Encapsulated specialty oils commercialized in São Paulo state, Brazil: evaluation of identity (fatty acid profile) and compliance of fatty acids and Vitamin E contents with nutrition labeling

Encapsulated specialty oils commercialized in São Paulo state, Brazil, were evaluated for their identity (fatty acids profile) and compliance with nutrition labeling (fatty acids and Vitamin E (alpha tocopherol) contents). Twenty one samples [flaxseed oil (6), evening primrose (5), safflower (8), borage (1), and black currant (1)] purchased from local markets or collected by the health surveillance agency were analyzed. The fatty acids and vitamin E contents were analyzed by gas chromatography with flame ionization detector and liquid chromatography with UV detector, respectively. Nine samples were adulterated (5 samples of safflower oil, 3 of flaxseed oil, and one of evening primrose). Among them, 3 flaxseed and 2 safflower oil samples were probably adulterated by the addition of soybean oil. Conjugated linoleic acid (CLA) was found in two safflower oils samples although the sale of oils with conjugated linoleic acid (CLA) is not permitted by the National Health Surveillance Agency in Brazil (ANVISA). Only two samples presented all values in compliance with nutrition labeling (one safflower oil sample and one borage oil sample). The results show that a continuous monitoring of encapsulated specialty oils commercialized in Brazil is necessary including a greater number of samples and sanitary surveillance.

Maize flour parameters that are related to the consumer perceived quality of ‘broa’ specialty bread

Abstract A wide range of quality parameters have been used to describe maize flours for food use, but there is no general agreement about the most suitable parameters for breadmaking. The objective of this study was to identify the maize flour parameters related to the consumer perceived quality of Portuguese broa bread (more than 50% maize flour). The influence of eleven maize landraces was assessed and compared with commercial flour using baking tests. The broa were evaluated by instrumental (colour, firmness) and sensory hedonic analysis with a consumer panel of 52 assessors. The broa sensory analysis revealed similar assessments among landraces and the lowest scores for commercial flour. The flour particle size distribution is the major influence, with commercial flour showing the highest mean diameter and a large particle distribution range. Broa consumer panel linkage associations and specific sensory descriptors have been identified; age as an influence on colour, cohesiveness, and source region as an influence on appearance and texture.

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Introduction Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identified during the hospital stay and after discharge. Results Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.

The general practitioner and the surgeon: stereotypes and medical specialties

OBJECTIVE: To investigate and characterize the professional stereotypes associated with general medicine and surgery among Brazilian medical residents. METHODS: A randomized sample of residents of the General Medicine and Surgery Residence Programs were interviewed and their perceptions and views of general and surgical doctors were compared. RESULTS: The general practitioner was characterized by the residents in general to be principally a sensitive and concerned doctor with a close relationship with the patient; (45%); calm, tranquil, and balanced (27%); with intellectual skills (25%); meticulous and attentive to details (23%); slow to resolve problems and make decisions (22%); and working more with probabilities and hypotheses (20%). The surgeon was considered to be practical and objective (40%); quickly resolving problems (35%); technical with manual skills (23%); omnipotent, arrogant, and domineering (23%); anxious, stressed, nervous, and temperamental (23%); and more decided, secure, and courageous (20%). Only the residents of general medicine attributed the surgeon with less knowledge of medicine and only the surgeons attributed gender characteristics to their own specialty. CONCLUSION: There was considerable similarity in the description of a typical general practitioner and surgeon among the residents in general, regardless of the specialty they had chosen. It was interesting to observe that these stereotypes persist despite the transformations in the history of medicine, i.e. the first physicians (especially regarding the valorization of knowledge) and the first surgeons, so-called "barber surgeons" in Brazil (associated with less knowledge and the performance of high-risk procedures).

Nursing care in the anesthetic procedure: an integrative review

Abstract OBJECTIVE To search for the scientific evidence available on nursing professional actions during the anesthetic procedure. METHOD An integrative review of articles in Portuguese, English and Spanish, indexed in MEDLINE/PubMed, CINAHL, LILACS, National Cochrane, SciELO databases and the VHL portal. RESULTS Seven studies were analyzed, showing nurse anesthetists' work in countries such as the United States and parts of Europe, with the formulation of a plan for anesthesia and patient care regarding the verification of materials and intraoperative controls. The barriers to their performance involved working in conjunction with or supervised by anesthesiologists, the lack of government guidelines and policies for the legal exercise of the profession, and the conflict between nursing and the health system for maintenance of the performance in places with legislation and defined protocols for the specialty. Conclusion Despite the methodological weaknesses found, the studies indicated a wide diversity of nursing work. Furthermore, in countries absent of the specialty, like Brazil, the need to develop guidelines for care during the anesthetic procedure was observed.

Contribuições recentes da reação de hidroformilação na síntese de produtos farmacêuticos: parte II

The hydroformylation reaction represents one of the most important C1-chemistry area in the chemical industry. This catalytic process, which has been developed up to now mainly to the production of commodities chemicals, has shown a remarkable potential for the preparation of several categories of specialty chemicals and in particular pharmaceutical compounds. Arylpropanoic acids, various amines containing aryl groups, and intermediates for the preparation of vitamins, carbocyclic and heterocyclic compounds and many other classes of organic molecules endowed with pharmacological activity are currently accessible in good-to-high yields through hydroformylation of selected olefinic substrates. The asymmetric hydroformylation is going to reach the stage of maturity and hence to contribute in solving many troublesome synthetic problems connected with the preparation of pharmacologically active compounds with very high enantiomeric purity. The present survey emphasizes the usefulness of synthesis gas as a starting material in fine chemistry, which is expected to be important for industry.

1,3-propanodiol: produção, aplicações e potencial biotecnológico

1,3-propanediol is a high-value specialty chemical which has many industrial applications. Its main use is the production of the polymer polypropylene terephthalate, a thermoplastic used in the textile and automobile industries. The interest in 1,3-propanediol production from glycerol bio-conversion has increased after the employment of biodiesel by various countries, being produced by chemical synthesis from petroleum intermediates or biotechnologically by microbial fermentation. Glycerol is an abundant low-cost byproduct from biodiesel refineries, and it is the only substrate that can be naturally or enzymatically converted to 1,3-propanediol by microbial fermentation. In this review, information on 1,3-propanediol's importance, production and purification are presented, along with results from recent research on glycerol microbial conversion to 1,3-propanediol. The bio-production of this intermediate compound from glycerol is very attractive both economically and environmentally, since it allows the replacement of fossil fuels by renewable resources.

Aplicações de enzimas na síntese e na modificação de polímeros

Enzymes are biological catalysts that offer great potential for use in the synthesis and modification of polymers, being more specific and greener than chemical catalysts. In this work, enzymes from the classes of hydrolases (lipase, cutinase and protease) and of oxidoreductases (horseradish peroxidase, manganese peroxidase and laccase) were identified as the main biocatalysts responsible for the synthesis of polymers. Biocatalysis can potentially be part of the life cycle of several polymers, including polyesters, polyurethanes, polycarbonates, polyamides, functionalized polysaccharides and polystyrene, allowing the synthesis of specialty macromolecules for fine applications and with higher added-value than commodity polymers.

Abordagem fisioterapêutica na dor pós-operatória: a eletroestimulação nervosa transcutânea (ENT)

This study provides an update on the use of Transcutaneous Eletric Nerve Stimulation (TENS) as a non-pharmacological resource of postoperative pain relief. National and international references regarding the use of TENS for the relief of postoperative pain had been selected, highlighting its mechanism of action, parameters of application, contraindications, side-effect and results. TENS is a non-pharmacological resource that has its mechanism of action based on the gate theory. It consists of a device that emits electric impulses in the skin through electrodes. It is a low cost technique, easily applicable, presents few collateral effects, good effectiveness related to the reduction of the painful perception, allowing early mobilization and reduced pharmacological analgesic consumption. TENS represents another option in the control of postoperative pain and should be inserted in a multiprofessional context.

The impact of a chest tube management protocol on the outcome of trauma patients with tube thoracostomy

ABSTRACTObjective:to investigate the effect of standardized interventions in the management of tube thoracostomy patients and to assess the independent effect of each intervention.Methods:A chest tube management protocol was assessed in a retrospective cohort study. The tube thoracostomy protocol (TTP) was implemented in August 2012, and consisted of: antimicrobial prophylaxis, chest tube insertion in the operating room (OR), admission post chest tube thoracostomy (CTT) in a hospital floor separate from the emergency department (ED), and daily respiratory therapy (RT) sessions post-CTT. The inclusion criteria were, hemodynamic stability, patients between the ages of 15 and 59 years, and injury severity score (ISS) < 17. All patients had isolated injuries to the chest wall, lung, and pleura. During the study period 92 patients were managed according to the standardized protocol. The outcomes of those patients were compared to 99 patients treated before the TTP. Multivariate logistic regression analysis was performed to assess the independent effect of each variable of the protocol on selected outcomes.Results:Demographics, injury severity, and trauma mechanisms were similar among the groups. As expected, protocol compliance increased after the implementation of the TTP. There was a significant reduction (p<0.05) in the incidence of retained hemothoraces, empyemas, pneumonias, surgical site infections, post-procedural complications, hospital length of stay, and number of chest tube days. Respiratory therapy was independently linked to significant reduction (p<0.05) in the incidence of seven out of eight undesired outcomes after CTT. Antimicrobial prophylaxis was linked to a significant decrease (p<0.05) in retained hemothoraces, despite no significant (p<0.10) reductions in empyema and surgical site infections. Conversely, OR chest tube insertion was associated with significant (p<0.05) reduction of both complications, and also significantly decreased the incidence of pneumonias.Conclusion:Implementation of a TTP effectively reduced complications after CTT in trauma patients.

Use of raw Euphorbia tirucalli extract for inhibition of ascitic Ehrlich tumor

Objective: to evaluate the effect of the Euphorbia tirucalli hydroalcoholic extract (ETHE) on the development of Ehrlich Tumor, in its ascitic form. Methods: we intraperitoneally inoculated 15 Swiss mice with 10.44 x 107 cells of Ehrlich Tumor and divided them in two groups one day after: ETHE Group (eight mice), treated with a dosage of 125 mg/kg/day of EHTE for five days; and Control Group (seven mice), treated only with 0.9% isotonic saline solution over the same period. The treatment was done by gavage. Ten days after inoculation, four mice from each group were sacrificed for quantification of tumor cell number, ascitic fluid volume and bone marrow cell number. The remaining animals were maintained to evaluate survival. Results: The ascitic fluid volume and the tumor cell number were decreased in the ETHE group when compared with the control group, but with no statistical significance. On the other hand, survival was higher in the ETHE group, as well as the number of bone marrow cells. Conclusion: Treatment with ETHE after inoculation of Ehrlich Tumor decreases its development and increases survival and the bone marrow cellularity, thus reducing the myelosuppression present in the Ehrlich Tumor bearing mice.

Can course format influence the performance of students in an advanced cardiac life support (ACLS) program?

Advanced cardiac life support (ACLS) is a problem-based course that employs simulation techniques to teach the standard management techniques of cardiovascular emergencies. Its structure is periodically revised according to new versions of the American Heart Association guidelines. Since it was introduced in Brazil in 1996, the ACLS has been through two conceptual and structural changes. Detailed documented reports on the effect of these changes on student performance are limited. The objective of the present study was to evaluate the effect of conceptual and structural changes of the course on student ACLS performance at a Brazilian training center. This was a retrospective study of 3266 students divided into two groups according to the teaching model: Model 1 (N = 1181; 1999-2003) and Model 2 (N = 2085; 2003-2007). Model 2 increased practical skill activities to 75% of the total versus 60% in Model 1. Furthermore, the teaching material provided to the students before the course was more objective than that used for Model 1. Scores greater than 85% in the theoretical evaluation and approval in the evaluation of practice by the instructor were considered to be a positive outcome. Multiple logistic regression was used to adjust for potential confounders (specialty, residency, study time, opportunity to enhance practical skills during the course and location where the course was given). Compared to Model 1, Model 2 presented odds ratios (OR) indicating better performance in the theoretical (OR = 1.34; 95%CI = 1.10-1.64), practical (OR = 1.19; 95%CI = 0.90-1.57), and combined (OR = 1.38; 95%CI = 1.13-1.68) outcomes. Increasing the time devoted to practical skills did not improve the performance of ACLS students.