Use of Caffeine for the Evaluation of the Anthropic Influence over the Upper and Middle Iguaçu River Basins

Many parameters are usually used as gauges to describe water quality worldwide, such as the concentrations of phosphorus, forms of nitrogen, dissolved oxygen (DO), among others. Though legislative limits for the concentrations of these substances are in place, such is not the case for caffeine. Caffeine is a pharmacologically active alkaloid, from the xanthine group, which can be used as a chemical tracer for anthropic influence over water resources. The objective of this study was to analyze the pollution indicators over the Igua?u River, one of the main rivers in Southern Brazil, through the examination of nutrients, DO and their correlations to caffeine. The water samples were collected from 10 sampling sites along the river course, unevenly spaced to better represent the different environmental scenarios present in its basin, extracted from 2014 to 2017. Caffeine was detected and quantified through high-efficiency liquid state chromatography. Results show that both nutrient and caffeine concentrations increased in intensely urbanized areas, specially from IG2 to IG5 sampling sites. Downstream from IG6 the contaminant concentrations decreased mainly due to higher river flows and lower population density. Caffeine was detected in 82% of the samples, indicating that most of the sampling sites were under anthropic influence.

Influence of Omega 3 Fatty Acid Supplementation on Phase Angle Values of People Living with HIV/AIDS with Lipodystrophy Secondary to Antiretroviral Therapy: A Randomized Clinical Trial

Objective: The measurement of phase angles is an important monitoring parameter and supplementation with omega-3 could promote benefits by modulating the electrical potential of membranes and increasing body cell mass. This study aimed to evaluate the effectiveness of omega-3 fatty acid supplementation on the phase angle of people living with HIV/AIDS. Methods: In this study, 63 individuals of all genders who were undergoing outpatient follow-up and showed lipodystrophy due to highly active antiretroviral therapy were analyzed. Our sample consisted of two groups, one that received supplementation containing 2550 mg of omega-3/day (1080 mg of eicosapentaenoic acid and 720 mg of docosahexaenoic acid) for three months (n = 32) and another that underwent nutrition guidance (n = 31). Phase angle and body cell mass were assessed for both groups and compared at the beginning of research (T0) and after our intervention (T1) for each group separately. Results: Phase angle averaged 6.45° ± 1.06 SD. The comparison between T0 and T1 showed a significant increase in phase angle and body cell mass, whereas the guidance group showed a decrease in body cell mass at T1 in relation to T0, with a significant p-value. Variance in phase angle between moments showed significant values between T0 and T1 in the supplementation group for all genders. Conclusion: Omega-3 positively modulated patients phase angle and body cell mass, but we emphasize the need for other studies that can solidify knowledge about supplementation dosage and intervention time.

Some Characteristics and Impacts of the Drought and Water Crisis in Southeastern Brazil during 2014 and 2015

Since the austral summer of 2014 southeastern Brazil has been experiencing one of the most severe droughts in decades. This rainfall deficiency has generated water shortages and a water crisis that have affected population and local economies in the metropolitan region of Sao Paulo, the largest megacity in South America. By January 2015, main reservoirs had reached storage levels of only 5% of their 1.3 billion m3 capacity. The meteorological causes of the drought situation were linked to changes in the regional circulation, characterized by a mid-troposphere blocking high that lasted 45 days during the summer of 2014 over southeastern Brazil, something not seen in five decades. The water crisis was aggravated by a combination of lack of rainfall and higher temperatures, the summer of 2014 being the warmest and driest over the Cantareira reservoir system since 1951. Increasing population and water consumption increased vulnerability in the region, and while human-induced warming may not have generated the atmospheric conditions behind the 2014 and 2015 summer droughts in Southeast Brazil, it is more likely that the warm temperatures have affected the severity of the drought and exacerbated the impacts on the population.

Generating Set of the Complete Semigroups of Binary Relations

Difficulties encountered in studying generators of semigroup of binary relations defined by a complete X -semilattice of unions D arise because of the fact that they are not regular as a rule, which makes their investigation problematic. In this work, for special D, it has been seen that the semigroup , which are defined by semilattice D, can be generated by the set .

Effects of Dexamethasone, Clonidine, Tramadol and Nalbuphine on Fentanyl-Induced Hyperalgesia in Rats

Opioids are drugs used to alleviate pain. However, studies have demonstrated that these drugs can cause an increase in pain sensitivity, which is called opioid-induced hyperalgesia. The objective of this study was to describe the effects of dexamethasone, clonidine, tramadol and nalbuphine on fentanyl-induced hyperalgesia in rats. After obtaining approval from the Committee for the Ethical Use of Animals (CEUA), 36 male Wistar rats were divided into 6 groups: Group 1 (GCSSL) wherein the rats received 1 ml 0.9% saline solution in two injections;Group 2 (GFTSL), received fentanyl at a dose of 100 ug·kg-1 followed by 1 ml 0.9% saline solution via intraperitoneal;the remaining groups (3, 4, 5, 6) received fentanyl at a dose of 100 ug·kg-1 following doses via intraperitoneal: Group 3 (GFTDX), dexamethasone at a dose of 1.0 mg·kg-1;Group 4 (GFTCL), clonidine at a dose of 20 mg·kg-1;Group 5 (GFTTR), tramadol at a dose of 50 mg·kg-1, and Group 6 (GFTNB), nalbuphine at a dose of 5 mg·kg-1. Under general anestesia using isoflurane, the animals were submitted to a surgical incision. Hyperalgesia was evaluated by applying Von Frey filaments at 2 hours after the incision and on the 1st, 3rd and 5th days afterward. At 2 hours after the surgical procedure, there was lower intensity of pain in the fentanyl group (GFTSL) compared to the other groups, and on the fifth day there were no significant differences for pain intensity between groups. The results suggest the presence of fentanyl-induced hyperalgesia and efficacy in its reduction by dexamethasone, clonidine, tramadol and nalbuphine.

Outcomes of Total and Subtotal Laparoscopic Gastrectomy with D2 Lymphadenectomy in Advanced Gastric Cancer in a Brazilian Hospital

Background: Although laparoscopic gastrectomy is becoming more popular as a curative therapy for gastric cancer, there are concerns about its oncological adequacy. We have compared the outcomes of laparoscopic total gastrectomy (LTG) and laparoscopic subtotal gastrectomy (LSG), both with modified D2 lymphadenectomies for the treatment of advanced gastric cancers. Aim: To compare the outcomes of laparoscopic (total and subtotal) gastrectomy with modified D2 lymphadenectomy for the treatment of gastric cancer, contributing to the literature regarding the overall survival of these patients and postoperative complications. Methods: From 1993 to 2014, 239 patients were operated on laparoscopic gastrectomy at our department. The routinely laparoscopic gastrectomy was performed in all patients with gastric cancer including those presenting with obstruction and bleeding. Data could be collected, on a retrospective way, from 2006 to 2014, from the medical records of 103 patients who underwent LSG (n = 72) or LTG (n = 31). We excluded patients with metastatic disease and those who could not have a complete tumor resection. Results: Most patients were in advanced stages of cancer. Adenocarcinoma was the most common find, with 43% of cases in stage IIA and 31% in stage IIIB. Intracorporeal Roux-en-Y or Billroth II anastomoses were employed. Postoperative complications, for LSG and LTG, were 18% and 35.4%;mortality rate, during hospital stay, was 4.9% and 7.7%;three-year survival rate, 53.1% and 59.3%;and five-year survival rate, 46.9% and 40.7%. Mean hospital stay was 7.08 days, being significantly lower in LSG group (p < 0.05). Hospital acquired pneumonia was the most prevalent clinical complication, while deaths arising from surgical complications were caused mainly by gastro-jejunal or esophago-jejunal anastomosis leaks. Conclusions: Both LSG and LTG with modified D2 lymphadenectomy are feasible alternatives to open surgery and survival rates were comparable. The increased risk of complications observed in LTG did not influence the overall mortality rate. We hope that these findings should contribute to improve the acceptance of laparoscopic gastrectomy as a safe procedure for gastric cancer treatment.

Physical Accessibility for Disabled People: Analysis of Toilet Facilities in Primary Health Care Units

Background: Accessibility enables the effective participation of disabled persons in public and private areas and the use of urban equipment and street furniture. Objective: This study aimed to analyze the physical accessibility of toilet facilities in urban and rural primary health care units. Methods: It was a quantitative descriptive study conducted in 157 Primary Health Care Units of 16 municipalities in the Baturité Massif region, Ceará, Brazil. The study took place from August 2014 to May 2015, with a checklist type form, designed from the Technical Standard 9050 of the Brazilian National Standards Organization, specifying the ideal access conditions established by law to allow mobility of persons with physical disabilities. Data were processed through the Statistical Package for the Social Sciences software and organized into tables. Results: Toilets designed for physically disabled people were accessible as the location and signs (59.9%), identified with symbols for males and females (57.3%);however, the doorway width was smaller than needed to accommodate a wheelchair (77.7%). Inside the bathroom, only the forward approach was possible (59.9%). Grab bars positioned on the side and rear walls were inadequate or nonexistent (67.6%);toilet seats (91.1%) and toilet paper dispensers (96.2%) were mostly in inaccessible heights;flush controls in appropriate height (59.2%) and activated by light pressure (58%). Sinks without pedestal (51%), but higher than recommended (80.3%) and without single handle faucets (95.6%). It was verified that the toilets of basic health units located in urban areas had better accessibility conditions compared to those in rural areas. Conclusion: Results showed that the analyzed units presented physical inaccessibility in some toilet facilities, making it difficult or even impossible the accessibility for the disabled. The inclusion of accessibility features in health services for this clientele provides equal opportunities and social inclusion.

Epidemiological Profile of Breast Neoplasia in the Municipality of Valença (RJ Brazil): Study from 2009 to 2017

Breast neoplasms are the main oncological pathology in Gynecology and Obstetrics, with increasing rates of incidence and mortality in the female population. According to the World Health Organization (WHO), more than 1 million new cases of breast cancer are diagnosed worldwide every year. This study aims to understand and analyze the epidemiological profile of patients diagnosed with breast cancer in the last nine years in the city of Valença—RJ, Brazil. A descriptive, documentary-retrospective analysis was carried out from January 2009 to December 2017, on 96 records of women who underwent breast biopsy at the Escola Escola de Valença (HEV), referred by the HEV Gynecology outpatient clinic. The results compared the variables age, race, parity, alcoholism, smoking, comorbidities, histological type, family history and screening performed with the scenario of breast cancer in the world, concluding that it is essential to identify patients at risk development of breast cancer to guide prevention, screening and early detection of pathology. The cases in the municipality are similar to other studies in relation to smoking, alcohol consumption, associated comorbidities, histological type and family history. However, the prevalence in younger people stands out, as well as the high percentage of women who have not had previous screening, which highlights the importance of the development and spread of women’s health in this city in the south of the state.

Splenectomy in Patient with Splendid Cysts

Introduction: Splenic cysts are uncommon and usually do not generate signs and symptoms, being diagnosed by incidental findings. Case report: A 35-year-old, female patient attended the Luiz Gioseffi Jannuzzi School Hospital (HELGJ) presenting episodes of vomiting and abdominal pain in the left hypochondrium. She was hospitalized for diagnostic investigation. Computed tomography showed the splenic cyst. The procedure was the surgical approach by laparotomy with splenectomy. Histopathological confirmed the diagnosis. Discussion: Compared to the scarce reports in literature, the case described presented typical epidemiology and clinical features. Conclusions: Given the rarity of this pathology cases, it is essential to report these in order to elucidate the specificities and also to discuss diagnostic and therapeutic methods.

Effects of Ketoprofen, Ketamine, Lidocaine and Propofol on Fentanyl-Induced Hyperalgesia in Rats

Opioid-induced hyperalgesia negatively affects physiological pain management and presents a complex causal mechanism, involving, pharmacodynamic and pharmacokinetic factors of interactions with receptors, opioid-independent ascending systems and with pro-nociceptive systems. After approval by the CEUA, 42 male Wistar rats were divided into 7 groups: In group 1 (GCSSL) the animals received 1 ml of 0.9% saline solution intraperitoneally (IP);in group 2 (GFTSL), they received fentanyl at a dose of 100 ug·kg-1 IP;in the remaining groups (3, 4, 5, 6 and 7) the animals received IP, fentanyl at a dose of 100 ug·kg-1 followed also by IP route of: group 3 (GFTKP) ketoprofen at a dose of 5 mg·kg-1;group 4 GFTKT), ketamine up to a dose of 10.0 mg·kg-1;group 5 (GFTLI), incisional lidocaine up to a dose of 10 mg·kg-1;group 6 (GFTLP), intraperitoneal lidocaine up to a dose of 10 mg·kg-1 and group 7 (GFTPP), propofol up to a dose of 60 mg·kg-1. Under general anesthesia, all animals with a plantar surgical incision. Hyperalgesia was evaluated by applying Von Frey filaments on the 2nd, 1st, 3rd and 5th days after treatment. In the 2nd hour and on the 5th day after the procedure, there was no hyperalgesia associated with the use of fentanyl, however, on the 1st and 3rd postoperative days there was hyperalgesia that was attenuated by ketoprofen, ketamine, lidocaine infiltrated in the incision and intraperitoneally, an effect not observed with the use of propofol. The results suggest fentanyl-induced hyperalgesia and the efficacy of ketoprofen, ketamine, incisional lidocaine and intraperitoneal lidocaine in reducing this effect.

Regular Elements of BX (D) Defined by the Class ∑1(X,10)-Ⅱ

This part of the paper is the continuotion of paper “Regular Elements of BX (D) Defined by the Class ∑1(X,10)-Ⅰ”.

Regular Elements of Bx(D) Defined by the Class ∑1(X,10)-I

In order to obtain some results in the theory of semigroups, the concept of regularity, introduced by J. V. Neumann for elements of rings, is useful. In this work, all regular elements of semigroup defined by semilattices of the class ∑1(X,10)-I are studied. When X has finitely many elements, we have given the number of regular elements.

Investment in Generation of Photovoltaic Solar Energy: A Fezsibility Study with Flexibility and Uncertainty

The objective of this research will be to calculate the feasibility of investing in a solar energy generation project through the development of a methodology that allows the capture of environmental uncertainties by improving decision making. The article presents a comparative study of the feasibility analysis of investment in a solar mini solar energy for a Shopping, considering a regime of certainty and uncertainty. The assumed stochastic variables were energy tariff and price of solar panels. The trajectories were simulated with the binomial approach that combined resulted in a quadratic diagram. The applied methodology presented the best recommendation and the option to wait was the most valuable. The exchange of the energy obtained from LIGHT by own generation of energy with solar photovoltaic source will be viable for the manager since it observes the behavior of the variables over time and follows the rules of optimal decision.

Occurrence of Delirium and Length of Stay of Patients in the Intensive Care Unit

Introduction: The delirium has received little attention from professionals working in the intensive care unit, mainly due to the fact that this is, rarely, the primary reason for patient admission. Given the high prevalence of delirium in an intensive care environment, the current guidelines recommend the daily assessment of delirium and a multidisciplinary approach. Delirium is a frequent and severe form of acute brain dysfunction, as well as an important source of concern in critical care. Objective: To assess the occurrence of delirium and time of stay in the intensive care unit. Method: This is a quantitative, descriptive study, with a cross-sectional design, which was carried out in a university hospital located in the interior of the State of Rio de Janeiro. The sample consisted of 89 patients, of both sexes, aged between 24 and 92 years. The RASS and CAM-ICU scales were used to assess delirium. The data were collected every 12 hours, for 3 months, 7 days a week and in an uninterrupted manner. Results: Were evaluated 89 patients, of which 16 were excluded according to the scale criteria, leaving 73 patients. After evaluation, 22 patients were diagnosed with delirium and 51 patients without delirium. Of the patients who presented delirium, 13 deaths and 9 had high to the nursery. Of the patients who did not have delirium, 40 had high to the nursery and 11 deaths. Patients with delirium had an average hospital stay of 23.25 days and patients who did not have delirium had an average of 4.5 days hospitalization. Conclusion: We can infer that the longer the patient spends in the intensive care unit, the greater the chance of delirium occurring. Therefore, preventive and interventional measures are necessary to decrease the mortality rate in patients with delirium and early detection is an excellent tool to improve this outcome.

Subcutaneous Model for the Study of Dengue Virus Infection in Immune Competent Mice

Various mouse models to study dengue have been described by different authors, some of them using immunodeficient or some using humanized mice. Our group reported previously a deadly murine model, which used the intracranial inoculum of highly virulent Dengue virus (DENV) in immune competent mouse. Here we present a model of immune competent mouse (C57BL/6), infected subcutaneously by the same highly virulent DENV (DENV3 genotype I). In this immunocompetent systemic mice model, the cytokine levels and hematological parameters such as total and differential leukocyte and platelets counts, together with weight loss, were considered important monitoring parameters, allowing a better understanding of the systemic human disease. Mice were inoculated subcutaneously and evaluated by the percentage weight variation as well as the clinical signs. Hematological parameters and cytokines levels were measured and viral titration in brain tissue or serum neutralization was performed to confirm mice infection. The subcutaneously DENV inoculated mice showed weight loss after infection, but they did not show any other clinical signs. The leukocytes and platelets decreased after subcutaneous inoculation. The cytokines TNF alpha and IFN gamma increased after infection in mice. The subcutaneous model provided scope for improved understanding of the dengue pathogenesis, as well as possible mechanism for protection to subsequent mouse infected by intracranial route in mice. This model could be used to study the vertebrate immune response and evaluation of drugs or vaccine against dengue virus.

Medical School Students’ Knowledge of Pain and Palliative Care: An Observational Study

Background: Pain and palliative care are a reality in daily routines of medical treatment. However, the theoretical-practical curricula of traditional medical school course still unsatisfactorily contemplate pain management, as well as the palliative care approach. Objective: To assess the knowledge of medical students about pain and palliative care, as well as to identify their perception of teaching these topics during hospitalization. Methods: A cross-sectional observational study, with a descriptive and exploratory approach, data collection for which was carried out between August and November 2020. The target population was medical students, who responded to an online survey of a quantitative, anonymous and follow-up nature. The survey study variables concerned knowledge about pain management and palliative care. Results: An expressive majority of academics showed difficulty in understanding the pathophysiology of pain related to prescribing drugs for pain management purposes, and all of them believe that it is necessary to acquire more knowledge about pain treatment. In parallel, only 9.3% report having received sufficient information regarding palliative care during medical school. Conclusion: The results suggest a certain lack of knowledge and insecurity among medical school students with respect to pain management and care for patients receiving palliative care. The didactical approach to this theme is still deficient in the medical curriculum and requires immediate improvement and new proposals that address the training of these professionals in a more specific and effective way.

Innate Immune Response in Human Kidney Transplantation: IRF3 and IRF7 Together with Interferon-Alpha Are Significantly Up-Regulated in Acute Rejection

Background: Ischemia-reperfusion injury of organ transplantation activates several mediators which may link the innate to the adaptive immune response. Down the cascade of TLRs, we selected to study the expression of Interferon Regulatory Factors (IRF)-3 and -7 inside human Kidney Transplanted (KTx) organs and the synthesis of IFNα, the main growth factor induced by them, in KTx aspiration biopsy cultures. Simultaneously, we tested their robustness in diagnosing Acute Rejection (AR). Methods: Fine-needle aspiration biopsies (F-nab) were performed either on day 7 or 14 post-KTx among stable patients or on the day of AR diagnosis. On Fnab cytopreparations, we studied IRF3 and IRF7 by the enzymatic avidin-biotin complex staining, and in a different group of cases we quantified IFNα by ELISA in 48 hours Fnab culture supernatants. Results: AR group showed a significantly up-regulated expression for IRF3 and IRF7, reaching Positive Predictive Values (PPV) of 0.824 and 0.8, respectively, as well as Negative Predictive Values (NPV) above 0.9 for both;IFNα presented a PPV = 1.0 and a NPV = 0.9. A variation in the results was noticed according to different immunosuppressive therapies. Conclusions: Our findings suggest that IRF3 and IRF7, and IFNα which they promote, may be very important players in the early days post-KTx, linking the innate with an adaptive response and triggering acute rejection. These differences were very clear-cut, lending consistency to our speculation. It would be important to scrutinize for other potential effects derived from these IRFs up-regulation which could be of clinical relevance.

Approach to Pain in Endometriosis Patients: Systematic Literature Review

Background: Endometriosis is a gynecological, multifactorial condition that affects women’s life quality, especially due to the pain inherent to it. Pain is caused by physical and psychological aspects;therefore, several factors must be analyzed, aiming to treat the whole. Conventional, drug or surgical treatments are the most used;however, the search for alternative therapeutic methods is growing. Objective: To analyze the approach to pain in women with endometriosis, seeking a better understanding of the pathophysiological mechanisms of this disease, its impact on life quality, as well as the means of treatments in use and innovations in this field. Methods: Systematic literature review, conducted in the Virtual Health Library databases between 2010 and 2021, restricted to articles in English and Portuguese with the descriptors: Endometriosis, Pain, and Treatment. After reading the abstracts, 197 articles were found, and, after reading them, 59 articles were selected. Results: This review analyzed 59 scientific studies that rigorously met the previously established characteristics in the sample selection. The synthesis included the following aspects: author/year of publication, article title, objective, type of study and database. Related factors such as acute or chronic pain, late diagnosis, discrediting symptomatic complaints and trivialization by health professionals have a profound impact on the physical and mental health of women with endometriosis. On the other hand, there are several classes of drugs, surgical procedures, and alternative therapies available for pain management. Conclusion: Given the context addressed, a certain need is suggested for health professionals to better understand the disease and adopt new behaviors or improve existing ones, such as reception, active listening, early diagnosis and comprehensive and individualized treatment. In addition, further studies are needed regarding alternative therapies, seeking to expand the scientific evidence of their benefits.

Myocardial Perfusion Abnormalities in Patients with Hereditary Hypertrophic Cardiomyopathy: A Study of Three Cases and Review of the Literature

Introduction: Hypertrophic cardiomyopathy (HCM) belongs to the very heterogeneous group of cardiomyopathies. This study aimed to study myocardial perfusion abnormalities on scintigraphy and assess the risk of sudden death from ventricular arrhythmia in hereditary sarcomeric HCM. Patients and Methods: This is a retrospective and prospective descriptive study over 18 months (January 01, 2021, to July 31, 2022) on the records of patients over 18 with the diagnosis of hypertrophic sarcomeric cardiomyopathy with or without ventricular rhythm disorders and who have undergone myocardial scintigraphy. Results: Three patients were included. The average age of our patients was 66 years old. Dyspnea is the primary symptomatology found in our patients. One patient presented with syncope and unsustained ventricular tachycardia. His risk score for sudden death from ESC at five years is estimated at 6.45%, and the patient received an ICD in primary prevention. The average sudden death risk score of our patients was 3.78%. The mean LV wall thickness was 20 mm. The mean maximum left intraventricular gradient was 39 mmHg. Myocardial fibrosis was present in all our patients. Myocardial scintigraphy was normal in all cases. Conclusion: Hypertrophic cardiomyopathy is a very heterogeneous group of cardiomyopathies. The rhythmic risk is multifactorial and constitutes a significant prognostic factor.

Synthesis, Characterization of Ruthenium Compounds and Studies of Biological Effects in MCF-7 Tumors Cell Lines

This work presents the synthesis and characterization of compounds derived from the ruthenium transition metal with the nitrogenous ligand 4-aminopy- ridine (4-ampy). The synthesized compounds were characterized by FTIRmed spectroscopy and TG-DTA thermal analysis. For the cytotoxic evaluation of ruthenium compounds, a 66.0 μM aqueous solution containing the complex and the study of data observed in the biological assessment was performed using variance (ANOVA) analysis, followed by Tukey’s multiple comparisons test. Differences between treatments were considered significant when the p-value was less than 0.05 (p < 0.05). TG/DSC thermal analysis for the first complex suggests a stoichiometry of [Ru(Cl)3(4-ampy)(H2O)2]·1/2H2O, which, due to the low solubility in an aqueous medium, was modified to increase its solubility for biological tests. The analysis of the spectra in the medium infrared region (FTIR) for the complex [Ru(Cl)3(4-ampy)(H2O)2]·1/2H2O, shows displacements of the bands observed at 1625 - 1566 cm﹣1 ν(C=C) e (C=N), indicating that coordination to the metallic center occurred by this group. Band displacements were observed in the modified Ru (III) complex, which suggests the presence of the 4-ampy ligand and the coordination by the groups ν(C=C) and (C=N) after the modification. In recent years, researchers worldwide have concentrated on obtaining, developing, and modifying drugs used as chemotherapeutic agents. The evaluation of the cell viability of the modified Ru (III) compound demonstrated cytotoxic effects in the MCF-7 cell line (15.33% ± DP 2.7) but did not affect normal cells (PBMC), which reflects the potential for possible applications.