Ages of the Magmatism and the Opening of the South Atlantic Ocean

The analysis of published and unpublished 368 K/Ar radiometric ages of basic, intermediate and alkaline volcanic rocks, related to the post-Paleozoic magmatism linked to the opening of the South Atlantic Ocean, yields some important evidence concerning the break up of the Gondwana supercontinent. At the Brazilian Equatorial margin, the Gondwana break up started in the Permo-Triassic, when the opening of the Equatorial South Atlantic Ocean began and spread out south-eastward up to the present day Amazon River mouth. During the middle Jurassic/lower Cretaceous (pre-Aptian), the continuity of this separation, towards the Potiguar Basin, was coeval with the northward opening of the south-east Brazilian margin, up to the Espírito Santo State latitude. The relationship between large volcanic events in the basins and the resistance to the rifting process development offered by the cratonic area was shown by the trend of the magmatic age. Along the equatorial margin, the fragmentation resistance caused by the São Luis / West African craton is manifested by a large basic magmatism described in the Tacutu, Acre, Solimões, Amazonas and Parnaíba basins. A similar mechanism along the south-east margin, is proposed for the magmatism described in the Paraná Basin which is associated with the fracturing resistance offered by the São Francisco/Congo cratonic area. The integration of geochronological, micropalentological, sedimentological and geochemical data from the basins of the east Brazilian continental margin supports a model to explain the final disruption between South America and Africa during Cenonian/Turonian time. This model implies that 90 Ma basic magmatic rocks, related to the oceanic crust formation, probably occur offshore from the present-day eastern Brazilian coast line

Torsion dystonia and Parkinson's syndrome

Four cases of torsion dystonia of the spasmodic torticollis type associated to Parkinson's syndrome are reported. All the patients were female and the ages at the begining of the parkinsonism and the dystonic syndrome varied respectively from 12 to 40 and from 18 to 40 years. In just one patient the dystonia preceded the parkinsonism. The Parkinson's syndrome was predominantly unilateral and hypertonic. The encephalitic etiology was suggested in all the cases.Os autores relatam 4 casos de distonia de torsão, do tipo torcicolo espasmódico, associada a síndrome parkinsoniana. Todos os pacientes eram do sexo feminino e as idades de início da síndrome parkinsoniana e da síndrome distônica variaram de 12 a 40 anos e de 18 a 40 anos, respectivamente. Em apenas uma paciente a distonia precedeu ao parkinsonismo. A síndrome parkinsoniana era predominantemente unilateral e hipertônica. A etiologia encefalítica foi a aventada em todos os casos.Escola Paulista de Medicina Departamento de Neurologia e NeurocirurgiaUNIFESP, EPM, Depto. de Neurologia e NeurocirurgiaSciEL

Knowledge of medical students about perioperative nutritional care in Bahia, Brazil: a transversal study

OBJECTIVE: Evaluate the medical students’ knowledge about perioperative nutritional care. These students are from public and private academic institutions in the state of Bahia, Brazil. METHODS: This is a cross-sectional study to analyze medical students based on an online instrument regarding topics related to perioperative care. For data analysis, absolute and relative frequencies were calculated for categorical variables, and mean and standard deviation were calculated for continuous variables. Fisher's Exact Test and G Test were used to analyze the association. Results: 209 responses were obtained. Regarding the learning on nutritional preparation of the patient submitted to a surgery, 25 (64.9%) students of public institutions and 90 (52.3%) students of private ones reported not knowing or not having been exposed to such knowledge. Regarding the importance of addressing topics related to nutritional therapy (NT), 37 (100%) students from public institutions and 168 (97.7%) from private ones recognize the importance of spreading this knowledge. Unnecessary absolute preoperative fasting, shortening techniques of fasting and bronchoaspiration prevention and reintroduction time of a diet in the postoperative period are unknown to most of the population studied. CONCLUSION: Most students included in this study do not have satisfactory knowledge in NT and for preparing the surgical patient

Performance of the Titanium-Nitride-Oxide Coated Stent in Patients with Multivessel Coronary Artery Disease

ABSTRACTBackgroundTo date, there are no studies evaluating the use of the titanium-nitride-oxide coated stent in patients with multivessel coronary artery disease. We have compared the performance of the Titan-2® stent to that of the second generation drug-eluting stents in this scenario.MethodsFrom 2011 to 2012, 284 patients were treated with the Titan-2® stent, of which 100 (35.2%) had multivessel coronary artery disease. This group was compared to 100 patients, of a group of 304 (38.9%) patients with multivessel coronary artery disease treated with second generation drug-eluting stents with durable or biodegradable polymers. The primary endpoint was the occurrence of major adverse cardiovascular events at 1 year.ResultsClinical, angiographic and procedure-related characteristics of the patients did not show differences between groups. Most patients in the Titan-2® group were male (70%), mean age was 68.4 ± 12.9 years and 25% were diabetic. Stable symptomatic patients were prevalent (68%), 51% had three-vessel disease and ventricular function was preserved (55.6 ± 12.7%). The incidence of major adverse cardiovascular events at 1 year in the Titan-2® group was 21% (vs. 17%; p = 0.59), death was observed in 3% (vs. 2%; p > 0.99) of the patients, acute myocardial infarction in 5% (vs. 4%; p > 0.99) and a new revascularization procedure in 13% (vs. 11%; p = 0.83). Definitive stent thrombosis was not observed in either group.ConclusionsThe Titan-2® stent showed similar results to those of the second-generation drug-eluting stents, which makes it attractive for use in the complex scenario of patients with multivessel coronary artery disease.RESUMODesempenho do Stent Recoberto por Titânio-Óxido Nítrico em Pacientes com Doença Coronária MultiarterialIntrodçãoAté o momento, nenhum estudo avaliou o stent recoberto por titânio-óxido nítrico em pacientes com doença arterial coronariana multiarterial. Comparamos o desempenho do stent Titan-2® ao stents farmacológicos de segunda geragao nesse cenário.MétodosNo período de 2011 a 2012, 284 pacientes foram tratados com o stent Titan-2®, dos quais 100 (35,2%) eram portadores de doença arterial coronariana multiarterial. Esse grupo foi comparado a 100 pacientes, de um grupo de 304 (38,9%), com doença arterial coronariana multiarterial, tratados com o stent farmacológico de segunda geração com polímeros duráveis ou biodegradáveis. O desfecho primário foi a ocorrência de eventos cardíacos adversos maiores em 1 ano.ResultadosCaracterísticas clínicas, angiográficas e do procedimento não apresentaram diferenças entre os grupos. A maioria dos pacientes do grupo Titan-2® era do sexo masculino (70%), com idade de 68,4 ± 12,9 anos e 25% eram diabéticos. Predominaram os quadros clínicos estáveis (68%), 51% tinham acometimento triarterial e a função ventricular estava preservada. A incidência de eventos cardiovasculares adversos maiores em 1 ano no grupo Titan-2® foi de 21% (vs. 17%; p = 0,59), óbito ocorreu em 3% (vs. 2%; p > 0,99) dos pacientes, infarto do miocárdio em 5% (vs. 4%; p > 0,99) e nova revascularização miocárdica em 13% (vs. 11%; p = 0,83). Não foram constatadas tromboses de stent definitivas em nenhum grupo.ConclusõesO uso do Titan-2® apresentou resultados similares aos do stent farmacológico de segunda geração, o que o torna atrativo para ser utilizado no complexo cenário de pacientes portadores de doença arterial coronariana multiarterial

FLORAÇÕES DE CIANOBACTÉRIAS TÓXICAS EM UMA LAGOA COSTEIRA HIPEREUTRÓFICA DO RIO DE JANEIRO/RJ (BRASIL) E SUAS CONSEQUÊNCIAS PARA SAÚDE HUMANA

revista vol 13 nº 2.indd The Jacarepaguá Basin, Rio de Janeiro, Brazil has over the last four decades undergone a disordered process of urban and industrial growth with direct consequences on water quality and incidence of cyanobacterial blooms in the Jacarepaguá Lagoon Complex (JLC). The present study combines data aiming to evaluate water quality in Jacarepaguá Lagoon (JL) from monitoring of physical variables (pH, water transparency, temperature), chemical variables (salinity, dissolved oxygen, chlorophyll), the planktonic community, and the concentration of microcystins in fish from the region. The data herein presented were divided into three periods according to seasonal cycles: PI (aug/96 to sep/97), PII (jan/99 to nov/99), and PIII (feb/07 to jan/08). Dominance by cyanobacteria characterized most of the study period, interspersed with sudden peaks (e.g. during PII and PIII) of high diversity of phytoplankton. Phytoplanktonic peaks were represented by Chlorophyta, diatoms, Prasinophyta and Criptophyta. Interestingly, the events observed in 1999 repeated almost 10 years later, suggesting roughly seasonal community structure dynamism in the JLC. Disappearance of the bloom coincided with the lowest recorded water temperatures, suggesting that temperature is an important factor in the observed dynamics. The JL had a high abundance of zooplankton, yet species diversity was relatively low. Concentrations of microcystins found in muscles of fish from JL often contained values above the levels recommended by OMS for human consumption.  revista vol 13 nº 2.indd La Cuenca de Jacarepaguá (RJ/Brasil) ha sufrido, en las últimas cuatro décadas, un proceso desordenado de ocupación urbana e industrial, que se refleja en un cambio en la calidad del agua y en la incidencia de floraciones de las cianobacterias en el Complejo Lagunar Jacarepaguá (CLJ). El presente estudio reúne una serie de datos con el objeto de evaluar la calidad del Lago Jacarepaguá (LJ), a través del monitoreo físico (pH, transparencia del agua y temperatura), químico (salinidad, O.D. y clorofila a) y de la comunidad planctónica. También fue analizada la concentración de microcistinas en pescados comercializados en la región. Los datos fueron divididos en tres períodos de acuerdo con los diferentes ciclos estacionales estudiados: PI (ago/96 a sept/07), PII (ene/99 a nov/99) y PIII (feb/07 a ene/08). La dominancia de cianobacterias ocurre en la mayor parte del período de estudio, intercalada con pulsos de mayor diversidad fitoplanctónica, observada desde 1999 (PII y PIII). Dicha diversidad estuvo representada por las clorofíceas, diatomeas, prasinoficeas y criptoficeas. Cabe destacar que la dinámica observada en 1999 se repitió casi 10 años después, lo que sugiere una tendencia estacional para la estructura de la comunidad del CLJ. La desaparición de la floración coincide con épocas de bajas temperaturas sugiriendo que ésta es un factor regulador importante de la dinámica observada. El LJ presentó una elevada abundancia zooplanctónica, con baja diversidad de especies. Durante algunos meses, las concentraciones de microcistinas encontradas en los músculos de los peces estuvieron por encima de los valores recomendados por la OMS para el consumo humano.A baixada de Jacarepaguá (RJ/Brasil) vem sofrendo há pelo menos quatro décadas um processo desordenado de ocupação urbana e industrial, o que tem se refletido em mudança na qualidade da água e na incidência de florações de cianobactérias no Complexo Lagunar de Jacarepaguá (CLJ). O presente estudo reuniu uma série de dados temporais objetivando avaliar a qualidade hídrica da Lagoa de Jacarepaguá (LJ) através do monitoramento físico (pH, transparência da água e temperatura), químico (salinidade, O.D. e clorofila a) e da comunidade planctônica. Foi também analisado a concentração de microcistinas no pescado comercializado na região. Os dados foram divididos em três períodos de acordo com os diferentes ciclos sazonais estudados: PI (ago/96 a set/97), PII (jan/99 a nov/99) e PIII (fev/07 a jan/08). Dominância de cianobactérias ocorreu na maior parte do tempo, intercalada por pulsos de maior diversidade fitoplanctônica, observados a partir de 1999 (PII e III). Esta diversidade foi representada pelas clorofíceas, diatomáceas, prasinoficeas e criptoficeas. Foi interessante notar que a dinâmica observada em 1999 tenha se repetido quase 10 anos depois, o que sugere uma tendência sazonal de estruturação da comunidade no CLJ. O desaparecimento da floração coincidiu com épocas de menores temperaturas, sugerindo ser esse um importante fator regulador da dinâmica observada. A LJ apresentou uma elevada abundância zooplanctônica, com baixa diversidade de espécies. Durante alguns meses, as concentrações de microcistinas encontradas nos músculos dos peixes estiveram acima dos valores recomendados pela OMS para consumo humano

A PSORÍASE NO CONTEXTO DA ATENÇÃO BÁSICA: UM PLANO DE INTERVENÇÃO ATRAVÉS DE UM RELATO DE CASO

  Introdução: A psoríase caracteriza-se por ser uma doença de etiologia desconhecida, com evolução crônica, acentuada e tendências às recidivas. A lesão característica é representada por uma placa eritemato-escamosa, saliente em relação a superfície da pele. Objetivos: Identificar as principais necessidades de educação em saúde de um paciente acometido por psoríase através de um relato de caso vivenciado em uma unidade básica de saúde e no próprio domicílio do paciente. Material e Métodos: A coleta de dados foi realizada através de um formulário com questões abertas e fechadas. Resultados: As principais metas para o paciente foram alcançadas por incluir melhor compreensão sobre a psoríase e o regime e adesão do tratamento, a obtenção da pele mais lisa com o controle das lesões e o desenvolvimento da auto-aceitação que é um enfretamento de estresse para realização das atividades normais e as interações sociais. Conclusões: Constatou-se que o paciente acometido com psoríase precisa está informado de sua patologia, como também toda a população que discrimina esses indivíduos. Portanto, acreditamos na educação em saúde como meio de transformação desta realidade que precisa ser mudada.   Palavras-chave: Psoríase. Educação em saúde. Qualidade de vida. Introduction: Psoriasis is characterized by being a disease of unknown etiology, with a chronic, marked evolution and tendencies to relapse. The characteristic lesion is represented by an erythematous-squamous plaque, protruding from the surface of the skin. Objectives: To identify the main health education needs of a patient affected by psoriasis through a case report in a primary healthcare unit and in the patient's own home. Material and Methods: The data collection was done through a form with open and closed questions. Results: The main goals for the patient were achieved by including a better understanding of psoriasis and treatment regimen and adherence, obtaining smoother skin with lesion control, and developing self-acceptance that is a stress coping for performance of normal activities and social interactions. Conclusions: It was verified that the patient with psoriasis is aware of his pathology, as well as the entire population that discriminates these individuals. Therefore, we believe in health education as a means of transforming this reality that needs to be changed. Keywords: Psoriasis. Health education. Life quality

Impactos da má qualidade do sono em profissionais da saúde em ambiente emergencial

This study aims to evaluate the impacts of poor sleep quality among healthcare professionals in emergency environments. Health services aimed at managing critical situations are often characterized by high pressure and stressful work environments. This is due to the severity of the conditions faced by patients, which may present an imminent risk of death or severe suffering. Professionals who work in these areas are particularly susceptible to occupational stress and health problems, due to the intrinsic demands of the role and adverse conditions, such as lack of human and material resources, work overload, inadequate environments, overcrowding and lack of recognition. by the administration. This is a narrative review of a critical and analytical nature, in research on the main concepts regarding CABG complications, in addition to the essential aspects of diagnosis and treatment. A review of articles was carried out in the Scientific Electronic Library Online (SciELO) and PubMed databases, with the following Health Sciences Descriptors (DeCS): Rest; Quality of life; Health. Work environments in emergency services are often associated with high levels of stress, resulting in a significant impact on the physical, mental and emotional well-being of professionals.Este estudio tiene como objetivo evaluar los impactos de la mala calidad del sueño entre los profesionales sanitarios en entornos de emergencia. Los servicios de salud destinados a gestionar situaciones críticas suelen caracterizarse por entornos laborales estresantes y de alta presión. Esto se debe a la gravedad de las condiciones que enfrentan los pacientes, que pueden presentar un riesgo inminente de muerte o sufrimiento severo. Los profesionales que actúan en estas áreas son particularmente susceptibles al estrés ocupacional y a problemas de salud, debido a las exigencias intrínsecas del rol y a condiciones adversas, como falta de recursos humanos y materiales, sobrecarga de trabajo, ambientes inadecuados, hacinamiento y falta de reconocimiento. por la administración. Se trata de una revisión narrativa, de carácter crítico y analítico, en la investigación sobre los principales conceptos sobre las complicaciones de la CABG, además de los aspectos esenciales del diagnóstico y tratamiento. Se realizó una revisión de artículos en las bases de datos Scientific Electronic Library Online (SciELO) y PubMed, con los siguientes Descriptores en Ciencias de la Salud (DeCS): Descanso; Calidad de vida; Salud. Los entornos laborales en los servicios de emergencia suelen estar asociados a altos niveles de estrés, lo que tiene como resultado un impacto significativo en el bienestar físico, mental y emocional de los profesionales.Este estudo tem como objetivo avaliar os impactos da má qualidade do sono entre os profissionais de saúde em ambientes emergenciais. Os serviços de saúde voltados para o manejo de situações críticas frequentemente são caracterizados por ambientes de trabalho de alta pressão e estresse. Isso ocorre devido à gravidade das condições enfrentadas pelos pacientes, que podem apresentar risco iminente de morte ou sofrimento severo. Os profissionais que atuam nessas áreas estão particularmente suscetíveis ao estresse ocupacional e a problemas de saúde, devido às demandas intrínsecas da função e às condições adversas, como a escassez de recursos humanos e materiais, sobrecarga de trabalho, ambientes inadequados, superlotação e falta de reconhecimento por parte da administração. trata-se de uma revisão narrativa de caráter crítico e analítico, na  pesquisa  sobre  os principais  conceitos  no  que tange às complicações da CRM, além dos aspectos essenciais de diagnóstico e tratamento. Foi  realizada  uma  revisão  de  artigos  nas  bases  de  dados   Scientific  Electronic  Library  Online (SciELO) e PubMed, com os seguintes Descritores em Ciências  da  Saúde  (DeCS): Descanso; Qualidade de vida; Saúde. Ambientes de trabalho em serviços de emergência estão frequentemente associados a elevados níveis de estresse, resultando em um impacto significativo no bem-estar físico, mental e emocional dos profissionais

High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.World Health OrganizationRevisión por pare

IMPACTO DE DETERMINANTES SOCIAIS NA SAÚDE MENTAL: UMA ANÁLISE DE SAÚDE COLETIVA

Introduction: It seeks to highlight the importance of social determinants of health in relation to the treatment and care of patients with mental disorders. Furthermore, it reports on the changes and how the determinants reflect positively and negatively on this topic, in addition to the evolution that has emerged since past years. Objective: Understand the impacts and the relationship of determinants with the issue of mental health. Methodology: A systematic literature review was carried out covering the years from January 2003 to December 2023 The study was based and guided by the question mentioned throughout the article. Results: The evident role of determinants in the subject of mental health stands out, in addition to showing that the evolution of these determinants can improve and facilitate the development of efficient and appropriate care strategies for patients suffering from some mental illness. Advanced cases can be mitigated gradually. Conclusion: With emphasis on social and economic issues, it is noted that these factors directly affect adherence to treatment and diagnosis for those in need and that even with all the efforts aimed at this topic to this day, an inequality is still seen in the way in which The health system is offered to the population.Introdução: Procura evidenciar a importância das determinantes sociais de saúde em relação ao tratamento e assistência de pacientes com transtornos mentais. Além disso, relata as mudanças e como as determinantes refletem positivamente e negativamente nessa temática, além da evolução que foi surgindo desde anos passados. Objetivo: Compreender os impactos e a relação das determinantes com a temática da saúde mental. Metodologia: Foi realizada uma revisão sistemática de literatura abrangendo os anos de janeiro de 2003 a dezembro de 2023. O estudo teve como base e norteamento a pergunta citada no decorrer do artigo. Resultados: Destaca-se o papel evidente das determinantes no assunto de saúde mental, além de evidenciar que a evolução dessas determinantes podem melhorar e facilitar o desenvolvimento de estratégias de cuidados eficientes e adequadas para pacientes que sofrem de com alguma doença mental Assim, o número avançado de casos podem ser mitigado de forma gradativa. Conclusão: Dando ênfase a questões sociais e econômicas, nota-se que esses fatores afetam diretamente a adesão ao tratamento e diagnóstico aos necessitados e que mesmo com todos os esforços voltados a essa temática até os dias atuais ainda é visto uma desigualdade na forma em como é ofertado o  sistema de saúde a população