O relaxamento como técnica de redução da ansiedade da pessoa com doença mental: revisão integrativa da literatura / Relaxation as a technique to reduce the anxiety of people with mental illness: an integrative literature review / La relajación como técnica para reducir la ansiedad de las personas con enfermedad mental: una revisión integrativa de la literatura

Resumo Contexto: As perturbações da ansiedade estão entre as perturbações mentais mais prevalentes, caracterizando-se por uma resposta exagerada e desadequada a um estímulo. A probabilidade do seu aparecimento na pessoa com doença mental aumenta consideravelmente, quando comparado com a população em geral. Torna-se perentório a implementação de intervenções de âmbito psicoterapêutico que incluem a técnica de relaxamento. Objetivo: Sistematizar a evidência científica sobre os resultados obtidos com a utilização da técnica de relaxamento, na redução da ansiedade na pessoa com doença mental. Métodos: Revisão integrativa da literatura, através da pesquisa nas bases de dados eletrónicas (CINAHL e MEDLINE) realizada em junho de 2022. Sendo aplicado um conjunto de descritores e critérios de inclusão e exclusão, obteve-se uma amostra final de 7 estudos, publicados entre 2012-2022. Resultados: A evidência científica analisada demonstra resultados benéficos na utilização da técnica de relaxamento na redução da ansiedade e sintomas psicóticos na pessoa com doença mental, devendo ser implementada como intervenção de âmbito psicoterapêutico. Os avanços tecnológicos (realidade virtual e programas online) são um grande aliado para potencializar os seus efeitos imediatos, produzindo efeitos positivos na audição, visão e sensoriais, melhorando consideravelmente a experiência do relaxamento. Conclusões: Os resultados obtidos revelam que a implementação de diversos métodos de técnica de relaxamento (muscular, respiração, imaginação guiada, yoga, biofeedback, bodywareness e meditação guiada) apresentam um potencial terapêutico benéfico na redução imediata dos sinais e sintomas de ansiedade, sendo potencializado através da exposição contínua à intervenção. Contudo, os seus efeitos a longo prazo devem ser alvo de mais estudo.

Abstract Context: Anxiety disorders are among the most prevalent mental disorders, characterized by an exaggerated and inadequate response to a stimulus. The probability of its appearance in people with mental illness increases considerably when compared to the general population. It is imperative to implement psychotherapeutic interventions that include the relaxation technique. Objective: To systematize the scientific evidence on the results obtained with the use of the relaxation technique, in reducing anxiety in people with mental illness. Methods: Integrative literature review, through research in electronic databases (CINAHL and MEDLINE) carried out in June 2022. Applying a set of descriptors and inclusion and exclusion criteria, a final sample of 7 published studies was obtained between 2012-2022. Results: The analyzed scientific evidence demonstrates beneficial results in the use of the relaxation technique in reducing anxiety and psychotic symptoms in people with mental illness and should be implemented as a psychotherapeutic intervention. Technological advances (virtual reality and online programs) are a great ally to enhance their immediate effects, producing positive effects on hearing, vision and sensory, considerably improving the experience of relaxation. Conclusions: The results obtained reveal that the implementation of various methods of relaxation techniques (muscle, breathing, guided imagery, yoga, biofeedback, bodywareness and guided meditation) have a beneficial therapeutic potential in the immediate reduction of signs and symptoms of anxiety, being enhanced through continuous exposure to the intervention. However, its long-term effects need to be studied further.

Resumen Contexto: Los trastornos de ansiedad se encuentran entre los trastornos mentales más prevalentes, caracterizados por una respuesta exagerada e inadecuada a un estímulo. La probabilidad de su aparición en personas con enfermedad mental aumenta considerablemente en comparación con la población general. Es imperativo implementar intervenciones psicoterapéuticas que incluyan la técnica de relajación. Objetivo: Sistematizar la evidencia científica sobre los resultados obtenidos con el uso de la técnica de relajación, en la reducción de la ansiedad en personas con enfermedad mental. Métodos: Revisión integrativa de la literatura, mediante investigación en bases de datos electrónicas (CINAHL y MEDLINE) realizada en junio de 2022. Aplicando un conjunto de descriptores y criterios de inclusión y exclusión, se obtuvo una muestra final de 7 estudios publicados entre 2012-2022. Resultados: A evidencia científica analizada demuestra resultados beneficiosos en el uso de la técnica de relajación en la reducción de la ansiedad y los síntomas psicóticos en personas con enfermedad mental, y debería implementarse como una intervención psicoterapéutica. Los avances tecnológicos (realidad virtual y programas online) son un gran aliado para potenciar sus efectos inmediatos, produciendo efectos positivos en la audición, la visión y los sentidos, mejorando considerablemente la experiencia de relajación. Conclusiones: Los resultados muestran que la implementación de diversos métodos de técnicas de relajación (muscular, respiratoria, imaginería guiada, yoga, biofeedback, bodywareness y meditación guiada) tienen un potencial terapéutico beneficioso en la reducción inmediata de signos y síntomas de ansiedad, siendo potenciado a través de exposición continua a la intervención. Sin embargo, sus efectos a largo plazo deben estudiarse más a fondo.

Implicações da prática profissional no acolhimento institucional de crianças: perspectiva de cuidadoras / Implications of professional practice in children's institutional sheltering: caregivers' perspective / Implicaciones de la práctica profesional en el alojamiento institucional de niños: perspectiva de cuidadoras

Este estudo qualitativo teve como objetivo compreender, a partir da teoria de bioecológica de desenvolvimento, as implicações da prática profissional no processo de acolhimento de crianças em uma casa-abrigo, na perspectiva de cuidadoras. As participantes foram 10 profissionais de uma casa-abrigo localizada na região sul do Brasil. Utilizou-se a entrevista semiestruturada e a organização e análise dos dados sustentou-se na Grounded Theory, com auxílio do software Atlas.ti 8.4.14. Os resultados evidenciaram uma centralização das ações de acolhimento e atenção em torno dos cuidados físicos das crianças. As ações para promover suporte e cuidados emocionais dentro da casa-abrigo eram delegadas às profissionais da equipe técnica da instituição. Observou-se que as dificuldades encontradas pelas cuidadoras diziam respeito à falta de segurança e preparação para responder e acolher as demandas emocionais das crianças, as quais estão presentes em diversos momentos do processo de acolhimento. Percebeu-se que as práticas institucionais afetaram decisivamente tanto as ações de acolhimento das participantes e o suporte emocional oferecido às crianças na passagem pela casa-abrigo quanto as cuidadoras, no sentido de vivenciarem no trabalho sentimentos de insegurança. Os resultados tensionam ecologicamente a interação nos processos proximais presentes no desenvolvimento humano. Advoga-se pela reflexão sobre as implicações das práticas institucionais de uma casa-abrigo e o desenvolvimento infantil, visando o cuidado integral dos acolhidos.(AU)

Based on the developmental bioecological theory, this study analyzes the implications of professional practice in children's user embracement at a shelter from the caregivers' perspective. Semi-structured interviews were conducted with 10 professionals from a shelter located in southern Brazil. Data organization and analysis was performed based on Grounded Theory using the Atlas.ti 8.4.14 software. Results showed that embracement and attention focus on the physical care of children. Support and emotional care activities were delegated to the institution's technical team. Caregivers faced difficulties regarding the lack of security and preparation to respond to and accept the children's emotional demands, which arise at different moments in the embracement process. The institutional practices decisively affected both user embracement actions and the emotional support offered to the children, as well as the caregivers, in the sense of experiencing feelings of insecurity. These findings ecologically tension the interaction in the proximal processes present in human development. Further reflections on the implications of institutional shelter-based practices for child development are needed to provide comprehensive care.(AU)

Este estudio cualitativo tuvo como objetivo comprender, desde la perspectiva de la teoría bioecológica del desarrollo, las implicaciones de la práctica profesional en el proceso de acogida de niños en una institución infantil desde la perspectiva de las cuidadoras. Las participantes fueron 10 profesionales de una institución de acogida infantil ubicada en la región Sur de Brasil. Se utilizó la entrevista semiestructurada, y para la organización y análisis de datos se aplicó Grounded Theory, con el uso del software Atlas.ti 8.4.14. Los resultados mostraron que las acciones de recepción y atención se centran en el cuidado físico de los niños. Las acciones de promoción de apoyo y cuidado emocional dentro del alojamiento se asignaron a los profesionales del equipo técnico de la institución. Se observó que las dificultades encontradas por las cuidadoras estaban relacionadas con la falta de seguridad y preparación para responder y aceptar las demandas emocionales de los niños, las cuales se encuentran presentes en diferentes momentos del proceso de acogida. Se notó que las prácticas institucionales afectaron decisivamente tanto las acciones de acogida de las participantes como el apoyo emocional que la institución brinda a los niños durante su paso, así como a las cuidadoras en el sentido de experimentar sentimientos de inseguridad en el trabajo. Estos resultados tensan ecológicamente la interacción en los procesos proximales presentes en el desarrollo humano. Se aboga por reflexionar sobre las implicaciones de las prácticas institucionales en los alojamientos institucionales y el desarrollo infantil, apuntando a la atención integral de los acogidos.(AU)

Evaluation of the ethanolic ultrasound-assisted extraction from clove (Syzygium aromaticum) leaves and chemical characterization of the extracts.

In this study, clove leaves (Syzygium aromaticum) were subjected to ultrasound-assisted extraction (UAE) with ethanol as the solvent, following a central composite design to evaluate the effects of time, amplitude, solvent/sample ratio, and temperature on the yield, eugenol content, and antioxidant capacity of the extracts. The results were compared with those obtained using the conventional method of maceration (ME). The optimum conditions for extract yield were achieved with an extraction time of 25 min,amplitude of 85%, solvent/sample ratio of 35 mL g-1, and temperature of 70 °C, and the result (14.63 wt%) was three times higher than that of conventional extraction. Eugenol was detected in the extracts obtained by both methods, with the highest yield of 2.94 g eugenol kg leaves-1obtained in the UAE method, while the ME method achieved 1.36 g eugenol kg leaves-1.In general, the extracts exhibited high antioxidant capacities.

Disruption of mitochondrial function as mechanism for anti-cancer activity of a novel mitochondriotropic menadione derivative.

Menadione, also known as vitamin K3, is a 2-methyl-1,4 naphthoquinone with a potent cytotoxic activity mainly resulting from its quinone redox-cycling with production of reactive oxygen species (ROS). Although increased ROS generation is considered a relevant mechanism in cancer cell death, it may not be sufficiently effective to kill cancer cells due to phenotypic adaptations. Therefore, combining ROS-generating agents with other molecules targeting important cancer cell phenotypes can be an effective therapeutic strategy. As mitochondrial dysfunction has been implicated in many human diseases, including cancer, we describe here the discovery of a mitochondrial-directed agent (MitoK3), which was developed by conjugating a TPP cation to the C3 position of the menadione's naphthoquinone ring, increasing its selective accumulation in mitochondria, as well as led to alterations of its redox properties and consequent biological outcome. MitoK3 disturbed the mitochondrial bioenergetic apparatus, with subsequent loss of mitochondrial ATP production. The combinatory strategy of MitoK3 with anticancer agent doxorubicin (DOX) resulted in a degree of cytotoxicity higher than those of the individual molecules, as the combination triggered tumour apoptotic cell death evident by caspase 3/9 activities, probably through mitochondrial destabilization or by interference with mitochondrial redox processes. The results of this investigation support the importance of drug discovery process in developing molecules that can be use as adjuvant therapy in patients with specific cancer subtypes.

Influence of VKORC1 gene polymorphisms on the effect of oral vitamin K supplementation in over-anticoagulated patients.

Significant inter-individual variability on the effect of vitamin K to reverse overanticoagulation has been identified. Genetic polymorphisms of the vitamin K epoxide reductase complex subunit 1 (VKORC1) gene might explain in part this variability. The objective of this study was to evaluate the influence of VKORC1 -1639G>A and 3730G>A polymorphisms on the effect of oral vitamin K supplementation in overanticoagulated patients. We performed an interventional trial of oral vitamin K supplementation in over-anticoagulated outpatients (international normalized ratio [INR] ≥ 4). Subjects received vitamin K (2.5-5.0 mg) according to baseline INR and were genotyped by real time polymerase chain reaction (PCR). INR values were determined at 3, 6, 24 and 72 h after supplementation. We evaluated 33 outpatients, 61 % were males, with a mean age of 62 ± 12 years old. There was a significant decrease in INR values over time for both polymorphisms after oral vitamin K. At 3 h after supplementation, patients carrying the G allele for the -1639G>A polymorphism had a greater decrease in INR values compared to AA patients (p < 0.05 for difference among groups; p < 0.001 for time variation; p = 0.001 for time × group interaction), with differences of -1.01 for GG versus AA (p = 0.003) and -0.84 for GA versus AA (p = 0.024). Mean INR value at 24 h was 1.9 ± 0.6 and at 72 h was 2.1 ± 0.7, with no differences among genotypes. No significant interaction was identified between the 3730G>A polymorphism and vitamin K supplementation. Our study indicated that the VKORC1 -1639G>A polymorphism plays a role in the response to acute vitamin K supplementation in over-anticoagulated patients, with faster decrease of INR value in patients carrying the G allele.

Effect of Coffea canephora aqueous extract on microbial counts in ex vivo oral biofilms: a case study.

In the present study, the ex vivo antimicrobial effect of brewed coffee was tested on oral biofilms. For this, unsweetened and sweetened (10 % sucrose) brewed light-roasted Coffea canephora at 20 % was used in biofilms formed by non-stimulated saliva from three volunteers. After 30 min contact with unsweetened and sweetened brews, the average microorganism count in the biofilms reduced by 15.2 % and 12.4 %, respectively, with no statistical difference among them. We also observed a drop of microorganisms in the biofilms after treatment with sucrose solution at 5 % compared to control (saline) and to sucrose at 1 % and 3 %. In conclusion, Coffea canephora extract reduces the microbial count in oral biofilm, and our data suggest that sucrose concentration in coffee brew can influence its antimicrobial property against the referred biofilm.

Recurrent herpes simplex infections: laser therapy as a potential tool for long-term successful treatment.

Herpes simplex virus types 1 and 2 are the main infectious agents associated with oral and genital ulcerations. These infections are now widely recognized as sexually transmitted diseases. Among treatment options, low-level laser therapy (LLLT) has shown promising clinical results as a longer-lasting suppression therapy. Two clinical cases are described with recurrent labial herpes for which LLLT was used. Following treatment, both patients remained symptom free during the 17-month clinical follow-up period.

Recurrent herpes simplex infections: laser therapy as a potential tool for long-term successful treatment / Herpes simplex recorrente: laser terapia como método alternativo para tratamento a longo prazo

Herpes simplex virus types 1 and 2 are the main infectious agents associated with oral and genital ulcerations. These infections are now widely recognized as sexually transmitted diseases. Among treatment options, low-level laser therapy (LLLT) has shown promising clinical results as a longer-lasting suppression therapy. Two clinical cases are described with recurrent labial herpes for which LLLT was used. Following treatment, both patients remained symptom free during the 17-month clinical follow-up period.

Os vírus do herpes simplex tipos 1 e 2 são os principais agentes infecciosos associados às ulcerações orais e vaginais. Estas infecções são amplamente reconhecidas como doenças sexualmente transmissíveis. Entre as opções de tratamento, o laser de baixa intensidade (LBI) mostrou resultados promissores como terapia de supressão de longa duração. Descrevemos dois casos clínicos com herpes labial recorrentes nos quais o LBI foi utilizado que permaneceram assintomáticos durante 17 meses de controle clínico.

Antibacterial and antioxidant activities and acute toxicity of Bumelia sartorum Mart., Sapotaceae, a Brazilian medicinal plant

In order to validate the Bumelia sartorum Mart., Sapotaceae, traditional use for infection diseases, this study evaluates the antibacterial activity of the stem bark fractions against methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus strains by using the agar dilution method and reported as MIC (minimal inhibitory concentration). In addition, the DPPH scavenging activity of these fractions was measured and the chemical composition and acute toxicity of the active fraction were also determined. The ethyl acetate (EtOAc) extract was chemically analyzed by LC/MS, direct ionization APCI/MS, ¹H NMR and 13C-NMR. All fractions, except butanol extract, presented high antioxidant activity, especially the methanol and the EtOAc extracts, which showed EC50 values (5.67 and 5.30 µg/mL, respectively) considerably lower than the Gingko-standard EGb 761® (38.58 µg/mL). The antibacterial activity against S. aureus strains was observed in EtOAc (MIC 256-512 µg/mL), which showed a very low toxicity. The chemical study of this fraction revealed the abundant presence of polyphenolic compounds. The antibacterial and antioxidant activities reported in this paper for EtOAc extract from B. sartorum and the low toxicity of this fraction opens the possibility that it could be helpful for the developing of new antibacterial agents for treating S. aureus infections.

Ceanothane and lupane type triterpenes from Zizyphus joazeiro - an anti-staphylococcal evaluation.

The present paper describes the phytochemical and anti-staphylococcal activity investigation of the dichloromethane extract of the Brazilian plant Zizyphus joazeiro Mart. The purification steps were guided by bioassays against 17 bacterial strains of clinical sources, including methicillin-resistant (MRSA) and -sensitive (MSSA) Staphylococcus aureus as well as MRSA (ATCC 33591) and MSSA (ATCC 29213) reference strains. One of the more active fractions is comprised of three lupane-type triterpenes, the methylbetulinate (1) as well as the known betulinic (2) and alphitolic (3) acids and, for the first time in the Z. joazeiro, two ceanothane type triterpenes, the methylceanothate (4) and the epigouanic acid A (5). These substances were assayed against one clinical (PVL+) and the reference strains of S. aureus as well as the ATTC 12228 strain of S. epidermidis, in concentrations that varied from 128 to 0.125 microg/mL in order to establish the minimum inhibitory concentration (MIC) of the drugs. The minimum bactericide concentration (MBC) was also evaluated to distinguish the bactericidal from bacteriostatic activity of the crude fractions and single compounds. Compounds 3 and 4 possess the highest antibacterial activity. They inhibit all bacteria tested at 32 microg/mL and 16 microg/mL, respectively, while the other compounds showed no activity at 128 microg/mL. In contrast to single compounds, the triterpenoid fraction showed bactericidal activity at 256 microg/mL. Structural elucidations are based on 1D and 2D NMR spectroscopy as well as HR-FT-ICR-MS experiments.

Marine Pseudomonas putida: a potential source of antimicrobial substances against antibiotic-resistant bacteria.

Bacteria isolated from marine sponges found off the coast of Rio de Janeiro, Brazil, were screened for the production of antimicrobial substances. We report a new Pseudomonas putida strain (designated P. putida Mm3) isolated from the sponge Mycale microsigmatosa that produces a powerful antimicrobial substance active against multidrug-resistant bacteria. P. putida Mm3 was identified on the basis of 16S rRNA gene sequencing and phenotypic tests. Molecular typing for Mm3 was performed by RAPD-PCR and comparison of the results to other Pseudomonas strains. Our results contribute to the search for new antimicrobial agents, an important strategy for developing alternative therapies to treat infections caused by multidrug-resistant bacteria.

Marine Pseudomonas putida: a potential source of antimicrobial substances against antibiotic-resistant bacteria

Bacteria isolated from marine sponges found off the coast of Rio de Janeiro, Brazil, were screened for the production of antimicrobial substances. We report a new Pseudomonas putida strain (designated P. putida Mm3) isolated from the sponge Mycale microsigmatosa that produces a powerful antimicrobial substance active against multidrug-resistant bacteria. P. putida Mm3 was identified on the basis of 16S rRNA gene sequencing and phenotypic tests. Molecular typing for Mm3 was performed by RAPD-PCR and comparison of the results to other Pseudomonas strains. Our results contribute to the search for new antimicrobial agents, an important strategy for developing alternative therapies to treat infections caused by multidrug-resistant bacteria.

Tabebuia avellanedae naphthoquinones: activity against methicillin-resistant staphylococcal strains, cytotoxic activity and in vivo dermal irritability analysis.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococcus infections are a worldwide concern. Currently, these isolates have also shown resistance to vancomycin, the last therapy used in these cases. It has been observed that quinones and other related compounds exhibit antibacterial activity. This study evaluated the antibacterial activity, toxicity and in vivo dermal irritability of lapachol extracted from Tabebuia avellanedae and derivatives against methicillin-resistant staphylococcal isolates. In addition, its mechanism of action was also analyzed. METHODS: The compounds beta-lapachone, 3-hydroxy beta N lapachone and alpha-lapachone were tested to determine the MIC values against methicillin-resistant S. aureus, S. epidermidis and S. haemolyticus strains, being the two last ones hetero-resistant to vancomycin. Experiments of protein synthesis analysis to investigate the naphthoquinones action were assessed. In vitro toxicity to eukaryotic BSC-40 African Green Monkey Kidney cell cultures and in vivo primary dermal irritability in healthy rabbits were also performed. RESULTS: The compounds tested showed antibacterial activity (MICs of 8, 4/8 and 64/128 microg/mL to beta-lapachone, 3-hydroxy beta N lapachone and alpha-lapachone, respectively), but no bactericidal activity was observed (MBC > 512 microg/mL for all compounds). Although it has been observed toxic effect in eukaryotic cells, the compounds were shown to be atoxic when applied as topic preparations in healthy rabbits. No inhibition of proteins synthesis was observed. CONCLUSION: Our results suggest that quinones could be used in topic preparations against wound infections caused by staphylococci, after major investigation of the pharmacological properties of the compounds. Studies about the use of these compounds on tumoral cells could be carried on, due to their effect in eukaryotic cells metabolism.

Brazilian phytopharmaceuticals--evaluation against hospital bacteria.

Pharmaceutical companies have demonstrated renewed interest in investigating higher plants as sources for new lead structures and also for the development of standardized phytotherapeutic agents of proven efficacy, safety and quality. This work analysed three commercial phytopharmaceuticals against multi-resistant bacteria of medical importance, including methicillin-resistant Staphylococcus aureus isolates from the Brazilian endemic clone. From the phytopharmaceuticals assayed, plants from the products 'Astmoflora' and 'Kókolos' were considered active, while plants from 'Uva do Mato' were not active in the tested concentrations, which ranged from 62.5 to 500 microg/mL. Among fractions of Aristolochia cymbifera and Myroxylon balsamum, the hexane extracts showed the best results against Staphylococcus spp. and Pseudomonas aeruginosa. These fractions showed growth inhibition of all methicillin-sensitive and -resistant Staphylococcus aureus strains and the majority of the Pseudomonas aeruginosa strains at a concentration of 500 microg/mL. Bioassay-guided fractionation of hexane extracts of Aristolochia cymbifera and Myroxylon balsamum led to the identification of the diterpene 2-oxo-populifolic acid and of the chalcone isoliquiritigenin, respectively, as antimicrobial compounds.