A síndrome de guillain-barré e o papel do psicólogo na reabilitação / Guillain-barré syndrome and the psychologist's role in rehabilitation

A Síndrome de Guillain-Barré, que é considerada uma doença autoimune, ocorrendo a partir de uma reação do sistema imunológico a agentes infecciosos como vírus e bactérias, comprometendo o sistema nervoso periférico responsável pelos movimentos do corpo. O indivíduo se depara com dificuldades no estabelecimento de um diagnóstico e percebe além das limitações físico-motoras adquiridas, as modificações sociais e psíquicas em torno da sua nova condição durante o período de reabilitação. Diante disso, este artigo tem como objetivo é investigar as experiências e os aspectos psicológicos de pessoas que foram acometidas pela Síndrome de Guillain-Barré, e assim, analisar as possibilidades de intervenção do psicólogo junto a estas pessoas durante a reabilitação. Realizou-se revisão bibliográfica para embasamento teórico e pesquisa de campo para a investigação dos aspectos psicológicos envolvidos nesse contexto. Foram entrevistados seis indivíduos que apresentaram esta síndrome em alguma fase da vida. Os resultados apontaram que os cuidados contínuos da equipe multidisciplinar de saúde e dos familiares durante o período de recuperação e reabilitação tornam o indivíduo dependente desses, e geram sentimentos, pensamentos e reflexões diante da sua condição. As transformações físicas refletem na vida social e na organização psíquica do indivíduo, visto que as mudanças ocasionadas por ela são inesperadas, levando o sujeito a buscar a compreensão da situação que vivencia, por meio do processo de escuta e acolhimento realizado pelo psicólogo durante a reabilitação.

Fears and beliefs of people living with rheumatoid arthritis : a systematic literature review

Objective: To assess the main fears and beliefs of people with rheumatoid arthritis (RA) and their effect on treatment outcomes; Methods: A systematic literature review was conducted in Pubmed/Medline; original articles published up to May 2017, reporting fears and/or beliefs of adult patients with RA were analyzed. Fears and beliefs were collected by two independent researchers and grouped into categories. Results: Among 474 references identified, 84 were analyzed, corresponding to 24,336 RA patients. Fears were reported in 38.4% of the articles (N = 32/84): most studies described fears related to pharmacological therapy (50.0%, N = 16/32) and fear of disability (28.1%, N = 9/32). Beliefs were reported in 88.0% of articles (N = 74/84) and were found to moderate the patient-perceived impact of RA in 44.6% (N = 33/74), mainly the emotional impact (18.9%, N = 14/74); measures of function, quality of life, fatigue and pain were also found to be affected by patients’ beliefs in 8.1% (N = 6/74), 6.8% (N = 5/74), 2.7% (N = 2/74) and 2.7% (N = 2/74) of the articles, respectively. Beliefs about therapy were linked to adherence in 17.6% of articles (N = 13/74) and beliefs about cause of RA predicted coping patterns in 12.2% of publications (N = 9/74). Only 9.5% (N = 8/84) of articles reported fears and/or beliefs of patients living outside Europe and North America: there was only one work which recruited patients in Latin America and no article included patients from Africa. Conclusion: In RA, patients’ beliefs are linked to impact of disease and non-adherence. Further research is needed on fears/ beliefs of patients living outside Europe and North America

Percutaneous Endoscopic Retrieval of Gizzard Foreign Body in a Goose Using an Operative Telescope

Background: Foreign bodies are most commonly diagnosed in stomach (proventriculus and gizzard) of galliformes birds and waterfowl. Endoscopyis routinely used to assess birds’ respiratory, gastrointestinal and urogenital tracts. Endosurgeryis also used for sex determination and intra-coelomaticorgan biopsy. Benefits of endoscopic approaches are widely reported in birds. Conventional surgical approaches are far more invasive and risky for those patients. Thus, the purpose of this study was to describe a successful case of gizzard foreign body removal in a greylag goose (Anseranser), using a rigid endoscopic approach through a minimally invasive percutaneous access. Case: A 2-year-old female greylag goose, weighting 3,116 g, was referred to a Veterinary Teaching Hospital presenting apathy and anorexia for at least 24 h. The results on hematologic assessment were within normal range for the species. Radiographic examination indicated presence of radiopaque content, resembling gizzard sediment. Thus, the patient undergone to endoscopy for examination and aspiration of the content. The goose was fasted for 6 h. Anesthesia was induced by face mask and maintained by endotracheal tube, using isoflurane vaporized in 100% oxygen. The patient was positionedin the lateral recumbence. The patient’s neck was longer than the working length of the rigid endoscope. Thus, the telescope was inserted into the esophagus following a small distal esophagotomy, carried out on the caudal third of the neck. A 0º 10-mm operative rigid telescope, with a 6-mm working channel, and a 5-mm diameter and 42-cm in length laparoscopic Babcock forceps were used. The endoscope was inserted through the esophagotomy up to the ventricle level. Sand sediments and stones were viewed. The stones were grasped and retrieved, and the sediments were rinsed with normal saline solution and aspirated with a suction cannula through the working channel of the telescope. Inspection following sediment and foreign body retrieval revealed moderate inflammation of the gizzard mucosa. Total procedure time was 24 min. The patient recovered uneventfully and was discharged following 72 h. Discussion: Rigid endoscopy provided accurate visualization of the thoracic esophagus, proventriculus and gizzard. In general, endosurgery is usually employed for sex determination in birds. It is also useful to access digestive tract using rigid endoscopy, in order to remove foreign body. Such minimally approach reduces postoperative morbidity, which is usually seen following conventional surgical approaches. This technique has been used for removal of foreign body in the digestive tract of several species. Foreign bodies found within crop should require ingluviotomy. However, could be easily removed by endoscopy. If the foreign body is within the proventriculus or gizzard, rigid endoscopy may be useful, as celiotomy could cause morbidity. The small esophagotomy access at the base of the neck was essential for the procedure. In short-necked birds, a 30º Trendelenburg positioning provides more caudal access to the digestive tract. In this case, such positioning was unnecessary. In conclusion, the use of an operative telescope provided accurate retrieval of foreign bodies and drainage of sediments within the digestive tract. Moreover, it can be used as a minimally invasive approach to foreign bodies in the esophagus, crop or stomach (esophagus and gizzard) of geese

Nanostructured systems containing an essential oil: protection against volatilization

The goal of this study was to evaluate the feasibility of preparing nanocapsules and nanoemulsions using tea tree oil as oily phase aiming to protect its volatilization. The nanostructures presented nanometric mean size (160-220 nm) with a polydispersity index below 0.25 and negative zeta potential. The pH values were 6.43 ± 0.37 and 5.98 ± 0.00 for nanoemulsions and nanocapsules, respectively. The oil content after preparation was 96%. The inclusion of tea tree oil in nanocapsules showed higher protection against volatilization. The analysis of mean size and polydispersity index of formulations presented no significant alteration during the storage time

Rendimento, qualidade física e bromatológica de rações peletizadas para coelhos após processamento e reprocessamento / Yield, physical and bromatological quality of pelleted diets for rabbits after processing and reprocessing

O objetivo foi avaliar o rendimento, a qualidade física e bromatológica de ração peletizada para coelhos após processamento e reprocessamento. Uma ração basal para coelhos foi fabricada, peletizada e peneirada, visando eliminar os finos gerados. Na sequência, esses finos foram integralmente reprocessados na peletizadora, para obtenção de nova ração oriunda de resíduo do peneiramento. O delineamento experimental foi inteiramente casualizado, com dois tratamentos (ração processada uma ou duas vezes) e seis repetições. De posse das duas rações obtidas após o peneiramento, ambas foram conduzidas para análises de qualidade física e bromatológica. Foram realizados cálculos de rendimento global, de péletes e de finos, além de análises de granulometria (DGM), método embrapa de peletização (MEP), matéria seca (MS), energia bruta (EB), proteína bruta (PB), extrato etéreo (EE), matéria mineral (MM), cálcio (Ca), fósforo (P), fibra em detergente neutro (FDN) e fibra em detergente ácido (FDA). Também foram estimados os valores de carboidratos não fibrosos (CNF). Os resultados obtidos foram submetidos à análise de variância, teste F e teste de Tukey (P<0,05). O reprocessamento do resíduo obtido a partir do peneiramento de rações peletizadas para coelhos altera sua densidade nutricional, porém eleva o rendimento e a qualidade física dos péletes

Satisfaction and self-confidence with realistic simulation as an active teaching-learning method / Satisfação e autoconfiança com a simulação realística como método ativo de ensino aprendizagem

Objective: To analyze the satisfaction and self-confidence of students in a realistic simulation clinical setting. Method: Almost experimental and quantitative study. Sociodemographic questionnaire, pre-test and post-test knowledge, scenario verification checklist, and satisfaction and self-confidence scale were applied. Approved by the Research Ethics Committee under opinion number 05290\2021. Results: Sample composed of 53 students from the 4th year of Nursing at a University Center in Araras/SP in 2021. The majority did not have previous training, but all showed more correct answers in the post-test. All considered the teaching methods used in the simulation useful and effective, 94.3% understood that the way the teacher taught was adequate for obtaining knowledge, 64.1% are more confident in mastering the content. Conclusion: The combination of active methodologies and realistic simulation resulted in an increase in knowledge and self-confidence of students for the training of qualified professionals.Objetivo: Analizar la satisfacción y autoconfianza de los estudiantes en un escenario clínico de simulación realista. Método: Estudio cuasi-experimental y cuantitativo. Se aplicaron cuestionario sociodemográfico, pre-test y post-test de conocimiento, lista de verificación del escenario y escala de satisfacción y autoconfianza. Aprobado por el Comité de Ética en Investigación bajo el dictamen número 05290\2021. Resultados: Muestra compuesta por 53 estudiantes del 4º año de Enfermería de un Centro Universitario de Araras/SP en el año 2021. La mayoría no tenía formación previa, pero todos presentaron más respuestas correctas en el post-test. Todos consideraron que los métodos de enseñanza utilizados en la simulación fueron útiles y efectivos, el 94,3% entendió que la forma en que el docente enseñó fue adecuada para obtener conocimientos, el 64,1% está más seguro de dominar el contenido. Conclusión: La combinación de metodologías activas y simulación realista resultó en un aumento del conocimiento y autoconfianza de los estudiantes para la formación de profesionales capacitados.Objetivo: analisar a satisfação e autoconfiança dos estudantes em cenário clínico de simulação realística. Método: estudo quase experimental e quantitativo. Foram aplicados questionário sociodemográfico, pré-teste e pós-teste de conhecimento, checklist de verificação do cenário e escala de satisfação e autoconfiança. Aprovado pelo Comitê de Ética em Pesquisa sob parecer nº 05290\2021. Resultados: amostra composta por 53 estudantes da 4ª série de Enfermagem de um Centro Universitário de Araras/SP no ano de 2021. A maioria não possuía formação prévia, porém todos apresentaram mais acertos no pós-teste. Todos consideraram os métodos de ensino utilizados na simulação úteis e eficazes, 94,3% entenderam que a forma como o docente ensinou foi adequada para a obtenção de conhecimentos, 64,1% estão mais confiantes em dominar o conteúdo. Conclusão: a combinação de metodologias ativas e simulação realística resultou em um aumento no conhecimento e autoconfiança dos estudantes para a formação de profissionais capacitados.

Replacing wheat bran by corn gluten feed without steep water in complete dog food

Twenty-four adult Beagles were utilised to evaluate the partial replacement of wheat bran with corn gluten feed without steep water on digestibility and characteristics of faeces. The treatments were 0 (no substitution), 30, 60 or 90 g/kg of corn gluten without steep water. There was no effect (p > .05) on the digestibility coefficients (g/kg) of dry matter (0.771), organic matter (0.806), crude protein (0.813), ether extract (0.798), crude fibre (0.393), neutral detergent fibre (0.425), acid detergent fibre (0.286) and crude energy (0.812), whilst there was effect (p  .05) was found on the remaining faecal characteristics: excretion for 100 g of food (56.77 g), excretion (129.6 g/day and 49.0 g dry matter/day), score (3.90), dry matter excretion for 100 g of food (22.86 g), buffering capacity (BC) at pH 5 (57.81), ammonia nitrogen (1.46 g/kg of faecal dry matter) and water balance (333.25 mL/day), in vivo and in situ gas production (p > .05). Corn gluten feed without steep water can be utilised to replace up to 90 g/kg of wheat bran without causing negative effect on the digestibility and characteristics of faeces

Practical screening tools for sarcopenia in patients with systemic sclerosis

Introduction In view of the method of diagnosing sarcopenia being complex and considered to be difficult to introduce into routine practice, the European Working Group on Sarcopenia in Older People (EWGSOP) recommends the use of the SARC-F questionnaire as a way to introduce assessment and treatment of sarcopenia into clinical practice. Only recently, some studies have turned their attention to the presence of sarcopenia in systemic sclerosis (SSc).There is no data about performance of SARC-F and other screening tests for sarcopenia in this population. Objective To compare the accuracy of SARC-F, SARC-CalF, SARC-F+EBM, and Ishii test as screening tools for sarcopenia in patients with SSc. Methods Cross-sectional study of 94 patients with SSc assessed by clinical and physical evaluation. Sarcopenia was defined according to the revised 2019 EWGSOP diagnostic criteria (EWGSOP2) with assessments of dual-energy X-ray absorptiometry, handgrip strength, and short physical performance battery (SPPB). As case finding tools, SARC-F, SARC-CalF, SARC-F+EBM and Ishii test were applied, including data on calf circumference, body mass index, limitations in strength, walking ability, rising from a chair, stair climbing, and self reported number of falls in the last year. The screening tests were evaluated through receiver operating characteristic (ROC) curves. Standard measures of diagnostic accuracy were computed using the EWGSOP2 criteria as the gold standard for diagnosis of sarcopenia. Results Sarcopenia was identified in 15 (15.9%) patients with SSc by the EWGSOP2 criteria. Area under the ROC curve of SARC-F screening for sarcopenia was 0.588 (95% confidence interval (CI) 0.420–0.756, p = 0.283). The results of sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic Odds Ratio (DOR) with the EWGSOP2 criteria as the gold standard were 40.0% (95% CI, 19.8–64.2), 81.0% (95% CI, 71.0–88.1), 2.11 (95% CI, 0.98–4.55), 0.74 (95% CI, 0.48–1.13) and 2.84 (95% CI, 0.88–9.22), respectively. SARC-CalF and SARC-F+EBM showed better sensitivity (53.3%, 95% CI 30.1–75.2 and 60.0%, 95% CI 35.7–80.2, respectively) and specificity (84.8%, 95% CI 75.3–91.1 and 86.1%, 95% CI 76.8–92.0, respectively) compared with SARC-F. The best sensitivity was obtained with the Ishii test (86.7%, 95% CI 62.1–96.3), at the expense of a small loss of specificity (73.4%, 95% CI 62.7–81.9). Comparing the ROC curves, SARC-F performed worse than SARC-CalF, SARC-F+EBM and Ishii test as a sarcopenia screening tool in this population (AUCs 0.588 vs. 0.718, 0.832, and 0.862, respectively). Direct comparisons between tests revealed differences only between SARC-F and Ishii test for sensitivity (p = 0.013) and AUC (p = 0.031). Conclusion SARC-CalF, SARC-F+EBM, and Ishii test performed better than SARC-F alone as screening tools for sarcopenia in patients with SSc. Considering diagnostic accuracy and feasibility aspects, SARC-F+EBM seems to be the most suitable screening tool to be adopted in routine care of patients with SSc