Effects of pharmaceuticals compounds and calcium on granulation, microbiology, and performance of anaerobic granular sludge systems

Granular sludge is a promising biotechnology to treat sewage contaminated with pharmaceuticals due to its increased toxicity resistance. In this context, this study evaluated the potential of Ca²⁺ as a granulation precursor and how pharmaceutical compounds (loratadine, prednisone, fluconazole, fenofibrate, betamethasone, 17α-ethinyl estradiol, and ketoprofen) affect granulation. Continuous and intermittent dosages of Ca²⁺ in the presence and absence of pharmaceuticals were evaluated. The results showed that intermittent addition of Ca²⁺ reduces the time for anaerobic sludge granulation, and pharmaceuticals presence did not impair granulation. 10% of the granules presented mean diameters greater than 2.11 mm within 93 days with intermittent Ca²⁺ dosage in the pharmaceuticals' presence. In contrast, no granules higher than 2.0 mm were observed with no precursor addition. The pharmaceuticals' toxicity may have created a stress condition for the microbial community, contributing to more EPS production and a greater potential for granulation. It was also verified that pharmaceuticals' presence did not decrease organic matter, total alkalinity, and volatile fatty acids removals. The 16S rRNA gene analysis revealed taxa resistance to recalcitrant compounds when pharmaceuticals were added. Besides, the efficiency of a granular sludge bioreactor (EGSB) was evaluated for pharmaceuticals removal, and betamethasone, fenofibrate, and prednisone were effectively removed.

Long-term evaluation of membrane bioreactor inoculated with commercial baker's yeast treating landfill leachate: pollutant removal, microorganism dynamic and membrane fouling

In this study, commercial baker's yeast (Saccharomyces cerevisiae) was employed as a novel inoculum for a membrane bioreactor (MBRy). It was applied to landfill leachate (LFL) treatment to remove recalcitrant organic compounds as well as for the assimilation of recalcitrant compounds, since yeasts have a high ability to break such compounds down. The MBR was inoculated with 10 g L^-1 of commercial baker's yeast and was operated at a hydraulic retention time of 48 h and pH of 3.5. The specific air demand based on the membrane area (SADm) was maintained at 0.6 m³ h^-1 m^-2. The MBRy achieved chemical oxygen demand (COD), color, NH₃, and humic substances removal of 68, 79, 68, and 50%, respectively. Furthermore, the MBRy showed lower fouling potential, which can be attributed to the low extracellular polymeric substances production, as the formation of a cake layer was the major mechanism of membrane fouling. The work demonstrated that novel MBR is a promising technology for treating recalcitrant landfill leachate.

A multiscale study of fungal endophyte communities of the foliar endosphere of native rubber trees in Eastern Amazon

Hevea brasiliensis is a native hyperdiverse tree species in the Amazon basin with great economic importance since it produces the highest quality natural rubber. H. brasiliensis, in its natural habitat, may harbor fungal endophytes that help defend against phytopathogenic fungi. In this work, we investigated the fungal endophytic communities in two pristine areas in Eastern Amazon (Anavilhanas National Park - ANP and Caxiuanã National Forest - CNF) at different spatial scales: regional, local, individual (tree), and intra-individual (leaflet). Using a culture-based approach, 210 fungal endophytes were isolated from 240 sampling units and assigned to 46 distinct MOTUs based on sequencing of the nrITS DNA. The community compositions of the endophytomes are different at both regional and local scales, dominated by very few taxa and highly skewed toward rare taxa, with many endophytes infrequently isolated across hosts in sampled space. Colletotrichum sp. 1, a probably latent pathogen, was the most abundant endophytic putative species and was obtained from all individual host trees in both study areas. Although the second most abundant putative species differed between the two collection sites, Clonostachys sp. 1 and Trichoderma sp. 1, they are phylogenetically related (Hypocreales) mycoparasites. Thus, they probably exhibit the same ecological function in the foliar endosphere of rubber tree as antagonists of its fungal pathogens.

Biological and physicochemical properties of biosurfactants produced by Lactobacillus jensenii P6A and Lactobacillus gasseri P65

Background

Lactobacillus species produce biosurfactants that can contribute to the bacteria’s ability to prevent microbial infections associated with urogenital and gastrointestinal tracts and the skin. Here, we described the biological and physicochemical properties of biosurfactants produced by Lactobacillus jensenii P_6A and Lactobacillus gasseri P₆₅.

Results

The biosurfactants produced by L. jensenii P_6A and L. gasseri P₆₅ reduced the water surface tension from 72 to 43.2 mN m⁻¹ and 42.5 mN m⁻¹ as their concentration increased up to the critical micelle concentration (CMC) values of 7.1 and 8.58 mg mL⁻¹, respectively. Maximum emulsifying activity was obtained at concentrations of 1 and 5 mg mL⁻¹ for the P_6A and P₆₅ strains, respectively. The Fourier transform infrared spectroscopy data revealed that the biomolecules consist of a mixture of carbohydrates, lipids and proteins. The gas chromatography-mass spectrum analysis of L. jensenii P_6A biosurfactant showed a major peak for 14-methypentadecanoic acid, which was the main fatty acid present in the biomolecule; conversely, eicosanoic acid dominated the biosurfactant produced by L. gasseri P₆₅. Although both biosurfactants contain different percentages of the sugars galactose, glucose and ribose; rhamnose was only detected in the biomolecule produced by L. jensenii P_6A. Emulsifying activities were stable after a 60-min incubation at 100 °C, at pH 2–10, and after the addition of potassium chloride and sodium bicarbonate, but not in the presence of sodium chloride. The biomolecules showed antimicrobial activity against clinical isolates of Escherichia coli and Candida albicans, with MIC values of 16 µg mL⁻¹, and against Staphylococcus saprophyticus, Enterobacter aerogenes and Klebsiella pneumoniae at 128 µg mL⁻¹. The biosurfactants also disrupted preformed biofilms of microorganisms at varying concentrations, being more efficient against E. aerogenes (64%) (P_6A biosurfactant), and E. coli (46.4%) and S. saprophyticus (39%) (P₆₅ biosurfactant). Both strains of lactobacilli could also co-aggregate pathogens.

Conclusions

This report presents the first characterization of biosurfactants produced by L. jensenii P_6A and L. gasseri P₆₅. The antimicrobial properties and stability of these biomolecules indicate their potential use as alternative antimicrobial agents in the medical field for applications against pathogens that are responsible for infections in the gastrointestinal and urogenital tracts and the skin.

Ocellatin peptides from the skin secretion of the South American frog Leptodactylus labyrinthicus (Leptodactylidae): characterization, antimicrobial activities and membrane interactions

Background

The availability of antimicrobial peptides from several different natural sources has opened an avenue for the discovery of new biologically active molecules. To the best of our knowledge, only two peptides isolated from the frog Leptodactylus labyrinthicus, namely pentadactylin and ocellatin-F1, have shown antimicrobial activities. Therefore, in order to explore the antimicrobial potential of this species, we have investigated the biological activities and membrane interactions of three peptides isolated from the anuran skin secretion.

Methods

Three peptide primary structures were determined by automated Edman degradation. These sequences were prepared by solid-phase synthesis and submitted to activity assays against gram-positive and gram-negative bacteria and against two fungal strains. The hemolytic properties of the peptides were also investigated in assays with rabbit blood erythrocytes. The conformational preferences of the peptides and their membrane interactions have been investigated by circular dichroism spectroscopy and liposome dye release assays.

Results

The amino acid compositions of three ocellatins were determined and the sequences exhibit 100% homology for the first 22 residues (ocellatin-LB1 sequence). Ocellatin-LB2 carries an extra Asn residue and ocellatin-F1 extra Asn-Lys-Leu residues at C-terminus. Ocellatin-F1 presents a stronger antibiotic potential and a broader spectrum of activities compared to the other peptides. The membrane interactions and pore formation capacities of the peptides correlate directly with their antimicrobial activities, i.e., ocellatin-F1 > ocellatin-LB1 > ocellatin-LB2. All peptides acquire high helical contents in membrane environments. However, ocellatin-F1 shows in average stronger helical propensities.

Conclusions

The obtained results indicate that the three extra amino acid residues at the ocellatin-F1 C-terminus play an important role in promoting stronger peptide-membrane interactions and antimicrobial properties. The extra Asn-23 residue present in ocellatin-LB2 sequence seems to decrease its antimicrobial potential and the strength of the peptide-membrane interactions.

Electronic supplementary material

The online version of this article (doi:10.1186/s40409-017-0094-y) contains supplementary material, which is available to authorized users.

Ethanol production from macaúba (Acrocomia aculeata) presscake hemicellulosic hydrolysate by Candida boidinii UFMG14

Yeasts capable of growth on xylose were isolated from macaúba (Acrocomia aculeata) fruit, a Brazilian palm tree with great potential for use as biodiesel feedstock production. Candida boidinii UFMG14 strain achieved the highest ethanol production (5 g/L) and was chosen to ferment macaúba presscake hemicellulosic hydrolysate (MPHH). The MPHH was produced by the first time in this work and the resultant fivefold concentrate showed considerable sugar content (52.3 and 34.2 g/L xylose and glucose, respectively) and low furfural (0.01 g/L) and hydroxymethylfurfural (0.15 g/L) concentrations. C. boidinii UFMG14 fermentation was evaluated in supplemented and non-supplemented MPHH containing either 10 or 25 g/L of xylose. The maximum ethanol production (12 g/L) was observed after 48 h of fermentation. The ethanol yield was significantly affected by supplementation and concentration of MPHH while ethanol productivity was affected only by MPHH concentration. This is the first study demonstrating theC. boidinii potential for ethanol production from hemicellulose byproducts.

Demulsifying properties of extracellular products and cells of Pseudomonas aeruginosa MSJ isolated from petroleum-contaminated soil

A strain of Pseudomonas aeruginosa isolated from a site contaminated with refined oil products exhibited demulsification capabilities against Tween 80-Span 80 stabilized oil-in-water (O/W), Tween 80-stabilized water-in-oil (W/O) model emulsions (kerosene-water), and an industrial emulsion (Daido Dairoll PA-5A). GC-MS analysis confirmed the presence of fatty acids and carbohydrates in the extracellular biodemulsifier. The demulsifying activity of cells and culture supernatants was favored by growth in media containing 1% diesel oil. There was a correlation between culture age, de-emulsification and cellular hydrophobicity, and highest activities were observed for cells and supernatants from 96-h cultures. Activity increased with addition of up to 60 mg cells or 300 μL supernatant to emulsions. The activity was relatively stable at 20-40 °C and to freezing, but was reduced by 69% by washing the cells with chloroform-methanol-water. This demulsifier has potential for application in biotreatment of emulsified oily wastewaters to promote recovery and/or degradation of oil.

Inhibition of Candida albicans CC biofilms formation in polystyrene plate surfaces by biosurfactant produced by Trichosporon montevideense CLOA72

This study evaluated the effects of glycolipid-type biosurfactant produced by Trichosporon montevideense CLOA72 in the formation of biofilms in polystyrene plate surfaces by Candida albicans CC isolated from the apical tooth canal. Biofilm formation was reduced up to 87.4% with use of biosurfactant at 16 mg/ml concentration. It has been suggested that the interaction with the cell or polystyrene plate surface could ultimately be responsible for these actions. Therefore, the interaction of C. albicans CC cells with the biosurfactant, as well as the corresponding thermodynamic parameters, have been determined by isothermal titration calorimetry and zeta potential measurements. This process is endothermic (((int)H°=+1284±5 cal/mg OD(600)) occurring with a high increase of entropy (T((int)S°=+10635 cal/mg OD(600)). The caloric energy rate data released during the titulation indicates saturation of the cell-biosurfactant at 1.28 mg/ml OD(600). Also, the zeta potential of the cell surface was monitored as a function of the biosurfactant concentration added to cell suspension showing partial neutralization of net surface charge, since the value of zeta potential ranged from -16 mV to -6 mV during the titration. The changes of cell surface characteristics can contribute to the inhibition of initial adherence of cells of C. albicans in surface. The CMC of the purified biosurfactant produced from T. montevideense CLOA72 is 2.2 mg/ml, as determined both by ITC dilution experiments and by surface tension measurements. This biomolecule did not presented any cytotoxic effect in HEK 293A cell line at concentrations of 0.25-1 mg/ml. This study suggests a possible application of the referred biosurfactant in inhibiting the formation of biofilms on plastic surfaces by C. albicans.

Identification and characterization of bioemulsifier-producing yeasts isolated from effluents of a dairy industry

New bioemulsifier-producing yeasts were isolated from the biological wastewater treatment plant of a dairy industry. Of the 31 bioemulsifier-producing strains, 12 showed emulsifying activity after 2months of incubation, with E(24) values ranging from 7% to 78%. However, only Trichosporon loubieri CLV20, Geotrichum sp. CLOA40, and T. montevideense CLOA70 exhibited high emulsion-stabilizing capacity, with E(24) values of 78%, 67%, and 66%, respectively. These isolates were shown to induce a strong emulsion stabilizing activity rather than the reduction of the interfacial tension. These strains exhibited similar growth rates in the exponential growth phase, with a clear acceleration after 24h and stabilization of the activity after 144h. Emulsification and stability properties of the bioemulsifiers were compared to those of commercial surfactants after the addition of NaCl and exposure to temperature of 100 degrees C. The compounds produced by the isolates appeared to be lipid-polysaccharide complexes. Gas chromatograph analysis of the lipidic fraction of the bioemulsifiers from CLV20, CLOA40, and CLOA70 shows the prevalence of (9Z,12Z)-octadeca-9,12-dienoic acid, in concentrations of 42.8%, 25.9%, and 49.8%, respectively. The carbohydrate composition, as determined by GC-MS of their alditol acetate derivatives, showed a predominance of mannose, galactose, xylose and arabinose.

A large scale analysis of resistance gene homologues in Arachis

Arachis hypogaea L., commonly known as the peanut or groundnut, is an important and widespread food legume. Because the crop has a narrow genetic base, genetic diversity in A. hypogaea is low and it lacks sources of resistance to many pests and diseases. In contrast, wild diploid Arachis species are genetically diverse and are rich sources of disease resistance genes. The majority of known plant disease resistance genes encode proteins with a nucleotide binding site domain (NBS). In this study, degenerate PCR primers designed to bind to DNA regions encoding conserved motifs within this domain were used to amplify NBS-encoding regions from Arachis spp. The Arachis spp. used were A. hypogaea var. Tatu and wild species that are known to be sources of disease resistance: A. cardenasii, A. duranensis, A. stenosperma and A. simpsonii. A total of 78 complete NBS-encoding regions were isolated, of which 63 had uninterrupted ORFs. Phylogenetic analysis of the Arachis NBS sequences derived in this study and other NBS sequences from Arabidopsis thaliana, Medicago trunculata, Glycine max, Lotus japonicus and Phaseolus vulgaris that are available in public databases This analysis indicates that most Arachis NBS sequences fall within legume-specific clades, some of which appear to have undergone extensive copy number expansions in the legumes. In addition, NBS motifs from A. thaliana and legumes were characterized. Differences in the TIR and non-TIR motifs were identified. The likely effect of these differences on the amplification of NBS-encoding sequences by PCR is discussed.

Phenol degradation by a Graphium sp. FIB4 isolated from industrial effluents

In this work, we show that the fungal strain Graphium sp. FIB4 was able to use phenol as the sole carbon source. Higher degradation of phenol was accomplished by alginate-immobilized mycelial mass than by mycelial suspensions of Graphium sp. FIB4. Free mycelium exhibited higher degradation rates when compared with the alginate-immobilized mycelium in the presence of 14 mM of phenol or less. Above this concentration, degradation rates by free mycelium decreased and the immobilized mycelium showed higher values. The maximum degradation rate for 8 mM phenol was found to be 20.13 mg/l x h by free mycelia and 16.24 mg/l x h by immobilized mycelial mass in the presence of 18 mM phenol. When the fungus was grown on medium without phenol, catechol 1,2-dioxygenase activity was not detected. This enzyme activity was induced at phenol concentrations as low as 0.05 mM and up to 6 mM at 24 h incubation at 30 degrees C, suggesting that catechol was oxidized by the ortho type of ring fission. Addition of glucose reduced phenol consumption rate, and both substrates were used simultaneously. Glucose concentrations higher than 0.075% repressed the induction of phenol oxidation by Graphium sp. FIB4 grown on glucose. But glucose did not fully repress utilization of phenol by phenol-pre-induced cells. Immobilization and addition of calcium and barium ions were detrimental to the stability of catechol 1,2-dioxygenase activity and phenol degradation by Graphium sp. FIB4.

Degradation of phenol by Trichosporon sp. LE3 cells immobilized in alginate

The degradation of phenol by freely suspended cells of Trichosporon sp. LE3 and alginate-immobilized cells was studied in batch culture. The alginate concentration (2 or 4%) and the cross-linking salt used (BaCl2 or CaCl2) affected the rate and percentage of phenol degradation. The highest values were obtained for immobilized cells at 2% calcium alginate, although complete degradation of 15 and 18 mM phenol was not observed. When the cell concentrations in the assays were doubled, the 2% calcium alginate-immobilized cells were able to degrade up to 30 mM phenol in less than 120 hours, although the free cells did not completely degrade phenol at concentrations above 20 mM. The maximum phenol degradation rate was a strong function of initial phenol concentrations, being the highest values being observed for 20 mM phenol.

Urinary incontinence knowledge and attitudes in São Paulo

Urinary incontinence is a social and hygienic problem that affects 15% to 35% of individuals aged 60 years or older, with an estimated annual cost in the United States of $16 billion. To better understand the effects of misinformation and underestimation of the problem, a study to identify knowledge and attitudes related to urinary incontinence was conducted among 400 community-dwelling residents (55 years of age or older). The instrument covered four knowledge/attitude subject areas: treatment and effects, causes, the relationship between aging and urinary incontinence, and physician/patient discussion regarding urinary incontinence. Interviews were conducted in waiting rooms, shopping centers, subways, and hospital/clinic waiting rooms. One hundred, forty-two people (43% women and 23% men) reported current or previous bladder problems. Only two of the 14 knowledge statements elicited a correct response from the majority (60%) of participants. The percentage of correct answers to the other 12 statements ranged from 23% to 43%. Most people believed that urinary incontinence is an inevitable consequence of aging, and the majority of treatment responses (58%) indicated a lack of knowledge about available treatments. Differences in the percentage of correct responses related to the treatment and causes of urinary incontinence were observed between respondents with varying educational levels (P = 0.001) and between Caucasian and African American respondents (P = 0.001). The results confirm that misinformation about urinary incontinence is common in the general population and that educational interventions are needed if the prevalence of uncontrolled urinary incontinence is to be solved.

Phenol degradation by yeasts isolated from industrial effluents

Yeast strains of the genera Aureobasidium, Rhodotorula and Trichosporon were isolated from stainless steel effluents and tested for their ability to utilize phenol as the sole carbon source. Fourteen strains grew in the presence of up to 10 mm phenol. Only the strain Trichosporon sp. LE3 was able to grow in the presence of up to 20 mm phenol. An inhibitory effect was observed at concentrations higher than 11 mm, resulting in reduction of specific growth rates. Phenol degradation was a function of strain, time of incubation and initial phenol concentration. All strains exhibited activity of catechol 1,2-dioxygenase and phenol hydroxylase in free cell extracts from cells grown on phenol, suggesting that catechol was oxidized by the ortho type of ring fission. Addition of glucose and benzoate reduced the phenol consumption rate, and both substrates were used simultaneously. Glucose concentrations higher than 0.25% inhibited the induction of phenol oxidation by non-proliferating cells and inhibited phenol oxidation by pre-induced cells.

The pouch acting as a mediator between "being a person with an ostomy" and "being a professional": analysis of a pedagogical strategy

OBJECTIVE

This study analyzes the process of constructing and reconstructing the meanings of the concepts ostomy, ostomy patient, and the nurse's role in managing an ostomy after the experience of wearing a pouch.

SUBJECTS AND SETTING

Thirty nurses who were students in the Enterostomal Therapy Nursing Education Program in 1992 and 1993 participated in this study. All of the participants were female, ages 20 to 55 years, had graduated from nursing at least 6 years previously, and had been working at acute care hospital units or at outpatient care centers. The research was completed at the Enterostomal Therapy Nursing Education Program in the Nursing College of the University of São Paulo.

METHODS

All participants wore a pouch and lived as an ostomy patient for a 24-hour period and then were interviewed about their experience. Two major themes were identified after analysis: "being a person with an ostomy" and "being a professional."

RESULTS

The experience of wearing a pouch promoted changes in perceived role, self-esteem, body image, sexuality, and social relations. These changes were sometimes perceived as stigmatization and sometimes as enhancing social support. The perceptions caused a crisis that provoked the use of coping and social defense mechanisms that ultimately altered the participants' perceptions of the meaning of "being a nurse." Prior to this learning experience, the participants' management of patients with ostomies was fragmented and marked by a dissociation among activity, thinking, and feeling. Before the experiences, participants defined their management of patients with ostomies as mostly technical, focusing on the ostomy and the pouch. Following the experience, participants proposed changes in practice designed to care for the whole human being, revealing an incorporation of the affective, symbolic, and relational dimensions critical to managing the care of patients with an ostomy.

CONCLUSION

The results showed that having subjects wear a pouch as a pedagogic strategy was successful in directing the participants' thinking about new meanings concerning "being a professional," resulting in some potential profound changes in the future nursing care of their patients.

[Wearing a pouch shows the difference between "being an "ostomized person" and "being a professional": analysis of a teaching strategy]

This study aimed at analyzing nurses (re)construction process regarding the meanings of ostomy, ostomized patients, nursing care and the professional role after they wore an ostomy appliance. This activity is a teaching strategy applied at the Enterostomal Therapy Nursing Education Program. Two major units were identified after the analysis of students speeches: "being an ostomized person" and "being a professional". When students wore the pouches they felt as ostomized patients experiencing a violation of their identity and quality of life that promotes profound changes in daily life. These symbolic contents cause a crisis regarding the meaning of being a professional as until this experience, nursing care seemed fragmented to them. Recognizing a previous care performed as a technical action mainly directed to the ostomy and the pouch, students were able to visualize a future care, that is holistic and considers the ostomized human being, enabling them to incorporate affective, symbolic and relational dimensions.

[Conceptual framework for ostomy care in the hospitalized adult patient]

The author points out a brief revision of the legal, ethical and scientific bases of the ostomy care process and describes some important topics about caring the ostomist in the different operatory phases.

Self-perceptions about having an ostomy: a postoperative analysis

The aim of this study is to identify the self-perceptions of patients at different postoperative phases and settings. The case study involves two ostomy patients: a young woman with a temporary ileostomy, and an older man with a permanent colostomy. Both patients were interviewed while still in the hospital on the third, fifth, and seventh postoperative days, and on the second day of the first and third months after discharge. Four major factors were identified after the patients were analyzed: social support, health and life expectations, physical suffering, and self-care. Family support predominated the social support category for both patients. The results showed that the patients' perceptions about having an ostomy were not influenced by the type of ostomy (i.e., whether the ostomy was temporary or permanent in the in-hospital phase). However, these results/perceptions, primarily those related to health and life expectancy and self-care, changed early in the study. We believe it is important for the healthcare team to know the perceptions patients have about their ostomies and themselves postoperatively. This, in turn, may contribute to systematic and personalized care based on specific patients' demands that vary at different stages of treatment and, most certainly, in different cultures.

[Special education in stoma therapy in Brazil 1990-1995]

The authors show the trajectory of the Brazilian Stomal Therapy Courses since their beginning in 1990 until 1995. Firstly they point out the changes of their contents initially based on medical and biological fields. Nowadays they also involve issues in the other Enterostomal Therapy fields-wounds and incontinence-besides discussions and reflections on the principles of organization and creation of care programmes, services and protocols as well as on the Stomal Therapy as a specialty in Brazilian nursing, society and politics. The 75 students' expectations, perspectives and evaluation related to the courses are presented, showing positive tendencies. The author finishes the study considering the importance of the evaluation process towards the improvement of the course according to the new challenges and discussions about nursing specialties in our country.

[Aspects of the social reintegration of stoma patients]

The social rehabilitation represents a challenge to ostomy patient and a concern for health professional team. This study intends to verify the difficulties related to returning to the daily domestic, leisure, job and sexual activities showed by 45 ostomizeds after hospital discharge in different periods of late post operative. The data was obtained from patients assisted by two Outpatient Services of São Paulo city, through the interviews. The patients were selected by previous established criteria agreement and then subdivided in three groups as the post operative period. It's possible to verify that the majority of the clients didn't returned totally or returned only partially to the daily activities like before the disease or surgery, specially in the sexual area. They justified these difficulties by physical problems, insecurity and the use of inadequate appliances.

[How I managed peristomal dermatitis]

Peristomal skin irritation is one of the most frequent complication in the ostomate's rehabilitation process. It can and must be avoid through a specialized care. The author makes a literature revision and approaches the causative and associated factors to the skin damage, its classification and the preventive and therapeutical principles in Nursing Stomal therapy.

[Skin care in digestive fistulae]

The author approaches about historical aspects, concepts, etiology and treatment of digestive fistula. The skin care and drainage control are the basis of stomal therapy. So, the author discusses the specific nursing and ET care in this subject, including evaluation, procedures and resources.

[Stoma therapy: an emerging specialty for Brazilian nursing]

The authors relate the experience in the organization and development of the I Enterostomal Therapy Specialization Course, the pioneer in Brazil. They report the concepts and history about enterostomal therapy as a specialty; discuss the objectives, contents, teaching strategies, and evaluation process of the course.

Direct bonded space maintainers

The aim of this study was to evaluate clinically a bonded space maintainer, which would reduce chair-side time and cost. Sixty appliances were fabricated from 0.7 mm stainless steel round wire and bonded using light-cured composite to the two teeth adjacent to the site of extraction of a posterior primary tooth. Twenty males and sixteen females (age range 5-9-years-old) were selected from the Pedodontic clinic of the State University of Rio de Janeiro. The sixty space maintainers were divided into two groups according to the site in which they were placed: a) absent first primary molar and b) absent second primary molar. Impressions and study models were obtained prior to and 6 months after bonding the appliances. During this period only 8.3% of failures were observed, most of them from occlusal or facial trauma. Student t-test did not show statistically significant alterations in the sizes of the maintained spaces during the trial period.

ESTUDO SOBRE OS RESULTADOS DA IRRIGAÇÃO EM COLOSTOMIZADOS SUBMETIDOS A UM PROCESSO DE TREINAMENTO SISTEMATIZADO

O presente estudo versa sobre os resultados do emprego da auto-irrigaçâo por 40 colostomizados, por nós treinados através de um processo de treinamento sistematizado. A efetividade do processo de treinamento pode ser constatada à medida que a maioria dos clientes o adotou em seus itens básicos, apontando pequeno número de dificuldades técnicas. Quanto aos resultados da autoirrigaçâo, como método de controle do hábito intestinal, verificou-se que 37,50% da população apresentou ausência de perdas fecais e 42,50%, perdas esporádicas entre as irrigações; 27,50% e 35,00% com ausência e redução dos gases nesses intervalos, respectivamente e 32,50% e 37,50% com abolição total e parcial do uso da bolsa coletora, respectivamente.

[The feelings and suggestions expressed by colostomy patients who self-irrigate]

The analysis of feelings and suggestions presented by a group of colostomy patients which use a specific method of colostomy self-irrigation showed that it's well accepted by these patients. After the positive results using this method, we obtained 88.14% of the positive feelings answers specially wellbeing, safety and normality and an average of 0.35 suggestions per client.

[Assistance in rehabilitation: a process marked by deficiencies]

This study characterizes some rehabilitation's agencies which provide assistance to deficients from Grande São Paulo. Analysis of data showed: the inadequate number and geographic distribution of theses institutions; the predominance of private agencies which promote variable services; just two agencies offered nursing services; the major group of patients was childrens and adolescents of both sexes. The authors believe that it's fundamental to make a reflexion about the resources to assist the deficient patients, the quality of the assistance and the effective participation of the nurse in this process.

[Teaching of medical surgical nursing: an approach via physiological changes]

O trabalho trata da metodologia empregada pela disciplina de enfermagem médico-cirúrgica da Escola de Enfermagem da Universidade de São Paulo no desenvolvimento de seu conteúdo programático. Justifica a abordagem teórico-prática por categorias de alterações fisiológicas. A seguir, conceitua problemas de enfermagem e a sua utilização co mo base da assistência global prestada ao indivíduo. Finalmente, discorre sobre as várias alterações englobadas no conteúdo programático e tece considerações finais sobre a etapa em que se encontra o emprego desta metodologia além de algumas recomendações específicas para a sua implementação.