Qualidade de vida de indivíduos com HIV: revisão integrativa / Quality of living of individuals with HIV integration review

 A qualidade de  vida de pacientes vivendo com HIV/AIDS é essencial, tendo em vista o caso específico dos adolescentes é ainda mais importante porque o jovem além de lidar com a resistência e a aceitação da doença, deve também enfrentar os conflitos da puberdade.O presente trabalho tem como objetivo realizar uma revisão integrativa em relação a qualidade de vida dos pacientes com HIV. Trata-se de um estudo de revisão integrativa realizado no período de 2016 a 2017, utilizando-se o banco de dados Medline e Lilacs. Apesar do impacto da infecção pelo HIV/AIDS na saúde psicológica e nas relações sociais dos indivíduos infectados, assim como no domínio físico, o uso da TARV provocou consequências positivas na saúde psicológica, proporcionando a desconstrução da ideia de morte advinda ao diagnóstico de portador do HIV/AIDS e a construção de melhores perspectivas de vida. A adesão ao tratamento em HIV/AIDS está relacionada a um aumento da sobrevida e de sua qualidade. Porém deve-se respeitar a posição pessoal do portador para fazer ou não o tratamento

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

COMPARAÇÃO DA QUALIDADE SANITÁRIA ENTRE AMOSTRAS DE Peumus boldus Molina INDUSTRIALIZADAS E ARTESANAIS DO MUNICÍPIO DE CURRAIS NOVOS, RN.

As plantas medicinais, embora constituam válida vertente da Medicina Tradicional, quando mal utilizadas representam risco potencial a saúde humana. O consumo de produtos contaminados pode gerar intoxicações diversas por subprodutos advindos de microrganismos patogênicos. O presente trabalho objetivou a avaliação da qualidade microbiológica de amostras de Peumus boldus Molina artesanais, comercializadas na feira popular, e compará-la com a qualidade microbiológica de amostras da mesma espécie industrializadas, comercializadas no comércio varejista local. Foram quantificados: aeróbios mesófilos (ágar Padrão de Contagem, 35±1°C/24h), coliformes totais/Escherichia coli (teste presuntivo: caldo LST, 35±0,5°C/24-48±2; CT: caldo VB, 35±0,5°C/24-48±2; E. coli: caldo EC, 44,5±0,2°C/24±2h; ágar L-EMB, 35±0,5°C/24±2h), bolores e leveduras (ágar Batata Dextrosado Acidificado, 25±1°C/5 dias) e Staphylococcus aureus (ágar Baird-Parker, 35-37°C/24±2h). Para a confirmação de E. coli, colônias foram submetidas às provas bioquímicas da série IMViC. A E. coli estava presente em 10% das amostras, o S. aureus em 50%, bolores e leveduras em 80% e aeróbios mesófilos em 100% das amostras analisadas. O estudo revelou que a tanto amostras industrializadas quanto artesanais não estavam de acordo com as recomendações de padrões sanitários e microbiológicos adequados para o comércio, caracterizando-se como riscos potenciais à Saúde Pública

Pasture structure and sheep performance supplemented on different tropical grasses in the dry season

The objective was to evaluate the productive and structural characteristics of tropical grasses and the performance of sheep supplemented during the dry season. The treatments consisted of Marandu, Piatã, Massai and Aruana cultivars managed under intermittent stocking with seven occupation days and 35 d of rest, with a variable stocking rate. The evaluated variables were the forage masses, the morphological components, the chemical composition of the pasture and sheep performance. The forage mass was similar among the cultivars, while the leaf blade mass and percentage were higher in the Massai cultivar. There were differences between the cultivars for the NDF, ADF, ADL and ash contents in the two grazing cycles. The lowest gains per animal and gain per area were observed in the Aruana grass pastures, while there were no differences for these variables among the other cultivars. Massai, Marandu and Piatã cultivars can be used as a forage option for the dry period when associated with protein supplementation for sheep being raised for meat.

ATIVIDADE ANTIBACTERIANA DO ÓLEO ESSENCIAL DE Lippia gracilis SCHAUER SOBRE PATÓGENOS DE IMPORTÂNCIA NA INDÚSTRIA DEALIMENTOS

A resistência bacteriana a antibióticos é um sério problema de saúde pública. Bactérias patogênicas como a Listeria monocytogenes, Staphylococcus aureus e Staphylococcus epidermis apresentam cepas resistentes, representando grave risco à saúde humana. A prospecção de fitoquímicos antimicrobianos é apontada como uma possível solução para o problema. Os óleos essenciais de espécies vegetais da caatinga têm sido testados em relação ao seu potencial antimicrobiano. Dentre as espécies medicinais da caatinga produtoras de óleo essencial encontra-se a Lippia gracilis Schauer, cujo fitocomplexo contém carvacrol, timol, ρ-cimeno, em concentrações variáveis. Apesar de sua composição e atividades biológicas apontarem para aplicações práticas no controle de patógenos humanos, a ação do óleo essencial desta espécie sobre bactérias patogênicas ainda não foi devidamente avaliada. Quadruplicatas de Placas de Petri contendo Agar Mueller-Hinton foram semeadas em superfície com culturas padronizadas dos microrganismos mencionados. Foram perfurados poços de 10 mm de diâmetro nos quais se inoculou 100 µL de cada diluição do óleo essencial de L.gracilis. As placas foram incubadas a 35±2°C/24h. Os halos de inibição foram mensurados com paquímetro. Todos os microrganismo-alvo foram fortemente inibidos. Sendo a maior inibição alcançada com O.E não diluído sobre o S. epidermis. S. aureus mostrou-se como o mais sensível sendo inibido em concentração de O.E de 9µL/mL; L. monocytogenes também foi fortemente inibido pelo óleo essencial de Lippia gracilis. PALAVRAS-CHAVE: resistência, antimicrobiano, carvacrol, Staphylococcus, Listeri

The effect of Brachiaria brizantha cultivars on host-parasite-environment interactions in sheep naturally infected with gastrointestinal nematodes.

The objective was to evaluate the effect of different cultivars of Brachiaria brizantha on the dynamics and concentration of the larval stages of gastrointestinal nematodes in the soil and forage strata, as well as their effects on the performance of naturally infected lambs. Overall, 48 90-day-old lambs with an initial weight of 19.04 ± 0.96 kg were observed. Moreover, a randomised block factorial design with four cultivars of Brachiaria brizantha (Marandu, Xaraés, Piatã and Paiaguás grasses) under intermittent stocking (with a pre-grazing canopy height of 40 cm and post-grazing canopy height of 20 cm) for two grazing cycles was used. The following variables were analysed: faecal egg counting, faecal culture, mean corpuscular volume, FAMACHA© score, weight and body condition score, the recovery of larvae from pasture and soil samples, nutritional value and the production and structural components of forage. Lambs grazing Marandu grass demonstrated the highest level of nematode infection (P < 0.05). However, the nutritional value did not differ between cultivars. Marandu grass had the highest pasture density (P < 0.05), while Paiaguás grass had the highest percentage of dead material (P < 0.05). The various genera of gastrointestinal nematodes found in the faecal cultures, regardless of the cultivars, include Haemonchus (92.01%), Trichostrongylus (4.55%), Strongyloides (3.06%) and Oesophagostomum (0.37%). Lambs grazing Xaraés grass had the lowest body weight (P < 0.05). Furthermore, larvae concentrations were highest in Marandu and Paiaguás pastures; infective Haemonchus and Trichostrongylus larvae were recovered from pasture and soil samples. The different cultivars of Brachiaria brizantha produce diverse and relevant microclimatic conditions to contaminate soil, pastures and animals. Animal performance was not compromised despite the Marandu and Paiaguás cultivars having the highest levels of contamination and infection. Based on parasitological aspects, the Brachiaria brizantha cultivars Xaraés and Piatã are recommended for grass-based sheep production systems over the other cultivars since they contribute to the reduction of larval contamination and infection

Epidemiologic and clinical investigations during a chikungunya outbreak in Rio Grande do Norte State, Brazil.

The first autochthonous case of chikungunya virus (CHIKV) infection in Brazil was in September 2014 in the State of Amapá, and from there it rapidly spread across the country. The present study was conducted in 2016 in the state of Rio Grande do Norte, and the aims were to describe the epidemiological and the clinical aspects of the CHIKV outbreak. Biological samples from 284 chikungunya suspected cases were screened for CHIKV and Flavivirus (FV) RNA using qRT-PCR. Negative PCR samples were also screened for anti-CHIKV and anti-FVIgM by ELISA. CHIKV RNA were detected in 125 samples mostly occurring from January through March (46%), mainly affecting adults and older adults. We found a gradual decrease in viral RNA over the disease time. Anti-CHIKV IgM was found in 47.5% after negative CHIKV qRT-PCR. Interestingly, 45.0% simultaneously had positive results for CHIKV and FV IgM, suggesting the occurrence of virus co-circulation. The most frequent symptom was fever (91%). Women presented more chance to develop nausea and abdominal pain compared to men. Our data described and allows us to better understand the clinical and epidemiological aspects of the 2016 chikungunya outbreak in Rio Grande do Norte and can help in the early clinical diagnosis of the virus

Prediction of Carcass Traits of Santa Inês Lambs Finished in Tropical Pastures through Biometric Measurements

The aim of this study was to predict carcass traits of Santa Inês lambs finished in tropical pastures by using biometric measurements. Data originated from two experiments involving 56 lambs (32 in experiment I and 24 in experiment II). In both experiments, the sheep were finished in that were finished in pastures of Panicum maximum and Brachiaria brizantha, experiment I being conducted in the rainy season and experiment II in the dry season. The following biometric measurements were recorded before slaughter: body length (BL), withers height (WH), rump height (RH), thorax width (TW), rump width (RW), chest width (CW), heart girth (HG), thigh circumference (TC), rump circumference (RC) and leg length (LL), in addition to live weight at slaughter (SW). After slaughter, hot carcass weight (HCW), cold carcass weight (CCW) and the weights of primal cuts (shoulder, neck, loin, leg and rib) were recorded. In the equations generated to predict SW, HCW and CCW, R2 ranged from 0.58 to 0.91 and the measurements of WH, TC, CW, HG and RW were the most relevant. In the equations developed to predict the weight of primal cuts, in turn, R2 ranged from 0.26 to 0.99. In these models, SW, BL, CW, TC, LL and HG explained most of the variation in the weight of primal cuts. Biometric measurements can be used to accurately and precisely predict HCW, CCW and the weight of primal cuts from the carcass of Santa Inês sheep finished in tropical pastures, since the equations presented R2 and correlation coefficient and agreement above 0.8