Dopamine neurons in the ventral tegmental area (VTA) receive cholinergic innervation from brainstem structures that are associated with either movement or reward. Whereas cholinergic neurons of the pedunculopontine nucleus (PPN) carry an associative/motor signal, those of the laterodorsal tegmental nucleus (LDT) convey limbic information. We used optogenetics and in vivo juxtacellular recording and labeling to examine the influence of brainstem cholinergic innervation of distinct neuronal subpopulations in the VTA. We found that LDT cholinergic axons selectively enhanced the bursting activity of mesolimbic dopamine neurons that were excited by aversive stimulation. In contrast, PPN cholinergic axons activated and changed the discharge properties of VTA neurons that were integrated in distinct functional circuits and were inhibited by aversive stimulation. Although both structures conveyed a reinforcing signal, they had opposite roles in locomotion. Our results demonstrate that two modes of cholinergic transmission operate in the VTA and segregate the neurons involved in different reward circuits.

RESUMO Objetivo: descrever as ações de enfermagem prescritas por enfermeiros para a prevenção de lesões por pressão e sua ocorrência em centros de terapia intensiva. Método: estudo transversal, descritivo e analítico, de abordagem quantitativa conduzido em duas instituições hospitalares de ensino de Campo Grande, Brasil. A coleta ocorreu entre março e junho de 2016 com 104 participantes. Os dados foram submetidos à análise estatística. Resultados: foi encontrada associação estatística entre as ações de mudança de decúbito, aplicação de cobertura hidrocoloide em região sacral, realização de higiene externa, troca de fixação do cateter orotraqueal e/ou cateter nasoenteral e inspeção da pele com a ausência de lesões por pressão. A ocorrência de lesões por pressão foi encontrada em 49% dos clientes em ambas as instituições. Conclusão: a elaboração e implementação de protocolos, o acompanhamento dos registros e dos grupos de maior risco são estratégias que direcionam a prescrição de ações preventivas adequadas para lesões por pressão.

The aim of this study was to evaluate the metabolic abnormalities (dyslipidaemia and insulin resistance) associated with highly active antiretroviral therapy (HAART) in AIDS patients, treated in Campo Grande, Mato Grosso do Sul, Brazil. The patients were distributed in five different groups: Group 1, HIV-infected without antiretroviral therapy; Group 2, with Zidovudine, Lamivudine and Efavirenz or Nevirapine; Group 3, with Zidovudine, Lamivudine and Protease Inhibitor; Group 4, with Stavudine, Lamivudine and Efavirenz or Nevirapine; and Group 5, with Stavudine, Lamivudine and Protease Inhibitor. The lipid and glucose profile were determined and statistics comparison was made. The findings of this study showed significant statistics elevations of total cholesterol and triglycerides levels in patients of Groups 3, 4 and 5, when comparing to patients of Groups 1 and 2. Significant differences were not observed between the groups in the others parameters evaluated: Glucose, HDL cholesterol and LDL cholesterol. Comparing two drugs of same class (NNRTI) through the subgroups II-efavirenz and II-nevirapine, significant differences in the serum levels of total cholesterol, triglycerides and glucose favorable to the subgroup II-NVP were observed. These findings suggest that combinations including Protease Inhibitors and/or Stavudine could cause more adverse metabolic effects, and if possible, should be avoided in patients with others cardiovascular risk factors to prevent the precocious atherosclerosis in AIDS patients receiving HAART.

RESUMOObjetivo: descrever a frequência e os fatores de risco para o desenvolvimento de lesões por pressão em clientes de Centros de Terapia Intensiva. Método: estudo quantitativo, transversal, realizado em uma amostra de 104 clientes de uma população de 936 sujeitos de dois hospitais públicos de ensino, atendidos entre os meses de março a junho de 2016. Os dados foram coletados com uso de um formulário de observação baseado em diretrizes nacionais e internacionais, e a análise estatística descritiva foi realizada com adoção de um nível de significância de 5%. Os resultados são apresentados em tabelas em valores absolutos e relativos, e cálculos para verificação de associação entre as variáveis. Resultados: dentre as variáveis estudadas, a idade foi igual ou maior a 60 anos, a presença de hipertermia e de pele edemaciada foram as que apresentaram significância estatística com a ocorrência de LP. Conclusão: os fatores de risco identificados como significativos para a ocorrência de LP podem ser prevenidos, portanto, o envolvimento da equipe de enfermagem é fundamental na prevenção dessas lesões. Descritores: Lesão por Pressão; Segurança do Paciente; Unidades de Terapia Intensiva; Enfermagem; Assistência à Saúde; Cuidados Críticos.ABSTRACT Objective: to describe the frequency and risk factors for development of pressure injuries (PIs) in clients of Intensive Care Centers. Method: quantitative, cross-sectional study of a sample of 104 clients from a population of 936 subjects from two public teaching hospitals assisted between March and June 2016. Data were collected using an observation form based on national and international guidelines, and descriptive statistical analysis was performed with a significance level of 5%. The results are presented as absolute and relative values, in tables, and the association between variables was calculated. Results: among the studied variables, age equal to or greater than 60 years, presence of hyperthermia and presence of swollen skin were the ones that had statistically significant effect on the occurrence of PIs. Conclusion: the risk factors identified as significant for the occurrence of PI can be prevented and, thus, the involvement of the nursing team is fundamental to prevent these lesions. Descriptors: Pressure Injury; Patient safety; Intensive Care Units; Nursing; Health Care; Critical Care.RESUMEN Objetivo: describir la frecuencia y los factores de riesgo para el desarrollo de lesiones por presión en clientes de Centros de Terapia Intensiva. Método: estudio cuantitativo, transversal, realizado en una muestra de 104 clientes de una población de 936 sujetos de dos hospitales públicos de enseñanza, atendidos entre los meses de marzo a junio de 2016. Los datos fueron recogidos con el uso de un formulario de observación basado en directrices nacionales e internacionales, y el análisis estadística descriptiva fue realizada con adopción de un nivel de significancia de 5%. Los resultados son presentados en planillas en valores absolutos y relativos, y cálculos para verificación de asociación entre las variables. Resultados: entre las variables estudiadas, la edad fue igual o mayor a 60 años, la presencia de hipertermia y de piel con edema fueron las que presentaron significancia estadística con la ocurrencia de LP. Conclusión: los factores de riesgo identificados como significativos para la ocurrencia de LP pueden ser prevenidos, por lo tanto, el envolvimiento del equipo de enfermería es fundamental en la prevención de esas lesiones. Descriptores: Úlcera por Presión; Seguridad del Paciente; Unidades de Cuidados Intensivos; Enfermería; Atención de Salud; Cuidados Críticos.

PURPOSE:To investigate biomarkers of acute renal injury in Wistar rats, subjected to left renal ischemia for 10 minutes, and then compare reperfusion at 24 hours, and at 5, 7, 14 and 21 days after the procedure. METHODS:Eight female and male rats between 60 and 81 days old were used in the Central Animal Facility of the UFMS. Assessed biomarkers included urine protein, urea, creatinine, glucose, sodium, potassium, urine alkaline phosphatase and gamma-glutamyl transferase activities, and protein-to-creatinine ratio; and in serum: urea, creatinine, sodium and potassium, fractional excretion of sodium, potassium, urine flow and creatinine clearance. RESULTS:Greater variance was observed in the parameters at 24 hours and at five days (p<0.05) after reperfusion. On the 21 st day, these parameters approximated those obtained for the control group. CONCLUSIONS:Renal ischemia for 10 minutes was sufficient to raise urine levels of protein, glucose, fractional excretion of potassium, urea, creatinine clearance, urine activity of gamma-glutamyltransferase and alkaline phosphatase enzymes in the first 24 hours, up to five days after reperfusion, which may indicate risk of acute kidney injury, according to the RIFLE classification.

BackgroundAlthough nutritional, metabolic and cardiovascular abnormalities are commonly seen in experimental studies of obesity, it is uncertain whether these effects result from the treatment or from body adiposity.ObjectiveTo evaluate the influence of treatment and body composition on metabolic and cardiovascular aspects in rats receiving high saturated fat diet.MethodsSixteen Wistar rats were used, distributed into two groups, the control (C) group, treated with isocaloric diet (2.93 kcal/g) and an obese (OB) group, treated with high-fat diet (3.64 kcal/g). The study period was 20 weeks. Analyses of nutritional behavior, body composition, glycemia, cholesterolemia, lipemia, systolic arterial pressure, echocardiography, and cardiac histology were performed.ResultsHigh-fat diet associates with manifestations of obesity, accompanied by changes in glycemia, cardiomyocyte hypertrophy, and myocardial interstitial fibrosis. After adjusting for adiposity, the metabolic effects were normalized, whereas differences in morphometric changes between groups were maintained.ConclusionsIt was concluded that adiposity body composition has a stronger association with metabolic disturbances in obese rodents, whereas the high-fat dietary intervention is found to be more related to cardiac morphological changes in experimental models of diet-induced obesity.

RESUMO O objetivo do presente trabalho foi analisar o processo de atenção domiciliar nas Equipes de Atenção Básica que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade. Realizou-se um estudo a partir do banco de dados do programa relativos à dimensão que avaliou a realização de visita domiciliar e cuidado domiciliar, com ênfase nas práticas das Equipes de Saúde Bucal. Quase 100% das Equipes de Saúde da Família avaliadas realizam visita domiciliar. O cuidado no domicílio é realizado por mais de 90% dos profissionais da equipe mínima, e por aproximadamente 50% dos profissionais da saúde bucal. A saúde bucal tem desafios a superar em direção a novas práticas na Atenção Básica. PALAVRAS-CHAVE

PURPOSE:To describe the hematologic values of male and female, young and adult, Swiss mice (Mus musculus). METHODS:Mus musculus (n=14) were randomly selected and separated by gender. The male and female, young and adult animals were sedation to obtain a blood sample, by intracardiac route at 30, 45, 60, 75, 90, 105 and 120 days after birth. RESULTS:The Swiss mouse hemogram values obtained, in relation to total eosinophils, basophils, and number of platelets, there was no statistical differences according to the genders or the age of the animals. Regarding the erythrocyte, hemoglobin and hematocrit values obtained, these were higher in females. The RDW-CD and MPV values were higher in the females than in the males. CONCLUSIONS:Lymphocytes are the predominant cells in the peripheral blood. The collection of 800 µL of blood by intracardiac route, every 15 days, did not affect the health of the animals. Analyses of the blood samples contribute to the experimental models provided by the Central Animal Facility of UFMS and used by professors.