Vitamin D is associated with a low quality of life: a primary care study

Introduction: Some studies have described impairment in quality of life of vitamin-deficient subjects. However, little is known about this association in primary care. This study aimed to evaluate the association between vitamin D deficiency and quality of life in postmenopausal women attending primary care in the municipality of Santa Maria ­ Brazil. Methods: A cross-sectional study was carried out with postmenopausal women over 55 years of age, accompanied in primary care, from March to August 2014. These women were randomly selected among the participants of a cohort study in the municipality of Santa Maria ­ Brazil. Data were collected through a standardized questionnaire, quality of life was assessed using the Short Form-36 Health Survey (SF-36), and 25-hydroxyvitamin D were measured using the ALPCO® ELISA method. Results: Of the total of 78 studied women, 11.54% had vitamin D deficiency. Women with vitamin D deficiency had a poorer quality of life assessed by SF-36. In the regression analysis, both vitamin D deficiency and falls were independently associated with a lower physical component of the SF-36. Conclusion: Vitamin D deficiency is associated with poorer quality of life in the studied postmenopausal women.

Comportamento da variabilidade glicêmica em pacientes hospitalizados com Diabetes Mellitus 2 / Behavior of glycemic variability in hospitalized type 2 Diabetes Mellitus patients / Comportamiento de la variable glucémica en pacientes Hospitalizados con Diabetes Mellitus 2

Introdução: A hiperglicemia pode estar presente em até 38% dos pacientes hospitalizados.O controle glicêmico está associado a melhores desfechos clínicos. Objetivo: avaliar o comportamento da variabilidade glicêmica em pacientes hospitalizados com Diabetes Mellitus 2. Metodologia: Estudo transversal, composto por pacientes hospi-talizados com e sem diabetes, adultos e idosos, de ambos os gêneros, em terapia nutricional enteral. As glicemias foram medidas por testes de glicemia capilar e classificadas como normoglicemia, hiperglicemia e variabilidade glicêmica, avaliados a partir do desvio-padrão glicêmico e coeficiente de variação glicêmico. Foram avaliados dados bioquímicos como Proteína C-reativa. A análise de variância de duas vias (ANOVA) foi utilizada para comparar os grupos, além da correlação de Spearman. Resultados: Participaram 85 indivíduos, com diabetes mellitus 2 (20%; n= 17), e sem diabetes mellitus (80%; n = 68), sendo 34% (n = 29) adultos e 66% (n=56) idosos. Adultos e idosos com diabetes mellitus apresentaram hiperglicemia em relação aos pacientes não diabéticos (p<0,01), valores supe-riores de desvio-padrão glicêmico (p<0,01) e coeficiente de variação glicêmica em relação aos pacientes sem dia-betes (p= 0,03), no entanto, não foram classificados com variabilidade glicêmica. Os valores da Proteína C-reativa foram correlacionados com o desvio-padrão glicêmico (R= 0,29; p= 0,0065), no entanto, a quantidade de carboi-dratos infundida na dieta enteral não se correlacionou estatisticamente com as glicemias nem com a variabilidade glicêmica dos pacientes (p>0,05). Conclusão: pacientes hospitalizados com ou sem diabetes mellitus 2 não apre-sentaram variabilidade glicêmica, demonstrando um controle glicêmico na hospitalização. (AU)

Introduction: Hyperglycemia may be present in up to 38% of hospitalized patients. Glycemic control is associated with better clinical outcomes. Objective: assess the behavior of glycemic variability in hospitalized patients with Diabetes Mellitus 2. Methodology: Cross-sectional study composed of hospitalized patients with and without diabetes, adults and elderly, of both genders, undergoing enteral nutritional therapy. Blood glucose was measured by capillary blood glucose tests and classified as normoglycemia, hyperglycemia, and glycemic variability, assessed from the glycemic standard deviation and glycemic variation coefficient. Biochemical data such as C-reactive protein were assessed. Two-way analysis of variance (ANOVA) was used to compare the groups, in addition to Spearman's correlation. Results: Eighty-five individuals with diabetes mellitus 2 (20%; n=17) and without diabetes mellitus (80%; n=68) participated in the study; 34% (n=29) were adults, and 66% (n=56) were elderly. Adults and elderly people with diabetes mellitus presented hyperglycemia concerning non-diabetic patients (p<0.01), higher values of glycemic standard deviation (p<0.01), and glycemic variation coefficient concerning patients without diabetes (p= 0.03); however, they were not classified with glycemic variability. The C-reactive protein values were correlated with the glycemic standard deviation (R= 0.29; p= 0.0065); however, the amount of carbohydrates infused in the enteral diet was not statistically correlated with glycemia or with the glycemic variability of patients (p>0.05). Conclusion: hospitalized patients with or without diabetes mellitus 2 did not show glycemic variability, demonstrating glycemic control during hospitalization. (AU)

Introducción: La hiperglucemia puede estar presente hasta en un 38% de los pacientes hospitalizados. El con-trol glucémico se asocia con mejores resultados clínicos. Objetivo: evaluar el comportamiento de la variación glucémica en pacientes con Diabetes Mellitus 2. Metodología: Estudio transversal, compuesto por pacientes hos-pitalizados con y sin diabetes, adultos y ancianos, con terapia nutricional enteral. Las glucemias fueron medidas por exámenes de glucemia capilar y clasificadas como normo glucemia, hiperglucemia y variación glucémica, evaluados a partir de la desviación estándar y coeficiente de variación glucémico. Fueron evaluados datos bioquí-micos como Proteína C-reactiva. El análisis de la variación de las dos vías (ANOVA) fue utilizada para comparar los grupos, junto a la correlación de Spearman. Resultados: Participaron 85 individuos, con diabetes mellitus 2 (20%; n+17), y sin diabetes mellitus (80%; n = 68). Adultos 34% (n=29) y ancianos 66% (n=56). Pacientes con diabetes mellitus presentaron hiperglucemia en relación a los pacientes nodiabéticos (p< 0,01), valores superiores de desviación estándar glucémico (p< 0,01) y coeficiente de variación glucémica en relación a los pacientes sin dia-betes (p= 0,03), sin embargo, no fueron clasificados con variación glucémica. Los valores de la Proteína C-reactiva fueron correlacionados con la desviación estándar glucémica (R = 0,29; P= 0,0065), la cantidad de carbohidratos administrada, no se correlacionó estadísticamente con las glucemias ni con la variación glucémica de los pacientes (p>0,05). Conclusión: pacientes hospitalizados con o sin diabetes mellitus 2 no presentaron variación glucémica, demostrando control glucémico en la hospitalización. (AU)

Low Food Consumption Interferes with the Nutritional Status of Surgical Patients with Neoplasia of the Gastrointestinal Tract.

Nutritional support strongly influence the nutritional status of the surgical neoplastic patients. This study aimed to evaluate the influence of food consumption on the perioperative nutritional status of hospitalized patients with neoplasia of the upper (UGIT) and lower (LGIT) gastrointestinal tract. METHOD: Observational, longitudinal, and prospective study. Data collected: food consumption, Subjective Global Assessment, anthropometry, laboratory tests. RESULTS: Eighty patients were followed up: 43 (54%) in the UGIT and 37 (46%) in the LGIT. The consumption in the perioperative period was lower than the usual consumption in the UGIT and LGIT groups, respectively, of energy (14.2 ± 6.5; 22.8 ± 11.2 Kcal/kg/d, p < 0.001; 13.6 ± 1.2; 19.0 ± 2.0 Kcal/kg/d; p = 0.014), protein (1.1 ± 0.7; 0.6 ± 0.3 g/kg/d, p < 0.001; 0.8 ± 0.1; 0.5 ± 0.1 g/kg/d; p = 0.058), selenium, zinc and copper. Most patients presented in the UGIT and LGIT groups, respectively, worsening malnutrition and muscle depletion according to the Subjective Global Assessment (61.9%; 51.4%) and hypoalbuminemia, mainly in the UGIT in the postoperative. CONCLUSION: Low food consumption during the perioperative period associated with prolongation of the postoperative fasting period worsens the nutritional status of patients undergoing surgery of the gastrointestinal tract for neoplasia, especially in the UGIT group.

Relation of micronutrients with antioxidant properties in patients with chronic diseases and exclusive enteral nutrition

ABSTRACT Objective: To evaluate the intake of micronutrients with antioxidant properties through exclusive enteral nutrition therapy (ENT) in hospitalized patients with chronic diseases compared to the estimated average requirement (EAR). Methods: This prospective, longitudinal, descriptive, observational study was performed in a public hospital, with adult and elderly patients. The adequacy of the volume of ENT prescribed and offered was considered satisfactory when >80%. The adequacy of micronutrients with antioxidant properties was performed according to the estimated average need (EAR). Data were considered statistically significant when p<0.05. Results: Of the 53 included patients, 58.5% were male. Most of patients (45.3%) were in the neurology clinic, and the main cause was cerebral vascular accident (18.9%). The volume administered was less than the prescribed volume of ENT in both male and female patients. However, recommendations for micronutrients with antioxidant properties, such as vitamin A, vitamin C, vitamin E, zinc, selenium, copper and iron, are according to EAR and did not exceed the tolerable intake limit (upper limit, UL), (p<0.05). The present study shows a very large variability in the concentration of micronutrients in each enteral diet. It is necessary to consider the pathologies that affect the patient, as some health conditions may be able to require specific amounts of micronutrients. Conclusions: Patients received a lower volume of enteral nutrition therapy compared to the prescribed volume. The micronutrient concentrations were consistent with daily EAR recommendations and did not exceed the tolerable intake limit (UL) for healthy individuals.

RESUMEN Objetivo: Evaluar la ingesta de micronutrientes con propiedades antioxidantes a través de la terapia de nutrición enteral exclusiva (ENT) en pacientes hospitalizados con enfermedades crónicas en comparación con el requerimiento promedio estimado (RPE). Métodos: Prospectivo, longitudinal, descriptivo y de observación, se realizó en un hospital público con pacientes adultos y ancianos. La adecuación del volumen de ENT prescrito y ofrecido se consideró satisfactoria cuando fue >80%. La adecuación de micronutrientes con propiedades antioxidantes se realizó de acuerdo con la RPE. Se consideraron estadísticamente significativos p<0,05. Resultados: De los 53 pacientes incluidos, 58,5% eran hombres. La mayoría de los pacientes (45,3%) se encontraban en la consulta de neurología y la principal causa fue el accidente vascular cerebral (18,9%). El volumen administrado fue menor que el volumen prescrito de ENT tanto en pacientes masculinos como femeninos. Sin embargo, las recomendaciones de micronutrientes con propiedades antioxidantes, como vitamina A, vitamina C, vitamina E, zinc, selenio, cobre y hierro, están de acuerdo con la RPE y no superan el límite de ingesta tolerable (UL), (p<0,05). El presente estudio muestra una variabilidad muy grande en la concentración de micronutrientes en cada dieta enteral. Es necesario considerar las patologías que afectan al paciente, ya que algunas condiciones de salud pueden requerir cantidades específicas de micronutrientes. Conclusiones: Los pacientes recibieron un volumen menor de ENT en comparación con el volumen prescrito. Las concentraciones de micronutrientes fueron consistentes con las recomendaciones diarias de la RPE y no excedieron el límite de ingesta tolerable (UL) para individuos sanos.

Validation of the UNESP-Botucatu pig composite acute pain scale (UPAPS).

The creation of species-specific valid tools for pain assessment is essential to recognize pain and determine the requirement and efficacy of analgesic treatments. This study aimed to assess behaviour and investigate the validity and reliability of an acute pain scale in pigs undergoing orchiectomy. Forty-five pigs aged 38±3 days were castrated under local anaesthesia. Behaviour was video-recorded 30 minutes before and intermittently up to 24 hours after castration. Edited footage (before surgery, after surgery before and after rescue analgesia, and 24 hours postoperatively) was analysed twice (one month apart) by one observer who was present during video-recording (in-person researcher) and three blinded observers. Statistical analysis was performed using R software and differences were considered significant when p<0.05. Intra and inter-observer agreement, based on intra-class correlation coefficient, was good or very good between most observers (>0.60), except between observers 1 and 3 (moderate agreement 0.57). The scale was unidimensional according to principal component analysis. The scale showed acceptable item-total Spearman correlation, excellent predictive and concurrent criterion validity (Spearman correlation ≥ 0.85 between the proposed scale versus visual analogue, numerical rating, and simple descriptive scales), internal consistency (Cronbach's α coefficient >0.80 for all items), responsiveness (the pain scores of all items of the scale increased after castration and decreased after intervention analgesia according to Friedman test), and specificity (> 95%). Sensitivity was good or excellent for most of the items. The optimal cut-off point for rescue analgesia was ≥ 6 of 18. Discriminatory ability was excellent for all observers according to the area under the curve (>0.95). The proposed scale is a reliable and valid instrument and may be used clinically and experimentally to assess postoperative acute pain in pigs. The well-defined cut-off point supports the evaluator´s decision to provide or not analgesia.

Anti-inflammatory activity and identification of the Verbena litoralis Kunth crude extract constituents

Verbena litoralis is a plant popularly known as "gervãozinho-do-campo" in Portuguese. It is traditionally used for stomach, liver and gallbladder problems, and as an anti-inflammatory and anthelmintic. The goal of this study was to determine the chemical composition of the crude extract obtained from the aerial parts of V. litoralis by Ultra High Performance Liquid chromatography coupled with Mass Spectrometry in Tandem (UHPLC-MS/MS); assess the anti-inflammatory activity of ethyl acetate fraction and of crude extract; and verify liver, kidney and pancreas damage. In this study, the chemical composition of the extract was identified via UHPLC/MS/MS, assessing the anti-inflammatory activity of the crude extract and the acetate fraction in an induction model of the granulomatous tissue, as well as given liver, kidney and pancreas damage markers. Chlorogenic acid, luteolin, caffeic acid, apigenin, p-coumaric acid, vanillic acid, ferulic acid and quercetin were quantified in the extract. After the seven-day treatment, the granuloma of the animals treated with the plant extract and fraction presented values very close to the positive control (nimesulide). The V. litoralis crude extract and ethyl acetate fraction show anti-inflammatory activity similar to the nimesulide without evidence of liver, kidney and pancreas damage, which attributes the plant's pharmacological action to the flavonoids found.

Validation of the Italian version of the UNESP-Botucatu multidimensional composite pain scale for the assessment of postoperative pain in cats.

The study described in this paper had the goal to validate the Italian version of the UNESP-Botucatu multidimensional composite pain scale (UNESP-Botucatu MCPS) to assess postoperative pain in cats using video analysis and psycometric testing. The English version of the scale was translated into Italian. Thirty videos of the perioperative period of ovariohysterectomy surgery were analysed by 5 Italian observers with the aim to determine the pain score using the Italian version of the scale and to verify the need for analgesic treatment for each cat. Obtained scores were submitted to psycometric validity, responsiveness, and reliability tests. Of the 3 domains identified by factor analysis, the internal consistency was excellent for 'Psychomotor changes' and 'Protection of the painful area and vocal expressions of pain', while 'Physiological variables' showed moderate internal consistency. Significant changes in pain scores in response to surgery and analgesics confirmed content and construct validity. The agreement between the 'gold standard' and the blinded observers supported the criterion validity. Inter- and intra-rater reliability ranged from good to very good for all scale items. The cut-off point for rescue analgesia was > 7. The study concluded that the Italian version of the UNESP-Botucatu MCPS is a valid and reliable instrument for assessing postoperative pain in cats. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy.

Validation of the Italian version of the UNESP-Botucatu unidimensional composite pain scale for the assessment of postoperative pain in cattle.

OBJECTIVE: The aim of this study was to validate the Italian version of the UNESP-Botucatu Unidimensional Composite Pain Scale (UCPS-IV) for assessing postoperative pain in cattle. STUDY DESIGN: Video analysis and psychometric testing. ANIMALS: A total of 40 Nellore cattle, age 2-3 years, weighing 365±51 kg. METHODS: An English version of the scale was translated to Italian and back translated to English to ensure semantic equivalence. A total of four Italian observers and the researcher who developed the original scale (considered as the gold standard) analysed videos of 40 cattle previously subjected to orchiectomy (recorded for each cattle at four predetermined timepoints during the perioperative period) unaware of the videos' timepoint. They assigned a pain score [ranging from no pain (0) to severe pain (10)] using the Italian version of the scale and verified the need for analgesic treatment for each animal. The obtained scores were subjected to psychometric validity, responsiveness and reliability tests. RESULTS: The factor analysis of the scale resulted in a one-factor solution. Significant changes in pain scores in response to surgery and analgesics confirmed not only the content and construct validity, but also responsiveness. The agreement between the researcher who developed the original scale and the blinded observers and the correlation between the pain scores determined by the scale and those determined by three classical unidimensional pain scales confirmed criterion and concurrent validity. Internal consistency of the scale was excellent. Inter- and intrarater reliability ranged from moderate to good and from moderate to very good for all scale items, respectively, supporting reproducibility and stability. The cut-off point for rescue analgesia calculated by the receiver operating characteristic curve was > 3. CONCLUSIONS AND CLINICAL RELEVANCE: The results confirm that the UNESP-Botucatu UCPS-IV appears to be a valid and reliable tool for the assessment of postorchiectomy pain in the bovine species. The determination of a cut-off point for rescue analgesia is also helpful for guiding analgesic therapy.

Evaluation of acute and subacute toxicity of hydroethanolic extract of Dolichandra unguis-cati L. leaves in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Dolichandra unguis-cati L. is a native climbing plant of Brazil, popularly known as "unha de gato". It has been traditionally used mainly as an antipyretic, anti-inflammatory and anti-tumor agent, yet little toxicological information is found in the literature. AIM OF THE STUDY: To identify the chemical composition of the hydroethanolic extract obtained from the leaves of Dolichandra uniguis-cati and to evaluate the acute and subacute toxicity in male and female rats, in order to assess the safety profile of this plant. MATERIALS AND METHODS: In the acute study, a single dose (2000mg/kg) of the extract was orally administered to male and female rats. In the subacute study, the extract was orally administered to male and female rats at doses 100, 200 and 400mg/kg for 28 days. Behavioral changes, catalase and tbars evaluations, biochemical, hematological and histopathological analysis were determined. The extract' chemical composition was accessed through UHPLC/MS. RESULTS: Chlorogenic acid, caffeic acid, ferulic acid, vanillinic acid, p-coumaric acid, rosmarinic acid, trans-cinnamic acid, luteolin, apigenin, quercitrin and quercetin were identified in the extract. In the acute treatment, the extract was classified as safe (category 5), according to the OECD guide. In relation to the subacute study, females showed a reduction in AST (100, 200 and 400mg/kg), ALT (200mg/kg) and BUN (100 and 200mg/kg) levels, while male rats 400mg/kg presented an increase in AST levels. The Chol dosage significantly decreased in female rats in a dose-dependent manner, whereas for male rats this parameter showed no statistically significant reductions. No behavioral and histopathological changes were recorded. CONCLUSIONS: Our results indicate that the hydroethanolic extract of Dolichandra unguis-cati leaves did not present relevant toxic effects when administered orally to male and female rats. The extract also showed a potential hypocholesterolemic activity.

Nutrição e saúde óssea: a importância do cálcio, fósforo, magnésio e proteínas / Nutrition and bone health: the importance of calcium, phosphorus, magnesium and protein

A osteoporose é uma doença silenciosa que afeta, especialmente, as mulheres na pós-menopausa, e suas principais consequências são as fraturas. Medidas não farmacológicas, tais como uma nutrição adequada, podem ajudar a manter a massa óssea, retardando o aparecimento da osteoporose. Nessa revisão, será abordada a importância da nutrição adequada nesta fase da vida, com ênfase para o cálcio, fósforo, magnésio e proteínas. Tanto uma baixa ingestão desses nutrientes quanto um excesso de cálcio e fosforo parecem estar associados a um risco maior de fraturas. Uma dieta balanceada pode vir a diminuir o impacto do envelhecimento na saúde óssea(AU)

Osteoporosis is a silent disease that affects especially women after menopause, and its main consequences are the fractures. Non-pharmacological measures, such as proper nutrition, can help maintain bone mass delaying the onset of osteoporosis. Here the authors review the importance of proper nutrition at this stage of life, with emphasis on calcium, phosphorus, magnesium and protein. Both a low intake of these nutrients and an excess of calcium and phosphorus seem to be associated with an increased risk of fractures. A balanced diet can come to lessen the impact of aging on bone health(AU)

Traditional usages, botany, phytochemistry, biological activity and toxicology of tropaeolum majus L: a review / Usos tradicionales, botánica, fitoquímica, actividad biológica y toxicología de tropaeolum majus L: una revisión

Tropaeolum majus presents medicinal, nutritional and ornamental value. Plant extracts and fractions have been found to exhibit diuretic, antihypertensive, anti-inflammatory, antimicrobial and antioxidant activities. Moreover, protective effects on blood and liver, scurvy’s treatment, antithrombin activity and prevention against macular degeneration have also been observed. T. majus contains biologically active compounds such as flavonoids, glucosilonates, fatty acids, essential oil, chlorogenic acid, aminoacids, cucurbitacins, proteins and carotenoids. Acute and subchronic studies demonstrated a lack of toxic effects, but the extracts of this plant can have deleterious consequences during the pregnancy. The revised databases were SciELO, PubMed, ScienceDirect and Portal da Capes, considering studies between 1963 and 2014 and by searching for terms like Tropaeolum majus, Tropaeolaceae, Tropaeolum majus constituents, Tropaeolum majus use and Tropaeolum majus toxicity.

Tropaeolum majus presenta valor medicinal, alimenticio y ornamental. A partir del extracto y las fracciones de la planta se han encontrado actividades biológicas, que incluyen efecto diurético, antihipertensivo, anti-inflamatorio, antimicrobiano y antioxidante. Además, efectos protectores sobre la sangre y el hígado, tratamiento del escorbuto, actividad antitrombina y prevención contra la degeneración macular. T. majus contiene compuestos biológicamente activos como flavonoides, glucosilonates, ácidos grasos, aceite esencial, ácido clorogénico, aminoácidos, cucurbitacinas, proteínas y carotenoides. Estudios de toxicidad aguda y subcrónica demostraron una falta de efectos toxicológicos, pero los extractos de esta planta pueden tener consecuencias perjudiciales durante el embarazo. Las bases de datos revisadas fueron SciELO, PubMed, ScienceDirect y Portal da Capes, teniendo en cuenta los estudios entre 1963 y 2014 y mediante la búsqueda de términos como Tropaeolum majus, Tropaeolaceae, Tropaeolum majus constituyentes, Tropaeolum majus usos y Tropaeolum majus toxicidad.

Comparison of morphine, ketoprofen and Arnica montana 6x and 30x per oral transmucosal or subcutaneous route for control of postoperative pain in cats subjected to hysterectomy with bilateral salpingo-oophorectomy / Comparação de morfina, cetoprofeno e Arnica montana 6x e 30x por via transmucosa oral ou subcutânea para control e de dor pós-operatória em gatas submetidas à histerectomia e ooforectomia bilateral

ABSTRACT: The postoperative analgesic effect of Arnica montana (Arnica) was compared to morphine and ketoprofen in 50 cats following hysterectomy with bilateral salpingo-oophorectomy (HSO). Cats were randomly allocated to five groups (n=10) and were treated 30 minutes before surgery and over 72 hours with 1ml of Arnica 30x per subcutaneous (SC) route (GA30SC); Arnica 30x per oral transmucosal route (P.O.) (GA30PO); Arnica 6x P.O. (GA6PO); morphine 0.1mg kg-1 SC (GM) SID or ketoprofen 2mg kg-1 SC (GK) before and 1mg kg-1 after surgery. Sedation and postoperative pain were assessed by means of a dynamic and interactive visual analogue scale (DIVAS) and variable count scale (VCS) and hyperalgesia using an esthesiometer. Whenever the VAS and VCS scores attained 33% of the maximum value, rescue analgesia was performed with morphine 0.3mg kg-1 per the intramuscular (IM) route. Other variables assessed were vomiting, defecation, urination, body weight and wound healing. Vomiting only occurred in animals treated with morphine. The groups did not differ in defecation, urination, body weight or wound healing. Hyperalgesia was detected only on the occasions that the criterion for rescue analgesia was met. One animal in GK and one in GM required rescue analgesia, differing from groups GA30SC, GA30PO and GA6PO, in which 4, 4 and 5 animals, respectively, required rescue analgesia. It can be concluded that ketoprofen and morphine were more efficacious than Arnica and that there was no difference among the various potencies and routes of administration of Arnica for postoperative analgesia in cats undergoing HSO.

RESUMO: Comparou-se o efeito analgésico de Arnica em relação à morfina ou cetoprofeno, no período pós-operatório, de 50 gatas submetidas à ovariossalpingohisterectomia (OSH). As gatas foram divididas em cinco grupos (n=10) e tratadas aleatoriamente 30 minutos antes da cirurgia por 72 horas com 1ml de Arnica 30D por via subcutânea (SC) (GA30SC); Arnica 30D por via oral (VO) (GA30VO); Arnica 6D VO (GA6VO); 0,1mg kg-1 de morfina SC (GM) TID ou 2mg kg-1 de cetoprofeno SC (GC) antes e 1mg kg-1 após a cirurgia SID. Foram avaliadas a sedação e a dor pós-operatória, por meio de escala analógica visual (EAV), escala de contagem variável (ECV) e hiperalgesia, esta última pelo estesiômetro. Quando os escores da ECV e EAV atingiram 33% do valor máximo, realizou-se resgate analgésico com 0,3mg kg-1 de morfina por via intramuscular (IM). Observou-se ocorrência de vômito, defecação, micção, alteração de peso e a cicatrização. Exceto nos animais tratados com morfina, não houve vômito. Não houve diferença entre os grupos para defecação, micção, peso e cicatrização. A hiperalgesia foi observada apenas nos momentos do resgate analgésico. Um animal de GC e um de GM receberam resgate analgésico, o que diferiu dos grupos GA30SC, GA30VO e GA6VO, onde, respectivamente, 4, 4 e 5 animais necessitaram resgate analgésico. Conclui-se que o cetoprofeno e a morfina foram mais eficazes que a Arnica e que, quanto à Arnica, não houve diferença nem entre as dinamizações e entre as vias SC e oral para analgesia de gatas submetidas à OSH.

Desafios da referência e contrarreferência na atenção em saúde na perspectiva dos trabalhadores / Challenges of referral and counter-referral in health care in the workers' perspective / Desafíos de la referencia y contrarreferencia en la atención en salud en la perspectiva de los trabajadores

O objetivo deste estudo foi identificar os desafios da Atenção Primária à Saúde e Terciária nos serviços de saúde de um município do sul do Brasil. Estudo descritivo-exploratório, de abordagem qualitativa, realizado com equipe multiprofissional. Os dados foram coletados entre julho e agosto de 2014, utilizando-se a entrevista semiestruturada. Os resultados foram organizados em duas categorias temáticas: Dificuldade de articulação nos serviços de saúde e o trabalho solitário. A falta de comunicação entre os trabalhadores dos serviços, o desconhecimento sobre os serviços da rede, a carência de educação permanente, a ausência de retorno dos serviços e a falta de responsabilização dos profissionais envolvidos no cuidado foram destaque, o que fragiliza os processos de referência e contrarreferência (AU).

This study's objective was to identify the challenges of Primary and Tertiary Healthcare in the health services of a municipality in the South of Brazil. It is a descriptive-exploratory study, with a qualitative approach, undertaken with the multi-professional team. The data were collected between July and August 2014, using semistructured interviews. The results were organized in two thematic categories: Difficulty in articulation in the health services and the solitary work. The lack of communication between the services' workers, lack of knowledge regarding the services in the network, lack of continuing education, the absence of feedback from the services and the lack of responsibilization of the professionals involved in the care were highlighted, which weakens the processes of referral and counter referral (AU).

El objetivo del estudio fue identificar los desafíos de la Atención Primaria a la Salud y Terciaria en los servicios de salud de un municipio del sur de Brasil. Estudio descriptivo exploratorio, de abordaje cualitativo, realizado con equipo multiprofesional. Los datos fueron obtenidos entre julio y agosto de 2014, utilizándose la entrevista semiestructurada. Los resultados fueron organizados en dos categorías temáticas: Dificultad de articulación en los servicios de salud y el trabajo solo. La falta de comunicación entre los trabajadores de los servicios, el desconocimiento acerca de los servicios de la red, la carencia de educación permanente, la ausencia de retorno de los servicios y la falta de responsabilización de los profesionales involucrados en el cuidado fueron destaque, lo que debilita los procesos de referencia y contrarreferencia (AU).

Acupuncture and pharmacopuncture are as effective as morphine or carprofen for postoperative analgesia in bitches undergoing ovariohysterectomy

ABSTRACT PURPOSE : To investigate the analgesic effect of acupuncture (AP) or micro-dose pharmacopuncture (PA), using carprofen or morphine, in bitches undergoing ovariohysterectomy (OHE). METHODS: Thirty five dogs were randomly assigned to five groups after sedation with acepromazine IM: AP, 0.5 mg.kg-1 of morphine subcutaneously (SC), 4 mg.kg-1 of carprofen SC, and PA with 0.05 mg.kg-1 of morphine or 0.4 mg.kg-1 of carprofen. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed after OHE by a blind observer for 24h, by dynamic visual analogue scale (DIVAS), Glasgow (CMPS-SF), Melbourne (UMPS) and Colorado University pain scale (CSU). Animals reaching 33% of the UMPS score received rescue analgesia with morphine IM. Non parametric data were analysed by Kruskal-Wallis or Friedman tests where applicable, followed by Dunn´s test. Parametric data were analysed by two way ANOVA, followed by Tukey test. RESULTS: There were no differences among groups in number of rescue analgesia. Except for the DIVAS score where animals treated with morphine had the lowest score compared with AP and carprofen, at 1h after surgery, there were no other differences among groups. CONCLUSION: Acupuncture or pharmacopuncture were equally effective as morphine or carprofen to control postoperative pain in bitches undergoing ovariohysterectomy.

Biological potential of plants from the genus Bauhinia

The genus Bauhinia (Fabaceae, Leguminosae) consists of approximately 300 species, which are commonly known as cows paw or cows hoof, because of the shape of their leaves. They are widely distributed in most tropical countries, including Africa, Asia and South America. Their leaves and stem-bark have been used frequently in folk medicine as a remedy for different kinds of disease, particularly diabetes, infections, pain and inflammatory processes. Bauhinia longifolia flavonoids demonstrated the highest antiviral activity of all tested substances, being that quercetin had the highest antiviral activity amongst purified flavonoids. The aim of this article is to summarize concisely recent advances published in the last 5 years on the most recent works about the biological activities and phytochemical composition of plants of the genusBauhinia. For this, was performed a search in some of the databases on the web as PubMed, Google Scholar and Medline, using the keywords Bauhinia, biological properties, diabetes, cancer(AU)

El género Bauhinia (Fabaceae, Leguminosae) consta de aproximadamente 300 especies, que se conocen comúnmente como pata de vaca o pezuña de vaca, debido a la forma de sus hojas. Están ampliamente distribuidos en la mayoría de los países tropicales, incluyendo África, Asia y América del Sur. Sus hojas y el tallo de corteza se utilizan con frecuencia en la medicina popular como un remedio para diferentes tipos de enfermedades, en particular la diabetes, infecciones, dolor y en los procesos inflamatorios. Los flavonoides de Bauhinia longifolia demostraron la mayor actividad antiviral de todas las sustancias analizadas, y es la quercetina la de mayor actividad antiviral entre los flavonoides purificados. El objetivo de este artículo fue resumir los trabajos publicados en los últimos cinco años sobre la actividad biológica y la composición fitoquímica de las plantas del género Bauhinia. Para ello, se realizó una búsqueda en algunas de las bases de datos en la web como PubMed, Google Scholar y Medline, usando las palabras clave Bauhinia, actividad biológica, diabetes, cáncer(AU)

Chemical constituents, biological activity and therapeutic uses, of Scutia buxifolia Reissek

Scutia buxifolia has been used in the treatment of a number of diseases, which includes bacterial and fungal infections, hypertension, Alzheimer's Disease and cancer. S. buxifolia contains biologically active compounds such as flavonoids, steroids, tanins, lipids, terpens and alkaloids. A range of biological activities has been found from plant extract and fractions, including antioxidant, acetylcholinesterase inhibitor, antiviral and antibiotic. Some studies about the potential toxicity were performed; however the results are not conclusive, suggesting that a single administration of the extract is safe, whereas prolonged use has deleterious effects for the body. The revised databases were SciELO, PubMed, ScienceDirect and Portal da Capes considering studies between 1964 and 2014 and by searching for terms like Scutia buxifolia, Rhamnaceae family, Scutia buxifolia Constituents, Scutia buxifolia use and OECD(AU)

Scutia buxifolia se utiliza en el tratamiento de una serie de enfermedades que incluye infecciones bacterianas y fúngicas, hipertensión, enfermedad de Alzheimer y cáncer. S. buxifolia contiene compuestos biológicamente activos tales como flavonoides, taninos, esteroides, lípidos, terpenos y alcaloides. A partir del extracto y las fracciones de la planta surgen una gama de actividades biológicas, que incluyen antioxidante, inhibidor de la acetilcolinesterasa, antiviral y antibiótico. Se realizaron algunos estudios sobre el potencial tóxico, sin embargo los resultados no son concluyentes, lo que sugiere que una sola administración del extracto es segura, mientras que el uso prolongado tiene efectos perjudiciales para el organismo. Las bases de datos revisadas fueron SciELO, PubMed, ScienceDirect y Portal de Capes, teniendo en cuenta los estudios entre 1964 y 2014 y mediante la búsqueda de términos como Scutia buxifolia, Rhamnaceae family, Scutia buxifolia constituents, Scutia buxifolia uses and OECD(AU)

Chemical composition of the Schinus molle L. essential oil and their biological activities

Introduction: essential oils and aromatic plant extracts have been recognized for many years as a great source of pharmaceutical agents. It is important to research on the chemical composition of the essential oils of plants widely used by the population because its usability becomes safer. Objective: to identify the chemical characterization of Schinus molle L. essential oils and their biological activities and to compare them with the biological activities of the main compounds found in literature. Methods: fifty grams of leaves were used to extract the oils through distillation in a modified Clevenger apparatus. The chemical analysis of volatile oils was carried out with capillary gas chromatography using flame ionization detector for quantitative analysis of its elements and, subsequently, a mass detector for qualitative analysis. Results: nineteen substances were separated and the major compounds were bicyclogermacrene (20.5 percent percent), betacaryophyllene (19.7 percent) and spathulenol (19.2 percent). Conclusions: given the extensive distribution of the raw material in Rio Grande do Sul state, Brazil, more studies on the chemical properties and biological activities of Schinus molle essential oil are needed(AU)

Introducción: los aceites esenciales y extractos de plantas aromáticas han sido reconocidos desde hace muchos años como una gran fuente de agentes farmacéuticos. Es importante la investigación de la composición química de los.aceites esenciales de las plantas utilizadas ampliamente por la población porque su aplicabilidad se torna más segura. Objetivo: identificar la composición química del aceite esencial de las hojas de Schinus molle L. y correlacionarlas con las actividades biológicas de los principales compuestos localizadas en la literatura. Métodos: cincuenta gramos de hojas se sometieron a extracción a través de destilación usando un equipo Clevenger modificado. Para el análisis químico, los aceites volátiles se sometieron a cromatografía capilar de gases usando un detector de ionización de llama para el análisis cuantitativo de sus elementos constituyentes y, posteriormente, un detector de masas para el análisis cualitativo. Resultados: diecinueve compuestos fueron separados y los principales eran biciclogermacreno (20,5 por ciento), betacariofileno (19,7 por ciento) y espatulenol (19,2 por ciento). Conclusiones: dada la extensa distribución del material crudo en el estado de Río Grande do Sul, Brasil, se debe incrementar los estudios sobre las características químicas y las actividades biológicas del aceite esencial de Schinus molle(AU)

Acupuncture and pharmacopuncture are as effective as morphine or carprofen for postoperative analgesia in bitches undergoing ovariohysterectomy.

PURPOSE: To investigate the analgesic effect of acupuncture (AP) or micro-dose pharmacopuncture (PA), using carprofen or morphine, in bitches undergoing ovariohysterectomy (OHE). METHODS: Thirty five dogs were randomly assigned to five groups after sedation with acepromazine IM: AP, 0.5 mg.kg(-1) of morphine subcutaneously (SC), 4 mg.kg(-1) of carprofen SC, and PA with 0.05 mg.kg(-1) of morphine or 0.4 mg.kg(-1) of carprofen. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed after OHE by a blind observer for 24h, by dynamic visual analogue scale (DIVAS), Glasgow (CMPS-SF), Melbourne (UMPS) and Colorado University pain scale (CSU). Animals reaching 33% of the UMPS score received rescue analgesia with morphine IM. Non parametric data were analysed by Kruskal-Wallis or Friedman tests where applicable, followed by Dunn's test. Parametric data were analysed by two way ANOVA, followed by Tukey test. RESULTS: There were no differences among groups in number of rescue analgesia. Except for the DIVAS score where animals treated with morphine had the lowest score compared with AP and carprofen, at 1h after surgery, there were no other differences among groups. CONCLUSION: Acupuncture or pharmacopuncture were equally effective as morphine or carprofen to control postoperative pain in bitches undergoing ovariohysterectomy.

Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle.

BACKGROUND: The recognition and measurement of pain in cattle are important in determining the necessity for and efficacy of analgesic intervention. The aim of this study was to record behaviour and determine the validity and reliability of an instrument to assess acute pain in 40 cattle subjected to orchiectomy after sedation with xylazine and local anaesthesia. The animals were filmed before and after orchiectomy to record behaviour. The pain scale was based on previous studies, on a pilot study and on analysis of the camera footage. Three blinded observers and a local observer assessed the edited films obtained during the preoperative and postoperative periods, before and after rescue analgesia and 24 hours after surgery. Re-evaluation was performed one month after the first analysis. Criterion validity (agreement) and item-total correlation using Spearman's coefficient were employed to refine the scale. Based on factor analysis, a unidimensional scale was adopted. RESULTS: The internal consistency of the data was excellent after refinement (Cronbach's α coefficient = 0.866). There was a high correlation (p < 0.001) between the proposed scale and the visual analogue, simple descriptive and numerical rating scales. The construct validity and responsiveness were confirmed by the increase and decrease in pain scores after surgery and rescue analgesia, respectively (p < 0.001). Inter- and intra-observer reliability ranged from moderate to very good. The optimal cut-off point for rescue analgesia was > 4, and analysis of the area under the curve (AUC = 0.963) showed excellent discriminatory ability. CONCLUSION: The UNESP-Botucatu unidimensional pain scale for assessing acute postoperative pain in cattle is a valid, reliable and responsive instrument with excellent internal consistency and discriminatory ability. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy.

Validation of the English version of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats.

BACKGROUND: A scale validated in one language is not automatically valid in another language or culture. The purpose of this study was to validate the English version of the UNESP-Botucatu multidimensional composite pain scale (MCPS) to assess postoperative pain in cats. The English version was developed using translation, back-translation, and review by individuals with expertise in feline pain management. In sequence, validity and reliability tests were performed. RESULTS: Of the three domains identified by factor analysis, the internal consistency was excellent for 'pain expression' and 'psychomotor change' (0.86 and 0.87) but not for 'physiological variables' (0.28). Relevant changes in pain scores at clinically distinct time points (e.g., post-surgery, post-analgesic therapy), confirmed the construct validity and responsiveness (Wilcoxon test, p < 0.001). Favorable correlation with the IVAS scores (p < 0.001) and moderate to very good agreement between blinded observers and 'gold standard' evaluations, supported criterion validity. The cut-off point for rescue analgesia was > 7 (range 0-30 points) with 96.5% sensitivity and 99.5% specificity. CONCLUSIONS: The English version of the UNESP-Botucatu-MCPS is a valid, reliable and responsive instrument for assessing acute pain in cats undergoing ovariohysterectomy, when used by anesthesiologists or anesthesia technicians. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy.