Raquitismo associado a hiperparatireoidismo secundário nutricional em Callithrix jacchus (Linnaeus, 1758): Relato de caso

Os seres humanos, macacos do velho e do novo mundo compõem os mamíferos pertencentes a ordem Primates, sendo os últimos exclusivos do continente americano e de hábitos arborícolas. Com os avanços das pesquisas nas áreas da medicina e biomedicina, a demanda da criação de primatas em cativeiro aumentou significantemente. Desta forma, o bem-estar dos primatas não humanos passou a ser alvo de estudos pela comunidade científica. O esqueleto é constituído pelos ossos e suas respectivas articulações. É dividido em duas porções: a porção axial, formada pelo crânio, vértebras, costelas e esterno e a porção apendicular pelos membros torácicos e pélvicos. As células responsáveis pela formação e integração dessas matrizes são os osteoblastos. Todavia, quando os mesmos estão revestidos pelas matrizes, são denominados de osteócitos, que têm a responsabilidade de manter o tecido ósseo hígido e assegurar a isocalcemia (equilíbrio de cálcio). Doenças osteometabólicas são resultantes do desequilíbrio entre alguns desses elementos e podem acometer primatas humanos ou não humanos, assim como outras espécies como aves, répteis, anfíbios e demais mamíferos. Caso os níveis de cálcio entrem em desordem, o organismo pode desenvolver com o tempo quadros de osteodistrofias, ou seja, lesões no tecido ósseo causadas pelo aumento exacerbado de reabsorção óssea e consequente fragilização do esqueleto. O presente relato de caso tem como objetivo descrever um quadro de osteodistrofia secundária à falha no manejo nutricional em uma fêmea de Callithrix jacchus (Linnaeus, 1758)

Dynamics and determinants of SARS-CoV-2 RT-PCR testing on symptomatic individuals attending healthcare centers during 2020 in Bahia, Brazil

RT-PCR testing data provides opportunities to explore regional and individual determinants of test positivity and surveillance infrastructure. Using Generalized Additive Models, we explored 222,515 tests of a random sample of individuals with COVID-19 compatible symptoms in the Brazilian state of Bahia during 2020. We found that age and male gender were the most significant determinants of test positivity. There was evidence of an unequal impact among socio-demographic strata, with higher positivity among those living in areas with low education levels during the first epidemic wave, followed by those living in areas with higher education levels in the second wave. Our estimated probability of testing positive after symptom onset corroborates previous reports that the probability decreases with time, more than halving by about two weeks and converging to zero by three weeks. Test positivity rates generally followed state-level reported cases, and while a single laboratory performed ~90% of tests covering ~99% of the state's area, test turn-around time generally remained below four days. This testing effort is a testimony to the Bahian surveillance capacity during public health emergencies, as previously witnessed during the recent Zika and Yellow Fever outbreaks

O perfil semiológico do paciente portador de hemorragia digestiva alta

OBJETIVO: O seguinte estudo objetivou descrever a semiologia do paciente portador de hemorragia digestiva alta, considerando como determinante na avaliação de potencias focos hemorrágicos. METODOLOGIA: Foram realizadas buscas nas plataformas do SciELO, LILACS, PubMed, Scopus e Google Scholar,utilizando os descritores gastrointestinal bleeding, peptic ulcerous disease e varicose hemorrhage, sendo identificados 35 estudos, dos quais foram incluídos 13 artigos completos. Desses estudos, 5 avaliaram as principais etiologias, 2 o surgimento de novos testes diagnósticos, 2 analisaram os aspectos epidemiológicos e 1 a sintomatologia apresentada pelo acometimento da hemorragia digestiva alta. Observou-se inicialmente a abundâncias de informações conceituais sobre o sangramento, como um transtorno clínico comum, acompanhada de inúmeras manifestações, considerando que o foco hemorrágico pode ocorrer em qualquer porção do trato gastrointestinal. Neste estudo, todas as publicações eleitas apresentaram o quadro semiológico composto por algia abdominal, indícios de choque hipovolêmico e taquicardia, alguns exibiram quedas abruptas da pressão arterial, odinofagia, êmese, náuseas e estado ictérico. Os pacientes implicados, cronicamente, já manifestaram ocorrências prévias, devido ao caráter recidivante torna-se essencial investigar a existência de varizes, fístula aorto-entérica, angiodisplasia e doença ulcerosa. CONCLUSÃO: Elucida-se que a hemorragia digestiva alta representa a principal causa de sangramento do trato gastrointestinal, majoritamente manifesta-se como hematêmese ou melena e cursam com o quadro sintomatológico que auxilia na avaliação da gravidade deste e o embasamento de potenciais focos de sangramento e que contribuam para disseminação de informações e intervenções futuras

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

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

Anxiety, Depression and Anger: Application of a Bifactor Model to Identify Common Symptoms

Anger manifestations, depression and anxiety are strongly related to individual´s discomfort and well-being. The aim of the present study is to investigate the fit of a bifactor model applied on emotional disposition measures emphasizing the specification of a general factor through the identification of specific responses or indicators that can account for the communality between depression, anxiety and anger. The results obtained show two large groups of indicators that would be common in these affective disposition types: affective and cognitive responses. On the one hand, affective responses include agitation, irritability, and tension or nervousness. On the other hand, cognitive symptoms are linked to the presence of repetitive worrying and uncontrollable thoughts. In this way, it is possible to identify a general stress response in this group of indicators.Fil: García Batista, Zoilo Emilio. Pontificia Universidad Católica Madre y Maestra; República DominicanaFil: Guerra Peña, Kiero. Pontificia Universidad Católica Madre y Maestra; República DominicanaFil: Flores Kanter, Pablo Ezequiel. Universidad Empresarial Siglo XXI. Vicerrectorado de Innovación e Investigación. Instituto de Organizaciones Saludables; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Moretti, Luciana Sofía. Universidad Nacional de Córdoba. Facultad de Psicología. Laboratorio de Psicología Cognitiva; Argentina. Pontificia Universidad Católica Madre y Maestra; República Dominicana. Universidad Empresarial Siglo XXI; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Medrano, Leonardo Adrián. Pontificia Universidad Católica Madre y Maestra; República Dominicana. Universidad Siglo 21; Argentin

Using Constrained Factor Mixture Analysis to Validate Mixed-Worded Psychological Scales: The Case of the Rosenberg Self-Esteem Scale in the Dominican Republic

A common method to collect information in the behavioral and health sciences is the self-report. However, the validity of self-reports is frequently threatened by response biases, particularly those associated with inconsistent responses to positively and negatively worded items of the same dimension, known as wording effects. Modeling strategies based on confirmatory factor analysis have traditionally been used to account for this response bias, but they have recently become under scrutiny due to their incorrect assumption of population homogeneity, inability to recover uncontaminated person scores or preserve structural validities, and their inherent ambiguity. Recently, two constrained factor mixture analysis (FMA) models have been proposed by Arias et al. (2020) and Steinmann et al. (2021) that can be used to identify and screen inconsistent response profiles. While these methods have shown promise, tests of their performance have been limited and they have not been directly compared. Thus the objective of the current study was to assess and compare their performance with data from the Dominican Republic of the Rosenberg Self-Esteem Scale (N = 632). Additionally, as this scale had not yet been studied for this population, another objective was to show how using constrained FMAs could help in the validation of mixed-worded scales. The results indicated that removing the inconsistent respondents identified by both FMAs (≈8%) reduced the amount of wording effects in the database. However, whereas the Steinmann et al. method only cleaned the data partially, the Arias et al. (2020) method was able to remove the great majority of the wording effects variance. Based on the screened data with the Arias et al. method, we evaluated the psychometric properties of the RSES for the Dominican population, and the results indicated that the scores had good validity and reliability properties. Given these findings, we recommend that researchers incorporate constrained FMAs into their toolbox and consider using them to screen out inconsistent respondents to mixed-worded scales

Higroma Subdural pós-traumático: relato de caso durante Internato em Clínica Médica / Posttraumatic Subdural Hygroma: case report during Internship in Clinical Medicine

Relato de caso de uma paciente que apresenta higroma subdural desenvolvimento provavelmente pós-trauma. O higroma subdural é a presença de líquido de densidade semelhante ao líquor no espaço subdural. Seu quadro clínico é variável, podendo ser desde assintomático até apresentar déficit neurológico importante. A paciente iniciou com quadro de tremores, fasciculações, disartria e alteração da força muscular, evoluindo para rebaixamento do nível de consciência. Seu diagnóstico foi confirmado após realização de ressonância magnética que mostrou a presença de coleções subdurais de 18mm e efeito compressivo. Em virtude disso, foi indicado abordagem cirúrgica e drenagem desse líquido. Após o procedimento, a paciente evoluiu com melhora gradativa e lenta dos sintomas, mantendo as alterações da fala

Design of virtual environments for the treatment of agoraphobia: Inclusion of culturally relevant elements for the population of the Dominican Republic

Virtual Reality is a powerful tool for the treatment of agoraphobia. However, how effective is the use of these scenarios when they do not resemble the sociocultural context? Literature suggests that the inclusion of culturally relevant elements increases the ecological validity and transferability of learning since it reduces the gap between the virtual and real context. Unfortunately, in Latin America, the development of virtual environments is incipient, and the use of generic virtual environments is commonplace. The objective of this study was to develop virtual environments that include elements that are culturally relevant to the population of the Dominican Republic. Three hundred people with symptoms of agoraphobia were interviewed. Based on the information obtained, four scenarios were designed: house, elevator, park and public transport. In each scenario, the parameters that increase anxiety levels (for example, number of people) may be controlled and modified, allowing the development of exposure levels