Novel insights into the application of recombinant mutated phospholipases D as antigens for developing new strategies against Loxoscelism.

Loxoscelism is the pathological condition triggered by a brown spider bite. The venom of these spiders is rich in phospholipases D (PLDs), which can induce virtually all local and systemic manifestations. Recombinant mutated PLDs from clinically relevant Loxosceles species in South America have been investigated as potential antigens to develop novel therapeutic strategies for loxoscelism. However, certain gaps need to be addressed before a clinical approach can be implemented. In this study, we examined the potential of these recombinant mutated PLDs as antigens by testing some variations in the immunization scheme. Furthermore, we evaluated the efficacy of the produced antibodies in neutralizing the nephrotoxicity and sphingomyelinase activity of brown spider venoms. Our findings indicate that the number of immunizations has a greater impact on the effectiveness of neutralization compared to the amount of antigen. Specifically, two or three doses were equally effective in reducing dermonecrosis and edema. Additionally, three immunizations proved to be more effective in neutralizing mice lethality than one or two. Moreover, immunizations mitigated the signs of kidney injury, a crucial aspect given that acute renal failure is a serious systemic complication. In vitro inhibition of the sphingomyelinase activity of Loxosceles venoms, a key factor in vivo toxicity, was nearly complete after incubation with antibodies raised against these antigens. These findings underscore the importance of implementing an effective immunization scheme with multiple immunizations, without the need for high antigen doses, and enhances the spectrum of neutralization exhibited by antibodies generated with these antigens. In summary, these results highlight the strong potential of these antigens for the development of new therapeutic strategies against cutaneous and systemic manifestations of loxoscelism.

Anxiolytic and Anticonvulsant Effects of Fisetin Isolated from Bauhinia pentandra on Adult Zebrafish (Danio rerio).

Anxiety and epilepsy are common worldwide and represent a primary global health concern. Fisetin, a flavonoid isolated from Bauhinia pentandra, has a wide range of biological activities may be a promising alternative to combat diseases related to the central nervous system (CNS). The present study aimed to investigate the anxiolytic and anticonvulsant effects of fisetin on adult zebrafish. Furthermore, molecular docking simulations were performed to improve the results. Fisetin did not present toxicity and caused anxiolytic behavior and delayed seizures in animals. This effect may occur through serotonin neurotransmission at 5-HT3A and/or 5-HT3B receptors. Molecular docking simulations showed that fisetin interacts with the orthosteric site of the 5-HT3A receptor with strong H-bond interactions with the Trp156 residue, with a strong contribution from the catechol ring, a behavior similar to that of the antagonist co-crystallized inhibitor granisetron (CWB). Fisetin may be a promising alternative to combat diseases related to the central nervous system.

Palliative care and COVID-19: acknowledging past mistakes to forge a better future.

Context: COVID-19 induces complex distress across physical, psychological, and social realms and palliative care (PC) has the potential to mitigate this suffering significantly. Objectives: To describe the clinical characteristics and outcomes of COVID-19 patients with an indication of PC, compared to patients who had no indication, in different pandemic waves. Methods: This retrospective multicenter observational cohort included patients from 40 hospitals, admitted from March 2020 to August 2022. Patients who had an indication of palliative care (PC) described in their medical records were included in the palliative care group (PCG), while those who had no such indication in their medical records were allocated to the non-palliative care group (NPCG). Results: Out of 21,158 patients, only 6.7% had indication for PC registered in their medical records. The PCG was older, had a higher frequency of comorbidities, exhibited higher frailty, and had a higher prevalence of clinical complications and mortality (81.4% vs. 17.7%, p < 0.001), when compared to the NPCG. Regarding artificial life support, the PCG had a higher frequency of dialysis (20.4% vs. 10.1%, p < 0.001), invasive mechanical ventilation (48.2% vs. 26.0%, p < 0.001) and admission to the intensive care unit (53.6% vs. 35.4%, p < 0.001). These differences were consistent across all three waves. Conclusion: A low proportion of patients received PC. Patients in PCG were more fragile, had more clinical complications, and had a higher mortality. On the contrary to our expectations, they received more artificial life support in all three waves. Taken together, these findings suggest that decisions regarding PC indication were made too late, within a context of end-of-life and therapeutic failure.

Is Having Urban Green Space in the Neighborhood Enough to Make a Difference? Insights for Healthier City Design.

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose: This study delves into whether merely having green space in the neighborhood is sufficient to impact residents' mental health in Brazilian metropolitan regions. Method: Utilizing a cross-sectional survey, data were collected from 2136 participants. The analyzed variables included the intensity, duration, and frequency of nature engagement, suitability of UGS for visitation and physical activities, and mental well-being indicators measured by the DASS-21 scale. Multivariate statistical analyses and multiple regression models were employed to verify hypothetical relationships. Results and conclusions: Higher intensity, duration, and frequency of nature engagement in UGS were significantly associated with lower depression, anxiety, and stress scores. Notably, having urban UGS in the neighborhood alone was not enough to reduce mental health issues. Practical implications: The findings point out the need for urban planning policies that prioritize the development of high-quality, accessible green spaces to maximize mental well-being benefits. These insights could inform city designs that foster healthier urban environments. Future directions: Longitudinal studies are needed to establish causality between nature engagement and mental health improvements. Further research should incorporate objective measures of nature engagement and explore more aspects of green space quality, such as biodiversity and amenities.

Influences on COVID-19 Vaccine Adherence among Pregnant Women: The Role of Internet Access and Pre-Vaccination Emotions.

INTRODUCTION: The onset of the COVID-19 pandemic brought about global uncertainties and fears, escalating the dissemination of fake news. This study aims to analyze the impact of fake news on COVID-19 vaccine adherence among pregnant women, providing crucial insights for effective communication strategies during the pandemic. METHODS: A cross-sectional, exploratory study was conducted with 113 pregnant women under care at a Women's Health Reference Center. Data analysis included relative frequency and odds ratio to assess the relationship between sociodemographic and behavioral variables regarding vaccination. RESULTS: In the behavioral context of vaccination, internet access shows a significant association with decision-making, influencing vaccine refusal due to online information. Nuances in the odds ratios results highlight the complexity of vaccine hesitancy, emphasizing the importance of information quality. Pre-vaccination sentiments include stress (87.61%), fear (50.44%), and anxiety (40.7%), indicating the need for sensitive communication strategies. DISCUSSION: Results revealed that pregnant women with higher education tend to adhere more to vaccination. Exposure to news about vaccine inefficacy had a subtle association with hesitancy, while finding secure sources was negatively associated with hesitancy. The behavioral complexity in the relationship between online information access and vaccination decision underscores the need for effective communication strategies. CONCLUSIONS: In the face of this challenging scenario, proactive strategies, such as developing specific campaigns for pregnant women, are essential. These should provide clear information, debunk myths, and address doubts. A user-centered approach, understanding their needs, is crucial. Furthermore, ensuring information quality and promoting secure sources are fundamental measures to strengthen trust in vaccination and enhance long-term public health.

Low Plasma Lipids Are Associated with Relapsing and Lethal Visceral Leishmaniasis in HIV-Infected Patients.

Visceral leishmaniasis (VL) results from protozoa Leishmania infantum and L. donovani infection. This study investigated whether host factors would explain the relapses. First, susceptibility to amphotericin B of L. infantum isolates was evaluated in vitro. Then, clinical data and the lipid profile of patients with relapsing and non-relapsing VL were assessed. Susceptibility to amphotericin B was similar between the isolates. CD4+ lymphocytes were reduced in both groups of patients in the first episode and with relapsing VL. Still, the strongest blood cell indicator associated with relapses was low total lymphocyte counts. Total plasma cholesterol, high-density lipoprotein, low-density lipoprotein, and, uniquely, triglycerides of the six individuals in the first episode and twenty-three with relapsing VL were lower in relapsing patients than those in the first episode. Deceased patients had extremely low low-density lipoprotein. After CD4+ decreases, lymphocyte CD8+ reduction is the final stage of immunological failure. The lower lipid concentrations appear to be secondary to the depletion of fat stores by inflammation-induced cachexia and fat exhaustion provoked by the co-occurrence of both diseases, which can finally lead to death.

Nursing and waste management in health services: unveiling meanings in the hospital context.

OBJECTIVE: To unveil the meanings that nursing professionals attribute to practices related to waste management in health services, within the hospital context. METHOD: Qualitative research, whose theoretical and methodological references were, respectively, Complexity Theory and Grounded Theory. A total of 30 nursing professionals from a public hospital in Rio de Janeiro participated in the study, between January and August 2022. A semi-structured interview was used for data collection. RESULTS: The professionals indicate the need for better knowledge about waste management in healthcare services, while revealing their understanding on the importance of this process and of themselves as important elements in impacting the environment and health. CONCLUSION: The complexity of the meanings attributed to healthcare waste management practices indicates the dialogue between the fragility of nursing professionals' knowledge and their expanded perceptions about the impacts they can have on this reality.

Body image of university students: a systematic review of the characteristics of interventions.

BACKGROUND: Body image is the mental representation of the body and can be influenced by cognitive, biological, behavioral, sociocultural, and environmental factors. University students often encounter challenges related to it. OBJECTIVE: This systematic review examined interventions aimed at holistically developing a positive body image within this population. METHODS: The PRISMA 2020 guidelines and the PICO method were employed to identify, select, assess, and synthesize studies. The consulted databases included Scopus, Web of Science, and PsycINFO, with inclusion criteria targeting body image interventions for university students aged 18 to 39. Study quality was evaluated using the QATSDD tool. RESULTS: Twenty-one relevant studies were identified, primarily from the United States, mostly employing quantitative methods, with a focus on female participants. Various intervention strategies were utilized, including cognitive-behavioral approaches, media literacy, and physical/resistance training, with a growing use of technology like mobile applications. The majority of studies reported effective outcomes, such as reduced body dissatisfaction and increased self-esteem following interventions. Nevertheless, literature gaps were identified, such as the scarcity of formative interventions and limited use of qualitative approaches. CONCLUSION: While technology in interventions offers promising opportunities, careful assessments and judicious selection of evaluation instruments are fundamental for reliable results. Future research should focus on addressing identified gaps, such as exploring more formative interventions and incorporating qualitative methodologies to provide a more comprehensive understanding of the effectiveness of body image interventions among university students.

Calcium modulation of bacterial wilt disease on potato.

Ralstonia solanacearum species complex (RSSC) is a phytopathogenic bacterial group that causes bacterial wilt in several crops, being potato (Solanum tuberosum) one of the most important hosts. The relationship between the potato plant ionome (mineral and trace elements composition) and the resistance levels to this pathogen has not been addressed until now. Mineral content of xylem sap, roots, stems and leaves of potato genotypes with different levels of resistance to bacterial wilt was assessed in this work, revealing a positive correlation between divalent calcium (Ca) cation concentrations and genotype resistance. The aim of this study was to investigate the effect of Ca on bacterial wilt resistance, and on the growth and virulence of RSSC. Ca supplementation significantly decreased the growth rate of Ralstonia pseudosolanacearum GMI1000 in minimal medium and affected several virulence traits such as biofilm formation and twitching motility. We also incorporate for the first time the use of microfluidic chambers to follow the pathogen growth and biofilm formation in conditions mimicking the plant vascular system. By using this approach, a reduction in biofilm formation was observed when both, rich and minimal media, were supplemented with Ca. Assessment of the effect of Ca amendments on bacterial wilt progress in potato genotypes revealed a significant delay in disease progress, or a complete absence of wilting symptoms in the case of partially resistant genotypes. This work contributes to the understanding of Ca effect on virulence of this important pathogen and provides new strategies for an integrated control of bacterial wilt on potato. IMPORTANCE: Ralstonia solanacearum species complex (RSSC) includes a diverse group of bacterial strains that cause bacterial wilt. This disease is difficult to control due to pathogen aggressiveness, persistence, wide range of hosts, and wide geographic distribution in tropical, subtropical, and temperate regions. RSSC causes considerable losses depending on the pathogen strain, host, soil type, environmental conditions, and cultural practices. In potato, losses of $19 billion per year have been estimated for this pathogen worldwide. In this study, we report for the first time the mineral composition found in xylem sap and plant tissues of potato germplasm with different levels of resistance to bacterial wilt. This study underscores the crucial role of calcium (Ca) concentration in the xylem sap and stem in relation to the resistance of different genotypes. Our in vitro experiments provide evidence of Ca's inhibitory effect on the growth, biofilm formation, and twitching movement of the model RSSC strain R. pseudosolanacearum GMI1000. This study introduces a novel element, the Ca concentration, which should be included into the integrated disease control management strategies for bacterial wilt in potatoes.

Tropane Alkaloid Isolated from Erythroxylum bezerrae Exhibits Neuropharmacological Potential in an Adult Zebrafish (Danio rerio) Model.

This study carried out to investigate the anti-inflammatory and antinociceptive effect of tropane alkaloid (EB7) isolated from E. bezerrae. It evaluated the toxicity and possible involvement of ion channels in the antinociceptive effect of EB7, as well as its anti-inflammatory effect in adult zebrafish (Zfa). Docking studies with EB7 and COX-1 and 2 were also performed. The tested doses of EB7 (4, 20 and 40 mg/kg) did not show any toxic effect on Zfa during the 96h of analysis (LD50>40 mg/kg). They did not produce any alteration in the locomotor behavior of the animals. Furthermore, EB7 showed promising pharmacological effects as it prevented the nociceptive behavior induced by hypertonic saline, capsaicin, formalin and acid saline. EB7 had its analgesic effect blocked by amiloride involving the neuromodulation of ASICs in Zfa. In evaluating the anti-inflammatory activity, the edema induced by κ-carrageenan 3.5 % was reduced by the dose of 40 mg/kg of EB7 observed after the fourth hour of analysis, indicating an effect similar to that of ibuprofen. Molecular docking results indicated that EB7 exhibited better affinity energy when compared to ibuprofen control against the two evaluated targets binding at different sites in the cocrystallized COX-1 and 2 inhibitors.

Effect of Cinnamaldehyde Chalcone on Behavior in Adult Zebrafish (Danio rerio): In Silico Approach.

The study focuses on the anxiolytic potential of chalcone (2E,4E)-1-(2-hydroxyphenyl)-5-phenylpenta-2,4-dien-1-one (CHALCNM) in adult zebrafish. Successfully synthesized in 58 % yield, CHALCNM demonstrated no toxicity after 96 h of exposure. In behavioral tests, CHALCNM (40 mg/kg) reduced locomotor activity and promoted less anxious behavior in zebrafish, confirmed by increased permanence in the light zone of the aquarium. Flumazenil reversed its anxiolytic effect, indicating interaction with GABAA receptors. Furthermore, CHALCNM (4 and 20 mg/kg) preserved zebrafish memory in inhibitory avoidance tests. Virtual screening and ADMET profile studies suggest high oral bioavailability, access to the CNS, favored by low topological polarity (TPSA≤75 Å2) and low incidence of hepatotoxicity, standing out as a promising pharmacological agent against the GABAergic system. In molecular coupling, CHALCNM demonstrated superior affinity to diazepam for the GABAA receptor. These results reinforce the therapeutic potential of CHALCNM in the treatment of anxiety, highlighting its possible future clinical application.

Salvia hispanica L. (chia) seed improves redox state and reverts extracellular matrix collagen deposition in skeletal muscle of sucrose-rich diet-fed rats.

Skeletal muscle (SkM) is a plastic and dynamic tissue, essential in energy metabolism. Growing evidence suggests a close relationship between intramuscular fat accumulation, oxidative stress (OS), extracellular matrix (ECM) remodeling, and metabolic deregulation in SkM. Nowadays natural products emerge as promising alternatives for the treatment of metabolic disorders. We have previously shown that chia seed administration reverts SkM lipotoxicity and whole-body insulin resistant (IR) in sucrose-rich diet (SRD) fed rats. The purpose of the present study was to assess the involvement of OS and fibrosis in SkM metabolic impairment of insulin-resistant rats fed a long-term SRD and the effects of chia seed upon these mechanisms as therapeutic strategy. Results showed that insulin-resistant SRD-fed rats exhibited sarcopenia, increase in lipid peroxidation, altered redox state, and ECM remodeling-increased collagen deposition and lower activity of the metalloproteinase 2 (MMP-2) in SkM. Chia seed increased ferric ion reducing antioxidant power and glutathione reduced form levels, and the activities of glutathione peroxidase and glutathione reductase enzymes. Moreover, chia seed reversed fibrosis and restored the MMP-2 activity. This work reveals a participation of the OS and ECM remodeling in the metabolic alterations of SkM in our experimental model. Moreover, current data show novel properties of chia seed with the potential to attenuate SkM OS and fibrosis, hallmark of insulin-resistant muscle.

Chrysoporthe brasiliensis sp. nov. pathogenic to Melastomataceae in southeast Brazil.

Species in the Melastomataceae (Myrtales) include trees and woody shrubs that are amongst the most common hosts of Chrysoporthe and related fungi. These fungi cause stem cankers, branch death and in extreme cases, kill their hosts. Chrysoporthe-like fungi were observed on Miconia spp. and Rhynchanthera grandiflora (Melastomataceae) plants during tree disease surveys in south-eastern Brazil including the states of Minas Gerais and Rio de Janeiro. The aims of this study were to isolate and identify the fungi utilising morphological characteristics and phylogenetic analyses. This led to the identification of a new species of Chrysoporthe described here as Chrysoporthe brasilensis sp.nov. Inoculations were conducted on R. grandiflora and M. theaezans, showing that C. brasiliensis is an aggressive pathogen. This study adds to a growing number of reports of new and pathogenic species of Chrysoporthe that potentially threaten native Myrtales globally, including important trees such as Eucalyptus, both in natural ecosystems and in planted forests.

Portfólio: percepção de estudantes de graduação da área da saúde / Portafolio: percepción de los estudiantes de pregrado en eláreade la salud / Portfolio: perception of undergraduate students in the healthcare field

Introdução:A formação em saúde norteia a prática profissional, incidindo diretamente na atenção e assistência à saúde ofertada à população. Nesse sentido, o uso de métodos ativos de aprendizagem e avaliação, como por exemplo, o portfólio, podem contribuir para a construção de conhecimentos crítico-reflexivos. Objetivo:Evidenciara percepção de estudantes dos cursos da área da saúde, que cursam a disciplina de Saúde e Cidadania na Universidade Federal do Rio Grande do Norte sobre o uso do portfólio enquanto instrumento de avaliação do ensino aprendizagem. Metodologia:Os dados foram obtidos por meio da formação de grupo focaleanalisados pela análise do conteúdo. Definiram-se, então, as categorias temáticas:percepção sobre o portfólio; a elaboração do portfólio e a sua contribuição para a formação; dificuldades para formulação doportfólio;o portfólio como instrumento de avaliação. Resultados:Os estudantes compreendem o portfólio como instrumento de diálogo entre docentes e discentes, através dos relatos das vivências em grupo nos equipamentos sociais e reflexões individuais na construção de conceitos e aprofundamento teórico. Ainda referem inseguranças e dúvidas acerca da estruturação e confecção do instrumento, no entanto, percebem o portfólio como potente e inovador no auxílio aconstrução do conhecimento uma vez que permite oacompanhamento do processo de ensino-aprendizagem, possibilitando maior interação entre educador-educando, com produção de uma aprendizagem significativa.Conclusões:o portfólio estimula a reflexão e a crítica acerca das vivências nos cenários de práticas onde se desenvolve o componente curricular Saúde e Cidadaniacorroborando, sobremaneira, para a construção do conhecimento dos estudantes (AU).

Introduction:A degreein healthcare guides the professional practice, directly affecting the healthcare attention and assistance offered to the population. In this sense, the use of active learning and assessment methods, such as portfolios, can contribute to the construction of critical-reflective knowledge. Objective:To highlight the perception of students from health courses, who study the Health and Citizenship discipline at the Federal University of Rio Grande do Norte, regarding the use of the portfolio as an instrument for evaluating teaching and learning.Methodology:Data were obtained through the formation of a focus group and analyzed using content analysis. Thematic categories were then defined: perception of the portfolio; the preparation of the portfolio and its contribution to training; difficulties in formulating the portfolio; the portfolio as an assessment tool. Results:Students understand the portfolio as an instrument of dialogue between teachers and students, through reports of group experiences in social facilities and individual reflections in the construction of concepts and theoretical deepening. They still report insecurities and doubts about the structuring and creation of the instrument, however, they perceive the portfolio as powerful and innovativein helping to build knowledge as it allows the monitoring of the teaching-learning process, enabling greater interaction between educator and student, with the production of significant learning. Conclusions:The portfolio encourages reflection and criticism about the experiences in the practical scenarios where the curricular component -SACI is developed, greatly supporting the construction of students' knowledge (AU).

Introducción:La formación en salud orienta la práctica profesional, incidiendo directamente en la atención y asistencia sanitaria que se ofrece a la población. En este sentido, el uso de métodos activos de aprendizaje y evaluación, como los portafolios, puedecontribuir a la construcción de conocimiento crítico-reflexivo. Objetivo:Resaltar la percepción de estudiantes de carreras de salud, que cursan la disciplina Salud y Ciudadanía de la Universidad Federal de Rio Grande do Norte, sobre el uso del portafolios como instrumento de evaluación de la enseñanza y del aprendizaje. Metodología:Los datos se obtuvieron mediante la formación de un grupo focal y se analizaron mediante análisis de contenido. Luego se definieron categorías temáticas: percepción del portafolio; la elaboración del portafolio y su contribución a la formación; dificultades para formular el portafolio; el portafolio como herramienta de evaluación.Resultados:Los estudiantes entienden el portafolio como un instrumento de diálogo entre docentes y estudiantes, a través de relatos de experiencias grupales en establecimientos sociales y reflexiones individuales en la construcción de conceptos y profundización teórica. Aún reportan inseguridades y dudas sobre la estructuración y creación del instrumento, sin embargo, perciben el portafolio como poderoso e innovador para ayudar a la construcción de conocimiento ya que permite el seguimiento del proceso de enseñanza-aprendizaje, posibilitando una mayor interacción entre educador y estudiante, con la producción de aprendizajes significativos.Conclusiones: El portafolio incentiva la reflexión y crítica sobre las experiencias en los escenarios prácticos donde se desarrolla el componente curricular -SACI, apoyando en gran medida la construcción del conocimiento de los estudiantes (AU).

Potencialidades e fragilidades da Sistematização da Assistência de Enfermagem no período puerperal / Strengths and weaknesses of the Systematization of Nursing Care in the postpartum period / Fortalezas y deblilidades de la Sistematización de la Atención de Enfermería en el posparto

Objetivo: identificar potencialidades e fragilidades da Sistematização da Assistência de Enfermagem no período puerperal. Método: estudo descritivo exploratório qualitativo desenvolvido entre agosto e dezembro de 2021 com 17 enfermeiros que atuam em equipes de Estratégia de Saúde da Família em um município do Rio Grande do Sul. Os dados foram coletados por meio de entrevista semiestruturada e submetidos à análise de conteúdo.Resultados: as potencialidades da Sistematização da Assistência de Enfermagemestão relacionadas à satisfação, organização do processo de trabalho e melhoria da qualidade do cuidado. E, as fragilidades estão associadas à falta de recursos humanos e de tempo, acúmulo de funções e pouco conhecimento sobre a temática. Conclusões: os enfermeiros reconhecem a importância da Sistematização da Assistência de Enfermagem, mas ainda é necessário qualificar o processo de enfermagem às mulheres no puerpério

Objective:to identify potentialities and weaknesses of the Systematization of Nursing Care in the postpartum period. Method:qualitative exploratory descriptive study developed between August and December 2021 with 17 nurses who work in Family Health Strategy teams in a city in Rio Grande do Sul. Data were collected through semi-structured interviews and subjected to content analysis. Results:the potential of Nursing Care Systematization is related to satisfaction, organization of the work process and improvement in the quality of care. And, the weaknesses are associated with the lack of human resources and time, accumulation of functions and little knowledge on the subject. Conclusions:nurses recognize the importance of Systematizing Nursing Care, but it is still necessary to qualify the nursing process for women in the postpartum period.

Objetivo: identificar potencialidades y debilidades de la Sistematización de la Atención de Enfermería en el posparto. Método:estudio descriptivo exploratorio cualitativo desarrollado entre agosto y diciembre de 2021 con 17 enfermeros que actúan en equipos de la Estrategia de Salud de la Familia en una ciudad de Rio Grande do Sul. Los datos fueron recolectados a través de entrevistas semiestructuradas y sometidos a análisis de contenido. Resultados:el potencial de la Sistematización de la Atención de Enfermería está relacionado con la satisfacción, la organización del proceso de trabajo y la mejora de la calidad de la atención. Y, las debilidades están asociadas a la falta de recursos humanos y de tiempo, acumulación de funciones y poco conocimiento sobre el tema. Conclusiones:los enfermeros reconocen la importancia de Sistematizar la Atención de Enfermería, pero aún es necesario calificar el proceso de enfermería para las mujeres en el posparto.

Systematic Review of Music Therapy and Musical Interventions for Patients with Moderate and Severe Mental Disorders.

Objective: This systematic review aims to assess the impact of music therapy and musical interventions on neuropsychiatric outcomes among patients with moderate and severe mental disorders, in comparison with conventional treatment in isolation. Methods: The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted on November 16, 2021, using the following databases and search interfaces: Cumulative Index to Nursing and Allied Health Literature, Embase, SCOPUS, Web of Science; PubMed, PsycINFO, Literatura Latino-Americana e do Caribe em Ciências da Saúde, and Scientific Electronic Library Online. Two authors independently assessed the studies for inclusion criteria, extracted the data, and evaluated the quality of the included studies using critical appraisal tools. Results: In total, 17 studies were included, 9 of which were randomized controlled trials. The experimental studies involved 5,082 adult and elderly patients. The most prevalent symptoms assessed in the studies were anxiety, depression, and positive and negative symptoms of psychotic disorders. Music interventions were predominantly conducted by music therapists and nurses, providing passive interventions with the selection of musical repertoire by therapists and patients. The frequency with which musical interventions occurred varied greatly in terms of session duration, number of times per week, and number of times during the day. The identified study designs included clinical and quasi-experimental studies. In terms of methodological quality, clinical studies showed weaknesses regarding deviations from intended interventions. Conclusion: The effectiveness of music therapy and musical interventions for neuropsychiatric symptoms in patients with moderate and severe mental disorders was evident in quasi-experimental and clinical studies with satisfactory methodological quality. Musical interventions, in various forms of application, represent an interdisciplinary therapeutic tool that complements and enhances conventional treatment. Unlike conventional treatments, the immersive and integrative nature of music interventions allows access to both intrapersonal and interpersonal dimensions during periods of psychic suffering. These findings highlight the importance of researchers addressing methodological limitations, such as deviations from intended interventions, and advocate for the expansion the use of music in community treatment settings.

Is there any association between fluoride exposure and thyroid function modulation? A systematic review.

Numerous pre-clinical and observational studies have explored the potential effects of fluoride (F) at varying concentrations on diverse systems and organs. While some have assessed the endocrinological conditions of children and adults, a consensus regarding the interaction between F and the thyroid remains elusive. This systematic review aimed to gather primary evidence on the association between F and changes in the thyroid at optimal and high levels in water supply as stipulated by the World Health Organization. A search strategy, incorporating terms pertinent to the studies, was employed across PubMed, Scopus, Web of Science, Lilacs, and Google Scholar. Following the review of studies, data were extracted and analyzed using the Grading of Recommendations, Assessment, Development, and Evaluations to assess the quality of the evidence. Our results yielded 3,568 studies, of which seven met the inclusion criteria for this review. Five of the seven studies identified an association between high F exposure and thyroid function. In the analysis of methodological quality, every study was found to have major or minor methodological issues and significant risk of bias. The overall confidence in the evidence was deemed low for all outcomes in the seven studies. The evidence compiled in this review suggests a potential association between chronic high levels of F exposure and thyroid damage. Nonetheless, further studies with robust design and high methodological quality are required to provide evidence for policy makers and health care practitioners.

Withanicandrin Isolated from Datura Ferox Promotes Antinociception by Modulating the Asics and TRPS Channels and Anti-Inflammation in Adult Zebrafish.

This is the first study to analyze the anti-inflammatory and antinociceptive effect of withanicandrin, isolated from Datura Ferox leaves, and the possible mechanism of action involved in adult zebrafish (ZFa). To this end, the animals were treated intraperitoneally (i. p.) with withanicandrin (4; 20 and 40 mg/kg; 20 µL) and subjected to locomotor activity and acute toxicity. Nociception tests were also carried out with chemical agents, in addition to tests to evaluate inflammatory processes induced by κ-Carrageenan 1.5 % and a Molecular Docking study. As a result, withanicandrin reduced nociceptive behavior by capsaicin at a dose of 40 mg/kg and by acid saline at doses of 4 and 40 mg/kg, through neuromodulation of TRPV1 channels and ASICs, identified through blocking the antinociceptive effect of withanicandrin by the antagonists capsazepine and naloxone. Furthermore, withanicandrin caused an anti-inflammatory effect through the reduction of abdominal edema, absence of leukocyte infiltrate in the liver tissue and reduction of ROS in thel liver tissue and presented better affinity energy compared to control morphine (TRPV1) and ibuprofen (COX-1 and COX-2).