Cost-Effectiveness of Passion Fruit Albedo versus Turmeric in the Glycemic and Lipaemic Control of People with Type 2 Diabetes: Randomized Clinical Trial.

BACKGROUND: Robust evidence has related yellow passion fruit albedo and long turmeric to the metabolic and glycemic control of diabetes. AIM: To analyze the incremental cost-effectiveness of the flour made from yellow passion fruit albedo versus long turmeric merged with piperine in the glycemic and lipid control of individuals with type 2 diabetes. METHOD: Eighty-nine patients were enrolled in this randomized, placebo-controlled, clinical trial for 120 days. The first group was prescribed 500 mg capsules, three times a day, of yellow passion fruit albedo flour (FAMA). The second group was prescribed long turmeric capsules (500 mg), merged with piperine (5 mg) (CURPI), at fasting. The third group followed the standard advice recommendations, and ingested a placebo of carboxymethyl cellulose (500 mg) at fasting. RESULTS: The group using FAMA showed a higher reduction (-5.9%) of glycemia after fasting, compared to placebo (+9%), and CURPI (-3.2%) (p < 0.05). Regarding HbA1c, the study observed a significant and similar statistical reduction (-0.8%) in the intervention groups, in contrast with the placebo group (p < 0.05). The reduction in HOMA-IR in the CURPI group (-9.4%) was higher than the other groups (p < 0.05). The CURPI group also showed a higher reduction of serum triglyceride levels (-20.8%) compared to the placebo (-0.09%) and FAMA (+1.8%) (p < 0.05) groups. CONCLUSION: It was concluded that turmeric is the most cost-effective in comparison with yellow passion fruit albedo, because of its decrease in the levels of triglycerides and HOMA-IR, even when adjusted for confounding variables. On the other hand, HbA1c cost-effectiveness relation was similar.

Effectiveness of the piperine-supplemented Curcuma longa L. in metabolic control of patients with type 2 diabetes: a randomised double-blind placebo-controlled clinical trial.

There is robust evidence of using Curcuma longa L. in reducing metabolic levels in people with diabetes. This study analysed the effectiveness of Curcuma longa L. in the metabolic control of patients with type 2 diabetes in Brazil. A randomised double-blind placebo-controlled clinical trial was conducted with 71 participants divided into a Curcuma longa L. group (500 mg/day with piperine 5 mg) and a placebo group, for 120 days. Anthropometric, clinical and biochemical variables were evaluated at baseline, 60 and 120 days after the beginning of the intervention. Paired and independent Student's t-test and chi-square test were used for statistical analysis. The curcuma group presented a significantly decreased glycaemia (p=.013), glycated haemoglobin (p=.015), HOMA index (p=.037) and triglycerides (TGs) (p=.002). The use of piperine-added Curcuma longa L. was effective in the glycaemic and TG control of patients with type 2 diabetes.

The teaching of sanitary surveillance in the training of nurses. / O ensino de vigilância sanitária na formação do enfermeiro.

OBJECTIVE: To investigate the teaching of sanitary surveillance in undergraduate nursing courses in Brazil, seeking to know how this theme is addressed during the training of nurses. METHOD: The universe of study was composed of Political-Pedagogical Projects, syllabi and curricula of nursing undergraduate courses from Brazilian public institutions. The quantitative analysis was developed through descriptive and inferential statistics, and for the qualitative part, a software was used to analyze the documents. RESULTS: A total of 153 public institutions' websites were analyzed. Of these, only 98 presented a Political-Pedagogical Project, a syllabus or a curriculum for on-line consultation, and only 2.04% of these programs had a specific discipline focused on teaching sanitary surveillance. CONCLUSION: The findings indicate that the contents related to the teaching of sanitary surveillance in nursing courses of public higher education institutions in Brazil, when present, are inserted, mostly, in other curricular components.

[Health indicators associated with poor sleep quality among university students]. / Indicadores de saúde associados com a má qualidade do sono de universitários.

OBJECTIVE: To associate the sleep quality of Brazilian undergraduate students with health indicators. METHOD: A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol) were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. RESULTS: For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (p<0.001). Prevalence rate values were nevertheless close to 1. CONCLUSION: The likelihood of poor sleep is almost the same in smokers and in alcoholics.


Effectiveness of cinnamon in the reduction of lipid levels in people with diabetes: a randomized clinical trial.

OBJECTIVE: To evaluate the effectiveness of cinnamon in reducing lipid levels in people with diabetes. METHOD: Randomized clinical trial of parallel groups, triple-blind, conducted in Basic Health Units in the state of Piauí in 2019. People with Type 2 Diabetes Mellitus, between 18 and 80 years old, using oral antidiabetics, were included, and divided into two groups. The experimental group tested 3g of cinnamon for 90 days. RESULTS: 140 people participated in the study. From these, the experimental group (n= 71) showed a reduction in mean levels of total cholesterol (p= 0.316 | CI 95% -24.9-8.1), LDL (p= 0.024 | CI 95% -29.3 -2.1) and triglycerides (p= 0.969 | 95% CI -28.6-27.5), and increased HDL (p= 0.001 | 95% CI 4.2-10.2). CONCLUSION: The use of 3g of cinnamon per day, for 90 days, seems to help reduce LDL values and increase HDL levels in patients with diabetes.

[Cross-cultural adaptation and evidence of psychometric validity of the Family Health Scale for Brazilian Portuguese]. / Adaptação transcultural e evidências de validade psicométricas da Family Health Scale para o português brasileiro.

This study aimed to translate and cross-culturally adapt the Family Health Scale into Brazilian Portuguese and analyze evidence of its psychometric validity. The 32 items on family health were cross-culturally adapted, using the content validity index to calculate semantic, idiomatic, cultural, and conceptual characteristics of the scale and its items. A pre-test to identify evidence of validity was applied to 40 families. At another time, the instrument was applied to 354 families in a Brazilian northeastern city. The index of agreement between the raters ranged from 0.84 for the scale items to 0.98 for the total scale, according to Kendall's coefficient. According to Cronbach's alpha, evidence of psychometric validity is adequate. Most families had a moderate degree of health, according to the scale. Therefore, the Brazilian version of the Family Health Scale showed conceptual, semantic, cultural, and operational equivalence with the original items, along with satisfactory psychometric properties for use among the Brazilian population with effectiveness and safety.

Os objetivos deste estudo foram realizar a tradução e adaptação transcultural da Family Health Scale (Escala de Saúde Familiar) para a língua portuguesa brasileira e analisar evidências de validade psicométricas dessa escala. Os 32 itens sobre a saúde familiar foram adaptados transculturalmente. Para a mensuração das evidências de validade do conteúdo, utilizou-se o cálculo do índice de validade de conteúdo das características semântica, idiomática, cultural e conceitual de cada item e da escala. Um pré-teste para identificação de evidência de validade foi realizado com 40 famílias. Em outro momento, a aplicação do instrumento foi executada com 354 famílias, em uma cidade no Nordeste do Brasil. O índice de concordância entre os juízes variou de 0,84, para os itens da escala, a 0,98, para a escala total, conforme o coeficiente de Kendall. As evidências de validade psicométricas mostram-se adequadas, conforme alfa de Cronbach. A maior parte das famílias teve um grau de saúde moderado, conforme aplicação da escala. Assim, a Family Health Scale, versão brasileira, apresentou equivalência conceitual, semântica, cultural e operacional em relação aos itens originais e propriedades psicométricas satisfatórias para a aplicação direcionada à população brasileira, atestando eficácia e segurança de sua utilização.

El objetivo de este estudio fue traducir y realizar la adaptación intercultural de Family Health Scale (Escala de Salud Familiar) al portugués brasileño, y analizar la evidencia de la validez psicométrica de esta escala. Los 32 ítems sobre salud familiar pasaron por una adaptación transcultural y, para medir la evidencia de validez de contenido, se utilizó el cálculo del índice de validez de contenido de las características semántica, idiomática, cultural y conceptual de cada ítem, y la escala. Se realizó una prueba previa con 40 familias para identificar la evidencia de validez. En otro momento, el instrumento se aplicó a 354 familias en una ciudad del Nordeste de Brasil. El índice de acuerdo entre los jueces osciló entre 0,84 para los ítems de la escala y 0,98 para la escala total de acuerdo con el coeficiente de Kendall. La evidencia de validez psicométrica es adecuada conforme el alfa de Cronbach. La mayoría de las familias tenían un grado de salud moderado de acuerdo con la aplicación de la escala. Por lo tanto, la Family Health Scale, versión brasileña, presentó equivalencia conceptual, semántica, cultural y operativa con relación a los ítems originales, y propiedades psicométricas satisfactorias para la aplicación en la población brasileña, lo que da fe de la eficacia y seguridad de su uso.

Bolus versus continuous insulin infusion in immediate postoperative blood glucose control in liver transplantation: pragmatic clinical trial.

OBJECTIVE: To analyze the effectiveness and safety of two insulin therapy techniques (continuous and intermittent infusion) in the blood glucose control of people who have undergone liver transplantation, in the immediate postoperative period. METHODS: The study was a prospective, open, pragmatic clinical trial with 42 participants, divided into two groups of 21 patients each, in the immediate postoperative period following liver transplantation. Participants in the Experimental Group and Control Group received continuous infusion and bolus insulin, respectively, starting at capillary blood glucose ≥150mg/dL. RESULTS: There were no statistically significant differences in the blood glucose reduction time to reach the target range between the Experimental Group and Control Group in the transplanted patients (p=0.919). No statistically significant differences regarding the presence of low blood glucose (p=0.500) and in the initial blood glucose value (p=0.345) were found. The study identified the final blood glucose value in postoperative intensive care unit lower and statistically significant in the continuous infusion pump group in relation to the Bolus Group (p<0.001). Additionally, the variation of blood glucose reduction was higher and statistically significant in the continuous method group (p<0.05). CONCLUSION: The continuous infusion method was more effective in the blood glucose control of patients in the postoperative period following liver transplantation. BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-9Y5tbp.

Serum Levels of Ficolin-3 and Mannose-Binding Lectin in Patients with Leprosy and Their Family Contacts in a Hyperendemic Region in Northeastern Brazil.

The present study aimed at analyzing the serum levels of mannose-binding lectin (MBL) and ficolin-3 (FCN3) in leprosy patients and their healthy family contacts in a hyperendemic region in northeastern Brazil. A cross-sectional study was carried out with 90 patients who had been diagnosed with leprosy and 79 healthy family contacts. Serum levels of the MBL and FCN3 proteins were measured using the immunofluorometric assay (ELISA). Clinical information was determined from the patients' charts. It was observed that the leprosy patients were more likely to be male (OR = 2.17; p = 0.01) and younger than fifteen years of age (OR = 2.01; p = 0.03) when compared to the family contacts. Those under 15 years of age had higher levels of MBL (4455 ng/mL) than those over 15 years of age (2342 ng/mL; p = 0.018). Higher FCN3 levels were identified in patients with indeterminate leprosy (41.9 µg/mL) compared to those with the lepromatous form (34.3 µg/mL; p = 0.033) and in those with no physical disabilities (38.1 µg/mL) compared to those with some disability (p = 0.031). Higher FCN3 levels were also observed in the group of patients without leprosy reactions (37.4 µg/mL) compared to those with type 1 (33.7 µg/mL) and type 2 (36.1 µg/mL) reactions. The MBL levels were higher in children under 15 years of age than they were in adults. It was evidenced that higher FCN3 serum levels were associated with early and transient clinical forms and lower expression in severe forms of leprosy.

Association between community-based and workplace violence and the sleep quality of health professionals: a cross-sectional study. / Associação entre a violência comunitária e no local de trabalho e a qualidade do sono de profissionais da saúde: estudo transversal.

Community-based and workplace violence against health professionals has caused feelings of vulnerability, emotional exhaustion, and psychological changes, reflecting on sleep quality disorders. Thus, we aimed to analyze the association between community and workplace violence and the sleep quality of health professionals working in primary health care. The study was conducted with 286 health professionals who worked in PHC in one of the largest cities in Brazil. The primary outcome was sleep quality as assessed by the Pittsburgh Sleep Quality Index. Most of the participants (69.2%/p=0.074) were classified as "bad sleepers", and nurses (73.3%/p=0.049) showed the worst sleep quality. Additionally, most professionals suffered some type of violence at work (p<0.001), which impaired professional activities (p=0.010), forcing them to change their behavior (p<0.001) and consider changing the workplace location (p=0.051). The results showed that professionals have been experiencing moments of fear, anxiety, and stress associated with workplace and community violence. This highlights the need for public policies geared to occupational health.

A violência comunitária e no local de trabalho contra os profissionais de saúde tem causado sentimentos de vulnerabilidade, desgaste emocional e alterações psicológicas, refletindo em distúrbios na qualidade do sono. Assim, buscou-se analisar a associação entre violência comunitária e no local de trabalho e a qualidade do sono de profissionais de saúde que atuam na atenção primária à saúde. O estudo foi realizado com 286 profissionais de saúde que atuavam na atenção primária à saúde, em uma das maiores cidades do Brasil. O desfecho primário foi a qualidade do sono, avaliada pelo Índice de Qualidade do Sono de Pittsburgh. A maioria dos participantes (69,2%/p=0,074) foi classificada como "maus dormidores", sendo os enfermeiros (73,3%/p=0,049) os que apresentaram a pior qualidade de sono. Ademais, grande parte dos profissionais sofreram algum tipo de violência durante o trabalho (p<0,001), que prejudicou as atividades profissionais (p=0,010), obrigando-os a mudar de conduta (p<0,001), e a cogitar mudança do local de trabalho (p=0,051). Os resultados mostraram que os profissionais têm apresentado episódios de medo, ansiedade e estresse, relacionados à violência no local de trabalho. Isso evidencia a necessidade de políticas públicas voltadas à saúde ocupacional.

Cultural, social, and healthcare access factors associated with delays in gastric cancer presentation, diagnosis, and treatment: A cross-sectional study.

BACKGROUND: The aim of this study was to identify the time intervals between the demand for health services and the initiation of cancer treatment, and to explore the associated factors, in gastric cancer patients being treated in an oncology hospital in northern Brazil. METHODS: This cross-sectional study. Gastric cancer patients receiving treatment in a northern Brazil reference hospital were interviewed. A Mann-Whitney test was used to verify associations between the time intervals of access to treatment and socioeconomic factors, clinical variables, and patient difficulties, adopting a 0.05 significance level. RESULTS: The average time intervals were 471.3 days between symptom onset and primary health service request and 180.9 days between diagnosis and treatment. The average time between the onset of symptoms and the treatment of gastric cancer was 747.8 days. Patients using herbal home remedies showed the longest times before seeking primary health care (p = 0.04). Delays between diagnosis and treatment were associated with unemployment (p = 0.03). High average times until oncologist appointments were related to the absence of comorbidities (p = 0.004). Personal difficulties and a lack of hospital beds were associated with long time intervals to specialist appointments and between diagnosis and treatment. Personal difficulties were associated with long time intervals between the onset of symptoms and the treatment of gastric cancer. CONCLUSION: Gastric cancer patients faced delays and healthcare access barriers in a region with high mortality for this disease. Appropriate interventions are necessary to reduce delays and better control the disease. POLICY SUMMARY: In this paper we have explored the barriers to access to diagnosis and treatment for patients with gastric cancer in a major cancer centre in Northern Brazil. The results will inform strategies for improving timely access to critical cancer services.

Development and validation of a MHEALTH technology for the promotion of self-care for adolescents with diabetes. / Desenvolvimento e validação de uma tecnologia MHEALTH para a promoção do autocuidado de adolescentes com diabetes.

Self-care is encouraged in the type 1 Diabetes Mellitus (DM1) setting. Thus, this research aimed to develop and validate a mobile application (APP) to promote self-care for adolescents with DM1. The method was divided into two stages: development and validation, ranging from literature review, benchmarking, prototype construction to validation by specialists. The APP construction was subsidized by the seven steps proposed by the American Association of Diabetes Educators. The screens were designed and possible functions were selected. After the design, the APP prototype was developed and named "DM Agendinha". The content validation process was mediated by the Suitability Assessment of Materials tool, where the percentage obtained was 85.3%, characterizing the APP as "Superior Material". The Smartphone Usability questionnaire was employed for technical validation, and the APP reached a global Content Validity Index of 0.96. We concluded, therefore, that the use of this material by adolescents will favor the acquisition of new knowledge and adherence to healthy practices, considering that it is a highly intelligible electronic technology.

No cenário do Diabetes Mellitus tipo 1 (DM1), uma prática incentivada é o autocuidado. Dessa forma, objetivou-se elaborar e validar um aplicativo móvel (APP) para a promoção do autocuidado em adolescentes com DM1. O método foi divido em duas etapas: elaboração e validação, que vão desde a revisão de literatura, benchmarking, construção do protótipo e validação por especialistas. A construção do APP foi subsidiada pelos sete passos propostos pela American Association of Diabetes Educators. Foram desenhadas as telas e selecionaram-se as possíveis funções; após o desenho, o protótipo do APP foi desenvolvido e nomeado como "DM Agendinha". O processo de validação de conteúdo foi mediado pelo instrumento Suitability Assessment of Materials, por meio do qual o percentual obtido foi de 85,3%, caracterizando o APP como "Material Superior". Para a validação técnica, empregou-se o questionário Smartphone Usability questionnaire, que obteve um Índice de Validade de Conteúdo global de 0,96. Conclui-se, portanto, que o uso desse material por parte dos adolescentes favorecerá a aquisição de novos conhecimentos e a adesão de práticas saudáveis, tendo em vista que se trata de uma tecnologia de caráter eletrônico e de fácil compreensão.

Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial.

OBJECTIVE: to evaluate the effectiveness of ginge (Zingiber officinale) in reducing blood sugar and lipid levels in people with type 2 diabetes. METHOD: a randomized and double-blind clinical trial conducted with people with type 2 diabetes in primary care facilities. The study included individuals aged between 20 and 80 years old, using oral antidiabetic drugs and with HbA1c levels between 6.0% and 10%. The participants were paired 1:1, allocated in two distinct groups, and randomized in blocks, based on their HbA1c levels. In the experimental group, the participants used 1.2g of ginger and, in the control group, 1.2g of placebo, daily for 90 days. The primary outcome was a reduction in fasting blood sugar and HbA1c, and the secondary outcome was a reduction in lipids and HOMA-IR. 103 individuals completed the study, 47 in the experimental group and 56 in the control group. RESULTS: the participants in the experimental group showed a greater reduction in the blood glucose and total cholesterol values compared to the control group. CONCLUSION: the use of ginger can help in the treatment of people with diabetes, and data support the inclusion of this herbal drug in the clinical practice of nurses. RBR-2rt2wy.

Evaluation of Primary Health Care attributes of Fortaleza city, Ceará State, Brazil.

OBJECTIVE: To evaluate the Primary Health Care attributes of Fortaleza city, Ceará State. METHOD: Evaluative study carried out at 97 Primary Health Care Units, from August 2015 to June 2016. 451 professionals from the Family Health Strategy participated in the study. We used the Primary Care Assessment Tool - Brazil, which evaluates the attributes, assigning scores on a scale of zero to ten. We adopted as a cut-off point, to consider high Primary Care score, attributes with a value of 6.60 or higher. RESULTS: Among the eight attributes evaluated the First Contact Access and the Coordination - Information System were the ones that obtained the lowest and highest scores, (2.98) and (7.82), respectively. The Overall Score, calculated by means of a mean of the attributes, was 6.34. CONCLUSION: The Primary Care evaluated had a low score, showing the need to discuss mechanisms to boost the attributes that obtained low scores.

Uso de suplementos nutricionais por crianças vivendo com HIV: revisão narrativa / Use of dietary supplements by children living with HIV: narrative review / Uso de suplementos dietéticos por niños que viven con el HIV: revisión narrativa

Introdução: A suplementação nutricional em pessoas vivendo com HIV ainda é pouco difundida, sendo essencial o levantamento de evidências que apontem as terapêuticas mais eficientes para beneficiar a saúde desta população. Ao se tratar do público infantil, no qual a prevalência de carências nutricionais é elevada, o conhecimento acerca da suplementação nutricional é bastante profícuo. Objetivo: Analisar relatórios de pesquisa acerca dos efeitos do uso de suplementos nutricionais em crianças vivendo com HIV. Desenho do estudo e local: Uma revisão narrativa realizada na Universidade Federal do Maranhão, em Imperatriz, município localizado no oeste do estado do Maranhão. Método: Foi realizada uma busca nos bancos de dados Cochrane, PubMed, Scopus, WHO/OMS e biblioteca digital de teses e dissertações da USP entre setembro de 2021 a janeiro de 2022. Resultados: Foram incluídas 26 produções, as quais demonstraram que o uso de múltiplos nutrientes reduziu o tempo de hospitalização em crianças admitidas com diarreia ou pneumonia, melhorando a morbidade, concentração de hemoglobina e ganho ponderal. A oferta de ferro foi considerada satisfatória no combate à progressão da doença, vitamina A melhorou o quadro de diarreia persistente e vitamina D a habilidade motora neuromuscular. Conclusão: Os estudos sobre suplementação nutricional e a relação dos nutrientes com os diversos aspectos de saúde das crianças vivendo com HIV tem avançado. Logo, é necessário alargar as pesquisas no tema em contextos distintos, a fim de incrementar e gerar novas evidências, colaborando para uma conduta mais assertiva dos profissionais de saúde e consequente melhora no prognóstico dessas crianças.

Background: Providing nutritional supplementation to people living with human immunodeficiency virus (HIV) is a therapeutic intervention still not widespread, so it is essential to gather evidence supporting efficient therapies to benefit the health of this population. The prevalence of nutritional deficiencies is high in children; consequently, the knowledge about nutritional supplementation in this age group is quite fruitful. Objective: To analyze research reports on the effects of nutritional supplementation in children living with HIV. Design and setting: A narrative review was conducted at the Federal University of Maranhão, Imperatriz, west of the Maranhão State. Methods: The searches were performed in the Cochrane, PubMed, Scopus, and World Health Organization (WHO) databases and the São Paulo University's digital library of theses and dissertations from September 2021 to January 2022. Results: Twenty-six studies were included and showed that using multiple nutrients reduced the hospitalization time of children admitted with diarrhea or pneumonia, improving morbidity, hemoglobin concentration, and weight gain. The supply of iron was considered effective in combating the progression of the disease, vitamin A improved the condition of persistent diarrhea, and vitamin D improved neuromuscular motor skills. Conclusion: Studies have advanced on nutritional supplementation, the relationship between nutrients, and the different health aspects of children living with HIV. Therefore, it is necessary to expand research on the subject in different contexts to increase and generate new evidence, contributing to more assertive conduct of health professionals and consequent improvement in the prognosis of these children.

Antecedentes: La administración de suplementos nutricionales a las personas que viven con el virus de la inmunodeficiencia humana (VIH) es una intervención terapéutica aún poco extendida, por lo que es fundamental reunir pruebas que apoyen terapias eficaces en beneficio de la salud de esta población. La prevalencia de deficiencias nutricionales es elevada en niños, por lo que el conocimiento sobre la suplementación nutricional en este grupo de edad es bastante fructífero. Objetivo: Analizar los informes de investigación sobre los efectos de la suplementación nutricional en niños que viven con el VIH. Diseño y escenario: Se realizó una revisión narrativa en la Universidad Federal de Maranhão, Imperatriz, al oeste del Estado de Maranhão. Métodos: Las búsquedas se realizaron en las bases de datos Cochrane, PubMed, Scopus y Organización Mundial de la Salud (OMS) y en la biblioteca digital de tesis y disertaciones de la Universidad de São Paulo desde septiembre de 2021 hasta enero de 2022. Resultados: Se incluyeron 26 estudios que mostraron que el uso de múltiples nutrientes redujo el tiempo de hospitalización de los niños ingresados con diarrea o neumonía, mejorando la morbilidad, la concentración de hemoglobina y el aumento de peso. El aporte de hierro se consideró eficaz para combatir la progresión de la enfermedad, la vitamina A mejoró el cuadro de diarrea persistente y la vitamina D mejoró las habilidades motoras neuromusculares. Conclusiones: Los estudios han avanzado sobre la suplementación nutricional, la relación entre los nutrientes y los diferentes aspectos de la salud de los niños que viven con el VIH. Por lo tanto, es necesario ampliar las investigaciones sobre el tema en diferentes contextos para aumentar y generar nuevas evidencias, contribuyendo para una conducta más asertiva de los profesionales de salud y consecuente mejoría en el pronóstico de estos niños.

Effectiveness of cinnamon in the reduction of lipid levels in people with diabetes: a randomized clinical trial / Eficacia de la canela en la reducción de los niveles de lípidos en personas con diabetes: un ensayo clínico aleatorizado / Efetividade da canela na redução de níveis lipídicos em pessoas com diabetes: ensaio clínico aleatorizado

ABSTRACT Objective: To evaluate the effectiveness of cinnamon in reducing lipid levels in people with diabetes. Method: Randomized clinical trial of parallel groups, triple-blind, conducted in Basic Health Units in the state of Piauí in 2019. People with Type 2 Diabetes Mellitus, between 18 and 80 years old, using oral antidiabetics, were included, and divided into two groups. The experimental group tested 3g of cinnamon for 90 days. Results: 140 people participated in the study. From these, the experimental group (n= 71) showed a reduction in mean levels of total cholesterol (p= 0.316 - CI 95% -24.9-8.1), LDL (p= 0.024 - CI 95% -29.3 -2.1) and triglycerides (p= 0.969 - 95% CI -28.6-27.5), and increased HDL (p= 0.001 - 95% CI 4.2-10.2). Conclusion: The use of 3g of cinnamon per day, for 90 days, seems to help reduce LDL values and increase HDL levels in patients with diabetes.

RESUMEN Objetivo: Evaluar la efectividad de la canela en la reducción de los niveles de lípidos en personas con diabetes. Método: Ensayo clínico aleatorizado, triple ciego, de grupos paralelos, realizado en Unidades Básicas de Salud de Piauí en 2019. Personas con Diabetes Mellitus tipo 2, entre 18 y 80 años, usuarias de antidiabéticos orales, fueron divididas en dos grupos. El grupo experimental probó 3g de canela durante 90 días. Resultados: 140 personas participaron en el estudio. De estos, el grupo experimental (n= 71) mostró una reducción en los niveles medios de colesterol total (p= 0,316 - IC 95% -24,9-8,1), LDL (p= 0,024 - IC 95% -29,3 - 2,1) y triglicéridos (p= 0,969 - IC 95% -28,6-27,5) y HDL elevado (p= 0,001 - IC 95% 4,2-10,2). Conclusión: El uso de 3g de canela al día durante 90 días parece ayudar a reducir los valores de LDL y aumentar los niveles de HDL en pacientes con diabetes.

RESUMO Objetivo: Avaliar a efetividade da canela na redução dos níveis lipídicos em pessoas com diabetes. Método: Ensaio clínico aleatorizado de grupos paralelos, triplo cego, realizado em Unidades Básicas de Saúde do estado do Piauí em 2019. Foram incluídas pessoas com Diabetes Mellitus tipo 2, entre 18 e 80 anos, em uso de antidiabéticos orais, e divididos em dois grupos. No grupo experimental testou-se 3g de canela por 90 dias. Resultados: 140 pessoas participaram do estudo. Destas, o grupo experimental (n= 71) apresentou redução na média dos níveis de colesterol total (p= 0,316 - IC 95% -24,9-8,1), LDL (p= 0,024 - IC 95% -29,3-2,1) e triglicerídeos (p= 0,969 - IC 95% -28,6-27,5), e aumento do HDL (p= 0,001 - IC95% 4,2-10,2). Conclusão: O uso de 3g de canela por dia, durante 90 dias, parece auxiliar na diminuição dos valores de LDL e aumento dos níveis de HDL em pacientes com diabetes.

Intervenções para uso do preservativo por adolescentes em situação de rua: protocolo de revisão sistemática / Interventions for condom use by homeless adolescents: a systematic review protocol

OBJETIVO: Avaliar a eficácia de intervenções em saúde para o uso do preservativo entre adolescentes em situação de rua. MÉTODO: Revisão sistemática de ensaios clínicos randomizados e não randomizados, estudos controlados antes e depois, coortes e caso-controle que apresentem intervenções que contribuem para o uso de preservativo em adolescentes em situação de rua, sem restrição de idioma. As buscas serão realizadas em bases de dados e seguirão os Guidelines Cochranee o checklist PRISMA. RESULTADOS: Espera-se identificar estudos que apontem intervenções relacionadas ao uso do preservativo e redução das IST/HIV/Aids, entre adolescentes em situação de rua, visando contribuir para promoção da saúde e das políticas públicas brasileiras. CONCLUSÃO: Este estudo encontra-se em andamento e o protocolo está aprovado na PROSPERO sob o número CRD42021266572.

OBJECTIVE: To evaluate the effectiveness of health interventions for condom useamong homeless adolescents. METHOD: A systematic review of randomized and non-randomized clinical trials, before-and-after controlled studies, cohort, and case-control studies will be conducted on interventions that contribute to the use of condoms by homeless adolescents without language restrictions. The searches will be carried out in data bases and follow the Cochrane Guidelines and the PRISMA checklist. RESULTS: We expect to identify studies that point to interventions related to the use of condoms and the reduction of STI/HIV/AIDS among homeless adolescents, aiming to contribute to the promotion of health and Brazilian public policies. CONCLUSION: This study is in progress, and the protocol is registered at PROSPERO under the code CRD42021266572.

Adaptação transcultural e evidências de validade psicométricas da Family Health Scale para o português brasileiro / Cross-cultural adaptation and evidence of psychometric validity of the Family Health Scale for Brazilian Portuguese / Adaptación transcultural y evidencia de validez psicométrica de Family Health Scale al portugués brasileño

Resumo: Os objetivos deste estudo foram realizar a tradução e adaptação transcultural da Family Health Scale (Escala de Saúde Familiar) para a língua portuguesa brasileira e analisar evidências de validade psicométricas dessa escala. Os 32 itens sobre a saúde familiar foram adaptados transculturalmente. Para a mensuração das evidências de validade do conteúdo, utilizou-se o cálculo do índice de validade de conteúdo das características semântica, idiomática, cultural e conceitual de cada item e da escala. Um pré-teste para identificação de evidência de validade foi realizado com 40 famílias. Em outro momento, a aplicação do instrumento foi executada com 354 famílias, em uma cidade no Nordeste do Brasil. O índice de concordância entre os juízes variou de 0,84, para os itens da escala, a 0,98, para a escala total, conforme o coeficiente de Kendall. As evidências de validade psicométricas mostram-se adequadas, conforme alfa de Cronbach. A maior parte das famílias teve um grau de saúde moderado, conforme aplicação da escala. Assim, a Family Health Scale, versão brasileira, apresentou equivalência conceitual, semântica, cultural e operacional em relação aos itens originais e propriedades psicométricas satisfatórias para a aplicação direcionada à população brasileira, atestando eficácia e segurança de sua utilização.

Abstract: This study aimed to translate and cross-culturally adapt the Family Health Scale into Brazilian Portuguese and analyze evidence of its psychometric validity. The 32 items on family health were cross-culturally adapted, using the content validity index to calculate semantic, idiomatic, cultural, and conceptual characteristics of the scale and its items. A pre-test to identify evidence of validity was applied to 40 families. At another time, the instrument was applied to 354 families in a Brazilian northeastern city. The index of agreement between the raters ranged from 0.84 for the scale items to 0.98 for the total scale, according to Kendall's coefficient. According to Cronbach's alpha, evidence of psychometric validity is adequate. Most families had a moderate degree of health, according to the scale. Therefore, the Brazilian version of the Family Health Scale showed conceptual, semantic, cultural, and operational equivalence with the original items, along with satisfactory psychometric properties for use among the Brazilian population with effectiveness and safety.

Resumen: El objetivo de este estudio fue traducir y realizar la adaptación intercultural de Family Health Scale (Escala de Salud Familiar) al portugués brasileño, y analizar la evidencia de la validez psicométrica de esta escala. Los 32 ítems sobre salud familiar pasaron por una adaptación transcultural y, para medir la evidencia de validez de contenido, se utilizó el cálculo del índice de validez de contenido de las características semántica, idiomática, cultural y conceptual de cada ítem, y la escala. Se realizó una prueba previa con 40 familias para identificar la evidencia de validez. En otro momento, el instrumento se aplicó a 354 familias en una ciudad del Nordeste de Brasil. El índice de acuerdo entre los jueces osciló entre 0,84 para los ítems de la escala y 0,98 para la escala total de acuerdo con el coeficiente de Kendall. La evidencia de validez psicométrica es adecuada conforme el alfa de Cronbach. La mayoría de las familias tenían un grado de salud moderado de acuerdo con la aplicación de la escala. Por lo tanto, la Family Health Scale, versión brasileña, presentó equivalencia conceptual, semántica, cultural y operativa con relación a los ítems originales, y propiedades psicométricas satisfactorias para la aplicación en la población brasileña, lo que da fe de la eficacia y seguridad de su uso.

Prevalence of Metabolic Syndrome in individuals with Type 2 Diabetes Mellitus.

OBJECTIVE: to identify the prevalence of Metabolic Syndrome and its components in a population of patients with type 2 Diabetes Mellitus. METHOD: a cross-sectional study was conducted with 201 diabetic patients. A descriptive analysis and Chi-square and Fisher's exact tests ( p <0.05) were performed. RESULTS: the majority of participants were females and overweight, with a mean age of 63.1 years and a low level of education, and categorized as physically inactive. Of all individuals investigated, 50.7% were diagnosed with Metabolic Syndrome and 92% had at least one of the syndrome components with values beyond those recommended. CONCLUSION: it is essential to take preventive actions and develop studies that help to identify the factors associated with this syndrome.

Bolus versus continuous insulin infusion in immediate postoperative blood glucose control in liver transplantation: pragmatic clinical trial

ABSTRACT Objective: To analyze the effectiveness and safety of two insulin therapy techniques (continuous and intermittent infusion) in the blood glucose control of people who have undergone liver transplantation, in the immediate postoperative period. Methods: The study was a prospective, open, pragmatic clinical trial with 42 participants, divided into two groups of 21 patients each, in the immediate postoperative period following liver transplantation. Participants in the Experimental Group and Control Group received continuous infusion and bolus insulin, respectively, starting at capillary blood glucose ≥150mg/dL. Results: There were no statistically significant differences in the blood glucose reduction time to reach the target range between the Experimental Group and Control Group in the transplanted patients (p=0.919). No statistically significant differences regarding the presence of low blood glucose (p=0.500) and in the initial blood glucose value (p=0.345) were found. The study identified the final blood glucose value in postoperative intensive care unit lower and statistically significant in the continuous infusion pump group in relation to the Bolus Group (p<0.001). Additionally, the variation of blood glucose reduction was higher and statistically significant in the continuous method group (p<0.05). Conclusion: The continuous infusion method was more effective in the blood glucose control of patients in the postoperative period following liver transplantation. Brazilian Registry of Clinical Trials: RBR-9Y5tbp

Estratégias educativas para prevenção de úlceras nos pés em pessoas com diabetes mellitus: uma revisão integrativa / Educational strategies for preventing foot ulcers in people with diabetes mellitus: an integrative review

Resumo Objetivo: Identificar estratégias educacionais para prevenção de úlceras nos pés em pessoas com diabetes mellitus. Método: Trata-se de uma revisão integrativa realizada entre dezembro de 2019 e janeiro de 2020, utilizando as bases de dados PUBMED, LILACS, COCHRANE e SCOPUS e os descritores Health Education, Foot Ulcer, Diabetes e Nursing. 19 artigos primários foram incluídos. Resultado: Foram implementadas 12 estratégias educacionais para prevenir úlceras nos pés em pessoas com diabetes: educação em saúde, programas educacionais com panfletos, acompanhamentos e PowerPoint para apresentação de seminários, brochuras informativas, exame do pé diabético com orientações: autocuidado, entrevistas motivacionais, vídeos motivacionais, intervenções educacionais, oficinas/workshops educacionais, serviços de pequenas mensagens, grupos educacionais, educação individualizada e brochura educacional. Conclusão: Os profissionais de saúde podem utilizar diferentes estratégias educacionais, em diferentes ambientes de saúde, para prevenir úlceras nos pés em pessoas com diabetes, de forma simples, eficaz e acessível.

Abstract Objective: To identify educational strategies to prevent foot ulcers in people with diabetes mellitus. Method: This is an integrative review conducted between December 2019 and January 2020 using PUBMED, LILACS, COCHRANE and SCOPUS databases and the descriptors Health Education, Foot Ulcer, Diabetes and Nursing. 19 primary articles were included. Results: There were 12 educational strategies that were implemented to prevent foot ulcers in people with diabetes: health education, educational programs with pamphlets, follow-ups and PowerPoint for presentation of seminars, information brochures, diabetic foot exam with guidelines. self-care, motivational interviews, motivational videos, educational interventions, educational workshops / workshops, small message services, educational groups, individualized education and educational brochure. Conclusión: Health professionals can use different educational strategies, in different health settings to prevent foot ulcers in people with diabetes, in a simple, effective and accessible way.

Resumen Objetivo: Identificar estrategias educativas para prevenir las úlceras del pie en personas con diabetes mellitus. Método: Esta es una revisión integradora realizada entre diciembre de 2019 y enero de 2020 utilizando bases de datos PUBMED, LILACS, COCHRANE y SCOPUS y los descriptores Educación para la salud, Úlcera del pie, Diabetes y Enfermería. Se incluyeron 19 artículos primarios. Resultado: Hubo 12 estrategias educativas que se llevaron a cabo para prevenir las úlceras del pie en personas con diabetes: educación para la salud, programas educativos con panfletos, seguimientos y PowerPoint para la presentación de seminarios, folletos informativos, examen del pie diabético con pautas. autocuidado, entrevistas motivacionales, videos motivacionales, intervenciones educativas, talleres / talleres educativos, servicios de mensajes pequeños, grupos educativos, educación individualizada y folleto educativo. Conclusión: Los profesionales de la salud pueden utilizar diferentes estrategias educativas, en diferentes escenarios de salud para prevenir las úlceras del pie de personas con diabetes, de una manera simple, efectiva y accesible.