Disability levels in cerebral vascular accident (CVA) survivors: the ICF model in action

Purpose: This study was designed to use the International of Classification of Functioning, Disability and Health (ICF tool) to establish an initial data base of disability levels for a group of cerebrovascular accident (CVA) survivors within the area of Campina Grande (Brazil). Methods: 38 survivors (17 females) participated in this study. 65.8% of the participants suffered ischemic CVA and 52.6% of all cases had injuries to the right cerebral cortical hemisphere. All neural injuries were considered chronic since they occurred at least five years from the date of this study. The ICF tool consisted of 49 questions distributed into 3 categories according to ICF’s core set for stroke. Results: The investigated group revealed high levels of dysfunction on very basic daily life activities: bipedal locomotion, use of upper limbs, and ability to interact with other citizens. Our study suggested that this population faces a much higher risk of developing secondary morbities caused by CVA and they include, [1] depression due to the inability of interaction and recreation, and [2] higher risk of falls due their impairment in bipedal ambulation. Significance: Results produced by our study have provided local public health agencies with a data base indicating what comorbidities local CVA survivors are more likely to suffer. This data base will aid these same agencies in developing effective local health policies aiming to prevent these comorbidities. Originality: This study shows that the introduction of a multi-factor score that integrates environmental and social aspects of disability is an essential tool for the development and evaluation of new public health policies

Evaluation of the Basic Sanitation Legislative System in Manaus - Amazonas

This study dealt with the legislative system of basic sanitation in the city of Manaus. From this approach we sought to develop the research from the parameters of the Brazilian legislation related to the basic sanitation sector, as well as to identify the important conducts on sustainable development. Understanding the importance of the subject in evidence, it is worth mentioning that Brazil has a considerable volume of freshwater in the world, and likewise, the Amazon has in its watershed much of that water in its rivers. Therefore, the objective of this investigation was to analyze the legislative system of basic sanitation of the city of Manaus - Amazonas, in order to understand the actions developed by this system. For the construction of this study, the methodology adopted was the bibliographic research with a qualitative approach, in order to reach the proposed objectives. Regarding the legislation that deals with basic sanitation, many advances in the sector were obtained. Most of the population does not have access to basic sanitation services, even if provided for by Brazilian law

Pancreatic tuberculosis in a liver transplant recipient: a case report

The pancreatic form of tuberculosis (TB) is rare and its diagnosis is challenging, since it manifests itself with non-specific symptoms and non-pathognomonic radiological findings, mimicking a neoplasia of the pancreas. Here, we report the case of a patient who had previously undergone liver transplantation and sought care for abdominal pain, weight loss, anorexia, hematochezia and postprandial fullness. Following an exploratory laparotomy and nucleic acid amplification testing on a pancreatic sample that had been collected, the patient was diagnosed with pancreatic TB. The patient received anti-tubercular pharmacological therapy and required percutaneous biliary drainage. Awareness of the possibility of a pancreatic TB diagnosis is important for clinicians. This attention should be even greater in patients who have undergone transplants, who are immunodeficient or who are from endemic areas

Physiological limitations in two sugarcane varieties under water suppression and after recovering

Increasing water scarcity and depleted water productivity in irrigated soils are inducing farmers to adopt improved varieties, such as those with high-capacity tolerance. The use of tolerant varieties of sugarcane might substantially avoid the decline of productivity under water deficit. This research aimed to evaluate the harmful effects of drought on the physiology of two sugarcane varieties (RB867515 and RB962962) during the initial development. Young plants were subjected to irrigation suspension until total stomata closure, and then rewatered. Significant reduction on stomatal conductance, transpiration, and net photosynthesis were observed. RB867515 showed a faster stomatal closure while RB962962 slowed the effects of drought on the gas exchanges parameters with a faster recovering after rewatering. Accumulation of carbohydrates, amino acids, proline, and protein in the leaves and roots of the stressed plants occurred in both varieties, substantially linked to reduction of the leaf water potential. Due to the severity of stress, this accumulation was not enough to maintain the cell turgor pressure, so relative water content was diminished. Water stress affected the contents of chlorophyll (a, b, and total) in both varieties, but not the levels of carotenoids. There was a significant reduction in dry matter under stress. In conclusion, RB962962 variety endured stressed conditions more than RB867515, since it slowed down the damaging effects of drought on the gas exchanges. In addition, RB962962 presented a faster recovery than RB867515, a feature that qualifies it as a variety capable of enduring short periods of drought without major losses in the initial stage of its development.213222Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

GAMMA RADIATION AS A METHOD FOR STERILIZATION OF ALL-IN-ONE ADMIXTURES BAGS FOR CLINICAL USE: A STUDY OF STABILITY

Objective: The aim of this work was to evaluate the stability of all-in-one (AIO) admixtures exposed to gamma irradiation sterilization.Methods: The samples were divided into four groups with 10 bags each: a) Group I: control samples (bags without sterilization or inoculation with microorganisms); b) Group II: bags sterilized by gamma irradiation; c) Group III: bags inoculated and then irradiated and, d) Group IV: bags only inoculated. The following studies were performed: macroscopic analysis of admixtures; physicochemical stability; degree of lipoperoxidation (LPO), and microbiological tests.Results: Gamma irradiation sterilization was 100% effective, since no irradiated sample showed growth of microorganisms. All groups exhibited similar particle size distribution, but a longer storage time led to a smaller percentage of large particles. In general, irradiated samples showed reduced LPO.Conclusion: Gamma irradiation sterilization of these admixtures can be extended to clinical practice, as it results in physicochemically stable admixtures

Existem prejuízos no sono e no humor entre profissionais de enfermagem? / Are there impairments in sleep and mood among nursing professionals?

A dessincronização dos ritmos circadianos a longo prazo, pode provocar distúrbios severos no sono, que podem estar associados a sintomas de ansiedade e depressão. Assim, objetivou-se investigar a qualidade do sono, sintomas de ansiedade e depressão em enfermeiros de um hospital da rede pública de Vitória de Santo Antão-PE. Essa pesquisa tratou-se de um estudo transversal com enfermeiros (n=18), que foi desenvolvido no Hospital João Murilo da cidade de Vitória de Santo Antão-PE. Para a coleta dos dados, utilizou-se os instrumentos: Questionário de Matutinidade-Vespertinidade, para avaliar o cronotipo; Inventário de Ansiedade Traço e Estado, para averiguar a presença de alguns distúrbios do humor; Índice de Qualidade do Sono de Pittsburgh e Escala de Sonolência de Epworth. A pesquisa foi aprovada pelo comitê de ética, sob o protocolo: CAAE 86426218.1.0000.5208. Os dados foram analisados e expressos em porcentagem. Foi verificado que 50% dos enfermeiros apresentaram o cronotipo intermediário e outros 50%, o cronotipo matutino. 50% apresentam uma boa qualidade de sono, porém 33% apresentam  distúrbio do sono e 17% possuíam uma qualidade de sono ruim. 61,11% relataram não cochilar durante o dia. Observou-se ainda que 38,89% apresentavam sintomas de ansiedade e 27,8%, depressão. A maioria não fazia uso de medicações psicotrópicas ou hipnóticas. Contudo, observa-se que há sintomas desses transtornos de humor nos enfermeiros avaliados. Dessa forma, há necessidade de mais pesquisas para entender os fatores causais e assim propor estratégias para melhorar a qualidade de vida dos enfermeiros

Aplicação de extrato vegetal no processamento de produtos cárneos como alternativa de substituição de nitrito residual: uma revisão integrativa / Application of plant extracts in the processing of meat products as an alternative substitute for residual nitrite: an integrative review

O nitrito é um aditivo alimentar utilizado em carnes curadas para melhorar os aspectos sensoriais do produto como cor, sabor, além de agir como antimicrobiano e conservante. O objetivo deste artigo foi identificar as alternativas naturais de substituição ou diminuição do uso de nitrito sintético no processamento de produtos cárneos aplicando extratos vegetais. Foi realizada uma revisão bibliográfica através das bases de dados: Google Acadêmico, Scielo e Pubmed no período de 2015 a 2020. Utilizando os descritores “nitrite” AND “vegetable juice” OR “plant extract” AND “meat products”. Como critérios de inclusão foram utilizados artigos em inglês, espanhol ou português, disponíveis na íntegra, estudos que relacionaram a substituição de nitrito por fonte vegetal em produtos cárneos de origem bovina, suína ou frango e estudos que realizaram testes físico-químicos e microbiológicos. Os critérios de exclusão, foram: teses, dissertações, revisão bibliográfica, resumo, resenhas e editoriais. O vegetal mais estudado foi o aipo, seguido pela beterraba vermelha e outros vegetais. O aipo foi indicado como fonte potencial de utilização, obtendo bons resultados eficientes pela ação antimicrobiana e antioxidante. Apesar de alguns resultados promissores, faz-se necessário realizar mais estudos identificar dos mais variados vegetais aumentando a escala de diversidade de produtos

ABORDANDO DESAFIOS NA IDENTIFICAÇÃO E INTERVENÇÃO PRECOCE DO TRANSTORNO DO ESPECTRO AUTISTA.

Autism Spectrum Disorder (ASD) is considered a neurodevelopmental disorder characterized by deficient social interaction and communication, stereotyped and repetitive patterns of behavior and irregular intellectual development, often with mental retardation. This study reviewed the challenges associated with the early diagnosis and treatment of ASD, emphasizing the importance of early identification of characteristic signs and symptoms of the condition. Guidelines for the Rehabilitation of Individuals with ASD underscore the crucial need for early interventions to improve the clinical condition of affected individuals. However, the average age of diagnosis in Brazil still falls short of ideal, indicating an urgent need to promote early detection and reduce delays in accessing early intervention services. Challenges in the early diagnosis and treatment of ASD include variations in the clinical presentation of the condition, lack of standardized screening tools, and healthcare professionals' unfamiliarity with early signs of ASD. Despite these obstacles, early interventions are associated with significant gains in the cognitive and adaptive functioning of affected children. Therefore, it is essential to adopt integrated and collaborative approaches to address these challenges and improve ASD management.O Transtorno do Espectro Autista (TEA) é considerado um transtorno do neurodesenvolvimento caracterizado por deficiente interação e comunicação social, padrões estereotipados e repetitivos de comportamento e desenvolvimento intelectual irregular, frequentemente com retardo mental. Este estudo revisou os desafios associados ao diagnóstico e tratamento precoce do TEA, destacando a importância da identificação precoce dos sinais e sintomas característicos da condição. As Diretrizes de Atenção à Reabilitação da Pessoa com TEA ressaltam a necessidade crucial de intervenções precoces para melhorar a condição clínica dos indivíduos afetados. No entanto, a média de diagnóstico no Brasil ainda está aquém do ideal, indicando a necessidade urgente de promover a detecção precoce e reduzir os atrasos no acesso aos serviços de intervenção precoce. Os desafios no diagnóstico e tratamento precoce do TEA incluem a variação na apresentação clínica da condição, a falta de ferramentas de triagem padronizadas e o desconhecimento dos profissionais de saúde sobre os sinais precoces do TEA. Apesar desses obstáculos, intervenções precoces estão associadas a ganhos significativos no funcionamento cognitivo e adaptativo das crianças afetadas. Portanto, é fundamental adotar abordagens integradas e colaborativas para enfrentar esses desafios e melhorar o manejo do TEA

Efficient sugar utilization and transition from oxidative to substrate‐level phosphorylation in high starch storage roots of African cassava genotypes

SUMMARYCassava's storage roots represent one of the most important sources of nutritional carbohydrates worldwide. Particularly, smallholder farmers in sub‐Saharan Africa depend on this crop plant, where resilient and yield‐improved varieties are of vital importance to support steadily increasing populations. Aided by a growing understanding of the plant's metabolism and physiology, targeted improvement concepts already led to visible gains in recent years. To expand our knowledge and to contribute to these successes, we investigated storage roots of eight cassava genotypes with differential dry matter content from three successive field trials for their proteomic and metabolic profiles. At large, the metabolic focus in storage roots transitioned from cellular growth processes toward carbohydrate and nitrogen storage with increasing dry matter content. This is reflected in higher abundance of proteins related to nucleotide synthesis, protein turnover, and vacuolar energization in low starch genotypes, while proteins involved in sugar conversion and glycolysis were more prevalent in high dry matter genotypes. This shift in metabolic orientation was underlined by a clear transition from oxidative‐ to substrate‐level phosphorylation in high dry matter genotypes. Our analyses highlight metabolic patterns that are consistently and quantitatively associated with high dry matter accumulation in cassava storage roots, providing fundamental understanding of cassava's metabolism as well as a data resource for targeted genetic improvement.Significance StatementDevelopment of resilient and high‐yielding cassava varieties is imperative to ensure food security in tropical countries, increasingly threatened by climate change and growing populations. To facilitate genetic improvement of this important food security crop, we employed metabolomic and proteomic profiling techniques to identify key metabolic differences for dry matter accumulation between the storage roots of low‐ and high‐yielding African cassava genotypes that are stable across three successive field trials conducted in Nigeria.Bill and Melinda Gates Foundation http://dx.doi.org/10.13039/10000086

O USO DE ELETROCONVULSOTERAPIA NO TRATAMENTO DA DEPRESSÃO: UMA REVISÃO ABRANGENTE

Electroconvulsive therapy (ECT) has been recognized as an effective yet often underutilized treatment option for treatment-resistant depression. This article provides a detailed review of current literature on the use of ECT in depression, addressing its efficacy, mechanisms of action, clinical indications, and safety considerations. Additionally, it discusses future perspectives and the potential role of ECT as an integral component of the therapeutic arsenal for severe and refractory depression. One of the primary obstacles is the social stigma and perceived fear by patients and their families regarding ECT. Despite its efficacy, misconceptions and prejudices about its use persist, often fueled by negative portrayals in the media and popular culture. As a result, many patients may resist receiving ECT treatment, even when other therapeutic options have failed. In addition to stigma, the limited availability of ECT services in many regions of the world represents another significant challenge. ECT is an intervention that requires specialized facilities, specific equipment, and a trained team to administer the procedure safely. Unfortunately, many mental health institutions do not offer ECT services due to resource constraints, lack of adequate training, or administrative concerns.A eletroconvulsoterapia (ECT) tem sido uma opção de tratamento eficaz e muitas vezes subutilizada para a depressão resistente ao tratamento. Este artigo oferece uma revisão detalhada da literatura atual sobre o uso da ECT na depressão, abordando sua eficácia, mecanismos de ação, indicações clínicas e considerações de segurança. Além disso, discute as perspectivas futuras e o papel potencial da ECT como parte integrante do arsenal terapêutico para a depressão grave e refratária.   Um dos principais obstáculos é o estigma social e o medo percebido pelos pacientes e suas famílias em relação à ECT. Apesar de sua eficácia, persistem equívocos e preconceitos sobre seu uso, muitas vezes alimentados por representações negativas na mídia e na cultura popular. Como resultado, muitos pacientes podem resistir a receber tratamento com ECT, mesmo quando outras opções terapêuticas falharam. Além do estigma, a disponibilidade limitada de serviços de ECT em muitas regiões do mundo representa outro desafio significativo. A ECT é uma intervenção que requer instalações especializadas, equipamentos específicos e uma equipe treinada para administrar o procedimento com segurança. Infelizmente, muitas instituições de saúde mental não oferecem serviços de ECT devido a restrições de recursos, falta de treinamento adequado ou preocupações administrativas