[Cross-cultural adaptation of the Caregiver Reaction Assessment for use in Brazil with informal caregivers of the elderly]. / Adaptação transcultural do Caregiver Reaction Assessment parauso no Brasil com cuidadores informais de idosos.

UNLABELLED: This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment CRA for use in Brazil with informal caregivers of dependent elderly METHOD: A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. RESULTS: The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). CONCLUSION: It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research.

[Factors associated with vaccination against influenza A (H1N1) in the elderly]. / Fatores associados à vacinação contra Influenza A (H1N1) em idosos.

This study aimed to investigate the sociodemographic, clinical and behavioral factors and receiving information about the vaccine against pandemic influenza A (H1N1) associated with vaccination of elderly people. Study of quantitative and transversal nature, in which 286 elderly residents in Fortaleza, CE, Brazil participated. The association between variables was analyzed by the Pearson chi-square test, considering a 95% confidence interval and significance level (p≤0.05). The results revealed that, unlike the sociodemographic characteristics, many clinical, behavioral and informational aspects correlated significantly with adherence to Influenza A (H1N1) vaccination. It is believed that the findings can be used in strategies to control and prevent infection by viral subtypes within the elderly population, extensible even to other vaccine-preventable diseases, especially in light of possible future pandemics.

Impact of prophylactic corticosteroids on systemic inflammation after extensive atrial ablation in pigs.

AIMS: Prophylactic corticosteroids have been reported to attenuate the increase in C-reactive protein (CRP) and the incidence of atrial fibrillation (AF) both after heart surgery and AF ablation. We tested the impact of a single prophylactic corticosteroid dose on ultrasensitive CRP 24 h and 14 days after extensive linear atrial ablation (8 mm or 3.5 irrigated tip) guided by electroanatomical mapping (NavX) in pigs with normal hearts. METHODS AND RESULTS: Pigs (n = 19; 35 kg) were divided into three groups: corticoid (n = 7), atrial ablation with administration of 500 mg methylprednisolone intravenous at anaesthetic induction; control (n = 7), atrial ablation only; and sham (n = 5), surgical procedure without ablation. Troponin and CRP were measured before, 24 h and 14 days after the procedure. After sacrifice, lesions were analysed macroscopically and histologically. Linear lesions were created in the right (n = 23) and left (n = 21) atrium of 14 animals, with no difference between groups. In all groups there was elevation of troponin and CRP 24 h after ablation, with a return to baseline values after 14 days. However, CRP levels of the control, corticoid, and sham groups were similar at all three time points analysed (baseline P = 0.52, 24 h P = 0.21, 14 days P = 0.66). Histological analysis did not show any difference between corticoid and control groups. CONCLUSION: In this model, extensive biatrial RF ablation, per se, does not promote systemic inflammation. The use of a prophylactic single corticoid dose before ablation did not prevent systemic inflammation or alter the healing of the lesions.

Antinociceptive Effects of Aza-Bicyclic Isoxazoline-Acylhydrazone Derivatives in Different Models of Nociception in Mice.

BACKGROUND: In a study recently published by our research group, the isoxazoline-acylhydrazone derivatives R-99 and R-123 presented promising antinociceptive activity. However, the mechanism of action of this compound is still unknown. OBJECTIVE: This study aimed to assess the mechanisms involved in the antinociceptive activity of these compounds in chemical models of pain. METHODS: Animals were orally pretreated and evaluated in the acetic acid-, formalin-, capsaicin-, carrageenan- and Complete Freund's Adjuvant (CFA)-induced pain models in mice. The effects of the compounds after pretreatment with naloxone, prazosin, yohimbine, atropine, L-arginine, or glibenclamide were studied, using the acetic acid-induced writhing test to verify the possible involvement of opioid, α1-adrenergic, α2-adrenergic or cholinergic receptors, and nitric oxide or potassium channels pathways, respectively. RESULTS: R-99 and R-123 compounds showed significant antinociceptive activity on pain models induced by acetic acid, formalin, and capsaicin. Both compounds decreased the mechanical hyperalgesia induced by carrageenan or CFA in mice. The antinociceptive effects of R-99 and R-123 on the acetic acid-induced writhing test were significantly attenuated by pretreatment with naloxone, yohimbine or atropine. R-99 also showed an attenuated response after pretreatment with atropine and glibenclamide. However, on the pretreatment with prazosin, there was no change in the animals' response to both compounds. CONCLUSION: R-99 and R-123 showed antinociceptive effects related to mechanisms that involve, at least in part, interaction with the opioid and adrenergic systems and TRPV1 pathways. The compound R-99 also interacts with the cholinergic pathways and potassium channels.

Effects of Acylhydrazone Derivatives on Experimental Pulmonary Inflammation by Chemical Sensitization.

BACKGROUND: Chronic lung diseases are characterized by airway inflammation and remodelling of the lung parenchyma that triggers considerable impairment of respiratory function. OBJECTIVE: In this study, two compounds belonging to the N-acylhydrazone class were evaluated, aiming to identify new therapeutic agents for pulmonary inflammatory diseases. MATERIALS AND METHODS: The acute toxicity of 2-cyano-N'-(3-ethoxy-4-hydroxybenzylidene)- acetohydrazide (JR-12) and N'-benzylidene-2-cyano-3-phenylacrylohydrazide (JR09-Bz) was evaluated. Afterwards, they were tested in models of ovalbumin (OVA)-induced allergic asthma and pleurisy, bleomycin-induced pulmonary fibrosis, in addition to mucolytic activity. RESULTS AND DISCUSSION: The compounds did not show toxicity at the dose of 2,000 mg/kg, and no animal died. On OVA-induced pleurisy, animals treated with JR-12 or JR09-Bz at a dose of 10 mg/kg (orally) showed significant inhibition of the leukocyte infiltrate in the bronchoalveolar lavage by 62.5% and 61.5%, respectively, compared to the control group. The compounds JR-12 and JR09-Bz were also active in blocking the allergic asthmatic response triggered by OVA, reducing the leukocyte infiltrate by 73.1% and 69.8%, respectively. Histopathological changes and mast cell migration in treated animals with JR-12 or JR09-Bz were similar to treatment with the reference drugs dexamethasone and montelukast. JR-12 and JR09-Bz also reversed airway remodeling in animals on the bleomycin-induced fibrosis model compared to the control group. Furthermore, it was observed that N-arylhydrazone derivatives showed expectorant and mucolytic activities, increasing mucus secretion by 45.6% and 63.8% for JR-12 and JR09-Bz, respectively. CONCLUSION: Together, the results show that JR-12 and JR09-Bz showed promising activity against airway inflammation, as well as low toxicity.

Gastroprotective effect of ethyl acetate extract from Avicennia schaueriana Stapf & Leechman and underlying mechanisms.

OBJECTIVE: Avicennia schaueriana Stapf is an endemic mangrove species widely used by traditional Brazilian communities as a folk remedy for the treatment of rheumatism, ulcers, and skin wounds. The aim of the present study was to evaluate the gastroprotective potential of the ethyl acetate extract from the leaves of A. schaueriana (As-AcOEt). METHODS: Ultra-performance liquid chromatography coupled with diode-array detection and quadrupole time-of-flight mass spectrometry (UPLC-DAD-QTOF-MS/MS) was performed to identify chemical constituents of the ethyl acetate extract from the leaves ofA. schaueriana. Total phenols, flavonoids and tannins were determined and antioxidant activity was evaluated using the DPPH and ABTS methods. The acute toxicity of As-AcOEt and gastroprotective activity on HCl/ethanol-induced gastric ulcers were assessed and mechanisms of action involving the role of nitric oxide, sulfhydryl compounds, and prostaglandins were investigated. RESULTS: Terpenes, flavonoids and tannins were detected in the extract. As-AcOEt exhibited antioxidant activity, with an EC50 of 42.2 ± 4.4 µg/mL (DPPH) and 73.2% inhibition of ABTS radicals. UPLC-DAD-QTOF-MS/MS analysis identified gallic acid, gallic acid derivative, ellagic acid, myricetin pentoside, myricetin deoxyhexose, quercetin pentoside, quercetin deoxyhexose, and other compounds. Gallic acid was isolated in this species for the first time. During the acute toxicity test, no deaths or changes occurred in the variables evaluated. In the ethanol-induced ulcer model, As-AcOEt reduced the ulcerative lesion index, with 50, 100 and 200 mg/kg achieving 83.8, 88.5 and 86.9% inhibition, respectively. MPO levels decreased and the gastric mucosa of the animals treated with the extract was preserved. Pre-treatment with N-omega-nitro-l-arginine methyl ester (L-NAME; NO blocker) or carbenoxolone (CBXN; NP-SH blocker) reversed the gastroprotective effect of As-AcOEt, but this effect was not reversed with the previous administration of indomethacin. CONCLUSION: The present findings reveal that the extract from the leaves ofA. schaueriana has gastroprotective effects, suggesting the involvement of nitric oxide and nonprotein sulfhydryl compounds, but not prostaglandin. Therefore, the use of A. schaueriana in Brazilian folk medicine for the treatment of gastric disorders has a scientific basis.

Anti-inflammatory and antinociceptive activities of the leaf methanol extract of Miconia minutiflora (Bonpl.) DC. and characterization of compounds by UPLC-DAD-QTOF-MS/MS.

Some species of the genus Miconia are used in Brazilian folk medicine as analgesic and anti-inflammatory; however, several species of this genus are still poorly studied. Therefore, the aims of this study were to investigate the phytochemistry characterization by UPLC-DAD-QTOF-MS/MS, acute toxicity, anti-inflammatory and antinociceptive properties of Miconia minutiflora (Bonpl.) DC. The methanol extract of M. minutiflora (Mm-MeOH) was subjected to ultra-high-performance liquid chromatography (UPLC-DAD-QTOF-MS/MS) for the identification of the main phytocompounds. The anti-inflammatory properties of the extracts were studied using several inflammation models induced by carrageenan and acetic acid-induced vascular permeability. Antinociceptive effects of Mm-MeOH were assessed in nociception induced by intraperitoneal acetic acid or subplantar formalin injection. The role of α-adrenergic, cholinergic, and opioid receptors in modulating the extract's antinociceptive activity was determined. Analyses by UPLC-DAD-QTOF-MS/MS revealed the presence of ellagic acid, gallotannin, and terpenes in the methanol extract. Mm-MeOH (100 mg/kg) reduced carrageenan-induced paw edema and vascular permeability and inhibited leukocyte migration toward the air pouch and pleural cavity. Furthermore, Mm-MeOH decreased tumor necrosis factor-α (TNF-α) and interleukin-1ß (IL-1ß) levels. Administration of Mm-MeOH reduced the number of writhes by 58.9% and increased the pain threshold in the formalin test. The anti-inflammatory action mechanism of Mm-MeOH is associated with inhibition of proinflammatory cytokines TNF-α and IL-1ß, whereas the antinociceptive actions involve peripheral and central mechanisms with participation of α2-adrenergic receptors. These effects may be attributed to the presence of polyphenolics in the extract.

Evaluation of anti-inflammatory activity and molecular docking study of new aza-bicyclic isoxazoline acylhydrazone derivatives.

The aim of this study was to investigate the anti-inflammatory effects of two new isoxazoline-acylhydrazone derivatives: N'-(4-methoxybenzylidene)-6-(4-nitro-benzoyl)-3a,5,6,6a-tetrahydro-4H-pyrrolo[3,2-d]isoxazole-3-carbohydrazide (R-123) and N'-(4-chlorobenzylidene)-6-(4-chlorobenzoyl)-3a,5,6,6a-tetrahydro-4H-pyrrolo[3,2-d]isoxazole-3-carbohydrazide (R-99). An air pouch induced by carrageenan was used for screening the best dose of R-99 and R-123. Using this mouse model, leukocyte migration and cytokine levels (TNF-α and IL-1ß) were determined. Paw edema induced by several phlogistic agents and vascular permeability induced by acetic acid were employed to investigate the mechanism of action of the isoxazoline-acylhydrazone derivatives. A docking study was performed with the human histamine H1 receptor to investigate potential antihistaminic activity. Treatment with the compounds reduced leukocyte migration in the air pouch at all doses tested. TNF-α and IL-1ß levels were similarly reduced by the two compounds. Vasoactive amines were inhibited in models of paw edema induced by several agents and vascular permeability induced by acetic acid. The docking study suggests that R-99 and R-123 may be inhibitors of the histamine H1 receptor. In conclusion, the results indicate that R-99 and R-123 exhibit promising anti-inflammatory activity related to their ability to inhibit TNF-α, IL-1ß, and vasoactive amine production, as well as reduce leukocyte migration and inhibit mast cell degranulation.

Validity and reliability of the Brazilian version of the Caregiver Reaction Assessment.

OBJECTIVE: To analyze the validity based on the internal structure and reliability of the Brazilian version of the Caregiver Reaction Assessment (CRA) applied to informal caregivers of dependent elderly. METHOD: A methodological study with 120 informal caregivers of the elderly. Validity based on the internal structure evaluated by exploratory factorial analysis, with extraction of main factorial axes, varimax orthogonal rotation and retention of factors by parallel analysis. Reliability assessed by Cronbach's alpha. RESULTS: The instrument revealed a factorial structure different from the original version: three factors were identified, equivalent to subscales, self-esteem, daily activities and family support, with explained variance of 42%. The values of the Cronbach alpha for the items belonging to each subscale were, respectively: 0.71, 0.81 and 0.83. CONCLUSION: The Brazilian version of CRA presents good evidence of validity based on internal structure and is reliable, and can be used to assess the overload of informal caregivers of dependent elderly.

New thiazolidinedione LPSF/GQ-2 inhibits NFκB and MAPK activation in LPS-induced acute lung inflammation.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are responsible for high mortality rates in critical patients. Despite >50 years of intensive research, there is no pharmacologically effective treatment to treat ALI. PPARs agonists, chemically named thiazolidinediones (TZDs) have emerged as potential drugs for the treatment of ALI and ARDS due to their anti-inflammatory efficacy. The present study aims to evaluate the potential anti-inflammatory effects of new TZDs derivatives, LPSF/GQ-2 and LPSF/RA-4, on ALI induced by LPS. BALB/c mice were divided into five groups: 1) Control; 2) LPS intranasal 25 µg; 3) LPSF/GQ-2 30 mg/kg + LPS; 4) LPSF/RA-4 20 mg/kg + LPS; and 5) DEXA 1 mg/Kg + LPS. BALF analyses revealed that LPSF/GQ-2 and LPSF/RA-4 reduced NO levels in BALF and inflammatory cell infiltration induced by LPS. MPO levels were also reduced by the LPSF/GQ-2 and LPSF/RA-4 pre-treatments. In contrast, histopathological analyses showed better tissue protection with LPSF/GQ-2 than DEXA and LPSF/RA-4 groups. Similarly, LPSF/GQ-2 reduced inflammatory markers (IL-1, iNOS, TNFα, IL-1ß, IL-6) better than LPSF/RA-4. The LPSF/GQ-2 anti-inflammatory action could be attributed to the inhibition of NFκB, ERK, p38, and PARP pathways. In contrast, LPSF/RA-4 had no effect on the expression of p38, JNK, NFκB. The present study indicates that LPSF/GQ-2 presents a potential therapeutic role as an anti-inflammatory drug for ALI.

Aspectos do cuidado integral para pessoas em situação de rua acompanhadas por serviço de saúde e de assistência social: um olhar para e pela terapia ocupacional / Aspects of the whole care for people in street followed by health and social assistance services: a look at and for occupational therapy

Resumo Introdução A população que (sobre)vive nas ruas se caracteriza, muitas vezes, pela ruptura dos vínculos sociais e pelo uso de drogas, necessitando de cuidados de saúde e de assistência social. Objetivo Identificar e analisar as percepções dos profissionais terapeutas ocupacionais e dos usuários sobre a atuação e especificidade da terapia ocupacional junto às pessoas em situação de rua atendidas pelo Centro de Atenção Psicossocial álcool e drogas (CAPS-ad III) e pela Unidade de Acolhimento (UA). Método Trata-se de um estudo exploratório, de abordagem qualitativa, realizada a partir de entrevistas semiestruturadas com três terapeutas ocupacionais e cinco usuários de um CAPS-ad III do Distrito Federal e da UA referenciada por este CAPS-ad III; os dados foram analisados a partir do método de Análise de Conteúdo. Resultados Os dados foram organizados em três categorias temáticas: (1) uso de drogas, a situação de morador de rua e o tratamento no CAPS-ad III; (2) o cotidiano de atuação da terapia ocupacional; e (3) terapia ocupacional e reinserção social. Conclusão A terapia ocupacional atua com população em situação de rua com olhar para o cotidiano e desempenho de Atividades de Vida Diária (AVD), trabalhando na perspectiva da Redução de Danos como forma de buscar uma maior qualidade de vida dos usuários. Torna-se necessário levar espaços de saúde e de assistência social para o contexto do usuário, realizar ações extrapolando o espaço físico do CAPS-ad e colocando o usuário como participante ativo desse processo.

Abstract Introduction The population that lives (survive) on the streets is often characterized by the rupture of social ties and the use of drugs, necessitating health care and social assistance. Objective To identify and analyze the perceptions of the occupational therapist professionals and the users about the performance and specificity of the occupational therapy with the street people assisted by the community-based drug treatment service (CAPS-ad III) and the Embracement Unit (EU). Method This is an exploratory and qualitative study based on semi-structured interviews with 3 occupational therapists and 5 users of a CAPS-ad III from the Federal District and the Embracement Unit (EU) referenced by this CAPS-ad III; the data were analyzed using analysis content. Results The data were organized into three thematic categories: (1) drug use, homelessness and treatment in CAPS-ad III; (2) the daily routine of Occupational Therapy; (3) Occupational Therapy and Social Integration. Conclusion The Occupational Therapy acts with the population in a street situation with a look at the daily life and performance of Activity of Daily Living (ADL), working in the perspective of Harm Reduction as a way to seek a higher quality of life of users. It is necessary to take care spaces and social assistance to the user context, to take actions extrapolating the physical space of CAPS-ad and placing the user as an active participant in this process.

Perfil e prevalência de resistência aos antimicrobianos de bactérias Gram-negativas isoladas de pacientes de uma unidade de terapia intensiva / Profile and prevalence of antimicrobial resistance of negative-Gram bacteria isolated from intensive care patients

Objetivo: Verificar a prevalência de infecção bacteriana e analisar o perfil de resistência aos antimicrobianos dos principais BGN isolados em pacientes internados na UTI. Métodos: Foi realizado um estudo descritivo e retrospectivo de 222 prontuários de pacientes internados na Unidade de Terapia Intensiva do Hospital Santa Casa de Misericórdia de Goiânia, obtendo-se dados de 245 amostras biológicas, no período de janeiro a dezembro de 2016. Resultados: A maioria dos pacientes era do sexo feminino, e foram isolados microrganismos principalmente de urocultura (48,6%). Das 13 espécies de BGN isoladas, Klebsiella pneumoniae foi o microrganismo mais prevalente (35,5%), seguido de Escherichia coli (24,1%), Acinetobacter baumannii (14,3%) e Pseudomonas aeruginosa (11,0%). Em relação às classes de antimicrobianos, houve resistência significativa para quinolonas (88,0%). Considerando o perfil de resistência dos principais BGN isolados, K. pneumoniae apresentou maior resistência para ampicilina e cefalosporinas; em E. coli, a resistência foi maior para ampicilina e ciprofloxacino; já para A. baumannii, cefalosporinas, quinolonas e carbapenêmicos obtiveram os maiores índices de resistência; em P. aeruginosa, a maior resistência foi observada para cefalosporinas e carbapenêmicos. Além disso, foram encontrados três BGN pan-resistentes, sendo eles K. pneumoniae, E. coli e A. baumannii. Conclusão: Observou-se maior prevalência de K. pneumoniae, a resistência foi mais elevada para as quinolonas e a maioria dos BGN apresentou uma importante e elevada multirresistência aos antimicrobianos.

Are the virtual lines created with the EnSite electroanatomical mapping system really continuous?

BACKGROUND: EnSiteNavx electroanatomic mapping system is widely used in radiofrequency (RF) atrial fibrillation ablation, helping the creation of linear lesions. However, the correspondence of the virtual line created by EnSite with the pathological lesion has not yet been evaluated. OBJECTIVE: to assess the continuousness of Ensite-guided virtual lines in a swine model. METHODS: we performed RF ablation linear lesions (8mm and irrigated catheters tips) in both atria of 14 pigs (35 Kg) guided by the EnSite. The animals were sacrificed 14 days post-ablation for macroscopic and histological analysis. RESULTS: a total of 23 lines in the right atrium and 21 lines in the left atrium were created in 14 animals. The medium power, impedance and temperature applications were 56 W, 54 ºC and 231 Ω for the 8mm tip, and 39 W, 37 ºC, 194 Ω for the irrigated tip catheter, respectively. All (100%) lines were identified on the epicardial and endocardial surfaces, denoting transmurality. At macroscopic examination, lesions were extensive and pale, continuous, with 3.61 cm long and 0.71 cm deep. The transmurality of the lesions was confirmed by microscopy. There was a correlation in the location of the lines at the virtual map and the anatomical lesions in 21 of 23 (91.3%) of the right atrium and 19/21 (90.4%) of the left atrium. CONCLUSION: In this model, the lines created in the virtual map by EnSiteNavX system correspond to continuous transmural linear lesions in anatomical specimen, suggesting that this method is suitable for linear ablation of atrial fibrillation.

Validity and reliability of the Brazilian version of the Caregiver Reaction Assessment / Validez y confiabilidad de la versión brasileña del Caregiver Reaction Assessment / Validade e confiabilidade da versão brasileira do Caregiver Reaction Assessment

ABSTRACT Objective: To analyze the validity based on the internal structure and reliability of the Brazilian version of the Caregiver Reaction Assessment (CRA) applied to informal caregivers of dependent elderly. Method: A methodological study with 120 informal caregivers of the elderly. Validity based on the internal structure evaluated by exploratory factorial analysis, with extraction of main factorial axes, varimax orthogonal rotation and retention of factors by parallel analysis. Reliability assessed by Cronbach's alpha. Results: The instrument revealed a factorial structure different from the original version: three factors were identified, equivalent to subscales, self-esteem, daily activities and family support, with explained variance of 42%. The values of the Cronbach alpha for the items belonging to each subscale were, respectively: 0.71, 0.81 and 0.83. Conclusion: The Brazilian version of CRA presents good evidence of validity based on internal structure and is reliable, and can be used to assess the overload of informal caregivers of dependent elderly.

RESUMEN Objetivo: Analizar la validez basada en la estructura interna y la confiabilidad de la versión brasileña del Caregiver Reaction Assessment (CRA) aplicado a cuidadores informales de ancianos dependientes. Método: Estudio metodológico, realizado con 120 cuidadores informales de ancianos. Validez basada en la estructura interna evaluada por análisis factorial exploratorio, con extracción de principales ejes factoriales, rotación ortogonal varimax y retención de factores por análisis paralelos. Confiabilidad examinada por el alpha de Cronbach. Resultados: El instrumento reveló una estructura factorial diferente de la versión original: tres factores fueron identificados, equivalentes a las subescalas autoestima, programación de las actividades diarias y soporte familiar, con varianza explicada de 42%. Los valores del alpha de Cronbach para los elementos integrantes de cada subescala fueron, respectivamente: 0,71, 0,81 y 0,83. Conclusión: La versión brasileña del CRA presenta buenas evidencias de validez basadas en la estructura interna y es confiable, pudiendo ser empleada en la evaluación de la sobrecarga de cuidadores informales de ancianos dependientes.

RESUMO Objetivo: Analisar a validade baseada na estrutura interna e a confiabilidade da versão brasileira do Caregiver Reaction Assessment (CRA) aplicado a cuidadores informais de idosos dependentes. Método: Estudo metodológico, realizado com 120 cuidadores informais de idosos. Validade baseada na estrutura interna avaliada por análise fatorial exploratória, com extração de principais eixos fatoriais, rotação ortogonal varimax e retenção de fatores por análises paralelas. Confiabilidade aferida pelo alpha de Cronbach. Resultados: O instrumento revelou estrutura fatorial diferente da versão original: três fatores foram identificados, equivalentes às subescalas, autoestima, programação das atividades diárias e suporte familiar, com variância explicada de 42%. Os valores do alpha de Cronbach para os itens integrantes de cada subescala foram, respectivamente: 0,71, 0,81 e 0,83. Conclusão: A versão brasileira do CRA apresenta boas evidências de validade baseada na estrutura interna e é confiável, podendo ser empregada na avaliação da sobrecarga de cuidadores informais de idosos dependentes.

Evaluation of cytotoxic and anti-inflammatory activities of extracts and lectins from Moringa oleifera seeds.

BACKGROUND: The extract from Moringa oleifera seeds is used worldwide, especially in rural areas of developing countries, to treat drinking water. M. oleifera seeds contain the lectins cmol and WSMoL, which are carbohydrate-binding proteins that are able to reduce water turbidity because of their coagulant activity. Studies investigating the ability of natural products to damage normal cells are essential for the safe use of these substances. This study evaluated the cytotoxic and anti-inflammatory properties of the aqueous seed extract, the extract used by population to treat water (named diluted seed extract in this work), and the isolated lectins cmol and WSMoL. METHODOLOGY/PRINCIPAL FINDINGS: The data showed that the aqueous seed extract and cmol were potentially cytotoxic to human peripheral blood mononuclear cells, while WSMoL and diluted seed extract were not cytotoxic. The M. oleifera aqueous seed extract and the lectins cmol and WSMoL were weakly/moderately cytotoxic to the NCI-H292, HT-29 and HEp-2 cancer cell lines and were not hemolytic to murine erythrocytes. Evaluation of acute toxicity in mice revealed that the aqueous seed extract (2.000 mg/kg) did not cause systemic toxicity. The aqueous seed extract, cmol and WSMoL (6.25 µg/mL) and diluted seed extract at 50 µg/mL exhibited anti-inflammatory activity on lipopolyssaccharide-stimulated murine macrophages by regulating the production of nitric oxide, TNF-α and IL-1ß. The aqueous seed extract reduced leukocyte migration in a mouse model of carrageenan-induced pleurisy; the myeloperoxidase activity and nitric oxide, TNF-α and IL-1ß levels were similarly reduced. Histological analysis of the lungs showed that the extract reduced the number of leukocytes. CONCLUSION/SIGNIFICANCE: This study shows that the extract prepared according to folk use and WSMoL may be non-toxic to mammalian cells; however, the aqueous seed extract and cmol may be cytotoxic to immune cells which may explain the immunosuppressive potential of the extract.

Tecnologias assistivas para idosos com demência: revisão sistemática / Tecnologías de asistencia para ancianos con demencia: revisión sistemática / Assistive technologies for demented elderly: a systematic review

Resumo Objetivo Analisar estudos de intervenções com tecnologias assistivas, empregadas no auxílio de idosos com demência, na execução das Atividades Básicas e Instrumentais de Vida Diária. Métodos Realizou-se levantamento, através das bases de dados CINAHL, MEDLINE/PubMed, LILACS, SCOPUS, Scielo, Cochrane e Web of Science . Utilizaram-se os descritores dementia/ demência , aged/ idoso , self-help devices/ equipamentos de autoajuda . Os artigos selecionados foram submetidos à análise de qualidade metodológica, na qual foi utilizada a escala de avaliação da Physiotherapy Evidence Database (PEDro). Resultados Quatro ensaios clínicos foram elencados para a revisão. Os estudos apresentaram classificação de baixa a moderada qualidade metodológica. As tecnologias de sistema de monitoramento noturno e as de comando de voz apresentaram melhor avaliação em relação aos efeitos nas Atividades Básicas e Instrumentais de Vida Diária. Conclusão A aplicação desse aparato tecnológico fornece resultados positivos no apoio a idosos e cuidadores na execução das atividades diárias. As utilizações de comandos verbais simples possuem menor custo, manuseio simples e maior eficiência para execução de Atividades Instrumentais de Vida Diária de idosos com demência.

Resumen Objetivo Analizar estudios de intervenciones con tecnologías de asistencia utilizadas para ayudar a ancianos con demencia, en la ejecución de las Actividades Básicas e Instrumentales de la Vida Diaria. Métodos Se realizó un relevamiento utilizando las bases CINAHL, MEDLINE/PubMed, LILACS, SCOPUS, Scielo, Cochrane y Web of Science. Se utilizaron los descriptores dementia/demência, aged/idoso, self-help devices/equipamentos de autoajuda . Artículos seleccionados sometidos a análisis de calidad metodológica, utilizando escala de evaluación de Physiotherapy Evidence Database (PEDro). Resultados Se incluyeron cuatro ensayos clínicos en la lista de revisión. Los estudios presentaron una clasificación de calidad metodológica de baja a moderada. Las tecnologías del sistema de monitoreo nocturno y de comando de voz presentaron mejor evaluación respecto de los efectos sobre las Actividades Básicas e Instrumentales de la Vida Diaria. Conclusión La aplicación de este aparato tecnológico proporciona resultados positivos en el apoyo al anciano y a los cuidadores pata ejecutar las actividades cotidianas. El uso de comandos verbales simples tiene menor costo, manejo simplificado y mayor eficiencia para realizar las Actividades Instrumentales de la Vida Diaria de los ancianos con demencia.

Abstract Objective Analyze intervention studies using assistive technologies to help demented elderly with the execution of Basic and Instrumental Activities of Daily Living. Methods A survey was undertaken in the databases CINAHL, MEDLINE/PubMed, LILACS, SCOPUS, Scielo, Cochrane and Web of Science . The descriptors used were dementia /demência, aged /idoso, self-help devices /equipamentos de autoajuda. The methodological quality of the selected articles was analyzed by means of the Physiotherapy Evidence Database (PEDro) assessment tool. Results Four clinical trials were reviewed. The classification of the studies' methodological quality ranged from low to moderate. The effects of the nighttime monitoring system and voice command technologies on the Basic and Instrumental Activities of Daily Living were assessed better. Conclusion The application of these technological devices offers positive results to support elderly people and caregivers in performing their daily activities. The use of simple voice prompts is cheaper, easier to manage and more efficient for demented elderly to perform Instrumental Activities of Daily Living.ene menor costo, manejo simplificado y mayor eficiencia para realizar las Actividades Instrumentales de la Vida Diaria de los ancianos con demencia.

[Development of a data collection tool for research with elderly]. / Elaboração de um instrumento de coleta de dados para pesquisa com idosos.

Report of experience aiming to show the importance of the participation of nursing students in the development of a data collection tool to assess families with aged. In order to elaborate it students were first exposed to the theory this study is based on and then the tool was developed. A pilot was made to identify possible problems concerning clarity and objectiveness of questions. After tested, the tool was adapted and applied in families with elderly. Data collection showed appropriacy of such instrument to be used in further studies in the area of Strategy for Family Health. Besides, the research enhanced creativity, critical and scientific thinking of the students involved in it.

Qualidade de vida de idosos que cuidam de idosos no domicílio / Quality of life of elderly people who care for the elderly at home

Objetivo: conhecer a autoavaliação da qualidade de vida (QV) de idosos que cuidam de idosos a partir do instrumento WHOQOL-bref. Método: estudo descritivo, exploratório, transversal, de natureza quantitativa realizado no período de fevereiro a abril de 2013 em Fortaleza (CE) com 151 idosos que cuidam de idosos. Utilizou-se como instrumento de pesquisa o World Health Organization Quality of Life instrumentbref (WHOQOL-bref). O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, protocolo n. 208.923. Resultados: a autoavaliação da QV do idoso cuidador foi satisfatória. A média do domínio relações sociais trouxe maior contribuição para a QV. Já o domínio meio ambiente apresentou os piores valores na avaliação da QV, portanto, é o domínio que necessita de maior intervenção. Conclusão: o estudo mostrou o impacto das tarefas do cuidado sobre a QV de indivíduos que já são idosos e ainda exercem função de cuidadores.(AU)

Objective: recognizing the self-assessment of quality of life (QOL) of older people caring for elderly from the WHOQOL-BREF tool. Method: a descriptive, exploratory, cross-sectional study, of quantitative nature carried out from February to April 2013 in Fortaleza (CE) with 151 older people caring for elderly. It was used as a research tool the World Health Organization Quality of Life instrument-bref (WHOQOL-bref). The research project was approved by the Research Ethics Committee, Protocol. 208.923. Results: self-assessment of QoL of the elderly caregiver was satisfactory. The average of the domain social relationships brought greater contribution to the quality of life. Already the domain environment presented the lowest values in the evaluation of QoL; therefore, it is the area that needs further intervention. Conclusion: the study showed the impact of care tasks on QoL of individuals who are already old and there are still caregivers who perform the function.(AU)

Objetivo: conocer la auto-evaluación de la calidad de vida (CV) de las personas mayores que cuidan a los ancianos del instrumento WHOQOL-bref. Método: es un estudio descriptivo, exploratorio, transversal, de naturaleza cuantitativa realizado entre febrero y abril de 2013 en Fortaleza (CE) con 151 personas mayores que cuidan de ancianos. Fue utilizada como una herramienta de investigación el World Health Organization Quality of Life instrument-bref (WHOQOL-bref). El proyecto de investigación fue aprobado por el Comité de Ética en la Investigación, Protocolo. 208.923. Resultados: la auto-evaluación de la calidad de vida del cuidador de ancianos fue satisfactoria. El dominio promedio relaciones sociales trajo una mayor contribución a la calidad de vida. Tener el dominio del medio ambiente tuvo los peores valores en la evaluación de la calidad de vida; por lo tanto, es el área que necesita de más intervención. Conclusión: el estudio mostró el impacto de las tareas de cuidado en la calidad de vida de las personas ya idosas y que todavía tienen la función de cuidadores.(AU)

Cross-cultural adaptation of the Caregiver Reaction Assessment for use in Brazil with informal caregivers of the elderly / Adaptación Transcultural Del Caregiver Reaction Assessment Para Empleo En Brasil Con Cuidadores Informales De Ancianos / Adaptação transcultural do Caregiver Reaction Assessment para uso no Brasil com cuidadores informais de idosos

This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment CRA for use in Brazil with informal caregivers of dependent elderly METHOD A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. RESULTS The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). CONCLUSION It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research. .

El blanco de este estudio fue llevar a cabo la adaptación transcultural del Caregiver Reaction Assessment para empleo en Brasil con cuidadores informales de ancianos dependientes. MÉTODO Estudio metodológico, de cinco etapas: traducción inicial, síntesis de las traducciones, retrotraducción, evaluación por comité de jueces y pre prueba con 30 cuidadores informales de ancianos de Fortaleza-CE, Brasil. La validez de contenido fue evaluada por cinco expertos en Salud del Anciano. La adaptación transcultural fue rigurosamente conducida, permitiendo desprender su credibilidad. RESULTADOS La versión brasileña del CRA tuvo aplicación sencilla, rápida (diez minutos) y fácilmente comprensible por el público meta. Equivale semántica, idiomática, experimental y conceptualmente a la versión original, con contenido válido para evaluar la sobrecarga de los cuidadores informales de ancianos (Índice de Validez de Contenido=0,883). CONCLUSIÓN Es necesario analizar sus demás propiedades psicométricas de validez y confiabilidad antes del empleo en la práctica asistencial y de investigación. .

Objetivou-se realizar a adaptação transcultural do Caregiver Reaction Assessment (CRA) para uso no Brasil com cuidadores informais de idosos dependentes MÉTODO Estudo metodológico, de cinco etapas: tradução inicial, síntese das traduções, retrotradução, avaliação por comitê de juízes e pré-teste com 30 cuidadores informais de idosos de Fortaleza-CE, Brasil. A validade de conteúdo foi avaliada por cinco especialistas em Saúde do Idoso. A adaptação transcultural foi rigorosamente conduzida, permitindo depreender sua credibilidade. RESULTADOS A versão brasileira do CRA teve aplicação simples, rápida (dez minutos), facilmente compreensível pelo público-alvo. É semanticamente, idiomaticamente, experimentalmente e conceitualmente equivalente à versão original, com conteúdo válido para avaliar a sobrecarga de cuidadores informais de idosos (Índice de Validade de Conteúdo=0,883). CONCLUSÃO É necessário que as suas demais propriedades psicométricas de validade e confiabilidade sejam analisadas, antes da utilização na prática assistencial e de pesquisa. .