Validação clínica do diagnóstico de enfermagem dor de parto

OBJECTIVE: The study intends to identify the presence of clinical indicators of pain during labor and to correlate the verbal reference of pain intensity with uterine contractions as a proposal to validate the clinical nursing diagnosis Labor Pain. METHOD: Observational study of the 22 clinical indicators that represented the defining characteristics for the diagnosis. RESULTS: There were 55 participants in labor (18 in the initial active stage, 6 in the final active stage and 31 in both stages), over 18 years old, in their first pregnancy, with effective contractions and cervical dilation of 4cm or more. Among the 22 defining characteristics tested, 6 were present in most participants during the two stages: verbal or codified report, noted evidence of uterine contraction, altered muscle tension, noted evidence of pain, expressive behavior and facial expression of pain. There were differences between the stages in relation to perspiration, facial expression of pain, protective gestures, anodyne position, distractive behavior, self-focus and perineum pressure feeling. CONCLUSIONS: A positive linear correlation was noted between pain intensity scores and the extent of intra-uterine pressure in the initial stage. Labor pain was proven to be compatible with a nursing diagnosis.OBJETIVOS: El estudio propuso identificar la presencia de los indicadores clínicos de dolor de parto y correlacionar el relato verbal de intensidad del dolor con la ocurrencia de contracciones uterinas, como propuesta de validación clínica del diagnóstico de enfermería Dolor de Parto. MÉTODO: Estudio observacional de los 22 indicadores clínicos que representan las características definidoras para el diagnóstico. RESULTADOS: Participaron 55 parturientes (18 en la fase activa inicial, 6 en la fase activa final y 31 en ambas fases), mayores de 18 años, gestación de feto único, contracciones efectivas y dilatación cervical ≥4cm. Fueron testadas 22 características definidoras, 6 presentes en la mayoría de las participantes en las dos fases: relato verbal o codificado, evidencia observada de contracción uterina, alteración del tono muscular, evidencia observada de dolor, comportamiento expresivo y expresión facial de dolor. Fueron encontradas diferencias entre las fases para diaforesis, expresión fácil de dolor, gestos protectores, posición antiálgica, comportamiento de distracción, foco en si mismo y relato de presión perineal. CONCLUSIONES: Se observó correlación linear positiva entre escores de intensidad de dolor y amplitud de presión intrauterina en la fase inicial. El dolor de parto se evidenció un fenómeno compatible para diagnóstico de enfermería.OBJETIVOS: a proposta neste estudo foi identificar a presença dos indicadores clínicos da dor em situação de parto e correlacionar a referência verbal de intensidade de dor com a ocorrência de contrações uterinas, como proposta de validação clínica do diagnóstico de enfermagem dor de parto. MÉTODO: trata-se de estudo observacional dos 22 indicadores clínicos que representaram as características definidoras para o diagnóstico. RESULTADOS: participaram 55 parturientes (18 na fase ativa inicial, 6 na fase ativa final e 31 em ambas as fases), maiores de 18 anos, gestação única, contrações efetivas e dilatação cervical ≥4cm. Testaram-se 22 características definidoras, 6 presentes na maioria das participantes nas duas fases: relato verbal ou codificado, evidência observada de contração uterina, alteração do tônus muscular, evidência observada de dor, comportamento expressivo e expressão facial de dor. Houve diferenças entre as fases para diaforese, expressão facial de dor, gestos protetores, posição antálgica, comportamento de distração, foco em si próprio e sensação de pressão perineal. CONCLUSÕES: observou-se correlação linear positiva entre escores de intensidade de dor e amplitude de pressão intrauterina na fase inicial. A dor de parto evidenciou-se como fenômeno compatível a um diagnóstico de enfermagem

Intracranial Meningioma in a Dog - Treatment with Radiotherapy

Background: The most common primary brain neoplasm is meningioma. Dolichocephalic breeds are predisposed and there is no sexual predilection. Clinical signs depend on the location and size of the tumor and have a progressive course. Primary treatement includes surgery, radiotherapy or both.  This study aimed to describe the treatment of a dog with suspected intracranial meningioma with definitive radiotherapy, which resulted in significant clinical improvement and prolonged survival. Case: A 9-year-old Shetland Shepherd bitch was diagnosed with a head tilt to the left side that progressed over a few weeks. She previously received corticosteroid therapy, which resulted a clinical improvement that worsened after treatment was discontinued. Computed tomography revealed an extra-axial brain mass in the caudal fossa, lateralized to the right, well-delimited, and measuring approximately 1.5 × 1.4 × 1.7 cm, suggestive of intracranial meningioma. The patient was treated with radiotherapy using Cobalt-60 equipment, with 18 daily fractions of 2.5 Gy at a total dose of 45 Gy using parallel and opposite technique fields. A new tomography performed 30 days after treatment showed a remission of 85% of the initial brain mass measuring approximately 0.9 × 1.0 × 0.5 cm, as well as complete resolution of the clinical signs initially presented. After 14 months, the patient presented with signs of lethargy and ataxia and was medicated with hydroxyurea at a dose of 50 mg/kg 3 times a week and corticosteroid therapy. However, the patient’s neurological condition deteriorated, and she was subjected to reirradiation using the same protocol used previously, which resulted in clinical improvement and a 54% reduction in tumor volume on magnetic resonance. As a late side effect, only permanent alopecia in the irradiated region was observed. The patient died of disease 330 days after the second course of radiotherapy, with a total survival time of 1087 days. Discussion: Meningiomas are extra-axial neoplasms of the central nervous system that grow inside the dura mater. The literature shows that meningiomas are more common in dolichocephalic races with a mean age of 9 years, which supports our findings. Meningiomas most commonly affect the cortical thalamus and cerebellopontine region in dogs, which are normally associated with vestibular symptoms, as seen in this case. Diencephalic damage can result in vestibular signals since the thalamus functions as a relay station for vestibular afferent stimuli that are relayed to the cerebral cortex. In addition to the vestibular syndrome, common clinical signs associated with meningiomas in dogs include seizures, behavioral changes, and walking in circles, which are frequently misinterpreted due to tumor-induced side effects, such as cerebral edema, obstructive hydrocephalus, and cerebral hernia. Advanced imaging techniques should be used to diagnose intracranial neoplasms. In this case, computed tomography was critical for diagnosis and treatment planning. Meningioma treatment may comprise palliative measures, surgery, and radiotherapy. Radiotherapy as a single treatment can improve the quality of life with a decrease in clinical signs and a median survival time of approximately 250-536 days, as reported in the literature. Hydroxyurea can be a therapeutic option in inoperable cases and for patients with clinical limitations to undergo successive anesthesia during radiotherapy. Its most serious side effect is progressive myelosuppression. It can cause temporary partial tumor remission and improvement in clinical signs. As previously stated, radiotherapy can be an effective primary treatment option for treating intracranial meningiomas in dogs, with significant improvement in neurological clinical signs and mild side effects. Keywords: dogs, central nervous system, radiotherapy, reirradiation, oncology. Título: Meningioma intracraniano em cão - tratamento com radioterapia Descritores: cães, sistema nervoso central, radioterapia, reirradiação, oncologia

Green processing of porous chitin structures for biomedical applications combining ionic liquids and supercritical fluid technology

The application of green chemistry principles in the processing of materials for advanced technologies is a steadily increasing field of research. In this work porous chitin-based materials were developed by combining the processing of chitin using ionic liquids (ILs)as a green solvent together with the use of super- critical fluid technology(SCF) as clean technology.Chitin was dissolved in 1-butyl-3-imidazolium acetate,followed by regeneration of the polymer in ethanol in specific moulds.The IL was removed using Soxhlet extraction and successive steps of extraction with SCF using carbon dioxide/ethanol ratios of 50/ 50 and70/30.The developed porous chitin-based structures (ChIL)can be classified as mesoporous materials,with very low density and high porosity.The cytotoxicity of ChIL extracts was investigated using L929 fibroblast like cells,and the results demonstrated that the produced materials have extremely lowcytotoxicityl evels.Therefore,the findings suggest that the porous chitin structures may be potential candidates for a number of biomedical applications,including tissue engineering.Fundação para a Ciência e Tecnologia (FCT)S.S.S. and A.R.C.D. thank the Portuguese Foundation for Science and Technology (FCT) for post-doctoral fellowships (SFRH/BPD/ 45307/2008 and SFRH/BDP/34994/2007, respectively). This work was partially supported by the FCT (Project PTDC/QUI/68804/ 2006) and was carried out under the scope of the European NoE EXPERTISSUES (NMP3-CT-2004-500283)

O USO DE BENZODIAZEPÍNICOS EM MULHERES IDOSAS E O PAPEL DO MEDICO DA ATENÇÃO PRIMÁRIA

O uso de benzodiazepínicos é frequente em idosos do gênero feminino. Essa situação é preocupante, na medida em que esse segmento populacional apresenta maior predisposição aos efeitos adversos e à toxicidade dessas medicações. Assim, este estudo teve como objetivo identificar o papel do médico da atenção primária diante do uso inadequado de benzodiazepínico em idosas. Esta pesquisa utilizou como metodologia a revisão integrativa. Os artigos foram comparados e agrupados por similaridade de conteúdo, sendo construídas duas categorias para análise: uso inadequado de benzodiazepínicos em idosas e papel do médico da atenção primária. Conclui-se que se deve instituir o uso racional de benzodiazepínicos na população idosa, além disso, o médico precisa saber identificar tolerância e dependência e como manejar esses pacientes

A combined approach for comparative exoproteome analysis of Corynebacterium pseudotuberculosis

Background: Bacterial exported proteins represent key components of the host-pathogen interplay. Hence, we sought to implement a combined approach for characterizing the entire exoproteome of the pathogenic bacterium Corynebacterium pseudotuberculosis, the etiological agent of caseous lymphadenitis (CLA) in sheep and goats. Results: An optimized protocol of three-phase partitioning (TPP) was used to obtain the C. pseudotuberculosis exoproteins, and a newly introduced method of data-independent MS acquisition (LC-MSE) was employed for protein identification and label-free quantification. Additionally, the recently developed tool SurfG+ was used for in silico prediction of sub-cellular localization of the identified proteins. In total, 93 different extracellular proteins of C. pseudotuberculosis were identified with high confidence by this strategy; 44 proteins were commonly identified in two different strains, isolated from distinct hosts, then composing a core C. pseudotuberculosis exoproteome. Analysis with the SurfG+ tool showed that more than 75% (70/93) of the identified proteins could be predicted as containing signals for active exportation. Moreover, evidence could be found for probable non-classical export of most of the remaining proteins. Conclusions: Comparative analyses of the exoproteomes of two C. pseudotuberculosis strains, in addition to comparison with other experimentally determined corynebacterial exoproteomes, were helpful to gain novel insights into the contribution of the exported proteins in the virulence of this bacterium. The results presented here compose the most comprehensive coverage of the exoproteome of a corynebacterial species so far

The Brazilian top executives’ psychological type and their stress perception: Where the weak ones don’t stand a chance

O estresse pode ser mais facilmente identificado em alguns grupos profissionais, como parece ser o caso dos executivos de alto escalão das grandes empresas. As fontes de estresse são mediadas pelas diferenças próprias a cada indivíduo. Logo, o estresse difere de uma pessoa para outra e cada um reage de uma forma diferente. Frente a esse panorama, este trabalho tem por objetivo analisar a relação entre o estresse percebido pelos executivos brasileiros e o seu tipo psicológico. A pesquisa, de cunho qualitativo-quantitativo, baseou-se em 965 questionários respondidos por presidentes, vice-presidentes/diretores e gerentes de terceiro nível de 344 grandes empresas. Além disso, foram realizadas entrevistas semiestruturadas e grupos de foco com 263 executivos. O referencial teórico descreve as tipologias de estresse e define um indicador de tipos psicológicos baseado no trabalho de Carl G. Jung, o Myers-Briggs Type Indicator (MBTI). A pesquisa indica diferença significativa em relação às percepções de estresse dos executivos versus o MBTI. O tipo psicológico mais encontrado entre os executivos (21,6%) tem como características eficiência, objetividade e assertividade, sendo que aqueles que se enquadram neste tipo percebem menos a manifestação de estresse, quando comparados com os executivos dos outros tipos psicológicos. O tipo ESFJ (3% da amostra) é o que sente mais fadiga e estresse; estes seriam os “fracos”, que não têm vez nas organizações, onde predomina o discurso do “eu sou forte”.Palavras-chave: executivos brasileiros, estresse, tipo psicológico, Carl Jung, assertividade.Stress can be more easily identified in some professional groups such as the senior executives working in corporations. The sources of stress in a work context are mediated by specific individual differences. Therefore, stress differs from one individual to another and each one responds differently. This paper aims to examine the relationship between the Brazilian executives’ perception of stress and their psychological type. The qualitative-quantitative mixed method research is based on 965 questionnaires answered by CEOs, vice presidents/directors and third level executives from 344 corporations. In addition, semi-structured interviews and focus groups were conducted with 263 executives. The theoretical framework describes the stress typologies as well as an indicator of psychological types based on Carl G. Jung’s work, the Myers-Briggs Type Indicator (MBTI). Results show that the dominant psychological type among the executives (21,6%) has as characteristics efficiency, objectivity and assertiveness. Individuals from this psychological type say they feel less the stress when compared with the executives of the other psychological types. The individuals from the psychological type that say they feel more fatigue and stress (3%) would be considered the “weak”, with no place in organizations where only the “strong ones” seem to have a chance.Keywords: Brazilian executives, stress, psychological type, Carl Jung, assertiveness

Hemangiosarcoma Associated with Polypropylene Suture in a Cat

Background: Sutures plays an important role in wound repair by providing hemostasis and support for healing suture. Synthetic non-absorbable like polypropylene suture materials induce minimal tissue reaction. Polypropylene has not been associated to neoplasms in domestic animals. The aim this study is to describe the first case of polypropylene suture induced hemangiosarcoma in an abdominal wall of a feline.Case: A 13-year-old female domestic shorthair cat was presented with a ventral abdominal subcutaneous mass. Clinical examination revealed a firm, rough, and irregular, approximately 6 x 4 cm subcutaneous mass involving the caudal ventral abdomen. A complete blood (cell) count (CBC) was within normal limits. Leukemia and FIV tests were negative; andthe results of a chemistry panel revealed elevated creatinine (valor: 2.0 reference range: 0.5-1.9). Abdominal ultrasound revealed a large mass of mixed echogenicity in the mid-ventral abdomen cranial to the bladder, measuring approximately 6 x 4 cm in the middle line with suture deeply embedded within mass suggesting foreign body reaction or neoplasm. There was evidence of sutures (hyperechoic lines) along the caudal abdominal wall extending into the mass. Records indicated that ovariohysterectomy procedure was performed 12 years previously at the same clinic and the closure of the abdominal wall was made with polypropylene sutures. No other abdominal surgery was performed in this cat. A fine-needle aspirate of the mass and contrast-enhanced computed tomography was not performed due to owner’s finance restrains. The catwas referred to surgery and the mass was excised. No evidence of metastasis was noted during surgery. Histologically, the neoplastic cells were oval to round with granular cytoplasm and vesicular nucleus and exhibited moderate cellular and nuclear pleomorphism. A diagnosis of abdominal wall hemangiosarcoma was made with suture deeply embedded within mass. Surgical margins were clear. Chemotherapy was indicated, but the owner declined due to financial reasons. This is the first polypropylene suture mass associated hemangiosarcoma in cats.Discussion: Hemangiosarcoma is a malignant neoplasm of vascular endothelial cells origin and it may be associated with chronic inflammation and neoplastic transformation. It was reported in previous studies, and it could be a hypothesis for the presented clinical case. There are two cases described in the literature of abdominal wall tumor associated with foreignbody and exuberant inflammatory response in cats using different types of suture; one case is a steel staple developing hemangiosarcoma and the other is polyester sutures developed fibrosarcoma. The present study shows a primary hemangiosarcoma diagnosed several years after closure of abdominal wall using polypropylene sutures in a female cat. Polypropylene is a monofilament suture that create less tissue-drag and induces less inflammation than multifilament sutures and is the preferred suture to close abdominal wall. Cats demonstrate a peculiar predisposition to neoplasms at the site of injury. Although the pathogenesis is still unclear, the introduction a “foreign body” may cause inflammatory process that act as a stimulus to neoplasia formation. We believe that polypropylene was the foreign material that may have played arole in tumor development in this case and it has not been reported before. Polypropylene sutures were found on gross examination of excised material. Any uncoated braided non-absorbable material located deeply in tissues may evoke a chronic inflammatory response (granuloma). A granuloma may evolve to malignancy in some cats. Despite polypropylenematerials induce minimal tissue reaction, it may be associated to neoplasm.Keywords: polypropylene suture, hemangiosarcoma, cat, tumor induced by foreign body

Biomassa arbórea e de sub-bosque e da serapilheira acumulada em povoamentos de Eucalyptus urophylla x Eucalyptus grandis

This study aimed to quantify the biomass in different parts of the trees, the litter accumulated on the ground and in the understory, and was conducted with Eucalyptus urophylla x Eucalyptus grandis, at seven years of age, in two different soils of Telêmaco Borba city - PR. Soil A (Cambisol Tb dystrophic Latosolic), characterized in that sandy texture and soil B (Rhodic Haplortox) with clayey. Delimited to four plots located on each floor, making the measurement of all diameters and selection of trees to be felled. The trees were cut at soil level, and the fractionated components: leaves, twigs, bark, stem wood and roots, collecting a representative sample of each fraction as well as the weight thereof, to determine biomass. For the analysis of litter accumulated were collected 10 samples in each portion with an iron frame of 30 cm x 30 cm. All the vegetation contained within the footprint of each felled tree (7.5 m² ), it was regarded as understory all the biomass collected above and below ground. The woody biomass total Eucalyptus urophylla x Eucalyptus grandis to soil A and B was 257.99 and 301.20 Mg ha-1, respectively. The litter accumulated on the soil was higher in soil B, equivalent to 16.62% in relation to the ground A. Since the understory had total biomass of 1.08 Mg ha-1 for soil A, which is 47.22% above the ground B. It was concluded that the total tree biomass soil B than total tree biomass soil A, but the components of woody biomass and litter accumulated in soil, showed a reduction when compared with the soil components B, except the root component and understory, which showed higher total biomass in the soil A.O presente trabalho teve por objetivos quantificar a biomassa nos diferentes componentes das árvores, na serapilheira acumulada sobre o solo e no sub-bosque. Foi realizado com híbridos de Eucalyptus urophylla x Eucalyptus grandis, aos 7 anos de idade, em dois solos distintos no município de Telêmaco Borba – PR. O solo A (Cambissolo Háplico Tb Distrófico latossólico) caracterizado por apresentar textura arenosa e o solo B (Latossolo Vermelho Distroférrico típico) com textura argilosa. Delimitaram-se quatro parcelas, localizadas em cada solo, realizaram-se a medição de todos os diâmetros e escolha das árvores a serem abatidas. As árvores foram seccionadas ao nível do solo e fracionadas nos componentes: folhas, galhos, casca, madeira do tronco e raiz, coletaram-se uma amostra representativa de cada fração, bem como se realizaram a pesagem das mesmas, para determinação da biomassa. Para a análise da serapilheira acumulada foram coletadas 10 amostras em cada parcela com uma moldura de ferro de 30 cm x 30 cm. Toda a vegetação contida dentro da área útil de cada árvore abatida (7,5 m2) foi considerada como sub-bosque, onde se coletou toda a biomassa acima e abaixo do solo. A biomassa arbórea total do Eucalyptus urophylla x Eucalyptus grandis para o solo A e B foi de 257,99 e 301,20 Mg ha-1, respectivamente. A serapilheira acumulada sobre o solo foi superior no solo B, equivalendo a 16,62% maior em relação ao solo A. Já, o sub-bosque apresentou biomassa total de 1,08 Mg ha-1para o solo A, sendo esta 47,22% superior ao solo B. Conclui-se que a biomassa arbórea total do solo B é superior a biomassa arbórea total do solo A, porém os componentes da biomassa arbórea e serapilheira acumulada no solo A apresentaram uma redução, quando comparados com os componentes do solo B, exceto os componentes raiz e sub bosque os quais apresentaram biomassa total maior no solo A