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ABSTRACT Introduction: Wrestling is an ancient combat sport, individual and of complex performance, which integrates high technical and tactical complexity, associated with a bioenergetic interaction and a high coordinative pattern. In Brazil, the number of competitors at different levels has increased significantly in the last years, evidencing the need to search for answers that can help coaches in the different situations of the competitive calendar. The prescription of the means and methods of training in Greco-Roman wrestling aims at the development of the technical effectiveness. However, there is no evidence of indicators of technical effectiveness, in Brazilian elite athletes of Greco-Roman wrestling, in national and international competitions. Objectives: The objective of the study was to verify and to compare the technical effectiveness of the wrestlers of Greco-Roman fight of the Brazilian selection, in two competitions: one in the national level and the other international. Methods: Seven athletes of the Brazilian wrestling team participated of the investigation (age: 25±5 years; stature: 175±12 cm; corporal mass: 80± 21kg). Analysis of the effective, not effective and total technique were accomplished. After identifying the normality of the data (SHAPIRO WILKS), the Student's t test was used to compare the variables, according to the moment evaluated, considering the significance level of 5%. Results: The results showed a significant decrease (p = 0.03) in the standing effective technique and in the total effective technique (p = 0.01), comparing the national competition with the international competition. Conclusion: Technical effectiveness of Brazilian wrestlers was found to be below the indices presented in studies with competitors from countries considered to have high world performance. In international competition, it presents a negative impact compared to national events. Level of Evidence IV; Therapeutic Studies - Investigation of Treatment Results.

RESUMEN Introducción: El Wrestling es una modalidad de combate milenaria, individual y de rendimiento complejo, que integra elevada complejidad técnico-táctica, asociada a una interacción bioenergética y un alto patrón coordinativo. En Brasil, el número de competidores en diferentes niveles aumentó significativamente en los últimos años, evidenciando la necesidad en la búsqueda de respuestas que auxilien a los entrenadores en las diferentes situaciones del calendario competitivo. La prescripción de los medios y métodos de entrenamiento en la lucha greco-romana tiene como objetivo el desarrollo de la efectividad técnica. Entre tanto, no hay evidencias de indicadores de efectividad técnica, en atletas de alto rendimiento brasileño en la lucha greco-romana, en competencias nacionales e internacionales. Objetivos: El objetivo de este estudio fue verificar y comparar la efectividad técnica de los atletas de lucha greco-romana de la selección brasileña, en dos competencias: una a nivel nacional y otra internacional. Métodos: Participaron de la investigación siete atletas de la selección brasileña de lucha greco-romana (edad: 25±5 años; estatura: 175±12 cm; masa corporal: 80± 21kg). Fueron realizados análisis de la técnica efectiva, no efectiva y total. Después de identificar la normalidad de los datos (SHAPIRO WILKS), fue utilizado el test de t de Student para la comparación de las variables, según el momento evaluado, considerando el nivel de significación de 5%. Resultados: Los resultados mostraron una disminución significativa (p = 0,03) en la técnica efectiva en pie y en la técnica efectiva total (p = 0,01), comparándose la competencia nacional con la internacional. Conclusión: Se concluyó que la eficacia técnica de los luchadores brasileños está por debajo de los índices presentados en estudios con competidores de países considerados de alto rendimiento mundial. En la competición internacional, presenta un impacto negativo en comparación con los eventos nacionales. Nivel de Evidencia IV; Estudios Terapéuticos - Investigación de Los Resultados Del Tratamiento.

RESUMO Introdução: O Wrestling é uma modalidade de combate milenar, individual e de rendimento complexo, que integra elevada complexidade técnico-táctica, associada a uma interação bioenergética e um alto padrão coordenativo. No Brasil, o número de competidores em diferentes níveis aumentou significativamente nos últimos anos, evidenciando a necessidade da busca de respostas que auxiliem os treinadores nas diferentes situações do calendário competitivo. A prescrição dos meios e métodos de treinamento na luta greco-romana visa o desenvolvimento da efetividade técnica. Entretanto, não há evidências de indicadores de efetividade técnica, em atletas de elite brasileira de luta greco-romana, em competições nacionais e internacionais. Objetivo: o objetivo do estudo foi verificar e comparar a efetividade técnica dos lutadores de luta greco-romana da seleção brasileira, em duas competições: uma no nível nacional e a outra internacional. Métodos: Participaram da investigação sete atletas da seleção brasileira de luta greco-romana (idade: 25±5 anos; estatura: 175±12 cm; massa corporal: 80± 21kg). Foram realizadas análises da técnica efetiva, não efetiva e total. Após identificar a normalidade dos dados (SHAPIRO WILKS), foi utilizado o teste t de Student para a comparação das variáveis, segundo o momento avaliado, considerando nível de significância de 5%. Resultados: Os resultados mostraram uma diminuição significativa (p = 0,03) na técnica efetiva em pé e na técnica efetiva total (p = 0,01), comparando-se a competição nacional com a internacional. Conclusão: Concluiu-se que a efetividade técnica dos lutadores brasileiros está abaixo dos índices apresentados em estudos com competidores de países considerados de alto desempenho mundial. Em competição internacional, apresenta um impacto negativo comparativamente a eventos nacionais. Nível de Evidência IV; Estudos Terapêuticos - Investigação dos Resultados do Tratamento.

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This study was conducted to characterize the transmission cycle of the tegumentary leishmaniasis (TL) in an old colonization area at Pernambuco State, Brazil. The aims were to identify autochthonous cases, sandflies fauna, domestic animals as possible reservoir hosts and the Leishmania species involved in this endemic area. A total of 168 suspected human cases of TL and 272 domestic animals (canine, feline, equine, goat, and sheep) were included. The sandflies were captured and identified by species. Patients were predominantly male and the average age was 37+18.1 years old. Of 85 patients who had skin lesions, 25.6% of them had direct positive smears for TL and 34 isolates were identified as Leishmania (Viannia) braziliensis. The confirmation for TL diagnosed by molecular detection (PCR) was almost three times more sensitive than the direct test [p < 0.001; PR = 2.72] associated with clinical examination. The Kappa test on PCR between two different specimens, biopsy, and skin lesion swab was 60.8% (p < 0.001). More than 200 specimens of sandflies (80 males and 159 females) were captured and identified as Lutzomyia whitmani (99.6%) and Lu. evandroi (0.4%). The detection of L. (V.) braziliensis by Real-Time PCR in the blood of a captured fed female was positive in 59.3% of Lu. whitmani. Of the 272 domestic animals included, 61.76% were male (n = 168). Thirty-six animals (13.2%) had lesions compatible with TL (34 dogs, 1 cat and 1 sheep) and 3 of them, all dogs, had lesions on the snout, showing destruction of cartilage and mucosa. The study suggests the participation of domestic animals as possible reservoirs. However, further studies are necessary to better understand the transmission cycle and take recommended measures in order to control the disease.

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ABSTRACT BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed considerable psychological stress on frontline healthcare workers (HCWs). OBJECTIVE: To evaluate the prevalence of burnout syndrome among HCWs facing the COVID-19 outbreak. DESIGN AND SETTING: Cross-sectional study conducted in six public intensive care units (ICUs) in the city of Fortaleza, Brazil. METHODS: An online survey was conducted among HCWs to measure the three dimensions of burnout. RESULTS: A total of 62 physicians (23.4%), 65 nurses (24.5%), 58 nurse technologists (21.9%) and 80 physiotherapists (30.2%) completed the questionnaire. Nearly half of the participants (48.6%) had high levels of emotional exhaustion, and almost one-third of them (29.4%) had high levels of depersonalization. Low levels of professional efficacy were observed in 18.1% of the sample. The independent determinants of depersonalization burnout were age < 33 years (odds ratio, OR 2.03; 95% confidence interval, CI 1.15-3.56; P = 0.01) and female gender (OR 0.33; 95% CI 0.18-0.62; P = 0.01). Increased workload was associated with both depersonalization (OR 2.37; 95% CI 2.02-5.50; P = 0.04) and emotional exhaustion (OR 1.89; 95% CI 1.04-3.58; P = 0.030). CONCLUSION: The COVID-19 pandemic has had a great impact on the dimensions of depersonalization and emotional exhaustion. Consideration of these dimensions is important when designing future burnout prevention programs for frontline personnel.

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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed considerable psychological stress on frontline healthcare workers (HCWs). OBJECTIVE: To evaluate the prevalence of burnout syndrome among HCWs facing the COVID-19 outbreak. DESIGN AND SETTING: Cross-sectional study conducted in six public intensive care units (ICUs) in the city of Fortaleza, Brazil. METHODS: An online survey was conducted among HCWs to measure the three dimensions of burnout. RESULTS: A total of 62 physicians (23.4%), 65 nurses (24.5%), 58 nurse technologists (21.9%) and 80 physiotherapists (30.2%) completed the questionnaire. Nearly half of the participants (48.6%) had high levels of emotional exhaustion, and almost one-third of them (29.4%) had high levels of depersonalization. Low levels of professional efficacy were observed in 18.1% of the sample. The independent determinants of depersonalization burnout were age < 33 years (odds ratio, OR 2.03; 95% confidence interval, CI 1.15-3.56; P = 0.01) and female gender (OR 0.33; 95% CI 0.18-0.62; P = 0.01). Increased workload was associated with both depersonalization (OR 2.37; 95% CI 2.02-5.50; P = 0.04) and emotional exhaustion (OR 1.89; 95% CI 1.04-3.58; P = 0.030). CONCLUSION: The COVID-19 pandemic has had a great impact on the dimensions of depersonalization and emotional exhaustion. Consideration of these dimensions is important when designing future burnout prevention programs for frontline personnel.

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ABSTRACT This study was conducted to characterize the transmission cycle of the tegumentary leishmaniasis (TL) in an old colonization area at Pernambuco State, Brazil. The aims were to identify autochthonous cases, sandflies fauna, domestic animals as possible reservoir hosts and the Leishmania species involved in this endemic area. A total of 168 suspected human cases of TL and 272 domestic animals (canine, feline, equine, goat, and sheep) were included. The sandflies were captured and identified by species. Patients were predominantly male and the average age was 37+18.1 years old. Of 85 patients who had skin lesions, 25.6% of them had direct positive smears for TL and 34 isolates were identified as Leishmania (Viannia) braziliensis. The confirmation for TL diagnosed by molecular detection (PCR) was almost three times more sensitive than the direct test [p < 0.001; PR = 2.72] associated with clinical examination. The Kappa test on PCR between two different specimens, biopsy, and skin lesion swab was 60.8% (p < 0.001). More than 200 specimens of sandflies (80 males and 159 females) were captured and identified as Lutzomyia whitmani (99.6%) and Lu. evandroi (0.4%). The detection of L. (V.) braziliensis by Real-Time PCR in the blood of a captured fed female was positive in 59.3% of Lu. whitmani. Of the 272 domestic animals included, 61.76% were male (n = 168). Thirty-six animals (13.2%) had lesions compatible with TL (34 dogs, 1 cat and 1 sheep) and 3 of them, all dogs, had lesions on the snout, showing destruction of cartilage and mucosa. The study suggests the participation of domestic animals as possible reservoirs. However, further studies are necessary to better understand the transmission cycle and take recommended measures in order to control the disease.

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Objetivo: avaliar a produção científica sobre o cuidado do enfermeiro em saúde mental na estratégia de saúde da família a partir da implantação do apoio matricial, bem como identificar os desafios ao cuidar em enfermagem nesse setor. Método: Trata-se de uma revisão narrativa da literatura, realizada em novembro de 2020 nas bases de dados: Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Biblioteca Virtual em Saúde, bem como documentos do Ministério da Saúde. Os materiais foram buscados por meio da seguinte estrutura: Saúde Mental; Apoio Matricial; Capacitação de Enfermeiros; Saúde da Família. Incluíram-se artigos da língua portuguesa, nos períodos de 2007 a 2018. Excluíram-se artigos com mais de 15 anos de publicação tendo em vista a atualidade do tema. Resultados: 11 artigos científicos compuseram a amostra da pesquisa. Embora os profissionais enfermeiros tenham reportado estarem preparados para lidar com seus pacientes e conhecerem os principais transtornos, poucos foram capazes de detalhar esses conhecimentos. As capacitações e cursos de residência foram citados como estratégia de preparação, mas a insegurança e tempo disposto para lidar com esses pacientes foram impasses para a qualidade do cuidado prestado. Conclusão: é necessária maior preparação dos enfermeiros na área de saúde mental a fim de se proporcionar um atendimento resolutivo aos pacientes. Os envolvidos reconhecem que a necessidade da auto avaliação dos apoiadores matriciais e enfermeiros, enfatizam o (re) pensamento das práticas instituídas nas políticas públicas e gestão da estratégia matricial de apoio para a saúde mental.

Objective: to assess the scientific production on mental health nurse care in the family health strategy from the implementation of matrix support, as well as to identify the challenges in nursing care in this sector. Method: This is a narrative review of the literature, carried out in November 2020 in the databases: Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences and Virtual Health Library, as well as documents from the Ministry of Health. Health. The materials were sought through the following structure: Mental Health; Matrix Support; Training of Nurses; Family Health. Articles from the Portuguese language were included in the periods from 2007 to 2018. Articles with more than 15 years of publication were excluded in view of the current nature of the topic. Results: 11 scientific articles comprised the research sample. Although professional nurses reported being prepared to deal with their patients and knowing the main disorders, few were able to detail this knowledge. The training and residency courses were cited as a preparation strategy, but the insecurity and time available to deal with these patients were impasses for the quality of care provided. Conclusion: greater preparation of nurses in the mental health area is necessary in order to provide resolutive care to patients. Those involved recognize that the need for self-assessment by matrix supporters and nurses, emphasizes the (re) thinking of the practices instituted in public policies and management of the matrix support strategy for mental health

Objetivo: evaluar la producción científica sobre la atención de enfermería en salud mental en la estrategia de salud de la familia a partir de la implementación de la matriz de soporte, así como identificar los desafíos en la atención de enfermería en este sector. Método: Se trata de una revisión narrativa de la literatura, realizada en noviembre de 2020 en las bases de datos: Biblioteca Científica Electrónica en Línea, Literatura Latinoamericana y del Caribe en Ciencias de la Salud y Biblioteca Virtual en Salud, así como documentos del Ministerio de Salud. Salud Los materiales se buscaron a través de la siguiente estructura: Salud Mental; Soporte de matriz; Formación de enfermeras; Salud familiar. Los artículos en lengua portuguesa se incluyeron en los períodos 2007 a 2018. Se excluyeron los artículos con más de 15 años de publicación debido a la naturaleza actual del tema. Resultados: 11 artículos científicos conformaron la muestra de investigación. Aunque las enfermeras profesionales informaron estar preparadas para tratar con sus pacientes y conocer los principales trastornos, pocas pudieron detallar este conocimiento. Los cursos de capacitación y residencia fueron citados como una estrategia de preparación, pero la inseguridad y el tiempo disponible para atender a estos pacientes fueron un callejón sin salida para la calidad de la atención brindada. Conclusión: es necesaria una mayor preparación del personal de enfermería en el área de salud mental para brindar atención resolutiva a los pacientes. Los involucrados reconocen que la necesidad de autoevaluación por parte de los apoyadores de la matriz y las enfermeras, enfatiza el (re) pensamiento de las prácticas instituidas en las políticas públicas y la gestión de la estrategia de soporte de la matriz para la salud mental.

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Dietary restriction and reduced reproduction have been linked to long lifespans in the vast majority of species tested. Although decreased mitochondrial mass and/or function are hallmarks of aging, little is known about the mechanisms by which these organelles contribute to physiological aging or to the effects of lifespan-extending interventions, particularly with respect to oxidative phosphorylation and energy production. Here, we employed the nematode Caenorhabditis elegans to examine the effects of inhibition of germline proliferation and dietary restriction, both of which extend the lifespan of C. elegans, on mitochondrial respiratory activity in whole animals and isolated organelles. We found that oxygen consumption rates and mitochondrial mass were reduced in wild-type (WT) C. elegans subjected to bacterial deprivation (BD) compared with animals fed ad libitum (AL). In contrast, BD decreased the rate of oxygen uptake but not mitochondrial mass in germline-less glp-1(e2144ts) mutants. Interestingly, mitochondria isolated from animals subjected to BD and/or inhibition of germline proliferation showed no differences in complex I-mediated respiratory activity compared to control mitochondria, whereas both interventions enhanced the efficiency with which mitochondria utilized lipids as respiratory substrates. Notably, the combination of BD and inhibition of germline proliferation further increased mitochondrial lipid oxidation compared to either intervention alone. We also detected a striking correlation between lifespan extension in response to BD and/or inhibition of germline proliferation and the capacity of C. elegans to generate ATP from lipids. Our results thus suggest that the ability to oxidize lipids may be determinant in enhanced longevity.

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The C. elegans lipase-like 5 (lipl-5) gene is predicted to code for a lipase homologous to the human gastric acid lipase. Its expression was previously shown to be modulated by nutritional or immune cues, but nothing is known about its impact on the lipid landscape and ensuing functional consequences. In the present work, we used mutants lacking LIPL-5 protein and found that lipl-5 is important for normal lipidome composition as well as its remodeling in response to food deprivation. Particularly, lipids with signaling functions such as ceramides and mitochondrial lipids were affected by lipl-5 silencing. In comparison with wild type worms, animals lacking LIPL-5 were enriched in cardiolipins linked to polyunsaturated C20 fatty acids and coenzyme Q-9. Differences in mitochondrial lipid composition were accompanied by differences in mitochondrial activity as mitochondria from well-fed lipl-5 mutants were significantly more able to oxidize respiratory substrates when compared with mitochondria from well-fed wild type worms. Strikingly, starvation elicited important changes in mitochondrial activity in wild type worms, but not in lipl-5 worms. This indicates that this lipase is a determinant of mitochondrial functional remodeling in response to food withdrawal.

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Pulmonary sequestration is a congenital anomaly defined as a nonfunctioning mass of lung parenchyma. Presence of an independent pleural envelope classifies it as intralobar, accounting for approximately 75% of the cases, while absence classifies cases as extralobar, accounting for the remaining 25%. Diagnosis is made through radiography and confirmed by computed tomography, magnetic resonance, or angiography. The traditional treatment is open surgical repair, but endovascular techniques have been used, with good results. We report the case of a 29-year-old-woman presenting with recurrent pneumonia for 5 years. A CT scan of the chest revealed poor vascular formation in the lower region of the right lung. The pulmonary sequestration was treated by embolization of the anomalous branch.