"What really matters to the patients?": assessing the impact of wound healing on the quality of life in patients undergoing incisional hernia repair.

PURPOSE: We aim to evaluate the impact of surgical wound complications in the first 30 postoperative days after incisional hernia repair on the long-term quality of life of patients. In addition, the impact of the surgical technique and preoperative comorbidities on the quality of life of patients will also be evaluated. METHOD: Prospective cohort study, which evaluates 115 patients who underwent incisional hernioplasty between 2019 and 2020, using the onlay and retromuscular techniques. These patients were initially assessed with regard to surgical wound outcomes in the first 30 postoperative days (surgical site infection (SSI) or surgical site occurrence (SSO)), and then, assessed after three years, through a specific quality of life questionnaire, the Hernia Related Quality of Life Survey (HerQLes). RESULTS: After some patients were lost to follow-up during the study period, due to death, difficulty in contact, refusal to respond to the questionnaire, eighty patients were evaluated. Of these, 11 patients (13.8%) had SSI in the first 30 postoperative days and 37 (46.3%) had some type of SSO. The impact of both SSI and SSO on quality of life indices was not identified. When analyzing others variables, we observed that the Body Mass Index (BMI) had a significant impact on the patients' quality of life. Likewise, hernia size and mesh size were identified as variables related to a worse quality of life outcome. No difference was observed regarding the surgical techniques used. CONCLUSION: In the present study, no relationship was identified between surgical wound outcomes (SSO and SSI) and worse quality of life results using the HerQLes score. We observed that both BMI and the size of meshes and hernias showed an inversely proportional relationship with quality of life indices. However, more studies evaluating preoperative quality of life indices and comparing them with postoperative indices should be carried out to evaluate these correlations.

Evaluation of Sexual Function of Transgender Individuals.

PURPOSE: The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors. METHODS: Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life. RESULTS: Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life. CONCLUSIONS: The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life.

Organização, gestão e cuidado nutricional de pessoas com sobrepeso e obesidade na Atenção Primária à Saúde / Organization, management and nutritional care of overweight and obesity people in Primary Health Care

Objetivo: Avaliar a organização, gestão e o cuidado nutricional ofertado às pessoas com sobrepeso e obesidade na Atenção Primária à Saúde (APS). Métodos: Trata-se de um estudo transversal realizado com 54 profissionais da Atenção Primária à Saúde da cidade de Goiânia-GO. Os dados foram obtidos por meio do questionário eletrônico semiestruturado e autoaplicável. Resultados: Os profissionais participantes eram enfermeiros 88,9%, e com mais de cinco anos na função atual 79,6%. Ao analisar a infraestrutura e mobiliário, apenas 11,1% relataram cadeiras e bancos adequados, 33,3% acessibilidade física. O mapeamento do território foi referido por 51,8% dos profissionais. As principais estratégias para organização do cuidado e tratamento foram: central de regulação 79,6%, referência e contrarreferência 77,8%. Conclusão: Os resultados deste estudo refletem que a APS em Goiânia-GO, está em processo de implantação da gestão e cuidado nutricional que atendam às políticas públicas previstas para a prevenção e manejo do sobrepeso e obesidade.

Objective: To evaluate the organization, management, and nutritional care offered to overweight and obese individuals in primary healthcare (PHC) centers. Methods: A cross-sectional study was conducted with 54 professionals from PHC in the city of Goiânia-GO. Data were obtained using a semi-structured, self-administered electronic questionnaire. Results: The participating professionals were predominantly nurses (88.9%) with more than five years in their current position (79.6%). Regarding office infrastructure, including seating, only 11.1% reported adequate chairs and benches, while 33.3% reported adequate physical accessibility. Territory mapping was reported by 51.8% of professionals. The main strategies for organizing care and treatment were central regulation (79.6%), and referrals and counter-referrals (77.6%). Conclusion: The results of this study reflect that PHC in Goiânia-GO is in the process of implementing management services and nutritional care that meet the public policy standards envisaged for the prevention and management of overweight conditions and obesity.

Mitochondrial function in skeletal muscle contributes to reproductive endothermy in tegu lizards (Salvator merianae).

AIM: In cyclic climate variations, including seasonal changes, many animals regulate their energy demands to overcome critical transitory moments, restricting their high-demand activities to phases of resource abundance, enabling rapid growth and reproduction. Tegu lizards (Salvator merianae) are ectotherms with a robust annual cycle, being active during summer, hibernating during winter, and presenting a remarkable endothermy during reproduction in spring. Here, we evaluated whether changes in mitochondrial respiratory physiology in skeletal muscle could serve as a mechanism for the increased thermogenesis observed during the tegu's reproductive endothermy. METHODS: We performed high-resolution respirometry and calorimetry in permeabilized red and white muscle fibers, sampled during summer (activity) and spring (high activity and reproduction), in association with citrate synthase measurements. RESULTS: During spring, the muscle fibers exhibited increased oxidative phosphorylation. They also enhanced uncoupled respiration and heat production via adenine nucleotide translocase (ANT), but not via uncoupling proteins (UCP). Citrate synthase activity was higher during the spring, suggesting greater mitochondrial density compared to the summer. These findings were consistent across both sexes and muscle types (red and white). CONCLUSION: The current results highlight potential cellular thermogenic mechanisms in an ectothermic reptile that contribute to transient endothermy. Our study indicates that the unique feature of transitioning to endothermy through nonshivering thermogenesis during the reproductive phase may be facilitated by higher mitochondrial density, function, and uncoupling within the skeletal muscle. This knowledge contributes significant elements to the broader picture of models for the evolution of endothermy, particularly in relation to the enhancement of aerobic capacity.

Assessment of the musculoskeletal discomfort scale for upper limb among workers in inner Brazil.

BACKGROUND: Work-related musculoskeletal disorders for upper limbs (UL-WMSDs) form a complex of occupational diseases common to many professions worldwide. UL-WMSDs are manifested in most cases by pain, resulting in musculoskeletal discomfort. OBJECTIVE: This research aimed to evaluate the perception of musculoskeletal discomfort in workers from the interior of the Brazilian states of Alagoas and Bahia through the construction of a scale to assess musculoskeletal discomfort for upper limb. METHODS: The discomfort assessment scale was constructed from self-reported pain symptoms by 420 workers from the inner regions of the Brazilian states of Alagoas and Bahia. The reliability and dimensionality of the collected data were analyzed by McDonald's Omega and exploratory factor analysis, respectively. Item Response Theory (IRT) was used to create parameters for the discomfort scale. RESULTS: The musculoskeletal discomfort metric was constructed from the workers' response with six levels (varying from minimum discomfort to maximum discomfort). At the lowest level of the scale, workers indicated symptoms in the shoulders and wrists were rare. At the highest level of the scale, daily pain symptoms are reported in all regions of the upper limbs. The shoulders are the last region to develop extreme pain symptoms. CONCLUSION: The metric was created to present satisfactory psychometric properties and capable measurement of the workers' level of musculoskeletal discomfort based on self-reported pain symptoms. Therefore, the metric can support measuring discomfort, contributing to decisions that improve a healthier occupational environment for the worker.

Pepsin Inhibitors Prevent Inflammation and Loss of Laryngeal Barrier Function in Mice with Gastroesophageal Reflux.

OBJECTIVE: This study aimed to evaluate the role of pepsin inhibitors in the inflammatory response and their effects on laryngeal mucosal integrity during gastroesophageal reflux (GERD) under in vivo conditions. METHODS: A surgical model of GERD was used, in which mice were treated with pepstatin (0.3 mg/kg) or darunavir (8.6 mg/kg) for 3 days. On the third day after the experimental protocol, the laryngeal samples were collected to assess the severity of inflammation (wet weight and myeloperoxidase activity) and mucosal integrity (transepithelial electrical resistance and paracellular epithelial permeability to fluorescein). RESULTS: The surgical GERD model was reproduced. It showed features of inflammation and loss of barrier function in the laryngeal mucosa. Pepstatin and darunavir administration suppressed laryngeal inflammation and preserved laryngeal mucosal integrity. CONCLUSION: Pepsin inhibition by the administration of pepstatin and darunavir improved inflammation and protected the laryngeal mucosa in a mouse experimental model of GERD. LEVEL OF EVIDENCE: NA Laryngoscope, 134:3080-3085, 2024.

Comparison between general obesity and abdominal adiposity to estimate cardiovascular disease prevalence in individuals with chronic kidney disease: results from NHANES 2005-2016.

Abdominal obesity, regardless of overall obesity, is associated with metabolic abnormalities and with direct impact on cardiovascular risk. The aim of this study was to compare body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) to estimate cardiovascular disease (CVD) prevalence in individuals with chronic kidney disease (CKD). The data analyzed is from 2005-2016 cycles of the NHANES. A total of 2,825 participants with CKD were included in this study, and most of them had a high BMI, 66.1%, to be exact (BMI ≥ 25.0 kg/m² if age <65 or >27.0 if age ≥ 65). The prevalence rates of high WC (≥102 cm for men or ≥88 cm for women) and high WHtR (WHtR>0.5) in the study population were 70.0% and 91.0%, respectively. The results of this study suggest that BMI is a good indicator of the risk of CVDs in individuals with CKD. In addition, the results show that WC and WHtR are associated with CVDs in non-overweight individuals of both sexes. These results indicate that the assessment of abdominal fat is essential even in non-overweight patients because the risk of CVDs cannot be identified in this subpopulation using only BMI.

THE WATER-SOLUBLE CONTRAST FOR ADHESIVE SMALL BOWEL OBSTRUCTION: ARE THERE ADVANTAGES?

BACKGROUND: Adhesive small bowel obstruction is one of the most common causes of surgical emergencies, representing about 15% of hospital admissions. Defining the need and timing of surgical intervention still remains a challenge. AIMS: To report the experience of using meglumine-based water-soluble contrast in a tertiary hospital in southern Brazil, comparing with the world literature. METHODS: Patients suspected of having adhesive small bowel obstruction, according to their clinical conditions, underwent an established protocol, consisting of the administration of water-soluble contrast, followed by plain abdominal radiograph within 12 hours and by a new clinical evaluation. The protocol was initiated after starting conservative management, including fasting and placement of a nasogastric tube, as well as intravenous fluid reposition. RESULTS: A total of 126 patients were submitted to the protocol. The water-soluble contrast test sensitivity and specificity after the first radiograph were 94.6 and 91.0%, respectively; after the second radiograph, these values were 92.3 and 100%. The general test values for sensitivity and specificity were 91.9 and 100%, respectively. CONCLUSIONS: The measure parameters evaluated in this study were similar to those found in the literature, contributing to endorse the importance of this test in the evaluation of patients with adhesive small bowel obstruction. The particular relevance of this study was the similar results that were found using a different type of meglumine-based contrast, which is available in Brazil.

Cuidado de crianças e adolescentes em tratamento oncológico na pandemia da COVID-19: experiência de familiares / Care of children and adolescents undergoing cancer treatment in the COVID-19 pandemic: experience of family members / Atención de niños y adolescentes en tratamiento oncológico en la pandemia de COVID-19: experiencia de familiares

RESUMO Objetivo: descrever as experiências vivenciadas por familiares de crianças e adolescentes com câncer, em tratamento oncológico, durante a pandemia da COVID-19. Método: estudo qualitativo, exploratório e descritivo, com 20 familiares de crianças e adolescentes em tratamento oncológico em um ambulatório de oncopediatria. Foram realizadas entrevistas semiestruturadas em setembro e outubro de 2020 e posterior análise de conteúdo. Resultados: as experiências vivenciadas pelos familiares no cuidado à criança e ao adolescente durante a pandemia revelam repercussões e formas de enfrentamento advindas das preocupações e inseguranças relacionadas à COVID-19, das mudanças na rotina e da reorganização das programações terapêuticas para a continuidade do tratamento oncológico. Conclusão: tanto as crianças e os adolescentes quanto seus familiares redobraram as precauções que estavam habituados antes da pandemia. Observou-se a necessidade de reorganização e reagendamentos de consultas, procedimentos e internações, mas sem prejuízos para a terapêutica programada. A insegurança e a ansiedade foram os sentimentos mais presentes, relacionados à evolução da COVID-19(AU)

ABSTRACT Objective: to describe the experience of family members of children and adolescents with cancer undergoing cancer treatment, during the COVID-19 pandemic. Method: qualitative, exploratory and descriptive study, with 20 family members of children and adolescents undergoing cancer treatment in a pediatric oncology outpatient clinic. Semi-structured interviews were carried out in September and October 2020 and subsequent content analysis. Results: the experiences lived by family members in the care of children and adolescents during the pandemic reveal repercussions and ways of coping arising from concerns and insecurities related to COVID-19, changes in routine and the reorganization of therapeutic programs for the continuity of cancer treatment. Conclusion: both children and adolescents and their families redoubled the precautions they were used to before the pandemic. There was a need for reorganization and rescheduling of consultations, procedures and hospitalizations, but without prejudice to the planned therapy. Insecurity and anxiety were the most present feelings related to the evolution of COVID-19(AU)

RESUMEN Objetivo: describir las vivencias de familiares de niños y adolescentes con cáncer, en tratamiento oncológico, durante la pandemia de COVID-19. Método: estudio cualitativo, exploratorio y descriptivo, junto a 20 familiares de niños y adolescentes en tratamiento oncológico en un ambulatorio de oncología pediátrica. Se realizaron entrevistas semiestructuradas en septiembre y octubre y posterior análisis de contenido. Resultados: las experiencias vividas por los familiares en el cuidado de niños y adolescentes durante la pandemia revelan repercusiones y formas de enfrentamiento derivadas de las preocupaciones e inseguridades relacionadas con el COVID-19, los cambios de rutina y la reorganización de los programas terapéuticos para la continuidad del tratamiento oncológico. Conclusión: tanto los niños y los adolescentes como sus familiares redoblaron las precauciones a las que estaban acostumbrados antes de la pandemia. Hubo necesidad de reorganización y reprogramación de consultas, procedimientos y hospitalizaciones, pero sin perjuicio de la terapia prevista. La inseguridad y la ansiedad fueron los sentimientos más presentes relacionados con la evolución del COVID-19(AU)

Segurança do paciente sob a ótica de enfermeiros da estratégia saúde da família / Patient safety from the perspective of family health strategy nurses / La seguridad del paciente en la perspectiva de los enfermeros de la estrategia de salud de la familia

Objetivo: identificar o conhecimento dos enfermeiros que atuam na Estratégia Saúde da Família quanto à segurança do paciente. Método: estudo qualitativo exploratório, descritivo, realizado com 20 enfermeiros da Estratégia Saúde da Família de um município paranaense. A coleta de dados foi realizada entre julho e dezembro de 2021 com entrevistas semiestruturadas. Os dados foram categorizados e analisados com auxílio do software Iramuteq. Resultados: os enfermeiros relataram dificuldades no processo de trabalho e aspectos que influenciavam nas ações relacionadas à segurança do paciente: falta de profissionais, sobrecarga de trabalho, falhas na comunicação, trabalho em equipe e processo de formação, impacto da pandemia contra COVID-19, eventos adversos e cultura de notificação. Considerações finais: o estudo demonstrou a fragilidade dos enfermeiros em relação à segurança do paciente na Atenção Primária à Saúde e a necessidade de o tema ser amplamente discutido entre todos os componentes das equipes da Estratégia Saúde da Família(AU)

Objective: to identify the knowledge of nurses who work in the Family Health Strategy regarding patient safety. Method: exploratory, descriptive qualitative research, carried out with 20 nurses from the Family Health Strategy in a municipality in Paraná. Data collection was carried out from July to December 2021 with semi-structured interviews. Data was categorized and analyzed using the Iramuteq software. Results: nurses reported difficulties in the work process that potentially jeopardize patient safety. The following factors contribute to the patient safety concerns: shortage of professiomals, work overload, communication failures, teamwork and training process, impact of the pandemic against COVID-19, adverse events and reporting culture. Final considerations: the study demonstrated the fragility of nurses in relation to patient safety in Primary Health Care and the need for the topic to be widely discussed among all components of the Family Health Strategy teams(AU)

Objetivo: identificar el conocimiento de los enfermeros que actúan en la Estrategia Salud de la Familia en cuanto a la seguridad del paciente. Método: Investigación cualitativa, descriptiva, exploratoria, realizada con 20 enfermeros de la Estrategia Salud de la Familia en un municipio de Paraná. La recolección de datos se realizó entre julio y diciembre de 2021 por medio de entrevistas semiestructuradas. Los datos fueron categorizados y analizados utilizando el software Iramuteq. Resultados: los enfermeros declararon dificultades en el proceso de trabajo y aspectos que influyeron en las acciones relacionadas con la seguridad del paciente: falta de profesionales, sobrecarga de trabajo, fallas en la comunicación, trabajo en equipo y proceso de capacitación, impacto de la pandemia frente a la COVID-19, eventos adversos y cultura de notificación. Consideraciones finales: el estudio demostró la fragilidad de los enfermeros respecto a la seguridad del paciente en la Atención Primaria de Salud y la necesidad de que el tema sea ampliamente discutido entre todos los componentes de los equipos de la Estrategia Salud de la Familia(AU)

Imunoterapia de dessensibilização para Malassezia spp. - Relato de caso experimental / Desensitization immunotherapy for Malassezia spp: experimental case report

A pitiríase versicolor (PV) consiste em uma infecção fúngica ocasionada por leveduras de Malassezia spp., que apesar de manejo simples, é uma doença com elevadas chances de recidiva e cronificação, além da pouca variedade de terapias efetivas para tratar cepas resistentes. Existem relatos na literatura sobre utilização de dessensibilização para Malassezia spp., mas para o tratamento de dermatite atópica e não PV, conferindo caráter inovador ao relato em questão. O caso apresentado consiste em um paciente de 28 anos, do sexo masculino, com manifestações típicas de PV em região de face, cervical, dorsal e axilar, há 4 anos, com resistência aos esquemas terapêuticos tópicos e sistêmicos. Uma vez identificada a ineficácia das terapias tradicionais, foi iniciado o tratamento com dessensiblização para Malassezia spp., em aplicações semanais, com aumento progressivo da dosagem e posterior aumento no intervalo das aplicações. Após onze meses de realização do novo tratamento, o paciente evoluiu com melhora completa das lesões. Conclui-se que a utilização de técnicas imunoterápicas para o tratamento de PV foi considerado eficaz no caso relatado, apesar de ainda não haver evidências que amparem sua utilização em maior escala.

Pityriasis versicolor is a infection caused by Malassezia yeast species, which, despite simple management, involves a high risk of recurrence and chronicity, and there are few effective therapies for resistant strains. Desensitization for Malassezia spp. has been reported in the literature, but for atopic dermatitis, rather than pityriasis versicolor, making this an innovative report. The case presented herein is of a 28-year-old man who had typical manifestations of pityriasis versicolor in the face, cervical, dorsal, and axillary region for 4 years that were resistant to topical and systemic therapies. Once the ineffectiveness of traditional therapies had been determined, weekly Malassezia desensitization sessions were begun, progressively increasing first in dosage and then in frequency. After 11 months, the lesions had improved completely. In this case, immunotherapeutic techniques effectively treated pityriasis versicolor, although the evidence is as yet insufficient to support large-scale use.

Necessidades humanas básicas afetadas e diagnósticos de enfermagem da nanda-i para pacientes graves com covid-19 / Necesidades humanas básicas afectadas y diagnósticos de enfermería de nanda-i para pacientes graves con covid-19 / Basic human needs affected and nanda-i nursing diagnoses for severe patients with covid-19

Objetivo: Identificar as Necessidades Humanas Básicas Psicobiológicas e os Diagnósticos de Enfermagem da NANDA-I para pacientes com covid-19 internados em unidade de terapia intensiva. Método: estudo descritivo, documental, transversal e quantitativo, realizado em uma unidade de terapia intensiva para pacientes com diagnóstico de covid-19, utilizando como fonte de dados o prontuário eletrônico do paciente. Para análise dos dados utilizou-se estatística descritiva, sendo avaliado frequência absoluta e relativa, média e desvio padrão. Resultados: foram identificadas sete Necessidades Humanas Básicas Psicobiológicas e 15 Diagnósticos de Enfermagem mais frequentes. Conclusão: o uso da Sistematização da Assistência de Enfermagem e a operacionalização do Processo de Enfermagem auxilia no planejamento individualizado do cuidado voltado à pacientes críticos com covid-19 internados em unidades de terapia intensiva. A identificação dessas necessidades contribui para o gerenciamento do cuidado e melhora a qualidade da assistência de enfermagem.

Objective: Identify Psychobiological Basic Human Needs and NANDA-I Nursing Diagnoses for patients with COVID-19 admitted to an intensive care unit. Method: descriptive, documentary, cross-sectional and quantitative study, carried out in an intensive care unit for patients diagnosed with COVID-19, using the patient's electronic medical record as a data source. Descriptive statistics were used for data analysis, with absolute and relative frequency, mean and standard deviation being evaluated. Results: seven Psychobiological Basic Human Needs and 15 most frequent Nursing Diagnoses were identified. Conclusion: the use of the Systematization of Nursing Care and the operationalization of the Nursing Process helps in the individualized planning of care aimed at critical patients with COVID-19 hospitalized in intensive care units. Identifying these needs contributes to the management of care and improves the quality of nursing care.

Objetivo: Identificar las Necesidades Humanas Básicas psicobiológicas y los Diagnósticos de Enfermería de NANDA-I para pacientes con covid-19 que ingresaron en una unidad de cuidados intensivos. Método: estudio descriptivo, documental, transversal y cuantitativo realizado en una unidad de cuidados intensivos para pacientes con diagnóstico de covid-19, utilizando como fuente de datos la historia clínica electrónica del paciente. Para el análisis de los datos se utilizó estadística descriptiva, que evaluó la frecuencia absoluta y relativa, la media y la desviación estándar. Resultados: se identificaron siete Necesidades Humanas Básicas Psicobiológicas y 15 Diagnósticos de Enfermería más frecuentes. Conclusión: el uso de la Sistematización de la Atención de Enfermería y la puesta en marcha del Proceso de Enfermería ayuda en la planificación individualizada de la atención dirigida a pacientes críticos con covid-19 hospitalizados en las unidades de cuidados intensivos. La identificación de esas necesidades contribuye a la gestión del cuidado y la mejora de la calidad de la atención de enfermería.

Construction and validation of an instrument to assess the comfort of adolescents undergoing chemotherapy.

OBJECTIVE: To build and validate a self-report instrument to assess the comfort of adolescents with cancer undergoing chemotherapy. METHODS: This methodological study was developed in five stages: scoping review; qualitative study to characterize comfort from the perspective of adolescents with cancer undergoing chemotherapy; instrument construction; instrument content validation by experts; pre-test with a group of adolescents. RESULTS: In the scoping review, 20 comfort changes were identified; regarding the perspective of comfort for adolescents, it was possible to identify the effects on their daily lives and the impact on chemotherapy; in content validation, the index was 0.96 and Cronbach's Alpha 0.87. In the pre-test, the instrument obtained the final version with 37 items and Cronbach's Alpha 0.94. CONCLUSIONS: The constructed and validated self-report instrument showed good reliability related to satisfactory psychometric parameters and can be used by nurses in clinical practice to assess and evidence comfort changes.

Relação entre a alimentação e o tratamento do transtorno da ansiedade: revisão da literatura / Relationship between food and treatment of disorder anxiety: literature review

Estudos recentes evidenciam que a ansiedade é conceituada como o mal do século. De acordo com a Organização Mundial da Saúde (OMS), 18,6 milhões de brasileiros sofrem com algum distúrbio relacionado à ansiedade. A fisiopatologia da doença tem relação com a disfunção de neurotransmissores, tornando extremamente necessário o estudo dos neurotransmissores que auxiliam no combate ao transtorno da ansiedade. Realizou-se uma revisão bibliográfica sistemática observacional retrospectiva baseada em artigos científicos coletados nas bases de dados Scielo, Google Acadêmico e Biblioteca Virtual em Saúde (BVS). Uma alimentação balanceada e rica em micronutrientes fornece aos neurônios os nutrientes essenciais para a produção dos neurotransmissores responsáveis pela transmissão de mensagens cognitivas, incluindo sentimentos, emoções e pensamentos do indivíduo, podendo auxiliar significativamente na melhora do quadro de ansiedade. Os estudos levantados associam a correta ingestão de nutrientes como triptofano, vitamina D e ômega-3 como eficaz auxílio no tratamento da ansiedade. O objetivo do presente estudo é descrever a relação e eficácia do fator alimentação no tratamento do transtorno da ansiedade.

Maternal pre-pregnancy body mass index, gestational weight gain and child weight during the first 2 years of life in an Amazonian birth cohort.

BACKGROUND: In socially vulnerable populations, evidence is needed regarding the role of maternal nutritional status on child weight during the first 2 years of life. OBJECTIVES: We aimed to assess the association of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with offspring BMI-for-age z-scores (BAZs) during the first 2 years of life. METHODS: A population-based birth cohort study was conducted with 900 mother-child pairs. Pre-pregnancy weight and weight at delivery were collected from medical records, and anthropometric data were measured at birth and at 6-month, 1-year and 2-year follow-up visits. Linear regression and linear mixed-effect models assessed associations with pre-pregnancy BMI, GWG and BAZ during the first 2 years of life. RESULTS: Pre-pregnancy overweight and obesity and excessive GWG were positively associated with BAZ at birth and at 1- and 2-year follow-up visits. There were no significant additional BAZ changes per year based on the exposures up to age 2 years. CONCLUSIONS: Elevated maternal pre-pregnancy BMI and GWG were associated with a child's higher BAZ at birth, and these differences remained constant throughout the first 2 years of life in Amazonian children. These findings highlight the importance of promoting adequate maternal weight before pregnancy and during prenatal care also in socially vulnerable populations.

Synthesis by Microwave Irradiation, Molecular Structural Analysis and Trypanocidal Activity of Novel Pyrazole-tetrahydropyrimidine Derivatives.

BACKGROUND: A series of new eight 2-(1-aryl-3-methyl-1H-pyrazol-4-yl)-1,4,5,6-tetrahydropyrimidines 1(a-h) were synthesized by microwave irradiation technique. In vitro phenotypic screening was performed to evaluate the effect of these compounds on intracellular amastigotes forms of Trypanosoma cruzi, the etiological agent of Chagas disease. METHODS: Compounds 1(a-h) were synthesized from pyrazole-carbonitriles 2(a-h) employing microwave irradiation (50W) for 10-20 minutes. Physicochemical properties were calculated using OSIRIS DataWarrior. The toxic effect on mammalian cells (Vero Cells) and the trypanocidal activity against Trypanosoma cruzi (Dm28c-Luc) were also evaluated. RESULTS: Compounds 1(a-h) were obtained in 24-94% yields. They were completely characterized by Fourier Transform Infrared (FT-IR), Nuclear Magnetic Resonance (NMR) and High-Resolution Mass Spectrometry (HRMS) analyses. The derivatives showed low trypanocidal activity, with IC50 ranging from 47.16 to > 100 µM, with lower activity than benznidazole (1.93 µM) used as reference drug. CONCLUSION: The attractive features of this synthetic methodology are mild conditions, short reaction time, and low power. All derivatives showed low toxicity in mammalian cells, good oral bioavailability, and did not violate Lipinski´s rule of 5.

Efeitos do D-limoneno no metabolismo energético de camundongos C57/Bl6 com obesidade induzida pela dieta / Effects of D-limonene on the energy metabolism of C57/Bl6 mice with diet-induced obesity

A obesidade está associada ao desenvolvimento de doenças crônicas não transmissíveis como hipertensão, resistência insulínica, dislipidemia e esteatose hepática. O consumo de compostos bioativos impacta na manutenção da saúde e na prevenção de risco de desenvolvimento dessas doenças. Entre os compostos bioativos, os monoterpenos são pouco investigados, apesar da literatura demonstrar efeitos promissores desses compostos sobre o metabolismo. O D-limoneno, o principal monoterpeno encontrado na laranja, é caracterizado por possuir efeitos hipolipemiantes, anti-inflamatórios e anti-obesogênicos. Estudos in vitro e in vivo descrevem sua capacidade de promover a ß-oxidação de ácidos graxos em adipócitos e redução da inflamação. Este estudo teve como objetivo investigar o efeito do D-limoneno no metabolismo e inflamação em um modelo de obesidade induzida por dieta. Para isso, quarenta camundongos machos (C57/Bl6) de 11 semanas de idade, foram distribuídos em 4 grupos, sendo que um dos grupos recebeu ração normolipídica e os demais, ração hiperlipídica. O D-limoneno foi suplementado na ração de dois grupos que receberam dieta hiperlipídica nas concentrações de 0,1%, e 0,8%. Considerando-se a ingestão alimentar dos animais, a ração suplementada com 0,1% D-limoneno correspondeu à ingestão de 0,15 g/kg/dia e ração com 0,8% de D-limoneno correspondeu a 1,3 g/kg/dia. Os animais tiveram o peso e a ingestão alimentar monitorados ao longo da intervenção com duração de 7 semanas. Os camundongos que receberam D-limoneno a 0,1% apresentaram menor ganho de peso e de acúmulo de tecido adiposo, comparado com os animais sem suplementação alimentados com a dieta hiperlipídica. Além disso, o D-limoneno promoveu a diminuição da concentração plasmática de marcadores inflamatórios incluindo TNF-α, INF-γ e IL-6 nos animais dos grupos que foram suplementados com D-limoneno. Entretanto, não houve diferença nos marcadores bioquímicos e metabólicos. Uma limitação do estudo foi o fato das complicações metabólicas associadas ao modelo de obesidade não terem sido plenamente estabelecidas, dados o alojamento individual, à curta duração da exposição à ração hiperlipídica e idade dos animais no início da suplementação. Esse fato pode ter dificultado a observação dos efeitos do D-limoneno na reversão dos parâmetros que seriam normalmente deteriorados pelo desenvolvimento da obesidade. Concluímos que o D-limoneno pode interferir no metabolismo energético, com possível efeito anti-obesogênico e anti-inflamatório. Devido às limitações do modelo, são necessários mais estudos para confirmar esses resultados

Obesity is associated with the development of chronic non-communicable diseases such as hypertension, insulin resistance, dyslipidemia, and hepatic steatosis. The intake of dietary bioactive compounds is associated with the maintenance of health and the prevention of chronic diseases. Among the group of bioactive compounds, monoterpenes are poorly investigated, in spite of several reports of their promising effects on metabolism. D-limonene is the main monoterpene found in oranges, known for its hypolipemic, anti-inflammatory, and anti-obesogenic effects. in vitro and in vivo studies associate D-limonene to increased ß-oxidation of fatty acids in adipocytes and reduced inflammation. This study aimed at investigating the effects of D-limonene on metabolism and inflammation in a diet-induced obesity model. For this purpose, forty male mice (C57/Bl6) were distributed in 4 groups, with one group receiving a normolipidic diet and the others, a high-fat diet. D-limonene was supplemented in the diets of two groups that received high-fat diet at the concentrations of 0.1% and 0.8%. Considering the feed intake, mice receiving D-limonene supplementation at 0.1% ingested in average 0.15 g/kg/day, while the mice receiving the supplemmentation at 0.8%, ingested approximately 1.3 g of D-limonene /kg/day. The animals had their weight and food intake monitored throughout the intervention. Mice that received Dlimonene supplementation at 0.1% showed reduced weight gain and accumulation of adipose tissue compared to the non-supplemented mice fed the high-fat diet. In addition, D-limonene promoted a decrease in hepatic inflammatory markers including TNF-α, INF-γ, and IL-6. However, there was no difference in biochemical and metabolic markers. A limitation of the study was that the metabolic complications associated with the obesity model were not fully established, probably due to the age at the start of the protocol (11 weeks), individual housing and short duration of the exposure to the high-fat feed. This fact may have prevented the observation of the positive effects of D-limonene in reversing parameters that would normally be impaired by the development of obesity. We conclude that D-limonene may interfere in energy metabolism, with a possible anti-obesogenic and anti-inflammatory effect. Due to the limitations of the model, further studies are needed to confirm these findings

The water-soluble contrast for adhesive small bowel obstruction: are there advantages? / O contraste hidrossolúvel na obstrução intestinal por bridas: há vantagens?

ABSTRACT BACKGROUND: Adhesive small bowel obstruction is one of the most common causes of surgical emergencies, representing about 15% of hospital admissions. Defining the need and timing of surgical intervention still remains a challenge. AIMS: To report the experience of using meglumine-based water-soluble contrast in a tertiary hospital in southern Brazil, comparing with the world literature. METHODS: Patients suspected of having adhesive small bowel obstruction, according to their clinical conditions, underwent an established protocol, consisting of the administration of water-soluble contrast, followed by plain abdominal radiograph within 12 hours and by a new clinical evaluation. The protocol was initiated after starting conservative management, including fasting and placement of a nasogastric tube, as well as intravenous fluid reposition. RESULTS: A total of 126 patients were submitted to the protocol. The water-soluble contrast test sensitivity and specificity after the first radiograph were 94.6 and 91.0%, respectively; after the second radiograph, these values were 92.3 and 100%. The general test values for sensitivity and specificity were 91.9 and 100%, respectively. CONCLUSIONS: The measure parameters evaluated in this study were similar to those found in the literature, contributing to endorse the importance of this test in the evaluation of patients with adhesive small bowel obstruction. The particular relevance of this study was the similar results that were found using a different type of meglumine-based contrast, which is available in Brazil.

RESUMO RACIONAL: A obstrução intestinal por bridas é uma das causas mais comuns de atendimento em emergências cirúrgicas, representando cerca de 15% das internações hospitalares. Definir a necessidade e o momento da intervenção cirúrgica ainda permanece um desafio. OBJETIVOS: Relatar a experiência do uso de contraste hidrossolúvel à base de meglumina em um hospital terciário do sul do Brasil, comparando com a literatura mundial. MÉTODOS: Pacientes com suspeita de obstrução do intestino delgado por bridas, de acordo com suas condições clínicas, foram submetidos a um protocolo estabelecido, que consiste na administração de contraste hidrossolúvel, seguido de radiografia abdominal simples em 12 horas e, posteriormente, de nova avaliação clínica. O protocolo foi iniciado após manejo conservador inicial, incluindo jejum e sonda nasogástrica, bem como reposição de fluidos intravenosos. RESULTADOS: Foram submetidos ao protocolo 126 pacientes. A sensibilidade e a especificidade após a primeira radiografia foram de 94,6 e de 91%, respectivamente; após a segunda radiografia, esses valores foram de 92,3 e 100%. Os valores gerais do teste para sensibilidade e especificidade foram 91,9 e 100%. CONCLUSÕES: Os parâmetros de medida avaliados neste estudo foram semelhantes aos encontrados na literatura, contribuindo para endossar a importância deste teste na avaliação de pacientes com obstrução adesiva do intestino delgado. A relevância particular deste estudo foram os resultados semelhantes encontrados usando tipos diferente de contraste hidrossolúveis, disponíveis no Brasil.

Construction and validation of an instrument to assess the comfort of adolescents undergoing chemotherapy / Construcción y validación de un instrumento para evaluar el confort de adolescentes en quimioterapia / Construção e validação de um instrumento para avaliação do conforto de adolescentes em tratamento quimioterápico

ABSTRACT Objective: To build and validate a self-report instrument to assess the comfort of adolescents with cancer undergoing chemotherapy. Methods: This methodological study was developed in five stages: scoping review; qualitative study to characterize comfort from the perspective of adolescents with cancer undergoing chemotherapy; instrument construction; instrument content validation by experts; pre-test with a group of adolescents. Results: In the scoping review, 20 comfort changes were identified; regarding the perspective of comfort for adolescents, it was possible to identify the effects on their daily lives and the impact on chemotherapy; in content validation, the index was 0.96 and Cronbach's Alpha 0.87. In the pre-test, the instrument obtained the final version with 37 items and Cronbach's Alpha 0.94. Conclusions: The constructed and validated self-report instrument showed good reliability related to satisfactory psychometric parameters and can be used by nurses in clinical practice to assess and evidence comfort changes.

RESUMEN Objetivo: Construir y validar un instrumento de autoinforme para evaluar el confort de adolescentes con cáncer en quimioterapia. Métodos: Estudio metodológico desarrollado en cinco etapas: revisión de alcance; estudio cualitativo para caracterizar el confort en la perspectiva de adolescentes con cáncer en quimioterapia; construcción de instrumentos; validación del contenido del instrumento por expertos; prueba previa con un grupo de adolescentes. Resultados: En la revisión del alcance, se identificaron 20 cambios en la comodidad; en cuanto a la perspectiva de la comodidad de los adolescentes, fue posible identificar los efectos en su vida cotidiana y el impacto en el tratamiento de quimioterapia; en la validación de contenido el índice fue de 0,96 y el Alfa de Cronbach de 0,87. En el pretest, el instrumento obtuvo la versión final con 37 ítems y Alpha de Cronbach 0,94. Conclusiones: El instrumento de autoinforme construido y validado mostró buena confiabilidad relacionada con parámetros psicométricos satisfactorios, y puede ser utilizado por enfermeros en la práctica clínica para evaluar el confort y evidenciar modificaciones.

RESUMO Objetivo: Construir e validar um instrumento de autorrelato para avaliação do conforto de adolescentes com câncer em tratamento quimioterápico. Métodos: Estudo metodológico desenvolvido em cinco etapas: revisão de escopo; estudo qualitativo para caracterização do conforto na perspectiva do adolescente com câncer em tratamento quimioterápico; construção do instrumento; validação de conteúdo do instrumento por experts; pré-teste com grupo de adolescentes. Resultados: Na revisão de escopo, identificaram-se 20 alterações de conforto; quanto à perspectiva do conforto para o adolescente, foi possível identificar os efeitos em seu cotidiano e o impacto no tratamento quimioterápico; na validação de conteúdo, o índice foi de 0,96 e Alfa de Cronbach 0,87. No pré-teste, o instrumento obteve a versão final com 37 itens e Alfa de Cronbach 0,94. Conclusões: O instrumento de autorrelato construído e validado apresentou boa confiabilidade relacionado aos parâmetros psicométricos satisfatórios, podendo ser utilizado pelo enfermeiro na prática clínica, para avaliação do conforto e evidenciar alterações.

Avaliação da intensidade e do desconforto da sede de pacientes em pós-operatório imediato* / Evaluación de la intensidad y malestar de la sed en pacientes en el postoperatorio inmediato / Assessment of the intensity and discomfort of the thirst of patients in the immediate postoperative period

Objetivo: avaliar a intensidade e o desconforto provocados pela sede em pacientes em pós-operatório imediato. Método: estudo exploratório-descritivo, desenvolvido com pacientes internados na sala de recuperação pós-anestésica de um hospital público paranaense. Avaliaram-se indivíduos maiores de 18 anos, de ambos os sexos, com cognitivo preservado, internados de junho de 2021 a janeiro de 2022. A intensidade e o desconforto da sede foram mensurados por escalas específicas. Resultados: avaliaram-se 150 pacientes, com média de 43,9 anos. A maioria era do sexo masculino (65,3%), sem comorbidades (68,7%), submetida à raquianestesia (58%) e cirurgia ortopédica (59,3%), com soroterapia em curso (92,7%). O tempo médio de cirurgia foi 1,5 hora e 14,6 horas de jejum; 72,7% da amostra verbalizou sede, sendo que 37,6% queixaram-se de forma espontânea. Conclusão: os participantes de pesquisa apresentaram intensidade (6,6) e desconforto (7,6) moderados de sede no pós-operatório, tornando-se necessário discutir protocolos institucionais de intervenção para diminuir tal evento.

Objective: to evaluate the intensity and discomfort caused by thirst in patients in the immediate postoperative period. Method: exploratory-descriptive study developed with patients hospitalized in the post-anesthetic recovery room of a public hospital in Paraná. Individuals over 18 years of age, of both sexes, with preserved cognitive function, hospitalized from June 2021 to January 2022, were evaluated. Thirst intensity and discomfort were measured by specific scales. Results: 150 patients were evaluated, with a mean of 43.9 years. Most were male (65.3%), without comorbidities (68.7%), underwent spinal anesthesia (58%) and orthopedic surgery (59.3%), with ongoing serotherapy (92.7%). The mean surgery time was 1.5 hours and 14.6 hours of fasting; 72.7% of the sample verbalized thirst, and 37.6% complained spontaneously. Conclusion: the research participants presented moderate intensity (6.6) and discomfort (7.6) of thirst in the postoperative period, making it necessary to discuss institutional intervention protocols to reduce such event.

Objetivo: evaluar la intensidad y el malestar causado por la sed en pacientes en el postoperatorio inmediato. Método: estudio exploratorio-descriptivo, desarrollado con pacientes internados en la sala de recuperación postanestésica de un hospital público de Paraná. Se evaluaron personas mayores de 18 años, de ambos sexos, con habilidades cognitivas conservadas, hospitalizadas entre junio de 2021 y enero de 2022. Se midió la intensidad y el malestar de la sed mediante escalas específicas. Resultados: Se evaluaron 150 pacientes, con una edad media de 43,9 años. La mayoría eran hombres (65,3%), sin comorbilidades (68,7%), con anestesia espinal (58%) y cirugía ortopédica (59,3%), con sueroterapia en curso (92,7%). El tiempo promedio de cirugía fue de 1,5 horas y 14,6 horas de ayuno; El 72,7% de la muestra verbalizó sed, con un 37,6% quejándose espontáneamente. Conclusión: los participantes de la investigación presentaron moderada intensidad (6,6) y malestar (7,6) de la sed en el postoperatorio, siendo necesario discutir protocolos de intervención institucional para la reducción de ese evento.