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Objetivo: Determinar la prevalencia y factores de riesgo asociados a la infección por virus SARS-CoV-2 en trabajadores del Instituto Nacional de Salud del Niño (INSN), en el periodo de abril 2020 a marzo 2021. Materiales y métodos: Estudio no experimental, descriptivo, transversal. La muestra corresponde a 608 trabajadores de salud que resultaron positivos a la prueba serológica rápida. Se revisaron las fichas de investigación clínica epidemiológica COVID-19 elaboradas por el Ministerio de Salud de Perú, que fueron autoadministradas por los trabajadores de salud, y el personal de Epidemiología del INSN verificó el llenado de la ficha. Los datos se introdujeron en una base de datos que sirvió para el análisis estadístico respectivo. El estudio fue aprobado por el Comité Institucional de Ética en Investigación del INSN (código de registro: PI-17/21). Resultados: La prevalencia fue de 7,24 % de COVID-19 en trabajadores del INSN entre abril del 2020 y marzo del 2021. El 71,4 % fueron mujeres, los participantes presentaron una media de edad de 44,71 años, mayoritariamente en el rango de los 30 a 59 años (83,4 %); el 65,6 % fueron asistenciales, de los cuales la mayoría fueron técnicos en enfermería. El 56,9 % de los trabajadores presentaron síntomas, principalmente fiebre/escalofríos (12,2 %), tos (8,9 %), malestar general (7,7 %), dolor de garganta (6,7 %), congestión nasal (2,5 %) y cefalea (1,3 %) . La mayoría de trabajadores residían en los distritos de Lima . Se encontró asociación significativa por sexo y grupos de edad, tipo de trabajador y perfil del trabajador. Conclusiones: La prevalencia de COVID-19 entre los trabajadores del INSN fue del 7,24 %; las características más frecuentes que mostraron diferencias significativas con el resto de los factores fueron el ser mujer, trabajador asistencial y técnica de enfermería. El 56,9 % de los trabajadores presentó síntomas, solo el 20,9 %, signos clínicos y el 10,9 % tuvo comorbilidades.

Objective: To determine the prevalence and risk factors associated with SARS-CoV-2 infection among workers of Instituto Nacional de Salud del Niño (INSN) from April 2020 to March 2021. Materials and methods: A non-experimental, descriptive, cross-sectional study. The sample consisted of 608 workers who tested positive for COVID-19 using a rapid antigen test. The COVID-19 clinical-epidemiological research sheets prepared by the Ministry of Health of Peru and self-administered by the workers were reviewed. The INSN Department of Epidemiology staff verified the completion of the sheets. The data was entered into a database, which was used for the respective statistical analysis. The study was approved by the INSN Institutional Research Ethics Committee (registration code: PI-17/21). Results: COVID-19 prevalence among INSN workers was 7.24 % from April 2020 to March 2021. Out of the workers with COVID-19, 71.4 % were women; 83.4 % were in the 30 to 59 age range with an average age of 44.71 years; 65.6 % were healthcare workers, most of whom were nursing technicians; and 56.9 % experienced symptoms, mainly fever/chills (12.2 %), cough (8.9 %), malaise (7.7 %), sore throat (6.7 %), stuffy nose (2.5 %) and headache (1.3 %). Most workers lived in Lima Centro districts (33.2 %). A significant association between sex, age groups, worker type and worker profile was found. Conclusions: COVID-19 prevalence among INSN workers was 7.24 %; the most frequent characteristics, which showed significant differences with the rest of the factors, were being a woman, healthcare worker and nursing technician. A total of 56.9 % of the workers experienced symptoms, only 20.9 % developed clinical signs and 10.9 % had comorbidities.

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Importance: Adenopathy and extensive skin patch overlying plasmacytoma syndrome is a paraneoplastic syndrome characterized by a cutaneous vascular patch overlying a plasmacytoma and systemic manifestations. It is thought to be an early stage of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome, which is a rare, but potentially fatal multisystemic disease that is associated with plasma cell dyscrasia. Thus, a high index of suspicion is required to identify patients with adenopathy and extensive skin patch overlying plasmacytoma as they may present with early polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes, which is curable if detected early. Objective: To report additional cases of adenopathy and extensive skin patch overlying plasmacytoma syndrome, describe dermatoscopic and histologic findings of the cutaneous patch and review all up to date literature on adenopathy and extensive skin patch overlying plasmacytoma syndrome. Design: Case series from a single tertiary care center. Participants: Here, we present the second case series of three patients with adenopathy and extensive skin patch overlying plasmacytoma syndrome who all meet the diagnostic criteria for polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. The diagnosis was suspected based on the presence of the violaceous cutaneous patch along with symptoms of systemic involvement (fatigue, weight loss, weakness). Dermoscopy revealing regular dilated parallel capillaries was suggestive of a benign/reactive vascular process. Histopathology in all three cases showed reactive vascular proliferation with a characteristic 90° branching. To date only 20 cases of adenopathy and extensive skin patch overlying plasmacytoma have been published, including ours. All patients presented with cutaneous lesions (violaceous patch and others) and most, at least 15/20, met the diagnostic criteria for polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. When clinical follow-up was reported, most patients had a favorable prognosis with partial or complete symptom resolution following treatment of the underlying plasmocytoma.

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Resumen: Introducción: La caquexia es un síndrome asociado al cáncer avanzado, VIH, pacientes en quimioterapia y quienes tienen seguimiento en cuidados paliativos. La prevalencia es de 25% de los pacientes con diagnóstico de cáncer, 26% en quienes reciben quimioterapia y de 14 a 38% de pacientes con VIH. Un pilar para el manejo es el cannabis debido al efecto del delta-9-tetrahidrocanabinol (THC), del cual se derivó el dronabinol, un fármaco desarrollado para estimular apetito y ganancia de peso. El objetivo de esta revisión bibliográfica es obtener la información sobre los cannabinoides y la evidencia más sólida existente con respecto al uso del dronabinol en pacientes que han presentado pérdida de peso y apetito. Material y métodos: Revisión de la bibliografía con buscador PubMed con las palabras clave Palliative care (cuidados paliativos), Cannabinoids (cannabinoides), cachexia (caquexia), Dronabinol (dronabinol), Appetite (apetito), de 1990 a 2018, limitado a humanos, obteniendo 259 artículos, eliminando 222 por repetirse o tener poca relevancia, dejando 37 artículos para análisis. Resultados: De 37 artículos revisados, nueve fueron estudios experimentales, 10 revisiones sistematizadas, un metaanálisis y 16 artículos de recomendaciones y sugerencias de manejo. Conclusión: El manejo del apetito y pérdida de peso en pacientes en cuidados paliativos, VIH, ancianos o en quimioterapia debe ser multidisciplinario, involucrando nutriólogos, psicólogos y médicos, ajustando el manejo a las características individuales que manifiesten. El dronabinol es un fármaco de primera elección para el manejo de dichos síntomas cuando la historia natural de la enfermedad se acompaña de náusea, vómito o dolor.

Abstract: Introduction: Cachexia is a syndrome associated with advanced cancer, HIV, patients on chemotherapy and those who are followed in palliative care. The prevalence is 25% of patients diagnosed with cancer, 26% in those receiving chemotherapy and 14 to 38% of patients with HIV. A mainstay for management is cannabis, due to the effect of delta-9-tetrahydrocannabinol (THC) from which dronabinol, a drug developed to stimulate appetite and weight gain, was derived. The aim of this literature review is to obtain information on cannabinoids and the strongest existing evidence regarding the use of dronabinol in patients who have presented weight and appetite loss. Material and methods: Literature review with PubMed search engine with the keywords Palliative care, Cannabinoids, cachexia, Dronabinol, Appetite, from 1990 to 2018, limited to humans, obtaining 259 articles, eliminating 222 for repetition or low relevance, leaving 37 articles for analysis. Results: Out of 37 articles reviewed 9 were experimental studies, 10 systematized reviews, 1 meta-analysis and 16 articles of recommendations and management suggestions. Conclusion: The management of appetite and weight loss in palliative care, HIV, elderly or chemotherapy patients should be multidisciplinary, involving nutritionists, psychologists and physicians, adjusting the management to the individual characteristics manifested. Dronabinol is a drug of first choice for the management of these symptoms when the natural history of the disease is accompanied by nausea, vomiting or pain.

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Objetivo: Investigar se a modelagem do sistema Reciproc interfere na realizaçÆo da técnica Sistema (TC) e compará-las com outras duas técnicas: Cone énico sistema Reciproc (CU) e McspaddenModificada(MC), quanto à porcentagem da área preenchida por gutapercha,cimento Ahplus e áreas vazias, no terço apical em canais instrumentados pelo sistema Reciproc©. Metodologia: Quinze raízes mesiais de molares inferiores foram instrumentadas por instrumento único recíproco R25 e separadas nosgrupos: CU, TC e MC. Após as obturaçães os dentes foram seccionadosnos níveis de 2mm e 4mm do forame e imagens foram obtidas para medir a porcentagem da área do canal obturada com os materiais obturadores e os espaços vazios, sendo os dados submetidos ao teste estatístico de Kruskal-Wallis. Resultados: Comparando-se as técnicas sem distinçÆo dos níveis, verificou-se que, para o preenchimento Guta Percha, TC se diferenciou de CU e de MC, apresentando média maior que ambas. Para o Cimento, novamente as diferenças surgiram entre TC e as outras duas, mas com TC apresentando média menor que elas. Com relaçÆo à µrea Vazia nÆo foi encontrada diferença estatisticamente significativa entre TC, CU e MC. Conclusães: A modelagem proporcionada pela lima R25 do SistemaReciproc nÆo interfere no emprego da técnica TC. O preenchimento com Guta Percha apresentou maior media na técnica TC, em conseqüência, o Cimento apresentou a menor média, ambos comdiferenças significantes para MC e CU. Com relaçÆo à µrea Vazia o comportamento foi igual para todas as técnicas...

Objective: To investigate whether the shaping promoted by the Reciproc© system interferes with performing the System technique (TC) in comparison with two other techniques - Single Cone Reciproc© system (CU) and Modified Mcspadden (MC) -, relative to the percentage of the area filled by gutta-percha and Ahplus sealer and non-filled areas in the apical third of canals instrumented with the Reciproc© system. Methods: Fifteen mesial roots of mandibular molars were instrumented by a single reciprocate R25 file and assigned to three groups: CU, TC and MC. After root filling, the teeth were sectioned at 2 and 4 mm short of the apical foramen. Images were captured to calculate the percentages of canal area occupied by and free of filling material. Data were analyzed statistically by the Kruskal-Wallis test. Results: Comparison of the techniques regardless of apical levels revealed that for gutta-percha filling, TC presented significantly greater means than CU and MC. For the sealer, TC presented significantly lower means than CU and MC. Regarding the area free of filling material, no statistically significant difference was found among TC, CU and MC. Conclusions: Canal shaping produced by the Reciproc© system?s R25 file does not interfere with the use of the TC technique. Gutta-percha filling presented the greatest mean value with the TC technique and sealer filling presented the lowest mean value, both with significant differences from MC and CU. Regarding the empty area (no filling), the same outcome was observed for all techniques...

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The improvement of natural pastures was consolidated in the highlands of Santa Catarina State only recently when a great area of improved natural pastures already existed. Technology adopted by farmers was due to its increase in fodder production and stocking capacity. Besides, this technology presented costs inferior to the ones for conventional pasture cultivation. However, this technology still needs a more rigorous evaluation, which is to be achieved by three on farm experiments, conducted in Campo Belo do Sul county. It was evaluated forage production and quality, animal liveweight gain (LWG) and the profitability of the native pasture improvement technology. The average results were as follows: the pastures showed an in vitro OMD of 66.1; 62.6; 72.4 and 66.5%, during summer, autumn, winter and spring season, respectively. The crude protein content was of 14.7; 19.7; 22.0 and 14.4% for the same season order. Animal LWG of 511, 63 kg ha-1 year-1 , with a daily animal LWG of 0.789 kg animal-1 day-1 and animal stocking of 648 kg of LW ha-1. Finally, the system showed an economic gross margin of R$ 811,10 ha-1 (U$ 477,00 ha-1).

O melhoramento de pastagens naturais foi consolidado na Serra Catarinense a partir da segunda metade da década de 90. Nesta época já existia uma grande área implantada, como resultado da adoção por diversos produtores, em função do aumento da produção de forragem, da elevação da capacidade de suporte, como também dos custos de implantação serem inferiores aos praticados em cultivos convencionais. Apesar da dimensão existente, esta tecnologia ainda necessitava de avaliação e acompanhamento mais rigorosos. Assim, foram conduzidos três ensaios de validação no município de Campo Belo do Sul, por um período de três anos, nos quais se avaliou a produção e qualidade da forragem, o rendimento animal e a rentabilidade econômica. Os resultados médios obtidos foram: 511,63 kg peso vivo (PV) ha-1 ano-1, sendo o granho médio diário (GMD) de 0,789 kg animal-1 dia-1 e carga animal de 648 kg de PV ha-1. A digestibilidade in vitro da matéria orgânica (DIVMO) foi de 66,1; 62,6; 72,4 e 66,5%, no verão, outono, inverno e primavera, respectivamente. O teor de proteína bruta foi de 14,7; 19,7; 22,0 e 14,4% para a mesma ordem das estações do ano. A margem bruta foi de R$ 811,10 ha-1.

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O portal "(En)Cena: a saúde mental em movimento", lançado em 18/05/2011, é idealizado pelos cursos de Psicologia, Comunicação Social e Sistemas de Informação do CEULP/ULBRA, tem por objetivo intervir na cultura e divulgar material referente ao campo da saúde, em especial, o da Saúde Mental. Apesar de um tema específico, o portal abarca uma ampla gama de assuntos e experiências, visto que dessa temática subentende-se um conhecimento transdisciplinar que extrapola as disciplinas mais comumente a ela ligadas, abrindo espaço para além do campo da saúde. O (En)Cena possui nove seções que estimulam produções que ultrapassem a ordem técnico-acadêmica, incluindo, portanto, manifestações artístico-culturais originadas nos e relacionadas aos serviços de saúde. O portal (http://www.ultra-to.br/encena) promove discussões de relevância social, fruto das práticas nas quais os colaboradores estão inseridos. O resultado se traduz em novos olhares e novas formas de pensar, de pesquisar, de ensinar e de atuar no campo da Saúde Mental que fomentam a transversalidade, o protagonismo e a tríplice inclusão; princípios esses estruturantes da Política Nacional de Humanização.(AU)

The website “(En)Cena: a saúde mental em movimento”, inaugurated on May 18, 2011, conceived by professors of Psychology, Social Communication and Information Systems of Centro Universitário Luterano de Palmas (CEULP/ULBRA), aims to act in culture and disclose material related to the field of Health, in particular to Mental Health field. Although it is devoted to a specific theme, the website covers a wide range of issues and experiences, since this theme requires a transdisciplinary knowledge, opening up a space beyond the boundaries of disciplines commonly related the field of health. The (En)Cena website consists of nine sections that stimulate productions that go beyond the academic matter and include cultural expressions that come from mental health services. The website (http://www.ulbra-to.br/encena) promotes socially relevant discussions, which are the result of practices in which collaborators are involved. The results are new perspectives and new ways of thinking, researching, teaching and acting in the field of Mental Health that promote mainstreaming, involvement and triple inclusion, principles that build the Política Nacional de Humanização.(AU)

El sitio web "(En) Cena: a saúde mental em movimento", concebido por profesores de Psicología, Comunicación Social y Sistemas de Información del Centro Universitario Luterano de Palmas (CEULP / ULBRA), inaugurado el 18 de mayo de 2011, tiene como objetivo actuar en la cultura y divulgar material relacionado con el campo de la salud, en particular com el campo de la Salud Mental. Aunque este espacio está dedicado a uno solo asunto, él cubre una amplia gama de temas y experiencias, ya que este tema requiere un conocimiento transdisciplinario, que abre un espacio más allá de los límites de las disciplinas comúnmente relacionadas con el campo de la salud. El sitio web (En)Cena consta de nueve secciones que estimulan producciones que van más allá de la cuestión académica e incluyen expresiones culturales procedentes de los servicios de salud mental. El sitio web (http://www.ulbra-to.br/encena) promueve discusiones de relevancia social, que son el resultado de prácticas en que sus colaboradores están insertados. Los resultados son nuevas perspectivas y nuevas formas de pensar, investigar, enseñar y actuar en el campo de la Salud Mental que promueven la integración, la participación y la inclusión triple, principios que conforman la Política Nacional de Humanização.(AU)

RESUMO

The improvement of natural pastures was consolidated in the highlands of Santa Catarina State only recently when a great area of improved natural pastures already existed. Technology adopted by farmers was due to its increase in fodder production and stocking capacity. Besides, this technology presented costs inferior to the ones for conventional pasture cultivation. However, this technology still needs a more rigorous evaluation, which is to be achieved by three on farm experiments, conducted in Campo Belo do Sul county. It was evaluated forage production and quality, animal liveweight gain (LWG) and the profitability of the native pasture improvement technology. The average results were as follows: the pastures showed an in vitro OMD of 66.1; 62.6; 72.4 and 66.5%, during summer, autumn, winter and spring season, respectively. The crude protein content was of 14.7; 19.7; 22.0 and 14.4% for the same season order. Animal LWG of 511, 63 kg ha-1 year-1 , with a daily animal LWG of 0.789 kg animal-1 day-1 and animal stocking of 648 kg of LW ha-1. Finally, the system showed an economic gross margin of R$ 811,10 ha-1 (U$ 477,00 ha-1).

O melhoramento de pastagens naturais foi consolidado na Serra Catarinense a partir da segunda metade da década de 90. Nesta época já existia uma grande área implantada, como resultado da adoção por diversos produtores, em função do aumento da produção de forragem, da elevação da capacidade de suporte, como também dos custos de implantação serem inferiores aos praticados em cultivos convencionais. Apesar da dimensão existente, esta tecnologia ainda necessitava de avaliação e acompanhamento mais rigorosos. Assim, foram conduzidos três ensaios de validação no município de Campo Belo do Sul, por um período de três anos, nos quais se avaliou a produção e qualidade da forragem, o rendimento animal e a rentabilidade econômica. Os resultados médios obtidos foram: 511,63 kg peso vivo (PV) ha-1 ano-1, sendo o granho médio diário (GMD) de 0,789 kg animal-1 dia-1 e carga animal de 648 kg de PV ha-1. A digestibilidade in vitro da matéria orgânica (DIVMO) foi de 66,1; 62,6; 72,4 e 66,5%, no verão, outono, inverno e primavera, respectivamente. O teor de proteína bruta foi de 14,7; 19,7; 22,0 e 14,4% para a mesma ordem das estações do ano. A margem bruta foi de R$ 811,10 ha-1.