SEPTIC SHOCK IN PATIENT WITH DISSEMINATED HISTOPLASMOSIS ASSOCIATED WITH AIDS: A CASE REPORT

SUMMARY Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum, which may present itself as a serious infection in immunocompromised individuals. We present a case of 31-year-old female with newly diagnosed HIV infection and history of fever, general and respiratory symptoms and diffuse hyperchromic papules through the body. She was admitted, with rapid progression to septic shock, and the presence of neutrophils filled with yeast-like organisms was detected on peripheral blood smear hematoscopia on the third day of hospitalization. The following is a brief review on the clinical picture and management of histoplasmosis.RESUMO A histoplasmose é micose sistêmica causada por Histoplasma capsulatum, a qual pode se apresentar de forma grave em indivíduos imunocomprometidos. Neste trabalho, apresenta-se o caso de paciente feminino, 31 anos, com diagnóstico recente de infecção por HIV e quadro de febre, sintomas gerais e respiratórios e pápulas hipercrômicas difusas pelo corpo. Foi internada, apresentando progressão rápida para choque séptico, sendo detectada a presença de leveduras inclusas em neutrófilos à hematoscopia no terceiro dia de internação. Apresenta-se uma revisão breve sobre a apresentação e o manejo clínico da histoplasmose

Estudo da Iteração das Nanopartículas de Dióxido de Titânio em Solos de Aterro Controlado Contaminados por Óxido de Cobre

As nanopartículas representam atualmente, uma nova e ampla classe de contaminantes produzidos pelo homem e são cada vez mais comuns nos ambientes naturais, visto que as atividades industriais envolvendo a nanotecnologia crescem de modo acelerado. Dessa forma, torna-se extremamente relevante compreender o transporte e o destino dos materiais nanoparticulados que são lançados no ambiente para então identificar os fenômenos físicos e químicos que ocorrem provenientes da disposição de resíduos. O objetivo geral deste trabalho é criar informação científica necessária para melhor compreender o comportamento e o transporte de nanopartículas TiO2 em suspensões aquosas através de solos impregnados com cobre. Permitindo assim, que a produção e o uso de nanomateriais nocivos possam ser melhor controlados, evitando os efeitos adversos à saúde humana e os custosos esforços para a remediação. Em particular, neste trabalho foram escolhidos dióxido de titânio por ser um nanomaterial largamente utilizado em escala industrial e o óxido de cobre por sua vez, por ser um contaminante de solo onipresente. O que torna singular a necessidade do estudo de seu transporte através do meio ambiente, especialmente em solos e águas. Para tal conhecimento serão realizados ensaios experimentais de e utilizando solo impregnado com óxido de cobre em suspensão aquosa de TiO2

Efecto de un programa multiprofesional en la promoción de la salud alimentaria de las personas mayores: un estudio longitudinal.

Objective: To analyze the food quality of elderly participants in a multi-professional project for health promotion and healthy longevity. Methodology: 55 older adults aged ≥ 60 years (66.03 ± 3.68 years) residents in the south of Brazil were recruited. However, 28 elderlies dropped out of the interventions. Thus, 27 elderlies were assessed (before and after 12-week interventions). To evaluate food quality, the data from the food record of three non-consecutive days and the healthy eating index (HEI) were used, which were applied before and after interventions. The intervention was developed for three months, with theoretical-practical classes on multidisciplinary groups as physical education, psychology, and nutrition (with food reeducation - without nutrition plan). The mean, (±) standard deviation, and 95% confidence interval (95% CI) were calculated. The comparison between pre- and post-intervention was performed by paired t-test, assuming a p≤ 0.05. Results: After 12 weeks, it was observed that the elderly showed higher values for the HEI after the interventions (pre: 47.78 ± 14.23 points; 95% CI: 42.41-53.15, versus 56.30 ± 13.05, 95% CI: 51.37-61.22; with p = 0.029; d = 0.59; medium effect). Conclusions: a multidisciplinary approach including a nutritional intervention could promote positive changes in the food quality of the elderly investigated. As a limitation, the absence of a control group and the conduction of a randomized controlled trial are highlighted. However, this study already promotes directions to provide nutritional health in older people.Objetivo: Analizar la calidad alimentaria de los adultos mayores participantes en un proyecto multiprofesional de promoción de la salud y longevidad saludable. Metodología: Se reclutaron 55 adultos mayores de ≥ 60 años (66,03 ± 3,68 años) residentes en el sur de Brasil. Sin embargo, 28 ancianos abandonaron las intervenciones. Así, se evaluaron 27 ancianos (antes y después de las intervenciones de 12 semanas). Para evaluar la calidad de los alimentos se utilizaron los datos del registro alimentario de tres días no consecutivos y el índice de alimentación saludable (IES), que se aplicaron antes y después de las intervenciones. La intervención se desarrolló durante tres meses, con clases teórico-prácticas en grupos multidisciplinares como educación física, psicología y nutrición (con reeducación alimentaria - sin plan de nutrición). Se calcularon la media, la desviación estándar (±) y el intervalo de confianza del 95% (IC del 95%). La comparación entre pre y postintervención se realizó mediante la prueba t pareada, asumiendo una p ≤ 0,05. Resultados: Después de 12 semanas, se observó que los ancianos mostraron valores más altos para la IES después de las intervenciones (pre: 47,78 ± 14,23 puntos; IC 95%: 42,41-53,15, versus 56,30 ± 13,05, IC 95%: 51,37-61,22; con p = 0,029; d = 0,59; efecto medio). Conclusiones: un enfoque multidisciplinario que incluya una intervención nutricional podría promover cambios positivos en la calidad alimentaria de los ancianos investigados. Como limitación se destaca la ausencia de un grupo control y la realización de un ensayo controlado aleatorizado. Sin embargo, este estudio ya promueve direcciones para brindar salud nutricional a las personas mayores

Análise comparativa da influência do aquecimento e resfriamento na resistência do concreto

The elaboration of this article occurred after a research in which the comparative analysis of the influence of heating and cooling on concrete strength was studied. For this, tests were carried out in the laboratory, in addition to the concreting of the concrete in concrete mixer, where it was observed that the use of the trace of the material mentioned above, refers to the characteristic resistance of the compression of 25 Mpa. The research also made a comparative study between natural concrete and another that was exposed to high temperatures, in a gas furnace and soon after removed, subjected to a cooling with water, whose objective is to analyze the control and qualification of this concrete. As previously stated, the tests were all done in the laboratory in order to demonstrate the influence at high temperatures and in its instantaneous drop, where a trace of concrete was executed, that shaped 25 specimens of which twelve were made to prove if the trace contains the required characteristic resistance. As the tests were carried out after seven days, twenty-one days and twenty-eight days, it was observed that in all of them, the concrete did not gain resistance, but lost much of it, reaching a reduction of 66.74%. This draws attention to the importance of being aware of the material and its behavior, since a fire in structures such as those analyzed can lead to massive cases of death and material loss. Therefore, it is extremely important to make such an assessment, to avoid possible tragedies.La elaboración de este artículo ocurrió después de una investigación en la que se estudió atentamente el análisis comparativo de la influencia del calentamiento y enfriamiento en la resistencia del hormigón. Para ello, se realizaron pruebas en laboratorio, además de la realización de la confección del hormigón en hormigón, donde se observó que la utilización del traza del material arriba mencionado, se refiere a la resistencia característica de la compresión de 25 Mpa. La investigación aún hizo un estudio comparativo entre el concreto natural y otro que fue expuesto a temperaturas elevadas, en un horno a gas y luego después de retirado, sometido a un enfriamiento con agua, cuyo objetivo es analizar el control y calificación de este concreto. En los últimos años, los ensayos se realizaron en laboratorio con la finalidad de demostrar la influencia en temperaturas elevadas y en secuencia, su caída instantánea, donde se ejecutó un trazado de concreto, que moldeó 25 cuerpos de prueba de los cuales doce fueron hechos para comprobar si el traza contiene la resistencia característica necesaria. Como las pruebas se efectuaron después de siete días, veintiún días y veintiocho días, se observó que en todos ellos, el hormigón no ganó resistencia, sino que perdió gran parte de la misma, llegando a una reducción del 66,74% . Esto llama la atención sobre la importancia de tener conocimiento del material y su comportamiento, ya que un incendio en estructuras como las analizadas, puede acarrear voluminosos casos de muertes y pérdidas materiales. Por lo tanto, es de extrema importancia hacer tal evaluación, para evitar posibles tragedias.A elaboração deste artigo ocorreu após uma pesquisa na qual foi estudada atentamente a análise comparativa da influência do aquecimento e resfriamento na resistência do concreto. Para isso, foram feitos testes em laboratório, além da realização da confecção do concreto em betoneira, onde observou-se que a utilização do traço do material acima mencionado, refere-se à resistência característica da compressão de 25 Mpa. A pesquisa ainda fez um estudo comparativo entre o concreto natural e outro que foi exposto a temperaturas elevadas, em um forno a gás e logo após retirado, submetido a um resfriamento com água, cujo objetivo é analisar o controle e qualificação desse concreto. Conforme dito anteriormente, os ensaios foram todos feitos em laboratório com a finalidade de demonstrar a influência em temperaturas elevadas e em sequência, sua queda instantânea, onde foi executado um traço de concreto, que moldaram 25 corpos de prova dos quais doze foram feitos para comprovar se o traço contém a resistência característica necessária. Como os testes foram efetuados após  sete dias, vinte e um dias e vinte e oito dias, foi observado que em todos eles, o concreto não ganhou resistência, e sim, perdeu grande parte da mesma, chegando a uma redução de 66,74%. Isso chama a atenção para a importância de se ter conhecimento do material e seu comportamento, visto que um incêndio em estruturas como as analisadas, pode acarretar volumosos casos de óbitos e perdas materiais. Sendo assim, é de extrema importância fazer tal avaliação, para evitar possíveis tragédias

Evaluation of the bond strength at the resin-dentin interface using self-etching adhesive systems containing different functional monomers / Avaliação da resistência de união na interface resina-dentina usando sistemas adesivos autocondicionantes contendo diferentes monômeros funcionais

Background: Self-etching adhesive systems have attracted considerable interest in dentistry, as these materials simplify the restorative protocol and allow a less sensitive adhesive technique. The objective of the present study was to analyze in vitro the performance of self-etching adhesive systems containing different functional monomers. Materials and Methods:  The adhesives evaluated were: Clearfil SE Bond (CSE) adhesive containing 10-MDP, Optibond All-in-One (OPT) containing GPDM, Palfique Bond (PB) containing 3D-SR monomer. Immediate microtensite bond strength (mTBS) and after thermocycling were realized. Interaction between the functional monomers and dentin was characterized using thin-film X-ray diffraction (TF-XRD) and scanning electron microscopy (SEM). In the experiments were used 60 molars. Thirty molars were divided into 3 experimental conditions (n=10) according to the adhesive system; the teeth were restored and sectioned on “toothpick” specimens for mTBS. Additionally, five teeth were prepared in the form of discs and the adhesives applied without light curing on the surface for XRD analysis. For morphological evaluation in SEM, 25 teeth were treated with the respective adhesives. The mTBS data were submitted to ANOVA two factors and Tukey's test (5%).  Results: The adhesive vs. time interaction was statistically significant (p<0.001), with the CSE adhesive obtaining the highest means and being the worst performance of BP. The analysis of XRD found that the monomers interact chemically with hydroxyapatite, but with different intensities. SEM images indicate that the applied adhesives infiltrate the dentin forming resin tags in greater or lesser amounts. Conclusions: The different functional monomers have a direct impact on the effectiveness of the adhesive bond, with the 10-MDP monomer, the CSE adhesive, highlighted by the higher TBS values. The self-etching adhesive systems allow a simplification in the restorative protocol, besides a less sensitive adhesive technique and less clinical time for the procedure. Therefore, knowing its mechanical and chemical properties is important to ensure longer-lasting restorations. 

Autonomy In the Choice of Childbirth in The Primiparous: Understanding Reality

Every pregnant woman has the right to care during childbirth and postpartum, and that this is performed in a humane and safe way. To ensure autonomy, it is necessary to put the woman in control of labor and birth, providing the necessary knowledge that allows her to make decisions about her own body. The study aimed to know the autonomy and knowledge of primiparous women in choosing the type of delivery. This is a qualitative field research. The participants were primiparous women, who agreed to participate in the research by signing the Informed Consent Form. The interviews were conducted after approval by the Research Ethics Committee under protocol n. CPEA 31364620.8.0000.5428, opinion n. 4,300,350. In view of the results, the following themes emerged: Reception and neglected bond between health units and pregnant women, revealed by reports of negative and frustrated experiences in the parturition process. Factors that prevent the autonomy of the choice of delivery in pregnant women and negative experiences and frustrated expectations regarding the moment of delivery, in which the reports indicated a lack of explanation of the procedures, lack of communication and prejudiced decision of the physician in relation to the delivery. It was concluded that the study showed the need for actions aimed at women’s health in the pregnancy-puerperal period, which enable conditions for female empowerment in decision-making about the body itself

Criptococose abdominal efusiva grave em felino doméstico: Relato de caso

A criptococose é uma doença fúngica causada por duas espécies de Cryptococcus, C. neoformans e C. gattii. Afeta diversas espécies animais, sendo os gatos considerados mais propensos. A doença no gato geralmente afeta o sistema respiratório, particularmente cavidades nasais. Envolvimento do sistema nervoso central é menos frequente, comparado ao cão. Manifestação em outros locais, como cavidade abdominal, é considerada rara. O objetivo desse trabalho é relatar um caso de criptococose abdominal em um gato, encaminhado para exame necroscópico. O animal apresentava progressiva perda de peso, com acentuado aumento de volume abdominal, sendo suspeito de peritonite infecciosa felina. À necropsia, observou-se intensa deposição de material brancacento gelatinoso no abdômen. A histopatologia revelou inflamação e a presença de estruturas leveduriformes nos tecidos, evidenciadas pelas colorações de azul de Alcian e ácido periódico de Schiff, confirmando o diagnóstico de criptococose. Conclui-se que manifestações de alterações abdominais devem ser profundamente investigadas, a fim de permitir diagnóstico precoce e possibilitar tentativas de tratamento

Diagnosis, oral rehabilitation and multidisciplinary approach of a patient with a severely worn dentition and reduced occlusal vertical dimension/ Diagnóstico, reabilitação oral e abordagem multidisciplinar de um paciente com uma dentição gravemente desgastada e dimensão vertical oclusal reduzida

Bruxism is a parafunction that presents as an involuntary and unconscious disorder of mandibular movement, characterized by flatness and grinding of the teeth. It is a hyperactivity of the masticatory muscles that is mainly associated with stress and emotion, and occurs in wakefulness and / or during sleep, without defined etiology and treatment, although there are etiological hypotheses with a strong implication in the central nervous system. The most common approach is to multidiscipline, in order to minimize etiological factors and restore lost function and esthetics. This case report describes the diagnosis, the associated treatments and the clinical follow-up of a patient with posterior teeth severely worn due to bruxism. Therefore, were made restoration of vertical dimension of occlusion with ceramic “table top” overlays in the posterior teeth and laminate veneers in the anterior teeth. Subsequently, cognitive/behavioral therapies and interocclusal devices were used

Teaching hospital management during the undergraduate nursing course

Learning takes place in the interaction between people through the teaching process, from which the academic community appropriates socially established knowledge. In nursing, teaching education is essential for nursing education, and the role of the teacher in this aspect is fundamental for teaching-learning. Identify the students\u27 expectations in relation to the discipline of hospital management, as well as the gaps found in the methodologies applied in the teaching process. The field research used a questionnaire structured by the researchers. 31 students from the last year of nursing participated in the research. The study was approved by the Research Ethics Committee of Unifunec. The data were analyzed in the Microsoft Office Excel and Microsoft Office Word programs. Of the 31 students interviewed, 55% (17) had a basic notion of how to identify the functions of the nurse manager, 16% (5) could not identify, 16% (5) knew how to identify with some difficulty, 13% (4) easily identified. Regarding the methodologies applied, technological advances were monitored, 51% (16) considered that partially, 39% (12) considered yes, 10% (3) considered no. It was identified that the discipline of hospital management generates many expectations in the students and, at the same time, point out gaps in the construction of this knowledge. Further research is suggested to find alternatives that allow the proximity of reality to learning and in the preparation of nurses to deal with managerial functions

Potencial de utilização do dietholate como protetor de clomazone em feijoeiro comum

Safeners are chemicals applied to crops, usually by seed treatment, to improve their tolerance to herbicides. The objective of this research was to evaluate the potential use of dietholate as a safener for pre-emergence applications of clomazone in common beans. Treatments were arranged in a factorial combination 2 x 5 x 6 composed by two herbicide treatments (without or with clomazone at 750 g ha-1), five doses of dietholate (0, 125, 250, 375 and 500 g. a.i. per 100 kg of seeds), and six cultivars (Diamante Negro, Ouro Branco, Jalo Precoce, BRS Pérola, BRS Pontal and BRS Radiante). Dietholate only did not exhibit potential to protect common bean from injuries caused by clomazone, but also increase crop sensibility to the herbicide.Protetores de plantas são produtos químicos usados com a finalidade de aumentar a seletividade de herbicidas. O objetivo deste trabalho foi verificar os efeitos da utilização de dietholathe como protetor para o herbicida clomazone aplicado em pré-emergência na cultura do feijoeiro. Os tratamentos foram arranjados em esquema fatorial 2 x 5 x 6, em que o primeiro fator foi constituído de dois tratamentos herbicidas (sem e com clomazone a 750 g ha-1); o segundo, de doses de dietholate (0, 125, 250, 375 e 500 g i.a. por 100 kg de semente); e o terceiro fator de diferentes cultivares de feijoeiro (Diamante Negro, Ouro Branco, Jalo Precoce, BRS Pérola, BRS Pontal e BRS Radiante). O dietholate não apresentou potencial para proteger as plantas de feijoeiro dos efeitos fitotóxicos do herbicida clomazone, aumentando a sensibilidade das plantas à aplicação do herbicida