Motivation and frustration in cardiology trial participation: The patient perspective

OBJECTIVE: The participation of humans in clinical cardiology trials remains essential, but little is known regarding participant perceptions of such studies. We examined the factors that motivated participation in such studies, as well as those that led to participant frustration. METHODS: Patients who had participated in hypertension and coronary arterial disease (phases II, III, and IV) clinical trials were invited to answer a questionnaire. They were divided into two groups: Group I, which included participants in placebo-controlled clinical trials after randomization, and Group II, which included participants in clinical trials in which the tested treatment was compared to another drug after randomization and in which a placebo was used in the washout period. RESULTS: Eighty patients (47 patients in Group I and 33 patients in Group II) with different socio-demographic characteristics were interviewed. Approximately 60% of the patients were motivated to participate in the trial with the expectation of personal benefit. Nine participants (11.2%) expressed the desire to withdraw, which was due to their perception of risk during the testing in the clinical trial (Group I) and to the necessity of repeated returns to the institution (Group II). However, the patients did not withdraw due to fear of termination of hospital treatment. CONCLUSIONS: Although this study had a small patient sample, the possibility of receiving a benefit from the new tested treatment was consistently reported as a motivation to participate in the trials

DIREITO INDIVIDUAL DO TRABALHO E A REFORMA TRABALHISTA (LEI 13.467/2017) À LUZ DA CONSTITUIÇÃO DE 1988

Objetiva-se analisar se a Reforma Trabalhista brasileira – Lei 13.467/2017 - foi redigida em atenção ao que preceitua a Constituição de 1988 ou, de modo diverso, se ela é inconstitucional. Para tanto, foram selecionados cinco artigos da nova lei que têm gerado discussão acerca da sua inconstitucionalidade, contrapondo referidos artigos com que prevê a Constituição de 1988. Conforme se observou, a Reforma Trabalhista, possui dispositivos inconstitucionais porque viola os seguintes direitos constitucionais: (i) acesso à justiça; (ii) o benefício da assistência judiciária gratuita; (iii) de ação; (iv) o direito ao trabalho; (v) o direito ao salário; (iv) o direito de proteção ao trabalho, etc. Como possíveis alternativas para sanar o problema da inconstitucionalidade, discorreu-se brevemente sobre os dois principais métodos de controle de constitucionalidade (concentrado e difuso) para atacar a validade das normas da Reforma Trabalhista

Crown-down preflaring in the determination of the first apical file

In this study, scanning electron microscopy (SEM) was used to evaluate the adaptation of the first apical file after preflaring in mesiobuccal (MB) and mesiolingual (ML) canals of mandibular molars considering the tactile sensibility as a reference. The mesial canals (n = 22) of human mandibular molar teeth were used, and the first instrument to bind to the working length was determined after preflaring and crown-down shaping. Digital images of the root apex were acquired and a single examiner determined the contact of the file with the walls using Image J software. The results showed that the file was in contact in 47.83% and 31.71% in the MB and ML canals, respectively. When the apexes are fused, the average was 40.03%. A descriptive analysis showed that the first apical file did not touch all dentin walls in any of the samples

Giant Fibrolipoma in the Distal Limb of a Cow

Background: Lipomas are adipocytic tumors of slow and expansive growth. They can be classified into several subtypes depending on the tissue present next to the neoplastic adipocytes. One of such subtypes is the fibrolipoma, which is formed by well-differentiated adipocytes and fibrous connective tissue. This neoplasm has been little described in cattle, and rare reports present the treatment and resolution of the case. Thus, the dissemination of cases of fibrolipomas in cattle is essential to help veterinarians diagnose this neoplasm. The present report describes a case of fibrolipoma in the distal pelvic limb of a cow successfully treated by surgical excision. Case: A 4-year-old 3/4 Girolando cow from the municipality of Vazante-MG, Brazil, was treated on the farm. According to the owner, the animal had been showing tumoral growth in the left pelvic limb over the period of 1 year and 3 months. The tumor involved the entire left metatarsus and was 40 x 37 cm, without ulcerations and painless on palpation. A neoplasm was suspected and surgical excision was the chosen approach. The cow was sedated, positioned and restrained in right lateral recumbency for surgery. The operative field was prepared and a subcutaneous locoregional ring block was performed dorsally to the tumor. The tumor mass was excised with a safety margin of 1 cm. After removal, the mass was found to weigh 10.4 kg and to be yellowish-white upon sectioning. Due to the distance between the edges of the surgical wound, skin suture could not be performed. Thus, second-intention healing and wound protection with bandages were the choice of management. In the postoperative period, the adopted treatment consisted of antibiotic therapy with benzathine penicillin, analgesia with non-steroidal anti-inflammatory drugs, daily dressings and wound protection with bandages. The animal did not show postoperative complications and, over 8 months of monitoring after surgery, there was no recurrence of the neoplasm and the cow was in productive activity. Tumor fragments were fixed in 10%buffered formalinand sent for histopathological examination, which revealed a neoplasm of mesenchymal cells in the subcutaneous adipose tissue supported by dense fibrovascular stroma with solid arrangement. A large amount of dense connective tissue was found among the neoplastic cells. In view of these findings, the diagnosis of fibrolipoma was established.Discussion: Fibrolipoma is a benign neoplasm little described in the veterinary literature, especially in cattle, with only 3 cases reported. To the knowledge of the authors, this is the first report of this neoplasm in the distal limb of cattle. Fibrolipomas are a rare type of lipoma formed by well-differentiated lipocytes and fibrous tissue. The fibrolipoma described in this report was 40 cm in diameter and weighed 10.4 kg, so it can be classified as a type of giant lipoma, as it was more than 10 cm in diameter and more than 1 kg in weight. In the present report and in others in the medical literature, surgical removal of the fibrolipoma resulted in complete recovery of the patient without postoperative complications. Surgical excision is the treatment of choice in these cases and usually promotes healing. However, surgery must be performed early and the neoplasm must be completely removed. The histological characteristics of the fibrolipoma in this case are similar to those found in other cases in cattle and corroborate the choice for surgical treatment and maintenance of the animal in the herd. Although rare, fibrolipomas should be included in the differential diagnosis of tumors of slow and expansive growth in cattle.Keywords: bovine, adipose tissue, lipoma, neoplasia, surgery.Descritores: bovino, cirurgia, tecido adiposo, lipoma, neoplasia.Título: Fibrolipoma gigante no membro distal de uma vaca

Recommendations of the neuroendocrinology department of the Brazilian society of endocrinology and metabolism for the diagnosis of Cushing’s disease in Brazil

Although it is a rare condition, the accurate diagnosis and treatment of Cushing’s disease is important due to its higher morbidity and mortality compared to the general population, which is attributed to cardiovascular diseases, diabetes mellitus and infections. Screening for hypercortisolism is recommended for patients who present multiple and progressive clinical signs and symptoms, especially those who are considered to be more specific to Cushing’s syndrome, abnormal findings relative to age (e.g., spinal osteoporosis and high blood pressure in young patients), weight gain associated with reduced growth rate in the pediatric population and for those with adrenal incidentalomas. Routine screening is not recommended for other groups of patients, such as those with obesity or diabetes mellitus. Magnetic resonance imaging (MRI) of the pituitary, the corticotropin-releasing hormone (CRH) test and the high-dose dexamethasone suppression test are the main tests for the differential diagnosis of ACTH-dependent Cushing’s syndrome. Bilateral and simultaneous petrosal sinus sampling is the gold standard method and is performed when the triad of initial tests is inconclusive, doubtful or conflicting. The aim of this article is to provide information on the early detection and establishment of a proper diagnosis of Cushing’s disease, recommending follow-up of these patients at experienced referral centers

IMPACTO DE VARIÁVEIS CONGNITIVAS E CONTEXTUAIS SOBRE O SUCESSO ACADÊMICO E O BEM ESTAR NA UNIVERSIDADE – QUE FAZER? QUE DEIXAR DE FAZER?

Este estudo parte de uma investigação longitudinal (2019-2022) mais ampla, vinculada ao Grupo Multidisciplinar de Pesquisa em Educação, Psicopedagogia e Psicologia Escolar, UFAM/CNPq, PROCAD/AMAZÔNIA-PPGEUFAM/UFPA/UFMT, Processo CAPES 8881.314288/2019-0, articula-se metodológica e teoricamente com interfaces entre a psicologia escolar, psicologia educacional, pedagogia do ensino superior e educação escolar. Atua no sentido de entender os efeitos de variáveis cognitivas e contextuais sobre o sucesso acadêmico e o bem estar na universidade. A metodologia para coleta de dados é a aplicação de caderno de instrumentos próprios com apoio do Googleodocs, a amostra atual é de n=1112 estudantes de diferentes países (Brasil, México, República Dominicana, Bolívia, Moçambique, Angola, Venezuela, Colômbia, Espanha e Portugal), do sexo masculino e feminino, idade entre 18 e 54 anos e de 51 universidades públicas e privadas que colaboram com a iniciativa. Os dados são analisados com auxílio do Excel e SPSS, de acordo com os interesses dos pesquisadores e objetivos da investigação. Os resultados atuais demonstram a importância da pesquisa sobre os temas abordados pela iniciativa considerando o impacto das variáveis estudadas sobre o rendimento acadêmico e bom estar tanto de estudantes como de docentes e técnicos no ensino superior. Foram identificadas diferenças de países, renda, etnia, gênero e renda. No caso dos docentes e técnicos verificamos evidências da exaustão feminina. Os resultados podem apoiar a administração geral e coordenação educativa e psicopedagógica universitária em sentido amplo, visando a melhoria dos indicadores de sucesso acadêmico e bem estar, por meio da proposição de novas políticas e gestão da educação superior. Palavras-chave: Pesquisa em educação, Ensino superior, Rendimento acadêmico, Bem estar. Políticas de gestão da educação superior. Educação comparada.   IMPACT OF COGNITIVE AND CONTEXTUAL VARIABLES ABOUT ACADEMIC PERFORMANCE AND  WELLBEING IN THE UNIVERSITY. Whato to do? Qhato not to do?   Abstract: This study, part of a further longitudinal investigation (2019-2022), attached to a multidisciplinary group of Educational Research  Scholar Psychotherapy and Psychology, UFAM/CNPq, PROCAD/AMAZONIA-PPGEUFAM/UFPA/UFMT, CAPES process 8881.314288/2019-0, it is articulated methodological and theoretically with interfaces between the scholar and educational psychology, upper and scholar education pedagogy. It acts in the direction of understanding 5he effects og cognitive and contextual variables about the academic achievement and wellness in the university. The methodology to data collection is the application of own instrument cards with the support of Googledocs, the actual sample is quantity of n=1112 students from 51 private and public universities of different countries (Brazil, Mexico, Dominican Republic, Bolivia, Mozambique, Angola, Venezuela, Colombia, Spain and Portugal), from both male and female genders, aging between 18 and 54 years-old. The data were analyzed with the support of software Excel and SPSS, according to the interests of researchers and investigation focus. The actual results show the importance of the research about the themes cited in the initiative considering the impacts of the studied variables over the academic performance and wellness of the students as the teachers and technicians from upper education. There were found differences between countries, income, ethnic and gender. In the cases of the teachers and technicians it was found evidences of female exhaustion. The results could support the general administration, educative and psychopedagogy coordination and in a wide range, looking forward the better successful academic indicators and wellness, through the proposition of new policies and management of upper education. Keywords: Educational Reserch, upper educatión, academic performance, wellness, upper educaciton mangement policies, compared education. &nbsp