Pythiosis : therapeutic approach

Pythiosis, a disease caused by the oomycete Pythium insidiosum, often presents inefficient response to chemotherapy. It is a consensus that, in spite the several therapeutic protocols, a combination of surgery, chemotherapy and immunotherapy should be used. Surgical excision requires the removal of the entire affected area, with a wide margin of safety. The use of antifungal drugs has resulted in variable results, both in vitro and in vivo, and presents low therapeutic efficiency due to differences in the agent characteristics, which differ from true fungi. Immunotherapy is a non-invasive alternative for the treatment of pythiosis, which aims at modifying the immune response of the host, thereby producing an effective response to the agent. Photodynamic therapy has emerged as a promising technique, with good activity against P. insidiosum in vitro and in vivo. However, more studies are necessary to increase the efficiency of the current treatment protocols and consequently improve the cure rates. This paper aims to conduct a review covering the conventional and recent therapeutic methods against P. insidiosum infections

A percepção do puerpério atrás das grades

The aim was to describe the perception of the puerperal woman deprived of freedom about the experience of this moment in the pregnancy-puerperal cycle. This is a documentary research, documentary review of a video sharing platform with Adobe Flash Player technology, which allows the display of your videos with quality, produced in the last five years. The selected documentaries allow us to infer that the feeling of abandonment, sadness, loneliness, and the desire for change portray the main perceptions of the woman who lives the puerperium under incarceration. Deficit of health professionals, neglect at the time of delivery, low number of consultations, lack of investments, omission, and negligence, represent fragments of the suffering reality experienced by women in the prison environment. Measures are necessary to avoid unnecessary suffering and health, in its broad concept, offered in a dignified way.Objetivou-se descrever a percepção da puérpera privada de liberdade sobre a vivência deste momento no ciclo gravídico-puerperal. Trata-se de uma pesquisa documental, revisão de documentários de uma plataforma de compartilhamento de vídeos com tecnologia Adobe Flash Player, que permite a exibição de seus vídeos com qualidade, produzidos nos últimos cinco anos. Os documentários selecionados permitem inferir que o sentimento de abandono, tristeza, solidão e o desejo de mudança retratam as principais percepções da mulher que vive o puerpério sob encarceramento. Déficit de profissionais da saúde, descaso na hora do parto, baixo número de consultas, escassez de investimentos, omissão e negligência, representam fragmentos da sofrida realidade vivenciada por mulheres no âmbito prisional. São necessárias a efetivação de medidas para que sofrimentos desnecessários sejam evitados e a saúde, em seu conceito amplo, ofertada de forma digna

Thromboembolism of the subclavian artery to the vertebral artery with haemorrhagic transformation

We report on the case of a 56-year-old male patient who, after fainting, regained consciousness in hospital in a confused state complaining of pain in the left arm. In the physical examination, the arm was seen to be cold and without pulse, so an arteriography was performed which identified an aneurysm of the subclavian artery with distal embolus of the upper limb. He was submitted to embolectomy of the limb but evolved with degeneration of the neurological state and so was transferred to a university hospital which confirmed the presence of thromboembolism of the vertebral artery. The upper limb had signs of distal ischaemia, so anticoagulation with heparin was initiated. The patient presented with further deterioration of the neurological condition and a transformation from ischaemic to hemorrhagic stroke was confirmed. Acta Angiol 2010; 16, 3: 135–137We report on the case of a 56-year-old male patient who, after fainting, regained consciousness in hospital in a confused state complaining of pain in the left arm. In the physical examination, the arm was seen to be cold and without pulse, so an arteriography was performed which identified an aneurysm of the subclavian artery with distal embolus of the upper limb. He was submitted to embolectomy of the limb but evolved with degeneration of the neurological state and so was transferred to a university hospital which confirmed the presence of thromboembolism of the vertebral artery. The upper limb had signs of distal ischaemia, so anticoagulation with heparin was initiated. The patient presented with further deterioration of the neurological condition and a transformation from ischaemic to hemorrhagic stroke was confirmed. Acta Angiol 2010; 16, 3: 135–13

Photocatalytic Activity and Antibacterial Effect of Ag3PO4 Powders Against Methicillin-resistant Staphylococcus aureus

In this study, silver phosphate (Ag3PO4) was successfully prepared through a simple precipitation method, and its structural, optical, and morphological properties were characterized by X-ray diffraction, Rietveld refinement, Fourier transform infrared spectroscopy, UV–vis diffuse reflectance spectroscopy, photoluminescence measurements, and field emission scanning electron microscopy (FE-SEM). Thereafter, the photocatalytic activity for the degradation of rhodamine B (RhB) dye and the antibacterial effect against methicillin-resistant Staphylococcus aureus (MRSA) were analyzed. Ag3PO4 was highly photocatalytic, degrading approximately 100% of the RhB after 25 min of visible light exposure. The photocatalytic mechanism was evaluated by trapping experiments indicating that photogenerated holes and superoxide radicals were the principal species present in the photocatalytic system. In addition, Ag3PO4 is a potential bacterial agent as it reduced the MRSA population even at sub-inhibitory concentrations. Morphological changes of the MRSA cells exposed to Ag3PO4 powder were investigated by the FE-SEM analysis, and a possible mechanism involving the release of dissolved Ag+, together with the production of reactive photocatalytic oxygen species is proposed based on the experimental results. DOI: http://dx.doi.org/10.17807/orbital.v13i3.156

Nitrogen Fertilization in Blackberry

Nutrition studies for blackberry crop are scarce worldwide. This chapter presents several aspects of nitrogen (N) in blackberry (Rubus spp.) nutrition. Soil characteristics that can influence nitrogen fertilization are the large discrepancies in the rates recommended in the literature, forms and times of application, sources of nitrogen, differences between cultivars and the main symptoms of N deficiency. The impact of moderate and severe nitrogen deficiency on vegetative growth and yield of ‘Tupy’ blackberry is also presented. In addition, a nitrogen fertilization recommendation system is proposed, based on the organic matter content of the soil, the age of the plants, and the expected productivity of the cultivars

O uso dos smartphones e a incidência da síndrome do túnel do carpo: uma avaliação das percepções físicas dos usuários / The use of smartphones and the incidence of carpal tunnel syndrome: an assessment of users' physical perceptions

Por meio do avanço tecnológico dos últimos anos, foi possível obter facilidades em variadas funções trazidas pelo uso dos aparelhos eletrônicos inteligentes, Smartphones. Reconhecendo o crescente uso excessivo do aparelho pela população geral, foi possível fazer um paralelo sobre os problemas musculoesqueléticos e patologias diversas, como a frequente síndrome do túnel do carpo, com o uso excessivo do aparelho seja pelas atividades repetitivas ou por determinados esforços físicos com as extremidades dos membros superiores. Deste modo, o presente estudo visou compreender quais os principais músculos envolvidos na neuropatia compressiva da síndrome do túnel do carpo, seus sinais e sintomas, e verificar a existência da correlação com os músculos e áreas utilizadas com os aparelhos Smartphone, e por meio de uma pesquisa criada em plataforma online, foi possível detectar possíveis sinais dos participantes usuários de Smartphones que possivelmente se deram em decorrência do uso excessivo do aparelho. Com os resultados do estudo, concluiu-se que os dedos mais utilizados pelos participantes da pesquisa foram os dedos que são enervados pelas ramificações do nervo mediano, principal nervo acometido pela síndrome do túnel do carpo, bem como a ocorrência de uma quantidade significativa de indivíduos que relataram dormência, um sintoma imprescindível na relação considerável entre sintoma-patologia. Porém, somente com a realização de exames físicos e neurológicos será possível confirmar a existência da patologia nos participantes do estudo.

Hospitalizations sensitive to primary health care at a regional hospital in the Federal District

Objetivo: caracterizar as internações por condições sensíveis à atenção primária em hospital regional do Distrito Federal. Método: estudo descritivo, tipo série de casos, que considerou usuários internados entre 2008 e 2012 no Hospital Regional de Ceilândia. A seleção das internações foi realizada com base na Lista Brasileira, e os dados obtidos no Sistema de Informações Hospitalares. Utilizou-se estatística descritiva no processamento e análise dos dados. Resultados: as ICSAP apresentaram tendência de crescimento, sobretudo em decorrência de doenças cerebrovasculares, doenças pulmonares e infecções no rim e trato urinário. Pacientes do sexo feminino e idosos apresentaram maior frequência de internações. Conclusão: os resultados poderão auxiliar gestores e profissionais de saúde na implementação de ações que objetivem maior resolubilidade da atenção primária, além de contribuir para a sistematização da assistência de enfermagem e melhoria do cuidado em saúde.Objective: to characterize hospitalizations for sensitive conditions to primary care of a regional hospital in the Federal District. Method: this is a descriptive study, such as case series that considered users admitted between 2008 and 2012 in the Regional Hospital of Ceilândia. The selection of hospitalizations was based on the Brazilian List, and the data were obtained from the Hospital information System. The descriptive statistics was used in the data processing and analysis. Results: ACSC (Ambulatory Care Sensitive Conditions) showed a growth tendency, mainly due to cerebrovascular diseases, lung diseases and infections in the kidney and urinary tract. Female and elderly patients showed a higher frequency of hospitalizations. Conclusion: the results may help managers and health professionals to implement actions that aim higher solvability of primary care, and contribute to the systematization of nursing care and improved health care.Objetivo: caracterizar las internaciones por condiciones sensibles a la atención primaria en hospital regional del Distrito Federal. Método: estudio descriptivo, tipo serie de casos, que consideró usuarios internados entre 2008 y 2012 en el Hospital Regional de Ceilândia. La selección de las internaciones fue realizada en base a la Lista Brasilera, y los datos obtenidos en el Sistema de Informaciones Hospitalarias. Se utilizó estadística descriptiva en el procesamiento y análisis de los datos. Resultados: as ICSAP (Internaciones por Condiciones Sensibles a la Atención Primaria) presentaron tendencia de crecimiento, sobre todo en recurrencia de enfermedades cerebrovasculares, enfermedades pulmonares e infecciones en el rinón y tracto urinario. Pacientes del sexo femenino y ancianos presentaron mayor frecuencia de internaciones. Conclusión: los resultados podrán auxiliar gestores y profesionales de salud en la implementación de acciones que objetiven mayor resolución de la atención primaria, además de contribuir para la sistematización de la asistencia de enfermería y mejoría del cuidado en salud

Testosterone deficiency increases hospital readmission and mortality rates in male patients with heart failure.

BackgroundTestosterone deficiency in patients with heart failure (HF) is associated with decreased exercise capacity and mortality; however, its impact on hospital readmission rate is uncertain. Furthermore, the relationship between testosterone deficiency and sympathetic activation is unknown.ObjectiveWe investigated the role of testosterone level on hospital readmission and mortality rates as well as sympathetic nerve activity in patients with HF.MethodsTotal testosterone (TT) and free testosterone (FT) were measured in 110 hospitalized male patients with a left ventricular ejection fraction < 45% and New York Heart Association classification IV. The patients were placed into low testosterone (LT; n = 66) and normal testosterone (NT; n = 44) groups. Hypogonadism was defined as TT < 300 ng/dL and FT < 131 pmol/L. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography in a subpopulation of 27 patients.ResultsLength of hospital stay was longer in the LT group compared to in the NT group (37 ± 4 vs. 25 ± 4 days; p = 0.008). Similarly, the cumulative hazard of readmission within 1 year was greater in the LT group compared to in the NT group (44% vs. 22%, p = 0.001). In the single-predictor analysis, TT (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.58-4.85; p = 0.02) predicted hospital readmission within 90 days. In addition, TT (HR, 4.65; 95% CI, 2.67-8.10; p = 0.009) and readmission within 90 days (HR, 3.27; 95% CI, 1.23-8.69; p = 0.02) predicted increased mortality. Neurohumoral activation, as estimated by MSNA, was significantly higher in the LT group compared to in the NT group (65 ± 3 vs. 51 ± 4 bursts/100 heart beats; p < 0.001).ConclusionThese results support the concept that LT is an independent risk factor for hospital readmission within 90 days and increased mortality in patients with HF. Furthermore, increased MSNA was observed in patients with LT

Comparação entre análise radiográfica de mão e punho e vértebras cervicais para determinação dos estágios pubertários / Comparison between radiographic analysis of hand and wrist and cervical vertebrae to determine pubertal stages

O uso e aplicação de conhecimentos clínicos e radiográficos na clínica diária do cirurgião dentista é um fator de grande importância no planejamento dos tratamentos ortodônticos e principalmente ortopédicos dentro da Odontologia atual, em uma busca por determinar e predizer a fase de maturação óssea em que o paciente se encontra. A determinação das fases do surto de crescimento puberal atende objetivamente às necessidades individuais do planejamento, essa análise permite a estimativa do crescimento em altura da criança e seu potencial de crescimento facial. Este trabalho foi realizado com o objetivo de avaliar a maturação óssea utilizando radiografias de mão e punho e telerradiografias de norma lateral de um mesmo paciente, comparando as tomadas radiográficas e avaliando se os estágios pubertários coincidem, contou ainda com o objetivo de determinar a idade padrão em que meninos e meninas atingem o pico do surto de crescimento puberal, visto que os estágios de maturação óssea apresentam um papel importante no diagnóstico, planejamento e prognóstico de cada caso, o estudo buscou oferecer ao paciente a melhor tomada radiográfica, evitando expô-lo a radiação desnecessária, onde o profissional poderá optar pelo exame mais confiável e assertivo