Terapia nutricional a pacientes com insuficiência respiratória aguda e ventilação mecânica não invasiva: uma revisão narrativa da literatura

In acute respiratory failure patients, noninvasive ventilation has a negative impact on nutritional status. Respiratory muscles deterioration secondary to nil per os prescription affects ventilator capacity.La instauración de la ventilación mecánica no invasiva impacta de forma negativa el estado nutricional del paciente con insuficiencia respiratoria aguda. El deterioro de la musculatura respiratoria, secundaria a la prescripción de ayuno, afecta la capacidad para sostener niveles adecuados de ventilación.O estabelecimento de ventilação mecânica não invasiva afeta negativamente o estado nutricional do paciente com insuficiência respiratória aguda. A deterioração da musculatura respiratória, secundária à prescrição do jejum, afeta a capacidade de manter níveis adequados de ventilação

Determination of Burnout Syndrome among Middle and Senior Managers in Manufacturing Industry in Ciudad Juarez

AbstractBurnout syndrome is caused by chronic job stress and it is considered one of the main professional diseases of XXI Century. In developing countries like Mexico, occupations as middle and senior manager positions have not been sufficiently explored on this topic, especially in the industrial manufacturing sector. These personnel are fundamental for the growth of industries and usually must respond to high work demands, such as: short time decision making processes, extended working hours, personnel organization, production difficulties, among others. A sample of 361 participants was conformed; 34 were senior managers and 327 middle managers from several departments. The Maslach Burnout Inventory General-Survey (MBI-GS) was applied in six manufacturing companies in Ciudad Juarez. The Burnout was determined by grades and levels. Percentiles 33.3 and 66.6 were used as cut off points for each dimension: Emotional Exhaustion, Cynicism and Professional Effectiveness, five levels of Burnout were determined as none, low, middle, fairly and extreme. Results indicate a middle grade of Burnout for all three dimensions among senior and middle managers. By levels, 46.26% presents fairly and extreme level, 15.51% have a middle level and 38.23% presents none or low levels of Burnout. In conclusion, it is recommended that manufacturing industries take preventive actions that contribute to physical and mental health of their key workers

EFFECT OF Cr AND Pb ON THE ACTIVITY OF ANTIOXIDANT ENZYMES IN A CELL SUSPENSION CULTURE OF Jatropha curcas

Jatropha curcas is a tolerant and accumulator plant of heavy metals (HMs). Little is known about the mechanisms behind this ability. It is suggested that antioxidant enzymes might participate; however, there are no studies reporting the relationship between the activities of antioxidant enzymes and the presence of HMs in an in vitro cell suspension culture of J. curcas. The aim of this study was to determine the effect of chromium (Cr) or lead (Pb) at 0.0 to 3.0 mM on the activity of three antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and peroxidase (POX) through the growthofcellsuspensioncultures(CSC)ofJ.curcas. Theactivitydisplayedbythoseenzymeswasstatisticallysignificant (P≤0.05) when Cr or Pb was used. The greatest enzymatic activity was noted at the first hour of culture for SOD and at five h for POX and CAT. After 192 h, the activity of these three enzymes decreased, which coincided with the exponential growth phase of the cell culture. The results indicated that there is a close relationship between the presence of Cr and Pb and SOD, CAT, and POX activities in a cell suspension culture of J. curcas, which can explain the plant’s capability for tolerating and accumulating high concentrations of Cr and P

Manejo nutricional do paciente com úlcera por pressão: uma revisão da literatura

Chronic wounds occur frequently in adult hospitalized patients and institutionalized seniors. Their occurrence has a close relationship with nutritional status. The objective of this narrative review is to analyze the relationship between nutrition and the incidence of pressure ulcers, as well as to study the nutritional strategies recommended in scientific literature, focusing on the contribution of energy, proteins, amino acids and other micronutrients. Nutrition is an influential factor in wound healing. However, additional studies are needed to establish the adequate intake of certain nutrients, and the impact these have on the progression of this condition.Las heridas crónicas se presentan con frecuencia en adultos hospitalizados y personas de la tercera edad institucionalizadas. Su desarrollo tiene una relación importante con el estado nutricional. El objetivo de esta revisión narrativa es analizar la relación entre la nutrición y la incidencia de úlceras por presión, además de estudiar las estrategias de abordaje nutricional sugeridas por la evidencia científica, haciendo énfasis en el aporte de energía, proteínas, aminoácidos y otros micronutrientes. La nutrición es un factor influyente en la cicatrización de heridas; sin embargo, se necesitan más estudios para establecer los aportes adecuados de ciertos nutrientes y el impacto que tendrán en la evolución de esta condición.As feridas crônicas ocorrem com frequência em adultos hospitalizados e idosos institucionalizados. O seu desenvolvimento, tem importante relação com o estado nutricional. O objetivo desta revisão narrativa é analisar a relação entre a nutrição e a incidência de úlceras por pressão, além de estudar as estratégias de abordagem nutricional sugeridas pela evidência científica, enfatizando o contributo do fornecimento de energia, proteínas, aminoácidos e outros micronutrientes. A nutrição é um fator influente na cicatrização de feridas; porem, é necessários mais estudo para estabelecer as contribuições adequadas de certos nutrientes e o impacto que eles terão na evolução desta condição

Lactic Acid Yield Using Different Bacterial Strains, Its Purification, and Polymerization through Ring-Opening Reactions

Laboratory-scale anaerobic fermentation was performed to obtain lactic acid from lactose, using five lactic acid bacteria: Lactococcus lactis, Lactobacillus bulgaricus, L. delbrueckii, L. plantarum, and L. delbrueckii lactis. A yield of 0.99 g lactic acid/g lactose was obtained with L. delbrueckii, from which a final concentration of 80.95 g/L aqueous solution was obtained through microfiltration, nanofiltration, and inverse osmosis membranes. The lactic acid was polymerized by means of ring-opening reactions (ROP) to obtain poly-DL-lactic acid (PDLLA), with a viscosity average molecular weight (Mv) of 19,264 g/mol

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

Computer games are ubiquitous and can be utilized for serious purposes such as health and education. “Applied games” including serious games (in brief, computerized games for serious purposes) and gamification (gaming elements used outside of games) have the potential to increase the impact of mental health internet interventions via three processes. First, by extending the reach of online programs to those who might not otherwise use them. Second, by improving engagement through both game-based and “serious” motivational dynamics. Third, by utilizing varied mechanisms for change, including therapeutic processes and gaming features. In this scoping review, we aim to advance the field by exploring the potential and opportunities available in this area. We review engagement factors which may be exploited and demonstrate that there is promising evidence of effectiveness for serious games for depression from contemporary systematic reviews. We illustrate six major categories of tested applied games for mental health (exergames, virtual reality, cognitive behavior therapy-based games, entertainment games, biofeedback, and cognitive training games) and demonstrate that it is feasible to translate traditional evidence-based interventions into computer gaming formats and to exploit features of computer games for therapeutic change. Applied games have considerable potential for increasing the impact of online interventions for mental health. However, there are few independent trials, and direct comparisons of game-based and non-game-based interventions are lacking. Further research, faster iterations, rapid testing, non-traditional collaborations, and user-centered approaches are needed to respond to diverse user needs and preferences in rapidly changing environments

Laparoscopic resection of a residual retroperitoneal tumor mass of nonseminomatous testicular germ cell tumors

Resection of a residual retroperitoneal tumor mass (RRRTM) is standard procedure after combination chemotherapy for metastatic nonseminomatous testicular germ cell tumors (NSTGCT). At the University Medical Center Groningen, 79 consecutive patients with disseminated NSTGCT were treated with cisplatin combination chemotherapy between 2005 and 2007. Laparoscopic RRRTM was performed for patients with RRTM located less than 5 cm ventrally or laterally from the aorta or the vena cava. The 29 patients who fulfilled the criteria had a median age of 25 years (range, 16-59 years). The stages of disease before chemotherapy treatment according to the Royal Marsden classification were 2A (n = 6, 21%), 2B (n = 14, 48%), 2C (n = 3, 10%), and 4 with a lymph node status of N2 (n = 6, 21%). The median duration of laparoscopy was 198 min (range, 122-325 min). The median diameter of the RRTM was 21 mm (range, 11-47 mm). Laparoscopic resection was successful for 25 patients (86%). Conversion was necessary for three patients (10%): two due to bleeding and one because of obesity. One nonplanned hand-assisted procedure (3%) also had to be performed. Histologic examination of the specimens showed fibrosis or necrosis in 12 patients (41%), mature teratoma in 16 patients (55%), and viable tumor in 1 patient (3%). The median hospital stay was 1 day (range, 1-6 days). During a median follow-up period of 47 months (29-70 months), one patient experienced an early relapse (1 month after the end of treatment) (4%). For properly selected patients, laparoscopic resection of RRTM is an improvement in the combined treatment of disseminated NSTGCT and associated with a short hospital stay, minimal morbidity, rapid recovery, and a neat cosmetic result. Long-term data to prove oncologic efficacy are awaited