The Roles of Bees and Hoverflies in the Pollination of Jacquemontia evolvuloides (Moric.) Meisn. (Convolvulaceae) in a Semiarid Region

Jacquemontia species are often found in disturbed areas, and their flowers are ephemeral and very attractive to insects. We investigated the interaction between the flowers of Jacquemontia evolvuloides and its visitors, with emphasis on potential pollinators, considering morphological, temporal, and behavioral aspects, between September/2009 and August/2010 in an anthropized area in Bahia State, Northeastern Brazil. Jacquemontia evolvuloides flowers are diurnal, ephemeral (approximately five to six hours duration), are present throughout the year, and offer nectar and pollen rewards. Because of the floral morphology of J. evolvuloides insect visitors have easy access to its resources, and its pollination could be considered generalized. While J. evolvuloides flowers are visited by several insects, only small bees (Augochlora spp.) and syrphids (Toxomerus spp.) appear to play a role in pollination of flowers. Although bees have been considered efficient pollinators of that plant, the significant presence of syrphids (considered occasional pollinators but showing high frequency visitation), may indicate their role as potential pollinators, especially when bees are not abundant in the fall/winter. As such, even in pollination systems that are considered generalized (with flowers allowing easy access to various visitor groups), visitor size may be an important factor for efficient pollination, especially when associated with high visitation frequencies

Flavonoids Of Lonchocarpus Montanus A.m.g. Azevedo And Biological Activity.

The analysis of root extracts from Lonchocarpus montanus A.M.G. Azevedo resulted in the isolation of twenty three compounds chiefly flavonoids of which five (four flavonoids and one benzophenone) are described for the first time. The molecular structures of the new compounds (1-5) were determined through spectral analysis (UV, IR, MS and NMR) as being: 2'-hydroxy-8-(alpha,alpha-dimethylallyl)-2, 2-dimethylpyrano-(5,6:3',4')-dibenzoylmethane (1), 2'-methoxy-8-(alpha,alpha-dimethylallyl)-2, 2-dimethylpyrano-(5,6:3',4')-dibenzoylmethane (2), 4'-methoxy-2,2-dimethylpyrano-(5,6:8,7)-flavone (3), 2-(1-hydroxy-1-methylethyl)-furano-(4,5:8,7)-flavone (4) and [2'-methoxy-furano-(4,5:3',4')-phenyl]-phenylmethanone (5). Additionally, fifteen fatty acids were detected through GC-MS analysis of the corresponding methyl esters [(CH3)2CH(CH2)8COOH and CH3(CH2)nCOOH (n = 6, 12-24)]. Quantitative RP-HPLC showed that the most abundant flavonoids in the petroleum ether and dichloromethane extracts were pongamol (19%) and lanceolatine B (8.0%), respectively. In the bioautography assay, the extracts, pongamol (9), lanceolatine B (10), isolonchocarpin (14), derriobtusone A (17) and medicarpine (18) were active against Staphylococcus aureus whereas 9 also against Bacillus subtilis and Cladosporium cladosporioides. Compound 1, 2,2-dimethylpyrano-(5,6:8,7)-flavone (11) and furano-(1200,1300:7,8)- 4'-methoxy flavone (12) were active against Fusarium oxysporium whereas 11 also against Rhizopus orizae. The extracts, compounds 9, 10, 17 and (E)-7-O-methoxypongamol (23) displayed high toxicity in the brine shrimp lethality assay.79351-6

Prevalence of Burnout in public hospital doctors in São Paulo

Objetivo:Métodos. Executou-se um estudo de caso em um Hospital Geral Público. Trata-se de um estudo transversal com a aplicação do Maslach Burnout Inventory (MBI) e questionário sócio-demografico em 76 médicos plantonistas que representam cerca de 25% da população total. O MBI é um questionário auto aplicado composto de três escalas: exaustão emocional (EE), realização pessoal (RP) e despersonalização (DE). Resultados e Discussão. Foi encontrado um índice de 11% dos médicos com Síndrome de Burnout que estão dispostos do seguinte modo: 47% dos casos estão na faixa etária dos 31 aos 45 anos; o sexo feminino representa 52% dos casos; os casados representam 67%; já a população com Burnout que não possui filhos representa 67%, 100% realizaram alguma especialização após a graduação e 34% estão no período que corresponde de 11 a 25 anos de formado; na questão “cargo” ou função os casos de Burnout estão distribuídos da seguinte forma:anestesistas com 25% dos casos, cirurgiões com 25%, pediatras 25%, ortopedistas e clínicos com 12,5% cada. Dos médicos ocupantes dos cargos acima descritos, 62% trabalham no pronto socorro e 37,5% em outros setores do hospital; 62,5% deles trabalham mais de 61 horas semanais e 100% possui mais de 03 empregos. Considerações finais . Este estudo demonstrou que, uma pequena parcela dos médicos (11%) apresentou a doença com todas as suas características (EE e DE elevados e PP baixos), contudo, uma grande porcentagem de médicos está a ponto de apresentar a síndrome, dado os elevados índices de exaustão emocional (EE) e despersonalização (DE) (perto de 80% entre moderado e alto), o que só não ocorreu ainda devido à grande realização pessoal na profissão. Verificar a prevalência da Síndrome de Burnout em médicos de um Hospital Público na cidade de São Paulo.Objective:Results and Discussion: Eleven percent (11%) of the doctors had Burnout Syndrome: 47% were between 31 and 45 years old; 52% were female; 67% were married; 100% had completed postgraduate level education; and 34% were in the period between 11 to 25 years after post graduation. Of the cases, 25% were anesthetists, 25% were surgeons, 25% were pediatricians, 12.5% were bonesetters and clinicians, 62% were emergency room doctors and 37.5% worker in other parts of the hospital. 62.5% worked more than 61 hours per week and 100% had more than three jobs. Conclusion: Although only 11% of the doctors showed signs of burnout (high results in emotional exhaustion, despersonalization and low personal fulfillment), 74% had high emotional exhaustion and 79% had high despersonalization, the protective farctor being the high level of personal fulfillment. To verify the Burnout Syndrome in doctors at a Public Hospital in São Paulo city. Methods. A case study was conduced at a general public hospital in São Paulo. The application of Maslach Burnout Inventory (MBI) and social-demography inventory was applied in this cross-sectional study of 76 doctors (25% of the total population). The MBI is an auto-applicable inventory composed of three scales: 1) emotional exhaustion, 2) personal fulfillment, and 3) despersonalization

Tempestade tiroideia – caso clínico

ResumoA tempestade tiroideia (TT) é uma condição clínica grave, resultante da exacerbação abrupta e potencialmente fatal do hipertiroidismo. O principal fator precipitante são as infeções. O diagnóstico é fundamentalmente clínico. Entre as manifestações clínicas destacam‐se a febre, taquicardia, agitação, delírio e coma.Apesar de se tratar de uma situação rara, perante sua suspeita o tratamento deve ser instituído imediatamente, independentemente dos resultados laboratoriais, pois o seu atraso pode ser fatal.Apresenta‐se o caso clínico de uma doente de 53 anos, com fibrilhação auricular paroxística entre outros antecedentes pessoais, medicada com amiodarona há vários anos, que recorreu ao serviço de urgência por quadro clínico de febre e agitação psicomotora, cuja investigação clínica levou ao diagnóstico de TT secundária à amiodarona.Os autores descrevem este caso clínico pela inespecificidade clínica, complexidade diagnóstica e uma vez que se trata de uma entidade clínica rara.AbstractThyroid Storm is a severe clinical condition resulting from a sudden and potentially life‐threatening exacerbation of hyperthyroidism. Underlying infection is the main precipitating factor. Diagnosis is mainly clinically‐based. Among the clinical manifestations, fever, tachycardia, agitation, delirium and coma are of particular emphasis.Although a rare disorder, when suspected, treatment should be instituted immediately, regardless of laboratory results, as delay may be fatal.The authors describe a case study of a 53 year old patient, with paroxysmal atrial fibrillation and other personal antecedents, treated with amiodarone for several years, presented to the emergency service with fever and psychomotor agitation, whose clinical research has led to the diagnosis thyroid storm secondary to amiodarone.The authors describe this clinical case by nonspecific clinical, diagnostic complexity and since it is a rare clinical entity

Eventos adversos em endoscopia gastrointestinal: uma coorte de 62.088 procedimentos realizados

Introduction: Endoscopes have greatly contributed to the prevention and treatment of various pathologies. However, despite the considerable advance in hospital care made possible by the advent of such equipment, the use of these devices has brought, beyond the obvious benefits, the risk of transmission of infection. Objective: To identify the incidence of adverse events (AD) related to endoscopic procedures. Method: Retrospective cohort study at a Digestive Endoscopy Service located in Salvador, BA. Gastrointestinal procedures, passive reports by patients and reports reported by endoscopists, between 2016 and 2018, were included in this cohort. Data collection occurred between October and November 2018, using our own instrument. Results: From 2016 to 2018, 21,827 colonoscopies, with an incidence of AE of 0.200%, were performed, and 40,261 upper digestive endoscopies, with incidence of AE of 0.080%, were also performed. In those years, the service performed 62,088 endoscopies, with a total incidence of AE of 0.100%. The most frequent adverse events were bacteremias, mucosal laceration, pain and abdominal distension, with an incidence of 0.030%, 0.010%, 0.010% and 0.010%, respectively. Conclusions: This study identified the incidence of AE related to endoscopic exams, contributing to the formation of data in the area of Brazilian gastrointestinal endoscopy. The incidence of 0.100% of AE identified here is much lower than the data in the international literature, as well as the incidence of the types of adverse events identified, signaling to the control of risks, quality and safety of the endoscopy service studied.Introdução: Os endoscópios muito têm contribuído para a prevenção e tratamento de várias patologias. Entretanto, a despeito do avanço considerável na assistência hospitalar possibilitada pelo advento desses equipamentos, a utilização desses dispositivos trouxe para além dos evidentes benefícios, o risco de transmissão de infecção. Objetivo: Identificar a incidência de eventos adversos (EA) relacionados a procedimento endoscópico. Método: Estudo de coorte retrospectiva em um Serviço de Endoscopia Digestiva localizado em Salvador, BA. Fizeram parte desta coorte os procedimentos gastrointestinais, as notificações passivas feitas pelos pacientes e notificações relatadas pelos endoscopistas entre 2016 e 2018. A coleta de dados ocorreu entre outubro a novembro de 2018, com instrumento próprio. Resultados: Durante 2016 e 2018 foram realizados 21.827 colonoscopias, com uma incidência de EA de 0,200% e 40.261 endoscopias digestivas altas com incidência de EA de 0,080%. Nesses anos, o serviço realizou 62.088 endoscopias, com uma incidência total de EA de 0,100%. Os EA mais frequentes foram: bacteremias, laceração de mucosa, dor e distensão abdominal, com incidência de 0,030%, 0,010%, 0,010% e 0,010%, respectivamente. Conclusões: Este estudo identificou a incidência de EA relacionados aos exames endoscópicos, contribuindo para a formação de dados na área da endoscopia gastrointestinal brasileira. A incidência de 0,100% de EA aqui identificada é muito menor do que os dados da literatura internacional, bem como a incidência dos tipos de eventos adversos identificados, sinalizando para o controle de riscos, qualidade e segurança do serviço de endoscopia estudado

Clinical and laboratorial evaluation of children and teenagers with vulvovaginal complaints

Objetivo: analisar as queixas vulvovaginais mais freqüentemente observadas no Ambulatório de Ginecologia Infanto-puberal (AGIP) do Hospital Universitário de Brasília (HUB). Métodos: foram avaliados retrospectivamente 210 prontuários de meninas, até 18 anos de idade, que procuraram o AGIP/HUB com queixas vulvovaginais. Analisaram-se as queixas mais freqüentes e os agentes etiológicos mais observados à secreção vaginal. Resultados: a idade média das 210 pacientes estudadas, até dezoito anos, foi de 12 ± 2,3 anos e as queixas mais comuns foram o corrimento vaginal e o prurido vulvar. Alterações inflamatórias inespecíficas foram observadas em 147 destas pacientes (70%) as quais foram tratadas com orientação a respeito de vestuário, de atividades diárias e de higiene. As outras 63 pacientes, nas quais foi observado um agente etiológico específico, necessitaram de tratamento medicamentoso apropriado. Somente em pacientes com vida sexual ativa foram observados infecções por Gardnerella vaginalis, Trichomoma vaginalis, HPV, assim como sífilis. Para estas pacientes a idade da sexarca foi de 14,1 ± 1,6 anos. Vinte pacientes apresentaram queixas vulvares concomitantemente, de fácil manuseio e orientação. Conclusão: higiene, vestuário e orientação adequada às pacientes e seus familiares são fundamentais para o controle e tratamento das queixas vulvovaginais, quase sempre dispensando o uso de antimicrobianos.Purpose: to assess the commonest vulvovaginal complaints and vaginal discharge etiology in the Child and Teenager Gynecologic Outpatient Clinic of the University Hospital of Brasília (AGIP/HUB). Methods: we evaluated retrospectively 210 charts of patients, younger than 19 years old, who attended AGIP/HUB with vulvovaginal complaints. Results: the average age of the 210 patients was 12 ± 2.3 years, and the vaginal discharge and vulvar pruritus were the commonest complaints. Unspecific inflammatory conditions were observed in 147 (70%) of these patients and their treatment consisted of appropriate clothing, daily activities and hygienic orientation. Antibiotic treatment was necessary in 63 patients, where specific etiologic agents were found. Gardnerella, Trichomonas, HPV and syphilis were observed only in sexually active patients. They had had their first sexual intercourse when they were 14.1 ± 1.6 years old. Twenty patients also presented vulvar complaints that were easy to handle. Conclusion: Hygiene, clothing and adequate orientation for these patients and their families are fundamental to treat vulvovaginitis, almost always avoiding the use of antibiotics

Dental caries prevalence, prospects, and challenges for latin america and caribbean countries: a summary and final recommendations from a regional consensus

Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future

Vaccination in murine schistosomiasis with adult worm derived antigens - II. Protective and immune response in inbred mice

Previous work in our laboratory, mainly foccused the prospects of achieving resistance against Schistosoma mansoni infection with adult worm-derived antigens in the form of a soluble extract (SE). This extract obtained by incubation of living adult schistosomes in saline, contains a large number of distinct molecules and was actually shown to be a significantly protective in different outbred animals models such as Swiss mice and rabbits. It thus appeared worthwile to investigate the potencial protective activity of SE in different inbred strains of mice, known to be highly susceptible to the infection. Herein we present data showing that DBA/2 mice, once immunized with SE acquire significant levels of resistance to a S. mansoni cercarial challenge. In addition, preliminary studies on the immune system of immunized animals reveled that, injection of SE caused no general inbalance of B or T cell responses

Artery of Percheron Ischaemic Stroke: A Classic Presentation of a Rare Case

The artery of Percheron (AoP) is a rare anatomic variant, where the paramedian thalami and the rostral midbrain are supplied by an artery emerging from the P1 segment of the posterior cerebral artery. Ischaemic infarction of the artery of Percheron occurs rarely, accounting for 0.1 to 2% of all ischaemic strokes. AoP occlusion can lead to an infarction of the paramedian thalami and mesencephalon, resulting in a triad of clinical features; namely, altered mental status, vertical gaze palsy and memory impairment. A larger mesencephalon infarction can also feature oculomotor disturbances. We describe here the case of an 88-year-old patient, presenting with this triad of features