As dificuldades dos alunos do sexto ano, com as operações envolvendo frações / The difficulties of sixth grade students with operations involving fractions

O seguinte artigo problematiza as dificuldades dos alunos do sexto ano com as operações envolvendo frações. Devido a experiência já vivida como professor em sala de aula, pude perceber que a maioria dos alunos literalmente temiam as operações entre esses números e tal situação fez-me buscar entender o porquê de tais dificuldades e encontrar métodos para solucionar os problemas que esses alunos encontram na hora de operar tais expressões, porém constatei inúmeras situações que causavam esse bloqueio na resolução desses problemas, algumas delas são a mudança de cotidiano e a forma que os conteúdos foram passados no fundamental 1. Um método bastante eficaz que encontrei foi a utilização de jogos matemáticos na hora de transmitir tal conteúdo

Transtornos de humor pré-cirúrgicos associados ao prognóstico pós-cirúrgico desfavorável em pacientes com epilepsia do lobo temporal e esclerose mesial temporal

OBJECTIVES: This study aims at verifying the impact of pre-surgical PD on seizure outcome in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). METHODS: After previous consent, retrospective data from 115 surgically treated (corticoamygdalohyppocampectomy) TLE-MTS patients (65 females; 56.5%) were analyzed. Psychiatric evaluations were performed through DSM-IV criteria. Engel IA was established as a favorable prognosis. RESULTS: Forty-five patients (41.6%) were classified as Engel IA, while 47 (40.8%) presented pre-surgical PD. Depression (OR=5.11; p=0.004) appeared as a risk factor associated to a non-favorable seizure outcome. CONCLUSION: In patients with refractory TLE-MTS, the presence of depression predicts an unfavorable outcome.OBJETIVO: No presente trabalho avaliamos o impacto da presença de transtorno psiquiátrico pré-cirúrgico sobre o prognóstico cirúrgico em pacientes com epilepsia do lobo temporal e esclerose mesial temporal (ELT-EMT). METODOLOGIA: Analisamos, retrospectivamente, os dados de 115 pacientes com ELT-EMT (65 mulheres, 56,5%) tratados cirurgicamente (corticoamigdalohipocampectomia). As avaliações psiquiátricas foram feitas de acordo com os critérios DSM-IV. O prognóstico favorável foi definido como ausência de crises desde a cirurgia (Engel IA). RESULTADOS: Dos 115 pacientes tratados, 45 (42,6%) tiveram prognóstico favorável e 47 (40,8%) apresentavam transtorno psiquiátrico pré-operatório. A presença de depressão (OR=5,11; p=0,004) foi associada ao prognóstico cirúrgico desfavorável. CONCLUSÃO: A presença de depressão durante a avaliação psiquiátrica pré-operatória é um fator preditivo de prognóstico desfavorável em pacientes com ELT-EMT.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP) Department of Neurology and NeurosurgeryUniversidade Federal de São Paulo (UNIFESP) Department of Psychiatry Laboratório Interdisciplinar de Neurociências ClínicasUNIFESP, Department of Neurology and NeurosurgeryUNIFESP, Department of Psychiatry Laboratório Interdisciplinar de Neurociências ClínicasSciEL

Rhinoscleroma causing severe bilateral nasal obstruction

AbstractRhinoscleroma is a chronic, infectious and granulomatous disease of the respiratory tract. There is often a delay in diagnosis due to unfamiliarity with the disease and also because culture is not always positive. We report a case in a 26-year-old woman with granular mass obstructing bilateral nasal cavities and causing breathing difficulty. Histopathological examination showed characteristic Mikulicz histiocytes containing numerous Gram-negative intracellular rod-shaped bacilli consistent with the diagnosis of rhinoscleroma. The patient was treated with gemifloxacin and tetracycline and remains asymptomatic over a year follow-up period. It is important to consider rhinoscleroma in cases of chronic nasal obstruction. As culture is not always positive, histopathological examination may be crucial to the diagnosis

Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis

Purpose: the association between pre-surgical psychiatric disorders (PDs) and worse seizure outcome in patients with refractory epilepsy submitted to surgery has been increasingly recognized in the literature. the present study aimed to verify the impact of pre- and post-surgical PD on seizure outcome in a series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS).Method: Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohip-pocampectomy (CAH) were analyzed. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV and ILAE criteria. the outcome subcategory Engel IA was considered as corresponding to a favorable prognosis. A multivariate logistic regression model was applied to identify possible risk factors associated with a worse seizure outcome.Results: Pre-surgical PDs, particularly major depressive disorder (MDD), anxiety and psychotic disorders, were common, being found in 47 patients (40.8%). Fifty-six patients (48.7%) were classified as having achieved an Engel IA one year after CAH. According to the logistic regression model, the presence of pre-surgical MDD (OR = 5.23: p = 0.003) appeared as the most important risk factor associated with a non-favorable seizure outcome.Conclusion: Although epilepsy surgery may be the best treatment option for patients with refractory TLE-MTS, our findings emphasize the importance of performing a detailed psychiatric examination as part of the pre-surgical evaluation protocol. (C) 2012 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo UNIFESP, Dept Neurol & Neurosurg, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psychiat, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Neurol & Neurosurg, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psychiat, LiNC, São Paulo, BrazilWeb of Scienc

Uso de resíduos como fonte de nutrientes na agricultura

O crescimento acelerado da população mundial, juntamente com a pouca eficiência dos processos produtivos, tem gerado grandes quantidades de resíduos os quais não podem ser inadvertidamente dispostos no meio ambiente. A presente revisão teve como objetivo fazer um breve levantamento sobre resíduos e de sua utilização na agricultura. A despeito da presença de elementos tóxicos nos resíduos, estes podem ser empregados como fonte de nutrientes para as plantas sem que haja contaminação das mesmas ou do solo quando recomendações técnicas são seguidas

Frequency and factors associated with hospital readmission after COVID-19 hospitalization: the importance of post-COVID diarrhea

Purpose: The aim of this study was to describe the incidence and risk factors for hospital readmission and infection during the months after COVID-19 hospital admission. Methods: This prospective study included adult patients who were hospitalized due to COVID-19 and had been discharged from April 2020 to August 2020. All patients had a medical evaluation with a structured questionnaire 6 to 11 months after hospital admission. The authors included only patients with confirmed COVID-19 by RT-PCR. Patients with pregnant/postpartum women, with a proven COVID-19 reinfection or incapable of answering the questionnaire were excluded. Results: A total of 822 patients completed the follow-up assessment, and 68% reported at least one recurrent symptom related to COVID-19. The most frequent symptom was myalgia (42%). Thirty-two percent of patients visited an emergency room after COVID-19 hospitalization, and 80 (10%) patients required re-hospitalization. Risk factors for hospital readmission were orotracheal intubation during COVID-19 hospitalization (p = 0.003, OR = 2.14), Charlson score (p = 0.002, OR = 1.21), congestive heart failure (p = 0.005, OR = 2.34), peripheral artery disease (p = 0.06, OR = 2.06) and persistent diarrhea after COVID-19 hospitalization discharge (p = 0.02, OR = 1.91). The main cause of hospital readmission was an infection, 43 (54%). Pneumonia was the most frequent infection (29%). Conclusions: The presence of symptoms after six months of COVID-19 diagnosis was frequent, and hospital readmission was relatively high

MODELAGEM DE ESTRUTURAS DE PONTES NO PROGRAMA SAP2000N: PRINCIPAIS RECOMENDAÇÕES DA AASHTO

O presente trabalho propõe-se compreender a modelagem de pontes no programa SAP 2000N. A pesquisa realizada foi exploratório-descritiva, onde os dados foram extraídos do referencial teórico para estabelecimento de relações com os objetivos da pesquisa. A análise de dados, confrontando-se aspectos quantitativos e qualitativos das teorias e conceitos da AASHTO LRFD 2007 com a modelagem de uma ponte de vigas mestras no programa SAP2000N, Mostrou ser preciso um conhecimento mínimo de recomendações da AASHTO LRFD 2007 para se obter expertise como o uso do programa para a modelagem de pontes, bem como é necessário conhecer as diferentes formas de análise que o programa oferece: “Static, Multistepstatic, Modal, Response spectrum, Time history, MovingLoad, Buckling, SteadState, Power spetral density, Hyperstatic”; para se ter o controle sobre o processamento do modelo gerado

Impact of COVID-19 on healthcare-associated infections: Antimicrobial consumption does not follow antimicrobial resistance

Background: This study aimed to analyze the Healthcare-Associated Infections (HAI) rates and antimicrobial consumption in Intensive Care Units (ICU) in São Paulo city during the COVID-19 pandemic and compare them with the pre-pandemic period. Methods: This cohort included all hospitals that reported HAI rates (Central-Line-Associated Bloodstream Infection ‒ CLABSI and Ventilator-Associated Pneumonia ‒ VAP), the proportion of microorganisms that caused CLABSI, the proportion of resistant microorganisms, and antimicrobial consumption from January 2017 ‒ December 2020. Hospitals were stratified by the number of beds, Central Venous Catheter (CVC) utilization rate, Mechanical-Ventilation (MV) utilization rate, and type of funding. Statistical analyses were based on time-series plots and regression models. Results: 220 ICUs were included. The authors observed an abrupt increase in CLABSI rates after the pandemic onset. High CLABSI rates during the pandemic were associated with hospital size, funding (public and non-profit private), and low CVC use (≤ 50%). An increase in VAP rates was associated with public hospitals, and high MV use (> 35%). The susceptibility profile of microorganisms did not differ from that of the pre-pandemic period. polymyxin, glycopeptides, and antifungal use increased, especially in COVID-19 ICUs. Conclusions: HAI increased during COVID-19. The microorganisms’ susceptibility profile did not change with the pandemic, but the authors observed a disproportionate increase in large-spectrum antimicrobial drug use

Clinical and molecular characterization of patients fulfilling Chompret criteria for Li-Fraumeni syndrome in Southern Brazil

Li-Fraumeni syndrome (LFS) is an autosomal dominant cancer predisposition syndrome caused by pathogenic germline variants in the TP53 gene, characterized by a predisposition to the development of a broad spectrum of tumors at an early age. The core tumors related to LFS are bone and soft tissue sarcomas, premenopausal breast cancer, brain tumors, adre nocortical carcinomas (ACC), and leukemias. The revised Chompret criteria has been widely used to establish clinical suspicion and support TP53 germline variant testing and LFS diag nosis. Information on TP53 germline pathogenic variant (PV) prevalence when using Chom pret criteria in South America and especially in Brazil is scarce. Therefore, the aim of this study was to characterize patients that fulfilled these specific criteria in southern Brazil, a region known for its high population frequency of a founder TP53 variant c.1010G>A (p. Arg337His), as known as R337H. TP53 germline testing of 191 cancer-affected and indepen dent probands with LFS phenotype identified a heterozygous pathogenic/likely pathogenic variant in 26 (13.6%) probands, both in the DNA binding domain (group A) and in the oligo merization domain (group B) of the gene. Of the 26 carriers, 18 (69.23%) were R337H het erozygotes. Median age at diagnosis of the first tumor in groups A and B differed significantly in this cohort: 22 and 2 years, respectively (P = 0.009). The present study shows the clinical heterogeneity of LFS, highlights particularities of the R337H variant and underscores the need for larger collaborative studies to better define LFS prevalence, clinical spectrum and penetrance of different germline TP53 pathogenic variants

Avaliação da qualidade centesimal da polpa de biribá (Rollinia mucosa) para uso na indústria de alimentos

The general objective of this work was to evaluate the proximate and physicochemical quality of biribá pulp for use in the food industry. The fruits were purchased at the municipal market in the city of Iranduba-AM. After the acquisition, they were taken to the Food and Nutrition Laboratory (LAN), of the National Institute for Research in the Amazon (INPA), where they were washed in running water, sanitized and pulped. The pulp was bleached and subjected to analysis. Biribá pulp was evaluated for moisture, lipids, fibers, proteins, total carbohydrates, energy value, pH, total soluble solids and total acidity. The pulp presented high moisture content with 83.85%, which can facilitate its deterioration if stored incorrectly. Carbohydrate content of 12.84% that can contribute natural sugars to products to which biribá pulp is added as an ingredient. It has a low lipid content with 0.70% and protein with 1.34%. Thus, the biribá pulp proved to be favorable to be used as an ingredient in various foods.El objetivo general de este trabajo fue evaluar la calidad próxima y fisicoquímica de la pulpa de biribá para su uso en la industria alimentaria. Los frutos fueron adquiridos en el mercado municipal de la ciudad de Iranduba-AM. Luego de la adquisición, fueron llevados al Laboratorio de Alimentos y Nutrición (LAN), del Instituto Nacional de Investigaciones de la Amazonía (INPA), donde fueron lavados con agua corriente, sanitizados y despulpados. La pulpa fue blanqueada y sometida a análisis. La pulpa de biribá se evaluó en cuanto a humedad, lípidos, fibras, proteínas, carbohidratos totales, valor energético, pH, sólidos solubles totales y acidez total. La pulpa presentó alto contenido de humedad con 83,85%, lo que puede facilitar su deterioro si se almacena incorrectamente. Contenido en hidratos de carbono del 12,84% que pueden aportar azúcares naturales a los productos a los que se les añade pulpa de biribá como ingrediente. Tiene un bajo contenido en lípidos con 0,70% y proteína con 1,34%. Así, la pulpa de biribá se mostró favorable para ser utilizada como ingrediente en diversos alimentos.O objetivo geral deste trabalho consistiu em avaliar a qualidade centesimal e físico-química da polpa de biribá para uso na indústria de alimentos. As frutas foram adquiridas no mercado municipal da cidade de Iranduba-AM. Após a aquisição, foram levadas ao Laboratório de Alimentos e Nutrição (LAN), do Instituto Nacional de Pesquisas da Amazônia (INPA), onde foram lavadas em água corrente, sanitizadas e despolpadas. A polpa foi branqueada e submetida as análises. A polpa de biribá foi avaliada quanto a umidade, lipídios, fibras, proteínas, carboidratos totais, valor energético, pH, sólidos solúveis totais e acidez total. A polpa apresentou elevada umidade com 83,85 %, que pode facilitar sua deteriorização caso seja armazenada de formada incorreta. Teor de carboidratos de 12,84% que pode contribuir com açúcares naturais aos produtos que a polpa de biribá for adicionada como ingrediente. Possui baixo teor de lipídeos com 0,70 % e de proteínas com 1,34%. Com isso, a polpa de biribá se mostrou favorável para ser utilizada como ingrediente de diversos alimentos