Effects of photobiomodulation therapy on functional recovery, angiogenesis and redox status in denervated muscle of rats.

OBJECTIVE: To evaluate the effects of photobiomodulation therapy in redox status, angiogenesis marker - vascular endothelial growth factor - and in the functional recovery in denervated muscle. METHODS: A total of 32 female Wistar rats underwent a crush injury and were randomly divided into four groups: Light Emitting Diode Group 2 and Control Group 2 (muscle collected 2 days after injury), and Light Emitting Diode Group 21 and Control Group 21 (muscle collected 21 days afterinjury). Light Emitting Diode Group 2 and Light Emitting Diode Group 21 received two and ten light emitting diode applications (630±20nm, 9J/cm2, 300mW), respectively, and the Control Group 2 and Control Group 21 did not receive any treatment. The function was evaluated by grasping test at four moments (pre-injury, 2, 10 and 21 post-injury days). The flexor digitorum muscle was collected for analysis of immunolocalization of vascular endothelial growth factor and redox parameters. RESULTS: Functional improvement was observed at the second and tenth post-injury day in treated groups compared to control (p<0.005). The muscle tissue of treated groups presented higher immunohistochemical expression of vascular endothelial growth factor. Photobiomodulation therapy decreased the oxidative damage to lipid in Light Emitting Diode Group 2 compared to Control Group 2 (p=0.023) in the denervated muscle. CONCLUSION: Photobiomodulation therapy accelerated the functional recovery, increased angiogenesis and reduced lipid peroxidation in the denervated muscle at 2 days after injury.

Açai (Euterpe oleracea Mart.) Seed Extract Induces ROS Production and Cell Death in MCF-7 Breast Cancer Cell Line.

Euterpe oleracea Mart. (açai) is a native palm from the Amazon region. There are various chemical constituents of açai with bioactive properties. This study aimed to evaluate the chemical composition and cytotoxic effects of açai seed extract on breast cancer cell line (MCF-7). Global Natural Products Social Molecular Networking (GNPS) was applied to identify chemical compounds present in açai seed extract. LC-MS/MS and molecular networking were employed to detect the phenolic compounds of açai. The antioxidant activity of açai seed extract was measured by DPPH assay. MCF-7 breast cancer cell line viability was evaluated by MTT assay. Cell death was evaluated by flow cytometry and time-lapse microscopy. Autophagy was evaluated by orange acridin immunofluorescence assay. Reactive oxygen species (ROS) production was evaluated by DAF assay. From the molecular networking, fifteen compounds were identified, mainly phenolic compounds. The açai seed extract showed cytotoxic effects against MCF-7, induced morphologic changes in the cell line by autophagy and increased the ROS production pathway. The present study suggests that açai seed extract has a high cytotoxic capacity and may induce autophagy by increasing ROS production in breast cancer. Apart from its antioxidant activity, flavonoids with high radical scavenging activity present in açai also generated NO (nitric oxide), contributing to its cytotoxic effect and autophagy induction.

Effects of Photobiomodulation Therapy (LED 630 nm) on Muscle and Nerve Histomorphometry after Axonotmesis.

Peripheral injuries constitute a substantial clinical problem with unsatisfactory treatment. The study's objective was to analyze the effects of photobiomodulation therapy (PBMT) on median nerve regeneration and muscle recovery after axonotmesis. Twenty-four rats were randomized into three groups: control (CG), injury (IG), and LED therapy (LEDG). A 630 ± 20 nm (300-mW) LED was placed in contact with the skin. One point over the injury site was irradiated for 30 s, delivering 9 J (9 J cm-2 ). PBMT irradiation was performed once daily for 5 days followed by two-day interval and then more five consecutive days of treatment. Proximal and distal segments of the nerve and flexors muscles were removed for histomorphometric analysis using H&E staining for muscles and osmium tetroxide for nerves. The myelinated fiber and axon diameter and the myelin sheath thickness were greater in the proximal and distal nerve segments in the LEDG compared to the IG (P ≤ 0.05). The number of myelinated fibers was greater in the distal segment of the LEDG (P ≤ 0.05). The area, circumference, and diameter of the muscle fibers were larger in the LEDG than in the IG (P ≤ 0.05). The PBMT protocol used favored axonal regeneration and muscle recovery.

Photobiomodulation Therapy (Light-Emitting Diode 630 nm) Favored the Oxidative Stress and the Preservation of Articular Cartilage in an Induced Knee Osteoarthritis Model.

Objective: To evaluate the effects of photobiomodulation (PBM) therapy on oxidative stress and histological aspects of knee osteoarthritis (OA) induced by sodium monoiodoacetate in Wistar rats. Background: OA is a chronic degenerative disease. In addition to the inflammatory role, other factors, such as redox balance, appear to contribute to changes in the articular cartilage, the main articular structure affected. PBM therapy using light-emitting diode (LED) has been proposed to treat the disease by favoring anti-inflammatory effects and modulating markers of oxidative stress, acting on the degenerative process of cartilage. Methods: Twenty-seven male rats were separated into three groups: control (CG), OA (OAG), and LED treatment (LEDG). In the LED group, PBM (LED 630 nm, 300 mW, 9 J/cm2, 0.3 W/cm2, 30 sec) was applied, starting 24 h after induction, three times per week, for 8 weeks. Cartilage thickness, number of chondrocytes, enzymatic antioxidant defenses [superoxide dismutase (SOD) and catalase (CAT)], oxidative damage [thiobarbituric acid reactive substances (TBARS)], and nonenzymatic defense (ferric reducing antioxidant power) were analyzed. Results: The LEDG had higher average cartilage thickness compared with the OAG and had similar thickness to the CG. Also, the number of chondrocytes was similar to the CG. In the oxidative stress analysis, the LEDG presented antioxidant enzymatic activity (SOD and CAT) higher than the CG, and presented concentration of TBARS lower than the CG and OAG groups. Conclusions: PBM therapy was effective in recovering oxidative stress and preserving the articular cartilage aspects in a knee OA animal model.

Acute supplementation with beetroot juice improves endothelial function in HIV-infected individuals.

Human immunodeficiency virus (HIV) is associated with lower nitric oxide (NO) bioavailability and vascular dysfunction. Nitrate-rich beetroot juice (BJ) has been shown to acutely increase NO availability and vascular function in healthy and individuals at high risk for cardiovascular disease. Thus, we tested the effects of BJ ingestion on flow-mediated dilation (FMD) and pulse wave velocity (PWV) measurements in healthy and HIV-infected patients. Thirteen HIV-infected individuals (age, 36 ± 10 years) and 18 healthy (age, 27 ± 8 years) participated in the study. Individuals were submitted to vascular tests such as FMD and pulse PWV at pre (T0) and at 120 min (T120) after BJ and placebo (PLA) ingestion. The %FMD at T0 of the control group was significantly higher than the %FMD at T0 of the HIV individuals in both interventions. BJ improved the %FMD at T120 when compared with T0 in the HIV and control groups. There was no change in %FMD after PLA ingestion in the control and HIV groups. There were no differences between groups (control vs HIV), time points (T0 vs T120), and interventions (BJ vs PLA) for PWV. Our findings showed that nitrate-rich BJ ingestion acutely improved vascular function in healthy and HIV-infected patients. Clinical Trials Registry no. NCT03485248. Novelty: HIV is associated with lower NO bioavailability and vascular dysfunction. Acute supplementation with nitrate-rich BJ has been shown to acutely increases NO bioavailability. We showed for the first time that BJ acutely improves endothelial function in HIV-infected patients.

Photobiomodulation therapy on expression of HSP70 protein and tissue repair in experimental acute Achilles tendinitis.

The aim of the present study was to investigate the effects of photobiomodulation (PBM) therapy on the expression of heat shock protein 70 (HSP70) and tissue repair in an experimental model of collagenase-induced Achilles tendinitis. Thirty Wistar rats (aged 12 weeks) were randomly distributed among control group (n = 8), tendinitis group (n = 11), and LED group (n = 11). Tendinitis was induced in the tendinitis and LED groups through a peritendinous injection of collagenase (100 µl). The LED group animals received the first irradiation 1 h after injury. A 630 ± 20 nm, 300-mW continuous wave light-emitting diode (LED), spot size 1 cm2, was placed in contact with the skin. One point over the tendon was irradiated for 30 s, delivering 9 J (9 J/cm2). LED irradiation was performed once daily for 7 days, with the total energy delivered being 63 J. The tendons were surgically removed and expression of the HSP70 protein was calculated using semi-quantitative analyses of immunohistochemistry (HSCORE). Number of fibroblasts and amount of collagen were measured using histological and histochemical analyses. An increase in the mean HSCORE for HSP70, in the number of fibroblasts, and in the amount of collagen were found in the LED group compared with those in the tendinitis and control group (P ≤ 0.05). PBM therapy increased the expression of the HSP70, number of fibroblasts, and amount of collagen in the acute Achilles tendinitis in rats.

Effects of photobiomodulation therapy on functional recovery, angiogenesis and redox status in denervated muscle of rats / Efeitos da terapia de fotobiomodulação na recuperação funcional, na angiogênese e no estado redox em músculo desnervado de ratos

ABSTRACT Objective: To evaluate the effects of photobiomodulation therapy in redox status, angiogenesis marker - vascular endothelial growth factor - and in the functional recovery in denervated muscle. Methods: A total of 32 female Wistar rats underwent a crush injury and were randomly divided into four groups: Light Emitting Diode Group 2 and Control Group 2 (muscle collected 2 days after injury), and Light Emitting Diode Group 21 and Control Group 21 (muscle collected 21 days afterinjury). Light Emitting Diode Group 2 and Light Emitting Diode Group 21 received two and ten light emitting diode applications (630±20nm, 9J/cm2, 300mW), respectively, and the Control Group 2 and Control Group 21 did not receive any treatment. The function was evaluated by grasping test at four moments (pre-injury, 2, 10 and 21 post-injury days). The flexor digitorum muscle was collected for analysis of immunolocalization of vascular endothelial growth factor and redox parameters. Results: Functional improvement was observed at the second and tenth post-injury day in treated groups compared to control (p<0.005). The muscle tissue of treated groups presented higher immunohistochemical expression of vascular endothelial growth factor. Photobiomodulation therapy decreased the oxidative damage to lipid in Light Emitting Diode Group 2 compared to Control Group 2 (p=0.023) in the denervated muscle. Conclusion: Photobiomodulation therapy accelerated the functional recovery, increased angiogenesis and reduced lipid peroxidation in the denervated muscle at 2 days after injury.

RESUMO Objetivo: Avaliar os efeitos da terapia de fotobiomodulação no estado redox, no marcador de angiogênese - fator de crescimento endotelial vascular - e na recuperação funcional do músculo desnervado. Métodos: Um total de 32 ratas Wistar foi submetido a uma lesão por esmagamento e dividido aleatoriamente em quatro grupos: Grupo Diodo Emissor de Luz 2 e Grupo Controle 2 (músculo coletado 2 dias após a lesão), além do Grupo Diodo Emissor de Luz 21 e do Grupo Controle 21 (músculo coletado 21 dias após a lesão). Grupo Diodo Emissor de Luz 2 e Grupo Diodo Emissor de Luz 21 receberam duas e dez aplicações de diodo emissor de luz (630±20nm, 9J/cm2e 300mW), respectivamente, e Grupo Controle 2 e Grupo Controle 21 não receberam tratamento. A função foi avaliada pelo teste de preensão em quatro momentos (pré-lesão, 2, 10 e 21 dias após a lesão). O músculo flexor dos dedos foi coletado para análise dos parâmetros redox e da imunolocalização do fator de crescimento endotelial vascular. Resultados: Houve melhora funcional no segundo e décimo dia pós-lesão nos grupos tratados em comparação aos controles (p<0,005). O tecido muscular dos grupos tratados apresentou maior expressão imuno-histoquímica do fator de crescimento endotelial vascular. A terapia de fotobiomodulação diminuiu o dano oxidativo aos lipídeos no Grupo Diodo Emissor de Luz 2 comparado ao Grupo Controle 2 (p=0,023) no músculo desnervado. Conclusão: A terapia de fotobiomodulação acelerou a recuperação funcional, aumentou a angiogênese e reduziu a peroxidação lipídica no músculo desnervado 2 dias após a lesão.

Goiter in Brazilian modernism paintings / Bócio em pinturas da arte moderna brasileira

Objective: To evaluate Di Cavalcanti's artworks in which goiters are represented before and after the introduction of iodized salt to the Brazilian population. Methods: One hundred and thirty paintings by Di Cavalcanti from the 20's to 70's demonstrating necks were evaluated. All the paintings were observed in reproductions. The neck circumference in the paintings was measured. Since there were no standard thresholds of neck circumference, cutoffs were based on the median. Baseline characteristics of artworks were compared based on high and normal neck circumference categories using Student's t-test, Mann-Whitney-Wilcoxon test, or chi square test. Results: We analyzed 29 artworks which portray the neck of 60 women (84.5%), 8 men (11.3%) and 3 children (4.2%). The analyses of the neck circumference showed 23.3% of women (14/60), 12.5% of men (1/8), and 33.3% of children (1/3) with an abnormal profile of the neck circumference. The neck circumference ratio in 29 paintings showed that the relative sizes of the necks painted between the 1920's and 1950's (r=0.45; p=0.03), and painted between the 1960's and 70's (r= 0.54; p=0.003) have linearly decreased. The decades in which the artworks were painted explained 40.0% of the variation in size of the neck circumference (p=0.002). Conclusion: Art imitates life. Di Cavalcanti was not a physician, and probably did not have the intention to illustrate a pathological condition, although the images observed in this study should be considered as goiter or enlarged neck.

Objetivo: Avaliar as obras de Di Cavalcanti em que bócios estão representados, antes e após a introdução da iodação do sal para a população brasileira. Método: Foram avaliadas 130 pinturas de Di Cavalcanti entre os anos 1920 e 1970 demonstrando pescoços. Todas as pinturas foram observadas em reproduções. A circunferência do pescoço nas pinturas foi mensurada. Como não existia limite-padrão da circunferência do pescoço, os limites foram baseados na mediana. As características básicas das obras de arte foram comparadas por categorias da circunferência do pescoço em elevadas e normais, usando o teste t de Student, o teste de Mann-Whitney-Wilcoxon ou o teste qui-quadrado. Resultados: Analisamos 29 obras de arte que representavam o pescoço de 60 mulheres (84,5%), 8 homens (11,3%) e 3 crianças (4,2%). Ao analisar a circunferência do pescoço, 23,3% das mulheres (14/60), 12,5% dos homens (1/8) e 33,3% das crianças (1/3) demonstraram perfil anormal dela. A relação da circunferência do pescoço em 29 pinturas demonstrou que as circunferências do pescoço relativas aos pescoços pintados entre os anos 1920 e 1950 (r=0,45; p=0,03) e pintados entre os anos 1960 e 1970 (r=0,54; p=0,003) reduziram linearmente. As décadas em que as obra foram pintadas explicaram 40,0% da variação no tamanho da circunferência do pescoço (p=0,002). Conclusão: A arte imita a vida. Di Cavalcanti não era médico e, provavelmente, não tinha intenção de ilustrar uma condição patológica, embora as observações das imagens, neste estudo, tenham sido consideradas como bócio ou com aumento de volume do pescoço

Therapeutic Use of Scoparia dulcis Reduces the Progression of Experimental Osteoarthritis.

Pain is recognized as one of the main symptoms in knee osteoarthritis and is the main reason why patients seek medical attention. Scoparia dulcis has been popularly used to relieve discomfort caused by various painful conditions. The objective of the study is to evaluate the analgesic and anti-inflammatory effect of the crude extract of S. dulcis, in an experimental model of osteoarthritis. The experiment was performed with Wistar rats divided into 4 groups with 5 animals each: healthy, saline, crude extract, and meloxicam groups. Knee osteoarthritis was induced by intra-articular injection of sodium mono-iodoacetate. First, clinical parameters of pain were assessed at days 0, 5, 10, 15, and 20 after induction. Second, the potential cyclooxygenase inhibition was evaluated, and the cytokines of the synovial fluid were quantified. An in silico test and Molecular Docking tests were performed. A histopathological evaluation was made on articular cartilage with safranin O staining. The results showed that a 15-day treatment with crude extract reduced edema, spontaneous pain, peripheral nociceptive activity, and proinflammatory cytokines in the synovial fluid. The highest inhibition of cyclooxygenase 2 in the crude extract occurred at 50 µg/mL. The crude extract of S. dulcis presents therapeutic potential for the treatment of osteoarthritis due to its anti-inflammatory and anti-nociceptive action.

High dose gabapentin does not alter tumor growth in mice but reduces arginase activity and increases superoxide dismutase, IL-6 and MCP-1 levels in Ehrlich ascites.

OBJECTIVES: The purpose of this study was to evaluate the effect of gabapentin on Ehrlich tumor growth in Swiss mice, a highly aggressive and inflammatory tumor model. Mice were grouped into sets of 5 animals and treated from days 2 to 8 with gabapentin 30 mg/kg body weight (G30) or 100 mg/kg body weight (G100), or normal sterile saline (control). RESULTS: The mice were euthanized on day 10. Tumor growth, tumoricidal agents and inflammatory cytokines levels were assessed. At day 10, G30 and G100 mice gained weight, but there were no differences in tumor cell count or in ascites volume. In G100, there was a reduction in arginase and an increase in SOD activities. There was an increase in IL-6 and MCP-1 levels, especially in G100, but no alterations in TNF-α. There was no direct evidence of tumor induction by gabapentin. However, the findings suggest that its use modulates immune response to a more effector and less deleterious profile, with increase in activity of anti-oxidant enzymes and in cytokines that favor activation of macrophages, which could improve the general status of the tumor host.

Treatment of chronic osteoarthritic hip pain with phenol neurolysis of the obturator nerve Quadfen1 / Tratamento da dor crônica na osteoartrite do quadril com neurólise do nervo obturador com fenol Quadfen1

The conservative treatment of osteoarthritis (OA) of the hip is essentially symptomatic, seeking to relieve pain and optimize function. Despite presenting great clinical effect, hip arthroplasty may have restrictions, and in these situations, the neurolytic blockade of the anterior branch of the obturator nerve can be a therapeutic alternative, since it stops the afferent pain from the hip joint. Objective: To describe the results of treating patients with severe OA of the hip by applying phenol to the obturator nerve. Method: Twelve consecutive patients with OA of the hip, refractory to conservative treatment, were recruited to have the obturator nerve localized through electrostimulation and blocked with phenol. They were evaluated in terms of pain intensity via the visual analogue scale (VAS), pressure dolorimetry in the medial and lateral gluteus medius, gluteus minimus, and piriformis, and quality of life by the Harris Hip Score (HHS) at baseline (BL) after 1 (M1), 2 (M2), and 6 months (M6). Results: The patients were between 30 and 72 years old with an avarege of 47.5 ± 1.7 years old, 5 of them were women. Three patients were excluded for not being able to come for follow up evaluations. VAS values vaieded from 8.2 ±.0.9 at BL to 6.6 ± 1.7 at M1, 6.5 ± 1.7 at M2, and 7.3 ± 1 in M6 (p=0.0094). As to the HHS, the values were BL:33.27 ± 2.9; M1:39.2 ± 6.4; M2:40.2 ± 8.1, and M6: 38.8 ± 9.7 in the final evaluation (p=0,040). For dolorimetry, non significant variation was BL: 11±5.7, M1: 7.9±2.2; M2: 10.9±5.6; M6: 8.1 ± 1.6 (p 0.69). Conclusion: The application of phenol to the anterior branch of the obturator nerve can be an alternative in the treatment of severe OA of the hip in patients with restrictions to Total Hip Replacement (THR), since it reduces pain and improves quality of life.

O tratamento conservador da osteoartrite (OA) do quadril é essencialmente sintomático, visando alívio da dor e otimização da funcionalidade. Apesar de apresentar grande efeito clínico, a artroplastia quadril pode ter restrições, nestas situações o bloqueio do ramo anterior do nervo obturador (RAO) pode ser uma alternativa terapêutica, uma vez que interrompe a aferência dolorosa da articulação do quadril. Objetivo: Descrever os resultados do tratamento de pacientes com OA grave do quadril por meio da aplicação de fenol no nervo obturatório. Método: Nove pacientes com OA de quadril resistente ao tratamento conservador que se apresentaram consecutivamente ao nosso serviço foram submetidos à aplicação de fenol no nervo obturatório com localização por meio de eletroestimulação e avaliados quanto a intensidade de dor pela escala visual analógica (EVA), dolorimetria de pressão e qualidade de vida pelo Haris Hip Score (HHS) após 01, 02 e 06 meses. Resultados: Foram selecionados 12 pacientes que preenchiam os critérios de inclusão e exclusão, destes, 3 foram excluídos após não conseguirem mais comparecer para as avaliações. Os valores médios de EVA variaram de 8,2 ±.0,9 na medida basal para 6,6 ± 1,7 ao final de um mês, 6,5 ± 1,7 ao final de dois meses e 7,3 ± 1 com 06 meses (p=0,0094). Quanto ao HHS, os valores foram 33,27 ± 2,9; 39,2 ± 6,4; 40,2 ± 8,1 e 38,8 ± 9,7, na avaliação final. A última variável analisada foi a Dolorimetria, onde foi realizada a média entre os valores atingidos pela avaliação com o dolorímetro no glúteo médio medial, glúteo médio lateral, glúteo mínimo e piriforme. Na avaliação inicial média de 11±5,7, 7,9±2,2 no final do primeiro mês, 10,9±5,6 no segundo e no 6º mês 8,1±1,6. Ao aplicarmos o teste ANOVA, não foi observado diferença estatística (p 0,69). Conclusão: A aplicação de Fenol em RAO pode ser uma alternativa no tratamento da OA de quadril grave em pacientes com restrições à realização de ATQ, pois implica em redução da dor e melhora da qualidade de vida.

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.

Antileishmanial and Immunomodulatory Effect of Babassu-Loaded PLGA Microparticles: A Useful Drug Target to Leishmania amazonensis Infection.

The immunological and the anti-Leishmania amazonensis activity of babassu-loaded poly(lactic-co-glycolic acid) [PLGA] microparticles was evaluated. The anti-Leishmania activity was evaluated against promastigotes or amastigotes forms, in Balb/c macrophages. The size of the microparticles ranged from 3 to 6.4 µm, with a zeta potential of -25 mV and encapsulation efficiency of 48%. The anti-Leishmania activity of the PLGA microparticles loaded with the aqueous extract of babassu mesocarp (MMP) (IC50) was 10-fold higher than that free extract (Meso). MMP exhibited overall bioavailability and was very effective in eliminating intracellular parasites. MMP also reduced ex vivo parasite infectivity probably by the increased production of nitric oxide, hydrogen peroxide, and TNF-α indicating the activation of M1 macrophages. The overexpression of TNF-α did not impair cell viability, suggesting antiapoptotic effects of MMP. In conclusion, babassu-loaded microparticles could be useful for drug targeting in the treatment of leishmaniasis, due to the immunomodulatory effect on macrophage polarization and the increased efficacy as an anti-Leishmania product after the microencapsulation. These findings are of great relevance since the development of new drugs for the treatment of neglected diseases is desirable, mainly if we consider the high morbidity and mortality rates of leishmaniasis worldwide.

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.

Indicadores de qualidade em terapia nutricional em uma unidade de terapia intensiva de trauma, Curitiba, PR, Brasil / Quality indicators in nutritional therapy in a trauma intensive care unit, Curitiba, PR, Brazil

Introdução: Os indicadores de qualidade em terapia nutricional são instrumentos avaliativos de efetividade da terapêutica empregada, que objetivam a melhora no desempenho dos procedimentos, bem como, o aprimoramento do cuidado nutricional e em saúde aos pacientes. Objetivo: Aplicar indicadores de qualidade em terapia nutricional enteral (TNE) em uma unidade de terapia intensiva (UTI) de trauma no município de Curitiba, PR, Brasil e comparar os resultados obtidos entre os anos de 2014 e 2015. Métodos: Estudo observacional descritivo retrospectivo composto por dados coletados de fichas de acompanhamento nutricional de pacientes com idade igual ou superior a 18 anos, internados nos anos de 2014 e 2015 em uma UTI de trauma em Curitiba, PR, que receberam TNE exclusiva. Sexo, idade, diagnóstico médico, tempo para iniciar a infusão da dieta, tempo decorrido entre o dia da admissão do paciente na UTI ao primeiro dia em que este recebeu 50% da meta energética proposta, volume prescrito, volume infundido e intercorrências relacionadas ao trato gastrointestinal (TGI) foram coletados das fichas de acompanhamento nutricional. Os indicadores de qualidade aplicados foram: (1) frequência de pacientes em jejum antes do início da TNE; (2) taxa de pacientes em TNE que atingiram 50% ou mais do valor energético total (VET) em até 7 dias; (3) frequência de intercorrências relacionadas ao TGI; (4) frequência de episódios de diarreia; (5) adequação do volume infundido em relação ao prescrito em pacientes em TNE. Resultados: Um total de 338 pacientes foram avaliados, sendo 194 indivíduos avaliados no ano de 2014 e 144 indivíduos no ano de 2015, com predomínio de diagnóstico de traumatismo craniano (82% casos em 2014 e 73% casos em 2015). O indicador de qualidade (1) apresentou 21 e 14% de frequência de pacientes em jejum antes do início da TNE em 2014 e 2015, respectivamente, o indicador de qualidade (2) obteve 78 e 92% de taxa de pacientes em TNE que atingiram 50% ou mais do VET em até 7 dias nos anos de 2014 e 2015, respectivamente, o indicador de qualidade (3) demonstrou 34% e 33% de frequência de intercorrências relacionas ao TGI nos anos de 2014 e 2015, respectivamente. O indicador de qualidade (4) evidenciou 24 e 31% da frequência de episódios de diarreia nos anos de 2014 e 2015, respectivamente e o indicador de qualidade (5) demonstrou 84 e 85% de adequação do volume infundido em relação ao prescrito em paciente em TNE nos anos de 2014 e 2015, respectivamente. Conclusão: Os indicadores de qualidade analisados nesse estudo que apresentaram conformidade foram o (2) e o (5), correspondendo a taxa de pacientes em TNE que atingiram 50% ou mais do valor energético total (VET) em até 7 dias e a adequação do volume infundido em relação ao prescrito em pacientes em TNE. Os indicadores de qualidade (1), (3) e (4) não alcançaram as metas estabelecidas, entretanto, a comparação entre os anos de 2014 e 2015 demonstrou melhoria na maioria dos indicadores de qualidade avaliados

Introduction: Quality indicators in nutritional therapy are evaluative instruments for the effectiveness of the therapeutics used, which aim to improve the performance of the procedures, as well as the improvement of nutritional and health care for the patients. Objective: To apply quality indicators in enteral nutritional therapy (ENT) in a trauma ICU in the city of Curitiba, PR, Brazil and compare the results obtained between the years 2014 and 2015. Methods: Retrospective descriptive observational study composed of data collected from nutritional monitoring charts of patients aged 18 years and over hospitalized in the years of 2014 and 2015 in a trauma ICU in Curitiba, PR, who received exclusive ENT. Sex, age, medical diagnosis, time to start infusion of the diet, time elapsed between the day of admission of the patient to the ICU on the first day that the patient received 50% of the proposed energetic goal, prescribed volume, volume infused and related complications gastrointestinal tract (GIT) were collected from the nutritional monitoring sheets. The quality indicators applied were: (1) frequency of fasting patients before the beginning of ENT; (2) rate of patients in ENT that reached 50% or more of the total energy value (TEV) within 7 days; (3) frequency of intercurrences related to the GIT; (4) frequency of episodes of diarrhea; (5) adequacy of the infused volume in relation to that prescribed in ENT patients. Results: A total of 338 patients were evaluated, of which 194 were evaluated in 2014 and 144 in the year 2015, with a predominance of cranial trauma (82% in 2014 and 73% in 2015). The quality indicator (1) presented a 21% and 14% frequency of fasting patients before the onset of ENT in 2014 and 2015, respectively, the quality indicator (2) obtained 78 and 92% of ENT patients that reached 50% or more of TEV in up to 7 days in 2014 and 2015, respectively, the quality indicator (3) showed 34% and 33% of frequency of intercurrences related to GIT in the years 2014 and 2015, respectively. The quality indicator (4) showed 24 and 31% of the frequency of episodes of diarrhea in the years 2014 and 2015, respectively, and the quality indicator (5) showed 84 and 85% of adequacy of the volume infused in relation to that prescribed in patient in ENT in the years of 2014 and 2015, respectively. Conclusion: The quality indicators analyzed in this study that presented compliance were (2) and (5), corresponding to the rate of patients in ENT that reached 50% or more of the total energy value (TEV) within 7 days and the adequacy of infused volume in relation to that prescribed in ENT patients. The quality indicators (1), (3) and (4) did not reach the established goals, however, the comparison between the years 2014 and 2015 showed improvement in most quality indicators evaluated

Introducción: Los indicadores de calidad en terapia nutricional son instrumentos evaluativos de efectividad de la terapéutica empleada ,que objetivan la mejora en el desempeño de los procedimientos, así como, el perfeccionamiento del cuidado nutricional y en salud a los pacientes. Objetivo: Aplicar indicadores de calidad en terapia nutriciona lenteral(TNE) en una UTI de trauma en el municipio de Curitiba, PR, Brasil y comparar los resultados obtenidos entre los años 2014 y2015. Métodos: Estudio observacional descriptivo retrospectivo compuesto por datos recolectados de fichas de acompañamiento nutricional de pacientes con edad igual o superior a 18 años, internados en los años de 2014 y2015 en una UTI de trauma en Curitiba, PR, que recibieron TNE exclusiva. Sexo, edad, diagnóstico médico, tiempo para iniciar la infusión de la dieta, tiempo transcurrido entre el día de la admisión del paciente en la UTI al primer día en que éste recibió el 50% de la meta energética propuesta, volumen prescrito, volumen infundido e intercurrencias relacionadas al trato gastrointestinal (TG I) fueron recogidos de las fichas de seguimiento nutricional. Se aplicaron los indicadores de calidad: (1) la frecuencia de pacientes en ayunas antes de la TNE; (2) tasa de pacientes en TNE que alcanzaron el 50% o más del valor energético total(VET)en hasta 7días; (3) frecuencia de intercurrencias relacionadas con el TGI; (4) frecuencia de episodios de diarrea; (5) adecuación del volumen infundido en relación a lo prescrito en pacientes en TNE. Resultados: Un total de 338 pacientes fueron evaluados, siendo 194 sujetos evaluados en 2014 y 144 individuos en el año 2015, con predominio de diagnóstico de traumatismo craneal (82% casos en 2014 y 73% casos en 2015). El indicador de calidad (1) ha presentado el 21 y el 14% de frecuencia de pacientes en ayunas antes de la TNE en 2014 y 2015, respectivamente, el indicador de calidad (2) dio 78 y 92% de TNE en pacientes tasa que alcanzó El 50% o más del VET en hasta 7días en los años 2014 y2015, respectivamente, el indicador de calidad (3) demostró un 34% y un 33% de frecuencia de interrelaciones relacionadas con el TGI en los años 2014 y2015, respectivamente. El indicador de calidad (4) evidenció 24 y 31% de la frecuencia de episodios de diarrea en los años 2014 y 2015, respectivamente y el indicador de calidad demostró 84 y 85 % de adecuación del volumen infundido en relación al prescrito en paciente en TNE en los años 2014 y 2015, respectivamente. Conclusión: Los indicadores de calidad analizados en este estudio que presentaron conformidad fueron el (2) y el (5), correspondiendo la tasa de pacientes en TNE que alcanzaron el 50% o más del valor energético total (VET) en hasta 7días y la adecuación del volumen infundido en relación a lo prescrito en pacientes en TNE. Los indicadores de calidad (1), (3) y (4)no alcanzaron los objetivos fijados, sin embargo, la comparación entre los años 2014 y2015 mostró una mejoría en la mayoría de los indicadores de calidad evaluados

Abordagem não-farmacológica na cefaleia do tipo tensional: efeitos da hidroterapia sobre a dor e a qualidade de vida / Non-pharmacological approach in tension-type headache: effects of hydrotherapy on pain and quality of life

Há poucos relatos na literatura de abordagens não-farmacológicas para o tratamento da cefaleia do tipo tensional (CTT), problema comum que gera impacto negativo na vida dos portadores, e nenhum sobre o protocolo de hidroterapia proposto. O objetivo do estudo foi verificar os efeitos da hidroterapia sobre a intensidade da dor e frequência das crises, bem como sua interferência na qualidade de vida dos portadores. Um protocolo de hidroterapia com 12 sessões de 60 minutos em piscina aquecida a 31º, contemplando aquecimento, alongamentos, exercícios aeróbicos e exercícios de relaxamento foi utilizado em três indivíduos com diagnóstico médico de CTT. A terapia promoveu melhora no Headache Impact Test (HIT-6), na Es- cala de sonolência de Epworth e no questionário de disfunção temporomandibular (RDC/TMD). Através do diário de dor de cabeça foi verificada redução da frequência da CTT nos três indivíduos durante a terapia e essa redução foi mantida após trinta dias do tratamento. Um indivíduo apresentou diminuição da intensidade da dor durante e após 30 dias do tratamento. O estudo sugere que a hidroterapia pode ser indicada para diminuir a frequência da CTT, bem como para melhorar a qualidade de vida dos portadores.

There are few reports in the literature of non-pharmacological approaches for the treatment of tension-type headache, common problem that generates significant negative impact on quality of life of patients, and none about therapeutic protocol proposed by this study. The aim of the study was to assess the effects of hydrotherapy on the reduction of pain intensity and frequency of crises and their interference in the quality of life of patients. A hydrotherapy protocol with 12 sessions of 60 minutes in pool heated to 31 degrees contemplating heating, stretching, aerobic and relaxation exercise was applied in three patients with clinical diagnosis of tension-type headache. The therapy promoted improvement in the Headache Impact Test (HIT-6), in the Epworth Sleepiness Scale and in the Temporomandibular Dysfunction Questionnaire (RDC / TMD). Through of a daily of headache a reduction in the frequency of tension-type headache was observed in the three individuals during therapy and this reduction was maintained after thirty days of treatment. An individual had a decrease in pain intensity during and after 30 days of treatment. The study suggests that hydrotherapy can be indicated to decrease the frequency of tension-type headache, as well as to improve the quality of life of individuals.

Evaluation of the antiplasmodial and leishmanicidal potential of Myrciaria dubia (Myrtaceae) extract.

INTRODUCTION:: Malaria and leishmaniasis are prevalent in tropical regions, which have environmental characteristics that are highly favorable to protozoa and vectors of these diseases; the transmission of these infections in sub-tropical regions, although recognized, represents only a small fraction of cases. Plants are constantly being used in the search for and acquisition of new drugs, and many compounds derived from them have been used to combat various diseases. In this study, we evaluated the action of the dichloromethanolic extract of Myrciaria dubia leaves against the protozoa Plasmodium falciparum, Leishmania amazonensis, Leishmania braziliensis, and Leishmania chagasi through bioassays. METHODS: The extract from M. dubia was tested for its anti-P. falciparum activity in an anti-histidine-rich protein II immunosorbent assay. The antileishmanial assays were performed using the resazurin method, while cytotoxicity against human hepatoma (HepG2) strain was determined using the colorimetric MTT [3-(4, 5-dimethyl-2- thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide] method. RESULTS: The M. dubia extract presented a half-maximal inhibitory concentration equal to 2.35 (1.05)µg/mL for P. falciparum, 190.73 (6.41) µg/mL for L. amazonensis, and greater than equal to 200µg/mL for L. chagasi and L. braziliensis strains. The cytotoxic concentration for 50% of the cells was above 500µg/mL for HepG2, indicating no toxicity and greater selectivity against parasites. CONCLUSIONS: The results obtained indicate the presence of antiplasmodial and leishmanicidal bioactive compounds in the dichloromethanolic extracts of M. dubia leaves, and point towards future studies to elucidate the mechanism of action for each physiological effect.

Evaluation of the antiplasmodial and leishmanicidal potential of Myrciaria dubia (Myrtaceae) extract

Abstract INTRODUCTION: Malaria and leishmaniasis are prevalent in tropical regions, which have environmental characteristics that are highly favorable to protozoa and vectors of these diseases; the transmission of these infections in sub-tropical regions, although recognized, represents only a small fraction of cases. Plants are constantly being used in the search for and acquisition of new drugs, and many compounds derived from them have been used to combat various diseases. In this study, we evaluated the action of the dichloromethanolic extract of Myrciaria dubia leaves against the protozoa Plasmodium falciparum, Leishmania amazonensis, Leishmania braziliensis, and Leishmania chagasi through bioassays. METHODS The extract from M. dubia was tested for its anti-P. falciparum activity in an anti-histidine-rich protein II immunosorbent assay. The antileishmanial assays were performed using the resazurin method, while cytotoxicity against human hepatoma (HepG2) strain was determined using the colorimetric MTT [3-(4, 5-dimethyl-2- thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide] method. RESULTS The M. dubia extract presented a half-maximal inhibitory concentration equal to 2.35 (1.05)μg/mL for P. falciparum, 190.73 (6.41) μg/mL for L. amazonensis, and greater than equal to 200µg/mL for L. chagasi and L. braziliensis strains. The cytotoxic concentration for 50% of the cells was above 500μg/mL for HepG2, indicating no toxicity and greater selectivity against parasites. CONCLUSIONS The results obtained indicate the presence of antiplasmodial and leishmanicidal bioactive compounds in the dichloromethanolic extracts of M. dubia leaves, and point towards future studies to elucidate the mechanism of action for each physiological effect.

Análise de objetivos e conclusões de estudos com nove plantas usadas para o controle de diabetes em Mato Grosso / Analysis of objectives and study findings with nine plants used for diabetes control in Mato Grosso

Diabetes é uma doença metabólica que ocorre devido à destruição das células pancreáticas ou falha na ação/secreção de insulina, causando hiperglicemia e outras complicações. O uso terapêutico de plantas representa prática antiga, em geral, de baixo custo e acessível. Este trabalho analisa os objetivos e conclusões de estudos sobre nove plantas medicinais usadas na terapia do diabetes, no estado de Mato Grosso. Os estudos foram recuperados na internet, por meio das ferramentas do Google Acadêmico, utilizando-se quatro modalidades de buscas e o nome científico das plantas, com cinco variantes da palavra diabetes. Dessas buscas foram aproveitados 208 artigos, que foram lançados em planilha de Excel e analisados em programa estatístico apropriado. As abordagens predominantes foram as que citam a aplicação da planta para diabetes (31,8%) e efeito glicemiante (16,4%). Para 111 estudos com bioatividade detectada, 108 foram favoráveis e 3 não favoráveis à terapia do diabetes. Nas espécies Sambucus australis Cham. & Schltdl e Vitex cymosa Bertero ex Spreng houve constatação de uso popular para a diabetes; para Sambucus nigra L. verificou-se a potencialização da insulina; para Alternanthera brasiliana (L.) Kuntze, houve efeito na cicatrização de feridas e, para as espécies: Cecropia pachystachya Trécul, Eryngium foetidum L., Scoparia dulcis L. e Stevia rebaudiana (Bertoni) Bertoni houve constatação de efeito hipoglicemiante.(AU)

Diabetes is a metabolic disease which occurs due to destruction of pancreatic cells, or failure in the action/insulin secretion, causing hyperglycemia and other complications. The therapeutic use of medicinal plants represents an old practice and generally is inexpensive and accessible. The study reveals the objectives and conclusions of studies on nine plants used in Mato Grosso applied in diabetes therapy. Data were retrieved on the Internet, through Google Scholar, using four search modes, scientific name of plants with five variants of the word diabetes. From these searches, there were intended for 208 articles, released in Excel and their analysis on appropriate statistical program. The prevalent approach was mentioning application of the plant for diabetes (31.8%) and glicemiante effect (16.4%). To 111 studies with bioactivity detected, 108 were favorable and 3 non-favorable to diabetes therapy. In Sambucus australis Cham. & Schltdl and Vitex cymosa Bertero ex Spreng species were popular use of observation for diabetes; Sambucus nigra L. found insulin potentiation; with Alternanthera brasiliana (L.) Kuntze, there was no effect on wound healing and for species: Cecropia pachystachya Trécul, Eryngium foetidum L., Scoparia dulcis L. and Stevia rebaudiana (Bertoni) Bertoni was hypoglycemic effect of observation.(AU)