Perfil clínico, farmacoterapêutico e laboratorial de pacientes internados com insuficiência cardíaca aguda / Clinical, pharmacotherapeutic and laboratory profile of hospitalized patients with acute heart failure / Perfil clínico, farmacoterapéutico y de laboratorio de los pacientes hospitalizados com insuficiência cardíaca aguda

A insuficiência cardíaca aguda (ICA) é uma das causas mais comuns de internação hospitalar, associada a um alto risco de mortalidade. O tratamento atual é principalmente sintomático, sendo os exames laboratoriais realizados, a fim de complementar a avaliação clínica no diagnóstico e auxiliar no estabelecimento do perfil de risco admissional e prognóstico. Este estudo teve como objetivo caracterizar o perfil clínico, farmacoterapêutico e laboratorial de pacientes internados com insuficiência cardíaca aguda em hospital referência regional. Trata-se de um estudo transversal retrospectivo, descritivo, de abordagem quantitativa. Os participantes do estudo foram aqueles com alta médica por ICA pela classificação Internacional de Doenças (CID-10), admitidos na sala de emergência. Excluindo-se a participação de pacientes com tempo de internação inferior a 24 horas, menores de 18 anos. Para análise estatística foi usado o programa SPSS versão 21.0. Quanto ao perfil farmacoterapêutico, os medicamentos mais frequentes foram os que atuam no aparelho cardiovascular e aparelho digestivo e metabolismo, sendo a furosemida o fármaco mais frequente. A análise entre as alterações laboratoriais e a escala de ADHERE, revelou diferença estatística significativa entre os pacientes com risco baixo e risco intermediário/alto nos valores de hemoglobina (p=0,005), TGO (p=0,001), creatinina (p=0,000), ureia (p=0,000), potássio (p=0,004), TTPA (p=0,004) e RNI (p=0,021). Concluiu-se que os medicamentos frequentemente corresponderam ao tratamento recomendado no manejo inicial de pacientes com ICA. O risco de mortalidade intra-hospitalar intermediário/alto de acordo com a escala de ADHERE estavam associados com alterações laboratoriais dos pacientes com ICA.

Acute heart failure (AHF) is one of the most common causes of hospitalization, associated with a high risk of mortality. The current treatment is mainly symptomatic, and laboratory tests are carried out in order to complement the clinical evaluation in the diagnosis and help in establishing the admission and prognostic risk profile. This study aimed to characterize the clinical, pharmacotherapeutic and laboratory profile of patients hospitalized with acute heart failure in a regional reference hospital. This is a retrospective, descriptive, cross-sectional study with a quantitative approach. Study participants were those discharged due to AHF according to the International Classification of Diseases (ICD-10), admitted to the emergency room. Excluding the participation of patients with hospitalization time of less than 24 hours, under 18 years old. For statistical analysis, SPSS version 21.0 was used. As for the pharmacotherapeutic profile, the most frequent drugs were those that act on the cardiovascular and digestive systems and metabolism, with furosemide being the most frequent drug. The analysis between laboratory changes and the ADHERE scale revealed a statistically significant difference between patients at low risk and intermediate/high risk in hemoglobin (p=0.005), TGO (p=0.001), creatinine (p=0.000) values, urea (p=0.000), potassium (p=0.004), APTT (p=0.004) and INR (p=0.021). It was concluded that the medications often corresponded to the recommended treatment in the initial management of patients with AHF. Intermediate/high risk of in-hospital mortality according to the ADHERE scale were associated with laboratory alterations in patients with AHF.

La insuficiencia cardiaca aguda (ICA) es una de las causas más frecuentes de hospitalización, asociada a un alto riesgo de mortalidad. El tratamiento actual es principalmente sintomático y se realizan pruebas de laboratorio para complementar la evaluación clínica en el diagnóstico y ayudar a establecer el perfil de riesgo de ingreso y pronóstico. Este estudio tuvo como objetivo caracterizar el perfil clínico, farmacoterapéutico y de laboratorio de pacientes hospitalizados con insuficiencia cardíaca aguda en un hospital regional de referencia. Se trata de un estudio retrospectivo, descriptivo, transversal con enfoque cuantitativo. Los participantes del estudio fueron los dados de alta por ICA según la Clasificación Internacional de Enfermedades (CIE-10), ingresados en urgencias. Se excluye la participación de pacientes con tiempo de hospitalización menor a 24 horas, menores de 18 años. Para el análisis estadístico se utilizó SPSS versión 21.0. En cuanto al perfil farmacoterapéutico, los fármacos más frecuentes fueron los que actúan sobre los sistemas cardiovascular, digestivo y el metabolismo, siendo la furosemida el fármaco más frecuente. El análisis entre los cambios de laboratorio y la escala ADHERE reveló una diferencia estadísticamente significativa entre los pacientes de riesgo bajo e intermedio/alto en los valores de hemoglobina (p=0,005), TGO (p=0,001), creatinina (p=0,000), urea (p =0,000), potasio (p=0,004), APTT (p=0,004) e INR (p=0,021). Se concluyó que los medicamentos correspondían muchas veces al tratamiento recomendado en el manejo inicial de pacientes con ICA. El riesgo intermedio/alto de mortalidad hospitalaria según la escala ADHERE se asoció con alteraciones de laboratorio en pacientes con ICA.

Toxoplasma gondii infection in pig intended for human consumption: seroprevalence, risk factors and influence of biosecurity measures.

A serologic and epidemiologic study was carried out in order to determinate herd and animal seroprevalence and associated factors for Toxoplasma gondii in commercial pigs from Espírito Santo state, Brazil. Blood samples were collected from 416 pigs from 55 producer farms in 27 municipalities. An indirect immunofluorescent assay (IFA) was performed to estimate the seroprevalence of T. gondii and identify the associated risk factors using a questionnaire. The T. gondii antibody prevalence rate in commercial swine herds was 15.4% (64/416) using a cutoff of 1:64. The seropositivity for T. gondii was related to the presence of cats, water origin and age of swine in the increase of seroprevalence, and the existence of internal isolation fences and use of composting chambers as protective factors. To the best of our knowledge, this is the first study to report anti- T. gondii antibodies in the serum of pigs in the state of Espírito Santo, Brazil. This finding is important to public health because seropositive pigs can harbor tissue cysts in their meat, thereby representing a zoonotic risk for consumers of raw or undercooked porcine meat or its products.

The role of the pharmacist in the hospital discharge of cancer patients: an integrative review.

INTRODUCTION: Patients with cancer need care from a multidisciplinary team due to the complexity of the clinical picture and proposed treatment. Hospital discharge is a critical step, because pharmacotherapy changes may occur during hospitalization, leading to potential medication-related problems at home. OBJECTIVE: To identify publications which describe the activities performed by the pharmacist at the hospital discharge of patients with cancer. METHOD: This is an integrative systematic literature review. A search was carried out in the MEDLINE databases, via Pubmed, Embase, and Virtual Health Library, using the following descriptors: "Patient Discharge", "Pharmacists", "Neoplasms." Studies that reported activities performed by the pharmacist at the hospital discharge of patients with cancer were included. RESULTS: Five hundred and two studies were identified, of which seven met the eligibility criteria. Most were conducted in the United States (n = 3), and the rest in Belgium, Brazil, Canada, and Italy. Among the services provided by the pharmacist at discharge, medication reconciliation was the most widely described. Other activities such as counseling, education, identification, and resolution of drug-related problems were also carried out. CONCLUSION: In the scenario of hospital discharge of patients with cancer, the participation of pharmacists is still to be seen as of significance in regards to publications. Despite this, the results suggest that the actions of this professional contribute to patient orientation and the safe use of prescription drugs for use at home.

Toxoplasma gondii infection in pig intended for human consumption: seroprevalence, risk factors and influence of biosecurity measures / Infecção por Toxoplasma gondii em suínos destinados ao consumo humano: soroprevalência, fatores de risco e influência de medidas de biosseguridade

Abstract A serologic and epidemiologic study was carried out in order to determinate herd and animal seroprevalence and associated factors for Toxoplasma gondii in commercial pigs from Espírito Santo state, Brazil. Blood samples were collected from 416 pigs from 55 producer farms in 27 municipalities. An indirect immunofluorescent assay (IFA) was performed to estimate the seroprevalence of T. gondii and identify the associated risk factors using a questionnaire. The T. gondii antibody prevalence rate in commercial swine herds was 15.4% (64/416) using a cutoff of 1:64. The seropositivity for T. gondii was related to the presence of cats, water origin and age of swine in the increase of seroprevalence, and the existence of internal isolation fences and use of composting chambers as protective factors. To the best of our knowledge, this is the first study to report anti- T. gondii antibodies in the serum of pigs in the state of Espírito Santo, Brazil. This finding is important to public health because seropositive pigs can harbor tissue cysts in their meat, thereby representing a zoonotic risk for consumers of raw or undercooked porcine meat or its products.

Resumo Um estudo sorológico e epidemiológico foi realizado com o objetivo de determinar a soroprevalência nas granjas e animais e também em fatores associados para Toxoplasma gondii em suínos comerciais do estado do Espírito Santo, Brasil. Foram coletadas amostras de sangue de 416 suínos de 55 granjas produtoras de 27 municípios. A reação de imunofluorescência indireta (RIFI) foi realizada com o uso de questionário, para estimar a soroprevalência do T. gondii e identificar os fatores de risco associados. A taxa de prevalência de anticorpos contra T. gondii, nos rebanhos comerciais de suínos, foi de 15,4% (64/416) com ponto de corte de 1:64. A soropositividade para T. gondii foi relacionada à presença de gatos, origem da água, a idade dos suínos no aumento da soroprevalência, a existência de cercas de isolamento interno e uso de câmaras de compostagem como fatores de proteção. De acordo com este estudo, ele é o primeiro a relatar anticorpos anti-T. gondii no soro de suínos no estado do Espírito Santo, Brasil. Este achado é importante para a saúde pública, pois suínos soropositivos podem abrigar cistos teciduais em suas carnes, representando um risco zoonótico para os consumidores de carne suína crua ou mal cozida ou seus produtos.

Development, physicochemical evaluation, and in vivo permeation studies of topical formulations containing 0.1% tacrolimus

Abstract The objective of this paper was to develop and evaluate two semi-solid pharmaceutical forms containing 0.1% tacrolimus: cream (CRT01) and gel (GLT01). For the evaluation of physicochemical stability, at times 0, 30, 60 and 90 days, at 23°C and at 40°C, High Performance Liquid Chromatography coupled with a Diode Array Detector (HPLC-DAD) was employed. This method was developed and validated for tacrolimus quantification. The occlusivity test and skin permeation assay were also performed, using an animal model (Wistar rats), and the CRT01 and GLT01 were compared to the 0.1% tacrolimus ointment (PFU01) obtained from the University Pharmacy, Federal University of Rio de Janeiro, Brazil. CRT01 and GLT01 presented a homogeneous aspect and consistency adequate for topical products, along with sensory characteristics above PFU01. They also presented adequate physicochemical stability for 90 days and a lower occlusive effect than PFU01 (p<0.05). CRT01 showed greater affinity for the skin when compared to PFU01 and GLT01, with low systemic absorption. The CRT01 semi-solid formulation was considered the most adequate one to treat patients with atopic dermatitis or other dermatologic inflammatory diseases, promoting rational use of tacrolimus

A Betulinic Acid Derivative, BA5, Induces G0/G1 Cell Arrest, Apoptosis Like-Death, and Morphological Alterations in Leishmania sp.

Leishmaniasis are endemic diseases caused by different species of intracellular parasites of the genus Leishmania. Due to the high toxicity and drug resistance of current antileishmanial drugs, it is necessary to identify new and more effective drugs. Previously, we investigated the immunomodulatory and anti-Trypanosoma cruzi action of BA5, a derivative of betulinic acid. In the present study, we investigated the in vitro activity of BA5 against different species of Leishmania and their action mechanism. BA5 exhibited low cytotoxicity against macrophages and inhibited the proliferation of promastigote forms of Leishmania amazonensis (IC50 = 4.5 ± 1.1 µM), Leishmania major (IC50 = 3.0 ± 0.8 µM), Leishmania braziliensis (IC50 = 0.9 ± 1.1 µM) and Leishmania infantum (IC50 = 0.15 ± 0.05 µM). Incubation with BA5 reduced the percentage of Leishmania amazonensis-infected macrophages and the number of intracellular parasites (IC50 = 4.1 ± 0.7 µM). To understand the mechanism of action underlying BA5 antileishmanial activity (incubation at IC50/2, IC50 or 2xIC50 values of the drug), we investigated ultrastructural changes by scanning electron microscopy and evaluated cell cycle, membrane mitochondrial potential, and cell death against promastigote forms of Leishmania amazonensis by flow cytometry. Promastigotes incubated with BA5 presented membrane blebbing, flagella damage, increased size, and body deformation. Flow cytometry analysis showed that parasite death is mainly caused by apoptosis-like death, arrested cell cycle in G0/G1 phase and did not alter the membrane mitochondrial potential of Leishmania amazonensis. Surprisingly, the combination of BA5 and amphotericin B, an assay used to determine the degree of drug interaction, revealed synergistic effects (CI = 0.15 ± 0.09) on promastigotes forms of Leishmania amazonensis. In conclusion, BA5 compound is an effective and selective antileishmanial agent.

E-learning on medical emergencies for Dentistry students: a randomized controlled trial / E-learning em emergências médicas para estudantes de Odontologia: um ensaio clínico randomizado

This study comparedtwo teaching pedagogies to addressmedical emergencies in dental officevisitsandevaluateddental school students' knowledge about medical emergencies.This randomized controlled trial involved54senior undergraduate dental students at theFederal University of Santa Mariadivided in two groups:students who received instruction via face-to-face traditional expository class;andstudents whoreceived the same instruction via distant learning format.The students were randomly allocated to the groupsby the randomiser.orgwebsite. Data were obtained by comparing the scores students received from answering to a semi-structured questionnaire containing inquiries on ethical and legal implications, and diagnosis and management of medicalemergencies in a dental officebefore and after the instruction. Before the instruction, 96%of studentsfrom the two groupslackedknowledge about the ethical and legal implications related to the dentist obligation to deal with medical emergencies. After the instruction, both groups increasedtheir knowledge similarly as there was no significant difference in the comparison between learning about medical emergencies through lectures and thorough an e-learning format.Both teaching methods presented satisfactory results, which makes the e-learning method an option as a didactic strategy (AU).

Esteestudocomparouduaspedagogiasdeensinoparalidarcomemergênciasmédicasemconsultasodontológicaseavaliouoconhecimentodealunosdocursoodontologiasobreemergênciasmédicas.Esteensaioclínicorandomizadoenvolveu54alunosdoúltimoanodocursodeodontologiadaUniversidadeFederaldeSantaMaria,divididosemdoisgrupos:alunosquereceberaminstruçãopormeiodeaulaexpositivatradicionalpresencial;ealunosquereceberamamesmainstruçãopormeiodoformatodeensinoadistância.Osalunosforamalocadosaleatoriamenteaosgrupospelositerandomiser.org.Osdadosforamobtidospormeiodacomparaçãodaspontuaçõesrecebidaspelosalunosaoresponderaumquestionáriosemiestruturadocontendoindagaçõessobreimplicaçõeséticaselegais,ediagnósticoemanejodeemergênciasmédicasemconsultórioodontológicoanteseapósainstrução.Antesdainstrução,96%dosalunosdosdoisgruposdesconheciamasimplicaçõeséticaselegaisrelacionadasàobrigaçãododentistaemlidarcomemergênciasmédicas.Apósainstrução,os dois grupos aumentaram seus conhecimentos de forma semelhante,poisnãohouvediferençasignificativanacomparaçãoentreoaprendizadosobreemergênciasmédicaspormeiodepalestrasepormeiodoformatoe-learning.Ambososmétodosdeensinoapresentaramresultadossatisfatórios,o que torna o método e-learning uma opção como estratégia didática (AU).

The emotional and psychiatric problems of adolescents on parole whose parents are substance users: A Brazilian cross-sectional study.

The aim of this study is to evaluate the associations between having parents with substance use problems, and having suffered neglect within the family, and behavioral problems (psychological and drug use) among adolescents. All the participants were enrolled on the socio-educational parole scheme, 'Assisted Freedom'. In this cross-sectional study, 150 adolescents were interviewed using the Drug Abuse Screening Test, Teen Addiction Severity Index, and Childhood Trauma Questionnaire. Ninety-five percent of the participants were male (n = 143), aged 13-17. Thirty percent of adolescents had a parent who used substances and had experienced neglect from their families. Those adolescents who were living with both parents (odds ratio adjusted (ORA) = 2.7, 95% confidence interval (CI) = 1.13-6.37), from a low-income family (ORA = 6.7, 95% CI = 1.85-24.22), experienced hallucinations (ORA = 2.8, 95% CI = 1.25-6.14), had problems controlling violent behavior (ORA = 2.6, 95% CI = 1.12-5.87), and were physically neglected (ORA = 3.0, 95% CI = 1.24-7.49) were more likely to have parents who used substances and to have experienced parental neglect. This article concludes that adolescents, who are on parole, come from families with high level of psychosocial vulnerabilities, including substance use, experience neglect by their families leading to adverse emotional and psychological states.

Synthesis, crystal structure and leishmanicidal activity of new trimethoprim Ru(III), Cu(II) and Pt(II) metal complexes.

Leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania, which has very limited treatment options and affects poor and underdeveloped populations. The current treatment is plagued by many complications, such as high toxicity, high cost and resistance to parasites; therefore, novel therapeutic agents are urgently needed. Herein, the synthesis, characterization and in vitro leishmanicidal potential of new complexes with the general formula [RuCl3(TMP)(dppb)] (1), [PtCl(TMP)(PPh3)2]PF6 (2) and [Cu(CH3COO)2(TMP)2]·DMF (3) (dppb = 1,4-bis(diphenylphosphino)butane, PPH3 = triphenylphosphine and TMP = trimethoprim) were evaluated. The complexes were characterized by infrared, UV-vis, cyclic voltammetry, molar conductance measurements, elemental analysis and NMR experiments. Also, the geometry of (2) and (3) were determined by single crystal X-ray diffraction. Despite being less potent against promastigote L. amazonensis proliferation than amphotericin B reference drug (IC50 = 0.09 ± 0.02 µM), complex (2) (IC50 = 3.6 ± 1.5 µM) was several times less cytotoxic (CC50 = 17.8 µM, SI = 4.9) in comparison with amphotericin B (CC50 = 3.3 µM, SI = 36.6) and gentian violet control (CC50 = 0.8 µM). Additionally, complex (2) inhibited J774 macrophage infection and amastigote number by macrophages (IC50 = 6.6 and SI = 2.7). Outstandingly, complex (2) was shown to be a promising candidate for a new leishmanicidal therapeutic agent, considering its biological power combined with low toxicity.

Práticas inovadoras de educação em saúde sobre avulsão dentária: relato de experiência / Innovative Practices In Dental Avulsion Health Education: Experience Report

A política nacional de promoção da saúde aponta estratégias para produzir saúde, sendo a escola um espaço privilegiado para o desenvolvimento destas ações. Sendo assim, o objetivo deste trabalho foi relatar a experiência durante as práticas educativas em saúde, sobre a avulsão dentária, desenvolvidas por graduandos de odontologia em um projeto de extensão voltado aos escolares do ensino fundamental de Belém-PA. Com base nas palestras, a falta de conhecimento sobre trauma dental foi rotineiramente observada durante as orientações, sendo o professor o principal ator, pois este é o responsável pelas crianças durante o horário escolar e precisa estar bem preparado para agir de forma eficaz em caso de acidente. Concluiu-se que esta vivência dos acadêmicos colaborou com a formação generalista e interdisciplinar, o vínculo, a troca de saberes e inovou a prática de educação em saúde articuladas com a temática prioritária sobre avulsão dental.

The national health promotion policy points out strategies to produce health, being the school a privileged space for the development of these actions. Thus, this paper aims to report the experiences during health educational practices on dental avulsion developed by undergraduate dentistry students in an extension project aimed at elementary school students from Belém-PA. Based on the meeting the lack of knowledge about dental trauma was routinely seen during the orientations, being the teacher the main actor, as this is responsible for the children during school hours and needs to be well prepared to act effectively in case of accident. It was concluded that this experience of academics collaborated with the generalist and interdisciplinary training, the bond, the exchange of knowledge and innovated the practice of health education articulated with the priority theme on dental avulsion.

Estudio de la Legalidad Brasileña de las Escuelas Públicas Municipales en Cuanto a la Promoción de la Alimentación Sana para el Control y Prevención de la Salud Oral en el Contexto de las Enfermedades Gastrointestinales Inflamatorias / Study of the Brazilian Legality of the Municipal Public Schools Regarding the Promotion of Healthy Eating for Control and Prevention of Oral Health in the Context of Inflammatory Intestinal Diseases

RESUMEN: Las enfermedades gastrointestinales inflamatorias se caracterizan por la desarmonía de la flora bacteriana del intestino. Estos cambios se caracterizan como un problema de salud pública que demuestra que las principales causas de las enfermedades están asociadas a la alimentación inadecuada y, como consecuencia de cambios en la mucosa oral. Los países desarrollados están actualmente definiendo estrategias para el control de esas enfermedades, teniendo como una de las estrategias públicas para la promoción de la alimentación sana. En este contexto, el objetivo de este trabajo fue evaluar la legislación brasileña vigente en cuanto al cuadro de profesional nutricionista para elaborar y acompañar el menú de la alimentación escolar, conforme prevé la Ley Federal nº 8.234, de 17 de septiembre de 1991, y la Resolución del Consejo Federal de Nutricionistas - CFN n ° 380/2005. Se realizó el levantamiento de las Leyes que establecen un cuadro de profesionales nutricionistas en las escuelas públicas de las principales ciudades brasileñas en los órganos competentes. Los resultados muestran que pocos Estados y Municipios abordan ese tema, entre ellos el Estado de Río de Janeiro, el Estado de São Paulo, la ciudad de Ribeirão Preto, la ciudad de Florianópolis, la ciudad de Belém, el Estado de Santa Catarina, El Estado de Paraná, el Distrito Federal y el Estado de Ceará ya regularon la materia, así como la Ley nº 13.666 / 2018 que modifica la Ley nº 9.394 / 16. Los autores concluyen que además de conocer las pecurialidades de las manifestaciones orales de estos pacientes es imprescindible el conocimiento multidisciplinario del cirujano dentista, creando no sólo oportunidades de diagnóstico precoz, sino también la prevención y promoción de la salud oral.

ABSTRACT: Inflammatory intestinal diseases are characterized by disharmony of the bacterial flora of the intestine. These changes are characterized as a public health problem demonstrating that the main causes of diseases are associated with inadequate nutrition and, as a consequence, changes in the oral mucosa. The developed countries are currently defining strategies for the control of these diseases, having as one of the public strategies to promote healthy eating. In this context, the objective of this study was to evaluate the Brazilian legislation in force regarding the professional dietitian to elaborate and follow the menu of school feeding, according to Federal Law No. 8,234, dated September 17, 1991, and the Resolution of the Federal Council of Nutritionists - CFN n ° 380/2005. It was carried out the survey of the Laws that establish a cadre of nutrition professionals in the public schools of the main Brazilian cities in the competent bodies. The results show that few States and Municipalities address this theme, among them the State of Rio de Janeiro, the State of São Paulo, the city of Ribeirão Preto, the city of Florianópolis, the city of Belém, the State of Santa Catarina, State of Paraná, the Federal District and the State of Ceará have already regulated the matter, as well as Law 13,666 / 2018, which amends Law 9,394 / 16. The authors conclude that besides knowing the characteristics of the oral manifestations of these patients, a multidisciplinary knowledge of the dental surgeon is essential, creating opportunities for early diagnosis, as well as the prevention and promotion of oral health.

Effect of cadmium on young plants of Virola surinamensis.

The steady increase in cadmium (Cd) levels in the environment from anthropogenic actions has contributed to environmental degradation. Virola surinamensis is a forest species that has desirable characteristics such as deep and dense roots, relatively rapid growth and high biomass production to remedy contaminated environments by Cd. The aim of this study was to assess the physiological responses and the phytoextraction and tolerance capacity of young plants of V. surinamensis submitted to Cd concentrations. The experimental design was a completely randomized design with five Cd concentrations (0, 15, 30, 45 and 60 mg L-1) for 60 days. Leaf water potential (Ψpd), stomatal conductance (gs) and transpiration (E) reduced in plants exposed to Cd. Lower values of maximum photochemical efficiency of photosystem II (Fv/Fm), electron transport rate (ETR) and photochemical quenching coefficient (qP) were accompanied by reduction of photosynthesis (A) with increasing concentrations of Cd, although the non-photochemical quenching coefficient (NPQ), and intercellular CO2 concentration (Ci) showed increase. Instantaneous water-use efficiency (A/E), net photosynthesis to intercellular CO2 concentration ratio (A/Ci) and total chlorophyll (Chl) reduced with increasing levels of Cd. Cadmium concentrations increased in different plant tissues (root > stem > leaf). The tolerance index (TI) indicated that V. surinamensis presented medium and high tolerance to Cd. The results of bioconcentration factor (BCF) and translocation factor (TF) showed low plant efficacy in Cd phytoextraction and suggest that V. surinamensis may be promising for phytostabilization of Cd.

Depressive symptoms and factors associated with depression and suicidal behavior in substances user in treatment: Focus on suicidal behavior and psychological problems.

AIM: To investigate the prevalence of depressive symptoms, psychological problems, suicidal behaviour and their associations in substance users in treatment. METHODS: A cross-sectional study, with 307 substance users in an out-patient treatment facility, was undertaken. Socio-demographic data, psychoactive substances used, depressive symptoms, and suicide information were obtained. RESULTS: 70% of participants were depressed; of those, 8.1% were either under the influence of drugs or in withdrawal. Suicidal ideation was found to be present in those who had anxiety, were nervous, had depressive symptoms, or were under drug influence or in withdrawal. CONCLUSION: It is important to identify potential suicidal risk factors and implement the management of these conditions in substance users.

Ensino da Saúde das Populações tradicionais em cursos de graduação em Enfermagem / Health education of traditional populations in nursing courses

Objetivo: Analisar a presença de disciplinas sobre Saúde de populações tradicionais nos cursos de graduação em enfermagem da região Centro-Oeste do Brasil. Método: Trata-se de um estudo transversal, descritivo e quantitativo, realizado a partir da consulta na base de dados eletrônica do Ministério da Educação e Cultura (E-MEC) no período de maio a novembro de 2017. Resultados: Foram identificadas 89 instituições com cadastro no E-MEC, sendo 16 da rede pública e 73 da privada. Conclusões: Constatou-se que apesar dos estados da região Centro-Oeste possuírem populações tradicionais, foi possível identificar um déficit de disciplinas curriculares específicas sobre a saúde de populações tradicionais, bem como falhas pedagógicas com a ausência de informação da matriz curricular em sistemas eletrônicos na região Centro-Oeste. Espera-se que estes dados possam subsidiar novas reflexões aos diversos cursos de graduação em enfermagem no país. (AU)

Objective: To analyze the presence of disciplines on Health of traditional populations in nursing undergraduate courses in the Center-West region of Brazil. Method: This is a cross-sectional, descriptive and quantitative study based on the electronic database of the Ministry of Education and Culture (E-MEC) from May to November 2017. Results: A total of 89 institutions with registration in the E-MEC, being 16 of the public network and 73 of the private. Conclusions: Although the states of the Central-West region have traditional populations, it was possible to identify a deficit of specific curricular subjects on the health of traditional populations, as well as pedagogical failures with the absence of information from the curricular matrix in electronic systems in the Midwest region. It is hoped that this data may support new reflections on the various nursing undergraduate courses in the country. (AU)

Objectivo: Analizar la presencia de disciplinas sobre salud de poblaciones tradicionales en cursos de pregrado de enfermería en la región Centro-Oeste de Brasil. Método: Este es un estudio transversal, descriptivo y cuantitativo basado en la base de datos electrónica del Ministerio de Educación y Cultura (E-MEC) de mayo a noviembre de 2017. Resultados: Un total de 89 instituciones con registro en el E-MEC, siendo 16 de la red pública y 73 de la privada. Conclusiones: Si bien los estados de la región Centro-Oeste tienen poblaciones tradicionales, fue posible identificar un déficit de temas curriculares específicos sobre la salud de las poblaciones tradicionales, así como fallas pedagógicas con la ausencia de información de la matriz curricular en los sistemas electrónicos. en la región del medio oeste. Se espera que estos datos puedan respaldar nuevas reflexiones sobre los diversos cursos de pregrado de enfermería en el país. (AU)

Development and characterization of photoprotective formulations containing keratin particles

This work deals with development and evaluation of MFQ protective formulation, which contains two organic filters, namely: octyl-p-methoxycinnamate (OMC) and benzophenone-3 (BP-3); a photostabilizing agent called ethylhexylmethoxycrylene (EHMCR) and keratin particles. The MFQ formulation was evaluated in order to measure its pH, spin-spin lattice relaxation time (T2H), occlusivity factor, formulation efficacy, photostability and skin permeation, as well as keratin particle properties. Keratin particle size increased when incorporated to formulation, however, it did not affect pH. The MFQ formulation was found to be photostable and photoprotective, as evidenced by sunlight photostability test, sun protection factor (SPF), UVA/UVB ratio and critical wavelength. Interaction between keratin particles and active substances (OMC, BP-3 and EHMCR) was evidenced by T2H measurements. Evidences suggest that keratin reduces the permeation of both UV filters employed along this study, therefore, it can be stated that keratin has a promising potential for use in sunscreen formulations.

Vitamin D nutritional status and its relationship with metabolic changes in adolescents and adults with severe obesity.

INTRODUCTION: increased vitamin D deficiency occurs together with obesity and the association between these conditions has been observed. OBJECTIVE: to assess the nutritional status of vitamin D and metabolic profile in adolescents and adults with obesity, and the relationship between complications arising from severe class of obesity with vitamin D nutritional status, and to compare the differences between these groups. METHODS: observational comparative study. Population comprises adolescents and adults with severe obesity. Waist circumference (WC) and body mass index (BMI) were measured. Analysis of vitamin D (25(OH)D), lipid profile, C-reactive protein (CRP), blood glucose, fasting insulinemia, insulin sensitivity, blood pressure and diagnoses of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) were performed. RESULTS: a total of 60 adolescents (G1) and 68 adults (G2) were evaluated. The percentage of vitamin D inadequacy was observed in 90% in G1 and 79.4% in G2. There was a negative and significant correlation of BMI with the values of 25(OH)D in the group of adults (r = -0.244; p = 0.045). Individuals with inadequacy of vitamin D showed higher values of CRP in both groups (p = 0.000). HOMA-IR showed a negative correlation with 25(OH)D in G1 (r = -0.832; p = 0.000) and G2 (r = -0.589; p = 0.000). The inadequacy of this vitamin showed association with high total cholesterol in G1 (p = 0.029) and higher values of LDL-c in G2 (p = 0.003). CONCLUSION: high prevalence of deficiency and insufficiency of vitamin D were observed, associated with metabolic changes both in obese adults and adolescents. It is necessary to develop strategies for the prevention and control of obesity and vitamin D deficiency.

Interlimb Dynamic after Unilateral Focal Lesion of the Cervical Dorsal Corticospinal Tract with Endothelin-1.

Handedness is one of the most recognized lateralized behavior in humans. Usually, it is associated with manual superiority regarding performance proficiency. For instance, more than 90% of the human population is considered more skilled with the right hand, which is controlled by the left hemisphere, than with the left. However, during the performance of bimanual tasks, the two hands usually assume asymmetric roles, with one hand acting on objects while the other provides support, stabilizing the object. Traditionally, the role of the two hands is viewed as fixed. However, several studies support an alternate view with flexible assignments for the two hands depending on the task. The supporting role of the hand depends on a closed loop pathway based on proprioceptive inputs from the periphery. The circuit's efferent arm courses through the dorsal corticospinal tract (dCST) in rodents and terminate on spinal cord interneurons which modulate the excitability of motoneurons in the ventral horn. In the present work, we developed an experimental model of unilateral lesion targeting the cervical dCST with microinjections of the vasoconstrictor endothelin-1 (ET-1) to evaluate the degree of flexibility of forelimb assignment during a food manipulation task. Our results show that just 3 days after unilateral corticospinal tract (CST) injury in the cervical region, rats display severe motor impairment of the ipsilateral forepaw together with a remarkable reversal of motor assignment between the forelimbs.

Influence of salivary parameters in the caries development in orthodontic patients-an observational clinical study.

BACKGROUND: Previous studies have shown during the orthodontic treatment, the prevalence of active caries lesions (ACL) in 30 to 70% of patients. AIM: To evaluate the effect of orthodontic treatment on salivary properties considering caries development. DESIGN: Twenty two individuals (11-22 years) were assessed regarding caries, oral hygiene, sugar exposure, salivary flow rate (SFR), buffering capacity, pH, carbonic anhydrase VI (CA VI) and amylase activity, at baseline, 1, 3 and 6 months after the orthodontic appliances placement. Caries index was determined by Nyvad criteria. CA VI and amylase activities were performed by zymography and ELISA, respectively. RESULTS: Buffering capacity decreased after 3 months (P < 0.0001) and showed positive correlation with pH at baseline and after 1 month in individuals who did not develop active caries lesions. Amylase activity decreased after 1 and 6 months (P = 0.0003) and presented positive correlation with CA VI in patients who developed ACL. SFR increased after 1 month (P = 0.0283) and showed positive correlation with CA VI activity after 3 months in individuals who did not develop ACL. Salivary pH showed negative correlation with CA VI after 1 month in patients who did not develop ACL. ACL were firstly diagnosed after 3 months. CONCLUSIONS: The present study demonstrated that saliva of individuals under orthodontic treatment is subjected to changes in properties that have implications on the onset of ACL.

A case study of the effect of cardiovascular training on cerebral palsy / Estudo do condicionamento cardiovascular na paralisia cerebral - um estudo de caso

Abstract Introduction: Cerebral palsy (CP) is a non-progressive disorder characterized by changes in muscle tone and voluntary movement, leading to adaptive changes in muscle length and in some cases, resulting in bone deformities and increased energy expenditure while performing activities of daily living. Objective: The aim of this study was to investigate the effects of cardiovascular training by an adult with athetoid CP. Methods: The sample was composed of one patient with athetoid CP. The instruments used were the timed ten-meter walk test; the SF-36 quality of life questionnaire, a six-minute walk test and the Timed Up and Go test. Using an exercise bike and resistance exercises for the upper limbs, the patient underwent 24 sessions lasting fifty minutes each during eight weeks. Results: In all tests, significant improvement was observed at four and eight weeks, especially in the first four, and progressed in the following four weeks. In the post-training period, improvement was observed when compared to pre-training values. The SF-36 questionnaire on quality of life showed increase in some areas and decrease in others. Conclusion: Patients with CP can benefit from a physical training program, which can improve their quality of life and be included in their rehabilitation protocol.

Resumo Introdução: A Paralisia Cerebral (PC) é um distúrbio não progressivo que caracteriza-se por alterações no tônus muscular e movimentação voluntária, levando a modificações adaptativas do comprimento muscular e em alguns casos, chegando a resultar em deformidades ósseas e aumento do gasto energético durante a realização de atividades da vida diária. Objetivo: Avaliar os efeitos do condicionamento cardiovascular em um adulto com PC atetóide. Métodos: Participou do estudo um paciente com quadriparesia atetóide. Como instrumentos foram utilizados o Teste de Dez metros; o Questionário de Qualidade de Vida SF-36, o Teste de Caminhada de 6 Minutos e Teste Timed Get Up and Go. Foram realizadas 24 sessões, com duração de cinquenta minutos, durante oito semanas, utilizando uma Bicicleta ergométrica e exercícios resistido de MMSS. Resultados: Em todos os testes aplicados foi possível observar melhora após a quarta e a oitava semanas, especialmente nas primeiras quatro semanas. No destreino, observou-se melhora quando comparado com os valores de pré-treinamento. O Questionário de Qualidade de Vida SF-36 apresentou melhora em alguns domínios e declínio em outros. Conclusão: Um paciente com PC pode se beneficiar de um programa de condicionamento, podendo este melhorar sua qualidade de vida, e ser incluído em seu protocolo de reabilitação.

Exercício físico aplicado a idosos como recurso para promoção de saúde na atenção primária à saúde

O processo de transição demográfica configura-se como um desafio para a saúde pública contemporânea. A fim de estimular a autonomia e promover a saúde biopsicossocial desse crescente número de idosos é necessário um alto investimento em estratégias de prevenção e promoção de saúde como, por exemplo, a estimulação do envelhecimento ativo por meio do exercício físico. O objetivo do trabalho foi avaliar os efeitos do exercício físico realizado em um grupo de idosos de uma Unidade Municipal de Saúde (UMS) enquanto recurso para prevenção de agravos à saúde (sintomas depressivos e risco de quedas) e promoção de saúde, com ênfase na qualidade de vida, bem como avaliar a percepção dos idosos sobre seus efeitos. O estudo contou com a participação de, 30 idosos divididos em dois grupos: G1, composto de 15 idosos praticantes de exercício físico na UMS e G2 composto de 15 idosos não praticantes de exercício físico na Atenção Primária à Saúde. Foi utilizada triangulação de método (quantitativo e qualitativo). A abordagem quantitativa se caracteriza como observacional, transversal, comparativa entre subgrupos, sendo realizada através da aplicação de escala de Depressão Geriátrica (EDGA), Escala de equilíbrio e marcha de Tinetti e Formulário de Qualidade de vida SF-36. Para a comparação entre os grupos foram utilizados os testes estatísticos Mann-Whitney e Teste T, realizados no programa Bioestat 5.0 com nível de significância de 5% (0,05). A abordagem qualitativa foi realizada através de entrevista semiestruturada sendo sua análise de conteúdo realizada por metodologia temático-categorial. Os resultados mostraram que G1 apresentou resultados estatisticamente significante para EDGA (p-valor 0,0410), Escala de Tinetti (p-valor 0,0001) e cinco das oito dimensões de Formulário SF-36 (p-valor de 0,0057 a 0,0231). As entrevistas mostraram que os idosos apesar de acessarem o grupo por diferentes meios, percebem os benefícios da prática regular de exercício físico e apreciam a UMS pela iniciativa de oferecer o serviço, assim como acham importante que outras Unidades também o ofereçam, de modo a contribuir com a saúde de outros idosos. Podemos concluir com essa pesquisa que a prática de exercício físico realizada no ambiente da Atenção Primária à Saúde evidencia uma estratégia capaz de, não apenas estimular, mas criar a oportunidade para a população idosa adotar estilo de vida saudável que ocasiona a emancipação física e a manutenção da capacidade funcional, resultando em melhor qualidade de vida dessa população

The demographic transition is characterized as a challenge to contemporary public health. In order to stimulate autonomy and promoting biopsychosocial health of this growing number of elderly a high investment in prevention and health promotion strategies is necessary, for example, stimulation of active aging through exercise. Our objective was to evaluate the effects of physical exercise in a group of elderly in a Municipal Health Unit (MHU) as a resource for prevention of health problems (depressive symptoms and risk of falls) and health promotion, with emphasis on quality of life as well as evaluate their perception of its effects. The study had the participation of 30 elderly divided into two groups: G1, composed of 15 elderly practitioners of physical exercise in the MHU and G2 composed of 15 elderly that do not exercise in primary health care. The methodology used was qualitative and quantitative. The quantitative approach is characterized as transversal, observational, comparative between subgroups, being performed by applying Geriatric Depression Scale (GDS), Tinetti balance scale and SF-36 Quality of Life Form. For comparison between groups were utilized Mann-Whitney and T statistical tests, made in Bioestat 5.0 software with a significance level of 5% (0.05). The qualitative approach was performed by semi-structured interview and its content analysis by subject-categorical approach. The results showed statistically significant results on G1 for GDS (p-value 0.0410), Tinetti Scale (p-value 0.0001) and five of the eight SF-36 Form dimensions (p-value 0.0057 to 0.0231). The interviews showed that the elderly although access the group through different means, realize the benefits of regular physical exercise and appreciate MHU for the initiative to provide the service, as well as find it important that other Unit also offer it to contribute with the health of other elderly. We can conclude from this survey that physical exercise performed in the Primary Health Care environment demonstrates a strategy that, not only stimulate, but create the opportunity for elderly people to adopt healthy lifestyle that causes physical emancipation and maintenance of functional capacity, resulting in better quality of life of this population