Activities of the oral health teams in primary health care: a time-motion study.

BACKGROUND: Efficient planning of the oral health workforce in Primary Health Care (PHC) is paramount to ensure equitable community access to services. This requires a meticulous examination of the population's needs, strategic distribution of oral health professionals, and effective human resource management. In this context, the average time spent on care to meet the needs of users/families/communities is the central variable in healthcare professional workforce planning methods. However, many time measures are solely based on professional judgment or experience. OBJECTIVE: Calculate the average time parameters for the activities carried out by the oral health team in primary health care. METHOD: This is a descriptive observational study using the time-motion method carried out in five Primary Health Care Units in the city of São Paulo, SP, Brazil. Direct and continuous observation of oral health team members occurred for 40 h spread over five days of a typical work week. RESULTS: A total of 696.05 h of observation were conducted with 12 Dentists, three Oral Health Assistants, and five Oral Health Technicians. The Dentists' main activity was consultation with an average duration of 24.39 min, which took up 42.36% of their working time, followed by documentation with 12.15%. Oral Health Assistants spent 31.57% of their time on infection control, while Oral Health Technicians spent 22.37% on documentation. CONCLUSION: The study establishes time standards for the activities performed by the dental care team and provides support for the application of workforce planning methods that allow for review and optimization of the work process and public policies.

Challenges and strategies for conducting research in primary health care practice: an integrative review.

BACKGROUND: Providing accessible and high-quality patient-centered healthcare remains a challenge in many countries, despite global efforts to strengthen primary health care (PHC). Research and knowledge management are integral to enhancing PHC, facilitating the implementation of successful strategies, and promoting the use of evidence-based practices. Practice-based research in primary care (PC-PBR) has emerged as a valuable approach, with its external validity to diverse PHC settings, making it an effective means of translating research findings into professional practice. OBJECTIVE: To identify challenges and strategies for conducting practice-based research in primary health care services. METHOD: An integrative literature review was conducted by searching the PubMed, Embase, Scopus, Web of Science, and Lilacs databases. The research question, guided by the PICo framework, directed the execution of study selection and data extraction. Data analysis followed the RAdAR method's three phases: pre-analysis, data analysis, and interpretation of results. RESULTS: Out of 440 initially identified articles, 26 met the inclusion criteria. Most studies were conducted in high-income countries, primarily the United States. The challenges and strategies for PC-PBR were categorized into six themes: research planning, infrastructure, engagement of healthcare professionals, knowledge translation, the relationship between universities and health services, and international collaboration. Notable challenges included research planning complexities, lack of infrastructure, difficulties in engaging healthcare professionals, and barriers to knowledge translation. Strategies underscore the importance of adapting research agendas to local contexts, providing research training, fostering stakeholder engagement, and establishing practice-based research networks. CONCLUSION: The challenges encountered in PC-PBR are consistent across various contexts, highlighting the need for systematic, long-term actions involving health managers, decision-makers, academics, diverse healthcare professionals, and patients. This approach is essential to transform primary care, especially in low- and middle-income countries, into an innovative, comprehensive, patient-centered, and accessible healthcare system. By addressing these challenges and implementing the strategies, PC-PBR can play a pivotal role in bridging the gap between research and practice, ultimately improving patient care and population health.

Matricide and schizophrenia- psychopathological, psychodynamic, and forensic aspects: a case report.

Matricide is the murder of a mother by her son or daughter, a form of homicide rarely seen in psychiatric practice. A narrative review was conducted on the relationship between matricide and schizophrenia, followed by a case report in Brazil of a schizophrenic patient who murdered his mother and was submitted to forensic psychiatric assessment for criminal liability. The article discusses psychopathological, psychodynamic, and forensic aspects related to the case. The observation of ambivalent and conflictive relations between schizophrenic individuals and their mothers suggests the need for family-level interventions to resolve the understandable occurrence of emotional conflicts, which can serve as stimuli that trigger the murder.

Mental Health Care in Primary Health Care: An Integrative Review.

In this study, we analyzed recent studies on mental health approaches developed in primary health care to identify the emphasis of such interventions, their technical feasibility for the setting in question, and their levels of evidence. An integrative review was conducted of primary studies from the LILACS, PubMed, Embase, CINAHL, and Web of Science databases using the PRISMA search strategy. Nineteen studies were identified with a high level of evidence that contribute to the advancement of knowledge in the area. However, academic, cultural, and linguistic barriers still need to be overcome to facilitate sharing of such interventions' findings and protocols.

Gasdermin-D activation promotes NLRP3 activation and host resistance to Leishmania infection.

Intracellular parasites from the Leishmania genus cause Leishmaniasis, a disease affecting millions of people worldwide. NLRP3 inflammasome is key for disease outcome, but the molecular mechanisms upstream of the inflammasome activation are still unclear. Here, we demonstrate that despite the absence of pyroptosis, Gasdermin-D (GSDMD) is active at the early stages of Leishmania infection in macrophages, allowing transient cell permeabilization, potassium efflux, and NLRP3 inflammasome activation. Further, GSDMD is processed into a non-canonical 25 kDa fragment. Gsdmd-/- macrophages and mice exhibit less NLRP3 inflammasome activation and are highly susceptible to infection by several Leishmania species, confirming the role of GSDMD for inflammasome-mediated host resistance. Active NLRP3 inflammasome and GSDMD are present in skin biopsies of patients, demonstrating activation of this pathway in human leishmaniasis. Altogether, our findings reveal that Leishmania subverts the normal functions of GSDMD, an important molecule to promote inflammasome activation and immunity in Leishmaniasis.

Psychosocial factors and physical activity among workers in Brazil.

BACKGROUND: Complex behaviors, such as physical activity (PA), may be related to different levels of influence. OBJECTIVE: To analyze the role of social support, mood and alcohol consumption as psychosocial predictors on the engagement in PA among Brazilian workers. METHODS: This is a quantitative, cross-sectional analytical study. A sample of 395 participants answered a sociodemographic questionnaire, the Alcohol Use Disorder Identification Test (AUDIT), the Baecke Habitual Physical Activity Questionnaire, the Social Support Scale for Physical Activities (SSSPA) and the Brunel Mood Scale (BRUMS). RESULTS: Analysis via Pearson's Correlation Test indicated a negative correlation between PA and depression and fatigue, and a positive correlation between PA and alcohol consumption, vigor and the four variables of social support (support of family members for walking; support of friends for walking; support of family members for moderate and vigorous physical activity; support of friends for moderate and vigorous physical activity). A positive relationship between PA and low-risk alcohol consumption was also identified. A hierarchical multiple regression analysis showed that family support for walking, friends support for moderate and vigorous physical activity, vigor and alcohol consumption are predictors of PA. Hayes' moderation analysis indicated that social support has a moderating effect on the relationship between alcohol use and PA. CONCLUSION: Different factors may be involved in engaging in PA. A broader approach that addresses the singularities of individuals, especially in actions for different patterns of alcohol consumption, is recommended.

Identification of immunomodulatory drugs that inhibit multiple inflammasomes and impair SARS-CoV-2 infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces mild or asymptomatic COVID-19 in most cases, but some patients develop an excessive inflammatory process that can be fatal. As the NLRP3 inflammasome and additional inflammasomes are implicated in disease aggravation, drug repositioning to target inflammasomes emerges as a strategy to treat COVID-19. Here, we performed a high-throughput screening using a 2560 small-molecule compound library and identified FDA-approved drugs that function as pan-inflammasome inhibitors. Our best hit, niclosamide (NIC), effectively inhibits both inflammasome activation and SARS-CoV-2 replication. Mechanistically, induction of autophagy by NIC partially accounts for inhibition of NLRP3 and AIM2 inflammasomes, but NIC-mediated inhibition of NAIP/NLRC4 inflammasome are autophagy independent. NIC potently inhibited inflammasome activation in human monocytes infected in vitro, in PBMCs from patients with COVID-19, and in vivo in a mouse model of SARS-CoV-2 infection. This study provides relevant information regarding the immunomodulatory functions of this promising drug for COVID-19 treatment.

Frozen-Thawed Sperm Analysis of Benign Prostatic Hyperplasia Dogs Treated With Finasteride.

Benign Prostatic Hyperplasia (BPH) is a pathological condition that directly interferes with the reproductive potential of senile dogs, by leading to prostate enlargement and sperm injury, which in turn may compromise sperm freezeability. Moreover, albeit finasteride treatment reduces prostatic volume and blood supply and maintains seminal quality and testicular integrity, the effects of sperm samples submitted to cryopreservation after the finasteride treatment are still unknown. Thus, the aim of this study was to evaluate frozen-thawed semen of BPH dogs, as well as dogs subjected to BPH pharmacological treatment with finasteride. For such purpose, 20 dogs were previously selected and assigned to three experimental groups, according to BPH diagnosis and treatment with finasteride: Control (n = 9), BPH Group (n = 5) and BPH-Finasteride Group (n = 6). Semen was subjected to one-step cryopreservation protocol with tris-fructose-citric acid extender with 5% glycerol and thawed at 37°C for 30 sec. Fresh and post-thaw sperm samples were evaluated for macroscopic parameters, sperm concentration, sperm motility kinetics, sperm mitochondrial activity and potential, oxidative stress, plasmatic and acrosome membrane integrity, sperm DNA fragmentation and sperm binding test on perivitelic membrane of chicken egg yolk. Regarding fresh semen, BPH-Finasteride group had the lowest ejaculate visual aspect (opacity), higher frequency of sperm flagellar beating (BCF) and percentage of sperm with medium velocity. Control group had the highest percentage of sperm DNA integrity compared to BPH group. For the frozen-thawed semen, Control group presented the highest percentage of spermatozoa with high mitochondrial activity. However, the BPH-Finasteride group showed higher number of sperm bound to the perivitelline membrane of chicken egg yolk compared to the BPH Group. Conversely, BPH group had higher percentage of DNA damage. In conclusion, the ejaculate of BPH dogs has higher susceptibility to cryoinjury, whereas finasteride-treated dogs have increased spermatozoa functional performance, suggesting a promising use of BPH dogs as semen donors in sperm cryopreservation programs.

Implementation of the drive-through strategy for COVID-19 vaccination: an experience report.

OBJECTIVE: To describe the experience of implementing a satellite vaccination unit in a drive-through system during a campaign against COVID-19. METHOD: This is an experience report carried out in a drive-through vaccination satellite unit. The study development was guided by the triad structure-process-results, proposed by Donabedian. RESULTS: The unit was structured in a soccer stadium, allowing it to serve large audiences safely. Care flow occurred in stages and professionals were organized by sectors, with emphasis on the nursing team' work. Initially, screening was performed; later, users went to the registration sector, and, finally, they were forwarded to the application station. The unit also had emergency sectors, a cold chain, space for professionals and a Basic Health Unit as a point of support. In 25 days of operation, 9698 doses were administered, with 1.8% of doses lost. CONCLUSION: The implementation of this system required planning, structure, process development and intense team articulation, with emphasis on the fundamental and strategic role of nurses in different points of action and leadership.

Both spontaneous vaginal delivery and elective caesarean section influence neonatal redox status in dogs.

BACKGROUND: The influence of birth mode on redox balance is unknown in dogs. We aimed to compare antioxidant activity and oxidative stress of puppies born by elective c-section or vaginal delivery. METHODS: Twenty-one bitches were elected for spontaneous vaginal delivery (n = 10) and elective cesarean section (n = 11) groups, considering only the first and last puppies born. Neonatal oxygen saturation, lactatemia, superoxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GPx) and total antioxidant capacity; marker of oxidative stress (thiobarbituric acid reactive substances [TBARS]) and protein oxidation were analysed at birth, 1 h, 12 h, 24 h and 72 h. RESULTS: C-section newborns had lower oximetry at birth and 1 h. Lactatemia was higher in the last vaginal delivery puppies and higher at birth, and 1 h. Regardless of birth mode, last puppies had hyperlactatemia at birth. Vaginal delivery puppies had higher TBARS, while protein oxidation was higher in c-section, mostly in last puppies. C-section puppies had higher GPx activity, whereas GSH concentration decreased overtime. Surgically born puppies had lowering SOD between 12 h and 72 h. CONCLUSIONS: Vaginal delivery enhances lipid peroxidation, counteracted mostly by GPx. Conversely, c-section triggers protein oxidation, acutely scavenged by SOD and GSH, thus puppies are less exposed to the negative consequences of oxidative stress.

Implementation of the drive-through strategy for COVID-19 vaccination: an experience report / Implementación de la estrategia drive-through para la vacunación contra el COVID-19: relato de experiencia / Implementação da estratégia drive-through para vacinação COVID-19: um relato de experiência

Abstract Objective: To describe the experience of implementing a satellite vaccination unit in a drive-through system during a campaign against COVID-19. Method: This is an experience report carried out in a drive-through vaccination satellite unit. The study development was guided by the triad structure-process-results, proposed by Donabedian. Results: The unit was structured in a soccer stadium, allowing it to serve large audiences safely. Care flow occurred in stages and professionals were organized by sectors, with emphasis on the nursing team' work. Initially, screening was performed; later, users went to the registration sector, and, finally, they were forwarded to the application station. The unit also had emergency sectors, a cold chain, space for professionals and a Basic Health Unit as a point of support. In 25 days of operation, 9698 doses were administered, with 1.8% of doses lost. Conclusion: The implementation of this system required planning, structure, process development and intense team articulation, with emphasis on the fundamental and strategic role of nurses in different points of action and leadership.

RESUMEN Objetivo: Describir la experiencia de implementación de una unidad de vacunación satélite en un sistema drive-through, durante la campaña contra el COVID-19. Método: Se trata de un relato de experiencia, realizado en una unidad satélite de vacunación drive-through. El desarrollo del estudio estuvo guiado por la tríada estructura-proceso-resultados, propuesta por Donabedian. Resultados: La unidad se estructuró en un estadio de fútbol, lo que le permitió atender grandes audiencias de manera segura. El flujo de la atención ocurrió por etapas, y los profesionales fueron organizados por sectores, con énfasis en el trabajo del equipo de enfermería. Inicialmente se realizaba el cribado, posteriormente el usuario se dirigía al sector de registro y finalmente se enviaba a la estación de aplicación. La unidad también contó con sectores de urgencia y emergencia, cadena de frío, espacio para profesionales y una Unidad Básica de Salud como punto de apoyo. En 25 días de operación, se administraron 9698 dosis, con un 1,8% de dosis olvidadas. Conclusión: La implementación de este sistema requirió planificación, estructuración, desarrollo de procesos y una intensa articulación de equipos, con énfasis en el papel fundamental y estratégico de los enfermeros en diferentes puntos de acción y liderazgo.

RESUMO Objetivo: Descrever a experiência de implementação de uma unidade satélite de vacinação em sistema drive-through, durante a campanha contra COVID-19. Método: Trata-se de um relato de experiência, realizado em uma unidade satélite de vacinação em sistema drive-through. O desenvolvimento do estudo foi norteado pela tríade estrutura-processo-resultados, proposta por Donabedian. Resultados: A unidade foi estruturada em um estádio de futebol, permitindo o atendimento de grandes públicos de forma segura. O fluxo de atendimento ocorreu por etapas, e os profissionais foram organizados por setores, com destaque para atuação da equipe de enfermagem. Inicialmente, realizou-se a triagem, posteriormente, o usuário dirigia-se ao setor de cadastramento, e, por fim, era encaminhado à estação de aplicação. A unidade contava também com os setores de urgência e emergência, rede de frio, espaço para os profissionais e uma Unidade Básica de Saúde como ponto de apoio. Em 25 dias de atuação, foram administradas 9698 doses, com 1,8% de doses perdidas. Conclusão: A implementação deste sistema exigiu planejamento, estrutura, desenvolvimento de processos e intensa articulação em equipe, com destaque para o papel fundamental e estratégico do enfermeiro em diferentes pontos de atuação e liderança.

Experience of Vulnerable Women Narrated through the Body-Mapping Technique.

Vulnerable women are considered a priority in public policies and research agendas. It is necessary to understand better the specificities of their daily lives and the meanings they attribute to their experiences, as this undoubtedly contributes to more grounded and culturally appropriate practices. Additionally, innovative techniques in qualitative research are demanded in academia. This narrative research study was carried out with fourteen women from a Brazilian socioeconomically vulnerable neighborhood. We used the body-mapping technique to investigate the experiences of women with mental health disorders or psychosocial distress. The aim was to analyze the self-perception about daily stressors and discuss the feasibility of this technique to facilitate this group's storytelling. Data collection was performed through focus groups, guided by the body-mapping technique steps, and supplemented with individual interviews. Interpersonal conflicts and violence were the main stressors. These strongly impacted the well-being of these women and their children. Some important personal qualities and resilience were identified. Body-mapping played a fundamental role in facilitating storytelling. It amplified the linguistic possibilities for participants to express their feelings and promoted reflections about the present, past, and glimpses into the future.

The influence of work environment relationships on mental health of Brazilian seamstresses.

BACKGROUND: The work environment is a place in which different kinds of interpersonal relationships are developed and can contribute positively or negatively to productivity and to workers' well-being. Discussion on this topic may contribute to building more coping strategies to fight against gender inequality and the emotional repercussions of these conditions. OBJECTIVE: This is a cross-sectional study that investigated the possible influence of work environment relationships on the mental health of Brazilian seamstresses. METHODS: The participants were seamstresses from four clothing factories in a city in the southwest of Brazil. For data collection, we used the Social Support Perception at Work Scale; Self-Report Questionnaire; Alcohol, Smoking and Substance Involvement Screening Test; and a focus group. The quantitative data were statistically analyzed, and data from the focus groups were analyzed using content analysis. RESULTS: Interpersonal relationships at work were mentioned as sources of conflict and stress but also as emotional and material social support providers. In the sample studied, these relationships did not influence directly the development of mental health disorders. CONCLUSIONS: Study results suggest that a low level of education is an important factor that increases the vulnerability of these women to the precariousness of work, and, consequently to developing mental health symptoms or aggravating previous mental health distress. However, emotional and material support from peers likely protects these workers' mental health.

Non-neoplastic intracranial cystic lesions: not everything is an arachnoid cyst.

Intracranial cystic lesions are common findings on neuroimaging examinations, arachnoid cysts being the most common type of such lesions. However, various lesions of congenital, infectious, or vascular origin can present with cysts. In this pictorial essay, we illustrate the main causes of non-neoplastic intracranial cystic lesions, discussing their possible differential diagnoses as well as their most relevant imaging aspects.

Lesões císticas intracranianas são achados comuns nos exames de neuroimagem, sendo os cistos aracnoides os mais comuns. Porém, muitas outras lesões, de origem congênita, infecciosa e vascular, podem se apresentar com cistos. Neste ensaio ilustramos as principais causas de lesões císticas intracranianas não neoplásicas, discutindo seus possíveis diagnósticos diferenciais, bem como seus aspectos de imagem mais relevantes.

Exploring the bioactivity potential of Leonotis nepetifolia: phytochemical composition, antimicrobial and antileishmanial activities of extracts from different anatomical parts.

Leonotis nepetifolia (L.) Br. (Lamiaceae) is an African shrub popularly known as 'cordão-de-frade' in Brazil, traditionally used to treat infectious diseases, among other uses. This study aimed to investigate the phytochemical composition of hydroethanolic extracts from L. nepetifolia prepared from stems, leaves, roots and glomerulus, as well as their cytotoxicity, antileishmanial and antimicrobial activities. The chemical composition of the extracts was assessed by UPLC-ESI-MS/MS, whereas the antileishmanial activity was evaluated against promastigote and amastigote forms of Leishmania amazonensis. Cytotoxicity was tested on murine macrophages and the antimicrobial activity was investigated by a microdilution assay against several strains of fungi, Gram-positive and Gram-negative bacteria. The flavonoids apigenin, cirsiliol apigenin-7-O-glucoside, luteolin, luteolin-4'-O-glucoside, luteolin-4'-O- glucuronide and luteolin-7-O-glucoside were identified in all tested extracts. Extracts from leaves and roots showed more potent antileishmanial activity (IC50 32.90 µg mL-1 and 57.70 µg mL-1, respectively) against amastigotes forms in comparison to the other extracts. The leaf extract inhibited Bacillus cereus and Staphylococcus aureus growth (125 µg mL-1 and 100 µg mL-1, respectively), and also showed anti-Candida activity (10-125 µg mL-1). The biological effect can be related to the identified flavonoids. Our findings disclose the potential of L. nepetifolia as a source of bioactive compounds for the development of new therapeutic options for treating infectious diseases, especially flavonoids.

Prostaglandin and antigestagen in pyometra bitches: vascular and stereological effect.

Effects of conservative treatment on uterine blood flow and morphometric findings are still unknown in bitches. Thus, this study aimed to compare uterine changes of pyometra bitches subjected to distinct modes of treatment. Pyometra bitches were assigned to: OHE (ovariohysterectomy immediately after diagnosis), Aglepristone (days 1, 2 and 8) and Associative (aglepristone treatment coupled with cloprostenol for 7 days) groups. After 9 days, bitches were ovariohysterectomized. Before surgery, uterine area was measured ultrasonographically and the uterine artery Doppler velocimetry analyzed blood flow velocity and indexes. Uterine horns were classified according to resistance index (RI) as more compromised and less compromised. Endometrial vasculature was quantitatively evaluated by color flow Doppler. Blood samples were collected to determine nitric oxide (NO) concentrations. Histological uterine structures were quantified by stereology and VEGF-A (vascular endothelial growth factor) and eNOS were (endothelial nitric oxide synthase) immunohistochemically analyzed. Aglepristone and Associative groups had lower uterine area and vascularization, and higher blood flow velocity and indexes compared to OHE group. Less compromised horn of Associative group had higher blood flow velocity compared to OHE group. Aglepristone group presented lower inflammatory infiltrate and larger uterine stroma. Associative group had lower volume density and absolute surface of endometrial cysts and lower VEGF-A expression for glandular epithelium and stromal cells. Blood NO and e-NOS immunostaining were not different among groups. In conclusion, association between aglepristone and prostaglandin is more effective in decreasing uterine vascularization and modulating uterine blood flow. Moreover, associative therapy promotes marked morphological changes. LAY SUMMARY: This research compared two medical protocols of treatment for uterine infection (pyometra) in bitches, using a hormone blocker (anti-progesterone aglepristone) solely or in association with a uterine contraction inducer (prostaglandin; associative therapy). After treatment, bitches were gonadectomized and a microscopic analysis of uterine blood vessel formation and uterine tissue elements were performed as well as uterine blood flow evaluation through Doppler ultrasonography. According to vascular resistance, uterine horns were additionally classified as more compromised and less compromised. Both treatment protocols led to reduction of uterine dimensions and vascularization, and higher blood flow compared to untreated bitches. Less compromised uterine horn of the associative treatment had higher blood flow compared to untreated bitches. The hormone blocker treatment had lower inflammatory cells and larger uterine histological structure, while associative treatment had less uterine pathological cysts and lower blood vessel formation. The associative therapy is effective in decreasing uterine vascularization and modulating uterine blood flow as well as reestablishing endometrium structure in bitches with uterine infection.

The Impact of Inflation on the Medical and Hospital Money Transfers of the Neurosurgical Procedures of the Brazilian Unified Healthcare System from 2008 to 2017

Introduction There are more than 1,500 hospital procedures included in the Brazilian Unified Healthcare System's (SUS, in the Portuguese acronym) table, which is the reference for service payment provided by establishments serving the public health network, and they are stagnant. The underfinancing of procedures is so dramatic that in some cases the amounts paid by the SUS are even lower than the taxes generated by the costs of the same procedures in Brazilian private hospitals. This article aims to compare the evolution of the compensation of neurosurgical procedures by calculating the percentile of the lag in the values transferred to both neurosurgeons and hospitals, according to the SUS table, establishing the ideal and real values according to the current inflation, in a retrospective 9-year comparison. Methodology This is an observational, comparative, retrospective study, based on the values of medical and hospital money transfers of 25 neurosurgical procedures in 2008, which were corrected according to the 2017 National Consumer Price Index (IPCA, in the Portuguese acronym). Results Through this study, from 2008 to 2017, the transfers of medical fees regarding neurosurgical techniques are almost completely outdated. As examples, we can mention: the external/subgaleal ventricular shunt, with a deficit of 43.6%; the electrode implant for brain stimulation, with - 41.67%; and decompressive craniotomy, with - 32.21% in relation to the corrected value. Only 4 of the 25 neurosurgeries present a value above that predicted by the IPCA, one of them being cerebral aneurysm embolization larger than 1.5 cm with a narrow neck (þ 8.0%). Regarding the money transfers to hospitals, all procedures are 43.6% lower than expected, since there was no readjustment in the amounts paid to the institutions in the analyzed period. For example, in 2008, for the transposition of the cubital nerve, R$ 267.30 were transferred, and the same amount was maintained in 2017; and, for the surgical treatment of compressive syndrome in osteofibrous tunnel at carpal level (R$ 145.18), the amount also remained fixed throughout these 9 years. Conclusion Because they did not follow the evolution of the economy, in 80% of the surgeries, the neurosurgeons did not have their economic demands met regarding the procedures performed through SUS. And the data became even more alarming when the money transfers to hospitals were evaluated, since there was no evolution in the money transfers for any of the neurosurgeries evaluated.

Efficacy of photodynamic therapy using TiO2 nanoparticles doped with Zn and hypericin in the treatment of cutaneous Leishmaniasis caused by Leishmania amazonensis.

Since Leishmania parasites exhibit resistance outbreaks to drugs conventionally used in medical treatments, research of new antileishmanial compounds or alternative treatment therapies are essential. A focus of interest has been the implementation of light-based therapies such as photodynamic therapy, where inorganic compounds such as titanium dioxide have shown promising results as drug delivery carriers. In this work, nanoparticles of TiO2 doped with Zn (TiO2/Zn) were synthesized through solution combustion route and with hypericin (HY) in order to enhance its photodynamic activity in the visible light region. Scanning (SEM) and transmission (TEM) electron microscopy analyses showed particles of (TiO2/Zn) with sizes smaller than 20 nm and formation of aggregates smaller than 1 µm, whilst electron diffraction spectroscopy (EDS) analysis ensured the presence of Zn in the system. The association of the TiO2/Zn with HY (TiO2/Zn-HY) was further confirmed by fluorescence spectrometry. Measurements of its cellular uptake showed the presence of smaller molecules into promastigotes after 120 min incubation. TiO2/Zn-HY showed good antileishmanial activity (EC50 of 17.5 ± 0.2 µg mL-1) and low cytotoxicity against murine macrophages (CC50 35.2 ± 0.3 µg mL-1) in the visible light (22 mW cm-2; 52.8 J cm-2). Moreover, in the in vivo analysis, TiO2/Zn-HY decreased the parasite load of L. amazonensis - BALB/c infected mice by 43% - 58% after a combination of blue and red light presenting 22 mW cm-2 of intensity and 52.8 J cm-2 of fluency delivered. All together, these data indicate a new combined system of nanoparticles associated with a photosensitizer and PDT as alternative to amphotericin B for the treatment of cutaneous leishmaniasis.

Effects of açai on oxidative stress, ER stress, and inflammation-related parameters in mice with high fat diet-fed induced NAFLD.

Non-alcoholic fatty liver disease (NAFLD), the most predominant liver disease worldwide, is a progressive condition that encompasses a spectrum of disorders ranging from steatosis to steatohepatitis, and, ultimately, cirrhosis and hepatocellular carcinoma. Although the underlying mechanism is complex and multifactorial, several intracellular events leading to its progression have been identified, including oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, and altered endoplasmic reticulum (ER) homeostasis. Phenolic compounds, such as those present in açai (Euterpe oleracea Mart.), are considered promising therapeutic agents due to their possible beneficial effects on the prevention and treatment of NAFLD. We tested in vitro effects of aqueous açai extract (AAE) in HepG2 cells and its influence on oxidative stress, endoplasmic reticulum stress, and inflammation in a murine model of high fat diet-induced NAFLD. In vitro AAE exhibited high antioxidant capacity, high potential to inhibit reactive oxygen species production, and no cytotoxicity. In vivo, AAE administration (3 g/kg) for six weeks attenuated liver damage (alanine aminotransferase levels), inflammatory process (number of inflammatory cells and serum TNFα), and oxidative stress, through the reduction of lipid peroxidation and carbonylation of proteins determined by OxyBlot and modulation of the antioxidant enzymes: glutathione reductase, SOD and catalase. No change was observed in collagen content indicating an absence of fibrosis, stress-related genes in RE, and protein expression of caspase-3, a marker of apoptosis. With these results, we provide evidence that açai exhibits hepatoprotective effects and may prevent the progression of liver damage related to NAFLD by targeting pathways involved in its progression.

The Social Support Buffering Effect in the Relationship Between Perceived Stress and Alcohol Use Among Brazilian Women.

This cross-sectional study interviewed Brazilian women regularly attending primary care to investigate whether the relationship between social support and alcohol use is direct or is mediated by stress, in order to support the development of recommendations related to health prevention and mental health promotion actions. The results suggest that social support affects the outcome alcohol use in the women studied by buffering the effect of stress. Based on these results, recommendations are made for amplifying the social support network that prevents stress-induced alcohol use.