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Objective: Evaluate stress in the work environment of professional nurses inside Intensive Care Units and identify the stressing agents associated to the triggering of stress, according to the Bianchi Stress Scale. Methods: Cross-sectional study developed with 22 nurses at the intensive therapy unit of a public pediatric hospital. Results: Despite the complete and effective performance of ICU nurses in face of the patient's instability, the conditions external to this situation are more stressing. Conclusion: The nurses have presented higher stress levels in the activities related to work conditions to perform activities and those related to personnel administration. ResumoObjetivo: Avaliar o estresse no ambiente de trabalho dos profissionais enfermeiros dentro das Unidades de Terapia Intensiva e identificar os agentes estressores associados ao desencadeamento do estresse segundo a Escala Bianchi de Estresse. Métodos: Estudo transversal, desenvolvido com 22 enfermeiros da unidade de terapia intensiva de um hospital público pediátrico. Resultados: Enfermeiro da UTI, apesar de sua completa e efetiva atuação frente à instabilidade do estado do paciente, as condições externas a essa situação são mais estressantes. Conclusão: Os enfermeiros apresentaram maiores índices de estresse nas atividades relacionadas às condições de trabalho para o desempenho das atividades e relacionadas à administração de pessoal.

Renal alterations caused by Bothrops venom and its compounds are studied to understand these effects and provide the best treatment. Previously, we studied the renal effect of the whole venom of Bothrops marajoensis and its phospholipase A2 (PLA2), but these effects could not to be attributed to PLA2. To continue the study, we report in this short communication the effects of l-amino acid oxidase from B. marajoensis venom (LAAOBm) on renal function parameter alterations observed in the same model of isolated perfused kidney, as well as the cytotoxic effect on renal cells. LAAOBm caused a decrease in PP, RVR, UF, GFR, %TNa(+) and %TCl(-), very similar to the effects of whole venom using the same model. We also demonstrated its cytotoxicity in MDCK cells with IC50 of 2.5 μg/mL and late apoptotic involvement demonstrated by flow cytometry assays. In conclusion, we suggested that LAAOBm is a nephrotoxic compound of B. marajoensis venom.

Acute kidney injury (AKI) is one of the most important complications of bothropic poisoning and its early identification remains challenging. The nephrotoxicity of Bothrops insularis venom (BinsV) was previously described by our research group. In this study, we continued to evaluate the effect of BinsV on kidney function in mice and LLC-MK2 proximal tubule cells, evaluating KIM-1 protein as an early AKI biomarker. Male Swiss mice were inoculated with BinsV intramuscularly and observed for 24 h in a metabolic cage model. Urine and blood were collected for biochemical analyses and the kidneys were examined for oxide-reducing balance and submitted to histological analysis. LLC-MK2 cells incubated with BinsV were assessed for cell viability and cell death mechanism by flow cytometry. Histological analysis of the kidneys indicated AKI and the oxide-reducing analyses demonstrated a decreasing in reduced glutathione (GSH) levels and an increasing on Malondialdehyde (MDA) levels. BinsV was cytotoxic to LLC-MK2 and the cytometry analyses suggested necrosis. Within 24 h after the envenomation, urinary creatinine did not increase, but the urinary levels of KIM-1 increased. In conclusion, we found AKI evidence in the kidney tissue and the increase in the KIM-1 levels suggest it can be used as an early AKI biomarker.

Objetivo. Realizar uma revisão bibliográfica sobre a ketamina, enfocando aspectos químicos e farmacocinéticos, seus mecanismos de ação, efeitos farmacológicos, usos terapêuticos, bem como aborda o uso da ketamina como droga de abuso. Ketamina. Método. Estudo de revisão bibliográfica através das bases de dados Pubmed, SciELO, Lilacs e Medline, na qual foram selecionados estudos clássicos e recentes relevantes para a discussão do tema abordado. Resultados. Após análise dos artigos selecionados, conclui-se que a ketamina apresenta perspectivas promissoras. Alguns estudos demonstraram propriedades analgésicas em relação à dor pós-operatória e outros revelaram uma ação antidepressiva rápida. Além disto, a ketamina também apresentou efeitos neuroprotetores em vários estudos animais. Embora a ketamina seja um campo promissor, essas ações precisam ser melhor investigadas. Atualmente, observou-se que o seu uso não se restringe apenas à prática clínica ou pesquisa, sendo frequentemente utilizada como droga de abuso pelos jovens em festas como um potente alucinógeno. Conclusão. Pesquisas sobre o uso recreacional da ketamina também são necessárias, especialmente no Brasil, assim como dados que mostrem a morbidade e mortalidade pelo uso desta substância como droga de abuso.

Abstract:In the present study, the effects of Polybia paulista venom (PPV) on renal and vascular tissues were investigated. Isolated kidneys perfused with PPV (1 and 3 µg/mL) had increased perfusion pressure, renal vascular resistance , urinary flow, and glomerular filtration rate; and reduced sodium tubular transport. Histological evaluation demonstrated deposits of proteins in Bowman's space and tubular lumen, and focal areas of necrosis. The venom promoted a cytotoxic effect on Madin-Darby canine kidney (MDCK) cells. A significant increase in lactic dehydrogenase levels was observed in response to venom exposure. In isolated mesenteric vascular beds, pressure and vascular resistance augmented in a dose-dependent manner. PPV increased the contractility of aortic rings maintained under basal tension. This contractile response was inhibited when preparations were maintained in Ca 2+ -free medium. Likewise, verapamil, a voltage-gated calcium channel blocker, also inhibited the contractile response. In this study, phentolamine, a blocker of α-adrenergic receptor blocker, significantly reduced the contractile effect of PPV in the aortic ring. In conclusion, PPV produced nephrotoxicity, which suggests a direct effect on necrotic cellular death in renal tubule cells. The vascular contractile effect of PPV appears to involve calcium influx through voltage-gated calcium channels via adrenergic regulation.

This study aimed to map the physical activity program carried out by the Family Health and Primary Health Care Expanded Support Center in accordance with the guidelines of the Ministry of Health. Cartography is a methodological path. The documentary sources served as an analytical device for hermeneutic apprehension, through content analysis. There was a program with a frequency of one to two days a week, with predominantly resisted and flexibility exercises, performed with light to moderate intensity and an average duration of 24.11 minutes. The existence of complementary therapies and the multiprofessional approach that enhance intervention in the area of physical education is highlighted, seeking to overcome the technical rationality of hegemonic bodily practices, emphasizing the intersubjective dimensions of corporeality. In addition, the satisfaction of the investigated actors, recognized through the processes of subjectification on the lived experience, capable of promoting the practice of healthy habits in an empowered and responsible manner, contributing to the adherence of these patients to the physical activity program.

Background and Aims A global increase in the prevalence of chronic kidney disease (CKD) and, consequently, in the number of individuals submitted to renal replacement therapy (RRT) has been observed. In Brazil, there was an increase from 46,557 to 144,779 (>310%) in the number of people on dialysis between the years 2001 and 2020, respectively. Although peritoneal dialysis (PD) is a safe, low-cost and less aggressive dialysis method when compared to hemodialysis (HD) and can be performed at the home, HD remains the most common RRT type in Brazil (92.2%). This study aimed to validate a PD section incorporated into an existing m-Health application (app) called 'Renal Health®'. Method This is a methodological study, with a quantitative and applied approach. For internal validation of the app usability, ten specialists/researchers in the study topic from the Nursing Nephrology participated in the study, hereafter referred to as ‘judges’, who carried out the validation process of the content to be inserted into the Renal Health® app. The validation instrument was sent to them electronically, organized according to a Likert scale following a four-degree gradation. Based on the specialists’ answers, the means of agreement were calculated, which ranged from –1 for a negative evaluation; 0 (zero) for a neither positive nor negative evaluation; and, +1 when the evaluation was positive. Data evaluation was done using descriptive statistics and the calculation of the content validity index (CVI). Each item of the validation instrument was analyzed in relation to these obtained averages, which, if they were less than 80%, would indicate the need for modifications. An evaluation instrument was created with 22 items arranged in three domains: objectives (4), structure and presentation (15), and relevance (3), aiming to reflect the app functionality, usability and appearance. Results Regarding the objectives related to the PD section, none of items received an “irrelevant” assessment and its CVI ranged from 0.90 to 1.0, with an overall CVI of 0.95. The sub-items with the highest scores were related to the text being compatible with the target audience and the PD section of the app having adequate information/content to guide the patients. Among the 15 sub-items related to the structure and presentation of the PD section, six showed 90% agreement among the judges and were distributed as follows: they indicated that the information directed to the object of interest was sufficient and adequate; stated that the colors applied to the text were relevant and facilitated its use; that the subtitles applied were adequate and helped the user to understand the image; confirmed that the amount of illustration was adequate for the content of the material; that the illustrations were clear and easy to understand and that they were relevant to the content of the material and elucidated the content. The other sub-items had a maximum CVI (1.0) and the overall CVI for this domain was 0.95. Finally, regarding the relevance of the PD section, all sub-items showed 100% agreement among the participants, so that the overall CVI was 1.0. Regarding the qualitative analysis of the instrument, there was no disagreement between the judges and/or suggestions for changes in the PD section. Conclusion The present study allowed the validation of the PD section in the Renal Health® app, which showed good reliability and could promote the use of m-Health technology to support users undergoing this type of dialysis.