Mediterranean Dietary Pattern for Healthy and Active Aging: A Narrative Review of an Integrative and Sustainable Approach.

The global population is on a trajectory of continuous growth, with estimates projecting an increase from 7.7 billion in 2019 to approximately 9.7 billion by 2050. Longevity is also expected to rise rapidly, with advancements in healthcare contributing to increased life expectancies and an increase in the maximum lifespan. The aging process is accompanied by different changes, often leading to a decline in daily life activities and an increased susceptibility to disease. Age-related changes can cause cellular damage and subsequent cellular death. Oxidative stress and inflammation play significant roles in this process contributing to molecular damage and mitochondrial dysfunction. Active aging has been associated with improved quality of life and a reduced risk of morbidity and premature mortality. In this context, the Mediterranean diet has emerged as a promising approach to promoting healthy aging and sustainability. The phytochemical compounds within the Mediterranean diet have been linked to a lower risk of developing cardiovascular disease, type 2 diabetes, obesity, cancer and neurodegenerative diseases. The findings of peer-reviewed articles regarding the use of the Mediterranean diet as a healthy and sustainable dietary pattern written in Portuguese, Spanish or English were included in this narrative literature review. This dietary pattern's emphasis on the consumption of fresh and local food aligns with both health and environmental sustainability goals. This work provides a comprehensive review of the benefits of the Mediterranean diet and its components in a healthy aging process and highlights the importance of this dietary pattern as a sustainable approach.

Case report: Wernicke-Korsakoff syndrome after bariatric surgery.

Vitamin and mineral deficiencies are prevalent nutritional disorders following bariatric surgery. Although they are more prevalent after malabsorptive procedures such as bypass, they also occur in restrictive procedures such as gastric sleeve. The mechanisms that lead to the occurrence of these deficits are related to the presence of poor nutritional intake or poor adherence to multivitamins and multimineral supplementation. Wernicke-Korsakoff syndrome (WKS) is an acute neurological disorder resulting from thiamine deficiency. This syndrome is composed of two distinct phases: first, Wernicke Encephalopathy (WE), the acute phase of this syndrome, which is characterized by a triad of mental confusion, ocular signs, and ataxia, followed by the chronic phase of WKS, called Korsakoff's syndrome (KS), which is known for the presence of anterograde amnesia and confabulation. We aimed to report a case of a patient with WKS after bariatric surgery. The patient's retrospective chart review was performed in order to retrieve the relevant clinical data. The patient was a 24-year-old female student with a BMI of 48 kg/m2 who underwent sleeve gastrectomy surgery for morbid obesity. Over the following 2 months, recovery from surgery was complicated by non-specific symptoms such as nausea, recurrent vomiting, and a significant reduction in food intake, which led the patient to visit the emergency department six times with hospitalization on the last occasion for a definitive diagnosis. During the 15 days of hospitalization, the patient developed ocular diplopia, nystagmus, complaints of rotatory vertigo, and gait abnormalities. A magnetic resonance imaging of the head was performed but revealed no significant changes. After a formal neurological assessment, treatment with parenteral thiamine (100 mg, three times a day) was started without prior dosing. The observed clinical improvement confirmed the diagnosis of WKS. Bariatric surgery may contribute to thiamine deficiency and, consequently, to WKS. Education about the adverse consequences of malnourishment is mandatory before and after the surgery. Investigation of nutritional deficiencies both pre- and post-operatively is crucial in order to prevent complications such as WKS.

The Effect of Ginger (Zingiber officinale Roscoe) Aqueous Extract on Postprandial Glycemia in Nondiabetic Adults: A Randomized Controlled Trial.

Ginger has shown beneficial effects on blood glucose control due to its antioxidant and anti-inflammatory properties. The present study investigated the effect of ginger aqueous extract on postprandial glucose levels in nondiabetic adults and characterized its antioxidant activity. Twenty-four nondiabetic participants were randomly assigned into two groups (NCT05152745), the intervention group (n = 12) and the control group (n = 12). Both groups were administered 200 mL of an oral glucose tolerance test (OGTT), after which participants in the intervention group ingested 100 mL of ginger extract (0.2 g/100 mL). Postprandial blood glucose was measured while fasting and after 30, 60, 90, and 120 min. The total phenolic content, flavonoid content, and antioxidant activity of ginger extract were quantified. In the intervention group, the incremental area under the curve for glucose levels decreased significantly (p < 0.001) and the maximum glucose concentration significantly reduced (p < 0.001). The extract possessed a polyphenolic content of 13.85 mg gallic acid equivalent/L, a flavonoid content of 3.35 mg quercetin equivalent/L, and a high superoxide radical inhibitory capacity (45.73%). This study showed that ginger has a beneficial effect on glucose homeostasis under acute conditions and encourages the use of ginger extract as a promising source of natural antioxidants.

Adansonia digitata L. (Baobab) Bioactive Compounds, Biological Activities, and the Potential Effect on Glycemia: A Narrative Review.

Adansonia digitata L. fruit, also known as baobab, has been used traditionally throughout the world for its medicinal properties. Ethnopharmacological uses of various plant parts have been reported for hydration, antipyretic, antiparasitic, antitussive, and sudorific properties and also in the treatment of diarrhea and dysentery in many African countries. Several studies have revealed that in addition to these applications, baobab has antioxidant, anti-inflammatory, analgesic, and antimicrobial activities. The health benefits of baobab have been attributed to its bioactive compounds, namely phenols, flavonoids, proanthocyanins, tannins, catechins, and carotenoids. Baobab fruit is also an important source of vitamin C and micronutrients, including zinc, potassium, magnesium, iron, calcium, and protein, which may reduce nutritional deficiencies. Despite scientific studies revealing that this fruit has a wide diversity of bioactive compounds with beneficial effects on health, there is a gap in the review of information about their mechanisms of action and critical analysis of clinical trials exploring, in particular, their effect on glycemia regulation. This work aims to present a current overview of the bioactive compounds, biological activities, and effects of A. digitata fruit on blood glucose, highlighting their potential mechanisms of action and effects on glycemia regulation, evaluated in recent animal and human trials.

Cinnamon as a Complementary Therapeutic Approach for Dysglycemia and Dyslipidemia Control in Type 2 Diabetes Mellitus and Its Molecular Mechanism of Action: A Review.

The scientific evidence that cinnamon may exert beneficial effects on type 2 diabetes mellitus due to the biological activity of its bioactive compounds has been increasing in recent years. This review provides an overview of the effects of cinnamon on clinical parameters of diabetes and summarizes the molecular mechanisms of action of cinnamon on glucose and lipid metabolism. Search criteria include an electronic search using PubMed, Medline, and Cochrane Library databases. English literature references from 2000 up to 2022 were included. Following title and abstract review, full articles that met the inclusion criteria were included. The results from the available evidence revealed that cinnamon improved glycemic and lipidemic indicators. Clinical trials clarified that cinnamon also possesses an anti-inflammatory effect, which may act beneficially in diabetes. Based on in vitro and in vivo studies, cinnamon seems to elicit the regulation of glucose metabolism in tissues by insulin-mimetic effect and enzyme activity improvement. Furthermore, cinnamon seems to decrease cholesterol and fatty acid absorption in the gut. The current literature search showed a considerable number of studies on diabetic subjects. Some limitations in comparing published data should be highlighted, including variability in doses, extracts and species of cinnamon, administration forms, and antidiabetic therapy.

Effect of Aqueous Cinnamon Extract on the Postprandial Glycemia Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

Cinnamon is a spice used in traditional cuisine that has been investigated due to hypoglycemic properties. The objective of this study was to investigate the effect of aqueous cinnamon extract on postprandial glycemia levels in type 2 diabetes mellitus (DM2) adults. This clinical trial enrolled 36 adults with DM2, randomly allocated in two groups: the control group (n = 18) took only an oral glucose tolerance test (OGTT) and the intervention group (n = 18) took OGTT immediately followed by aqueous cinnamon extract (6 g/100 mL) ingestion. Blood glucose levels were measured on fasting and after 30, 60, 90 and 120 min in both groups. The chemical analysis of the aqueous cinnamon extract included total phenols content determination and antioxidant activity assessment through FRAP and DPPH methods. The data reveal that aqueous cinnamon extract ingestion did not show a significant difference in the incremental area under the curve (p = 0.834), maximum glucose concentration (p = 0.527) and glucose concentration variation (p = 0.873) compared with the control group. Cinnamon extract possess a total phenol content of 1554.9 mg/L gallic acid equivalent and a strong antioxidant capacity, revealed by the DPPH (5125.0 µmol Trolox/L) and FRAP (3658.8 µmol Trolox/L) tests. Aqueous cinnamon extract did not significantly influence postprandial glucose response in diabetic patients during an OGTT.

Adansonia digitata L. (Baobab Fruit) Effect on Postprandial Glycemia in Healthy Adults: A Randomized Controlled Trial.

Baobab fruits have been traditionally used in Africa due to their therapeutic properties attributed to their high polyphenol content. The aim of the study was to investigate the effect of baobab fruit on postprandial glycaemia in healthy adults and to measure its bioactive compounds and antioxidant activity. The study (NCT05140629) was conducted on 31 healthy subjects. The participants were randomly allocated in the control group (oral glucose tolerance test (OGTT); n = 16) and in the intervention group (OGTT, followed by administration of 250 mL baobab aqueous extract (BAE); n = 15). Total phenols, proanthocyanins, hydrolyzable tannins, and antioxidant activity (FRAP, DPPH, ABTS, and inhibition of O2•- and NO• methods) were quantified. Repeated measures ANOVA of mixed type and independent samples t-test were used. Glycemia incremental area under the curve (p = 0.012) and glucose maximum concentration (p = 0.029) was significantly lower in the intervention group compared to the control group. The BAE revealed high total contents of phenols, proanthocyanins, and hydrolyzable tannins, as well as a strong capacity to scavenge superoxide anions and nitric oxide radicals and a high antioxidant activity. In conclusion, this study encourages the use of this food component as a promising source of natural antioxidants and a hypoglycemic agent under glucose load acute conditions.

An anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols diet improved patient reported outcomes in fibromyalgia: A randomized controlled trial.

Background: Fibromyalgia (FM) has been associated with dysbiosis and low-grade inflammation. Studies have reported that diet influences clinical features in FM. Objective: To evaluate the effect of an anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols (FODMAP) diet on clinical outcomes of patients with FM. Methods: This two arms Randomized Controlled Trial (NCT04007705) included 46 female patients with FM. The intervention group (n = 22) adopted an anti-inflammatory diet for 3 months, excluding gluten, dairy, added sugar, and ultra-processed foods, along with a low FODMAPs diet in the first month. The control group (n = 24) followed general healthy eating recommendations. Both diets were applied by a certified dietitian. Before and after the intervention, participants were assessed regarding pain, fatigue, gastrointestinal symptoms, quality of sleep, and quality of life, through the Revised Fibromyalgia Impact Questionnaire (FIQR), Visual Analogue Pain Scale (VAS), Visual Analog Scale from gastrointestinal symptoms (VAS GI), Brief Pain Inventory (BPI), Pittsburg Sleep Quality Index (PSQI), Fatigue Severity Survey (FSS), and The Short Form Health Survey (SF-36). A blood sample was collected and high-sensitive C-Reactive Protein and Erythrocyte Sedimentation Rate were quantified. Paired Samples t-test/Wilcoxon and independent samples t-test/Mann-Whitney were used to compare variables between groups. Results: After intervention, there was an improvement in intervention group scores of FIQR (p = 0.001), VAS (p = 0.002), BPI (p = 0.011), FSS (p = 0.042), VAS_GI (p = 0.002), PSQI (p = 0.048), and SF36 (p = 0.045) compared to control group. Inflammatory biomarkers (hs-CRP, ESR) did not change in both groups. The intervention was beneficial in the intervention group, regardless of age, disease duration, body mass index variation, and body fat change between baseline and post-intervention. Conclusion: An anti-inflammatory and low-FODMAP diet improved clinical features in patients with FM and may be useful as a complement to pharmacological therapy. Clinical Trial Registration: [https://clinicaltrials.gov/ct2/show/NCT04007705], identifier [NCT04007705].

A study protocol for a randomized controlled trial of an anti-inflammatory nutritional intervention in patients with fibromyalgia.

BACKGROUND: This study aims to analyze the effects of a potentially anti-inflammatory nutritional intervention in disease assessment parameters, inflammatory markers, and quality of life of fibromyalgia (FM) patients. METHODS: A sample of 100 female patients diagnosed with FM, followed up at Portuguese Institute of Rheumatology (IPR) in Lisbon, is being randomly allocated in two groups. Patients in the intervention group are adopting an anti-inflammatory diet, characterized by the exemption of the intake of foods containing gluten, dairy, sugar, and ultra-processed foods, during 3 months. During the first month, a low fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) diet is implemented, along with the anti-inflammatory diet, followed by the reintroduction of all fruits and vegetables over a consecutive period of 2 months. Patients in the control group are adopting a diet based on general recommendations for healthy eating. The outcomes are pain, fatigue, quality of sleep, quality of life, gastrointestinal symptoms, and inflammation. Before and after the 3 months intervention, and also 1 month after beginning the intervention, the following questionnaires are applied: Revised Fibromyalgia Impact Questionnaire, visual analog pain scale, Brief Pain Inventory,visual analog scale from a list of common gastrointestinal and extraintestinal symptoms in FM, Short Form 36, Fatigue Severity Survey, and Pittsburg Sleep Quality Index. Ultra-sensitive serum C-reactive protein, eritrocyte sedimentation rate, and interleukin-8 are determined. Age, physical activity, anthropometric parameters, and body composition are being collected. Student's t test will assess the association between the disease evaluation parameters, the inflammatory markers, and the dietary interventions. DISCUSSION: The results of this study are expected to determine whether a change in patient nutrition helps to alleviate symptoms, which would optimize medical intervention. TRIAL REGISTRATION: www.ClinicalTrials.gov NCT04007705 . Registered on July 5, 2019.

Comparing Assessment Tools as Candidates for Personalized Nutritional Evaluation of Senior Citizens in a Nursing Home.

Nutrition is an important health issue for seniors. In nursing homes, simple, inexpensive, fast, and validated tools to assess nutritional risk/status are indispensable. A multisurvey cross-sectional study with a convenient sample was created, comparing five nutritional screening/assessment tools and the time required for each, in order to identify the most useful instrument for a nursing home setting. Nutrition risk/status was evaluated using the following tools: Subjective Global Assessment (SGA), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening 2002 (NRS 2002), and calf girth (CG). The time spent completing each tool was recorded. Eighty-three subjects were included. MNA-SF and CG were the screening tools that ranked highest with regards to malnutrition identification. CG failed to identify nutritional risk/malnutrition in seniors with lower limb edema. CG was the fastest tool while SGA was the slowest. This was the first study comparing non-invasive nutritional tools with time expended as a consideration in the implementation. CG is responsive, fast, and reliable in elders without edema. MNA-SF was more efficient at detecting malnutrition cases in the elderly population. Both MNA-SF and CG are considered the most suitable for the nursing home setting.

Clinical Features and Prognostic Factors of 245 Portuguese Patients Hospitalized With COVID-19.

Introduction Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in March 2020, Portugal was considered a role model with regards to the first COVID-19 wave. However, a third wave started in 2021 started, turning the country into the worst in the world regarding new infections and death rate per capita in the last weeks of January 2021. No significant data regarding the country's first wave of hospitalized patients have been published. Those data may help understand the differences over time regarding patients and the clinical approach to them. Herein, we present data of COVID-19 patients hospitalized at the main tertiary hospital of the second-most affected county at the time and identify risk factors associated with disease progression and outcomes. Materials and methods We performed a prospective observational study of patients admitted with COVID-19 to a central hospital between March 20 and June 1, 2020. The primary endpoint of this study was 30-day mortality or the need for ventilatory support and the secondary outcomes were both outcomes individually. Results 245 patients were included, with a median age of 79 years, 52% males. Hypertension (n = 172) and dyslipidemia (n = 114) were the most frequent comorbidities. Half of the patients (n = 121) were treated with hydroxychloroquine. The primary outcome occurred in 114 patients; mortality at 30 days was 35%. Age (OR 1.05; 1.02-1.07) and active cancer (OR 3.89; 1.43-10.57) were associated with the primary outcome, with dyslipidemia being protective (OR 0.46; 0.25-0.80). Treatment with hydroxychloroquine or lopinavir/ritonavir was not associated with the main outcome. Patients who had been symptomatic for more than 7 days had lower mortality (OR 0.23; 0.09-0.63). Discussion In the present study, age and cancer were associated with higher mortality, as noted in prior articles. The population had a higher median age than reported in previous studies, which may explain the increased mortality. The protective association of dyslipidemia was not previously described. This association was not related to statin intake. Conclusion The reported high mortality of COVID-19 is rarely seen in other infectious diseases. Our elderly population probably reflects more reliably the incidence of COVID-19 in European countries with constricted age pyramids.

Dietary interventions in fibromyalgia: a systematic review.

Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial. This systematic review aimed to synthesize the knowledge about the effect of dietary interventions on patient-reported outcomes (PRO) and inflammation in patients with FM. Six electronic databases - PubMed, BioMed Central, Cochrane library, EMBASE, LILACS and ISI - were searched for clinical trials, in which a dietary intervention in patients with FM diagnosed was conducted. Quality of evidence assessment was measured in accordance with GRADE methodology. Seven clinical trials - 3 randomized controlled trials, 1 unrandomized clinical trial and 3 uncontrolled clinical trials were identified. Dietary approaches included gluten-free diet (n = 1), raw vegetarian diet (n = 2), low Fermentable oligo-, di- and monossacharides, alcohols and polyols (FODMAPs) diet (n = 1), hypocaloric diet (n = 2) and monosodium glutamate- and aspartame-free diet interventions (n = 1). The major PRO were pain and functional repercussion, with 5 out of 7 studies reporting an improvement. The progress in secondary outcomes was reported for fatigue (2/5 studies), sleep quality (2/3 studies), depression and anxiety (3/6 studies), quality of life (4/5 studies), gastrointestinal symptoms (1/2 studies) and inflammatory biomarkers (1/1 study). However, according to Cochrane Risk of Bias, these studies had poor statistical quality. Well-designed studies should be performed to investigate the dietary interventions effect on FM. Key messages Fibromyalgia (FM) is a chronic non-degenerative disease, whose nutritional therapy seems controversial but promising. Pain and functional repercussion in FM patients seem to improve with a hypocaloric diet, a raw vegetarian diet or a low FODMAPs diet, as much as quality of life, quality of sleep, anxiety and depression and inflammatory biomarkers. Existing studies in this subject are scarce and low quality, which does not allow conclusions to be drawn.

O contexto vivido pelo familiar e pessoa em tratamento hemodialítico / The context experienced by family members and people under hemodialytic treatment / El contexto vivido por familiares y personas en tratamiento de hemodiálisis

Objetivo: compreender o contexto vivido pelo familiar e pessoa em tratamento hemodialítico. Método: estudo descritivo exploratório, qualitativo e transversal, aprovado pelo comitê de ética em pesquisa, realizado com pacientes com doença renal crônica e seus familiares, em um munícipio do interior do estado do Rio Grande do Norte, entre junho e julho de 2019. Utilizada entrevista semiestruturada, com perguntas norteadoras para a composição estrutural do genograma e ecomapa. Posteriormente à transcrição das falas, seguiu-se a leitura e construção das categorias a partir das informações encontradas. Resultados: Foram realizadas 18 entrevistas, compondo nove famílias participantes, obtendo-se as categorias: Apoio da família, Apoio externo à família, Renúncia e Enfrentamento da doença. Conclusão: a maneira com que cada paciente e família irão vivenciar o estar doente e interpretar esse significado fará essa adaptação particular e pessoal, assim como o seu enfrentamento, particularmente ao considerar que, no núcleo familiar, ocorre uma reestruturação em meio às demandas de cuidado(AU)

Objective: to understand the context experienced by the family member and person undergoing hemodialysis treatment. Method: exploratory, qualitative and cross-sectional descriptive study, approved by the research ethics committee, carried out with patients with chronic kidney disease and their families, in a municipality in the interior of the state of Rio Grande do Norte, between June and July 2019. Used semi-structured interview, with guiding questions for the structural composition of the genogram and ecomap. After transcribing the speeches, the categories were read and constructed based on the information found. Results: comprising nine participating families, 18 interviews were carried out, obtaining the categories: Family support, External support to the family, Resignation and Coping with the disease. Conclusion: the way in which each patient and family will experience being sick and interpret this meaning will make this particular and personal adaptation, as well as coping, particularly when considering that, within the family nucleus, a restructuring occurs amid the demands of care(AU)

Objetivo: comprender el contexto vivido por el familiar y la persona en tratamiento de hemodiálisis. Método: estudio descriptivo exploratorio, cualitativo y transversal, aprobado por el comité de ética en investigación, realizado con pacientes con enfermedad renal crónica y sus familiares, en un municipio del interior del estado de Rio Grande do Norte, entre junio y julio de 2019. Se utilizó una entrevista semiestructurada, con preguntas orientadoras para la composición estructural del genograma y del ecomapa. Luego de transcribir las declaraciones, se leyó la construcción de las categorías a partir de las informaciones encontradas. Resultados: Se realizaron 18 entrevistas, comprendiendo nueve familias participantes, obteniendo las categorías: Apoyo familiar, Apoyo externo a la familia, Rendimiento y Enfrentamiento de la enfermedad. Conclusión: la forma en que cada paciente y familia vivirá el estar enfermo e interpretará este significado, condicionará esa adaptación particular y personal, así como su enfrentamiento, particularmente si se considera que, dentro del núcleo familiar, se produce una reestructuración en medio de las demandas del cuidado(AU)

Optimizing the pharmacological component of integrated balance therapy.

UNLABELLED: Drug treatment is an important option for the treatment of peripheral vestibular diseases. AIM: To identify the drug component associated with optimal integrated balance therapy (IBT) for Ménières disease or other peripheral vestibular disorders. MATERIALS AND METHODS: Analysis of a series of patients with Ménières disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days. RESULTS: In Ménières disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-Ménières disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated. CONCLUSIONS: Drug therapies were more effective than no medication in the IBT for patients with Ménières disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with Ménières disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.

Medidas de segurança do paciente em unidades de terapia intensiva / Patient safety measures in intensive care units / Medidas de seguridad del paciente en unidades de atención intensiva

Objetivo: Identificar as medidas de segurança do paciente utilizadas em Unidades de Terapia Intensiva, a partir de estudos primários publicados em bases de dados. Métodos: Trata-se de uma revisão integrativa realizada nas seguintes fontes de dados: BVS, SCIELO, SCOPUS, PubMed, Science Direct, Web of Science, CINAHL. A amostra final foi constituída por 97 artigos. Resultados: Identificaram-se categorias temáticas com medidas de segurança do paciente, a saber: melhorar a comunicação entre os profissionais de saúde; melhorar a segurança na prescrição, no uso e na administração de medicamentos; reduzir o risco de quedas e lesões por pressão; higienizar as mãos para evitar infecções; identificar corretamente o paciente; e outras medidas utilizadas para promover a segurança do paciente. Conclusão: Conclui-se que o trabalho em equipe, cuidados na prescrição/administração de medicações, medidas de prevenção de lesão por pressão e higienização das mãos foram as variáveis mais frequentes na amostra, sendo intervenções importantes para promover a segurança do paciente, sobretudo em Unidades de Terapia Intensiva. (AU)

Objective: Identify patient safety measures used in Intensive Care Units, based on primary studies published in databases. Methods: This is an integrative review carried out on the following data sources: VHL, SCIELO, SCOPUS, PubMed, Science Direct, Web of Science, CINAHL. The final sample consisted of 97 articles. Results: Thematic categories with patient safety measures were identified, namely: improve communication between health professionals; improve safety in the prescription, use and administration of medications; reduce the risk of falls and pressure injuries; sanitize your hands to avoid infections; correctly identify the patient; and other measures used to promote patient safety. Conclusion: It is concluded that teamwork, care in the prescription/administration of medications, measures to prevent pressure injuries and hand hygiene were the most frequent variables in the sample, being important interventions to promote patient safety, especially in Intensive Care Units. (AU)

Objetivo: Identificar las medidas de seguridad del paciente utilizadas en las Unidades de Cuidados Intensivos, en base a estudios primarios publicados en bases de datos. Métodos: Se trata de una revisión integradora realizada sobre las siguientes fuentes de datos: VHL, SCIELO, SCOPUS, PubMed, Science Direct, Web of Science, CINAHL. La muestra final estuvo formada por 97 artículos. Resultados: Se identificaron categorías temáticas con medidas de seguridad del paciente, a saber: mejorar la comunicación entre los profesionales de la salud; mejorar la seguridad en la prescripción, uso y administración de medicamentos; reducir el riesgo de caídas y lesiones por presión; higienice sus manos para evitar infecciones; identificar correctamente al paciente; y otras medidas utilizadas para promover la seguridad del paciente. Conclusión: Se concluye que el trabajo en equipo, el cuidado en la prescripción/ administración de medicamentos, las medidas para prevenir las lesiones por presión y la higiene de manos fueron las variables más frecuentes en la muestra, siendo intervenciones importantes para promover la seguridad del paciente, especialmente en las Unidades de Terapia Intensiva. (AU)

Effect of Cinnamon Tea on Postprandial Glucose Concentration.

Glycaemic control, in particular at postprandial period, has a key role in prevention of different diseases, including diabetes and cardiovascular events. Previous studies suggest that postprandial high blood glucose levels (BGL) can lead to an oxidative stress status, which is associated with metabolic alterations. Cinnamon powder has demonstrated a beneficial effect on postprandial glucose homeostasis in animals and human models. The purpose of this study is to investigate the effect of cinnamon tea (C. burmannii) on postprandial capillary blood glucose level on nondiabetic adults. Participants were given oral glucose tolerance test either with or without cinnamon tea in a randomized clinical trial. The data revealed that cinnamon tea administration slightly decreased postprandial BGL. Cinnamon tea ingestion also results in a significantly lower postprandial maximum glucose concentration and variation of maximum glucose concentration (p < 0.05). Chemical analysis showed that cinnamon tea has a high antioxidant capacity, which may be due to its polyphenol content. The present study provides evidence that cinnamon tea, obtained from C. burmannii, could be beneficial for controlling glucose metabolism in nondiabetic adults during postprandial period.

Clonazepam in the pharmacological treatment of vertigo and tinnitus.

We carried out a retrospective survey of 25 years of clinical experience with the use of clonazepam as a vestibular and tinnitus suppressant in the pharmacological treatment of vestibular or cochleovestibular disorders due to different causes. We reviewed the medical records of 3,357 outpatients treated with a 0.5 or 1.0-mg daily dosage of oral clonazepam during 60-180 days. Complete or substantial control of vertigo or nonvertiginous dizziness was achieved in 77.4% of the vertigo patients. Tinnitus was improved in 32.0% of the tinnitus patients. Light or mild drowsiness, depression, nightmares, or lowering of libido, reported by 16.9% of the patients as adverse side effects, tended to subside with continued therapy. We concluded that clonazepam is a very useful and safe drug for the symptomatic treatment of patients suffering from cochleovestibular disorders.

Epidemiological profile of traumatic brain injury victims of a general hospital in a brazilian capital / Perfil epidemiológico de vítimas de traumatismo cranioencefálico de um hospital geral de uma capital brasileira

In Brazil, the accidents and urban violence, the external causes, build a public health problem that has taken big proportions and transcendence, with a big impact on the population's lives. In the set of injuries resulting from external causes, the Traumatic brain injury (TBI) stands out in terms of magnitude, both among dead and injured, being one of the most frequent injuries. Thus, it is important to know epidemiological profile of traumatic brain injury victims, local characteristics, in order to take more effective prevention actions based on this reality, since the primary causes of TBI can vary according to the people involved. The objective of this study was to know the epidemiological profile of traumatic brain injury victims, the type of causative event and the severity of the trauma. Exploratory, crosssectional, quantitative and descriptive research, conducted with 372 patients suffering from traumatic brain injury. Data were collected from form itself, semi-structured form, and analyzed using the SPSS 20.0 software. The research had the project approved by the Research Ethics Committee, CAAE 30487514.6.0000.5568. There was a predominance of males, aged 18-30 years. The cause of the most common brain injury was traffic accident with a prevalence of moderate traumatic brain injury. It is necessary to the development of preventive actions as well as the development of public policies that contribute to the reduction of morbidity and mortality from TEC and qualified assistance to victims.

No Brasil, os acidentes e a violência urbana, ou seja, as causas externas configuram um problema de saúde pública que tem tomado grandes proporções e transcendência, com forte impacto na vida da população. No conjunto de lesões decorrentes das causas externas, o Traumatismo Cranioencefálico (TCE) destaca-se em termos de magnitude, tanto entre mortos quanto em feridos, sendo uma das lesões mais frequentes. Assim, é de fundamental importância o conhecimento do perfil epidemiológico das vítimas das de traumatismo cranioencefálico, as características locais, para que sejam, então, adotadas medidas de prevenção mais efetivas baseadas nessa realidade, uma vez que as causas primárias do TCE variam de acordo com a população envolvida. O estudo pretende conhecer o perfil epidemiológico das vítimas de traumatismo cranioencefálico, o tipo de evento causador e a gravidade do trauma. Pesquisa exploratória, transversal, quantitativa e descritiva, realizada com 372 pacientes vítimas de traumatismo cranioencefálico. Os dados foram coletados a partir de formulário próprio, semiestruturado, e analisados por meio do software SPSS 20.0. A pesquisa teve o projeto aprovado pelo Comitê de Ética em Pesquisa, CAAE 30487514.6.0000.5568. Houve predomínio do sexo masculino, na faixa etária de 18 a 30 anos. A causa do traumatismo cranioencefálico mais frequente foi a de acidentes de trânsito, havendo predomínio do traumatismo cranioencefálico moderado. Faz-se necessário o planejamento de ações preventivas, bem como o desenvolvimento de políticas públicas que contribuam com a diminuição da morbimortalidade por traumatismo cranioencefálico e com o atendimento qualificado às vítimas.

Vivências dos profissionais da enfermagem sobre procedimentos executados no hospital / Experiencias del profesional de enfermería sobre los procedimientos realizados en hospital / Experiences of the nursing professional about hospital procedures

Introdução: o cotidiano dos profissionais de enfermagem que atuam em unidades hospitalares apresenta inúmeras experiências e vivências de procedimentos e situações práticas na instituição hospitalar. Objetivo: analisar as vivências dos profissionais de enfermagem no âmbito hospitalar a partir de seus aspectos éticos. Métodos: estudo descritivo-exploratório de abordagem qualitativa, realizado com dezoito profissionais da enfermagem de dois hospitais na cidade de Santa Cruz/RN, Brasil. Resultados: as entrevistas foram coletadas de junho a julho de 2015 e submetidas à análise de conteúdo temática. Diante das vivências hospitalares dos profissionais que fizeram parte do estudo, destaca-se a importância da lei do exercício profissional e do código de ética da enfermagem e mostram situações a serem refletidas diante da ética profissional. Conclusões: As vivências dos profissionais de enfermagem no âmbito hospitalar acerca de atividades e procedimentos realizados revelam que, apesar dos erros éticos que existem na profissão, a enfermagem tem como objetivo principal o cuidado humanizado(AU)

Introducción: el día a día de las enfermeras que trabajan en los hospitales presenta numerosos experimentos y procedimientos de experiencias y situaciones prácticas en el hospital. Objetivo: analizar, en sus aspectos éticos, las experiencias de las enfermeras en los hospitales. Métodos: estudio descriptivo de enfoque cualitativo, realizado con veinte profesionales de enfermería de dos hospitales en la ciudad de Santa Cruz/RN, Brasil. Las entrevistas se recogieron de junio a julio 2015 y fueron sometidas a análisis de contenido temático. Resultados: ante la experiencia de los profesionales que participaron en el estudio en el hospital, se pone de relieve la importancia de la ley de la práctica profesional y el código ético de enfermería y muestran situaciones que se refleja en la ética profesional. Conclusiones: las experiencias de los profesionales de enfermería en los hospitales sobre las actividades y los procedimientos realizados revelan que a pesar de los errores éticos que existen en la profesión, la enfermería tiene como objetivo la atención humanizada(AU)

Introduction: The hospital nurses' daily routine presents several experiments and procedures of experiences and situations practiced in the hospital. Objective: Analyze, in their ethical aspects, the experiences of hospital nurses. Methods: Descriptive study with qualitative approach carried out with 20 nursing professional in two hospitals of the city of Santa Cruz, Brazil. The interviews were gathered from June to July 2015 and were analyzed by their thematic content. Results: In front of the experience of the professionals who participated in the hospital study, the importance is emphasized of the professional practice law and the nursing ethical code, and situations are shown as reflecting the professional ethics. Conclusions: The hospital nursing professionals' experiences about the activities and procedures performed reveal that in spite of the ethical mistake existing in the profession, humanized attention is a nursing objective(AU)

Otimizando o componente farmacológico da terapia integrada da vertigem / Optimizing the pharmacological component of integrated balance therapy

A farmacoterapia é opção importante no tratamento das vestibulopatias periféricas. OBJETIVO: Identificar a medicação que otimiza a terapia integrada da vertigem (TIV) na doença de Ménière e em outras vestibulopatias periféricas. MATERIAL E MÉTODO: Estudo de casos em que pacientes com doença de Ménière ou outras vestibulopatias periféricas receberam TIV com betaistina, cinarizina, clonazepam, flunarizina, Ginkgo biloba ou sem medicação durante 120 dias. RESULTADOS: Na doença de Ménière, TIV com qualquer um dos medicamentos foi mais eficaz do que TIV sem medicação, após 60 dias; a betaistina foi mais efetiva que todas as outras drogas, após 60 e 120 dias. Nas outras vestibulopatias periféricas, diferenças significantes foram observadas entre TIV com betaistina, cinarizina, clonazepam ou flunarizina e TIV sem medicação após 60 dias e todas as drogas foram mais efetivas que TIV sem medicação após 120 dias; betaistina, cinarizina ou clonazepam foram igualmente efetivos e betaistina foi mais efetiva que flunarizina e Ginkgo biloba. Os tratamentos foram bem tolerados. CONCLUSÕES: TIV incluindo medicação é mais efetiva que sem medicação na doença de Ménière ou em outras vestibulopatias periféricas. Betaistina foi o medicamento mais efetivo na doença de Ménière e tão eficaz quanto cinarizina ou clonazepam em outras vestibulopatias periféricas.

Drug treatment is an important option for the treatment of peripheral vestibular diseases. AIM: To identify the drug component associated with optimal integrated balance therapy (IBT) for MénièreÆs disease or other peripheral vestibular disorders. MATERIALS AND METHODS: Analysis of a series of patients with MénièreÆs disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days. RESULTS: In MénièreÆs disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-MénièreÆs disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated. CONCLUSIONS: Drug therapies were more effective than no medication in the IBT for patients with MénièreÆs disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with MénièreÆs disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.