AVALIAÇÃO DA FRAGILIDADE DE DOENTES RENAIS CRÔNICOS EM TRATAMENTO DE HEMODIÁLISE

Este estudo teve como objetivo avaliar a presença e o grau de fragilidade de pacientes portadores de Doença Renal Crônica, em tratamento de hemodiálise em uma clinica renal da região noroeste do estado do Rio Grande do Sul. A fragilidade foi avaliada através de três questionários, sendo eles Edmonton Frail Scale, Índice de Vulnerabilidade Clinico Funcional-20 (IVCF-20) e Survey of Health Ageing and Retirement in Europe (SHARE-FIx). Os dados foram analisados através de média, desvio padrão, percentual, teste “t” student, Qui-quadrado de Pearson, Análise de Variância (ANOVA) e análise de resíduos ajustados. A amostra foi composta de 94 pacientes em tratamento de hemodiálise, onde foi possível identificar a presença de fragilidade através dos 3 questionários utilizados, com uma prevalência entre 60,6 a 86,2%. A fragilidade apresentou correlação apenas com gênero e idade. Conclui-se que a amostra estudada apresentou fragilidade principalmente nos graus de moderada a severa, sendo que quanto maior a idade, maior a severidade da fragilidade. Sugere-se a realização de novos estudos a fim de identificar precocemente a síndrome de fragilidade possibilitando alguma intervenção preventiva e doentes renais crônicos

Contribuição do sistema de cultivo microbiológico na fazenda (OnFarm®) no uso racional de antimicrobianos para mastite: um relato na bacia leiteira de Nossa Senhora da Glória - Sergipe / Contribution of the microbiological cultivation system to the farm (OnFarm®) in the rational use of antimicrobials for mastitis: a report in the dairy basin of Nossa Senhora da Gloria - Sergipe

O presente estudo tem como objetivo destacar a contribuição do sistema de cultivo microbiológico na fazenda (OnFarm®) no uso racional de antibióticos no tratamento de animais diagnosticados com mastite. Os animais acometidos com mastite apresentavam úbere com edema, diminuição na produção de leite e secreção purulenta nos primeiros jatos na ordenha. Após constatação dos sinais foram realizadas coletas de amostras de leite dos tetos afetados para identificação dos agentes etiológicos envolvidos no processo inflamatório das glândulas mamárias. Os agentes identificados foram o Staphylococcus não aureus e Serratia spp, sendo então instituído o correto tratamento para a eliminação desses agentes

Environmental Exposure and Leptospirosis, Peru

Human infection by leptospires has highly variable clinical manifestations, which range from subclinical infection to fulminant disease. We conducted a population-based, cross-sectional seroepidemiologic study in Peru to determine potential relationships of environmental context to human exposure to Leptospira and disease associated with seroconversion. Three areas were studied: a flooded, urban slum in the Peruvian Amazon city of Iquitos; rural, peri-Iquitos villages; and a desert shantytown near Lima. Seroprevalence in Belen was 28% (182/650); in rural areas, 17% (52/316); and in a desert shantytown, 0.7% (1/150). Leptospira-infected peridomestic rats were found in all locales. In Belen, 20 (12.4%) of 161 patients seroconverted between dry and wet seasons (an incidence rate of 288/1,000). Seroconversion was associated with history of febrile illness; severe leptospirosis was not seen. Human exposure to Leptospira in the Iquitos region is high, likely related both to the ubiquity of leptospires in the environment and human behavior conducive to transmission from infected zoonotic sources

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Styles of thinking and creating in organizational context: Differences according to professional position?

This study aimed to identify the style of thinking and creating in professionals a pharmaceutical distribution company, in order to verify the existence of different styles according to gender, educational level and position held. Forty professionals, including 30 women and 10 men, aged 17 years and 35 years (M=24.5, SD=5.4), with high school education (n=14) and college (n=26) were divided into two groups, the first being formed by professionals working in the tax and accounting (n=20), and another group of professionals who hold positions in the sales (n=20). They answered the scale Styles of Thinking and Creating individually during office hours. The results showed that only the logical-objective style proved to be influenced by the area of performance (F=4.745; p<=0.037), with all others variables showed no significant influences. In the present study, gender and educational level did not influence the styles of thinking and creating of the participants as well as all other interactions. It was also found that most of the sample appears as the predominant style logical-objective, regardless of sex (62.0% of women and 72.7% of men were classified in this style), level of education (with 57 1% of professionals with high school and 69.2% with college) and in relation to the field (60.0% of the participants in the accounting/tax filing this predominant style and 70.0% of professionals in sales)