from 20 days after emergence (DAE), reaching maximum values near 50 DAE. The genotype Alessa presented a higher overall accumulation, while UEL-1 was more productive regarding fresh pods, characterizing such genotype as more efficient for using the macronutrients. For both genotypes, N had the highest accumulation, followed by K, Ca, P, S and Mg.Para um melhor manejo da fertirrigação em cultivos protegidos de olerícolas, como o feijão-vagem, faz-se necessário conhecer a demanda nutricional dessas plantas. Portanto, objetivou-se caracterizar o acúmulo de biomassa e nutrientes por genótipos de feijão-vagem em cultivo protegido fertirrigado. Para tanto, foi conduzido experimento inteiramente casualizado em casa-de-vegetação, com os genótipos UEL-1 e Alessa, cultivados em vasos plásticos com substrato areia grossa e fertirrigação por micro-aspersão. A cada dez dias, as plantas foram coletadas e mensuradas a massa de matéria seca e a concentração nos tecidos de nitrogênio (N), fósforo (P), potássio (K), cálcio (Ca), magnésio (Mg) e enxofre (S), ajustando-se o acúmulo destes ao longo do tempo por meio do modelo gaussiano. A produtividade de vagens frescas (kg m-2) também foi medida. O acúmulo de biomassa e nutrientes foi intensificado a partir dos 20 dias após a emergência (DAE), atingindo valores máximos próximo aos 50 DAE. O genótipo Alessa teve maior acúmulo de biomassa e macronutrientes, enquanto UEL-1 foi mais produtivo em vagens frescas, caracterizando maior eficiência no uso dos nutrientes. Para ambos genótipos, o N teve o maior acúmulo, seguido por K, Ca, P, S e Mg

Políticas culturais emergenciais na pandemia da COVID-19? Demandas e estratégias de enfrentamento e as respostas dos poderes públicos

A vulnerabilidade da economia criativa, que antecede a crise sanitária de 2020, tem tornado o contexto da pandemia ainda mais impactante para os segmentos artísticos, culturais e criativos. A paralisação das atividades não fez discriminação: afetou formais e informais; empreendimentos criativos de grande e pequeno porte; organizações e artistas que atuam em todas as etapas da cadeia produtiva: na produção, na distribuição e no consumo. Diante do contexto de crise, a atuação dos poderes públicos através da elaboração de políticas culturais emergenciais tem sido demandada pelos agentes do setor. Este artigo apresenta recursos, necessidades, e estratégias de enfrentamento apontadas pelos respondentes da pesquisa “Impactos da  COVID-19 na Economia Criativa”, propondo reflexões sobre as primeiras respostas dos poderes públicos

Mortalidade por câncer de boca e faringe no Brasil entre 2008 e 2019: estudo descritivo

Introduction: Oral and pharyngeal cancer is a multifactorial-etiology disease, which represents around 3% of cancer cases from all over the world, being the 5th most prevalent amongst men in Brazil. Objective: Analyzing oral and pharyngeal cancer mortality in Brazil and its regions between 2008 and 2019. Material and Methods: Data were obtained from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IBGE). It was carried out a descriptive analysis and general mortality rates and rates for gender, age, and anatomical site were assessed. A statistical analysis regarding temporal trends was also conducted by simple linear regression. Results: Over the years studied, deaths increased by 33.25%; the average mortality rate was around 3.64/100,000 habitants. In that way, the temporal trend showed an annual rise of 0.06 deaths per 100,000 habitants. Furthermore, deaths were higher in the Southeast region (49.38%), in the age groups between 50 and 79 years old (73.31%), married people (41.19%), white individuals (53.49%), people of lower education levels -from 1 to 3 education years- (25.73%) and male gender (78.97%). Additionally, the male mortality rate was 3.75 times higher than the female one. On top of that, the mortality rate for men has been increasing steadily, being an average 5.83/100,000 habitants, in contrast to women’s rate (1.51/100,000). Conclusion: Finally, the present study shows that oral and pharyngeal cancer deaths in Brazil are more frequent amongst white men, from 50 to 69 years old, married, with lower education levels, located in the oropharynx, and in the South and Southeast regions. However, those rates show a trend for annual increases, especially in the Northeast.Introdução: O câncer de boca e faringe tem etiologia multifatorial e representa cerca de 3% de todos os casos de câncer no mundo, sendo o quinto tipo mais prevalente em homens brasileiros. Objetivo: Analisar a mortalidade por câncer de boca e faringe ocorrida no Brasil e suas regiões no período de 2008 a 2019. Material e Métodos: Os dados foram extraídos no Sistema de Informações sobre Mortalidade (SIM) e no Instituto Brasileiro de Geografia e Estatística (IBGE). Foi conduzida uma análise descritiva das taxas de mortalidade global por sexo, raça, faixa etária, estado civil, escolaridade e sítio anatômico, com subsequente análise estatística por meio da tendência temporal por regressão linear simples. Resultados: No período, houve o crescimento de 33,25% dos óbitos, taxa de mortalidade média de 3,64/100 mil habitantes e a análise de tendência temporal demonstrou aumento anual de 0,06 óbitos para cada cem mil habitantes. Ademais, pode-se observar mais frequentes óbitos no Sudeste 49,28%, nas faixas etárias de 50 a 79 anos com 73,31%, em pessoas casadas, 41,19%, na raça branca, 53,49%, com escolaridade de 1 a 3 anos, 25,73% e sexo masculino, 78,97%. Nesses, obteve-se a razão das taxas de mortalidade masculina e feminina de 3,75 e taxa de mortalidade masculina crescente, com uma taxa média de 5,83, sendo a feminina de 1,51 cem mil habitantes. Conclusão: O perfil de mortalidade do estudo por câncer de boca e orofaringe é predominantemente composto por indivíduos do sexo masculino, brancos, de 50 a 69 anos, casados e de baixa escolaridade. Embora mais frequente nas regiões Sul e Sudeste, as taxas de mortalidade apresentam uma tendência de crescimento anual, em especial na região Nordeste do país

IDENTIFICAÇÃO DE OVOS DE HELMINTOS EM EQUINOS DE POLICIAMENTO E TERAPIA ASSISTIDA DA CIDADE DE SALVADOR/BA

The health and well-being of animals used in the police and assisted therapy service is linked to nutritional and preventive care. Routine preventions include control of intestinal parasites, The objective of this work was to identify the occurrence of gastrointestinal helminth eggs in horses in service horses in the Mounted Police Squadron / Salvador-BA. The methodology used was qualitative evaluation of 50 feces, analyzed by the Willis- Mollay fluctuation method adapted and quantitative egg count per gram (OPG). It was possible to observe that 86% (43/50) of the animals obtained were infected to a degree of mild to moderate by helminths of the Strongylidae families 32.55% (14/43), Trichostrongylidae 30.23% (13/43), Ascarididae 25.58% (11/43) and family Oxyuridae 11.62% (5/43).A saúde e bem-estar de animais utilizados no serviço de policiamento e terapia assistida estão diretamente ligados aos cuidados nutricionais e preventivos. Entre as prevenções de rotina está o controle de parasitoses gastrointestinais. O objetivo deste trabalho foi identificar a ocorrência de ovos de helmintos gastrointestinais em equinos de serviço, no Esquadrão de Polícia Montada em Salvador/BA. A metodologia empregada foi a avaliação qualitativa de 50 amostras de fezes, analisadas pelo método flutuação de Willis-Mollay adaptado, e quantitativa, de contagem de ovos por grama (OPG). Foi possível observar que 86% (43/50) dos animais avaliados encontravam-se infectados, em grau de leve a moderado, por helmintos das famílias Strongylidae 32,55% (14/ 43), Trichostrongylidae 30,23% (13/43), Ascarididae 25,58% (11/43) e fammília Oxyuridae 11,62% (5/43)

Investigating academic performance and perceptions of human physiology and exercise physiology courses among undergraduate students of physical education at a Brazilian public university

Purpose To compare the academic performance of undergraduate students in physical education who studied exercise physiology before and after studying human physiology and investigate students’ perceptions of human physiology and exercise physiology courses. Methods This study included 311 undergraduate students pursuing a bachelor’s degree in physical education. Participants were divided into two groups: those who had previously attended and completed the human physiology course (group 1, n = 212, 68.2%) and those who had not previously attended or had attended but failed the human physiology course (group 2, n = 99, 31.8%). The prevalence ratio (PR) and 95% confidence interval (95% CI) were calculated using a Poisson regression model with a robust variance estimator. The second aim comprised 67 students with bachelor’s degrees in physical education who completed an electronic questionnaire about their perceptions of human physiology and exercise physiology curriculum. Results Compared with those who attended human physiology and passed, those who had not previously attended or had attended but failed the human physiology course have a higher PR of 2.37 (95% CI, 1.68–3.34) for failing exercise physiology. Regarding the students’ perceptions of human physiology and exercise physiology courses, most students reported that they were challenging (58.2% and 64.2%, respectively), but they also recognized the importance of these courses for professional practice (59.7% and 85.1%, respectively). Conclusion Human physiology should be considered a prerequisite for an undergraduate course leading to a bachelor’s degree in physical education. Furthermore, students considered human physiology and exercise physiology courses important yet challenging. Therefore, continuous student assessment is vital for improving the teaching–learning process