ABSTRACT
Acne vulgaris is an inflammatory dermatological pathology that affects mostly young people. However, it can also appear in adulthood, mainly in women. It has a high psychosocial impact, not only at the time of active lesions but also due to the consequences of lesions such as scarring and hyperpigmentation. Several factors are involved in the physiopathology of acne and the constant search for active ingredients is a reality, namely phytotherapeutic ingredients. Tea tree oil is an essential oil extracted from Melaleuca alternifolia (Maiden & Betch) Cheel with known antibacterial, anti-inflammatory, and antioxidant properties, making it a candidate for the treatment of acne. This review aims to describe the various properties of tea tree oil that make it a possible ingredient to use in the treatment of acne and to present several human studies that have evaluated the efficacy and safety of using tea tree oil in the treatment of acne. It can be concluded that tea tree oil has good antibacterial, anti-inflammatory, and antioxidant properties that result in a decrease in the number of inflammatory lesions, mainly papules, and pustules. However, given the diversity of study designs, it is not possible to draw concrete conclusions on the efficacy and safety of this oil in the treatment of acne.
ABSTRACT
O presente Relatório de Estágio de cunho profissional (Parte I), surge no âmbito do Mestrado de Enfermagem à Pessoa em Situação Crítica da Escola Superior de Saúde do Instituto Politécnico de Leiria, tendo como objetivo relatar e evidenciar, através de uma análise reflexiva, as competências comuns e específicas do enfermeiro especialista em Enfermagem Médico-Cirúrgica na área de Enfermagem à Pessoa em Situação Crítica, desenvolvidas ao longo de três ensinos clínicos (EC) propostos. Para o desenvolvimento das competências comuns e específicas e aprimoramento das práticas de enfermagem no cuidado à pessoa em situação crítica, os EC decorreram entre 2019 e 2020, em três locais distintos, nomeadamente: Serviço de Urgência Geral do Hospital Santo André (Leiria), Serviço de Medicina Intensiva do Hospital Santo André (Leiria) e no Centro de Diálise DaVita (Leiria). O componente de investigação (Parte II) deste relatório foi desenvolvido através de uma Revisão Sistemática da Literatura (RSL), tendo como objetivo sintetizar as evidencias científicas relativamente à eficácia da musicoterapia aplicada pelos enfermeiros no alívio da dor em doentes críticos. A musicoterapia, em consonância com o tratamento alopático, proporcionam ao doente um desfecho positivo, proporcionando um importante espaço para reconhecer e amenizar as dores e angustias vivenciadas pelo doente em cuidados críticos. Ressalta-se o potencial da musicoterapia como estratégia para melhorar o enfrentamento e potencializar o relacionamento terapêutico e humanizado ao doente crítico.
Subject(s)
Pain , Patients , Nurse's Role , Critical Care Nursing , Medical-Surgical Nursing , Music TherapyABSTRACT
Diabetic foot ulcers (DFUs) are major complications of Diabetes mellitus being responsible for significant morbidity and mortality. DFUs frequently become chronically infected by a complex community of bacteria, including multidrug-resistant and biofilm-producing strains of Staphylococcus aureus and Pseudomonas aeruginosa. Diabetic foot infections (DFI) are often recalcitrant to conventional antibiotics and alternative treatment strategies are urgently needed. Antimicrobial Peptides (AMPs), such as pexiganan and nisin, have been increasingly investigated and reported as effective antimicrobial agents. Here, we evaluated the antibacterial potential of pexiganan and nisin used in combination (dual-AMP) to control the growth of planktonic and biofilm co-cultures of S. aureus and P. aeruginosa clinical strains, co-isolated from a DFU. A DFU collagen three-dimensional (3D) model was used to evaluate the distribution and efficacy of AMPs locally delivered into the model. The concentration of pexiganan required to inhibit and eradicate both planktonic and biofilm-based bacterial cells was substantially reduced when used in combination with nisin. Moreover, incorporation of both AMPs in a guar gum delivery system (dual-AMP biogel) did not affect the dual-AMP antimicrobial activity. Importantly, the application of the dual-AMP biogel resulted in the eradication of the S. aureus strain from the model. In conclusion, data suggest that the local application of the dual-AMPs biogel constitutes a potential complementary therapy for the treatment of infected DFU.
ABSTRACT
Diabetic patients frequently develop diabetic foot ulcers (DFUs), particularly those patients vulnerable to Staphylococcus aureus opportunistic infections. It is urgent to find new treatments for bacterial infections. The antimicrobial peptide (AMP) nisin is a potential candidate, mainly due to its broad spectrum of action against pathogens. Considering that AMP can be degraded or inactivated before reaching its target at therapeutic concentrations, it is mandatory to establish effective AMP delivery systems, with the natural polysaccharide guar gum being one of the most promising. We analysed the antimicrobial potential of nisin against 23 S. aureus DFU biofilm-producing isolates. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC) and minimum biofilm eradication concentration (MBEC) were determined for nisin diluted in HCl and incorporated in guar gum gel. Statistical analysis was performed using the Wilcoxon matched-pair test. Nisin was effective against all isolates, including some multidrug-resistant clinical isolates, independent of whether it is incorporated in guar gum. While differences among MIC, MBC and MBIC values were observed for HCl- and guar gum- nisin, no significant differences were found between MBEC values. Inhibitory activity of both systems seems to differ only twofold, which does not compromise guar gum gel efficiency as a delivery system. Our results highlight the potential of nisin as a substitute for or complementary therapy to current antibiotics used for treating DFU infections, which is extremely relevant considering the increase in multidrug-resistant bacteria dissemination. The guar gum gel represents an alternative, practical and safe delivery system for AMPs, allowing the development of novel topical therapies as treatments for bacterial skin infections.