Atypical parathyroid adenoma with severe bone manifestations in early adolescence.

This is a case of primary hyperparathyroidism in a female teenager with multiple fractures and severe bone manifestations. The histopathology revealed atypical parathyroid adenoma, an exceedingly rare form of hyperparathyroidism; its main differential diagnosis is parathyroid carcinoma, as it shares both clinical and histological characteristics with it, in addition to its still uncertain malignant potential.

Effects of andiroba oil (Carapa guianensis aublet) on the immune system in inflammation and wound healing: A scoping review.

ETHNOPHARMACOLOGICAL RELEVANCE: Andiroba seed oil (Carapa guianensis Aubl.) is widely used by traditional populations in tropical countries, especially in the Brazilian Amazon, because of its anti-inflammatory, antirheumatic, antiseptic, healing and antipyretic properties, among others, which makes it useful for the treatment, mainly, of skin afflictions and wounds. AIM OF THE STUDY: To describe the modulation of the immune system by andiroba oil (Carapa guianensis Aubl.) in inflammation and wound healing. MATERIALS AND METHODS: A scoping review was performed, following the recommendations of the Joanna Briggs Institute (JBI) and PRISMA for Scoping Reviews (PRISMA-ScR). As inclusion criteria, in vitro, in vivo, ex vivo, and clinical studies were selected, in Portuguese, English, or Spanish, in thirteen databases of published studies, gray literature, and references of the included studies, which deal with immune modulation by andiroba oil in the context of the various therapeutic applications that make use of its anti-inflammatory and wound healing properties. The selection of information sources was carried out by two independent reviewers between November 2022 and January 2023. The process of data extraction and evidence analysis was conducted by four pairs of independent reviewers between January and February 2023. RESULTS: 22 sources of evidence were included in this scoping review, mostly scientific articles published between 2005 and 2021 with in vivo sampling. The evidence suggests that andiroba oil reduces inflammation and promotes the healing of wounds of multiple etiologies by reducing leukocyte infiltration, increasing phagocytic activity, enhancing interleukin and inflammatory cytokine activity, promoting fibroblast recovery, increasing growth factors, reducing apoptotic cells, promoting reepithelialization, as well as promoting angiogenesis, reducing edema, and stimulating the production of glucocorticoids that alleviate pain. Additionally, different formulations of the oil (such as nanoemulsions, films and gels) are more effective in modulating inflammation and wound healing compared to in natura oil. CONCLUSIONS: Evidence in the literature suggests that andiroba oil (Carapa guianensis Aubl.) has positive effects on immune modulation in inflammation and wound healing, which makes it a biocompound with high therapeutic potential.

Protective Effects of Kefir Against Unpredictable Chronic Stress Alterations in Mice Central Nervous System, Heart, and Kidney.

Kefir is a probiotic mixture with anxiolytic and antioxidant properties. Chronic stress can lead to anxiety disorders and increase oxidative damage in organs such as the heart and kidney. In this study, we examined whether kefir ameliorates the anxiety-like behavior of mice submitted to chronic unpredictable stress (CUS) by modulating brain-derived neurotrophic factor (BDNF) and corticosterone levels and whether kefir modifies the oxidative parameters in the heart and kidney of mice. Male Swiss mice received kefir (0.3 mL/100 g/day) or milk for 30 days (gavage). On the 10th day, the mice were submitted to CUS. Behavioral analysis was performed using the elevated plus maze and forced swimming tests. BDNF levels were analyzed in brain tissues. Heart and kidney superoxide dismutase (SOD), catalase, glutathione (GSH), thiobarbituric acid reactive substances (TBARS), 3-nitrotyrosine, metalloproteinase-2 (MMP-2), and plasma corticosterone were evaluated. Kefir reverted the CUS-induced decrease in the time spent in the open arms, the increase in grooming frequency, and decrease in the head dipping frequency, but not the reduced immobility time. CUS decreased the cerebellum BDNF levels and increased corticosterone levels, which were restored by Kefir. Neither catalase and SOD activities nor GSH, TBARS, 3-nitrotyrosine, and MMP-2 were modified by CUS in the heart. In the kidney, CUS increased 3-nitrotyrosine and MMP-2. Kefir increased the antioxidant defense in the heart and kidney of control and CUS mice. These results suggest that kefir ameliorated CUS-induced anxiety-like behavior by modulating brain BDNF and corticosterone levels. Kefir also increased the antioxidant defense of mice heart and kidney.

Baseline concentrations, source apportionment, and probabilistic risk assessment of heavy metals in urban street dust in Northeast Brazil.

Heavy metal pollution by accelerating urbanization is an emerging socio-environmental issue that poses a potential risk to human health and the environment. In this scenario, street dust is a primary source of contaminants. Here, the metal concentrations in street dust of one of the biggest Brazilian cities were assessed aiming to identify and quantify the sources of contamination. The metal bioaccessibility and estimated probabilistic (non)-carcinogenic risks to humans were also evaluated. Thirty-six dust samples were collected in the metropolitan region of Recife. Results showed that the traffic governed the distribution and accumulation of metals in street dust. Emissions from vehicles were the primary source (> 70 %) of heavy metals, except for Cd, which had a mixed origin (natural, traffic, and industrial). Moderate to heavy dust contamination by Ba, Cu, Mn, Pb, and Zn were found, with a very high potential ecological risk. The main exposure route depended on the metal. Barium, Cu, and Pb had ingestion rather than dermal contact as the main route of exposure, while inhalation and dermal contact posed the main risks to Mn and Cr, respectively. The risk for children was higher than for adults. The probabilities of unacceptable carcinogenic risk scenarios (TCRI >10-6) for children and adults were 27 and 4 %, respectively, with Cr being the most concerning metal for the health of the urban population.

Case Report: Composite pheochromocytoma with ganglioneuroma component: A report of three cases.

Composite pheochromocytoma (CP) is a very rare tumor originating from neural crest cells, predominantly composed of pheochromocytoma (PCC), a chromaffin cell tumor arising in adrenal medulla, and ganglioneuroma, a tumor derived from autonomic ganglion cells of the nervous system. Moreover, CP may be present in the hereditary syndromes of which pheochromocytoma is part. Literature offers scarce data on this subject, and particularly about its biological behavior, clinical evolution, and molecular profile. We report the phenotype and outcome of three cases of CP (PCC and ganglioneuroma components), followed up at the Endocrine Service of the Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil. Two nonsyndromic patients (cases 1 and 2) were negative to germline mutations in genes VHL, SDHB, SDHC, SDHD, SDHAF2, TMEM127, and MAX, while the third case (case 3) had clinical diagnosis of neurofibromatosis syndrome. Cases 1, 2, and 3 were diagnosed at 29, 39, and 47 years old, respectively, and were followed up for 3, 17, and 9 years without no CP recurrence. All cases had apparent symptoms of catecholaminergic excess secreted by PCC. Ganglioneuroma, the neurogenic component present in all three cases, had a percentage representation ranging from 5% to 15%. Tumors were unilateral and large, measuring 7.0 cm × 6.0 cm × 6.0 cm, 6.0 cm × 4.0 cm × 3.2 cm, and 7.5 cm × 6.0 cm × 4.5 cm, respectively. All cases underwent adrenalectomy with no recurrence, metastasis, or development of contralateral tumor during follow-up. Genetic testing has been scarcely offered to CP cases. However, a similar frequency of genetic background is found when compared with classic PCC, mainly by the overrepresentation of NF1 cases in the CP subset. By literature review, we identified a notorious increase in cases reported with CP in the last decade, especially in the last 3 years, indicating a recent improvement in the diagnosis of this rare disorder in clinical practice.

A busca de informação sobre covid-19 na web: uma perspectiva cibermétrica / The search for information about covid-19 on the web: a cybermetric perspective / La búsqueda de información sobre covid-19 en la web: una perspectiva cibermetrica

Demonstrar a influência da pandemia de covid-19 nas buscas realizadas no Google por meio do levantamento de dados em uma aplicação cibermétrica. Método: Estudo de aplicação cibermétrica que utiliza a ferramenta Google Trends e os termos 'covid-19', 'coronavírus', 'cloroquina' e 'vacina contra a covid-19', para o período de 31 de dezembro de 2019 a 17 de janeiro de 2021. Resultados: Reconhecer que as primeiras buscas pelo termo 'covid-19' ocorreram na mesma data do anúncio do primeiro caso confirmado. Ocorreu também o crescimento no volume de busca por informações sobre os sintomas de pneumonia relacionadas com a primeira morte por coronavírus. A intensificação nas consultas relativas a 'covid vaccine allergy' esteve associada ao início da vacinação no mundo. Conclusão: Em períodos de pandemia, a sociedade procura intensamente por informações relacionadas ao seu contexto e a busca pode ser motivada pelos meios de comunicação.

It aims to show the influence of the covid-19 pandemic on the searches on Google, using the data survey in a cybermetric application. Method: It is a cybermetric study that uses the Google Trends tool by searching for 'covid-19', 'cononavírus', 'cloroquina' and 'vacina contra a covid-19' between December 31st, 2019, and January 17th, 2021. Results: It acknowledges that the first searches for the term 'covid-19' were made on the same day of the announcement of the first confirmed case. There was also a rise in the number of searches for information on symptoms of pneumonia related to the first death caused by coronavirus. The intensification in the searches related to 'covid vaccine allergy' was associated to the start of the vaccination in the world. Conclusion: In pandemic times, the society intensely searches for information related to their context and the searches can be motivated by the media.

Demostrar la influencia de la pandemia de la covid-19 en las búsquedas realizadas en Google, mediante la recolección de datos en una aplicación cibermétrica. Método: Estudio de aplicación cibernética utilizando la herramienta Google Trends y los términos 'covid-19', 'coronavírus', 'cloroquina' y 'vacina contra a covid-19' para el período de 31 de diciembre de 2019 al 17 de enero de 2021. Resultados: Reconoce que las primeras búsquedas del término 'covid-19' ocurrieron en la misma fecha que el anuncio del primer caso confirmado. También hubo un aumento en el volumen de búsqueda de información sobre síntomas de neumonía relacionados con la primera muerte por coronavirus. La intensificación de las consultas relacionadas con la 'covid vaccine allergy' se asoció con el inicio de la vacunación en todo el mundo. Conclusión: En períodos de pandemia, la sociedad búsqueda de manera intensiva información relacionada con su contexto y puede ser motivada por los medios de comunicación.

In silico identification of candidate miRNA-encoded Peptides in four Fabaceae species.

MicroRNAs (miRNAs) are one of the main regulators of gene expression. Recent studies have demonstrated that primary transcripts of miRNAs (pri-miRNAs) encode regulatory peptides, called miRNA-encoded peptides (miPEPs), capable of enhancing the expression of their associated miRNAs in plants. In this work, we aimed to computationally identify miPEPs produced by small open reading frames (ORFs) in pri-miRNAs from four species of Fabaceae. Five families of miRNAs were investigated, based on their role in plant-microorganism interaction. We used the miR171 family as a training dataset centered on the information about mtr-miPEP171b and vvi-miPEP171d already described. From the sequences of the pri-miRNAs and the genomic regions where they were located, ORFs encoding putative miPEPs were predicted. The 5'-most ORFs encoding peptides on pri-miRNAs were aligned and the amino acids conservation was observed. In total, 81 sequences of potential miPEPs were identified. We found conserved miPEPs inside pri-miRNAs from soybean and between soybean, common bean, and cowpea. Besides, our results showed few conserved miPEPs among isoforms of the same miRNA and no conservation among different miRNA families, which indicate the possible specificity of miPEPs in relation to their corresponding miRNAs. Our findings contribute to the understanding of miPEPs features in plants and provide the basis for studies aiming the biotechnological use of miPEPs in leguminous species.

Lauric acid bilayer-functionalized iron oxide nanoparticles disrupt early development of freshwater snail Biomphalaria glabrata (Say, 1818).

Iron oxide nanoparticles (IONPs) have been indicated for the control of parasites and intermediate hosts, as well as applications in several sectors of nanomedicine. However, knowledge regarding its toxicity, mechanisms of action and the role of functionalization in gastropods that act as intermediate hosts of neglected disease parasites is still scarce. The present study aimed to evaluate the toxicity of lauric acid bilayer-functionalized IONPs (LA-IONPs), lauric acid isolated (LA) and iron ions in embryos and newly-hatched Biomphalaria glabrata. The snails were exposed to different concentrations of IONPs, LA and iron ions (1.0-97.65 mg L-1) during 144 h (embryos) and 96 h (newly-hatched) and multiple parameters were analyzed, such as mortality, hatching rate, developmental delay, and morphological changes. The results showed that both iron forms (LA-IONPs and iron ions) and LA promoted mortality, hatching inhibition and morphological changes in snail embryos in a concentration-dependent patterns. Embryos also showed iron bioaccumulation after exposure to both iron forms. High toxicity was observed in newly-hatched snails compared to embryos, indicating the protective role of ovigerous masses during the early developmental stages. LA induced high developmental toxicity compared to LA-IONPs and iron ions. Results showed the molluscicide activity of LA-IONPs and isolated LA, indicating their potential use as molluscicide in the snail control program.

Simulação clínica na retenção tardia de conhecimento e autoconfiança de profissionais de enfermagem: estudo quase-experimental / Clinical simulation in nursing professionals' late retention of knowledge and self-confidence: a quasi-experimental study / Simulación clínica en la retención a largo plazo del conocimiento y autoconfianza de profesionales de enfermería: estudio cuasiexperimental

RESUMO: Objetivo: Avaliar o efeito tardio do uso da simulação combinada a aula expositiva dialogada em comparação ao uso exclusivo da simulação na autoconfiança e no conhecimento de profissionais de enfermagem diante de situações de parada cardiopulmonar. Método: Quase experimento com pré e pós-teste. Amostra de conveniência de 53 profissionais de enfermagem divididos em grupos controle e experimental. Foram aplicados um questionário semiestruturado e a dimensão Autoconfiança da Escala de Satisfação e Autoconfiança na Aprendizagem. Q testes foram utilizados com valor de p≤ 0,05. Resultados: A autoconfiança aumentou de forma significativa entre os profissionais do grupo experimental (p=0,007) em relação ao controle (p=0,06). Nenhum dos grupos mostrou ganho significativo de conhecimento retido ao longo do tempo. Conclusão: Independentemente da forma como o método de simulação é empregado, ele representa uma estratégia pedagógica que pode possibilitar desenvolvimento e aprimoramento de autoconfiança e fixação tardia do conhecimento em relação a situações de parada cardiopulmonar.

ABSTRACT Objective: to evaluate the late effect of using combined simulation of a dialog lecture class, as compared to the exclusive use of simulation, on Nursing professionals' self-confidence and knowledge under cardiopulmonary arrest situations. Method: quasi-experimental with pre- and post-test. Convenience sample comprised by 53 Nursing professionals divided into control and experimental groups. A semi-structured questionnaire and the Self-confidence dimension of the Satisfaction and Self-Confidence in Learning Scale were applied. Q tests were used with p-value≤ 0.05. Results: self-confidence increased significantly among the professionals from the experimental group (p=0.007) in relation to the control group (p=0.06). None of the groups showed significant gains in retained knowledge over time. Conclusion: regardless of how the simulation method is employed, it represents a pedagogical strategy that can enable the development and improvement of self-confidence and late knowledge fixation in relation to cardiopulmonary arrest situations.

RESUMEN Objetivo: Evaluar el efecto a largo plazo del uso de la simulación combinada con una clase expositiva dialogada en comparación con el uso exclusivo de la simulación sobre la autoconfianza y el conocimiento de los profesionales de enfermería en situaciones de paro cardiorrespiratorio. Método: cuasi experimento con pre y post test. Muestra por conveniencia de 53 profesionales de enfermería divididos en grupos control y experimental. Se aplicó un cuestionario semiestructurado y la dimensión Autoconfianza de la Escala de Satisfacción y Autoconfianza en el Aprendizaje. Se utilizaron pruebas Q con p≤ 0,05. Resultados: La autoconfianza de los profesionales del grupo experimental (p=0,007) aumentó significativamente en comparación con la del grupo control (p=0,06). Ninguno de los dos grupos demostró un aumento significativo del conocimiento retenido a lo largo del tiempo. Conclusión: Independientemente de la forma en que se aplique el método de simulación, representa una estrategia pedagógica que puede posibilitar el desarrollo y mejora de la confianza en sí mismo y la fijación a largo plazo del conocimiento en relación a las situaciones de paro cardiorrespiratorio.

Análise da microdureza de diferentes materiais restauradores

Objetivo: realizar um ensaio in vitro de microdureza em diferentes materiais restauradores. Métodos: Para cada material restaurador (FUJI IX - Cimento de Ionômero de Vidro; Tetric - resina composta convencional; Beautifil II; resina composta bioativa) foram confeccionadas 10 restaurações em dentes incisivos bovinos, cavitados por uma ponta diamantada 2092 KG Sonrensen, seguindo as recomendações de cada fabricante. O ensaio de microdureza foi realizado em diferentes profundidades (superfície, 0.4mm, 1.0mm, 2.0mm, 3.0mm e 4.0mm) e em dois momentos, imediatamente e 24h após a fotoativação. Os dados foram analisados pelo teste de análise de variância (ANOVA) e teste Tukey. Resultados: As médias de microdureza diminuíram significativamente com o aumento da profundidade, com valores mais baixos no primeiro momento avaliado. A resina composta bioativa apresentou as maiores médias de microdureza. Conclusão: os materiais testados apresentaram diminuição gradual da microdureza com o aumento da profundidade, sendo mais acentuada em profundidades acima de 2.0mm. Em todos os materiais restauradores, as médias de microdureza mais altas foram registradas 24 horas após a fotoativação. A resina composta bioativa apresentou os melhores resultados nas diferentes profundidades avaliadas.

Gonadal histopathology and inflammatory response in the freshwater snail exposed to iron oxide nanoparticles and ferric chloride: Insights into reproductive nanotoxicity.

Considering that most animals in an aquatic ecosystem are invertebrates, concerns about the ecotoxicological impact of emerging pollutants, such as nanomaterials, in these populations are relevant, which can lead to loss of aquatic biodiversity. However, knowledge concerning the effects of iron-based nanoparticles (IONPs) at cell and tissue-levels on freshwater gastropods remains limited. Thus, the present study aimed to analyse the histopathological changes and inflammatory response in the freshwater snail Biomphalaria glabrata after chronic exposure to gluconic-acid functionalized IONPs (GLA-IONPs) in comparison with their dissolved counterpart (FeCl3). Snails were exposed to both iron forms (1.0, 2.5, 6.25, and 15.62 mg L-1) for 28 days, and the qualitative and quantitative histopathological assessment on hermaphrodite gonads was conducted, following by analysis of histopathological indices and inflammatory responses. Results showed that both iron forms (GLA-IONPs and FeCl3) induced several gonadal histopathologies in the snails, mainly atresic acini, vacuolization of pre-vitellogenic oocytes, and atresic oocytes in a concentration-dependent pattern. GLA-IONPs induced a more intense inflammatory response and high frequency of vacuolized vitellogenic oocytes in comparison with FeCl3. Environmentally relevant concentration (2.5 mg L-1) of GLA-IONPs and FeCl3 induced high gonadal histopathological indices, indicating their potential reproductive toxicity. The current study showed that the chronic exposure of snails to GLA-IONPs and their dissolved counterpart (FeCl3) induced several gonadal histopathological changes and inflammatory responses in B. glabrata, confirming their potential risk to aquatic biodiversity.

Assessing the spatial distribution and ecologic and human health risks in mangrove soils polluted by Hg in northeastern Brazil.

The emission of mercury (Hg) by chlor-alkali plants can pollute soils and sediments, posing risks to the environment and human health. Mangrove ecosystems are particularly sensitive to Hg contamination. Here, we studied the Hg spatial distribution and associated human and ecologic risks in mangrove soils impacted by a chlor-alkali plant. Sixty-six samples of superficial soils were collected from the mangrove of the Botafogo River, Brazil. Mercury contents were determined and ecological and human health risks were estimated from the soil. The Hg contents exceeded the local Hg background by up to 180 times, indicating the substantial anthropic contribution that occurred in the area. Mercury concentrations followed a gradient as a function of the distance from the chlor-alkali plant, with an apparent contribution from the estuary's hydrodynamic regime. The ecological risk was considered high in all the soils evaluated, while the daily average exposure for humans, considering multiple exposure routes to soil, is below the tolerable dose recommended by the World Health Organization (WHO). However, the risk to human health was unacceptable in the estuary section closest to the plant, mainly for children. Vapor inhalation was the main route for estimating non-carcinogenic risk. The results of this study indicate a severe scenario of Hg pollution with unacceptable risks to the ecosystem and the health of human beings, especially of the communities that live from fishery and shellfish colletion and are exposed daily to soils polluted by mercury. Studies on the organomercurial species in the food chain and Hg levels in individuals living close to the estuary are warranted. This research is an important reference in the world regarding the contamination of mangrove areas by Hg.

Risk assessment of iron oxide nanoparticles in an aquatic ecosystem: A case study on Biomphalaria glabrata.

Iron oxide nanoparticles (IONPs) have been applied in several sectors in the environmental field, such as aquatic nanoremediation, due to their unique superparamagnetic and nanospecific properties. However, the knowledge of chronic toxicity of IONPs on aquatic invertebrate remains limited. Thus, the present study aimed to analyze the chronic toxicity of gluconic acid-functionalized IONPs (GLA-IONPs) and their dissolved counterpart (FeCl3) to freshwater snail Biomphalaria glabrata. GLA-IONPs were synthesized and characterized by multiple techniques, and the snails were exposed to both Fe forms at environmentally relevant concentrations (1.0-15.6 mg L-1) for 28 days. The bioaccumulation, mortality rate, behavior impairments, morphological alterations, fecundity and fertility of snails were analyzed. Results showed that GLA-IONPs induced high iron bioaccumulation in the entire soft tissue portion. Chronic exposure to GLA-IONP increased the behavioral impairments of snails compared to iron ions and control groups. Both Fe forms reduced the fecundity, while the mortality and reduced fertility were observed only after the exposure to GLA-IONPs at 15.6 mg L-1. Overall results indicated the behavioral impairments and reproductive toxicity associated, possibly, to bioaccumulation of GLA-IONPs in the B. glabrata. These results can be useful for the development of eco-friendly nanotechnologies.

Erros e incidentes de medicação na atenção primária: revisão integrativa / Errores e incidentes de medicación en la atención primaria: revisión integradora / Medication errors and incidents in primary care: integrative review

RESUMO Objetivo: Identificar, na literatura científica, publicações acerca dos erros de medicação e os incidentes relacionados, na atenção primária à saúde. Método: Realizou-se uma revisão integrativa da literatura nas bases de dados Medical Literature Analysis and Retrieval System on Line, Cumulative Index to Nursing and Allied Health Literature, Scientific Eletronic Library Online e Web of Science. Analisaram-se 17 artigos que atenderam aos critérios de inclusão. Para extração dos dados, fez-se a leitura, na íntegra, dos artigos selecionados. Resultados: dos 17 estudos analisados, sete (41,17%) foram indexados, tanto no PubMed, quanto no Medline; nove (52,94%) na Web of Science; um (5,9%) na base Scielo; e nenhum na Cinahl. Os estudos apontam fortes evidências na aplicação clínica, sendo que a maioria desses mostra que prescrições com medicamento incorreto, dose incorreta, interações medicamentosas e alergias medicamentosas foram as principais causas de erros com potencial para danos graves. Conclusão: Ainda é crescente o desenvolvimento de pesquisas que visem identificar estratégias e intervenções voltadas aos erros de medicação. Sabe-se que esses estudos fornecem subsídios para o aprimoramento das práticas, além de propiciar maior segurança no processo de medicação, a fim de reduzir os eventos adversos evitáveis.

RESUMEN Objetivo: identificar, en la literatura científica, publicaciones acerca de los errores de medicación y los incidentes relacionados, en la atención primaria a la salud. Método: se realizó una revisión integradora de la literatura en las bases de datos Medical Literature Analysis and Retrieval System on Line, Cumulative Index to Nursing and Allied Health Literature, Scientific Eletronic Library Online y Web of Science. Se analizaron 17 artículos que atendieron a los criterios de inclusión. Para la recolección de los datos, fue hecha la lectura, en su totalidad, de los artículos seleccionados. Resultados: de los 17 estudios analizados, siete (41,17%) fueron indexados, tanto en el PubMed, como en el Medline; nueve (52,94%) en la Web of Science; uno (5,9%) en la base Scielo; y ninguno en la Cinahl. Los estudios señalan fuertes evidencias en la aplicación clínica, siendo que la mayoría de ellos muestra que prescripciones con medicamento incorrecto, dosis incorrecta, interacciones y alergias a los fármacos fueron las principales causas de errores con potencial para daños graves. Conclusión: aún es creciente el desarrollo de investigaciones con el objetivo de identificar estrategias e intervenciones dirigidas a los errores de medicación. Sabemos que estos estudios aportan herramientas para el perfeccionamiento de las prácticas, además de ofrecer mayor seguridad en el proceso de medicación, a fin de reducir los eventos adversos evitables.

ABSTRACT Objective: To identify, in the scientific literature, publications on medication errors and related incidents in primary health care. Method: An integrative literature review was conducted in the databases Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online and Web of Science. Seventeen articles that met the inclusion criteria were analyzed. For data extraction, the selected articles were read in full. Results: Of the 17 studies analyzed, seven (41.17%) were indexed in both PubMed and Medline, nine (52.94%) in Web of Science, one (5.9%) in Scielo and none in Cinahl. The studies point to strong evidence in clinical application, most of these show that prescriptions with incorrect drugs, incorrect doses, drug interactions and drug allergies were the main causes of errors with potential for serious harms. Conclusion: The development of research aimed to identify strategies and interventions for medication errors is still growing. It is known that these studies provide subsidies for the improvement of practices, in addition to providing greater safety in the medication process, in order to reduce preventable adverse events.

Influência da polimerização na estabilidade de cor de resinas compostas

Objetivo: Avaliar a influência da polimerização na estabilidade de cor de resinas compostas. Métodos: Avaliou-se o efeito da polimerização na cor de 14 resinas compostas: Empress Direct - A2E; Empress Direct - A2D; Empress Direct - Trans Opal; Vittra - EA2; Vittra - DA2; Vittra - Trans OPL; Essentia ­ LE; Essentia ­ LD; Essentia - OM; Filtek ­ AE2; Filtek - A2D; Filtek ­AT; Grandioso - A2; FillMagic - B2 Dentin. As resinas compostas foram inseridas em incremento único (n=5) em matrizes de 5X2mm (diâmetro x altura). Foi realizada a avaliação de cor pelos parâmetros CIE L*a*B* (AC) em triplicata com um espectrofotômetro (Easy Shade, Vita). As resinas compostas foram ativadas de acordo com as recomendações dos fabricantes e avaliadas imediatamente e após 24h em estufa a 37oC. Foi calculado o ΔE, analisado por 2-way ANOVA e teste de Bonferroni (p<0,05). Resultados: Observou-se interação significativa entre resina*tempo, todas resinas compostas apresentaram mudança de cor após a polimerização. Conclusão: Pode-se concluir que há mudança de cor após a ativação das resinas compostas e essa cor pode mudar após 24h em umidade.

Exploring the Applications of the Photoprotective Properties of Anthocyanins in Biological Systems.

Due to their physical and chemical characteristics, anthocyanins are amongst the most versatile groups of natural compounds. Such unique signature makes these compounds a focus in several different areas of research. Anthocyanins have well been reported as bioactive compounds in a myriad of health disorders such as cardiovascular diseases, cancer, and obesity, among others, due to their anti-inflammatory, antioxidant, anti-diabetic, anti-bacterial, and anti-proliferative capacities. Such a vast number of action mechanisms may be also due to the number of structurally different anthocyanins plus their related derivatives. In this review, we highlight the recent advances on the potential use of anthocyanins in biological systems with particular focus on their photoprotective properties. Topics such as skin aging and eye degenerative diseases, highly influenced by light, and the action of anthocyanins against such damages will be discussed. Photodynamic Therapy and the potential role of anthocyanins as novel photosensitizers will be also a central theme of this review.

Comprehensive Metabolome Analysis of Fermented Aqueous Extracts of Viscum album L. by Liquid Chromatography-High Resolution Tandem Mass Spectrometry.

Fermented aqueous extracts of Viscum album L. are widely used for cancer treatment in complementary medicine. The high molecular weight compounds viscotoxins and lectins are considered to be the main active substances in the extracts. However, a vast number of small molecules (≤1500 Da) is also expected to be present, and few studies have investigated their identities. In this study, a comprehensive metabolome analysis of samples of fermented aqueous extracts of V. album from two host tree species (Malus domestica and Pinus sylvestris), both prepared by two pharmaceutical manufacturing processes, was performed by liquid chromatography-high resolution tandem mass spectrometry (LC-HRMS/MS). A total of 212 metabolites were putatively annotated, including primary metabolites (e.g., amino acids, organic acids, etc.) and secondary metabolites (mostly phenolic compounds). A clear separation between V. album samples according to the host tree species, but not due to manufacturing processes, was observed by principal component analysis. The biomarkers responsible for this discrimination were assessed by partial least squares-discriminant analysis. Because V. album extracts from different host trees have different clinical applications, the present work highlights the possibility of characterizing the metabolome for identification and traceability of V. album fermented aqueous extracts.

Gestão da Enfermagem em Hospital Geral Público Acreditado no Enfrentamento da Pandemia por COVID-19 / Nursing management in an accredited public general hospital in the response to the COVID-19 pandemic

Objetivo: Relatar a experiência vivenciada pela gestão de enfermagem de um hospital geral público acreditado e apresentar as principais mudanças na estrutura institucional para o enfrentamento da pandemia. Método: Relato de experiência em uma Organização Social de Saúde de parceria com governo estadual. Trata-se de um hospital geral de nível terciário com 247 leitos. Resultados: As principais mudanças estruturais e de processos de trabalho ocorridas durante o período de 13 de março a 23 de abril de 2020 foram: Implantação de um Comitê de Crise; programação de treinamentos institucionais; medidas administrativas voltadas ao cancelamento de cirurgias eletivas; disponibilização de equipamentos de proteção individual; mudanças no fluxo de entrada do paciente com suspeita de COVID-19; mudanças nas características das unidades; incremento no número de leitos; contratação de pessoal; e apoio para equipe. Conclusão: Destaca-se a importância da equipe de enfermagem e seu preparo para gerenciar novos espaços, alocar recursos e treinar a equipe no atendimento direto ao paciente. (AU)

Objective: Reporting the experiences of the nursing management team of an accredited Brazilian public general hospital and the main institutional changes made to face the COVID-19 pandemic. Method: An experience report about a Social Healthcare Organization that has a partnership with the São Paulo state government. This is a 247-bed tertiary care hospital. Results: During the period between March 13 and April 23 2020, the main changes made to the institution and its work practices were: Implementing a Crisis Committee; scheduling institutional trainings; managerial measures concerning the cancellation of elective surgeries; providing personal protective equipment; changes in the admission of patients with suspected COVID-19; changes in the characteristics of the hospital unit; an increase in the number of beds; hiring new personnel; and supporting the current staff. Conclusion: This highlights the importance of the nursing team and how prepared it is to manage new rooms, allocate resources, and get the staff ready for the direct care of patients. (AU)

Objetivo: Reportar la experiencia de la gestión de enfermería de un hospital general público acreditado brasileño y presentar los principales cambios en la estructura institucional para enfrentar la pandemia de COVID-19. Metodo: Registro de experiencia en una Organización Social de Salud en colaboración con el gobierno del Estado de São Paulo. Se trata de un hospital general de nivel tercer nivel con 247 camas. Resultados: Los principales cambios estructurales y en los procesos de trabajo ocurridos en el periodo entre el 13 de marzo y el 23 de abril fueron: La implantación de un Comité de Crisis; programación de prácticas institucionales; medidas administrativas dirigidas a la cancelación de cirugías electivas; disponibilidad de equipos de protección individual; cambios en el flujo de ingreso de pacientes con sospecha de COVID-19; cambios en las características de la unidad hospitalaria; incremento en el número de camas; contratación de personal; y apoyo al equipo. Conclusión: Se destaca la importancia del equipo de enfermería y su preparación para gestionar nuevos espacios, alocar recursos e instruir el equipo para la atención directa al paciente. (AU)

Molluscicidal activity of polyvinylpyrrolidone (PVP)-functionalized silver nanoparticles to Biomphalaria glabrata: Implications for control of intermediate host snail of Schistosoma mansoni.

Silver nanoparticles (Ag NPs) have been applied in several commercial products due to their antimicrobial properties, while their molluscicide properties, mode of action and toxicity to snail species remain unclear. In this study, the comparative toxicity of polyvinylpyrrolidone (PVP)-functionalized Ag NPs and their dissolved counterpart (Ag ions) was analyzed during the early developmental stages of the freshwater snail Biomphalaria glabrata, intermediate host of Schistosoma mansoni. Ag NPs were synthesized and characterized by multiple techniques, and the snail embryotoxicity was analyzed in terms of mortality, hatching, developmental stages and morphological alterations, while the acute toxicity to newly-hatched snails was analyzed by mortality and behavioral impairments. Results showed that both Ag forms induced mortality, hatching delay and morphological alterations (especially hydropic abnormalities) in snail embryos in a concentration and exposure time dependent patterns. Ag NPs showed low embryotoxic effects and similar toxicity for newly-hatched snails when compared to their dissolved counterparts, indicating that the nanotoxicity was dependent of snail developmental stages. The knowledge about the Ag NP toxicity to different early development stages of B. glabrata contributes to its potential use as molluscicide and control of neglected tropical diseases, including schistosomiasis.

Virulence factors of Paracoccidioides brasiliensis as therapeutic targets: a review.

Paracoccidiodomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and Paracoccidioides lutzii. The disease requires long and complicated treatment. The aim of this review is to address the fungal virulence factors that could be the target of the development of new drugs for PCM treatment. Virulence factors favoring the process of fungal infection and pathogenicity are considered as a microbial attribute associated with host susceptibility. P. brasiliensis has some known virulence factors which are 43 kDa glycoprotein (gp 43) which is an important fungal antigen, 70 kDa glycoprotein (gp 70), the carbohydrates constituting the fungal cell wall α-1,3, glucan and ß-1,3-glucan, cell adhesion molecules and the presence of melanin pigments. The discovery and development of drugs that interact with these factors, such as inhibitors of ß-1,3-glucan, reduced synthesis of gp 43, inhibitors of melanin production, is of great importance for the treatment of PCM. The study of virulence factors favors the understanding of pathogen-host relationships, aiming to evaluate the possibility of developing new therapeutic targets and mechanisms that these molecules play in the infectious process, favoring the design of a more specific treatment for this disease.