Influence of Anaerobic Exercise in Type 1 Diabetes Mellitus Biomarkers: A Systematic Review.

AIM: Physical exercise is part of the type 1 diabetes mellitus (T1DM) treatment. However, this practice is still neglected due to the wide variety of glycemic responses under the influence of anaerobic exercise. Therefore, this study aimed to investigate the influence of anaerobic exercise on biomarkers of T1DM. METHODS: The systematic review was conducted on PubMed, Lilacs, and Embase, according to PRISMA. For this purpose, three groups of descriptors were used: adults with T1DM, anaerobic physical exercise, and glycemic control. The search filter was set to human beings older than 18 years of age, longitudinal and cross-sectional studies, with studies published from 2000 to 2023 in English, Spanish, or Portuguese. Titles and abstracts were read independently by two reviewers, and then the articles were selected for this review. The Kappa coefficient was measured to evaluate the selection. RESULTS: A total of 738 articles were identified, and five were selected to be part of the review after applying the steps of the procedure. Some benefits were observed in fatigue reduction, absence of diabetic ketoacidosis requiring hospitalization, and enhancement of glucose monitoring during exercise. In the anaerobic workouts of the groups with T1DM, glycemic mean values ranged from 124.5-185.0 mg/dl, and glycated hemoglobin records ranged from 6.7-8.1%. CONCLUSION: Anaerobic exercise improved the biomarkers of T1DM, especially glycemic control, and the reduction of symptomatic hypoglycemic episodes. Anaerobic exercise can be performed by individuals with T1DM, suggesting an individualized training prescription and encouraging its practice associated with aerobic exercise.

Spatial-temporal risk clusters, social vulnerability, and identification of priority areas for surveillance and control of cutaneous leishmaniasis in Maranhão, Brazil: an ecological study.

Cutaneous leishmaniasis (CL) is a neglected disease widely distributed in Maranhão, Brazil and presents a significant public health problem. However, its transmission dynamics and determining factors are not clearly understood. In this context, geospatial technologies help interpret the process. This study, then, characterized the space-time dynamics and the influence of social vulnerability on CL in an endemic area in Northeast Brazil. This is an ecological study about new cases of CL in Maranhão, from 2007 to 2020, obtained directly from the Notifiable Diseases Information System. The incidence rate was smoothed using a spatial empirical Bayesian method. Subsequently, global and local Moran statistics and their association with social vulnerability indicators were determined. Disease distribution was not random but grouped in space and time. All Social Vulnerability Index domains were positively correlated with the CL incidence. A likely cluster was detected in western Maranhão (P < 0.001), which encompassed 18 municipalities, from January 2007 to December 2013, with a high relative risk (5.06). The research findings suggest that planning public health actions and allocating resources should be prioritized in these areas to help effectively reduce the incidence of the disease.

Evaluation of the skin whitening and antioxidant activity of Myracrodruon urundeuva extract (aroeira-do-sertão).

Myracrodruon urundeuva, popularly known as 'aroeira-do-sertão', a large tree, with a tall trunk. Belonging to the Anacardiaceae family, it occurs in the 'caatinga' and dry forests of Brazil, from Ceará to the states of Paraná and Mato Grosso do Sul. The present study aimed to analyse the whitening and antioxidant activities of the aqueous extract of the leaves of Myracrodruon urundeuva (AELMU). Inhibition of the tyrosinase enzyme, as well as its copper chelating capacity and antioxidant effect were evaluated. The AELMU (at 2000 µg/mL) showed excellent inhibitory action (83.76%) on tyrosinase by chelating the copper ion while kojic acid at the same concentration inhibited 97.81%. Moreover, the extract displayed important antioxidant activity (inhibited 76,46% of the 2,2-diphenyl-1-picrylhydrazyl radical - DPPH; 49,59% of thiobarbituric acid reactive substances and 51,07% of the hydroxyl radical). Thus, the extract under study is promising for use in cosmetics, given its multifactorial action.

Evaluation of the performance indicators of the Previne Brasil Program in the Massif of Baturité: Chronic Diseases. / Avaliação dos indicadores de desempenho do programa Previne Brasil no Maciço de Baturité: Doenças crônicas.

Objective: to evaluate the results of performance indicators 6 (proportion of people with hypertension, with consultation and blood pressure checked in the semester) and 7 (proportion of people with diabetes mellitus, with consultation and glycated hemoglobin requested in the semester) of the Previne Brasil Program in the Massif of Baturité, located in Ceará in the period from 2020 to the year 2023. Methods: Cross-sectional study with a quantitative approach Results: The Maciço de Baturité region has 136 primary health care units in active status and registered in the National Register of Health Establishments (CNES), with a total of 99 Family Health teams (eSF), displaying a coverage indicator of 100% eSF. However, the performance indicators of the Previne Brasil program showed inadequate results. Indicator 6 did not reach the target of 50% coverage in the years 2020 to 2022 and indicator 7 reached the target only in 2021, however it shows a downward trend in 2022. Conclusion: the coverage of the indicators is unsatisfactory, in view of the predominance of quarters where the targets established for the indicators are not achieved. However, the study reveals that the coverage rate of Family Health teams is adequate in the thirteen municipalities evaluated. Thus, the research expresses the need to review the profile of care for patients with chronic non-communicable diseases.

Objetivo: avaliar os resultados dos indicadores de desempenho 6 (proporção de pessoas com hipertensão, com consulta e pressão arterial aferida no semestre) e 7 (proporção de pessoas com diabetes mellitus, com consulta e hemoglobina glicada solicitada no semestre) do Programa Previne Brasil no Maciço de Baturité, situado no Ceará no período de 2020 ao ano de 2023. Métodos: Estudo transversal de abordagem quantitativa Resultados: A região do Maciço de Baturité possui 136 unidades de atenção primária à saúde em situação ativa e registradas no Cadastro Nacional de Estabelecimentos de Saúde (CNES), com o total 99 equipes de Saúde da Família (eSF), exibindo um indicador de cobertura de eSF de 100%. Contudo, os indicadores de desempenho do programa Previne Brasil apresentaram resultados inadequados. O indicador 6 não alcançou a meta de 50% de cobertura nos anos de 2020 a 2022 e o indicador 7 atingiu a meta somente no ano de 2021, todavia apresenta uma tendência de queda em 2022.  Conclusão: a cobertura dos indicadores é insatisfatória, em observância ao predomínio de quadrimestres onde as metas estabelecidas para os indicadores não são alcançadas. No entanto, o estudo revela que a taxa de cobertura de equipes de Saúde da Família encontra-se adequada nos treze municípios avaliados. Assim, a pesquisa expressa a necessidade de revisão no perfil de atendimento a pacientes com doenças crônicas não transmissíveis. 

M-shaped Genioplasty: New Findings after 10 Years of Experience.

This study aimed to evaluate changes of the M-shaped genioplasty in sagittal and vertical planes in a group of 34 patients and describe other indications, such as the increase of the mentolabial angle, decrease in the depth of the mentolabial fold, and the centering of the chin. Methods: A retrospective analysis was performed on 34 patients between 2010 and 2019. All studies were conducted at T0 (preoperative), T1 (a month after surgery), and T2 (1 year after surgery). The position of the bone pogonion (Pg) was measured vertically and horizontally at T0, T1, and T2; the mentolabial angle and the depth of the mentolabial fold were measured at T0 and T2. Results: The average sagittal advancement at T1 was 6.6 mm and at T2 was 6.4 mm. The inferior movement was an average of 5.6 mm at T1 and T2, showing both movements excellent stability. The mentolabial angle increased at T2 an average of 28.2 degrees (5 degrees per each millimeter of inferior movement), whereas the depth of the mentolabial fold decreased an average of 2.8 mm (decreased 49% from the initial depth and decreased 0.56 mm per each mm of inferior movement). The average increase of the lower third of the face was 5 mm. No complications were observed in any patient. Conclusions: M-shaped genioplasty is an anterior osteotomy of the mandible, which allows the chin to move forward and downward. Additionally, it allows an increase of the mentolabial angle and decreases the mentolabial fold.

Atividade in vitro de extratos e frações de Copernicia prunifera (Arecaceae) contra bactérias de importância clínica em saúde pública / In vitro activity of extracts and fractions of Copernicia prunifera (Arecaceae) against bacteria of clinical importance in public health / Actividad in vitro de extractos y fracciones de Copernicia prunifera (Arecaceae) frente a bacterias de importancia clínica en salud pública

Introdução: O aumento contínuo da resistência bacteriana aos antibióticos convencionais é um problema de importância global. Encontrar produtos como alternativas terapêuticas naturais é essencial. As plantas medicinais possuem uma composição química muito rica, que podem ser estruturalmente otimizadas e processadas em novos antimicrobianos. Objetivo: Avaliar o potencial antibacteriano frente a microrganismos humanos potencialmente patogênicos do extrato etanólico e frações de Copernicia prunifera. Metodologia: A triagem fitoquímica de plantas foi realizada usando métodos de precipitação e coloração e a atividade antibacteriana utilizando o método de difusão em disco e microdiluição em caldo contra cepas padronizadas de Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa e Staphylococcus aureus. Resultados: A triagem fitoquímica revela a presença de taninos, flavonoides, esteroides, triterpernóides, saponinas e alcaloides. Os extratos etanólico e frações da casca do caule e folhas tiveram atividade inibitória contra S. aureus e K. pneumonie com zona de inibição que variou de 7,0±1,73 a 9,33±0,58 mm pelo método de difusão em disco. Pelo método de microdiluição em caldo os extratos foram satisfatórios somente contra K. pneumoniae (CIM = 125 a 1000 µg/mL) S. aureus, P. aeruginosa e E. coli se mostraram resistentes aos testes (CIM > 1000 µg/mL). Conclusão: Esses resultados fornecem uma base para futuras investigações em modelos in vivo, para que os compostos de C. prunifera possam ser aplicados no desenvolvimento de novos agentes antimicrobianos contra K. pneumoniae.

Introduction: The continuous increase in bacterial resistance to conventional antibiotics is a problem of global importance. Finding products as natural therapeutic alternatives is essential. Medicinal plants have a very rich chemical composition, which can be structurally optimized and processed into novel antimicrobials. Objective: To evaluate the antibacterial potential against potentially pathogenic human microorganisms of the ethanolic extract and fractions of Copernicia prunifera. Methodology: Phytochemical screening of plants was performed using precipitation and staining methods and antibacterial activity using the disk diffusion and broth microdilution method against standardized strains of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Results: Phytochemical screening reveals the presence of tannins, flavonoids, steroids, triterpernoids, saponins and alkaloids. The ethanolic extracts and fractions of stem bark and leaves had inhibitory activity against S. aureus and K. pneumonie with zone of inhibition ranging from 7.0±1.73 to 9.33±0.58 mm by disc diffusion method. By broth microdilution method the extracts were satisfactory only against K. pneumoniae (MIC = 125 to 1000 µg/mL) S. aureus, P. aeruginosa and E. coli were resistant to the tests (MIC > 1000 µg/mL). Conclusion: These results provide a basis for further investigation in in vivo models, so that compounds from C. prunifera can be applied in the development of new antimicrobial agents against K. pneumoniae.

Introducción: El continuo aumento de la resistencia bacteriana a los antibióticos convencionales es un problema de importancia mundial. Es esencial encontrar productos como alternativas terapéuticas naturales. Las plantas medicinales tienen una composición química muy rica, que puede optimizarse estructuralmente y transformarse en nuevos antimicrobianos. Objetivo: Evaluar el potencial antibacteriano frente a microorganismos humanos potencialmente patógenos del extracto etanólico y fracciones de Copernicia prunifera. Metodología: Se realizó el cribado fitoquímico de las plantas mediante los métodos de precipitación y tinción y la actividad antibacteriana mediante el método de difusión en disco y microdilución en caldo frente a cepas estandarizadas de Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa y Staphylococcus aureus. Resultados: El cribado fitoquímico revela la presencia de taninos, flavonoides, esteroides, triterpernoides, saponinas y alcaloides. Los extractos etanólicos y las fracciones de la corteza del tallo y las hojas presentaron actividad inhibitoria contra S. aureus y K. pneumonie con una zona de inhibición que osciló entre 7,0±1,73 y 9,33±0,58 mm por el método de difusión en disco. Por el método de microdilución en caldo, los extractos sólo fueron satisfactorios frente a K. pneumoniae (CMI = 125 a 1000 µg/mL). S. aureus, P. aeruginosa y E. coli fueron resistentes a las pruebas (CMI > 1000 µg/mL). Conclusiones: Estos resultados proporcionan una base para futuras investigaciones en modelos in vivo, de modo que los compuestos de C. prunifera puedan aplicarse en el desarrollo de nuevos agentes antimicrobianos contra K. pneumoniae.

Spatiotemporal Distribution of Leishmaniasis in an Endemic Area of Northeast Brazil: Implications for Intervention Actions.

This study aimed to analyze the spatiotemporal distribution of leishmaniases, and contribute to the knowledge of their epidemiological dynamics from 2007 to 2017 in the municipality of Caxias, Maranhão, Northeast Brazil. Data on American tegumentary leishmaniasis (ATL) and human visceral leishmaniasis (HVL) were obtained in the Epidemiological Surveillance Sector of Caxias, while data on canine visceral leishmaniasis (CVL) were obtained in the Zoonoses Surveillance Unit. For data analysis and spatial representation of leishmaniasis cases, the geoprocessing of the data was performed, and the geometric features of the state of Maranhão, Caxias, and the disease registration sites were obtained from the shapefile database of the Brazilian Institute of Geography and Statistics. Geostatistics was used to create maps based on the Kernel density method, starting from the points, producing a raster file for each case with several data frames, allowing the instantaneous comparison of the phenomena. During the study period, ATL, HVL, and CVL were reported in Caxias, accounting for 114,304 and 8,498 cases, respectively. The geoprocessing analysis showed that leishmaniasis is widely distributed in the urban area of Caxias. However, there are risk areas for the transmission of these diseases to humans and dogs, associated with deforestation and urban expansion, and may vary over time. Preventive measures must focus on risk areas, including conservation efforts and urban planning, in order to reduce the transmission of leishmaniases.

Phytochemical analysis and antimicrobial potential of extracts and fractions of brosimum gaudichaudii trécul against bacteria of clinical importance / Análise fitoquímica e potencial antimicrobiano de extratos e frações de brosimum gaudichaudii trécul contra bactérias de importância clínica / Análisis fitoquímico y potencial antimicrobiano de extractos y fracciones de brosimum gaudichaudii trécul contra bacterias de importancia clínica

Medicinal plants constitute an arsenal of products with different potentials to be explored. Therefore, the objective of this paper was to assess the antimicrobial potential of the ethanolic extract from Brosimum gaudichaudii leaves and fractions against clinically important bacteria. The crude extracts and fractions from the leaves and stem bark were used against Escherichia coli, Klesbsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus strains. The crude extracts and the fractions were obtained by means of maceration in ethanol and chemically characterized. In the results of the phytochemical screening, the presence of a variety of secondary metabolites was verified, such as flavonoids, steroids, saponins, alkaloids, tannins and coumarins. The extracts and their fractions showed inhibitory activity for all three bacteria tested. The inhibition halo varied from 8±0.00 to 14±0.00 mm fir K. pneumoniae, from 8±0.00 to 10±0.00 mm for P. aeruginosa and from 8±0.00 to 9±0.00 mm for S. aureus. Among the fractions tested, the ethyl acetate fraction from both the stem and the leaves presented the best inhibition potential. This indicates that the Brosimum gaudichaudii Trécul vegetable extracts present antimicrobial potential. Such being the case, it is suggested to isolate the metabolites present in this fraction to delimit the main compounds responsible for the antimicrobial action.

As plantas medicinais constituem um arsenal de produtos com diferentes potenciais a serem explorados. Portanto, o objetivo deste trabalho foi avaliar o potencial antimicrobiano do extrato etanólico das folhas e frações de Brosimum gaudichaudii contra bactérias de importância clínica. Os extratos brutos e as frações das folhas e da casca do caule foram usados contra cepas de Escherichia coli, Klesbsiella pneumoniae, Pseudomonas aeruginosa e Staphylococcus aureus. Os extratos brutos e as frações foram obtidos por meio de maceração em etanol e caracterizados quimicamente. Nos resultados da triagem fitoquímica, foi verificada a presença de uma variedade de metabólitos secundários, como flavonoides, esteroides, saponinas, alcaloides, taninos e cumarinas. Os extratos e suas frações apresentaram atividade inibitória para todas as três bactérias testadas. O halo de inibição variou de 8±0,00 a 14±0,00 mm para K. pneumoniae, de 8±0,00 a 10±0,00 mm para P. aeruginosa e de 8±0,00 a 9±0,00 mm para S. aureus. Entre as frações testadas, a fração de acetato de etila do caule e das folhas apresentou o melhor potencial de inibição. Isso indica que os extratos vegetais de Brosimum gaudichaudii Trécul apresentam potencial antimicrobiano. Sendo assim, sugere-se o isolamento dos metabólitos presentes nessa fração para delimitar os principais compostos responsáveis pela ação antimicrobiana.

Las plantas medicinales constituyen un arsenal de productos con diferentes potenciales por explorar. Por lo tanto, el objetivo de este estudio fue evaluar el potencial antimicrobiano del extracto etanólico de hojas de Brosimum gaudichaudii y fracciones contra bacterias clínicamente importantes. Los extractos crudos y las fracciones de las hojas y la corteza del tallo se utilizaron contra cepas de Escherichia coli, Klesbsiella pneumoniae, Pseudomonas aeruginosa y Staphylococcus aureus. Los extractos crudos y las fracciones se obtuvieron por maceración en etanol y se caracterizaron químicamente. Los resultados del cribado fitoquímico verificaron la presencia de diversos metabolitos secundarios, como flavonoides, esteroides, saponinas, alcaloides, taninos y cumarinas. Los extractos y sus fracciones presentaron actividad inhibitoria para las tres bacterias ensayadas. El halo de inhibición varió de 8±0,00 a 14±0,00 mm para K. pneumoniae, de 8±0,00 a 10±0,00 mm para P. aeruginosa y de 8±0,00 a 9±0,00 mm para S. aureus. Entre las fracciones probadas, la fracción de acetato de etilo del tallo y las hojas mostró el mejor potencial de inhibición. Esto indica que los extractos vegetales de Brosimum gaudichaudii Trécul tienen potencial antimicrobiano. Así, se sugiere el aislamiento de los metabolitos presentes en esta fracción para determinar los principales compuestos responsables de la acción antimicrobiana.

Teleodontology as a tool for adolescent oral health care / Teleodontologia como ferramenta para atenção à saúde bucal do adolescente

ABSTRACT Adolescence comprises a life cycle with high contact to information and communication technological tools. For this reason, it was decided to incorporate these tools into the oral health work process aimed at this public. The COVID-19 pandemic contextualized the use of digital technological tools in several productive sectors, including oral health care in the Unified Health System. Objective: The objective was to stimulate the use of teledentistry in the oral health care of adolescents in Primary Health Care in the Ceará interior. Methods: The participants were adolescents between 12 and 15 years old from two micro areas of the territory, in total there are 25 participants. The intervention was divided into three stages: application of an electronic form, creation of an instant messaging application group and creation and expansion of a flow for access to the service. Results: The reasons for the dropout in dental consultations by adolescents were the lack of vacancies, long wait and the low number of educational actions aimed at health. In the messaging application group, remote educational activities were carried out, as well as restructuring of the dental care flow with the possibility of scheduling a first appointment through the group. Conclusion: The interaction obtained in the intervention favored the improvement of access to dental appointments.

RESUMO A adolescência compreende um ciclo de vida com alto contato com ferramentas tecnológicas de informação e comunicação. Por este motivo optou-se pela incorporação dessas ferramentas no processo de trabalho em saúde bucal voltado a este público. A pandemia de COVID-19 contextualizou a utilização de ferramentas tecnológicas digitais em diversos setores produtivos, incluindo a assistência à saúde bucal no Sistema Único de Saúde. Objetivos: Objetivou-se estimular o uso da teleodontologia na atenção à saúde bucal de adolescentes na Atenção Primária à Saúde do interior do Ceará. Métodos: Os participantes foram adolescentes entre 12 e 15 anos de duas microáreas do território, totalizando 25 participantes. A intervenção foi dividida em três etapas: a aplicação de um formulário eletrônico, criação de um grupo de aplicativo de mensagens instantâneas e criação com ampliação de um fluxo para acesso ao serviço. Resultados: Os motivos da evasão em consultas odontológicas pelos adolescentes foram a falta de vagas, o longo tempo de espera e o baixo número de ações educativas voltadas à saúde. No grupo do aplicativo de mensagens, foram realizadas atividades educativas remotas, assim como restruturação do fluxo de atendimento com a possibilidade de marcação de primeira consulta através do grupo. Conclusão: A interação obtida na intervenção favoreceu a melhoria do acesso às consultas odontológicas.

ROS: Basic Concepts, Sources, Cellular Signaling, and its Implications in Aging Pathways.

Reactive oxygen species (ROS) are bioproducts of cellular metabolism. There is a range of molecules with oxidizing properties known as ROS. Despite those molecules being implied negatively in aging and numerous diseases, their key role in cellular signaling is evident. ROS control several biological processes such as inflammation, proliferation, and cell death. The redox signaling underlying these cellular events is one characteristic of the new generation of scientists aimed at defining the role of ROS in the cellular environment. The control of redox potential, which includes the balance of the sources of ROS and the antioxidant system, implies an important target for understanding the cells' fate derived from redox signaling. In this review, we summarized the chemical, the redox balance, the signaling, and the implications of ROS in biological aging.

Rastreamento clínico e nutricional de gestantes de alto risco na estratégia de saúde da família de Santa Quitéria - CE / Clinical and nutritional screening of high-risk pregnant women in the family health strategy of Santa Quitéria - CE / Cribado clínico y nutricional de las embarazadas de alto riesgo en la estrategia de salud familiar de Santa Quitéria - CE

Considera-se gestação de alto risco quando a mulher apresenta comorbidade materna e/ou condição sociobiológica que levam as chances de ocorrer alguma intercorrência na evolução natural da gravidez, como hipertensão arterial, diabetes, anemia, alcoolismo e obesidade. É de grande importância o acompanhamento pré-natal com uma equipe de assistência capaz de identificar os problemas antes mesmo que possam ser agravados. O objetivo deste estudo foi rastrear o perfil clínico e nutricional de mulheres com gestação de alto risco na Estratégia de Saúde da Família de Santa Quitéria- CE. Trata-se de um estudo descritivo, com abordagem quantitativa realizado com 33 gestantes. Para a coleta de dados foi utilizado o cartão da gestante e prontuário, o estado nutricional foi avaliado através do peso pré- gestacional contido no cartão e peso atual através da balança. Para análise estatística, foram usados frequências, percentuais, médias e desvio padrão, verificadas por meio dos testes de Kolmogorov-Smirnov e Levene. Para a comparação de médias entre duas categorias, utilizou-se o teste t de Student para amostras independentes. Os resultados mostraram que a maioria tinha o ensino médio como nível de escolaridade, renda igual ou menor que um salário mínimo, multíparas com um ou mais abortos. Em relação às características do estado clínico patológico, as condições mais prevalentes nas gestantes do presente estudo foram hipertensão arterial sistêmica, pré-eclâmpsia, seguidos de DMG e eritoblastose. Excesso de peso antes e durante a gravidez com ganho ponderal de peso adequado. O que demonstra a necessidade de estratégias para a saúde da mulher. É apropriado acionar sinal de alerta no acompanhamento da saúde da mulher também antes da gestação e não somente no pré-natal para que transcorra bem durante e após o parto. PALAVRAS-CHAVE: Estado nutricional; Gestação de alto risco; Assistência Pré-Natal.

High-risk pregnancy is considered when the woman presents maternal comorbidity and/or sociobiological condition that increase the chances of some complication occurring in the natural evolution of pregnancy, such as arterial hypertension, diabetes, anemia, alcoholism, and obesity; It is of great importance the prenatal follow-up with an assistance team capable of identifying the problems even before they can be aggravated; The objective of this study was to track the clinical and nutritional profile of women with high-risk pregnancy in the Family Health Strategy of Santa Quitéria-CE; This is a descriptive study with a quantitative approach carried out with 33 pregnant women; For data collection the pregnant woman's card and medical records were used, the nutritional status was evaluated through the pre-gestational weight contained in the card and current weight through the scale; For statistical analysis, frequencies, percentages, means and standard deviation were used, verified by means of the Kolmogorov-Smirnov and Levene tests;For comparison of means between two categories, Student's t test for independent samples was used; The results showed that most had high school education, income equal to or less than one minimum wage, multiparous women with one or more abortions; Regarding the characteristics of the pathological medical condition, the most prevalent conditions in the pregnant women of the present study were hypertension, pre- eclampsia, followed by GDM and erythoblastosis; Overweight before and during pregnancy with adequate weight gain; This demonstrates the need for women's health strategies; It is appropriate to trigger warning signals in the monitoring of women's health also before pregnancy and not only in the prenatal period so that it goes well during and after delivery;

Se considera embarazo de alto riesgo cuando la mujer presenta comorbilidad materna y/o condición socio-biológica que conlleva las posibilidades de aparición de alguna complicación en la evolución natural del embarazo, como son la hipertensión, la diabetes, la anemia, el alcoholismo y la obesidad. Es de gran importancia el seguimiento prenatal con un equipo de asistencia capaz de identificar los problemas incluso antes de que puedan agravarse. El objetivo de este estudio fue rastrear el perfil clínico y nutricional de las mujeres con embarazo de alto riesgo en la Estrategia de Salud Familiar de Santa Quitéria-CE. Se trata de un estudio descriptivo con un enfoque cuantitativo realizado con 33 mujeres embarazadas. Para la recopilación de datos se utilizó el cartón de la gestante y el prontuario, el estado nutricional se evaluó a través del peso pregestacional contenido en el cartón y el peso actual a través de la balanza. Para el análisis estadístico se utilizaron frecuencias, porcentajes, medias y desviación estándar, verificados mediante las pruebas de Kolmogorov-Smirnov y Levene. Para la comparación de medias entre dos categorías, se utilizó la prueba t de Student para muestras independientes. Los resultados mostraron que la mayoría tenía estudios secundarios, ingresos iguales o inferiores a un salario mínimo, mujeres multíparas con uno o más abortos. En cuanto a las características del estado clínico patológico, las condiciones más prevalentes en las embarazadas del presente estudio fueron la hipertensión arterial sistémica, la preeclampsia, seguidas de la DMG y la eritoblastosis. Exceso de peso antes y durante el embarazo con un aumento de peso adecuado. Lo que demuestra la necesidad de estrategias de salud para las mujeres. Es conveniente activar la señal de alarma en el seguimiento de la salud de las mujeres también antes del embarazo y no sólo en la atención prenatal para que funcione bien durante y después del parto.

Blood pressure variability in individuals with diabetes mellitus: a scoping review.

OBJECTIVES: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. METHODS: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. RESULTS: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). CONCLUSIONS: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

Predominance of Leishmania (Leishmania) amazonensis DNA in Lutzomyia longipalpis sand flies (Diptera: Psychodidae) from an endemic area for leishmaniasis in Northeastern Brazil.

Leishmaniasis is a serious public health concern in the Northeastern region of Brazil, where the sand fly fauna is well studied, although few species have been identified as competent vectors. The detection of Leishmania spp. parasites in wild-caught sand flies could help sanitary authorities draw strategies to avoid the transmission of the parasites and, therefore, the incidence of leishmaniases. We detected Leishmania DNA in wild-caught sand flies and correlated that data with aspects of sand fly ecology in the Caxias municipality, Maranhao State, Brazil. The sand flies were sampled in the peridomicile (open areas in the vicinity of human residences) and intradomicile (inside the residences) from July/2019 to March/2020. Leishmania DNA was detected in females, targeting a fragment of the Internal Transcribed Spacer (ITS1) from ribosomal DNA. Among the fourteen species of sand flies identified, five (Lutzomyia longipalpis, Nyssomyia whitmani, Evandromyia evandroi, Micropygomyia trinidadensis, and Micropygomyia quinquefer) harbored DNA of Leishmania (Leishmania) amazonensis. The most abundant species in rural (Ny. whitmani: 35.2% and Ev. evandroi: 32.4%) and urban areas (Lu. longipalpis: 89.8%) are the permissive vectors of L. (L.) amazonensis, especially Ny. whitmani, a known vector of causative agents of cutaneous leishmaniasis. Although Lu. longipalpis is the vector of L. (L.) infantum, which was not detected in this study, its permissiveness for the transmission of L. (L.) amazonensis has been reported. We suspect that visceral leishmaniasis and cutaneous leishmaniasis are caused by L. (L.) amazonensis, and the transmission may be occurring through Lu. longipalpis, at least in the urban area.

Validação do Conteúdo de um Instrumento para Consulta de Enfermagem à Pessoa com Úlcera Venosa / Validation of the Content of an Instrument for Nursing Consultation for People With Venous Ulcer / Validación del Contenido de un Instrumento para Consulta de Enfermería para Personas con Úlcera Venosa

Objetivo:Validação do conteúdo de um instrumento para consulta de enfermagem à pessoa com úlcera venosa (UV). Metodologia: Estudo metodológico de validação interna de conteúdo baseado no julgamento de juízes estomaterapeutas, cuja identificação se deu através de busca na Plataforma Lattes. O processo ocorreu nos meses de janeiro e fevereiro de 2019 e 24 especialistas participaram. Os dados relativos à avaliação da consulta foram compilados em planilha do Microsoft Office Excel e considerados conforme índice de concordância (IC) total e global, totalizando 209 itens e 2.400 variáveis da consulta, sendo adotadas respostas dicotômicas. Resultados: Com relação à caracterização dos juízes, obteve-se idade média de 36,6 anos. A maioria foi do sexo feminino e localizada no estado do Ceará. A principal titulação observada foi o mestrado (62,5%) e os juízes atuavam na assistência e coordenação de serviço de estomaterapia. Dois terços apresentavam experiência com validação de instrumentos (66,7%). Com relação à validação da consulta, obteve-se um IC global de 92% e alfa de 0,91. Conclusão: A consulta possui aparência adequada para ser utilizada, é de fácil aplicação, possui sequência lógica, além de possibilitar um cuidado de enfermagem sistemático.

Objective:To validate the content of an instrument for nursing consultation with people with venous ulcers. Methodology:Methodological study of internal validation of content based on the judgment of enterostomal therapist judges, whose identification occurred through a search on the Lattes Platform. The process occurred in the months of January and February 2019 and 24 experts participated. Data regarding the evaluation of the query were compiled in Microsoft Office Excel spreadsheet and considered according to total and global agreement index, totaling 209 items and 2,400 variables of the query, dichotomous responses being adopted. Results: Regarding the characterization of the judges, a mean age of 36.6 years was obtained. Most were female and located in the state of Ceará. The main qualification observed was Master's degree (62.5%) and the judges worked in assistance and coordination of enterostomal therapy services. Two thirds had experience with validation of instruments (66.7%). Regarding the validation of the consultation, an overall agreement index of 92% and an alpha of 0.91 were obtained. Conclusion: The consultation has an adequate appearance to be used, is easy to apply, has a logical sequence, and enables a systematic nursing care.

Objetivo:Validación de contenido de un instrumento para consulta de enfermería a personas con úlceras venosas Metodología: Estudio metodológico de validación interna de contenido, a partir del juicio de jueces estomaterapeutas. Su identificación se dio a través de una búsqueda en la Plataforma Lattes que tuvieran experiencia en la atención de personas con úlceras venosas. El proceso se llevó a cabo en enero y febrero de 2019, donde participaron 24 expertos. Los datos relacionados a la evaluación de la consulta fueron recopilados en planilla de Microsoft Office Excel y analizados según el índice de concordancia total y global, totalizando 209 ítems y 2400 variables de consulta, siendo adoptadas respuestas dicotómicas. Resultados: En cuanto a la caracterización de los jueces se obtuvo una edad promedio de 36,6 años. La mayoría eran mujeres, así como del estado de Ceará. La principal titulación observada fue la de maestría, (62,5%) trabajaba en la asistencia y coordinación del servicio de estomaterapia. Dos tercios tenían experiencia con la validación de instrumentos (66,7%). En cuanto a la validación de la consulta se obtuvo un índice de acuerdo global del 92% y un alfa de 0,91. Conclusión: La consulta tiene una apariencia adecuada para ser utilizada, es fácil de aplicar, tiene una secuencia lógica, además de permitir una atención sistemática de enfermería.

Nursing knowledge of people with paresis of voluntary muscles: a living scoping review protocol.

OBJECTIVE: This review aims to continuously map the nursing knowledge about people with paresis of voluntary muscles in any context of care. INTRODUCTION: Muscle paresis is a condition that significantly impacts quality of life. Nurses have a crucial role in managing this condition, particularly paresis of voluntary movement muscles. However, nursing knowledge about patients with paresis of voluntary muscles is dispersed, hampering the integration of evidence within the structure of information systems. Mapping how the nursing process components are identified is the first step in creating a Nursing Clinical Information Model for this condition, capable of integrating evidence into information systems. INCLUSION CRITERIA: This scoping review will consider studies focusing on the nursing process regarding people with paresis of voluntary muscles in all care contexts. The review will include quantitative, qualitative, and mixed-methods study designs, systematic reviews, clinical guidelines, dissertations, and theses. METHODS: The review process will follow JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews. Screening of new literature will be performed regularly, with the review being updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched will include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis , and the Cochrane Central Register of Controlled Trials. Searches for unpublished studies will include OpenGrey and Repositorios Científicos de Acesso Aberto de Portugal. Studies published in English and Portuguese from 1975 will be considered for inclusion. REGISTRATION: Open Science Framework: https://osf.io/d7c9g/.

Nursing knowledge on skin ulcer healing: a living scoping review protocol.

OBJECTIVE: This review aims to continuously map the nursing knowledge on skin ulcer healing in any context of care. INTRODUCTION: Chronic wounds are an increasing concern for society and health care providers. Pressure ulcers and venous ulcers, among others, have devastating effects on morbidity and quality of life and require a systematic approach. The nursing process is an important method that allows a better organization and overall care quality for a systematic and continuous professional approach to nursing management of skin ulcers. The integration of this nursing knowledge in informatics systems creates an opportunity to embed decision-support models in clinical activity, promoting evidence-based practice. INCLUSION CRITERIA: This scoping review will consider articles on nursing data, diagnosis, interventions, and outcomes focused on people with skin ulcers in all contexts of care. This review will include quantitative, qualitative, and mixed methods study designs as well as systematic reviews and dissertations. METHODS: JBI's scoping review guidance, as well as the Cochrane Collaboration's guidance on living reviews, will be followed to meet the review's objective. Screening of new literature will be performed regularly, with the review updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PEDro. Searches for unpublished studies will include OpenGrey and Repositórios Científicos de Acesso Aberto de Portugal. Studies published in English and Portuguese since 2010 will be considered for inclusion. SCOPING REVIEW PROTOCOL REGISTRATION: Open Science Framework: https://osf.io/f6s4e/.

Conhecimento, prática e impedimentos do autocuidado com os pés de pessoas com diabetes mellitus tipo 2 / Knowledge, practice and barriers of diabetic foot self-care among individuals with type 2 diabetes mellitus / Conocimiento, práctica e impedimentos del autocuidado de los pies en personas con diabetes mellitus tipo 2

RESUMO: Objetivo: relacionar o conhecimento, a prática e os impedimentos do autocuidado com os pés em pessoas com Diabetes Mellitus Tipo 2 conforme sexo e escolaridade. Método: estudo transversal analítico, com 102 usuários de 4 unidades básicas de cidade interiorana do Piauí, Brasil. Coletaram-se dados socioeconômicos e clínicos, entre dezembro de 2018 a julho de 2019, analisados descritivamente por meio do teste de Qui-quadrado. Resultados: as mulheres obtiveram maior conhecimento e prática de hidratação (p<0,001), secagem entre os dedos do pé no pós-banho (p=0,020), hidratação dos pés com cremes/óleos hidrantes nos calcanhares (p<0,001), hidratação na planta do pé (p=0,003) e uso de calçados macios e fechados (p=0,001); uso frequente de meias pelos homens (p<0,001) e de algodão (p<0,001). Houve associação entre o nível de escolaridade e o uso de salto >5cm (p=0,001) e <5cm (p<0,001). Conclusão: espera-se que este estudo permita uma nova forma de abordagem, visando à aquisição e aperfeiçoamento do autocuidado.

ABSTRACT Objective: To relate knowledge, practice and barriers of diabetic foot self-care among people with Type 2 Diabetes Mellitus, according to gender and education. Method: Analytical cross-sectional study with 102 users of 4 basic units in the inland of the state of Piauí, Brazil. Socioeconomic and clinical data were collected between December 2018 and July 2019. Descriptive analysis was performed with the use of the Chi-square test. Results: Women showed greater knowledge and practice of moisturizing (p<0.001), drying between the toes after bathing (p=0.020), foot hydration with moisturizing creams/oils on the heels (p<0.001), hydration on the sole of the foot (p=0.003) and use of soft and closed-toed shoes (p=0.001); there was frequent use of socks by men (p<0.001) and they were mostly made of cotton (p<0.001). There was an association between educational level and the use of shoes with heels >5cm (p=0.001) and <5cm (p<0.001). Conclusion: It is hoped that this study will allow a new type of approach aimed to the improvement of diabetic foot self-care.

RESUMEN Objetivo: relacionar el conocimiento, la práctica y los impedimentos del autocuidado de los pies en personas con Diabetes Mellitus Tipo 2, de acuerdo con sexo y nivel de estudios. Método: estudio transversal y analítico realizado con 102 usuarios de 4 unidades básicas de una ciudad del interior de Piauí, Brasil. Se recolectaron datos sociodemográficos y clínicos entre diciembre de 2018 y julio de 2019, y se los analizó en forma descriptiva por medio de la prueba de chi-cuadrado. Resultados: las mujeres presentaron mayor conocimiento y práctica en las siguientes acciones de autocuidado: hidratación (p<0,001), secado del espacio entre los dedos de los pies después de bañarse (p=0,020), hidratación de los pies con cremas/aceites hidrantes en los talones (p<0,001), hidratación de la planta de los pies (p=0,003) y uso de calzado macizo y cerrado (p=0,001); en los hombres se observó uso frecuente de calcetines (p<0,001) y medias de algodón (p<0,001). Se registró una asociación entre nivel de estudios y uso de tacones de más de 5 cm (p=0,001) y menos de 5 cm (p<0,001). Conclusión: se espera que este estudio haga posible una nueva modalidad de enfoque, con vistas a adquirir y perfeccionar acciones de autocuidado.

Predominance of Leishmania (Leishmania) amazonensis DNA in Lutzomyia longipalpis sand flies (Diptera: Psychodidae) from an endemic area for leishmaniasis in Northeastern Brazil

ABSTRACT Leishmaniasis is a serious public health concern in the Northeastern region of Brazil, where the sand fly fauna is well studied, although few species have been identified as competent vectors. The detection of Leishmania spp. parasites in wild-caught sand flies could help sanitary authorities draw strategies to avoid the transmission of the parasites and, therefore, the incidence of leishmaniases. We detected Leishmania DNA in wild-caught sand flies and correlated that data with aspects of sand fly ecology in the Caxias municipality, Maranhao State, Brazil. The sand flies were sampled in the peridomicile (open areas in the vicinity of human residences) and intradomicile (inside the residences) from July/2019 to March/2020. Leishmania DNA was detected in females, targeting a fragment of the Internal Transcribed Spacer (ITS1) from ribosomal DNA. Among the fourteen species of sand flies identified, five (Lutzomyia longipalpis, Nyssomyia whitmani, Evandromyia evandroi, Micropygomyia trinidadensis, and Micropygomyia quinquefer) harbored DNA of Leishmania (Leishmania) amazonensis. The most abundant species in rural (Ny. whitmani: 35.2% and Ev. evandroi: 32.4%) and urban areas (Lu. longipalpis: 89.8%) are the permissive vectors of L. (L.) amazonensis, especially Ny. whitmani, a known vector of causative agents of cutaneous leishmaniasis. Although Lu. longipalpis is the vector of L. (L.) infantum, which was not detected in this study, its permissiveness for the transmission of L. (L.) amazonensis has been reported. We suspect that visceral leishmaniasis and cutaneous leishmaniasis are caused by L. (L.) amazonensis, and the transmission may be occurring through Lu. longipalpis, at least in the urban area.