Oral glutamine supplementation relieves muscle loss in immobilized rats, altering p38MAPK and FOXO3a signaling pathways.

BACKGROUND: Skeletal muscle synthesizes, stores, and releases body L-glutamine (GLN). Muscle atrophy due to disabling diseases triggers the activation of proteolytic and pro-apoptotic cell signaling, thus impairing the body's capacity to manage GLN content. This situation has a poor therapeutic prognosis. OBJECTIVE: Evaluating if oral GLN supplementation can attenuate muscle wasting mediated by elevated plasma cortisol and activation of caspase-3, p38MAPK, and FOXO3a signaling pathways in soleus and gastrocnemius muscles of rats submitted to 14-day bilateral hindlimbs immobilization. METHODS: Animals were randomly distributed into six groups: non-immobilized rats (Control), control orally supplemented with GLN (1 g kg-1) in solution with L-alanine (ALA: 0.61 g kg-1; GLN+ALA), control orally supplemented with dipeptide L-alanyl-L-glutamine (DIP; 1.49 g kg-1), hindlimbs immobilized rats (IMOB), IMOB orally GLN+ALA supplemented (GLN+ALA-IMOB), and IMOB orally DIP supplemented (DIP-IMOB). Plasma and muscle GLN concentration, plasma cortisol level, muscle caspase-3 activity, muscle p38MAPK and FOXO3a protein content (total and phosphorylated forms), and muscle cross-sectional area (CSA) were measured. RESULTS: Compared to controls, IMOB rats presented: a) increased plasma cortisol levels; b) decreased plasma and muscle GLN concentration; c) increased muscle caspase-3 activity; d) increased total and phosphorylated p38MAPK protein content; e) increased FOXO3a and decreased phosphorylated FOXO3a protein content; f) reduced muscle weight and CSA befitting to atrophy. Oral supplementation with GLN+ALA and DIP was able to significantly attenuate these effects. CONCLUSIONS: These findings attest that oral GLN supplementation in GLN+ALA solution or DIP forms attenuates rats' skeletal muscle mass wasting caused by disuse-mediated muscle atrophy.

Relevância da deambulação precoce no tempo de internação hospitalar de pacientes idosos: revisão integrativa / Relevance of early deambulation in the time of hospital admission of elderlypatients: integrative review / Relevancia de la caminata temprana en el tiempo de internamientohospitalariodel anciano: revisión integrativa

Introdução:No Brasil, a população considerada idosa representa a faixa etária que mais utiliza os serviçoshospitalares.Mesmo sendo um importante recurso, a admissão hospitalar frequente ou por um tempo prolongado, pode gerar comprometimentos funcionais a este público.A prática da reabilitação precoce contribui para minimizar e prevenir estesimpactos deletérios do imobilismo, favorecer a capacidade funcional, diminuindo o tempo de hospitalização, além de promover qualidade de vida. Objetivo:Observar a relevância da mobilização precoce em idosos, bem como os prejuízos acarretados pelo imobilismo durante internação hospitalar.Metodologia:Trata-se de uma revisão integrativa com busca online nas bases de dados PEDro, PUBMED, MEDLINE, LILACS e SciELO, os descritores foram: mobilização precoce, imobilismoeidosos, com seus respectivos em língua inglesa, foram selecionados artigos publicados entre os anos de 2016 a 2020, em língua portuguesa e estrangeira.Resultados:Foram selecionados cinco artigos para a discussão, sendo utilizado a deambulação precoce de precisão como limiar de segurança para reabilitação cardíaca; avaliou-se a influência da reabilitação precoce e terapia de reabilitação em pacientes com mais de 72 horas de ventilação mecânica prolongada; observou-se a intensificação da fisioterapia pós-operatória, com exercícios de respiração profunda e mobilização precoce; observou-se que a reabilitação domiciliar interdisciplinar geriátrica em idosos com fratura de quadril poderia melhorar a capacidade de locomoção e reduzir tempo de internação pós-operatória. Os achados discutidos entre os autores, apontam com unanimidade a aprovação da deambulação e mobilização precoce.Conclusões:A mobilização precoce mostrou-se eficaz tanto nos pacientes em atendimento hospitalar como no ambiente domiciliar, reduzindo significativamente os prejuízos ocasionados pelo imobilismo (AU).

Introduction:In Brazil, the population considered elderly represents the age group that most uses hospital services. Even though an important resource, frequent hospital admission orfor a prolonged period of time can generate functional impairments for this public. The practice of early rehabilitation helps to minimize and prevent the deleterious impacts of immobility, favoring functional capacity, decreasing the length of hospital stay and promoting quality of life. Objective:The study aims to observe the relevance of early mobilization in the elderly, as well as the damage caused by immobility during hospitalization. Methodology:This is an integrative review with an online search in the PEDro, PUBMED, MEDLINE, LILACS and SciELO databases. The descriptors were: early mobilization, immobility in the elderly and their respective in English. Articles published between the years 2016 to 2020, in Portuguese and foreign languages, were used. Results:Five articles were selected for discussion, using Precision Early Ambulation as a safety threshold for cardiac rehabilitation; the influence of early rehabilitation and rehabilitation therapyin patients with more than 72 hours of prolonged mechanical ventilation was evaluated; it was observed the intensification of postoperative physical therapy, with deep breathing exercises and early mobilization; geriatric interdisciplinary home rehabilitation in elderly patients with hip fractures was evaluated to improve mobility and reduce postoperative hospital stay. Discussions among the authors unanimously point to the approval of ambulation and early mobilization.Conclusions:Early mobilization proved to be effective both in patients in hospital care and in the home environment, significantly reducing the damage caused by immobility (AU).

Introducción:En Brasil, la población considerada anciana representa el grupo de edad que más utiliza los servicios hospitalarios. A pesar de que es un recurso importante, la hospitalización frecuente o por un período prolongado de tiempo puede generar deficiencias funcionales para este público. La práctica de la rehabilitación temprana ayuda a minimizar y prevenir los impactos deletéreos de la inmovilidad, favoreciendo la capacidad funcional, reduciendo el tiempo de hospitalización, además de promover la calidad de vida. Objetivo: El estudio tiene como objetivo observar la relevancia de la movilización temprana en ancianos, así como los daños causados por la inmovilización durante la hospitalización. Metodología: Esta es una revisión integradora con una búsqueda en línea de las bases de datos PEDro, PUBMED, MEDLINE, LILACS y SciELO, los descriptores fueron: movilización temprana, inmovilidad y ancianos en el idioma inglés, se seleccionaron artículos publicados entre los años de 2016 a 2020, en portugués y lenguas extranjeras. Resultados: Se seleccionaron cinco artículos para discusión, utilizando deambulación temprana de precisión como umbral de seguridad para la rehabilitación cardiaca; se evaluó la influencia de la rehabilitación temprana y la terapia de rehabilitaciónen pacientes con más de 72 horas de ventilación mecánica prolongada; hubo una intensificación de la fisioterapia posoperatoria, con ejercicios de respiración profunda y movilización precoz; Se evaluó la rehabilitación domiciliaria interdisciplinaria geriátrica en pacientes ancianos con fractura de caderapara mejorar la movilidad y reducir la estancia hospitalaria postoperatoria. Los hallazgos discutidos entre los autores apuntan unánimemente a la aprobación de la deambulación y la movilización precoz. Conclusiones: La movilización temprana demostró ser efectiva tanto en pacientes en atención hospitalaria como en el ámbito domiciliario, reduciendo significativamente el daño ocasionado por la inmovilización (AU).

Phytochemical profile, evaluation of antimicrobial and antioxidant activity in vitro of the hydroalcoholic extract of two species of the genus Cyperus (Cyperaceae)

Abstract Several factors contribute to the resistance of some pathogenic microorganisms and this fact requires the search for new therapeutic alternatives. The genus Cyperus (family Cyperaceae) groups species that present chemical compounds of pharmacological interest, mainly with antimicrobial action. Thus, the present work was carried out to investigate the antimicrobial activities, antioxidants and the phytochemical profile of Cyperus articulatus L. and Cyperus iria L. Hydroalcoholic extracts (1:1, v:v) of the aerial and underground parts of these species were used to analyze the total phenol content and to evaluate the in vitro antioxidant activity against the DPPH (2,2-diphenyl-1-picrylhydrazyl). The ethyl acetate and chloroform phases resulting from liquid-liquid partitioning of C. articulatus and C. iria extracts were evaluated in antimicrobial assays and subject to high performance liquid chromatography (HPLC-DAD) analysis. The chromatograms obtained by HPLC-DAD allowed us to identify four compounds: chlorogenic acid, catechin, quercetin, and quercitrin. The hydroalcoholic extracts of C. articulatus and C. iria showed a weak antioxidant activity with IC50 of 395.57 and 321.33 µg/mL (aerial parts), and 1,114.01 and 436.82 µg/mL (underground parts), respectively. Regarding antimicrobial activity, the chloroform phase of C. iria showed the best result at the concentration of only 31.2 µg/mL against the pathogens Candida albicans and Staphylococcus aureus. The ethyl acetate phases of the aerial parts of C. articulatus and C. iria did not show antimicrobial activity

Discovery of a Bromodomain and Extraterminal Inhibitor with a Low Predicted Human Dose through Synergistic Use of Encoded Library Technology and Fragment Screening.

The bromodomain and extraterminal (BET) family of bromodomain-containing proteins are important regulators of the epigenome through their ability to recognize N-acetyl lysine (KAc) post-translational modifications on histone tails. These interactions have been implicated in various disease states and, consequently, disruption of BET-KAc binding has emerged as an attractive therapeutic strategy with a number of small molecule inhibitors now under investigation in the clinic. However, until the utility of these advanced candidates is fully assessed by these trials, there remains scope for the discovery of inhibitors from new chemotypes with alternative physicochemical, pharmacokinetic, and pharmacodynamic profiles. Herein, we describe the discovery of a candidate-quality dimethylpyridone benzimidazole compound which originated from the hybridization of a dimethylphenol benzimidazole series, identified using encoded library technology, with an N-methyl pyridone series identified through fragment screening. Optimization via structure- and property-based design led to I-BET469, which possesses favorable oral pharmacokinetic properties, displays activity in vivo, and is projected to have a low human efficacious dose.

Antiplasmodial and antileishmanial activities of compounds from Piper tuberculatum Jacq fruits.

INTRODUCTION: This study assessed the activity of compounds from Piper tuberculatum against Plasmodium falciparum and Leishmania guyanensis. METHODS: The effects of compounds from P. tuberculatum fruits on P. falciparum and L. guyanensis promastigote growth in vitro were determined. Hemolytic action and cytotoxicity in HepG2 and J774 cells were measured. RESULTS: Three compounds showed strong antiplasmodial activity and one compound showed strong antileishmanial activity. Two compounds were non-toxic to HepG2 cells and all were toxic to J774 cells. The compounds showed no hemolytic activity. CONCLUSIONS: The tested compounds from P. tuberculatum exhibited antiparasitic and cytotoxic effects.

Antiplasmodial and antileishmanial activities of compounds from Piper tuberculatum Jacq fruits

Abstract INTRODUCTION This study assessed the activity of compounds from Piper tuberculatum against Plasmodium falciparum and Leishmania guyanensis. METHODS The effects of compounds from P. tuberculatum fruits on P. falciparum and L. guyanensis promastigote growth in vitro were determined. Hemolytic action and cytotoxicity in HepG2 and J774 cells were measured. RESULTS Three compounds showed strong antiplasmodial activity and one compound showed strong antileishmanial activity. Two compounds were non-toxic to HepG2 cells and all were toxic to J774 cells. The compounds showed no hemolytic activity. CONCLUSIONS The tested compounds from P. tuberculatum exhibited antiparasitic and cytotoxic effects.

Semisynthesis, cytotoxicity, antimalarial evaluation and structure-activity relationship of two series of triterpene derivatives.

In this report, we describe the semisynthesis of two series of ursolic and betulinic acid derivatives through designed by modifications at the C-3 and C-28 positions and demonstrate their antimalarial activity against chloroquine-resistant P. falciparum (W2 strain). Structural modifications at C-3 were more advantageous to antimalarial activity than simultaneous modifications at C-3 and C-28 positions. The ester derivative, 3ß-butanoyl betulinic acid (7b), was the most active compound (IC50 = 3.4 µM) and it did not exhibit cytotoxicity against VERO nor HepG2 cells (CC50 > 400 µM), showing selectivity towards parasites (selectivity index > 117.47). In combination with artemisinin, compound 7b showed an additive effect (CI = 1.14). While docking analysis showed a possible interaction of 7b with the Plasmodium protease PfSUB1, with an optimum binding affinity of -7.02 kcal/mol, the rather low inhibition displayed on a Bacillus licheniformis subtilisin A protease activity assay (IC50 = 93 µM) and the observed accumulation of ring forms together with a delay of appearance of trophozoites in vitro suggests that the main target of 3ß-butanoyl betulinic acid on Plasmodium may be related to other molecules and processes pertaining to the ring stage. Therefore, compound 7b is the most promising compound for further studies on antimalarial chemotherapy. The results obtained in this study provide suitable information about scaffolds to develop novel antimalarials from natural sources.

The use of different indicators for interpreting the local knowledge loss on medical plants

ABSTRACT The increasing loss of local ecological knowledge may have negative impacts on the resilience of socio-ecological systems and may also negatively impact bioprospecting efforts, since local ecological knowledge is an important source of information for searching new drugs. Recent studies try to evaluate whether communities are experiencing loss of local ecological knowledge. However, some of them make conclusions which are erroneously based on specific analyses of a single indicator. We propose an integrative analysis of three indicators, namely: number of plants cited by young people and elders, therapeutic choices and people's connectance in terms of medicinal plant learning. The study was carried out in the community of Sucruiuzinho (Bahia, Brazil). We conducted semistructured interviews and a therapeutic recall with 24 local dwellers. We did not find evidence of local ecological knowledge loss in the studied community. Although younger people know fewer plants, they are well connected in terms of knowledge transmission. Moreover, in illness events, young people and adults have similar proportions of choice for plants when compared to allopathy. Concomitant use of the three indicators leads to a more realistic scenario of local ecological knowledge loss than the use of only one of them.

Screening of the in vitro antileishmanial activities of compounds and secondary metabolites isolated from Maytenus guianensis Klotzsch ex Reissek (Celastraceae) chichuá Amazon.

INTRODUCTION: Maytenus guianensis is a member of the Celastraceae family that is used in traditional medicine, particularly for its anti-parasitic and anti-cancer effects. To explore the ethnopharmacological potential of this plant, the present study was designed to screen the in vitro antileishmanial activities of extracts and compounds isolated from M. guianensis. METHODS: Maytenus guianensis stems and leaves were extracted in acetone, followed by the preparation of eluates and isolation of secondary metabolites using chromatography on a glass column with silica gel as the fixed phase. The chemical components were identified using spectroscopic methods, including one- and two-dimensional nuclear magnetic resonance of hydrogen-1 and carbon-13, mass spectroscopy, and infrared spectroscopy. The anti-Leishmania amazonensis activities of these eluates and compounds were evaluated by direct promastigote counting and viability assays. RESULTS: It was found that the hexane bark eluate produced the strongest anti-L. amazonensis effect, with 90-100% inhibition of the promastigote form. The isolated metabolite that produced the best result was tingenone B, followed by a compound formed by the union of tingenone and tingenone B (80-90% inhibition). CONCLUSIONS: Maytenus guianensis shows anti-parasite activity that warrants further investigation to determine the mechanisms underlying this antileishmanial effect and to evaluate the pharmacological potential of these eluates and isolated secondary metabolites, while minimizing any adverse effects.

Screening of the in vitro antileishmanial activities of compounds and secondary metabolites isolated from Maytenus guianensis Klotzsch ex Reissek (Celastraceae) chichuá Amazon

Abstract INTRODUCTION Maytenus guianensis is a member of the Celastraceae family that is used in traditional medicine, particularly for its anti-parasitic and anti-cancer effects. To explore the ethnopharmacological potential of this plant, the present study was designed to screen the in vitro antileishmanial activities of extracts and compounds isolated from M. guianensis. METHODS Maytenus guianensis stems and leaves were extracted in acetone, followed by the preparation of eluates and isolation of secondary metabolites using chromatography on a glass column with silica gel as the fixed phase. The chemical components were identified using spectroscopic methods, including one- and two-dimensional nuclear magnetic resonance of hydrogen-1 and carbon-13, mass spectroscopy, and infrared spectroscopy. The anti-Leishmania amazonensis activities of these eluates and compounds were evaluated by direct promastigote counting and viability assays. RESULTS It was found that the hexane bark eluate produced the strongest anti-L. amazonensis effect, with 90-100% inhibition of the promastigote form. The isolated metabolite that produced the best result was tingenone B, followed by a compound formed by the union of tingenone and tingenone B (80-90% inhibition). CONCLUSIONS Maytenus guianensis shows anti-parasite activity that warrants further investigation to determine the mechanisms underlying this antileishmanial effect and to evaluate the pharmacological potential of these eluates and isolated secondary metabolites, while minimizing any adverse effects.

Antimalarial ethnopharmacology in the Brazilian Amazon / Etnofarmacologia antimalárica na Amazônia Brasileira

The preoccupation to find new drugs for the treatment of malaria is increasing steadily due to the resistance of the parasite, which is a threat to disease control, The present study describes a literature review on the antimalarial ethnopharmacology (Anti-Plasmodium falciparum - in vitro) of the Brazilian Amazon plants, It was found a great diversity of plant species in the Brazilian Amazon with potential for research of new herbal and secondary metabolites with antiplasmodial action, in addition to treating other neglected parasitic diseases, However, for these studies is needed in addition to financial support, the interaction between different laboratories and research groups for the formation of multidisciplinary and interdisciplinary teams, which will enhance the research level in the region and increase the likelihood of new antimalarial drugs discovery...

Está cada vez maior a necessidade em se buscar novos fármacos para o tratamento da malária, principalmente devido à resistência do parasito, o que é uma ameaça ao controle da doença. O presente estudo descreve uma revisão bibliográfica sobre a etnofarmacologia antimalárica (Anti-Plasmodium falciparum - in vitro) de plantas da Amazônia brasileira. Constatou-se uma grande diversidade de espécies vegetais na Amazônia brasileira com potencial para a investigação de novos fitoterápicos e metabólitos secundários com ação antiplasmodial, além do tratamento de outras parasitoses negligenciadas. Porém, para a realização desses estudos são necessários além de apoio financeiro, a interação entre diferentes laboratórios e grupos de pesquisa para a formação de equipes multidisciplinares e interdisciplinares, o que irá potencializar o nível da pesquisa na região e aumentar a probabilidade de descoberta de novos fármacos antimaláricos...

Chemical dispersants can suppress the activity of natural oil-degrading microorganisms.

During the Deepwater Horizon oil well blowout in the Gulf of Mexico, the application of 7 million liters of chemical dispersants aimed to stimulate microbial crude oil degradation by increasing the bioavailability of oil compounds. However, the effects of dispersants on oil biodegradation rates are debated. In laboratory experiments, we simulated environmental conditions comparable to the hydrocarbon-rich, 1,100 m deep plume that formed during the Deepwater Horizon discharge. The presence of dispersant significantly altered the microbial community composition through selection for potential dispersant-degrading Colwellia, which also bloomed in situ in Gulf deep waters during the discharge. In contrast, oil addition to deepwater samples in the absence of dispersant stimulated growth of natural hydrocarbon-degrading Marinobacter. In these deepwater microcosm experiments, dispersants did not enhance heterotrophic microbial activity or hydrocarbon oxidation rates. An experiment with surface seawater from an anthropogenically derived oil slick corroborated the deepwater microcosm results as inhibition of hydrocarbon turnover was observed in the presence of dispersants, suggesting that the microcosm findings are broadly applicable across marine habitats. Extrapolating this comprehensive dataset to real world scenarios questions whether dispersants stimulate microbial oil degradation in deep ocean waters and instead highlights that dispersants can exert a negative effect on microbial hydrocarbon degradation rates.

Sampling problems in Brazilian research: a critical evaluation of studies on medicinal plants

This work compiled Brazilian articles regarding medicinal plant use by local communities in order to analyze the most common sampling problems and if research characteristics can influence the presence of sampling irregularities. We focused on studies about medicinal plants that present a species-indications list and had a quantitative nature. The proportion of works with and without sampling problems was evaluated considering the journal impact factor, period of publication, community status (urban x rural), sample type, presence of testing hypothesis and presence of research questions. We found that an alarming proportion of papers had some kind of sampling problems (48.39% serious and 19.35% moderate). The most common problems were related to: lack of information regarding the sample size or the universe, small sample sizes and selection of specialists based on obscure criteria. We could not find a significant influence between our tested variables and the occurrence of sampling problems, except for the community status (urban x rural). Results indicate that a significant amount of intracultural diversity is not properly captured, taking into consideration both the population as a whole and a group of interest in the community (= healers).

Are ethnopharmacological surveys useful for the discovery and development of drugs from medicinal plants?

Ethnopharmacological and ethnobotanical approaches are described in the literature as efficient to identify plants of interest for phytochemical and pharmacological studies. In the present work, we reflect on the quality of the data collected in ethno-directed studies. In accordance to the problems identified in published studies, and their theoretical and methodological underpinnings, we believe that these studies are poorly suited to contribute to the advancement of research aimed at the development of novel drugs.

Processo de cuidar do portador de diabetes mellitus:revisão integrativa da literatura / Process of caring for patients with diabetes mellitus: an integrative literature review

Objetivo: O objetivo do presente artigo é descrever o conhecimentonacional produzido sobre o cuidado de enfermagem às pessoascom diabetes mellitus.Método: A coleta foi realizada em julho do ano de 2012, em pares,seguindo protocolo de pesquisa. Para seleção dos estudos, foramutilizados os descritores controlados “diabetes mellitus” e “cuidadosde enfermagem” em duas bases de dados científicos – LILACSe BDENF.Resultados: Inicialmente, foi encontrado um total de 155 artigos,que, seguindo critérios de inclusão e exclusão, foi reduzido a 8 artigos.Estes foram analisados segundo indicadores de coleta, quaissejam: ano de publicação, desenho metodológico e temática abordada.Os autores ressaltam problemas com os pés e comprometimentorenal como complicações mais comuns do diabetes.Conclusão: Destacou-se a relevância do processo de cuidar da enfermagemao paciente portador de diabetes mellitus, sobretudo noque diz respeito à educação em saúde, a saber, entre outros temas:técnica correta de aplicação de insulina, cuidados com os pés, orientaçõesalimentares, importância da adesão ao tratamento e do autocuidado,para que conjugando os conhecimentos técnico-científicoaos humanísticos, possa prestar um cuidado integral e individual.

Objective: The purpose of this article is to describe the nationalknowledge produced about nursing care for people with diabetesmellitus.Method: The collection was made in July 2012, in pairs, followingthe research protocol. To study selection were used descriptors controlled“diabetes mellitus” and “nursing care” in two scientific databases- LILACS and BDENF.Results: Initially, we found a total of 155 articles, which, followingthe inclusion and exclusion criteria, was reduced to 8 items. Theseindicators were analyzed according collection, which are: year ofpublication, methodological design and theme. The authors pointout problems with feet and renal impairment as the most commoncomplications of diabetes.Conclusion: They emphasized the importance of nursing’s careto patients with diabetes mellitus, especially as regards to healtheducation, among other things: correct technique of insulin delivery,foot care, dietary counseling, importance of adherence to treatmentand self-care, so that combining the technical and scientificknowledge to humanistic, can provide comprehensive and individualcare.

Polyomavirus BK: possibly associated skin eruption in a patient with hemorrhagic cystitis.

A 14-year-old girl with Fanconi anemia was submitted to allogeneic hematopoietic stem cell transplantation. After 17 days she developed hemorrhagic cystitis due to polyoma BK virus (BKV), confirmed by PCR (polymerase chain reaction). Two weeks after the appearance of the urinary symptoms the patient presented numerous papules and vesicles on both hands and feet. PCR of the skin lesions and plasma was positive for BKV. The relationship of BKV with frequent infections in immunocompromised patients is well established. The positive PCR of vesicular fluid suggests that this was the causative agent of the skin lesion in this case. There are no reports of skin lesions with positive PCR for BKV.

Nova técnica: operação de Norwood com perfusão regional cerebral e coronariana / New technique: Norwood operation with regional cerebral and coronary perfusion

Objetivo: Avaliar o resultado imediato da operação de Norwood modificado com nova técnica de perfusão regional cerebral (PRCeA) anterógrada associado a perfusão regional coronariana (PRCoR) retrógrada em substituição à parada circulatória total com hipotermia profunda em crianças portadoras da Síndrome da Hipoplasia do Coração Esquerdo (SHCE) com aorta ascendente extremamente hipoplásica (AH). Métodos: No período de dezembro de 2006 a fevereiro de 2008, a operação de Norwood modificado com tubo entre o ventrículo direito e as artérias pulmonares ou shunt tipo Sano foi realizada em oito crianças portadoras de SHCE e aorta ascendente com diâmetro inferior a 3 mm, (quatro do sexo masculino e quatro do sexo feminino) com idade média de 9,2 dias (variando de 1 a 29 dias) e peso médio de 3,3 kg (variando de 2,7 a 3,8 kg). Utilizada CEC e hipotermia a 25ºC com duas cânulas venosas e anastomose de um enxerto de politetrafluoretileno com a artéria inominada utilizado como linha arterial e para PRCeA. A PRCoR foi realizada por meio de um desvio na linha arterial e colocação de um cateter na aorta ascendente. Foram analisados o resultado cirúrgico imediato e a presença de alterações neurológicas nesse período. Resultados: O resultado cirúrgico imediato revelou mortalidade de 25 por cento e ausência de comprometimento neurológico ao exame clínico. Conclusão: A operação de Norwood modificado pode ser realizada com PRCeA e PRCoR em crianças com SHCE e AH com resultado cirúrgico imediato satisfatório e ausência de complicações neurológicas.

Objective: To assess the immediate result of the modified Norwood procedure with new technique of anterograde regional cerebral perfusion (ARCeP) and retrograde regional coronary perfusion (RRCoP) in substitution of profound hypothermia and circulatory arrest in children with hypoplastic left heart syndrome (HLHS) with extremely hypoplastic ascending aorta (HA). Methods: In the period of December of 2006 to February 2008 the modified Norwood procedure with tube between the right ventricle and pulmonary arteries or Sano shunt was performed in eight children with HLHS and with ascending aorta diameter less than 3 mm, (four male and four female) with median age of 9.2 days (ranging from 1 to 29 days) and median weigh of 3.3 kg (ranging from 2.7 to 3.8 kg). We used cardiopulmonary bypass and hypothermia at 25ºC with two venous cannulas and suture with a polytetrafluoroethylene graft sutured to the innominate artery as an arterial line and used to ARCeP. The RRCoP was performed by a deviation in the arterial line and placement of a catheter in the ascending aorta. The immediate surgical results and the clinical neurological manifestation were assessed. Results: The immediate surgical results revealed mortality of 25 percent and there were absence of neurological injury at clinical examination. Conclusions: The modified Norwood procedure can be accomplished with ARCeP and RRCoP in children with HLHS with HA with satisfactory immediate surgical result and without neurological complications.

Avaliação psicológica de depressão em pacientes internados em enfermaria de hospital geral / Psychological evaluation of depresion in in-patients of a general hospital / Evaluación psicológica de depresión en pacientes internados en enfermería de hospital general

Este trabalho foi desenvolvido em um hospital geral de São Paulo com o objetivo de realizar uma avaliação psicológica por meio da escala diagnóstica adaptativa operacionalizada (Edao) e do inventário Beck de depressão (BDI), verificando a possibilidade de detectar sintomas depressivos aliados às diferentes patologias de base que motivaram a internação do paciente. Vários são os pedidos de interconsulta por parte da equipe de saúde para que o serviço de psicologia e/ou psiquiatria avalie - e realize as intervenções necessárias - os pacientes internados em enfermarias que se apresentam ôtristes, apáticos, chorososõ. Essas solicitações demonstram a importância do diagnóstico dos transtornos depressivos. A depressão está intimamente ligada à baixa aderência ao tratamento médico e à mortalidade. Uma intervenção específica auxilia na recuperação mais rápida do paciente, aumentando sua qualidade de vida e diminuindo os gastos com a internação. Foram sujeitos da pesquisa 29 pacientes adultos, de ambos os sexos, internados em enfermaria de um hospital de São Paulo. Neste trabalho, dois pontos de corte foram utilizados: um escore de 18 a 19 que revela uma estimativa de possível depressão, e um escore acima de 15 que indica disforia e acima de 20 que revela depressão. A pesquisa teve caráter quantitativo e qualitativo, numa visão psicanalítica. Os resultados para o BDI indicam que 13,8 por cento da amostra apresentou possível depressão e 86,2 por cento não apontaram alterações. Os resultados da Edao indicam que 40 por cento da amostra apresentou adaptação eficaz, 30 por cento adaptação ineficaz moderada e 10 por cento adaptação ineficaz severa. Concluiu-se que o BDI demonstrou ser um instrumento de fácil aplicação, portanto eficiente para ajudar a detectar alterações de humor relacionadas à disforia e depressão, bem como a Edao traz para o psicólogo uma avaliação que, em conjunto com o BDI, permite-lhe avaliar o grau de adaptação dos pacientes hospitalizados.

This study was developed at General Hospital, in São Paulo, with the purpose of making a psychological evaluation through Adaptive Operational Diagnostic Scale (Edao in Portuguese) and Beck's Depression Inventory (BDI), verifying the possibility to identify depressive symptoms associated with different pathologies that motivate patient internment. Several inter-appointment requests occur by people from health group to psychological and/or psychiatry service to evaluate and interfere with in-patients that seem ôunhappy, apathetic, and weepyõ. These requests show the importance of depression disorder diagnostics. Depression is intimately linked with low adherence to medical treatment and to mortality. A specific intervention support the faster recovery of patient, improving his/her quality of life and decreasing internment expenses. In this research two cut points were made. One of them is suggested where the score from 18 to 19 would bring out an estimation of depression possibility. Second one, suggested that classify a score above 15 as disphoria and above 20 points as depression. The research was carried out with 29 adults in-patients, both genders. The research was qualitative, according to a psychoanalytical approach. The results according to the BDI were: Possible depression (13.8 percent) and No Alterations (86.2 percent). According to the Edao: 40 percent of the sample showed Efficient Adaptation; 30 percent showed Moderate Inefficient Adaptation; and 10 percent showed Severe Inefficient Adaptation. The conclusion is that the BDI showed to be an efficient instrument in helping to detect mood alterations related to disphoria and depression, and that Edao gives to the psychologist an evaluation which together with the BDI enables the understanding of the evolution of depression as well as the degree of patients' adaptation in a hospital environment.

Este trabajo fué desarrollado en un Hospital General en São Paulo con el objetivo de realizar una evaluación psicológica por medio de la escala diagnóstica adaptativa operacionalizada (Edao) y del inventario Beck de depresión (BDI), verificando la posibilidad de detectar síntomas depresivos aliados a las diferentes patologías de base que motivaron La internación del paciente. Son diversos los pedidos de interconsulta por parte del equipo de salud para que el servicio de psicología y/o psiquiatría evaluen o intervengan en los pacientes internados en enfermerías que se presentan ôtristes, apáticos, llorososõ. Estas solicitaciones demuestran la importancia del diagnóstico de los trastornos depresivos. La depresión está intimamente ligada a la baja adherencia al tratamiento médico y a la mortalidad. Una intervención específica auxilia en la recuperación más rápida del paciente, aumentando su calidad de vida y disminuyendo los gastos con la internación. Fueron sujetos de la investigación 29 pacientes adultos de los dos sexos, internados en enfermerías de un hospital de São Paulo. En este trabajo fueron utilizados dos puntos de corte, un escore de 18 a 19 revelaría una estimativa de posible depresión y el segundo, que clasifican un escore encima de 15 como disforía y encima de 20 puntos como depresión. La investigación tuvo carácter cuantitativo y cualitativo, en una visión psicoanalítica. Los resultados para el BDI indican que 13,8 por ciento de la muestra presentó posible depresión y 86,2 por ciento se presentó sin alteraciones. Los resultados de la Edao indican que 40 por ciento de la muestra presentó adaptación eficaz, 30 por ciento adaptación ineficaz moderada y 10 por ciento adaptación ineficaz severa. Se concluye que el BDI demonstró ser un instrument de fácil aplicación y por lo tanto eficiente para ayudar a detectar alteraciones de humor relacionadas a la disforía y a la depresión, bien como la Edao trae para el psicólogo una evaluación que en conjunto con...

A mídia como ferramenta de pesquisa: produção de saberes no cotidiano sobre a saúde das filhas deste solo / Mediaas a research tool: knowledge production in everyday life

Este artigo tem como objetivo discutir a mídia como ferramenta de pesquisa a partir de sua produção de saberes no cotidiano e, portanto, relações de poder. Poder aqui entendido como uma rede produtiva que atravessa todo o corpo social e que produz coisas, prazeres, formas de saber e discursos. Focalizamos o programa Fantástico, especificamente, o quadro sobre saúde apresentado pelo Dr. Drauzio Varella, que indica estatísticas sobre a população brasileira e dialoga com mulheres sobre programa de planejamento familiar. Com isso, pretendemos tornar a mídia um campo social demarcando-a como uma evidência, para em seguida, a partir das ferramentas teóricas foucaultianas problematizá-la. Assim, a mídia deixa de ser pensada como uma evidência que naturaliza os objetos dos quais fala e nos permite discuti-la, ou seja, pensá-la como algo que produz aquilo do qual fala.

This article aims at discussing media as a research tool considering its knowledge production in everyday life and, therefore, power relations. Power is understood as a productive network that traverses the whole social body and produces things, pleasures, ways of knowing, and discourses. We have focused on the television program Fantástico, more specifically, on its section dedicated to health, presented by Dr. Drauzio Varella, who presents statistics about the Brazilian population and dialogues with women about family planning programs. We intend to make media as a social field, delimiting it as evidence, so to problematize it using Foucaultian theoretical tools. Thus, media is no longer thought as an evidence that naturalizes the objects it talks about, and lets us discuss it, that is, think of it as something that produces what it talks about.