Botulism in Cattle Associated with Osteophagy in the State of Acre, Brazil

Background:Botulism is a non-febrile intoxication resulting from the ingestion of Clostridium botulinum neurotoxins manifested by partial or complete flaccid paralysis of the musculature of locomotion, swallowing and respiration. The objective of this study was to report the first case of botulinum intoxication associated with osteopathy in the state of Acre, as well as to alert breeders and veterinarians to the incidence of this disease in cattle farming.Case: The present report is an outbreak of botulism in the municipality of Acrelândia, in the state of Acre, which resulted in the death of 16 Nelore beef cattle in approximately 30 days. The affected animals were females in reproductive phase maintained under extensive breeding system. The main clinical signs presented were weakness in the pelvic limbs, prostration, recumbency and death in less than 48 hours. Only one animal, with similar symptomatology, was found alive and submitted to emergency therapeutic measures, but without success. During the necropsy of this bovine, no significant changes were found, only related to the decubitus and agony time, except for fragments of long bones visualized in the reticulum. Samples of bone particles, ruminal contents, reticulum, rumen and intestine fragments were collected for the detection of botulinum toxins by the mouse bioassay method, as well as brain and brain stem for differential diagnosis of rabies and bovine spongiform encephalopathy by direct immunofluorescence and immunohistochemistry, respectively. The samples were sent to the Laboratory of General Bacteriology of the Biological Institute, São Paulo, Brazil, and all the analyzes presented negative results.Discussion: One of the main risk factors for the occurrence of botulinum toxin is the presence of carcasses in the pastures, added to the deficiency of phosphorus and other minerals. The cattle develop the habit of gnawing bones and tissues from dead animals in the field. With this exercise, animals can ingest pre-formed toxins in corpses, as decomposing remains offer an anaerobic environment conducive to spore development and toxin production. Bovine females, in breeding, present greater nutritional need than adult males and younger animals. This is because the reproductive phase increases the demands of minerals, vitamins and organic compounds that participate in the female's reproductive physiological process. In this case, the inadequate supply of minerals may stimulate the osteopagic practice of cadaveric remains in the pastures, making the bovids susceptible to botulism. Diagnosis is established by means of clinical signs, epidemiological characteristics and absence of specific anatomopathological findings. Confirmation is given by the isolation of the toxin in the body of the diseased animal. However, the lack of detection of this does not rule out the possibility of occurrence of the disease, in view of the rapid passage of the neurotoxin through the hematogenous route and through the tissues before reaching the neuromuscular junctions. In suspect cases, it is important to perform a differential diagnosis for other diseases that demonstrate clinical symptoms of neurological or acute neuromuscular character. The description of this outbreak, besides exposing the first notification of botulism in the state of Acre, shows the epidemiological relationship between the main risk factors and the occurrence of the disease in the Brazilian herds

CARACTERIZAÇÃO DE FOOD TRUCKS PRESENTES EM EVENTOS GASTRONÔMICOS NO MUNICÍPIO DO RIO DE JANEIRO

Eventos de food truck têm acontecido em vários locais do Rio de Janeiro, nos quais encontram-se tantos pratos internacionais famosos quanto comidas locais, além de cervejas gourmet. Essa pesquisa caracterizou food trucks no Rio de Janeiro, sendo para tanto realizado um estudo em cinco eventos gastronômicos desse tipo, selecionando em cada evento 10 empresas. Foi observada uma maior presença de caminhões do que food bikes e carrocinhas. Percebeu-se ser comum nesses eventos a baixa presença de propagandas; e poucos funcionários, estes receptivos e comprometidos um atendimento baseado na hospitalidade. Sobre os perfis dos cardápios, houve predominância de itens da Cozinha Norte Americana, seguida da Italiana; e muitas opções de sanduíches diversos. Um ponto negativo nesses eventos é o fator higiene, pois medidas simples desse quesito não foram atendidas.  Palavras-chave:cardápios; evento gastronômico; street foo

Orientações sobre transferências na redução da intensidade da dor lombar crônica de cuidadores familiares em um ambulatório de cuidados paliativos: estudo piloto

Objetivo: Avaliar a eficácia de uma estratégia de orientações verbal e escrita sobre transferências na redução da dor lombar em cuidador familiar de pacientes em cuidados paliativos; o impacto no desempenho das tarefas diárias do cuidador antes e após a intervenção e se a adesão às orientações resultou em melhora clínica significativa da dor e do desempenho nas atividades. Método: Trata-se de ensaio clínico piloto, realizado no ambulatório de cuidados paliativos do HCFMUSP. Foram avaliados 4 cuidadores familiares divididos em dois grupos. O grupo intervenção recebeu orientação verbal e escrita e o grupo controle apenas orientação verbal. A análise dos dados foi realizada através de medida de proporção e análise de significância estatística pelo teste exato de Fisher. A correlação entre as variáveis será realizada através de regressão logística. Resultados: Houve dificuldade no recrutamento com influência direta no tamanho reduzido da amostra. Os resultados preliminares sobre a eficácia da intervenção para redução de dor e aumento de desempenho em cuidadores familiares não demonstraram significância estatística. A análise descritiva de aderência às recomendações aponta para uma tendência promissora quanto à viabilidade da intervenção educativa. Conclusão: A relevância deste ensaio piloto deve-se a avaliação preliminar do tempo necessário para se recrutar um número adequado de participantes e a tendência de boa aderência à intervenção. A dificuldade de recrutamento de pacientes em final de vida é previsível devido ao tempo reduzido de sobrevida e a complexidade do cuidado. A eficácia da intervenção somente poderá ser demonstrada com o ajuste do tamanho da amostra.Objective: To evaluate the efficacy of strategy of verbal and written guidance on transference in the reduction of low back pain in the family caregiver of patients in palliative care; the impact on the performance of the daily tasks of the caregiver before and after the intervention and whether adherence to the guidelines resulted in a significant clinical improvement of pain and performance in the activities. Method: This is a pilot clinical trial, performed at the HCFMUSP palliative care outpatient. Four family caregivers were divided into two groups. The intervention group received verbal and written guidance and the group controlled verbal guidance. The analysis of the data was performed by measurement of proportion and analysis of statistical significance by the Fisher exact test. The correlation between the variables will be performed through logistic regression. Results: Due to the small sample size, preliminary results on the efficacy of the intervention to reduce pain and increase performance in family caregivers did not demonstrate statistical significance. The descriptive analysis of adherence to the recommendations points to a promising tendency towards the feasibility of the educational intervention. Conclusion: The relevance of this pilot test is due to the preliminary evaluation of the time needed to recruit an adequate number of participants and the tendency of good adherence to the intervention. The difficulty of recruiting end-of-life patients is predictable due to reduced survival time and the complexity of care. The effectiveness of the intervention can only be demonstrated by adjusting the sample size

Caminhos e vertentes: os sentimentos reprimidos pelos profissionais de saúde da linha de frente da pandemia pela COVID-19

The aim was to identify the feelings repressed by health professionals in the face of the COVID-19 pandemic. Experience report carried out by nursing interns at a municipal health center in the city of Rio de Janeiro. The performance of this practice enabled the opportunity to listen to health professionals from different areas of expertise, in which it was possible to identify the feelings repressed by them during the COVID-19 pandemic. The experience of six students from the penultimate period of the nursing graduation was narrated who, while fulfilling the mandatory internship time at a municipal health center, came across overworked professionals, with a high demand for services due to the consequences of the COVID pandemic -19. The physical and mental burden of health professionals, especially the nursing staff, is evident in this pandemic scenario. It is important, therefore, to have a more sensitive look at workers, so that they can express the feelings they experience, and thus mitigate the suffering in the face of physical and emotional exhaustion in dealing with the pandemic.Objetivou-se identificar os sentimentos reprimidos por profissionais de saúde, frente à pandemia do COVID-19. Relato de experiência realizado por internas de Enfermagem em um centro municipal de saúde no município do Rio de Janeiro. A realização dessa prática viabilizou a oportunidade de escuta dos profissionais de saúde de diferentes áreas de atuação, em que foi possível identificar os sentimentos reprimidos por estes durante a pandemia do COVID-19. Narrou-se a vivência de seis estudantes do penúltimo período da graduação de enfermagem que, ao cumprir o tempo de estágio obrigatório em um centro municipal de saúde, se depararam com profissionais sobrecarregados, com uma alta demanda de serviços devido às consequências da pandemia do COVID-19. É evidente a sobrecarga física e mental dos profissionais de saúde, sobretudo, da equipe de enfermagem diante desse cenário de pandemia. Torna-se importante, portanto, um olhar mais sensível para os trabalhadores, para que possam expressar os sentimentos vivenciados, e assim mitigar o sofrimento frente ao desgaste físico e emocional no enfrentamento da pandemia

Caminhos e vertentes: os sentimentos reprimidos pelos profissionais de saúde da linha de frente da pandemia pela COVID-19

The aim was to identify the feelings repressed by health professionals in the face of the COVID-19 pandemic. Experience report carried out by nursing interns at a municipal health center in the city of Rio de Janeiro. The performance of this practice enabled the opportunity to listen to health professionals from different areas of expertise, in which it was possible to identify the feelings repressed by them during the COVID-19 pandemic. The experience of six students from the penultimate period of the nursing graduation was narrated who, while fulfilling the mandatory internship time at a municipal health center, came across overworked professionals, with a high demand for services due to the consequences of the COVID pandemic -19. The physical and mental burden of health professionals, especially the nursing staff, is evident in this pandemic scenario. It is important, therefore, to have a more sensitive look at workers, so that they can express the feelings they experience, and thus mitigate the suffering in the face of physical and emotional exhaustion in dealing with the pandemic.Objetivou-se identificar os sentimentos reprimidos por profissionais de saúde, frente à pandemia do COVID-19. Relato de experiência realizado por internas de Enfermagem em um centro municipal de saúde no município do Rio de Janeiro. A realização dessa prática viabilizou a oportunidade de escuta dos profissionais de saúde de diferentes áreas de atuação, em que foi possível identificar os sentimentos reprimidos por estes durante a pandemia do COVID-19. Narrou-se a vivência de seis estudantes do penúltimo período da graduação de enfermagem que, ao cumprir o tempo de estágio obrigatório em um centro municipal de saúde, se depararam com profissionais sobrecarregados, com uma alta demanda de serviços devido às consequências da pandemia do COVID-19. É evidente a sobrecarga física e mental dos profissionais de saúde, sobretudo, da equipe de enfermagem diante desse cenário de pandemia. Torna-se importante, portanto, um olhar mais sensível para os trabalhadores, para que possam expressar os sentimentos vivenciados, e assim mitigar o sofrimento frente ao desgaste físico e emocional no enfrentamento da pandemia

Process optimization of physicochemical properties of spray-dried Hydrocotyle umbellata L. extract

Hydrocotyle umbellata L., Araliaceae, is a species that is recommended in Ayurvedic medicine for its effects on the central nervous system, such as anxiolytic and memory-stimulant effects. Despite the medicinal potential of this species, its phytopharmaceutical and technological potential to produce standardized extracts has not been investigated. This study analyzes the influence of spray drying parameters on the contents of the chemical markers (total phenolic, total flavonoid, and hibalactone) and the functional properties of H. umbellata extract. The optimization of drying conditions was performed using a central composite design combined with response surface methodology and desirability function approach. The mathematical models fitted to experimental data indicated that all the evaluated drying parameters significantly influenced the chemical contents. The optimal conditions were: inlet temperature of 120 °C, feed flow rate of 4 mL min-1, and colloidal silicon dioxide:maltodextrin ratio of 16%:4%. Under these conditions, the powder samples had spherical particles and desirable physicochemical and functional properties, such as low water activity and moisture content, good product recovery, reconstitution, and flowability. Thus, spray drying might be a promising technique for processing standardized H. umbellata extracts