La cateterización urinaria: facilidades y dificultades relacionadas con su estandarización

Pesquisa exploratória e descritiva para verificar a existência e fatores relacionados a padronização do cateterismo urinário, em uma cidade do interior do estado de São Paulo, Brasil. Os dados foram coletados por meio de entrevista, mediante aprovação do Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto. Das nove instituições hospitalares entrevistadas, 100% possuem o procedimento de cateterismo urinário padronizado. As instituições apresentam diferenças nos procedimentos propostos, o que interfere de maneira positiva e negativa na sua padronização e coloca em dúvida se o padronizado é o que está sendo realizado. Conclui-se que existe a necessidade de se reavaliar a padronização proposta, com discussões interdisciplinares, verificar se o proposto está sendo realizado e buscar estratégias de treinamento e ensino passíveis de aplicação.This descriptive and exploratory study aimed to verify the existence of factors related to the standardization of urinary catheters in a city in the interior of the state of São Paulo, Brazil. Data was collected through interviews after approval obtained from the Research Ethics Committee of the University of São Paulo at Ribeirão Preto School of Nursing. Of the nine hospital institutions who took part in the study, 100% have a standardized procedure for urinary catheterization. The institutions present differences in the proposed procedure, which interferes positively and negatively in its standardization and places doubt upon whether the standardized procedure is indeed being carried out. This study concludes that there is a need to reevaluate the proposed standardization, with interdisciplinary discussions to verify if the proposal is being carried out and to search for applicable training and teaching strategies.Estudio exploratorio y descriptivo con objeto de determinar qué factores están relacionados con la estandarización de los catéteres urinarios, en una ciudad del interior del estado de São Paulo, Brasil. El estudio fue realizado a través de entrevistas, mediante aprobación del Comité de Ética en Investigación de la Escuela de Enfermería de Ribeirão Preto. De las nueve instituciones hospitalarias entrevistadas, 100% posee un procedimiento de cateterización vesical estandarizado. Las instituciones presentan diferencias en el procedimiento propuesto, lo que interfiere de manera positiva y negativa en su estandarización y pone en duda si el estandarizado es el que está siendo realizado. Se concluye que existe la necesidad de reevaluar la estandarización propuesta, con discusiones interdisciplinarias, verificar si el propuesto está siendo realizado y buscar estrategias de entrenamiento y enseñanza pasibles de aplicación

CABE MAIS OU CABE MENOS? ATITUDES QUE MUDAM O MUNDO

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Naa12 compensates for Naa10 in mice in the amino-terminal acetylation pathway

Amino-terminal acetylation is catalyzed by a set of N-terminal acetyltransferases (NATs). The NatA complex (including X-linked Naa10 and Naa15) is the major acetyltransferase, with 40-50% of all mammalian proteins being potential substrates. However, the overall role of amino-terminal acetylation on a whole-organism level is poorly understood, particularly in mammals. Male mice lacking Naa10 show no globally apparent in vivo amino-terminal acetylation impairment and do not exhibit complete embryonic lethality. Rather Naa10 nulls display increased neonatal lethality, and the majority of surviving undersized mutants exhibit a combination of hydrocephaly, cardiac defects, homeotic anterior transformation, piebaldism, and urogenital anomalies. Naa12 is a previously unannotated Naa10-like paralog with NAT activity that genetically compensates for Naa10. Mice deficient for Naa12 have no apparent phenotype, whereas mice deficient for Naa10 and Naa12 display embryonic lethality. The discovery of Naa12 adds to the currently known machinery involved in amino-terminal acetylation in mice

Naa12 compensates for Naa10 in mice in the amino-terminal acetylation pathway.

Amino-terminal acetylation is catalyzed by a set of N-terminal acetyltransferases (NATs). The NatA complex (including X-linked Naa10 and Naa15) is the major acetyltransferase, with 40-50% of all mammalian proteins being potential substrates. However, the overall role of amino-terminal acetylation on a whole-organism level is poorly understood, particularly in mammals. Male mice lacking Naa10 show no globally apparent in vivo amino-terminal acetylation impairment and do not exhibit complete embryonic lethality. Rather Naa10 nulls display increased neonatal lethality, and the majority of surviving undersized mutants exhibit a combination of hydrocephaly, cardiac defects, homeotic anterior transformation, piebaldism and urogenital anomalies. Naa12 is a previously unannotated Naa10-like paralogue with NAT activity that genetically compensates for Naa10. Mice deficient for Naa12 have no apparent phenotype, whereas mice deficient for Naa10 and Naa12 display embryonic lethality. The discovery of Naa12 adds to the currently known machinery involved in amino-terminal acetylation in mice

The neuropathology of autism: defects of neurogenesis and neuronal migration, and dysplastic changes

Autism is characterized by a broad spectrum of clinical manifestations including qualitative impairments in social interactions and communication, and repetitive and stereotyped patterns of behavior. Abnormal acceleration of brain growth in early childhood, signs of slower growth of neurons, and minicolumn developmental abnormalities suggest multiregional alterations. The aim of this study was to detect the patterns of focal qualitative developmental defects and to identify brain regions that are prone to developmental alterations in autism. Formalin-fixed brain hemispheres of 13 autistic (4–60 years of age) and 14 age-matched control subjects were embedded in celloidin and cut into 200-μm-thick coronal sections, which were stained with cresyl violet and used for neuropathological evaluation. Thickening of the subependymal cell layer in two brains and subependymal nodular dysplasia in one brain is indicative of active neurogenesis in two autistic children. Subcortical, periventricular, hippocampal and cerebellar heterotopias detected in the brains of four autistic subjects (31%) reflect abnormal neuronal migration. Multifocal cerebral dysplasia resulted in local distortion of the cytoarchitecture of the neocortex in four brains (31%), of the entorhinal cortex in two brains (15%), of the cornu Ammonis in four brains and of the dentate gyrus in two brains. Cerebellar flocculonodular dysplasia detected in six subjects (46%), focal dysplasia in the vermis in one case, and hypoplasia in one subject indicate local failure of cerebellar development in 62% of autistic subjects. Detection of flocculonodular dysplasia in only one control subject and of a broad spectrum of focal qualitative neuropathological developmental changes in 12 of 13 examined brains of autistic subjects (92%) reflects multiregional dysregulation of neurogenesis, neuronal migration and maturation in autism, which may contribute to the heterogeneity of the clinical phenotype

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

A qualificação em gestão da agricultura familiar: a experiência da Alta Paulista

Family-based agriculture plays an important socio-economic role in Brazilian agribusiness. Its development is considered a pre-condition for an economically efficient and socially fair society. There are numerous variables influencing the performance of rural business. Several variables can not be controlled by the farmers, but, there are some variables which can be controlled, as farm management. Appropriate managerial techniques for family based agriculture aim to promote economical sustainability of the activity. This research has a main objective to present the experience of an extension project focused on managerial capacitation for family based agriculture at Alta Paulista Region in São Paulo state. The capacitation was composed of five modules: a) production planning; b) quality management; c) costs management; d) commercialization; and e) financial resources capture. Over 150 farmers attended the capacitation in 9 towns of the region. The experience generated technical and bibliographical publications, as well as divulgation texts. This extension project has attended to the principals of executing institution, as well as regional demands.El sector de la agricultura familiar asume un papel socioeconómico de gran importancia en el campo del agronegocio brasileño. Su desarrollo comprende una de las pre condiciones para llegar a un tipo de sociedad económicamente más eficiente y más justa. Existe una serie de factores que afectan significativamente el desempeño de los negocios rurales. Muchos de ellos quedan fuera del control de la unidad de producción, otros, como el gerenciamiento de la producción se encuentran vinculados directamente a su control. La oferta de técnicas de gerenciamiento adecuadas para la agricultura familiar tiende a contribuir para promover la sustentabilidad económica de esas iniciativas. Este trabajo tiene como objetivo mostrar la experiencia de un proyecto de extensión que ofrece capacitación de gerenciamiento para agricultores que actúan familiarmente en la región de la Alta Paulista. El curso de capacitación de gerenciamiento fue realizado y aplicado en 5 módulos, subdivididos en: a) planificación de la producción; b) gerenciamiento de calidad; c) gerenciamiento de los costos; d) comercialización; e) captación de los recursos financieros. Fueron capacitados más de 150 productores en 7 municipios de la región. Por medio de la experiencia surgida de la elaboración, organización e implementación de este proyecto de extensión, fueron elaborados trabajos técnicos y bibliográficos, bien como textos de divulgación. Por medio de sociedades inter y multi-institucionales, el proyecto de extensión siguió los principios de institución ejecutora, como también las demandas de la región.O segmento da agricultura familiar assume papel sócio-econômico de grande importância no agronegócio brasileiro. Seu desenvolvimento é entendido como uma das pré-condições para uma sociedade economicamente mais eficiente e socialmente mais justa. Existe uma série de fatores que afetam significativamente o desempenho dos empreendimentos rurais. Muitas dessas variáveis fogem ao controle da unidade de produção, mas outras, como a gestão da produção, estão mais diretamente vinculadas ao seu controle. A disponibilização de técnicas gerenciais apropriadas para a agricultura familiar visa contribuir para a promoção da sustentabilidade econômica desses empreendimentos. Este trabalho tem o objetivo de apresentar a experiência de um projeto de extensão em capacitação gerencial de agricultores familiares na região Alta Paulista. O curso de capacitação gerencial foi realizado e aplicado por meio de cinco módulos, subdivididos em: a) planejamento da produção; b) gestão da qualidade; c) gestão de custos; d) comercialização; e, e) captação de recursos financeiros. Foram capacitados mais de 150 produtores em 7 municípios da região. Por meio da experiência advinda da elaboração, organização e implementação deste projeto de extensão foram elaborados trabalhos técnicos e bibliográficos, bem como textos de divulgação sobre este trabalho. Por fim, por meio de parcerias inter e multi-institucional, esse projeto de extensão atendeu aos princípios orientadores da instituição executora, bem como as demandas da sociedade regional. Palavras-chave

Obesidad infantil ayer y hoy: la importancia de la evaluación antropométrica por el enfermero

Estudos comprovam que a incidência de doenças crônicas em adultos está diretamente relacionada à obesidade na infância. Esta investigação teve como objetivo determinar a classificação nutricional infantil e comparar os índices de sobrepeso e obesidade de crianças atendidas em uma Unidade de Saúde de um município do interior paulista nos anos de 1983/1984 e 2003/2004. Os dados relacionados ao crescimento e desenvolvimento infantil foram obtidos dos prontuários. Para classificação do estado nutricional foi adotado o percentil. Para a análise descritiva, foram consideradas as frequências absolutas e percentuais. Os dados foram analisados utilizando-se teste t para comparações das médias. Foi observado maior risco de sobrepeso e diferença significativa no peso de crianças nascidas nos anos de 2003/2004 comparado aos nascidos em 1983/1984. A avaliação antropométrica realizada pelo enfermeiro é de fundamental importância no diagnóstico nutricional infantil para a identificação acurada das anormalidades e definição de estratégias de atuação eficazes.Studies have shown relation between the incidence of chronic diseases in adults and obesity in infancy. This research aimed to determine and compare the indexes of overweight and infant obesity in the years 1983/1984 and 2003/2004. Secondary data related to child growth and development were collected through consults in patient files, of users who had been under follow-up at the Pediatrics Service in the Unit located in the state of São Paulo, Brazil. The percentile was adopted for classification of the nutritional status. Absolute and percentage frequencies were considered for descriptive analysis. Data analysis was done using t test for comparisons of means. It was observed greater risk of overweight and significant difference in the weight of children born in 2003/2004 compared to users born in 1983/1984. Anthropometric assessment carried out by nurses has a fundamental importance in child nutritional diagnosis, to accurately identify abnormalities and define efficient action strategies.Estudios comprueban relación directa entre la incidencia de enfermedades crónicas en adultos y obesidad en la infancia. Esta investigación objetivó determinar y comparar los índices de sobrepeso y obesidad infantil de niños atendidos en el servicio de Pediatría de una ciudad del estado de São Paulo, Brasil, en los años de 1983/1984 y 2003/2004. Fueron recolectados datos relacionados al crecimiento y desarrollo infantil de los usuarios a través de los prontuarios. El percentil fue adoptado para clasificación del estado nutricional. Las frecuencias absolutas y porcentuales fueron consideradas para el análisis descriptivo. El teste t fue utilizado para comparaciones de medias. Fue observado mayor riesgo de sobrepeso y diferencia significativa en el peso de niños nacidos en los años 2003/2004 comparado a los nascidos en 1983/1984. La evaluación antropométrica realizada por el enfermero es fundamental en el diagnóstico nutricional infantil para identificación exacta de las anormalidades y definición de estrategias de actuación eficaces