Escala de braden: benefícios de sua aplicação na prevenção de lesão por pressão no âmbito domiciliar / Braden scale: benefits of its use in the prevention of pressure injury in the household

Objetivo: Averiguar a eficácia da Escala de Braden como instrumento norteador na assistência para prevenção de lesão por pressão em indivíduos acamados no âmbito domiciliar. Método: Trata-se de um estudo descritivo com abordagem quantitativa com coleta de dados realizada em domicílio por meio de entrevista e inspeção da pele de 41 participantes. Resultados: A incidência de lesão por pressão foi de 7%. Constatou-se que os indivíduos acamados em domicílio com alto risco, na escala de Braden, não mostraram incidência de lesão por pressão, enquanto os que apresentaram risco moderado houve incidência. Conclusão: Apesar de ser um instrumento bastante utilizado pelos profissionais da área da saúde, o presente trabalho demonstrou que a alta sensibilidade e especificidade da Escala de Braden é questionável. Os cuidados foram essênciais para essa baixa incidência de lesão por pressão, diminuindo sua associação com a idade e tempo de acamado.

Objective: investigate the effectiveness of the Braden Scale as a guiding instrument in assisting in the prevention of pressure injury in bedridden individuals at home. Method: This is a descriptive study with a quantitative approach, with data collected at home through interviews and skin inspection of 41 participants. Results: There was an incidence of 7% of pressure injuries. It was found that individuals at high risk at home, according to the Braden scale, did not show incidence of pressure injuries, while those with moderate risk presented such incidence. Conclusion: Despite being widely used by health professionals, this study demonstrated that the high sensitivity and specificity of the Braden Scale is questionable. Care was essential for this low incidence of pressure injuries, reducing its association with age and bedridden time.

Diabetes mellitus alters electrophysiological properties in neurons of superior cervical ganglion of rats.

Diabetic neuropathy is the most prevalent complication associated with diabetes mellitus (DM). The superior cervical ganglion (SCG) is an important sympathetic component of the autonomic nervous system. We investigated the changes in cellular electrophysiological properties and on Na+K+-ATPase activity of SCG neurons of rats with DM induced by streptozotocin (STZ). Three types of action potentials (AP) firing pattern were observed in response to a long (1 s) depolarizing pulse. Whilst some neurons fired a single AP (single firing phasic, SFP), others fired few APs (multiple firing phasic, MFP). A third type fired APs during more than 80% of the stimulus duration (tonic-like, TL). The occurrence of SFP, MFP and TL was 84.5, 13.8, and 1.7%, respectively. SFP and MFP differed significantly in their membrane input resistance (Rin). At the end of the 4th week of its time course, DM differently affected most types of neurons: DM induced depolarization of resting membrane potential (RMP), decreased AP amplitude in SFP, and decreased Rin in MFP. DM decreased spike after-hyperpolarization amplitude in MFP and the duration in SFP. Based on the RMP depolarization, we investigated the Na+K+-ATPase action and observed that DM caused a significant decrease in Na+K+-ATPase activity of SCG. In conclusion, we have demonstrated that DM affects several parameters of SCG physiology in a manner likely to have pathophysiological relevance.

Monoterpenoid terpinen-4-ol inhibits voltage-dependent Na+ channels of small dorsal root ganglia rat neurons.

The monoterpenoid terpinen-4-ol (4TERP) is known to inhibit cell excitability, has low toxicity and important pharmacological activities, which are likely related to neural excitability, such as anti-inflammatory, antiepileptic and antinociceptive effects. However, the pharmacological characteristics and mechanisms underlying the effects of 4TERP on blockade of neural action potential are not completely elucidated. Since Na+ current (INa) through voltage-dependent Na+ channels (NaV) is a major mechanism for excitability, the present study investigated the pharmacological characteristics and mechanisms of the action of 4TERP on INa through NaV. For this aim, dissociated small neurons of dorsal root ganglia of adult rats were used for whole cell patch-clamp recordings. 4TERP concentration-dependently inhibits INa (IC50 0.8 ±â€¯0.3 mM; pharmacological efficacy 42.89 ±â€¯5.54%). 4TERP interfered with INa through a mechanism with various components, which includes predominantly channel pore block and sensitivity to frequency of use. In presence of 4TERP (3 mM), decreasing stimulation from 5 Hz to very low frequency (75 s of quiescence previously to stimulation) induced INa decrease to 65.17 ±â€¯5.86% of control. 4TERP also altered (left shift) voltage sensitivity of the steady state activation of NaV. Data are discussed aiming to interpret the importance of blockade of INa through NaV as participant of 4TERP-induced inhibition of membrane excitability.