Abordagem do serviço de emergência para cefaleia não traumática em crianças / Emergency service approach for non-traumatic headache in children

A cefaleia é a queixa neurológica mais comum na população pediátrica e uma queixa comum no departamento de emergência. Na emergência pediátrica, as dores de cabeça não traumáticas representam até 2,5% das visitas. As cefaleias primárias compreendem 90% de todas as cefaleias pediátricas, são tipicamente autolimitadas e diagnosticadas com base nos perfis de sintomas e padrões de crises de cefaleia. As dores de cabeça secundárias têm condições subjacentes identificáveis. A maioria das crianças que passam por avaliação de emergência para cefaleias não traumáticas tem condições autolimitadas, como uma doença febril ou uma síndrome de cefaleia primária. No entanto, uma minoria significativa de pacientes previamente saudáveis tem causas com risco de vida que requerem diagnóstico e tratamento urgentes. As características de cefaleia não traumática que levantam preocupação por uma causa com risco de vida incluem cefaleias de início abrupto que é muito doloroso, posicional, desperta a criança do sono, ocorre logo após o despertar pela manhã, precipitado ou agravado por uma manobra ou exercício de Valsalva, crônica e progressiva, associado a vômitos, alterações comportamentais, alterações na visão, polidipsia e poliúria, ataxia e ocorrendo em pacientes com hidrocefalia com derivação, doença falciforme, imunodeficiência e coagulopatia ou cardiopatia cianótica

Salicylic acid does not alleviate salt stress on physiological indicators and growth of guava

In the semi-arid region, the quality of water for irrigation stands out as a limiting factor for the expansion ofagriculture. Thus, it is extremely important to search for alternatives that minimize the effects of salt stress onplants. Foliar application of salicylic acid stands out among these strategies. In this context, the objective ofthis study was to evaluate the gas exchange, photosynthetic pigments, and growth of guava as a function ofirrigation water salinity and exogenous application of salicylic acid in the post-grafting stage. The experimentwas conducted under greenhouse conditions, in a randomized block experimental design, in a 2 × 4 facto rialscheme, corresponding to two levels of electrical conductivity of irrigation water (0.6 and 3.2 dS m-1) and fourconcentrations of salicylic acid (0; 1.2; 2.4 and 3.6 mM), with three replicates. Irrigation with water of 3.2 dS m-1caused reductions in transpiration, CO2 assimilation rate, instantaneous water use efficiency and instantaneouscarboxylation efficiency of guava, at 150 days after transplanting. Water with electrical conductivity of 3.2 dSm-1 reduced the growth in stem diameter and the absolute and relative growth rates, as well as the relativewater content, and chlorophyll a and b contents of guava plants. The interaction between water salinity levelsand salicylic acid concentrations did not influence the physiological indices and growth of guava in the postgraftingphase

Oral formulation of DPP-4 inhibitor plus Quercetin improves metabolic homeostasis in type 1 diabetic rats.

This study aimed to investigate the potential of an oral formulation (QV formulation) containing Quercetin and a Dipeptidyl Peptidase-4 Inhibitor (DPP-4 inhibitor), Vildagliptin, in improving metabolic homeostasis in type 1 diabetes model. Female albino Fischer rats were divided into four groups: untreated control animals (C), untreated diabetic animals (D), diabetic animals treated with QV formulation (DQV), and diabetic animals treated with insulin (DI). Diabetes was induced by injection of alloxan (135?mg?kg body mass)?1 and confirmed by glycemic test. After the 30-day treatment period, biochemical parameters were analyzed in the pancreas, liver, and serum. Histopathological changes in pancreatic tissue were examined by Hematoxyline & Eosin staining and the insulin content in the islet measured by immunohistochemistry with anti-insulin antibody. The glycogen content in the hepatocytes was quantified by Periodic Schiff Acid staining. The QV formulation reduced the glycemia, preserved the pancreatic architecture, increased insulin levels, furthermore ameliorated lipid profile and to promote higher survival rate of animals. Together, our data suggest that the QV formulation treatment was able to normalize metabolic homeostasis in type 1 diabetic rats

Prevalence of Burnout Syndrome among professors of the State School in Niterói, Brazil

O objetivo deste estudo foi descrever a prevalência da Síndrome de Burnout entre os professores da Escola Estadual em Niterói, Brasil. É um estudo quantitativo e descritivo, com informações de uma pesquisa realizada com professores. O questionário utilizado consistiu em questões fechadas que abordavam as características sociodemográficas e as características de trabalho dos sujeitos da pesquisa e o Inventário Maslach Burnout. A suspeita de prevalência de síndrome de burnout de acordo com os critérios de Grunfeld foi de 33 casos (63,5%). A prevalência significativa desta síndrome entre os professores gera alerta sobre as condições de trabalho e a saúde mental desses profissionais. Conclui-se que, a partir dos dados analisados, observou-se que a profissão não possui intervenções para melhorar a qualidade de vida dos professores em seus trabalhos.El objetivo de este estudio fue describir la prevalencia del Síndrome de Burnout entre los profesores de la Escuela Estatal en Niterói, Brasil. Se trata de un estudio cuantitativo, descriptivo, con información de una encuesta realizada con maestros. El cuestionario utilizado constó de preguntas cerradas que abordaron las características sociodemográficas y las características del trabajo de los sujetos de investigación y el Maslach Burnout Inventory. La sospecha de prevalencia de síndrome de burnout según criterio de Grunfeld fue de 33 casos (63.5%). La prevalencia significativa de este síndrome entre los maestros genera alerta sobre las condiciones de trabajo y de la salud mental de estos profesionales. Se concluye que, a partir de los datos analizados, se observó que la profesión carece de intervenciones para mejorar la calidad de vida de los docentes en su trabajoThe objective of this study was to describe the prevalence of Burnout Syndrome among the professors of the State School in Niterói, Brazil. It is a quantitative, descriptive study, with information from a survey conducted with teachers. The questionnaire used consisted of closed questions that addressed the sociodemographic characteristics and work characteristics of the research subjects and the Maslach Burnout Inventory. Suspected prevalence of burnout syndrome according to Grunfeld's criteria was 33 cases (63.5%). The significant prevalence of this syndrome among teachers generates alert about working conditions and the mental health of these professionals. It is concluded that, from the data analyzed, it was observed that the profession lacks interventions to improve the quality of life of teachers in their work

Cytotoxicity and genotoxicity of intravitreal adalimumab administration in rabbit retinal cells

Purpose: To assess the cytotoxicity and genotoxicity of intravitreal adalimumab treatment in an animal experimental model using cytological and molecular techniques. Methods: Eighteen rabbits were randomly assigned to three groups: control, adalimumab treatment, and placebo. Cytotoxicity on retinal cells was evaluated using flow cytometry assays to determine the level of apoptosis and necrosis. Genotoxicity was evaluated by comet assays to assess DNA damage, and quantitative real-time polymerase chain reaction (qPCR) was used to evaluate expression of apoptosis-inducing caspases (8 and 3). Results: No cytotoxicity or genotoxicity was observed in any of the two treatment groups (adalimumab and placebo) following intravitreal administration compared with the control group. Flow cytometry analysis revealed that more than 90% of the cells were viable, and only a low proportion of retinal cells presented apoptotic (~10%) or necrotic (<1%) activity across all groups. Molecular damage was also low with a maximum of 6.4% DNA degradation observed in the comet assays. In addition, no increase in gene expression of apoptosis-inducing caspases was observed on retinal cells by qPCR in both the adalimumab and placebo groups compared with the control group. Conclusion: The use of adalimumab resulted in no detectable cytotoxicity or genotoxicity on retinal cells for up to 60 days upon administration. These results therefore indicate that adalimumab may be a safe option for intravitreal application to treat ocular inflammatory diseases in which TNF-α is involved

Dicephalia in a Bovine

Background: Congenital defects consist of structural or functional abnormalities present at birth, which partially or globally affect the systems. Among the defects are the conjoined twins, a rare congenital anomaly caused by fusion of two monozygotic embryos which can be classified according to the different sites of union. The Siamese twins and embryonic duplication are represented by a progressive series of malformations, since partial duplication of part of the body to the training almost full two bodies. Siamese twins occur in humans and in several animal species. Dicephalia refers to two totally separate heads. The aim of this study was to report a case of dicephalia in a bovine fetus.Case: A crossbred bovine fetus from a cow pregnant at. The animal was fixed by immersion in 10% formalin for sample collection. Muscles were dissected, with exposure of the bones of the right head, neck, forelimb, and hind limb. After dissection, the fetus was subjected to a preservation process by impregnation with glycerin. Next, internal organs were removed in bloc (from tongue to rectum) for evaluation of internal alterations. Additionally, radiographs of the spinal cord were performed to diagnose alterations by diagnostic imaging. Radiography revealed the presence of two skulls; two cervical spines, both with seven vertebrae; two thoracic spines, both with 13 vertebrae; and two lumbar spines, both with six vertebrae, however, fused at L4, i.e., connected in the final third part. Further information could not be obtained by the radiographs due to severe overlapping of structures, causing image subtraction. The findings are compatible with mineralized conjoined twin fetuses. After dissection, it was possible to see that each head exhibited normal development of tongue, trachea, and esophagus. In the thorax, there were two lungs with their typical lobes; however, there was atrophy of the lobes located medially. There was one pericardial sac surrounding two hearts. There was dextroposition of the aorta of the right heart, which would pass over the esophagus and trachea, and was connected to the aorta of the left heart in the cervical region. The ribs of the medial portion of the thorax were absent. The diaphragm had a central opening with protrusion of the diaphragmatic portion of the right lung lobe. The abdomen exhibited two rumens, one was blind-ended, and the other had normal prestomachs development, with connection to normal small and large intestines. There was a lung lobe close to the kidneys (pulmonary choristoma).Discussion: The bovine fetus reported here can be classified as dicephalic, since it exhibited two well defined heads and only one body. That is different from diprosopia, which refers to the development of two faces in one skull. Such anomalies are rare and isolated in bovines, with few studies and information about them. The factors that trigger embryonic duplication are still unclear; however, the cause can be attributed to genetic defects in the germ cells, environmental influences, and heredity. The most important known causes are prenatal viral infection, ingestion of teratogens by the mother, vitamin A and folic acid deficiency, genetic factors, and/or a combination of these factors. No reports of rumen duplication in dicephalic bovines have been observed. Although the occurrence of such malformations is rare, they are relevant and cause economic losses to the farmers.Keywords: siamese twins, malformations, radiography, ruminant

DOENÇA TROFOBLÁSTICA GESTACIONAL E SUAS COMPLICAÇÕES: ANÁLISE DE CASOS

Gestational Trophoblastic Disease is a spectrum of disorders characterized by abnormal trophoblastic proliferation, subclassified into hydatidiform mole (complete and partial) and potentially fatal trophoblastic neoplasms with high metastatic potential, such as invasive mole, choriocarcinoma and trophoblastic tumors. Choriocarcinoma is the most common neoplasm secondary to hydatidiform mole, with a high incidence of lung metastasis, whose initial manifestation is hemoptysis. On the other hand, hydatidiform mole originates from villous trophoblasts and is considered a pre-neoplastic condition, whose clinical picture includes vaginal bleeding, hyperemesis and uterine enlargement, with complications such as preeclampsia, anemia and dyspnea. Objective: To analyze cases regarding Gestational Trophoblastic Disease and its complications. Methodology: This is an integrative literature review, of a quantitative nature, whose articles were selected from PubMed, Scientific Electronic Library On-line (SciELO) and Cochrane Library databases, in English. The choice of articles was performed by reading the title, abstract and, finally, reading the article in its entirety, with a careful analysis of the articles based on the inclusion and exclusion criteria. Final considerations: It is concluded that gestational choriocarcinoma is the most common gestational trophoblastic neoplasm, often secondary to hydatidiform mole, and its main metastatic target is the lung parenchyma, the main clinical manifestation being hemoptysis. There is a tendency to increase blood pressure in pregnant women with hydatidiform mole, which can lead to preeclampsia. Thus, it is possible for the fetus to have intrauterine growth restriction, requiring histopathological examination in all cases.La enfermedad trofoblástica gestacional es un espectro de trastornos caracterizados por una proliferación trofoblástica anormal, subclasificados en mola hidatiforme (completa y parcial) y neoplasias trofoblásticas potencialmente mortales con alto potencial metastásico, como la mola invasiva, el coriocarcinoma y los tumores trofoblásticos. El coriocarcinoma es la neoplasia más frecuente secundaria a mola hidatiforme, con alta incidencia de metástasis pulmonares, cuya manifestación inicial es la hemoptisis. Por otro lado, la mola hidatiforme se origina a partir de trofoblastos vellosos y se considera una condición preneoplásica, cuyo cuadro clínico incluye sangrado vaginal, hiperémesis y agrandamiento uterino, con complicaciones como preeclampsia, anemia y disnea. Objetivo: Analizar casos de Enfermedad Trofoblástica Gestacional y sus complicaciones. Metodología: Se trata de una revisión bibliográfica integradora, de carácter cuantitativo, cuyos artículos fueron seleccionados de las bases de datos PubMed, SciELO y Cochrane Library, en inglés. La elección de los artículos se realizó mediante la lectura del título, resumen y, finalmente, lectura del artículo en su totalidad, con un análisis cuidadoso de los artículos a partir de los criterios de inclusión y exclusión. Consideraciones finales: Se concluye que el coriocarcinoma gestacional es la neoplasia trofoblástica gestacional más frecuente, muchas veces secundaria a mola hidatiforme, y su principal diana metastásica es el parénquima pulmonar, siendo la principal manifestación clínica la hemoptisis. Hay una tendencia a aumentar la presión arterial en mujeres embarazadas con mola hidatiforme, lo que puede conducir a la preeclampsia. Así, es posible que el feto tenga restricción del crecimiento intrauterino, requiriendo examen histopatológico en todos los casos.A Doença Trofoblástica Gestacional é um espectro de distúrbios caracterizados por proliferação trofoblástica anormal, subclassificada em mola hidatiforme (completa e parcial) e neoplasias trofoblásticas com alto potencial metastático e potencialmente fatais, como a mola invasora, coriocarcinoma e tumores trofoblásticos. O coriocarcinoma é a neoplasia mais comum e secundária à mola hidatiforme, com alta incidência de metástase pulmonar, cuja manifestação inicial é a hemoptise. Por outro lado, a mola hidatiforme se originam de trofoblastos vilosos e é considerada condição pré-neoplásica, cujo quadro clínico inclui sangramentos vaginais, hiperêmese e aumento uterino e tem como complicações a pré-eclâmpsia, anemia e dispneia. Objetivo: Analisar casos a respeito da Doença Trofoblástica Gestacional e suas complicações. Metodologia: Trata-se de uma revisão bibliográfica integrativa, de natureza quantitativa, cujos artigos foram selecionados das bases de dados PubMed, Scientific Eletronic Library On-line (SciELO) e Cochrane Library, na língua inglesa. A escolha dos artigos foi realizada por meio da leitura do título, resumo e, por fim, da leitura do artigo na íntegra, sendo realizada uma análise criteriosa dos artigos fundamentados nos critérios de inclusão e exclusão. Considerações finais: Conclui-se que o coriocarcinoma gestacional é a neoplasia trofoblástica gestacional mais comum, muitas vezes secundária à mola hidatiforme, e tem como principal alvo metastático o parênquima pulmonar, sendo a principal manifestação clínica a hemoptise. Há uma tendência ao aumento da pressão arterial na gestante com mola hidatiforme, podendo adquirir pré-eclâmpsia. Desse modo, é possível o feto possuir restrição de crescimento intrauterino, sendo necessária a realização do exame histopatológico em todos os casos

Background and common lesions in the female reproductive organs of giant anteaters (Myrmecophaga tridactyla)

The giant anteater (Myrmecophaga tridactyla) is a vulnerable species in South America and is considered endangered or near extinction in Central America. Therefore, studies describing the reproductive characteristics of this species are pivotal for its conservation. Thus, this study aimed to provide a morphological description of the female reproductive tissues of this species. We collected tissue samples from six female giant anteaters and performed gross, morphological, and histochemical analyses. Five adult subjects and one juvenile were included in the study. In the ovary, classifications were made according to the follicle and oocyte sizes: primordial, primary, secondary, early antral, or antral. Typical follicles with a single oocyte surrounded by a simple or stratified layer of cubic epithelium, atretic follicles, corpora lutea, corpora albicans, and ovarian cysts were also observed. No ovarian lesions were observed. By contrast, endometritis, metritis, mucometra, and endometrial cysts were identified in the uterus. Uterine alterations in these subjects were frequent and could affect reproduction

Kinase Inhibitor Screening Displayed ALK as a Possible Therapeutic Biomarker for Gastric Cancer

Despite advances in cancer chemotherapy, gastric cancer (GC) continues to have high recurrence rates and poor prognosis with limited treatment options. Understanding the etiology of GC and developing more effective, less harmful therapeutic approaches are vital and urgent. Therefore, this work describes a novel kinase target in malignant gastric cells as a potential therapeutic strategy. Our results demonstrate that among 147 kinase inhibitors (KI), only three molecules were significantly cytotoxic for the AGP-01 cell line. Hence, these three molecules were further characterized in their cellular mode of action. There was significant cell cycle impairment due to the expression modulation of genes such as TP53, CDKN1A, CDC25A, MYC, and CDK2 with subsequent induction of apoptosis. In fact, the Gene Ontology analysis revealed a significant enrichment of pathways related to cell cycle regulation (GO:1902749 and GO:1903047). Moreover, the three selected KIs significantly reduced cell migration and Vimentin mRNA expression after treatment. Surprisingly, the three KIs share the same target, ALK and INSR, but only the ALK gene was found to have a high expression level in the gastric cancer cell line. Additionally, lower survival rates were observed for patients with high ALK expression in TCGA-STAD analysis. In summary, we hypothesize that ALK gene overexpression can be a promising biomarker for prognosis and therapeutic management of gastric adenocarcinoma