Characteristics and prognosis of young breast cancer patients treated in a public comprehensive cancer centre in Brazil: A retrospective cohort study.

BACKGROUND: The incidence of breast cancer among women under 41 years old varies worldwide, with higher rates observed in developing countries. These young women often face later-stage diagnoses. In this study, we examine a cohort of young women who were treated for breast cancer in São Paulo, Brazil. METHODS: We conducted a retrospective cohort study involving women under 41 years old. Our objective was to describe patient and treatment characteristics, with the main outcomes being overall and disease-free survival. Our analysis explored the associations between age of menarche, history of breastfeeding, use of hormonal contraceptives, and age at diagnosis. RESULTS: Our study included 493 patients with a mean follow-up of 62.8 months. The mean age of the patients was 34.6 (SD=4.19). Of the patients, 68% presented with locally advanced disease, and 19.27% were metastatic at the time of diagnosis. We observed significant associations between age of menarche and age at diagnosis (p = 0.0096), as well as age at diagnosis and breastfeeding (p = 0.0232). Chemotherapy was administered to 92.91% of the patients as part of their treatment, while 27.2% were eligible for breast-conserving surgery. During the follow-up period, 153 patients died, with disease progression being the cause of death in 73.2% of cases. The median survival time for the entire cohort is still under review, while the metastatic patients at diagnosis had a median survival time of 28.64 months (95%CI 20.21-40.89). CONCLUSION: Our findings highlight significant associations between late-stage diagnosis and overall and disease-free survival in this patient age group. Given that the majority of patients present with locally advanced breast cancer, it is crucial to implement strategies that promote early-stage diagnosis and improve survival rates.

Plantas medicinais na Atenção Primária à Saúde: riscos, toxicidade e potencial para interação medicamentosa / Medicinal plants in primary health care: risks, toxicity and potential for drug interaction

Visando contribuir para o fortalecimento do uso adequado de fitoterápicos na Atenção Primária à Saúde (APS), este estudo apresenta resultados de pesquisa exploratório-descritiva que buscou avaliar o risco associado ao uso de plantas medicinais. Foi realizado um levantamento etnobotânico e etnofarmacológico junto à população da área de abrangência de uma Unidade de Saúde da Família (USF) rural localizada em um município da região Sul do Brasil. Em 80,65% dos domicílios visitados, verificou-se que o uso terapêutico de plantas medicinais estava associado a medicamentos de uso contínuo, e 51,61% dos entrevistados relataram não comunicar o uso de plantas medicinais ao profissional de saúde. 58,33% das espécies identificadas apresentaram possíveis riscos, contraindicações ou toxicidade, e 35,83% apresentaram possíveis interações com medicamentos convencionais de acordo com a literatura consultada. Discute-se sobre os riscos associados ao uso dessas plantas nessa população, e apresentam-se sugestões e orientações para minimizar esses riscos.

To contribute to the strengthening of the appropriate use of herbal medicines in primary health care, this study presents the results of exploratory and descriptive research which sought to assess the risk associated with the use of medicinal plants. It was realized an ethnobotanical and ethnopharmacological survey, carried out with the population of the areacovered by a rural Family Health Care Unit located in a county in the South region of Brazil. In 80.65% of the households visited, it was found that the therapeutic use of medicinal plants was associated with continuous-use medications, and 51.61% of the interviewees reported not communicating the use of medicinal plants to the health professional. 58.33% of the identified species presented possible risks, contraindications, or toxicity, and 35.83% presented possible interactions with conventional drugs according to the literature consulted. It discusses the risks associated with the use of these plants in this population and offers suggestions and guidelines to minimize these risks.

Os marcos legais das políticas públicas de plantas medicinais e fitoterápicos no Brasil / Legal frameworks of the public policies of medicinal plants and herbal medicines in Brazil

Apresenta-se resultado de pesquisa documental, cujo objetivo é verificar a evolução dos marcos legais associados às políticas públicas de plantas medicinais e fitoterápicos no Brasil. Realizou-se a identificação e análise do conteúdo de Leis, Decretos, Resoluções, Políticas, Portarias e Instruções Normativas relacionadas ao tema. Apesar de consideradas intrínsecas à cultura popular, a legislação instituiu-se de forma recente no Brasil. Constatou-se que as mudanças na legislação sanitária foram significativas e tornaram as exigências para o setor de fitoterápicos brasileiro, especialmente quanto à qualidade dos produtos, mais próximas dos padrões encontrados na legislação internacional. Porém, evidencia-se ainda uma carência de políticas públicas que incentivem a inserção dessas práticas dentro dos serviços de saúde, a fim de preencher a lacuna existente entre a regulamentação e a prática instituída nesses serviços.

A documentary research was carried out with the aim to verify the evolution of legal frameworks associated with public policies of medicinal plants and herbal medicines in Brazil. We conducted the identification and analysis of the content of Laws, Decrees, Resolutions, Policies, Administrative Rules, and Normative Instructions related to the topic. Although it is considered intrinsic to popular culture, legislation has been instituted in Brazil recently. It was found that changes in sanitary legislation were significant, which made the requirements for the Brazilian herbal medicine sector, especially regarding product quality, closer to the international standards. However, there is also a lack of public policies that encourage the insertion of these practices within the health services in order to fill the gap between the regulations and the practice established in these services.

Silver chitosan nanocomposites as a potential treatment for superficial candidiasis.

Silver compounds are widely known for their antimicrobial activity, but can exert toxic effects to the host. Among the strategies to reduce its toxicity, incorporation into biopolymers has shown promising results. We investigated the green syntheses of silver nanoparticles (AgNPs) and their functionalization in a chitosan matrix (AgNPs@Chi) as a potential treatment against Candida spp. Inhibitory concentrations ranging between 0.06 and  1 µg/ml were observed against distinct Candida species. Nanocomposite-treated cells displayed cytoplasmic degeneration and a cell membrane and wall disruption. Silver nanocomposites in combination with fluconazole and amphotericin B showed an additive effect when analyzed by the Bliss method. The low cytotoxicity displayed in mammalian cells and in the Galleria mellonella larvae suggested their potential use in vivo. When tested as a topical treatment against murine cutaneous candidiasis, silver nanocomposites reduced the skin fungal burden in a dose-response behavior and favored tissue repair. In addition, the anti-biofilm effect of AgNPs@Chi in human nail model was demonstrated, suggesting that the polymeric formulation of AgNPs does not affect antifungal activity even against sessile cells. Our results suggest that AgNPs@Chi seems to be a less toxic and effective topical treatment for superficial candidiasis. LAY SUMMARY: This study demonstrated the efficacy of silver nanoparticles (AgNPs) in inhibiting the growth of Candida. AgNPs incorporated in chitosan displayed a reduced toxicity. Tests in infected mice showed the effectiveness of the treatment. AgNPs-chitosan could be an alternative to combat candidiasis.

Inhibition of neutrophil migration and reduction of oxidative stress by ethyl p-coumarate in acute and chronic inflammatory models.

BACKGROUND: It is well known that medicinal plants and their products are relevant candidates for the treatment of inflammatory conditions. Ethyl p-coumarate is a phenylpropanoid that has similar structure to others anti-inflammatory and antioxidant substances. However, these activities have never been tested. PURPOSE: The aim of this study was to investigate the effect of ethyl p-coumarate on inflammatory and oxidative stress parameters. STUDY DESIGN: This is an experimental study to evaluate the anti-inflammatory and antioxidant activities of ethyl p-coumarate in acute and chronic models of inflammation. METHODS: The anti-inflammatory effect of ethyl p-coumarate was evaluated in Swiss mice by carrageenan-induced paw edema model (1%, 50 µl), followed by histological analysis, and edema induced by compound 48/80 (12 µg/paw), histamine (100  µg/paw), serotonin (100 µg/paw) and prostaglandin E2 (3 nmol/paw) in comparison to indomethacin treatment (10 mg/kg, p.o.). In addition, peritonitis was induced by carrageenan (500 µg/cavity) to neutrophil and total leukocytes counting, myeloperoxidase (MPO), interleukin 6 (IL-6) and 8 (IL-8), nitrite (NO2-), glutathione (GSH) and malondialdehyde (MDA) measurements. The arthritis model was induced with Freund's complete adjuvant (id. 0.1 ml) in female Wistar rats, with measurement of joint diameter and X-ray. Changes in gastric tissue of Swiss mice were analyzed in comparison to indomethacin (20  mg/kg, p.o.). RESULTS: After treatment with ethyl p-coumarate, the animals had no apparent toxic effects, and significantly inhibited paw edema induced by edematogenic agents, neutrophil (p < 0.001) and total leukocyte (p < 0.001) migration, MPO (p < 0.01), IL-6 (p < 0.05) and IL-8 (p < 0.5), MDA (p < 0.5), GSH (p < 0.5), NO2- (p < 0.001), joint thickness and bones changes. Furthermore, were not observed significant formation of gastric lesions. CONCLUSION: Taken together, these results suggest that ethyl p-coumarate exhibits anti-inflammatory activity through the inhibition of inflammatory mediators and leukocyte migration without causing gastric lesions.

DNA damage and primordial follicle activation after in vitro culture of sheep ovarian cortex in Morus nigra leaf extract / Dano ao DNA e ativação do folículo primordial após a cultivo in vitro do córtex ovariano de ovelha em extrato de folha de Morus nigra

This study evaluated the effect of Morus nigra leaf extract, with or without supplementation, on morphology, activation and DNA damage of preantral follicles cultured within sheep ovarian tissue. Ovaries were collected and divided into fragments, being one fixed for histological and Terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick-end labeling (TUNEL) analysis (fresh control). The remaining fragments were cultured for 7 days in alpha minimum essential media (α-MEM) supplemented with bovine serum albumin (BSA), insulin, transferrin, selenium, glutamine, hypoxanthine and ascorbic acid (α-MEM+; control medium) or into medium composed of M. nigra extract without supplements (0.1; 0.2 or 0.4mg/mL) or supplemented with the same substances described above for α-MEM+ (MN 0.1+; 0.2+ or 0.4+mg/mL). Then, tissues were destined to histological and TUNEL analysis. The α-MEM+ treatment had more morphologically normal follicles than all M. nigra extract treatments. However, α-MEM+ treatment also showed signs of atresia because the percentage of TUNEL positive cells was similar in α-MEM+ and in 0.1mg/mL M. nigra without and with supplements. Moreover, a reduction in the primordial follicles and an increase in the growing ones were observed in all treatments, except 0.2mg/mL M. nigra. In conclusion, the follicles cultured at 0.1mg/mL M. nigra extract were in good condition and able to continue their development, as demonstrated by the same rates of DNA damage and follicular activation as the control medium.(AU)

Este estudo avaliou o efeito do extrato das folhas de Morus nigra, com ou sem suplementos, sobre a morfologia, a ativação e o dano ao DNA de folículos pré-antrais cultivados inclusos em tecido ovariano. Os ovários foram coletados e divididos em fragmentos, sendo um fixado para análise histológica e ensaio de marcação de terminações dUTP mediada por desoxinucleotidil transferase terminal (TUNEL) (controle fresco). Os fragmentos restantes foram cultivados durante 7 dias em meio essencial mínimo alfa (α-MEM) suplementado com albumina sérica bovina (BSA), insulina, transferrina, selênio, glutamina, hipoxantina e ácido ascorbico (α-MEM+; meio controle) ou em meio composto de extrato de M. nigra sem suplementos (0,1; 0,2 or 0,4mg/mL) ou suplementado com as mesmas substâncias descritas para α-MEM+ (MN 0,1+; 0,2+ or 0,4+mg/mL). Então, os tecidos foram destinados à análise histológica e TUNEL. O tratamento do α-MEM+ apresentou mais folículos morfologicamente normais que todos os tratamentos do extrato de M. nigra. No entanto, o tratamento com α-MEM+ também mostrou sinais de atresia, pois a porcentagem de células TUNEL positivas foi semelhante em α-MEM+ e em 0,1mg/mL M. nigra sem e com suplementos. Além disso, observou-se uma redução nos folículos primordiais e um aumento nos folículos em crescimento em todos os tratamentos, exceto 0,2mg/mL M. nigra. Em conclusão, os folículos cultivados com 0,1mg/mL de extrato de M. nigra estavam em boas condições e aptos a continuar seu desenvolvimento, como demonstrado pelas taxas de dano ao DNA e de ativação folicular semelhantes ao meio controle.(AU)

Reconhecimento da suspensão de juízo do princípio de semelhança na promoção de saúde de mulheres em situação de violência e vulnerabilidade / Recognition of suspension of judgment of the principle of similarity in health promotion for women in situations of violence and vulnerability

A violência consiste em objetificação dos sujeitos com compressões sobre a ação comunicativa e, portanto, sobre a práxis de autonomia. A solução interessa à promoção de saúde, em suas articulações no contexto da democracia e do direito, conjuntamente, e da mesma forma, à medicina homeopática e ao princípio de semelhança que a fundamenta, em que ambas possibilitem o agir comunicativo, conferindo brevidade a acordos em acolhimento de singularidades diversas. Objetivou-se, com esse estudo, reconhecer a suspensão de juízo do princípio de semelhança enquanto promoção de saúde em sujeitos em situação de violência e vulnerabilidade. Foi desenvolvida pesquisa qualitativa com análise de conteúdo categorial temática, com base em dados de dezesseis entrevistas em profundidade com mulheres participantes, bem como de doze observações participativas das rodas de conversas do ambulatório do Instituto Jenny de Andrade Faria, do Hospital das Clínicas da UFMG, do programa "Para Elas. Por Elas, Por Eles, Por Nós". A partir da análise dos dados, estabeleceram-se três categorias que compreendessem os objetivos propostos. Observou-se que o princípio de semelhança, como verbo em ação nas rodas de conversas, onde a suspensão de juízo se faz presente, com espantoso e oportuno poder de conciliação de momento, permite abraços em assimilação entre as partes, com perdão de diferenças, aconjuntando-as, favorecendo participação e fortalecendo-as, amenizando padecimentos, onde apropriam-se de saberes provenientes da própria roda e a conversa reconduz a conversões rumo ao bem comum. Destarte, pode-se entender que a suspensão de juízo do princípio de semelhança favorece promoção de saúde como fluxo desimpedido da vida e, consequentemente, prevenção da violência.

Violence consists in objectifying the subjects with compressions over communicative action and, therefore, over autonomy praxis. The solution is of interest to health promotion, in its articulations in the context of democracy and law, together, and in the same way, to homeopathic medicine and its fundamental principle of similarity, in which both enable communicative action, giving brevity to agreements in the reception of diverse singularities. The objective of this study was to recognize the suspension of judgment of the principle of similarity as health promotion in subjects in situations of violence and vulnerability. A qualitative research with thematic categorical content analysis was developed, based on data from sixteen in-depth interviews with participating women, as well as twelve participatory observations from the conversation wheels of the "Jenny de Andrade Faria" Institute outpatient clinic, "UFMG Hospital das Clínicas", of the program "Para Elas. Por Elas, Por Eles, Por Nós". From the data analysis, three categories were established that would the proposed objectives. It was observed that the principle of similarity, as verb in action in the conversation wheels, where the suspension of judgment is present, with astonishing and timely conciliation power of the moment, allows hugs in assimilation between the individual parts, with forgiveness of differences, bringing them together, favoring participation and strengthening them, alleviating suffering, where they appropriate knowledge from what rolls on the wheel, and conversation leads to conversions towards the common good. Thus, it can be understood that the suspension of judgment of the principle of similarity favors health promotion as an unimpeded flow of life and, consequently, prevention of violence.

Práticas Integrativas e Complementares: inserção no contexto do ensino Odontológico / Complementary and Integrative Practices: Incorporation into Dental Education

O presente estudo visa discutir a inserção de Práticas Integrativas e Complementares (PIC) nos modelos flexneriano e giesiano, e seus reflexos na formação superior em Odontologia. Para tal, foi realizado um estudo reflexivo baseado em revisão de literatura. Foram consultadas publicações indexadas nas bases de dados Scientific Electronic Library Online e Biblioteca Virtual em Saúde. Documentos oficiais e periódicos não indexados foram investigados por meio de busca ativa. Os descritores aplicados foram: práticas integrativas e complementares, complementary and integrative practices, relatório flexner, flexner report, relatório gies, gies report, Odontologia de mercado, market dentistry, modelo assistencial em saúde. Observou-se que as características e concepções inseridas nos modelos provenientes dos relatórios Flexner e Gies, de 1910 e 1926 respectivamente, privilegiam a prática dita tecnológica, com a exclusão das práticas tradicionais. As PIC, apesar de seu potencial terapêutico, enfrentam, ainda, resistências de ordem científica, econômica e cultural para sua plena adoção. Nessa lógica, discutem-se os atuais desafios, bem como possibilidades e potencialidades da inserção de PIC na atenção odontológica (AU).

The present study aims to discuss the inclusion of complementary and integrative practices (CIP) in the Flexnerian and Giesian models and their effects on higher education in dentistry. Thus, a reflexive study based on a literature review was carried out. Indexed publications were consulted in the databases Scientific Electronic Library Online and Virtual Health Library. Official documents and non-indexed journals were searched. The descriptors applied were as follows: práticas integrativas e complementares, complementary and integrative practices, relatório flexner, flexner report, relatório gies, gies report, Odontologia de mercado, market dentistry, modelo assistencial em saúde. It was observed that the features and concepts embedded in the models from the Flexner and Gies reports, dated 1910 and 1926, respectively, favor technological practices and exclude traditional practices. Despite their therapeutic potential, CIP also face scientific, economic and cultural resistance to their full adoption. By this logic, the current challenges as well as the possibilities and potential of CIP in dental care are discussed (AU).

Gastroprotective effect of ethanol extracts of cladodes and roots of Pilosocereus gounellei (A. Weber ex K. Schum.) Bly. Ex Rowl (Cactaceae) on experimental ulcer models.

ETHNOPHARMACOLOGICAL RELEVANCE: Pilosocereus gounellei Cactaceae), popularly known as "xique xique", is a species native from Caatinga region of Northeast Brazil, which is used by traditional communities in folk medicine for a variety of health problems, especially inflammatory processes and gastritis. AIM OF THE STUDY: The present study investigates the possible gastric antiulceractivity of ethanol extracts obtained from the cladodes and roots of Pilosocereus gounellei (EECPG and EERPG, respectively) and mechanisms of action underlying this effect. MATERIALS AND METHODS: Mice were used for the evaluation of the acute toxicity, and mice and rats to study the gastroprotective activity. The gastroprotective action of EECPG and EERPG was analyzed in the absolute ethanol in mice, ischemia-reperfusion and cold restraint stress in rats. In the investigation of the gastroprotective mechanisms of EECPG and EERPG, the participation of the NO and prostaglandins, the levels of the non-protein sulfhydril groups (NP-SH) and the catalase activity using the ethanol-induced gastric mucosa lesion model and the quantification of the gastric mucus and the antisecretory activity through pylorus ligature model in rats were analyzed. RESULTS: The animals did not present any signs of acute toxicity for the EECPG and EERPG, and it was not possible to calculate the DL50. EECPG and EERPG (200 and 400 mg/kg) exhibited a significant gastroprotective effect in absolute ethanol, ischemia-reperfusion-induced and cold restraint stress gastric lesion models. Gastroprotection of EECPG and EERPG (200 mg/kg) was significantly decreased in pre-treated mice with L-NAME. Our studies revealed that EECPG and EERPG (200 mg/kg) prevented the decrease of the non-protein sulfhydril groups (NPSH) and increased the catalase levels in ethanol-treated animals. However, the gastric secretion parameters (volume, [H+], pH) did not show any alteration. CONCLUSIONS: Our results indicate that the ethanolic extract from the cladodes and roots of Pilosocereus gounellei exhibits a significant gastroprotection, because it inhibits the formation of gastric lesions using different models. The participation of the nitric oxide, prostaglandins, the non-protein sulfhydril groups (NP-SH), catalase seem to be involved in the gastroprotection activity of the EECPG and EERPG. Nevertheless, this activity does not seem to be related to antisecretory mechanisms.

Selenium Levels in the Whole Blood of Children and Teenagers from Two Riparian Communities at the Madeira River Basin in the Western Brazilian Amazon.

Selenium (Se) is an essential micronutrient that exerts multiple functions in the organism, and both its deficiency and excess can cause health impairments. Thus, it is important to monitor its levels in the population, especially in vulnerable groups, such as children from the Brazilian Amazon region, where there is a lack of information in this regard. The aim of this research was to study Se levels in the whole blood of children and teenagers (5-16 years old) from two riparian communities at the Madeira River (Cuniã RESEX and Belmont). Se level variations related to the communities' location, seasonality, diet, and body mass index (BMI) were assessed. Blood samples were collected in both communities for Se determinations, using ICP-MS and hemogram analyses, during May and September of 2011. Food frequency questionnaires were applied to assess consumption rates of specific food items. Non-parametric tests and linear multiple regressions were applied in the data analyses. Median Se levels were significantly higher during May (Cuniã RESEX 149 µg L-1; Belmont 85 µg L-1) compared to September (Cuniã RESEX 79 µg L-1; Belmont 53 µg L-1). No significant differences were found between the communities regarding BMI measurements and anemia prevalence. However, Se blood levels were significantly higher at the Cuniã RESEX compared to Belmont. In addition, the former showed higher fish and Brazil nut intakes, which may be the main Se sources for this community. These results contribute to a better understanding of Se reference levels for children and teenagers of Western Amazon riparian communities.

Meta proteica versus disfunção renal na Unidade de Terapia Intensiva / Protein goal and renal dysfunction in the Intensive Care Unit

Introdução: As atuais recomendações de oferta proteica para o doente crítico orientam uma grande quantidade, sendo a orientação entre 1,2 e 2,0 g/kg/dia. Todavia, os grandes estudos demonstram que esta oferta proteica não é atingida, trazendo prejuízos à evolução dos pacientes. A utilização de uma oferta proteica alta frente a uma disfunção renal instalada também é tema de discussão na condução da terapia nutricional. Objetivo: Este artigo busca discutir os principais pontos dos estudos atuais relacionados ao tema. Método: Foram avaliados artigos de 2010 até 2016, na base de dados PubMed e LILACS, que relatavam a oferta proteica oferecida aos doentes críticos, embora nem sempre este fosse o principal dado do estudo. Resultados: A maioria dos estudos tinha desenho observacional, sendo possível notar que, em grande parte destes estudos, a oferta proteica mínima recomendada não foi atingida, tanto no grupo intervenção como controle. Outro ponto importante é que com o aumento da oferta para 1,5 g/kg/dia a 2 g/kg/dia ocorre aumento significativo do balanço nitrogenado, sem alterar a função renal. Não foram encontrados estudos randomizados que mostrem melhora do desfecho com uma oferta proteica mais elevada. Conclusões: Pacientes críticos apresentam geralmente elevado catabolismo proteico, desta forma existe um racional de recomendação de elevada oferta proteica. Entretanto, a maioria dos estudos mostra que tal recomendação não é cumprida na prática clínica. Dúvidas persistem em relação à meta proteica, particularmente na primeira semana da doença grave de pacientes com lesão renal aguda.(AU)

Introduction: The current recommendations of protein supply for the critical patient guide a great quantity, being the orientation between 1.2 and 2.0 g/kg/day. However, the large studies show that this protein supply is not reached, bringing losses to the evolution of the patients. The use of a high protein supply facing an established renal dysfunction is also a topic of discussion in the conduction of nutritional therapy. Objective: This article aims to discuss the main points of the current studies related to the theme. Methods: Articles from 2010 to 2016 were evaluated in the PubMed and LILACS databases, which reported the protein supply offered to critically ill patients, although this was not always the main data of the study. Results: Most of the studies had an observational design, being possible to observe that in the majority of these studies, the recommended minimum protein supply was not reached, both in the intervention and in the control group. Another important point is that with the increasing supply to 1.5 g/kg/day at 2 g/kg/day there is a significant increase in the nitrogen balance, without altering renal function. No randomized trials were found to show improvement in outcome with a higher protein supply. Conclusions: Critical ill patients generally present high protein catabolism in thus there is a rational recommendation of high protein supply. However,the majority of the studies show that this recommendation is not fulfilled in clinical practice. Doubts persist regarding the protein target, particularly in the first week of severe disease in patients with acute kidney injury.(AU)

Relato de um caso de tratamento homeopático de portadora de gastroparesia diabética / Report of a case of homeopathic treatment of patients with diabetic gastroparesis

O presente trabalho consiste num estudo descritivo baseado em coleta e análise de dados de prontuário. Trata do caso de uma paciente diabética, com gastroparesia internada no Hospital Público Regional de Betim, Minas Gerais. Reconheceu-se, na base da doença, específico desequilíbrio de saúde, susceptível de ser tratado com Silicea terra. Recorreu-se a memória sintética experimental, que compreende timidez, sensibilidade à contradição, conscienciosidade, antecipação, transtornos por separação, acne e intolerância a corpos estranhos. Após dose única do medicamento na diluição 30cH, observaram-se rápida melhora de sensação de doença, processos exonerativos e exercícios de vitalidade. Apesar do ambiente hospitalar enfatizar a paliação da doença, consegue-se demonstrar a efetividade da homeopatia neste nível de atenção médica e de ensino, auxiliando na simplificação terapêutica. Conclui-se que a homeopatia pode integrar o conjunto de alternativas médicas disponíveis para a atenção hospitalar, com finalidades de ensino, e pode auxiliar na simplificação terapêutica, a partir da cura de sensação de doença.

The present is a descriptive study based on collection and analysis of data from medical records. It concerns the case of a diabetic patient with gastroparesis admitted to Public Regional Hospital, Betim, Minas Gerais, Brazil. At the bottom of her disease we detected a specific health imbalance likely to respond to Silicea terra. We had resource to an experimental synthetic memory comprising: timidity; sensitivity to contradiction; consciousness; anticipation; ailments from separation; acne; and intolerance to foreign bodies. Following a single dose of Sil 30cH the patient exhibited fast improvement of her feeling of illness, exoneration symptoms and exercise of vitality. While the hospital setting prioritized the palliation of disease, the effectiveness of homeopathy also in this level of medical care and teaching might be demonstrated, contributing to the simplification of treatment. We conclude that homeopathy can be included among the medical alternatives available for inpatient care and teaching, and that it might contribute to the simplification of treatments based on the cure of the feeling of illness.

Relato de um caso de tratamento homeopático de portadora de gastroparesia diabética / Report of a case of homeopathic treatment of patients with diabetic gastroparesis

O presente trabalho consiste num estudo descritivo baseado em coleta e análise de dados de prontuário. Trata do caso de uma paciente diabética, com gastroparesia internada no Hospital Público Regional de Betim, Minas Gerais. Reconheceu-se, na base da doença, específico desequilíbrio de saúde, susceptível de ser tratado com Silicea terra. Recorreu-se a memória sintética experimental,que compreende timidez, sensibilidade à contradição, conscienciosidade, antecipação, transtornos por separação, acne e intolerância a corpos estranhos. Após dose única do medicamento na diluição 30cH, observaram-se rápida melhora de sensação de doença, processos exonerativos e exercíciosde vitalidade. Apesar do ambiente hospitalar enfatizar a paliação da doença, consegue-se demonstrar a efetividade da homeopatia neste nível de atenção médica e de ensino, auxiliando na simplificação terapêutica. Conclui-se que a homeopatia pode integrar oconjunto de alternativas médicas disponíveis para a atenção hospitalar,com finalidades de ensino,e pode auxiliar na simplificação terapêutica, a partir da cura de sensação de doença. (AU)

The present is a descriptive study based on collection and analysis of data from medical records. It concerns the case of a diabetic patient with gastroparesisadmitted to Public Regional Hospital, Betim, Minas Gerais, Brazil. At the bottom of her disease we detected a specific health imbalance likely to respond to Silicea terra. We had resource to an experimental synthetic memory comprising: timidity; sensitivity to contradiction; consciousness; anticipation; ailments from separation; acne; and intolerance to foreign bodies. Following a single dose of Sil30cH the patient exhibited fast improvement of her feeling of illness, exoneration symptoms and exercise of vitality. While the hospital setting prioritized the palliation of disease, the effectiveness of homeopathy also in this level of medical care and teaching might be demonstrated, contributing to the simplification of treatment. We conclude that homeopathy can be included among the medical alternatives available for inpatient care and teaching, and that it might contribute to the simplification of treatments based on the cure of the feeling of illness. (AU)

Effects of Dietary Supplementation with Brazil Nuts on Microvascular Endothelial Function in Hypertensive and Dyslipidemic Patients: A Randomized Crossover Placebo-Controlled Trial.

OBJECTIVE: To investigate the effects of dietary supplementation with GBNs on microvascular endothelial function in hypertensive and dyslipidemic patients. METHODS: Ninety-one patients of both sexes aged 62.1 ± 9.3 years received 13 g/day of GBNs or a placebo for three months with a washout period of one month between treatments. Microvascular endothelial function was assessed using LSCI coupled with iontophoresis of ACh and PORH. We also used skin video capillaroscopy to measure capillary density and recruitment at rest and during PORH. Plasma concentrations of NOx were also measured as a marker of nitric oxide bioavailability. RESULTS: Supplementation with GBNs significantly increased the plasma levels of Se (p < 0.05) and NOx (p < 0.05). However, we did not observe any effects of GBN consumption on microvascular vasodilator responses to ACh or PORH (p > 0.05), and GBNs did not improve capillary density at baseline or recruitment during PORH (p > 0.05). CONCLUSIONS: Supplementation with GBNs induced significant increases in the plasma Se concentration and systemic bioavailability of nitric oxide. Nevertheless, GBN supplementation did not lead to any improvement in systemic microvascular reactivity or density in patients with arterial hypertension and dyslipidemia who were undergoing multiple drug therapies.

Improvement of antioxidant status after Brazil nut intake in hypertensive and dyslipidemic subjects.

OBJECTIVES: To investigate the effect of partially defatted Granulated Brazil nut (GBN) on biomarkers of oxidative stress and antioxidant status of hypertensive and dyslipidemic patients on nutrition and drug approaches. METHODS: Ninety one hypertensive and dyslipidemic subjects of both genders (51.6 % men), mean age 62.1 ± 9.3 years, performed a randomized crossover trial, double-blind, placebo controlled. Subjects received a diet and partially defatted GBN 13 g per day (≈227.5 µg/day of selenium) or placebo for twelve weeks with four-week washout interval. Anthropometric, laboratory and clinic characteristics were investigated at baseline. Plasma selenium (Se), plasma glutathione peroxidase (GPx3) activity, total antioxidant capacity (TAC), 8-epi PGF2α and oxidized LDL were evaluated at the beginning and in the end of each intervention. RESULTS: GBN intake significantly increased plasma Se from 87.0 ± 16.8 to 180.6 ± 67.1 µg/L, increased GPx3 activity in 24,8% (from 112.66 ± 40.09 to 128.32 ± 38.31 nmol/min/mL, p < 0,05), and reduced 3.25% of oxidized-LDL levels (from 66.31 ± 23.59 to 60.68 ± 20.88 U/L, p < 0.05). An inverse association between GPx3 and oxidized LDL levels was observed after supplementation with GBN by simple model (ß -0.232, p = 0.032) and after adjustment for gender, age, diabetes and BMI (ß -0.298, p = 0.008). There wasn't association between GPx3 and 8-epi PGF2α (ß -0.209, p = 0.052) by simple model. CONCLUSION: The partially defatted GBN intake has a potential benefit to increase plasma selenium, increase enzymatic antioxidant activity of GPx3 and to reduction oxidation in LDL in hypertensive and dyslipidemic patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01990391; November 20, 2013.

Resposta aguda da pressão arterial, da frequência cardíaca e do duplo-produto após uma sessão de eletroestimulação em exercício de força / Acute response of blood pressure, heart rate and dual output after an electro-stimulation session with strength training exercises

Objetivo: Verificar as respostas cardiovasculares(frequência cardíaca, pressão arterial e duplo-produto)agudas após a utilização da eletroestimulação (EE) prévia aos exercícios de força. Métodos: Foram estudados 16 homens voluntários do sexo masculino (idade 25,7 mais ou menos 6 anos, massa 80 mais ou menos 10,5 kg, estatura 177,1 mais ou menos 7,41 cm) com previa experiência em exercício de força. Os indivíduos foram separados aleatoriamente em dois grupos: Grupo I: Grupo sem eletroestimulação )GSE n igual 8), Grupo 2: Grupo eletroestimulação (GEE n igual 8). Antes da coleta de dados, todos os indivíduos realizaram o teste de 10 repetições máximas (10-RM) no exercício extensão de joelhos simultâneos. Após 48 h do teste 10-RM, foi realizada a coleta de dados, com a execução de 3 séries de 10 repetições, a 80 por cento de 10-RM e intervalo de recuperação de 2 minutos fixos, para ambos os grupos, no exercício cadeira extensora. As mensurações da pressão arterial, da frequência cardíaca e do duplo-produto (PAS X FC) foram realizadas no repouso e ao final da 1, 2 e 3 séries de exercícios. No GEE foi adotada a aplicação da EE prévia à realização do exercício em uma frequência de 50 Hz...

The determination of total Se in urine and serum by graphite furnace atomic absorption spectrometry using Ir as permanent modifier and in situ oxidation for complete trimethylselenonium recovery.

The present work evaluated the use of iridium (Ir) as permanent modifier for the determination of total selenium in urine and serum by graphite furnace atomic absorption spectrometry. Concerning urine, the presence of trimethylselenonium (TMSe(+)) was especially considered. Pyrolysis and atomization temperatures of 1,000 and 2,100 degrees C, respectively, were used. For nondigested urine and serum samples, 0.2% v/v HNO(3) and Triton X-100 were used as diluents, respectively, and the same initial platform Ir treatment was effective for up to 1,100 atomization cycles. Good precision [less than 5% relative standard deviation (RSD)] can be achieved with the proposed method. Low TMSe(+) recovery was observed for nondigested urine samples. Thus, if this species is to be considered in urine analysis, a previous external mineralization step was found to be necessary. Alternatively, an in situ oxidation treatment was developed. Detection limits of 8, 10, and 7 mug l(-1) were obtained after dilution, microwave-assisted digestion, and in situ oxidation procedures, respectively. The accuracy of the method was validated by the analysis of certified reference or commercial quality control materials and spiked samples.