Cefaleia pós anestesia raquidiana: uma revisão integrativa

The aim was to analyze and list the risk factors that predispose to headache after spinal anesthesia, as well as the form of prevention, through an integrative review of the literature. The study refers to an integrative review with data taken from the SciELO, Google Scholar and other databases found in the VHL (LILACS and MedLine). The 11 articles studied revealed that there are relationships between the incidence of CPR and the physiological and anatomical aspects of the patient, as well as the type of needle used in the procedure and the number of punctures. In addition, alternative therapeutic forms to the blood patch were discussed, such as the blockade of ganglia and nerves in pain control and relief of associated symptoms, which were presented in a positive way. The analysis of the different predisposing factors to headache and the treatment of this condition is essential for maximizing subarachnoid anesthesia and mitigating this adverse effect.Objetivou-se analisar e elencar os fatores de risco que predispõem à cefaleia pós anestesia subaracnóidea, bem como a forma de prevenção, através de uma revisão integrativa da literatura. O estudo refere-se a uma revisão integrativa com dados retirados das bases de dados da SciELO, Google Acadêmico e as demais bases encontradas na BVS (LILACS e MedLine). Os 11 artigos estudados revelaram existir relações entre a incidência de CPR com aspectos fisiológicos e anatômicos do paciente, bem como com o tipo de agulha usada no procedimento e o número de punções. Ademais, foram discutidas formas terapêuticas alternativas ao “blood-patch”, como o bloqueio de gânglios e nervos no controle da dor e alívio de sintomas associados, que se apresentaram de forma positiva. A análise dos diversos fatores predisponentes à cefaleia e ao tratamento dessa condição é indispensável para a maximização da anestesia subaracnóide e atenuação desse efeito adverso

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Avaliação microbiológica de alimentos isentos de registro no Ministério da Saúde

The aim of this study was to analyze the sanitary quality of foods commercialized in Londrina, Paraná that are exempt of Brazilian Health Ministry registration procedures, according to Resolution n°. 23 from the National Sanitary Administration Agency (ANVISA). The food categories analyzed were chosen according to ANVISA, Londrina, PR which took the epidemiological risk in account. Microbiological standards were evaluated according to ANVISA Resolution n°. 12. Escherichia coli and coagulase positive Staphylococcus counts were above standards in 11 (18.3%) and 13 (21.6%) of food samples analyzed, respectively. The others microbiological results were in conformity to ANVISA Resolution n°. 12. These results indicate inadequate sanitary conditions during food processing especially for ice-cream, stuffed pasta, “pães de queijo”, lasanha, cream felled pastries, and “salgado recheado”. The results could help the State and Local Sanitary Administration Agencies to evaluate the potentiality of these foods cause food-borne diseases and the adequacy of their liberation from Brazilian Health Ministry registration procedures. The results also show that microbiological analysis of the final product is a valuable validation and verification procedure for the GMP and HACCP system.O objetivo deste trabalho foi avaliar o padrão higiênico-sanitário de alimentos comercializados na Região de Londrina cadastrados no Ministério da Saúde, porém, dispensados de registro, conforme a RDC nº. 23 da Agência Nacional de Vigilância Sanitária (ANVISA). Os alimentos foram escolhidos de acordo com as sugestões da Vigilância Sanitária de Londrina, PR, que levou em consideração o risco epidemiológico. Os padrões microbiológicos foram avaliados conforme a RDC nº. 12 da ANVISA. Contagens de E. coli e S. aureus acima do permitido foram observadas respectivamente em 11 (18,3%) e 13 (21,6%) dos 60 alimentos analisados. Os demais resultados microbiológicos estavam dentro do estabelecido pela RDC nº. 12. Ficou clara a necessidade de maior fiscalização do processamento e armazenagem de vários alimentos analisados, em especial, sorvetes, massas recheadas, pães de queijo, lasanha, doces com creme e salgados recheados. Esses resultados serão encaminhados às Vigilâncias Regional e Municipal alertando sobre a real potencialidade desses alimentos veicularem doenças e na intenção de abrir uma discussão sobre a liberação ou não de registro desses alimentos junto ao Ministério da Saúde. Além disso, os resultados obtidos confirmam que a análise microbiológica do produto final é um instrumento essencial de validação e verificação das Boas Práticas de Fabricação (BPF) e da Análise de Perigos e Pontos Críticos de Controle (APPCC)

Nucleic Acid-Based Nanobiosensor (NAB) Used for <i>Salmonella</i> Detection in Foods: A Systematic Review

Salmonella bacteria is a foodborne pathogen found mainly in food products causing severe symptoms in the individual, such as diarrhea, fever, and abdominal cramps after consuming the infected food, which can be fatal in some severe cases. Rapid and selective methods to detect Salmonella bacteria can prevent outbreaks when ingesting contaminated food. Nanobiosensors are a highly sensitive, simple, faster, and lower cost method for the rapid detection of Salmonella, an alternative to conventional enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) techniques. This study systematically searched and analyzed literature data related to nucleic acid-based nanobiosensors (NABs) with nanomaterials to detect Salmonella in food, retrieved from three databases, published between 2010 and 2021. We extracted data and critically analyzed the effect of nanomaterial functionalized with aptamer or DNA at the limit of detection (LOD). Among the nanomaterials, gold nanoparticles (AuNPs) were the most used nanomaterial in studies due to their unique optical properties of the metal, followed by magnetic nanoparticles (MNPs) of Fe3O4, copper nanoparticles (CuNPs), and also hybrid nanomaterials multiwalled carbon nanotubes (c-MWCNT/AuNP), QD/UCNP-MB (quantum dotes upconverting nanoparticle of magnetic beads), and cadmium telluride quantum dots (CdTe QDs@MNPs) showed excellent LOD values. The transducers used for detection also varied from electrochemical, fluorescent, surface-enhanced Raman spectroscopy (SERS), RAMAN spectroscopy, and mainly colorimetric due to the possibility of visualizing the detection result with the naked eye. Furthermore, we show the magnetic separation system capable of detecting the target amplification of the genetic material. Finally, we present perspectives, future research, and opportunities to use point-of-care (POC) diagnostic devices as a faster and lower cost approach for detecting Salmonella in food as they prove to be viable for resource-constrained environments such as field-based or economically limited conditions

Dredging Activities Carried Out in a Brazilian Estuary Affect Mercury Levels in Swimming Crabs

(1) Although suffers from intense pollution inputs, Guanabara Bay, the most socioeconomically and environmentally important estuary in Rio de Janeiro, Brazil, is still home to a diverse fauna, including several fish and crab species consumed by humans. The bay presents high sedimentation rates and sediment contamination, further aggravated by dredging processes carried out in recent years. In this context, this study aimed to verify the effect of the dredging process on total mercury (THg) concentrations at Guanabara Bay through swimming crab assessments sampled before (2016), during (2017), and after (2018) the dredging process, and mainly, if the detected concentrations can be harmful to consumer health; (2) Methods: Swimming crab samplings were carried out at the same time and sampling points in 2016, 2017 and 2018 and the total Hg was determined using a Direct Mercury Analyzer (DMA-80, Milestone, Bergamo, Italy); (3) Results: Increased Hg concentrations were observed during the dredging process, decreasing to lower values, close to the initial concentrations, at the end of the process. Some of the investigated abiotic factors favor Hg dynamics in the aquatic environment, while others were positively altered at some of the assessed sampling areas at the end of the dredging process; (4) Conclusions: Although crab Hg levels were below maximum permissible limits for human consumption, it is important to note that these animals are significantly consumed around Guanabara Bay, which may lead to public health issues in the long term

Expression of the marA, soxS, acrB and ramA genes related to the AcrAB/TolC efflux pump in Salmonella entérica strains with and without quinolone resistance-determining regions gyrA gene mutations

Several studies have been conducted in recent years to elucidate the structure, function and significance of AcrB, MarA, SoxS and RamA in Salmonella enterica. In this study, the relative quantification of acrB, soxS, marA and ramA genes expression was evaluated in 14 strains of S. enterica, with or without accompanying mutations in the quinolone resistance-determining regions of the gyrA gene, that were exposed to ciprofloxacin during the exponential growth phase. The presence of ciprofloxacin during the log phase of bacterial growth activated the genes marA, soxS, ramA and acrB in all S. enterica strains analyzed in this study. The highest expression levels for acrB were observed in strains with gyrA mutation, and marA showed the highest expression in the strains without mutation. Considering only the strains with ciprofloxacin minimum inhibitory concentration values 0.125 [1]g/mL (low susceptibility), with and without mutations in gyrA, the most expressed gene was marA. In this study, we observed that strains resistant to nalidixic acid may express genes associated with the efflux pump and the expression of the AcrAB-TolC pump genes seems to occur independently of mutations in gyrA