No caminho da Estratégia da Saúde da Família: itinerário terapêutico das trabalhadoras rurais durante a pandemia de covid-19 / On the way to the Family Health Strategic: therapeutic program for rural workers during the COVID-19 pandemic

Resumo Este artigo teve como objetivo descrever o itinerário terapêutico das trabalhadoras rurais durante a pandemia de covid-19. Realizou-se um estudo qualitativo por meio da metodologia da história oral temática. Foram realizadas 15 entrevistas com trabalhadoras rurais pertencentes ao território da Estratégia da Saúde da Família (ESF) de um distrito municipal do interior de Minas Gerais. As narrativas foram submetidas à análise de conteúdo proposta por Bardin. Os resultados apontaram duas categorias: "Um caminho a percorrer: desvelando o contexto e a organização da ESF no território"; e "Entre medo e (des)atenção à saúde: visibilidade para as trajetórias das trabalhadoras rurais durante a pandemia de covid-19". Na primeira categoria, revelou-se o itinerário terapêutico das trabalhadoras rurais para a busca de cuidados na ESF do território, bem como a organização do serviço de saúde local. A segunda retratou a intensificação da desatenção à saúde para com as trabalhadoras rurais. Conclui-se que, no itinerário terapêutico das trabalhadoras rurais, a utilização da ESF do território se apresentou como rede preferencial, evidenciando a premência de fortalecimento da APS rural. A pandemia de covid-19 acentuou os dilemas para a busca de cuidados de saúde, revelando a urgência de ações de saúde para esse território.

Abstract This study aimed to describe the therapeutic itinerary of rural female workers during the COVID-19 pandemic. It is a qualitative study using oral history methodology. A total of 15 interviews were carried out with rural female workers belonging to the field of the Family Health Strategy (ESF in Portuguese) of a municipal district in the state of Minas Gerais. The narratives were subjected to content analysis following Bardin. The results pointed to two categories: "A way to go: revealing the context and the organization of ESF in the area;" and "Between fear and (lack of) health assistance: visibility for the trajectories of rural female workers during the COVID-19 pandemic." The first category demonstrated the therapeutic itinerary of rural female workers aiming to access health care in the ESF of their area besides the organization of local health service. The second category illustrated the intensified lack of assistance experienced by rural workers. In conclusion, the use of ESF represented the preferred network in the therapeutic itinerary of rural workers demonstrating the urgent action to strengthen Primary Health Care in rural areas. The COVID-19 pandemic stressed the challenges concerning the search of health assistance showing the urgency of health actions for this territory.

Analysis toxicity by different methods and anxiolytic effect of the aqueous extract Lippia sidoides Cham.

Lippia sidoides Cham. (Verbenaceae) is a species often mentioned in traditional medicine due to the medicinal properties attributed to its leaves, which include antibacterial, antifungal, acaricidal and antioxidant. Several of these actions have been scientifically proven, according to reports in the literature; however, little is known about toxicological aspects of this plant. This work included studies to determine the chemical composition and toxicity tests, using several methods aiming to evaluate the safety for use of the aqueous extract of L. sidoides leaves, in addition, the anxiolytic effect on adult zebrafish was investigated, thus contributing to the pharmacological knowledge and traditional medicine concerning the specie under study. The chemical profile was determined by liquid chromatography coupled to mass spectrometry-HPLC/MS with electrospray ionization. Toxicity was evaluated by zebrafish, Drosophila melanogaster, blood cells, and Artemia salina models. 12 compounds belonging to the flavonoid class were identified. In the toxicity assays, the observed results showed low toxicity of the aqueous extract in all tests performed. In the analysis with zebrafish, the highest doses of the extract were anxiolytic, neuromodulating the GABAa receptor. The obtained results support the safe use of the aqueous extract of L. sidoides leaves for the development of new drugs and for the use by populations in traditional medicine.

Utilization of Agro-Industrial Residues in the Rearing and Nutritional Enrichment of Zophobas atratus Larvae: New Food Raw Materials.

Edible insects are a potential alternative food source of high feed conversion efficiency and protein content. Zophobas atratus is an edible insect that adapts to different diets, enabling sustainable rearing by adding value to by-products and agro-industrial residues. This study aimed to evaluate the performance and nutritional characterization of Zophobas atratus larvae fed with different proportions of grape residue. Physicochemical analysis of the diets and larvae (AOAC procedures), fatty acid profile (chromatographic techniques), metals and non-metals (inductively coupled plasma optical emission spectrometry), larval mass gain, feed conversion efficiency, and mortality rate were assessed. The replacement of 25% of the conventional diet with grape residue increased lipid, ash, and fiber contents and reduced protein, carbohydrates, and energy. It promoted greater mass gain, lower mortality rate, and reduced larval growth time by 51%. Among the replacements, 25% resulted in the second-highest content of calcium, sodium, magnesium, and zinc, and the lowest content of potassium and phosphorus in the larvae. The 100% replacement resulted in the highest amounts of C18:2n6 (27.8%), C18:3n3 (2.2%), and PUFA (30.0%). Replacing 25% of the conventional diet with grape residue is equivalent to the conventional diet in many aspects and improves several larvae performance indices and nutritional values.

Annona Genus: Traditional Uses, Phytochemistry and Biological Activities.

Species from the Annona (Anonaceae) genus are used in traditional medicine for the treatment of various diseases. Ethnobotanical studies provide information regarding the plant part and the preparation method being used, while scientific studies such as in vitro, in vivo, and clinical tests can provide evidence supporting ethnopharmacological reports, directing studies towards the isolation of compounds which may be active for specific pathologies. Annona muricata and Annona squamosa were the most commonly reported species from those studied, with Annona cherimola and Annona classiflora also standing out. Acetogenins were the most commonly isolated metabolite class due to their cytotoxic properties, with flavonoids, alkaloids, steroids, and peptides also being reported. Many species from the Annona genus have proven biological activities, such as antitumor, antioxidant, antimicrobial and antifungal. The present review had as its objective to facilitate access to ethnobotanical, chemical and biological information in order to direct future researches.

Caracterización química y evaluación de las propiedades antioxidantes y antimicrobianas del aceite de pulpa de frutas de Mauritia flexuosa L. f. / Chemical characterization and evaluation of antioxidant and antimicrobial properties of the pulp oil of fruits of Mauritia flexuosa L. f

Este estudio tuvo como objetivo caracterizar las propiedades químicas, antioxidantes y antimicrobianas del aceite de pulpa de Mauritia flexuosa L. f. (Arecaceae). La identificación química se realizó por cromatografía de gases acoplada a espectrometría de masas. Se caracterizaron las propiedades fisicoquímicas. La capacidad antioxidante se ha verificado eliminando los radicales libres, reduciendo y quelando el hierro. La actividad antimicrobiana se evaluó mediante la concentración inhibitoria mínima y la acción moduladora de los antibióticos. Los principales ácidos grasos identificados fueron ácido esteárico, ácido palmítico y ácido oleico. La acidez y el índice de saponificación están dentro de los límites establecidos por la Agencia Nacional de Vigilancia Sanitaria. El aceite mostró actividad antioxidante moderada y actividad antimicrobiana contra las cepas de Candida. También mostró efectos sinérgicos, especialmente acerca de cefotaxima contra Bacillus cereus. Los resultados sugieren el potencial de la especie como antioxidante y en terapia antimicrobiana.

This study aimed to characterize the chemical, antioxidant and antimicrobial properties of the pulp oil of Mauritia flexuosa L. f. (Arecaceae). Chemical identification was performed by gas chromatography coupled to mass spectrometry. The physicochemical properties were characterized. Antioxidant capacity has been verified by eliminating of free radicals, reducing and chelation of iron. The antimicrobial activity was evaluated by the minimum inhibitory concentration and the modulatory action of antibiotics. The major fatty acids identified were stearic acid, palmitic acid and oleic acid. The acidity and the saponification index are within the limits established by the National Sanitary Surveillance Agency. The oil showed moderate antioxidant activity and antimicrobial activity against Candida strains. It also showed synergistic effects, especially on cefotaxime against Bacillus cereus. The results suggest the potential of the species as an antioxidant and in antimicrobial therapy.

Antibiotic-Potentiating Activity of Phanostenine Isolated from Cissampelos sympodialis Eichler.

Cissampelos sympodialis Eichler is well studied and investigated for its antiasthmatic properties, but there are no data in the literature describing antibacterial properties of alkaloids isolated from this botanical species. This work reports the isolation and characterization of phanostenine obtained from roots of C. sympodialis and describes for the first time its antimicrobial and antibiotic modulatory properties. Phanostenine was first isolated from Cissampelos sympodialis and its antibacterial activities were determined. Chemical structures of the alkaloid isolate were determined using spectroscopic and chemical analyses. Phanostenine was also tested for its antibacterial activity against standard strains and clinical isolates of Escherichia coli and Staphylococcus aureus. Minimal inhibitory concentration (MIC) was determined in a microdilution assay and for the evaluation of antibiotic resistance-modifying activity. MIC of the antibiotics was determined in the presence or absence of phanostenine at sub-inhibitory concentrations. The evaluation of antibacterial activity by microdilution assay showed activity for all strains with better values against S. aureus ATCC 12692 and E. coli 27 (787.69 mm). The evaluation of aminoglycoside antibiotic resistance-modifying activity showed reduction in the MIC of the aminoglycosides (amikacin, gentamicin and neomycin) when associated with phanostenine, MIC reduction of antibiotics ranging from 21 % to 80 %. The data demonstrated that phanostenine possesses a relevant ability to modify the antibiotic activity in vitro. We can suggest that phanostenine presents itself as a promising tool as an adjuvant for novel antibiotics formulations against bacterial resistance.

Nutrição, qualidade de vida e cuidados paliativos: uma revisão integrativa / Nutrition, quality of life and palliative care: integrative review

RESUMO JUSTIFICATIVA E OBJETIVOS: A intervenção nutricional adequada promove bem-estar, controle de sintomas e melhora da qualidade de vida dos pacientes e de seus familiares. O objetivo deste estudo foi verificar se a nutrição pode ou não melhorar a qualidade de vida do paciente em cuidados paliativos. CONTEÚDO: Trata-se de uma revisão integrativa, utilizando as bases de dados Pubmed, Scielo e Medline. A pergunta norteadora foi "A terapia nutricional é capaz de melhorar a qualidade de vida dos pacientes em cuidados paliativos?". Seis artigos se enquadravam nos critérios de inclusão pré-estabelecidos. O nutricionista foi o profissional que mais orientou sobre a terapia nutricional em uso, além de fornecer esclarecimentos sobre estratégias nutricionais para redução de desconfortos ligados à alimentação. A terapia adequada deve respeitar as preferências alimentares e culturais, garantindo, assim, melhor qualidade de vida. CONCLUSÃO: A conduta nutricional em cuidados paliativos deve respeitar as decisões do paciente e de sua família e os princípios bioéticos. As intervenções nutricionais devem dar maior importância à prestação de aconselhamento e de apoio, ao invés de centrar apenas na adequação das necessidades nutricionais. O nutricionista deve orientar o paciente e sua família sobre a terapia nutricional em uso, além de fornecer orientações e esclarecimentos, a fim de prolongar a sobrevida, reduzir a perda de peso e melhorar a qualidade de vida.

ABSTRACT BACKGROUND AND OBJECTIVES: Adequate nutritional intervention promotes wellbeing, symptoms control and improved quality of life for patients and their families. This study aimed at evaluating whether nutrition may or may not improve quality of life of patients under palliative care. CONTENTS: This is an integrative review using Pubmed, Scielo and Medline databases. Guiding question was: "Is nutritional therapy able to improve quality of life of patients under palliative care?" Six articles met pre-established inclusion criteria. Nutritionists were professionals most orienting nutritional therapy, in addition to explaining nutritional strategies to minimize diet-related discomforts. Adequate therapy should respect dietary and cultural preferences, thus assuring better quality of life. CONCLUSION: Nutritional approach during palliative care should respect patients and their families' decisions and bioethics principles. Nutritional interventions should give more importance to counseling and support, instead of focusing just on matching nutritional needs. Nutritionists should orient patients and their families about nutritional therapy, in addition to giving further explanations to prolong survival, decrease weight loss and improve quality of life.