O estreito acesso das Pessoas com Deficiência aos serviços de saúde em uma capital nordestina / The limited access of People with Disabilities to health services in a northeastern capital

Resumo Analisou-se, a partir das dimensões disponibilidade-acomodação e adequação, o acesso das Pessoas com Deficiência (PcD) aos serviços de atenção especializada. Trata-se de estudo de caso de abordagem qualitativa com triangulação de fontes a partir de pesquisa documental, dados dos Sistemas de Informações em Saúde e entrevistas semiestruturadas com gestores, profissionais de saúde e PcD. Observou-se a ampliação de serviços de reabilitação no Recife, embora não tenha sido possível analisar a capacidade de produção de tais serviços. Os achados apontam para a existência de barreiras arquitetônicas e urbanísticas e insuficiência de recursos nos serviços estudados. Ademais, há um longo tempo de espera para atenção especializada e um difícil acesso às tecnologias assistivas. Pôde-se observar ainda que os profissionais têm baixa qualificação para atender às necessidades das PcD e não se tem instituído um processo de educação permanente para os trabalhadores dos diversos níveis de complexidade. Conclui-se que a instituição da Politica Municipal de Atenção Integral à Saúde da PcD não foi suficiente para garantir o acesso aos serviços de saúde com continuidade do cuidado, considerando a permanência da fragmentação da rede de atenção, ferindo, assim, o direito à saúde deste segmento.

Abstract The access of People with Disabilities (PwD) to specialized care services was analyzed on the basis of the availability-accommodation and adequacy dimensions. This is a case study with a qualitative approach and triangulation of sources based on documentary research, data from the Health Information Systems and semi-structured interviews with managers, health professionals and PwD. There was an expansion of rehabilitation services in Recife, although it was not possible to analyze the production capacity of such services. The findings point to the existence of architectural and urban barriers and insufficient resources in the services studied. Furthermore, there is a long waiting time for specialized care and difficult access to assistive technologies. It was also observed that professionals have low qualifications to meet the needs of PwD and a process of permanent education in different levels of complexity has not been instituted for workers. The conclusion drawn is that the institution of the Municipal Policy of Comprehensive Health Care for the PwD was insufficient to guarantee access to health services with continuity of care, considering the permanence of the fragmentation of the care network, thus violating the right to health of this segment.

Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy: a systematic review and meta-analysis.

BACKGROUND: Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy (CP) populations. Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients. The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function, functional capacity, respiratory muscle strength, gross motor function and quality of life in children and adolescents with CP. METHODS: We searched for randomized controlled clinical trials in PubMed/Medline, Lilacs, SciELO, EMBASE and Physiotheraphy Evidence (PEDro) from their inception until July 2022 without language restrictions. Studies that included respiratory exercises (breathing exercise program; feedback respiratory training; incentive spirometer exercise; inspiratory muscle training; and combination of respiratory exercises + incentive spirometer exercise) in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers. The mean difference (MD) and 95% confidence interval (CI) were estimated by random effect models. RESULTS: Ten studies met the eligibility criteria, including 324 children aged from 6 to 16 years. The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O (18.63-27.27, n = 55) and pulmonary function of 0.60 (0.38-0.82, n = 98) for forced vital capacity (L); 0.22 (0.06-0.39, n = 98) for forced expiratory volume at 1 second (L); and 0.50 (0.05-0.04, n = 98) for peak expiratory flow (L/min). Functional skills in daily living activities improved in the intervention group. Caregivers' assistance of daily living activities, functional capacity, gross motor function and expiratory muscle strength showed a nonsignificant improvement. Social well-being and acceptance and functioning domains improved in only one study. CONCLUSIONS: Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation. There is no consensus on the frequency, type or intensity of respiratory exercises for children with and adolescents with CP.

Análise da Política de Atenção Integral à Pessoa com Deficiência em uma capital da Região Nordeste do Brasil / Analysis of the Comprehensive Care Policy for Persons with Disabilities in a capital city in the Northeast Region of Brazil

Resumo Na cidade do Recife, a primeira formulação de uma política de saúde direcionada às pessoas com deficiência (PCD) ocorreu 14 anos após a publicação da Política Nacional. Nesse sentido, o artigo analisou o processo de formulação da Política Municipal de Atenção Integrada à Saúde da Pessoa com Deficiência da cidade do Recife em 2016. Por meio de um estudo de caso, foram estudados o contexto, atores, conteúdo e processo de formulação da política através da realização de análise documental e entrevistas com gestores, representantes do Conselho de Saúde e de entidades representativas da PCD. A Política estudada foi formulada em um macrocontexto de vulnerabilidade social acentuado pelo golpe de 2015 e por medidas severas de austeridade fiscal que têm impactado desproporcionalmente as PCD. No microcontexto, percebeu-se influência da área de Direitos Humanos, das eleições municipais e da epidemia da síndrome congênita pelo Zika vírus, que descortinou um vazio assistencial. Houve incipiente participação das PCD, que desconhecem seu conteúdo e pouco acompanham sua implementação. A participação social é fundamental para atender às necessidades das PCD, por isso, pode-se afirmar que é imperativo o estabelecimento de uma relação dialógica em torno da Política e dos desafios de sua implementação.

Abstract In the city of Recife, the first formulation of a health policy aimed at people with disabilities (PWD) took place 14 years after the publication of the National Policy. In this sense, the article has analyzed the process of formulating the Municipal Policy for Integrated Health Care for People with Disabilities in the city of Recife in 2016. Through a case study, the context, actors, content and process of policy formulation were studied through document analysis and interviews with managers, representatives of the Health Council and representative entities of PWD. The Policy studied was formulated in a macro context of social vulnerability accentuated by the 2015 coup and by severe fiscal austerity measures that have disproportionately impacted PWDs. In the micro context, the influence of the Human Rights area, municipal elections and the epidemic of the Congenital Syndrome by the Zika Virus was noticed, which revealed a care void. There was an incipient participation of PWDs, which are unaware of its content and rarely follow its implementation. Social participation is essential to meet the needs of PWDs, so it can be said that it is imperative to establish a dialogic relationship around the Policy and the challenges of its implementation.

The use of biofeedback intervention in the improvement of depression levels: a randomised trial.

OBJECTIVE: To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group. METHODS: A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher's exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2. RESULTS: The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group. CONCLUSION: The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.

Unraveling Complexity about Childhood Obesity and Nutritional Interventions: Modeling Interactions Among Psychological Factors.

As the global prevalence of childhood obesity continues to rise, researchers and clinicians have sought to develop more effective and personalized intervention techniques. In doing so, obesity interventions have expanded beyond the traditional context of nutrition to address several facets of a child's life, including their psychological state. While the consideration of psychological features has significantly advanced the view of obesity as a holistic condition, attempts to associate such features with outcomes of treatment have been inconclusive. We posit that such uncertainty may arise from the univariate manner in which features are evaluated, focusing on a particular aspect such as loneliness or insecurity, but failing to account for the impact of co-occurring psychological characteristics. Moreover, co-occurrence of psychological characteristics (both child and parent/guardian) have not been studied from the perspective of their relationship with nutritional intervention outcomes. To that end, this work looks to broaden the prevailing view: laying the foundation for the existence of complex interactions among psychological features. In collaboration with a non-profit nutritional clinic in Brazil, this paper demonstrates and models these interactions and their associations with the outcomes of a nutritional intervention.

Access to healthcare for children with Congenital Zika Syndrome in Brazil: perspectives of mothers and health professionals.

The Congenital Zika Syndrome (CZS) epidemic took place in Brazil between 2015 and 2017 and led to the emergence of at least 3194 children born with CZS. We explored access to healthcare services and activities in the Unified Health Service (Sistema Único de Saúde: SUS) from the perspective of mothers of children with CZS and professionals in the Public Healthcare Network. We carried out a qualitative, exploratory study, using semi-structured interviews, in two Brazilian states-Pernambuco, which was the epicentre of the epidemic in Brazil, and Rio de Janeiro, where the epidemic was less intense. The mothers and health professionals reported that healthcare provision was insufficient and fragmented and there were problems with follow-up care. There was a lack of co-ordination and an absence of communication between the various specialized services and between different levels of the health system. We also noted a public-private mixture in access to healthcare services, resulting from a segmented system and related to inequality of access. High reported household expenditure is an expression of the phenomenon of underfunding of the public system. The challenges that mothers and health professionals reported exposes contradictions in the health system which, although universal, does not guarantee equitable and comprehensive care. Other gaps were revealed through the outbreak. The epidemic provided visibility regarding difficulties of access for other children with disabilities determined by other causes. It also made explicit the gender inequalities that had an impact on the lives of mothers and other female caregivers, as well as an absence of the provision of care for these groups. In the face of an epidemic, the Brazilian State reproduced old fashioned forms of action-activities related to the transmitting mosquito and to prevention with an emphasis on the individual and no action related to social determinants.

Tocoyena sellowiana extract decreases bone loss in an experimental model of periodontitis in rats: Putative role for cyclooxygenase-2 and IL-1? inhibition.

Tocoyena sellowiana (Cham. & Schltdl.) K.Schum is one of the most important families of Brazilian medicinal plants. This study aimed to evaluate the effect of Tocoyena sellowiana (Cham. & Schltdl.) K.Schum ethanolic extract in a pre-clinical trial of periodontitis and to investigate possible mechanisms underlying such effects. Periodontitis was induced in Wistar rats by placing a nylon thread ligature around second upper left molars for 11 days. Rats received (per os) Tocoyena sellowiana (0.1, 1 or 10?mg?kg) or vehicle 1?h before ligature and daily until day 11. Macroscopic, histopathological, and COX-2 immunohistochemical analyses were performed to evaluate the periodontium. The gingival tissue was used to quantify the myeloperoxidase (MPO) activity and interleukin (IL)-1? levels by ELISA. Blood samples were collected to evaluate bone-specific alkaline phosphatase (BALP), the dosage of creatinine, aspartate and alanine transaminases. The liver, kidneys, spleen, and body mass variations were also evaluated. Tocoyena sellowiana decreased bone loss, reduced MPO, IL-1? levels as well as COX-2 immunostaining, and increased BALP activity. Moreover, Tocoyena sellowiana did not alter organs nor body weight. Tocoyena sellowiana reduced bone loss in rats and its efficacy was at least partially dependent upon both IL-1? and cyclooxygenase-2 inhibition.

Atenção preventiva e educativa em saúde do idoso: uma proposta de integração de saberes e práticas / Preventive care and education in elderly health: a proposal for the integration of knowledges and practices

O envelhecimento da população brasileira trouxe mudanças em seu perfil epidemiológico, como o aumento da ocorrência de doenças crônicas e incapacidades funcionais, além de maior demanda por serviços de saúde, representando um desafio para a Saúde Coletiva no conhecimento das suas especificidades. Nesse sentido, idosos do Programa de Assistência ao Idoso do SESC Minas, na cidade de Governador Valadares (MG), responderam a um questionário semi estruturado para variáveis socioeconômicas, condições de saúde e hábitos de vida a fim de se traçar um diagnóstico desta população e direcionar ações interdisciplinares educativas e preventivas como incentivo ao envelhecimento ativo. Os dados revelaram as principais doenças: hipertensão arterial (63,8%), osteoartrite (25,5%), cardiopatias (17%) e diabetes (10,6%). A poli farmácia foi identificada em 29,8% dos idosos, incluindo o uso de medicamentos alopáticos, fitoterápicos e plantas medicinais. Doze idosos (25,5%) relataram possuir lesões de pele, 72,3% informaram uso de próteses dentárias e 2,1% próteses ortopédicas. A maioria dos idosos classificou sua alimentação como saudável (85,1%), mas todos relataram algum tipo de perda funcional. Os resultados demonstram que o Programa Assistencial conta com idosos com o perfil de saúde semelhante ao da população idosa brasileira, com ampla ocorrência de doenças crônicas, edentulismo, incapacidades funcionais e elevado consumo de medicamentos. O presente estudo reforça a importância do trabalho interdisciplinar como subsídio para o desenvolvimento de intervenções mais sensíveis e eficazes, considerando a perspectiva do próprio indivíduo e suas necessidades.

The aging of the Brazilian population brought changes in their epidemiological profile: increased occurrence of chronic illnesses and functional disabilities; increased demand for health services. The knowledge of the characteristics and elements of such changes have represented a challenge to public health researchers. A preliminary attempt to meet such challenge comes from a program of assistance to the elderly in the city of Governador Valadares, Minas Gerais, Brazil, with the support of an independent agency backed by the commercial sector (SESC-Minas). A sample of individuals aged 60 and above responded to a semi-structured questionnaire to socioeconomic variables, health conditions and life styles. The survey was a research instrument for the proposal of preventive action and active ageing. The data revealed the main diseases: arterial hypertension (63.8 percent); osteoarthritis (25.5 percent); heart diseases (17%) and diabetes (10.6 percent). “`Polipharmacy” was identified in 29.8% of seniors, including the use of allopathic drugs, phytotherapy and medicinal plants. 25.5 percent reported skin lesions, 72.3% wore dentures and 2.1% orthopedic prostheses. Most elderly people claimed to follow a healthy diet (85.1%), but all reported some form of functional loss. The results suggest that the Program relies on the participation of seniors with health profile similar to the general population of Brazilian elderly, with wide occurrence of chronic diseases, edentulism and high consumption of medicines. This study reinforces the importance of interdisciplinary work as subsidy for the development of more effective interventions, taking into account the perspectives of the elderly and their needs.

Atenção preventiva e educativa em saúde do idoso: uma proposta de integração de saberes e práticas / Preventive care and education in elderly health: a proposal for the integration of knowledges and practices

O envelhecimento da população brasileira trouxe mudanças em seu perfil epidemiológico, como o aumento da ocorrência de doenças crônicas e incapacidades funcionais, além de maior demanda por serviços de saúde, representando um desafio para a Saúde Coletiva no conhecimento das suas especificidades. Nesse sentido, idosos do Programa de Assistência ao Idoso do SESC Minas, na cidade de Governador Valadares (MG), responderam a um questionário semiestruturado para variáveis socioeconômicas, condições de saúde e hábitos de vida a fim de se traçar um diagnóstico desta população e direcionar ações interdisciplinares educativas e preventivas como incentivo ao envelhecimento ativo. Os dados revelaram as principais doenças: hipertensão arterial (63,8%), osteoartrite (25,5%), cardiopatias (17%) e diabetes (10,6%). A polifarmácia foi identificada em 29,8% dos idosos, incluindo o uso de medicamentos alopáticos, fitoterápicos e plantas medicinais. Doze idosos (25,5%) relataram possuir lesões de pele, 72,3% informaram uso de próteses dentárias e 2,1% próteses ortopédicas. A maioria dos idosos classificou sua alimentação como saudável (85,1%), mas todos relataram algum tipo de perda funcional. Os resultados demonstram que o Programa Assistencial conta com idosos com o perfil de saúde semelhante ao da população idosa brasileira, com ampla ocorrência de doenças crônicas, edentulismo, incapacidades funcionais e elevado consumo de medicamentos. O presente estudo reforça a importância do trabalho interdisciplinar como subsídio para o desenvolvimento de intervenções mais sensíveis e eficazes, considerando a perspectiva do próprio indivíduo e suas necessidades. (AU)

The aging of the Brazilian population brought changes in their epidemiological profile: increased occurrence of chronic illnesses and functional disabilities; increased demand for health services. The knowledge of the characteristics and elements of such changes have represented a challenge to public health researchers. A preliminary attempt to meet such challenge comes from a program of assistance to the elderly in the city of Governador Valadares, Minas Gerais, Brazil, with the support of an independent agency backed by the commercial sector (SESC-Minas). A sample of individuals aged 60 and above responded to a semi-structured questionnaire to socioeconomic variables, health conditions and life styles. The survey was a research instrument for the proposal of preventive action and active ageing. The data revealed the main diseases: arterial hypertension (63.8 percent); osteoarthritis (25.5 percent); heart diseases (17%) and diabetes (10.6 percent). “`Polipharmacy” was identified in 29.8% of seniors, including the use of allopathic drugs, phytotherapy and medicinal plants. 25.5 percent reported skin lesions, 72.3% wore dentures and 2.1% orthopedic prostheses. Most elderly people claimed to follow a healthy diet (85.1%), but all reported some form of functional loss. The results suggest that the Program relies on the participation of seniors with health profile similar to the general population of Brazilian elderly, with wide occurrence of chronic diseases, edentulism and high consumption of medicines. This study reinforces the importance of interdisciplinary work as subsidy for the development of more effective interventions, taking into account the perspectives of the elderly and their needs. (AU)

Understanding of polyhydroxybutyrate production under carbon and phosphorus-limited growth conditions in non-axenic continuous culture.

In a waste into resource strategy, a selection of polyhydroxybutyrate (PHB)-accumulating organisms from activated sludge was achieved in an open continuous culture under acetic acid and phosphorus limitation. Once the microbial population was selected at a dilution rate (D), an increase in phosphorus limitation degree was applied in order to study the intracellular phosphorus plasticity of selected bacteria and the resulting capacity to produce PHB. Whatever D, all selected populations were able to produce PHB. At a D, the phosphorus availability determined the phosphorus-cell content which in turn fixed the amount of cell. All the remaining carbon was thus directed toward PHB. By decreasing D, microorganisms adapted more easily to higher phosphorus limitation leading to higher PHB content. A one-stage continuous reactor operated at D=0.023h(-)(1) gave reliable high PHB productivity with PHB content up to 80%. A two-stage reactor could ensure better productivity while allowing tuning product quality.

Effect of the triterpene 3ß, 6ß, 16ß-trihydroxylup-20(29)-ene isolated from the leaves of Combretum leprosum Mart. on cutaneous wounds in mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Combretum leprosum Mart. is a native species of the Caatinga, an important biome in the Brazilian semi-arid region. This species is commonly used in Brazil as a healing agent, as well as for the treatment of skin diseases. AIM OF THE STUDY: This study investigated the healing potential of the ethanolic extract (EECL) and the bioactive triterpene 3ß, 6ß, 16ß-trihydroxylup-20 (29)-ene (CLF-1) isolated from the leaves of C. leprosum. MATERIALS AND METHODS: Skin wounds (1cm(2)) were created in the dorsal zone of mice with a scalpel blade number 15. The treatment consisted in a daily topical application of 100 µl of 150 mM NaCl, EECL and CLF-1 (at 10 µg/100 µl) for 12 days. The lesions were then macro and microscopically evaluated. RESULTS: On postoperative day (POD) 2, the lesions treated with EECL and CLF-1 showed a moderate presence of vessels of the granulation tissue progressing in the dermis. The same effect was not observed in the control group. The treatment with EECL and CLF-1 stimulated angiogenesis, resulting in a rapid deposition of extracellular matrix (ECM). Moreover, the animals treated with EECL and CLF-1 showed smaller lesions on POD 7, primarily due to the contraction in the reticular dermis induced by organization of myofibroblasts, which was not observed in the group treated with NaCl. In addition, the lesions treated with EECL and CLF-1 showed ECM restructuration and presence of epithelium coating, which was not observed in the group treated with NaCl, in which the lesions showed no epithelial lining, suggesting delayed healing. CONCLUSION: CLF-1 isolated from the leaves of C. leprosum may be considered to be an important molecule for the treatment of skin lesions. However, further investigations are necessary to establish its role in chronic lesions and to elucidate the mechanism of action involved in the cutaneous healing process. To the best of our knowledge, this is the first report describing the pro-healing activity of the ethanolic extract and the triterpene 3ß, 6ß, 16ß-trihydroxylup-20(29)-ene isolated from leaves of C. leprosum.

Antimicrobial Effects of Novel Triple Antibiotic Paste-Mimic Scaffolds on Actinomyces naeslundii Biofilm.

INTRODUCTION: Actinomyces naeslundii has been recovered from traumatized permanent teeth diagnosed with necrotic pulps. In this work, a triple antibiotic paste (TAP)-mimic scaffold is proposed as a drug-delivery strategy to eliminate A. naeslundii dentin biofilm. METHODS: Metronidazole, ciprofloxacin, and minocycline were added to a polydioxanone (PDS) polymer solution and spun into fibrous scaffolds. Fiber morphology, mechanical properties, and drug release were investigated by using scanning electron microscopy, microtensile testing, and high-performance liquid chromatography, respectively. Human dentin specimens (4 × 4 × 1 mm(3), n = 4/group) were inoculated with A. naeslundii (ATCC 43146) for 7 days for biofilm formation. The infected dentin specimens were exposed to TAP-mimic scaffolds, TAP solution (positive control), and pure PDS (drug-free scaffold). Dentin infected (7-day biofilm) specimens were used for comparison (negative control). Confocal laser scanning microscopy was done to determine bacterial viability. RESULTS: Scaffolds displayed a submicron mean fiber diameter (PDS = 689 ± 312 nm and TAP-mimic = 718 ± 125 nm). Overall, TAP-mimic scaffolds showed significantly (P ≤ .040) lower mechanical properties than PDS. Within the first 24 hours, a burst release for all drugs was seen. A sustained maintenance of metronidazole and ciprofloxacin was observed over 4 weeks, but not for minocycline. Confocal laser scanning microscopy demonstrated complete elimination of all viable bacteria exposed to the TAP solution. Meanwhile, TAP-mimic scaffolds led to a significant (P < .05) reduction in the percentage of viable bacteria compared with the negative control and PDS. CONCLUSIONS: Our findings suggest that TAP-mimic scaffolds hold significant potential in the eradication/elimination of bacterial biofilm, a critical step in regenerative endodontics.

Antimicrobial effect of the triterpene 3ß,6ß,16ß-trihydroxylup-20(29)-ene on planktonic cells and biofilms from Gram positive and Gram negative bacteria.

This study evaluated the antimicrobial effect of 3ß,6ß,16ß-trihydroxylup-20(29)-ene (CLF1), a triterpene isolated from Combretum leprosum Mart., in inhibiting the planktonic growth and biofilms of Gram positive bacteria Streptococcus mutans and S. mitis. The antimicrobial activity was assessed by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The antibiofilm potential was determined by quantifying total biomass and enumerating biofilm-entrapped viable bacteria. In addition, the acute toxicity of CLF1 on Artemia sp. nauplii was also determined. The results showed that CLF1 was able in inhibiting the growth of S. mutans and S. mitis with MIC and MBC of 7.8 µg/mL and 15.6 µg/mL, respectively. CLF1 was highly effective on biofilms of both bacteria. Only 7.8 µg/mL CLF1 was enough to inhibit by 97% and 90% biomass production of S. mutans and S. mitis, respectively. On the other hand, such effects were not evident on Gram negative Pseudomonas aeruginosa and Klebsiella oxytoca. The toxicity tests showed that the LC50 of CLF1 was 98.19 µg/mL. Therefore, CLF1 isolated from C. leprosum may constitute an important natural agent for the development of new therapies for caries and other infectious diseases caused by S. mutans and S. mitis.

Antibacterial and antioxidant activities of derriobtusone A isolated from Lonchocarpus obtusus.

This study evaluated the effect of derriobtusone A, a flavonoid isolated from Lonchocarpus obtusus, on two important pathogenic bacteria, Staphylococcus aureus and Escherichia coli, as well as its antioxidant activity and toxicity. Planktonic growth assays were performed, and the inhibition of biofilm formation was evaluated. In addition, antioxidant activity was assessed by DPPH radical scavenging assay, ferrous ion chelating assay, ferric-reducing antioxidant power assay, and ß -carotene bleaching assay. Toxicity was evaluated by the brine shrimp lethality test. Results showed that derriobtusone A completely inhibited the planktonic growth of S. aureus at 250 and 500 µ g/mL; however, it did not have the same activity on E. coli. Derriobtusone A reduced the biomass and colony-forming unit (cfu) of S. aureus biofilm at concentrations of 250 and 500 µ g/mL. In various concentrations, it reduced the biofilm biomass of E. coli, and, in all concentrations, it weakly reduced the cfu. Derriobtusone A showed highly efficient antioxidant ability in scavenging DPPH radical and inhibiting ß -carotene oxidation. The compound showed no lethality to Artemia sp. nauplii. In conclusion, derriobtusone A may be an effective molecule against S. aureus and its biofilm, as well as a potential antioxidant compound with no toxicity.

Identification and modulatory activity assessment of 2-hydroxy-3,4,6-trimethoxyacetophenone isolated from croton anisodontus müll. Arg.(euphorbiaceae).

The n-hexane extract of the stem bark of Croton anisodontus yielded 2-hydroxy-3,4,6-trimethoxyacetophenone, a well-known substance, but isolated from this species for the first time. The antimicrobial and modulatory activities of the compound towards Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans, C. krusei and C. tropicalis strains were assessed. Antibiotics such as amikacin, gentamicin and neomycin were used in a sub-inhibitory concentration. Significant activity was observed towards P. aeruginosa and S. aureus 358, with p < 0.001 in association with amikacin. The present results place C anisodontus as an alternative source of 2-hydroxy-3,4,6-trimethoxyacetophenone with antibacterial potential.

O uso de alimentos e suplementos alimentares com atividade antioxidante em idosos / The use of foods and dietary supplements with antioxidant activity in the elderly

Objetivo: descrever o uso de alimentos e suplementos alimentares com atividade antioxidante em idosos frequentadores de dois centros de convivência. Metodologia: Pesquisa descritiva de abordagem quantitativa, desenvolvida no âmbito do Programa Institucional de Bolsas de Iniciação Científica da Faculdade Integral Diferencial, cujo objetivo foi descrever o uso de alimentos e suplementos alimentares com atividade antioxidante em idosos. A amostra constituiu-se de 152 sujeitos com idade igual ou superior a 60 anos e frequentadores ativos em dois Centros de Convivência da Terceira Idade no município de Teresina-Piauí, que voluntariamente se dispuseram a aceitar responder ao Termo de Consentimento Livre e Esclarecido. Utilizou-se como instrumento para coleta de dados um questionário de entrevista que abordou questões relacionadas ao conhecimento, frequência, quantidade e qualidade do consumo de frutas, legumes e verduras e suplementação alimentar. Resultados: todos os idosos pesquisados consomem algum tipo de alimento com propriedade antioxidante, predominando, majoritariamente: compostos fenólicos, carotenoides e vitamina C, com variação de frequência e, em 77,6% dos casos, associada ao uso de suplementação alimentar. Os mesmos possuem pouco conhecimento acerca da propriedade antioxidante dos alimentos. Conclusão: A grande maioria considera importante a inclusão destes na dieta. A prevalência do uso da suplementação alimentar é elevada.

Objective: To describe the use of foods and dietary supplements with antioxidant activity in elderly patrons of two centers. Methods: Descriptive study of quantitative approach, developed within the Institutional Program for Scientific Initiation Scholarships School of Integral Differential, whose aim was to describe the use of foods and dietary supplements with antioxidant activity in the elderly. The sample consisted of 152 subjects aged over 60 years and active patrons in two Centres for the Elderly Living in the city of Teresina, Piauí, who willingly volunteered to accept answer the Statement of Informed Consent. Was used as an instrument for data collection a questionnaire interview that addressed issues related to knowledge, frequency, quantity and quality of fruit, vegetables and food supplementation. Results: all seniors surveyed consume any type of food with antioxidant properties, predominantly, overwhelmingly, phenolic compounds, carotenoids, and vitamin C, with varying frequency and in 77.6% of cases associated with the use of dietary supplementation. They have little knowledge about the antioxidant properties of foods. Conclusion: The majority considers the inclusion of these in the diet. The prevalence of use of dietary supplementation is high.

Phosphorus limitation strategy to increase propionic acid flux towards 3-hydroxyvaleric acid monomers in Cupriavidus necator.

Properties of polyhydroxybutyrate-co-hydroxyvalerate (P(3HB-co-3HV)) depend on their 3HV content. 3HV can be produced by Cupriavidus necator from propionic acid. Few studies explored carbon distribution and dynamics of 3HV and 3HB monomers production, and none of them have been done with phosphorus as limiting nutrient. In this study, fed-batch cultures of C. necator with propionic acid, as sole carbon source or mixed with butyric acid, were performed. Phosphorus deficiency allowed sustaining 3HV production rate and decreasing 3HB production rate, leading to an instant production of up to 100% of 3HV. When a residual growth is sustained by a phosphorus feeding, the maximum 3HV percentage produced from propionic acid is limited to 33% (Mole.Mole(-1)). The association of a second carbon source like butyric acid lead to higher conversion of propionic acid into 3HV. This study showed the importance of the limiting nutrient and of the culture strategy to get the appropriate product.

Impact of sustaining a controlled residual growth on polyhydroxybutyrate yield and production kinetics in Cupriavidus necator.

In this study a complementary modeling and experimental approach was used to explore how growth controls the NADPH generation and availability, and the resulting impact on PHB (polyhydroxybutyrate) yields and kinetics. The results show that the anabolic demand allowed the NADPH production through the Entner-Doudoroff (ED) pathway, leading to a high maximal theoretical PHB production yield of 0.89 C mole C mole(-1); whereas without biomass production, NADPH regeneration is only possible via the isocitrate dehydrogenase leading to a theoretical yield of 0.67 C mole C mole(-1). Furthermore, the maximum specific rate of NADPH produced at maximal growth rate (to fulfil biomass requirement) was found to be the maximum set in every conditions, which by consequence determines the maximal PHB production rate. These results imply that sustaining a controlled residual growth improves the PHB specific production rate without altering production yield.

Os efeitos da música em idosos com doença de Alzheimer de uma instituição de longa permanência / The effects of music on aged Alzheimer patients in a long-term care facility / Efectos de la música en ancianos con enfermedad de Alzheimer de una institución de larga permanencia

O presente trabalho trata-se de estudo descritivo-exploratório de abordagem qualitativa, cujo objetivo foi descrever os efeitos do uso da música em idosos com Alzheimer de uma instituição de longa permanência. Participaram da pesquisa cinco idosos com Alzheimer, que compartilharam sessões musicais. Os dados foram coletados por meio de entrevistas semiestruturadas, instrumento de acompanhamento do idoso e diário de campo, sendo averiguados pela análise de conteúdo e modalidade temática. Os resultados evidenciaram os efeitos benéficos da música na vida atual do idoso, possibilitando resgate de lembranças relacionadas aos familiares, lugares e situações vivenciadas, à memória musical e à memória recente; evocação de sentimentos; expressão de manifestações corporais por meio da fisionomia facial e sua influência no controle da dor. Concluiu-se que a música proporcionou aos idosos a sensação de bem-estar, alívio da dor, relaxamento, distração e conforto.

This descriptive-exploratory study was performed using a qualitative approach with the objective to describe the effect of music on aged Alzheimer patients living in a long-term care facility. The participants were five aged Alzheimer patients who participated in musical sessions. Data collection was performed through semi-structured interviews using an instrument to evaluate the aged patients, as well as a diary. Thematic content analysis was performed. The results showed the beneficial effects of music in the current lives of the aged patients, allowing them to recover memories related to relatives, places and lived situations; to their musical memory and recent memory; in evoking feelings; making facial expressions; and on their pain control. In conclusion, music provides aged patients with a sense of wellbeing, pain relief, relaxation, entertainment and comfort.

Estudio descriptivo-exploratorio de abordaje cualitativo, cuyo objetivo fue describir los efectos del uso de la música en ancianos con Alzheimer de una institución de larga permanencia. Participaron cinco ancianos con Alzheimer, que compartieron sesiones musicales. Datos recolectados mediante entrevistas semiestructuradas, instrumento de seguimiento del anciano y diario de campo, estudiados según análisis de contenido, modalidad temática. Los resultados evidenciaron los efectos beneficiosos de la música en la vida actual del anciano, posibilitando rescate de recuerdos relacionados a los familiares, lugares reconocibles y situaciones experimentadas, a la memoria musical y a la memoria reciente; evocación de sentimientos; expresión de manifestaciones corporales mediante la fisonomía facial y su influencia en el control del dolor. Se concluye en que la música proporcionó a los ancianos una sensación de bienestar, alivio del dolor, relajamiento, distracción y comodidad.

Antimicrobial and antibiofilm action of Casbane Diterpene from Croton nepetaefolius against oral bacteria.

OBJECTIVE: The antibacterial activity of Casbane Diterpene (CD) was evaluated in vitro against Streptococcus oralis, S. mutans, S. salivarius, S. sobrinus, S. mitis and S. sanguinis. The viability of planktonic cells was analysed by susceptibility tests (MIC and MBC) and antibiofilm action was assayed. METHODS: The minimal inhibitory and bactericidal concentrations (MIC and MBC) of oral Streptococcus were evaluated through microdilution tests. To assay antibiofilm activity, biofilms were generated on 96-wells polystyrene plates under the presence of CD and quantified by a crystal violet technique and colonies forming units counting. RESULTS: The CD isolated from Croton nepetaefolius showed antimicrobial effect on planktonic forms and biofilms of oral pathogens, with MIC values of 62.5 µg/mL against Streptococcus oralis and values between 125 and 500 µg/mL against S. mutans, S. salivarius, S. sobrinus, S. mitis and S. sanguinis. CD showed an inhibitory effect on S. mutans biofilm formation at 250 µg/mL, and a decrease on viable cell of 94.28% compared to the normal biofilm growth. CONCLUSIONS: The compound CD can be considered as a promising molecule for the treatment against oral pathogens responsible for dental biofilm.