Natália Gonçalves

Determination of Aflatoxins in Peanut Products in the Northeast Region of São Paulo, Brazil

The aim of the present study was to determine aflatoxin levels in peanut products traded in the Northeast region of São Paulo, Brazil. To this end, 240 samples of peanut products traded in the cities of Araras, Leme, Pirassununga and Porto Ferreira were collected from June 2006 to May 2007. The samples were analyzed for aflatoxins (AF) B1, B2, G1 and G2 by high performance liquid chromatography. Results showed 44.2% samples positive for AF at levels of 0.5 to 103.8 μg·kg−1. Nine of the positive samples (3.7% of the analysed samples) had total aflatoxin concentrations (B1+B2+G1+G2) higher than the limit established by Brazilian regulations (20 μg·kg−1). Based on the above data, the probable mean daily intake (PDIM) of aflatoxins from peanut products in the Northeast region of São Paulo was estimated to be 0.23 ng kg b.w. day−1. Although this PDIM value was relatively low, results indicate that aflatoxin contamination of peanut products may be a public health concern in Brazil, when considering the potential exposure of highly susceptible consumers. For example, it should be emphasized that children are potentially exposed to aflatoxins, since they consume large quantities of peanut candies, and these products had the highest number of samples positive for AFB1.

Assessment of the health status in Brazilian burn victims five to seven months after hospital discharge

PURPOSE To evaluate health status, impact of event, anxiety, and depression in burn victims at five-to-seven months after hospital discharge, and to explore the association between those variables with age, body surface area burn (BSA), sex, and marital status. METHODS Cross-sectional study involving 73 adults who were interviewed for general health status (BSHS-R), impact of event (IES), and anxiety and depression (HADS). RESULTS Participants were mostly men (68.5%), with mean age 38.4 years (SD = 14.5), and mean hospital length of stay (LOS) 24.5 days (SD = 25.3). Mean scores were: 128.1 (SD = 18.9) for BSHS-R, 62.1(SD = 35.8) for IES, 5.5 (SD = 4.1) for anxiety, and 3.9 (SD = 3.9) for depression. Health status was highly and inversely correlated with impact of event, depression, anxiety, LOS, number of surgeries, and BSA. Men and women differed in the BSHS-R affect and body image domains, and depression. Individuals with larger BSA reported worse scores for BSHS-R (work domain). CONCLUSION Burn victims reported good health status on average, which was negatively correlated with reported depression, anxiety, impact of event, LOS, number of operations, and BSA. These findings suggest that general health might be improved by interventions that target modifiable behavioral factors, such as support groups and cognitive behavioral therapies.

Marsupial morphology of reproduction: South America opossum male model

This study aims to describe the morphology of Didelphis sp. male genital organs (penis, testes, epididymis, ductus deferens, prostate, and bulbourethral gland). Ten male animals were used, eight for macroscopic and light microscopy analysis, and two for scanning electron microscopy. The testes and epididymis showed similarity to other eutherian mammals. The bifid penis showed the urethra ending in the medial region where the bifurcation begins, occurring in each segment extension of the urethral groove until the beginning of the glans. Histologically, the penis consists of a cavernous and spongy body, covered by stratified squamous epithelium with loose connective tissue. The urethra was lined by transitional stratified epithelium. In the prostate, prostatic segments were found consisting of tubular glands in a radial arrangement around the urethra, coated externally by a dense connective tissue associated with a relatively thick layer of smooth muscle arranged in two layers that surround the glandular tissue. The animals had three pairs of bulbourethral glands placed at the membranous and cavernous urethra junction with descending and parallel excretory ducts ending caudally in the urethral lumen. Microsc. Res. Tech. 76:388–397, 2013.

Biopsychosocial factors that interfere in the rehabilitation of burn victims: integrative literature review

This study aimed to identify the biopsychosocial factors that influence the rehabilitation of burn victims, through an integrative literature review, from January 1987 to January 2007. Articles were searched in databases Scielo, Pubmed and Lilacs, resulting in 982 articles, of which 45 were selected, after the analysis and categorization processes. Most studies were descriptive and qualitative. The most frequently associated factors to the rehabilitation process were: mental health state before the accident, coping strategies and family support, besides the severity of the burn and the total body surface area burned. The quality of the selected studies, most classified as evidence level VI, shows the scarce production of strong evidences in this knowledge area, which needs more investment, considering the important implications of the sequelae of burns in the social reintegration of these people.Correspondencia: Lidia Aparecida Rossi Universidade de Sao Paulo. Escola de Enfermagem de Ribeirao Preto Departamento de Enfermagem Geral e Especializada Av. dos Bandeirantes, 3900 Bairro: Monte Alegre CEP: 14040-902, Ribeirao Preto, SP, Brasil E-mail: rizzardo@eerp.usp.br Factores biopsicosociales que interfieren en la rehabilitacion de victimas de quemaduras: revision integradora de la literatura

Reliability and Validity of the Body Image Quality of Life Inventory: Version for Brazilian Burn Victims

The aims of this study were to adapt the Body Image Quality of Life Inventory (BIQLI) into Brazilian Portuguese (BP) and to assess the psychometric properties of the adapted version. Construct validity was assessed by correlating the BIQLI-BP scores with the Rosenbergs Self-Esteem Scale, with Burns Specific Health Scale-Revised (BSHS-R), and with gender, total body surface area burned, and visibility of the scars. Participants were 77 adult burn patients. Cronbachs alpha for the adapted version was .90 and moderate linear correlations were found between body image and self-esteem and between BIQLI-BP scores and two domains of the BSHS-R: affect and body image and interpersonal relationships. The BIQLI-BP showed acceptable levels of reliability and validity for Brazilian burn patients.

An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients

Objetivo:analizar y sintetizar el conocimiento relacionado a componentes criticos de intervenciones que han sido propuestas e implementadas por enfermeros(as) con el objetivo de optimizar el autocuidado entre pacientes con insuficiencia cardiaca.Metodo:PUBMED y CINAHL han sido las bases de datos electronicas usadas para investigar articulos revisados por pares (peer review), presentando descripciones de intervenciones destinadas a perfeccionar el autocuidado dirigido al paciente o al paciente y a su familia. Se incluyeron 42 estudios en la muestra final (n=4799 pacientes).Resultados:esta revision apunto a una variedad y complejidad de intervenciones de enfermeria. Como el autocuidado abarca varios comportamientos, las intervenciones tuvieron como blanco, en media, 3,6 comportamientos. Actividades de educacion/consejeria fueron combinadas o no con estrategias cognitivo-comportamentales, pero tan solo cerca de la mitad de los estudios tenian aporte teorico para guiar intervenciones. La gestion y la evaluacion clinica fueron frecuentemente asociadas a intervenciones de autocuidado, las cuales oscilaron en numero de sesiones (1 a 30), duracion del seguimiento (2 semanas a 12 meses) y objetivos.Conclusiones:estos resultados pueden ser utiles para informar a las enfermeras acerca de nuevas investigaciones en intervenciones de autocuidado, de modo a proponer la comparacion de distintas modalidades de intervencion, el uso de un aporte teorico y el establecimiento de objetivos para evaluar su eficacia.Abstract Objective: to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients. Methods: PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients). Results: this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints. Conclusions: these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness.Objetivo: analizar y sintetizar el conocimiento relacionado a componentes criticos de intervenciones que han sido propuestas e implementadas por enfermeros(as) con el objetivo de optimizar el autocuidado entre pacientes con insuficiencia cardiaca. Metodo: PUBMED y CINAHL han sido las bases de datos electronicas usadas para investigar articulos revisados por pares (peer review), presentando descripciones de intervenciones destinadas a perfeccionar el autocuidado dirigido al paciente o al paciente y a su familia. Se incluyeron 42 estudios en la muestra final (n=4799 pacientes). Resultados: esta revision apunto a una variedad y complejidad de intervenciones de enfermeria. Como el autocuidado abarca varios comportamientos, las intervenciones tuvieron como blanco, en media, 3,6 comportamientos. Actividades de educacion/consejeria fueron combinadas o no con estrategias cognitivo-comportamentales, pero tan solo cerca de la mitad de los estudios tenian aporte teorico para guiar intervenciones. La gestion y la evaluacion clinica fueron frecuentemente asociadas a intervenciones de autocuidado, las cuales oscilaron en numero de sesiones (1 a 30), duracion del seguimiento (2 semanas a 12 meses) y objetivos. Conclusiones: estos resultados pueden ser utiles para informar a las enfermeras acerca de nuevas investigaciones en intervenciones de autocuidado, de modo a proponer la comparacion de distintas modalidades de intervencion, el uso de un aporte teorico y el establecimiento de objetivos para evaluar su eficacia.Descriptores: Insuficiencia Cardiaca; Autocuidado; Enfermeria; Intervencion; Revision.753

Site of catheter insertion in burn patients and infection: A systematic review

The aim of the study was to conduct a systematic review to identify and appraise the evidence on possible association of the site of venous catheter insertion in burn patients and an increased occurrence of catheter-related infection. Searches were performed in MEDLINE, LILACS, CINAHL, EMBASE, Web of Science and The Cochrane Library. Nine studies were selected for the review; four of them mentioned, directly or indirectly, an association between catheter-related infection and the insertion of the catheter either in the burn wound or in surrounding area, and five studies investigated the occurrence of infection related to both the catheter and the anatomical sites of catheter insertion. Higher infection rates occurred when the catheters were inserted directly in the burn wound or near the wound (level of evidence IV) or in the femoral vein (level of evidence IV). No significant differences in infection occurrence rates were observed between central catheters and peripherally inserted central catheter (level of evidence IV). Further investigations for techniques and types of coverage of venous catheter insertion dressings are important for preventing infection in burn patients. Also, new technologies for venous access must be evaluated.

Sexuality in burn victims: An integrative literature review

AIMS To analyze and synthesize knowledge concerning sexuality in adult burn victims through an integrative literature review. METHOD Two researchers independently searched six electronic databases (PUBMED, LILACS, ISI Web of Science, PSYCINFO, CINAHL and EMBASE) and also performed a hand search using the following descriptors, in different combinations: burn, sexuality, gender identity, sexual behavior and sexual factors, in order to identify the articles published in English, Portuguese or Spanish, in the last 20 years. A total of 1781 articles were found and 22 were selected based on the inclusion and exclusion criteria. RESULTS The findings were organized into two categories that influence sexuality: (1) studies where the main purpose was to assess sexuality in burn victims; (2) studies that indirectly assess sexuality. CONCLUSION The synthesis of the knowledge concerning sexuality in burn victims showed that sexual dysfunction can be related to the younger ages, TBSA > 20%, burns on the genitalia and on exposed areas, prolonged length of hospital stay, avoidance coping, and mental disorders. The multidisciplinary team should be prepared to integrate sexuality as an important variable in the continuing treatment of burn patients.

Fatores biopsicossociais que interferem na reabilitação de vítimas de queimaduras: revisão integrativa da literatura

This study aimed to identify the biopsychosocial factors that influence the rehabilitation of burn victims, through an integrative literature review, from January 1987 to January 2007. Articles were searched in databases Scielo, Pubmed and Lilacs, resulting in 982 articles, of which 45 were selected, after the analysis and categorization processes. Most studies were descriptive and qualitative. The most frequently associated factors to the rehabilitation process were: mental health state before the accident, coping strategies and family support, besides the severity of the burn and the total body surface area burned. The quality of the selected studies, most classified as evidence level VI, shows the scarce production of strong evidences in this knowledge area, which needs more investment, considering the important implications of the sequelae of burns in the social reintegration of these people.Correspondencia: Lidia Aparecida Rossi Universidade de Sao Paulo. Escola de Enfermagem de Ribeirao Preto Departamento de Enfermagem Geral e Especializada Av. dos Bandeirantes, 3900 Bairro: Monte Alegre CEP: 14040-902, Ribeirao Preto, SP, Brasil E-mail: rizzardo@eerp.usp.br Factores biopsicosociales que interfieren en la rehabilitacion de victimas de quemaduras: revision integradora de la literatura

Cultural adaptation of the 5-D itch scale and its reliability for Brazilian burn survivors

This was a methodological study whose objective was to culturally adapt the 5-D itch scale for Brazilian Portuguese and verify its practicability, acceptability and reliability for burn survivors. This study followed the five internationally recommended steps for the adaptation process: translation, synthesis, back translation, assessment by an expert committee and pretesting process; besides, an evaluation of its practicability, acceptability and reliability was conducted. The pretest was carried out with thirty burn survivors - hospitalized or on outpatient follow-up - from two public hospitals in the state of São Paulo. Most burn survivors were male (18; 60%), aged at mean of 39.2 (SD=11.1), with deep partial burn injuries (16; 59.3%), percentage of total burn surface area of 12.3 (SD=9.8); and most accidents occurred at domestic environment (18; 60%). The Brazilian version had semantic and idiomatic, conceptual and cultural equivalences, with a satisfactory content validity index for each item (CVI-I). Mean application time was 3.5minutes, acceptability was good, and there was evidence of reliability for the total score (0.793). The Brazilian version of the 5-D itch scale showed equivalence and evidence of reliability for assessing pruritus and its impact in burn survivors.