Physical activity components associated with gait parameters in community-dwelling older adults.

OBJECTIVE: To investigate the association between components of physical activity and spatiotemporal gait parameters in community-dwelling older adults. METHODS: Cross-sectional study with 134 independent community-dwelling older adults. A questionnaire was applied to obtain information related to the components of physical activity (frequency, duration, modality, and history of physical activity in the life course) and the GAITRite System was used to quantify gait parameters. Three MANOVA models adjusted for potential confounders were conducted to identify associations between components of physical activity (predictors) and gait performance (outcome). RESULTS: Higher weekly frequency but not daily hours of physical activity and sports practice (tennis, boxing, football, volleyball, and tai chi) were significantly associated with better gait performance, specifically gait speed and stride length. CONCLUSION: Understanding the most effective components of physical activity to maintain functional capacity and independence in community-dwelling older adults, allowing for active aging, is essential for formulating more effective strategies.

Biotechnological potential of actinomycetes in the 21st century: a brief review.

This brief review aims to draw attention to the biotechnological potential of actinomycetes. Their main uses as sources of antibiotics and in agriculture would be enough not to neglect them; however, as we will see, their biotechnological application is much broader. Far from intending to exhaust this issue, we present a short survey of the research involving actinomycetes and their applications published in the last 23 years. We highlight a perspective for the discovery of new active ingredients or new applications for the known metabolites of these microorganisms that, for approximately 80 years, since the discovery of streptomycin, have been the main source of antibiotics. Based on the collected data, we organize the text to show how the cosmopolitanism of actinomycetes and the evolutionary biotic and abiotic ecological relationships of actinomycetes translate into the expression of metabolites in the environment and the richness of biosynthetic gene clusters, many of which remain silenced in traditional laboratory cultures. We also present the main strategies used in the twenty-first century to promote the expression of these silenced genes and obtain new secondary metabolites from known or new strains. Many of these metabolites have biological activities relevant to medicine, agriculture, and biotechnology industries, including candidates for new drugs or drug models against infectious and non-infectious diseases. Below, we present significant examples of the antimicrobial spectrum of actinomycetes, which is the most commonly investigated and best known, as well as their non-antimicrobial spectrum, which is becoming better known and increasingly explored.

Genetically modified ZIKA virus as a microRNA-sensitive oncolytic virus against central nervous system tumors

Here we introduce a first-in-class microRNA-sensitive oncolytic Zika virus (ZIKV) for virotherapy application against central nervous system (CNS) tumors. The described methodology produced two synthetic modified ZIKV strains that are safe in normal cells, including neural stem cells, while preserving brain tropism and oncolytic effects in tumor cells. The microRNA-sensitive ZIKV introduces genetic modifications in two different virus sites: first, in the established 3′UTR region, and secondly, in the ZIKV protein coding sequence, demonstrating for the first time that the miRNA inhibition systems can be functional outside the UTR RNA sites. The total tumor remission in mice bearing human CNS tumors, including metastatic tumor growth, after intraventricular and systemic modified ZIKV administration, confirms the promise of this virotherapy as a novel agent against brain tumors—highly deadly diseases in urgent need of effective advanced therapies.

Effect of Systemic and Auricular Acupuncture with a 2/100 Hz Frequency and Nogier Frequency in Fibromyalgia: a Randomized Clinical Trial, Pilot Study.

Background: Fibromyalgia is a syndrome of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cardic autonomic dysfunction that will affect the quality of life. There is currently no gold standard treatment. There are limitations of studies with electroacupuncture in auricular acupuncture. Objectives: We evaluate the effects of systemic electroacupuncture (EA) with frequencies of 2/100 Hz associated of auricular acupuncture with a Nogier frequency (2.28, 4.56 and 9.12 Hz) for pain intensity, heart rate variability (HRV), and quality of life in fibromyalgia. Methods: Randomized clinical trial, a pilot study. Eighteen volunteers were randomized into a control group (CG, n = 9) and an experimental group (EG, n = 9). Six systemic EA sessions systemic and auricular were applied in the EG for 20 min, twice a week, for six weeks consecutive. The Numerical Pain Assessment Scale (NPRS), 2010 diagnostic criteria of the American College of Rheumatology (FDC 2010), Fibromyalgia Impact Questionnaire (FIQ) and analysis of HRV were the instruments used. The independent t-test compared to the groups was applied. Results: There was no statistically significant difference for the primary outcome for NPRS (p > 0.05). In the secondary outcome there was a significant difference in the total score and in some FIQ domains (p = 0.008) and some variables such as pain (p = 0.02) and anxiety (p = 0.006). There was no significant difference for the FDC 2010 and HRV variables (p > 0.05). Conclusion: 2/100 Hz systemic EA associated with the Nogier frequency positively influenced some quality of life variables; however, pain intensity, diagnostic criteria, and HRV variables did not change.

Diagnóstico de Enfermagem Síndrome do Idoso Frágil: revisão integrativa / Nursing Diagnosis Frail Elderly Syndrome: an integrative review

RESUMO Objetivo identificar as características definidoras e os fatores relacionados ao Diagnóstico de Enfermagem Síndrome do Idoso Frágil. Métodos revisão integrativa desenvolvida em sete bases de dados, além da utilização de literatura cinzenta no Google Scholar e no Open Grey. A estratégia Problema, Conceito e Contexto foi utilizada para elaborar a questão norteadora e selecionar os descritores. Foram incluídos oito artigos e uma tese na amostragem final. Resultados três novas características foram identificadas: Incontinência Urinária; Processos Familiares Disfuncionais e Distúrbio no Padrão de Sono. As características definidoras do Diagnóstico de Enfermagem Síndrome do Idoso Frágil mais frequentes foram: Mobilidade física prejudicada; Tolerância à atividade diminuída; Nutrição desequilibrada: menor do que as necessidades corporais e Deambulação prejudicada. Sobre os fatores relacionados, os mais presentes foram: Força muscular diminuída; Disfunção cognitiva e Equilíbrio postural prejudicado. Conclusão verificou-se que as três características definidoras que não estão presentes na NANDA-I precisam ser mais bem investigadas, a fim de serem incluídas ao Diagnóstico de Enfermagem Síndrome do Idoso Frágil. Contribuições para prática o estudo disponibiliza, ao enfermeiro, um aprofundamento no referido diagnóstico, subsidiando e fortalecendo o raciocínio clínico necessário à tomada de decisão para atribuir, corretamente, o diagnóstico ao paciente.

ABSTRACT Objective to identify the defining characteristics and factors related to the Nursing diagnosis is Frail Elderly Syndrome. Methods integrative review developed in seven databases, besides the use of Grey literature in Google Scholar and Open Grey. The Problem, Concept, and Context strategies were used to develop the guiding question and select the descriptors. Eight articles and one thesis were included in the final sampling. Results three new characteristics were identified: Urinary Incontinence; Dysfunctional Family Processes and Sleep Pattern Disorder. The most frequent defining characteristics of the Frail Elderly Syndrome Nursing Diagnosis were: impaired physical mobility; decreased activity tolerance; unbalanced nutrition: less than the body needs and impaired ambulation. Among the related factors, the most present was: impaired muscle strength; cognitive dysfunction, and impaired postural balance. Conclusion it was found that the three defining characteristics that are not present in NANDA-I need to be further investigated to be included in the Nursing Diagnosis Frail Elderly Syndrome. Contributions to practice the study provides nurses with a deeper understanding of this diagnosis, supporting and strengthening the clinical reasoning necessary for decision-making to correctly assign the diagnosis to the patient.

O nível de ansiedade, a renda e o acompanhamento psicológico podem influenciar na recorrência de peso corporal em mulheres submetidas a cirurgia bariátrica / Anxiety level, income and psychological monitoring can influence the recurrence of body weight in women submitted to bariatric surgery

Introdução: A melhora nos sintomas de ansiedade após a cirurgia bariátrica pode não permanecer estável em longo prazo, favorecendo a adoção de comportamentos alimentares disfuncionais. Objetivo: Testar a correlação entre o nível de ansiedade e a recorrência de peso em mulheres no pós-operatório tardio de cirurgia bariátrica e metabólica. Métodos: Foram avaliadas 50 mulheres adultas com no mínimo 24 meses após a cirurgia bariátrica e metabólica. Foram coletados dados sociodemográficos (idade, renda e nível de escolaridade) e de acompanhamento psicológico. Foram aferidos dados antropométricos (peso e altura). Para avaliar o nível de sintomas de ansiedade, foi utilizado o Inventário de Beck. Resultados: Foi encontrada média de idade de 40,9±11,4 anos. Todas apresentavam sintomas de ansiedade moderados a graves. Aquelas que estavam sem acompanhamento psicológico apresentavam maior peso corporal (p=0,049) e maior recorrência de peso (p=0,040). Observou-se correlação positiva entre o escore de ansiedade e a recorrência de peso, e correlação negativa entre o escore de ansiedade e a renda familiar. No modelo de regressão linear, a correlação entre o escore de ansiedade com a recorrência de peso (B=0,276; IC 0,003;0,594; p=0,048) e a renda (B=-0,310; IC -0,004;0,000; p=0,027) permaneceu significativa. Contudo, ao adicionar a variável "tempo de cirurgia", observou-se perda de significância entre ansiedade e recorrência de peso (B=0,270; IC -0,040; -0,624; p=0,083), mas manteve-se a correlação com a renda (B=-0,310; IC -0,004;-0,000; p=0,029). Conclusões: Ressalta-se a importância de suporte financeiro no pós-operatório, pelos custos com o tratamento, além de manter o acompanhamento com a equipe multiprofissional em longo prazo.

Introduction: The improvement in anxiety symptoms after bariatric surgery may not remain stable in the long term, favoring the adoption of dysfunctional eating behaviors. Objective: To test the correlation between anxiety level and weight recurrence in women in the late postoperative period of bariatric and metabolic surgery. Methods: Fifty adult women with at least 24 months after bariatric and metabolic surgery were evaluated. Sociodemographic data (age, income and level of education) and psychological monitoring were collected. Anthropometric data (weight and height) were measured. To assess the level of anxiety symptoms, the Beck Anxiety Inventory was used. Results: A mean age of 40.9±11.4 years was found. All had moderate to severe anxiety symptoms. Those who were without psychological support had higher body weight (p=0.049) and greater recurrence of weight (p=0.040). There was a positive correlation between the anxiety score and body weight recurrence, and a negative correlation between the anxiety score and family income. In the linear regression model, the correlation between anxiety score and weight recurrence (B=0.276; CI 0.003; 0.594; p=0.048) and income (B=-0.310; CI -0.004; 0.000; p=0.027) remained significant. However, when adding the variable "surgery time", there was a loss of significance between anxiety and weight recurrence (B=0.270; CI -0.040; -0.624; p=0.083), but the correlation with income was maintained (B=-0.310; CI -0.004; -0.000; p=0.029). Conclusions: We emphasize the importance of financial support in the postoperative period, due to treatment costs, in addition to maintaining monitoring with the multidisciplinary team in the long term.

Emotional and behavioral problems in adolescents in the context of COVID-19: a mixed method study.

OBJECTIVE: to estimate the prevalence of emotional and behavioral problems in adolescents in the context of the COVID-19 pandemic e to explore adolescents' perception of emotional and behavioral problems identified. METHOD: mixed-method explanatory sequential design. Participants were 479 adolescents aged 15 to 18 from a Brazilian Central-West region capital. RESULTS: with a total of 479 participants, mean age was 16.03 years (SD=1.01). The prevalence of emotional and behavioral problems was 61.17%, and there was a difference between the sexes (ORb=2.93; p<0.01). The highest prevalence was related to peer relationship problems (54.49%) and emotional symptoms (52.40%). Adolescents noticed an increase in loneliness, anxiety, sadness, distancing from friends and difficulties in socializing during the pandemic. CONCLUSION: most of the investigated adolescents were classified as having emotional and behavioral problems, and girls were more likely to have them than boys. The adolescents' statements reinforce the quantitative findings. In this way, there is a need to implement actions to promote and restore the adolescents' mental health, in order to mitigate the COVID-19 pandemic socio-emotional impact on this population. KEYPOINTS: (1) The COVID-19 pandemic had a negative impact on emotions and behaviors. (2) 61.17% of adolescents were classified as having emotional and behavioral problems (EBPs). (3) Girls presented the highest level of prevalence of EBP in the pandemic context. (4) Peer relationship problems and emotional symptoms were the most prevalent.

Nursing diagnosis Frail Elderly Syndrome: Literature review / Diagnóstico de Enfermagem Síndrome do Idoso Frágil: Revisão de Literatura

Objective: to identify, in the literature, the defining characteristics and factors related to the Frail Elderly Syndrome Nursing Diagnosis. Method: Integrative Literature Review, through the CAPES journal portal, in the LILACS, SCOPUS, BDENF, CINAHL MEDLINE, PubMed, Web Of Sciences and SciELO databases. In addition to the use of gray literature in Google Scholar and Open Grey. Result: Eight articles and one dissertation were included. All publications were Brazilian, with a predominance of cross-sectional studies. The most frequent defining characteristics were: Impaired physical mobility; Decreased activity tolerance; Imbalanced nutrition: less than body needs and impaired ambulation. Three new features were identified: Urinary Incontinence; Dysfunctional family processes and sleep pattern disturbance. Regarding related factors, the most frequent were: Decreased muscle strength; Cognitive dysfunction and impaired postural balance. Conclusion: given the results found, we suggest the inclusion of the defining characteristic Urinary Incontinence, for the nursing diagnosis Frail Elderly Syndrome. Contributions to practice: the study provides nurses with a deeper understanding of the aforementioned diagnosis, supporting clinical reasoning.

Objetivo: identificar, na literatura, as características definidoras e os fatores relacionados ao Diagnóstico de Enfermagem Síndrome do Idoso Frágil. Método: Revisão Integrativa da Literatura, por meio do portal de periódicos da CAPES, nas bases de dados LILACS, SCOPUS, BDENF, CINAHL MEDLINE, PubMed, Web Of Sciences e SciELO. Além da utilização de literatura cinzenta no Google Scholar e Open Grey. Resultado: Foram incluídos oito artigos e uma dissertação. Todas as publicações eram brasileiras, com a predominância de estudos do tipo transversal. As características definidoras mais frequentes foram: Mobilidade física prejudicada; Tolerância à atividade diminuída; Nutrição desequilibrada: menor do que as necessidades corporais e Deambulação prejudicada. Três novas características foram identificadas: Incontinência Urinária; Processos familiares disfuncionais e Distúrbio no padrão de sono. Sobre os fatores relacionados, os mais frequentes foram: Força muscular diminuída; Disfunção cognitiva e Equilíbrio postural prejudicado. Conclusão: diante dos resultados encontrados, sugere-se a inclusão da característica definidora Incontinência Urinária, para o diagnóstico de enfermagem Síndrome do Idoso Frágil. Contribuições para prática: o estudo disponibiliza ao enfermeiro um aprofundamento no referido diagnóstico, subsidiando o raciocínio clínico.

Inhibition of Carrageenan-Induced Acute Inflammation in Mice by the Microgramma vacciniifolia Frond Lectin (MvFL).

Most anti-inflammatory drugs used nowadays have an excessive cost and their prolonged use has been connected with several injurious effects. Thus, the search for new anti-inflammatory agents is increasing. Lectins are carbohydrate-interacting proteins that can modulate immune response and the release of inflammation mediators. The Microgramma vacciniifolia frond lectin (MvFL) was previously reported to be an immunomodulatory agent in vitro. This work aimed to evaluate the effects of MvFL on the in vivo inflammatory status in the carrageenan-induced peritonitis and paw edema, using female Swiss mice. The animals were pretreated intraperitoneally with MvFL (5 and 10 mg/kg). In the peritonitis assay, the total and differential migration of white blood cells was evaluated, as well as the levels of cytokines, nitric oxide (NO), and total proteins in the peritoneal fluid. In the paw edema evaluation, the paw volume was measured in the early (from 30 min-2 h) and late (3-4 h) phases of edema formation. MvFL (5 and 10 mg/kg) was efficient in reducing neutrophil infiltration, pro-inflammatory cytokines (IL-6, IL-17, and TNF-α), NO, and protein content in the peritoneal fluid. It also repressed the edema formation in the late phase of the assay. In conclusion, MvFL showed inhibitory effects in in vivo acute inflammation, which encouraged future studies exploiting its immunomodulatory ability.

Pulsed Laser Acupuncture in the Treatment of Pain and Heart Rate Variability in Fibromyalgia Patients: A Pilot Randomized Clinical Trial.

Introduction: Laser acupuncture (LA) is a medically approved treatment for chronic pain, especially fibromyalgia. It is widely known that all pain is related to autonomic modulation, which may influence heart rate variability (HRV). There are robust studies in the literature on the effect of LA with continuous frequency on musculoskeletal pain and autonomic modulation. However, little is known about the effect of pulsed frequency on fibromyalgia. Therefore, this study aimed to evaluate whether an individualized intervention protocol applying pulsed LA would provide benefits related to pain symptoms and cardiac autonomic modulation in patients with fibromyalgia. Methods: In this pilot randomized clinical controlled trial, the sample consisted of women with fibromyalgia between the ages of 40 and 80, randomized into two groups: a control group (CG; n=10) and an experimental group (EG; n=10). EG received the intervention twice per week for 3 weeks. Statistical analysis was conducted by delta (difference between post-intervention and pre-intervention) and the Shapiro-Wilk test (normality). For comparison between the groups, the Mann-Whitney test was used. Results: The results showed a significant reduction in pain intensity as reported via the pain numerical scale (PNS; P=0.00), generalized pain index (GPI; P=0.00), and symptom severity scale (SSS; P=0.00). There was no significant difference in any HRV variable (P>0.05). Conclusion: Pulsed LA, when applied in an individualized protocol, can reduce pain intensity, as reported on the PNS, GPI, and SSS. However, no therapeutic effect was observed for HRV.

Emotional and behavioral problems in adolescents in the context of COVID-19: a mixed method study / Problemas emocionais e comportamentais em adolescentes no contexto da COVID-19: um estudo de método misto / Problemas emocionales y de comportamiento en adolescentes en el contexto de COVID-19: un estudio de método mixto

Abstract Objective: to estimate the prevalence of emotional and behavioral problems in adolescents in the context of the COVID-19 pandemic e to explore adolescents' perception of emotional and behavioral problems identified. Method: mixed-method explanatory sequential design. Participants were 479 adolescents aged 15 to 18 from a Brazilian Central-West region capital. Results: with a total of 479 participants, mean age was 16.03 years (SD=1.01). The prevalence of emotional and behavioral problems was 61.17%, and there was a difference between the sexes (ORb=2.93; p<0.01). The highest prevalence was related to peer relationship problems (54.49%) and emotional symptoms (52.40%). Adolescents noticed an increase in loneliness, anxiety, sadness, distancing from friends and difficulties in socializing during the pandemic. Conclusion: most of the investigated adolescents were classified as having emotional and behavioral problems, and girls were more likely to have them than boys. The adolescents' statements reinforce the quantitative findings. In this way, there is a need to implement actions to promote and restore the adolescents' mental health, in order to mitigate the COVID-19 pandemic socio-emotional impact on this population.

Resumo Objetivo: estimar a prevalência de problemas emocionais e comportamentais em adolescentes no contexto da pandemia de COVID-19 e explorar a percepção dos adolescentes sobre os problemas emocionais e comportamentais identificados. Método: estudo de método misto de desenho explanatório sequencial. Participaram 479 adolescentes de 15 a 18 anos de uma capital do Centro-Oeste brasileiro. Resultados: dos 479 participantes, a média de idade foi de 16,03 anos (DP=1,01). A prevalência de problemas emocionais e comportamentais foi de 61,17% e houve diferença em relação ao sexo (ORb=2,93; p<0,01). As maiores prevalências foram relativas aos problemas de relacionamentos com os pares (54,49%) e aos sintomas emocionais (52,40%). Os adolescentes perceberam o aumento de solidão, ansiedade, tristeza, distanciamento dos amigos e dificuldades de socialização durante a pandemia. Conclusão: a maioria dos adolescentes foi classificada com problemas emocionais e comportamentais, sendo que as meninas apresentaram maior chance de manifestá-los em comparação aos meninos. Os depoimentos dos adolescentes reforçam os resultados quantitativos. Dessa forma, nota-se a necessidade de implementar ações de promoção e restabelecimento da saúde mental dos adolescentes, de modo a mitigar o impacto socioemocional da pandemia de COVID-19 junto a essa população.

Resumen Objetivo: estimar la prevalencia de problemas emocionales y de comportamiento en adolescentes en el contexto de la pandemia de COVID-19 e explorar la percepción de los adolescentes acerca de los problemas emocionales y de comportamiento identificados. Método: un estudio de método mixto de diseño explicativo secuencial. Participaron 479 adolescentes de 15 a 18 años de una capital de la región Centro-Oeste brasileña. Resultados: de los 479 participantes, la media de las edades fue los 16,03 años (DP=1,01). La prevalencia de PEC fue del 61,17% y había una diferencia en cuanto al sexo (ORb=2,93; p<0,01). Las mayores prevalencias se relacionaron con los problemas de relación entre pares (54,49%) y con los síntomas emocionales (52,40%). Los adolescentes notaron un aumento de soledad, ansiedad, tristeza, alejamiento de amigos y dificultades de socialización durante la pandemia. Conclusión: se clasificó la mayoría de los adolescentes investigados con problemas emocionales y de comportamiento, y las chicas presentaron una mayor probabilidad de manifestarlos en comparación con los chicos. Las declaraciones de los adolescentes refuerzan los resultados cuantitativos. Así, se señala la necesidad de implementar acciones para promover y restaurar la salud mental de los adolescentes, para mitigar los impactos socioemocionales de la pandemia de COVID-19 en esa población.

Capacidade funcional de idosos longevos amazônicos / La estrategia de salud de la familia en la ciudad de São Paulo y las atribuciones del enfermero / Functional capacity of the amazonian long-lived elderly people

Objetivo: avaliar a capacidade funcional dos idosos longevos da zona urbana de um município do Estado do Amazonas.Método: Estudo descritivo, transversal e quantitativo, realizado com 135 idosos longevos cadastrados nas Unidades Básicas de Saúde em um município do Amazonas, no período de dezembro de 2019 a fevereiro de 2020. Resultados: Os resultados demonstraram predominância do sexo feminino (61,5%) e a faixa etária entre 80 a 89 (79,3%). Com relação as Atividades Básicas, verificou-se um maior frequência de independência nas eliminações intestinais (88, 1 %) e menor para dependência para escada (38,5%). Quanto às atividades instrumentais, houve uma alta independência por parte dos idosos na administração do consumo de remédios (51, 1 %), enquanto a dependência total foi maior para lavar e passar roupas (44,4%). Conclusão: avaliar a capacidade funcional dos idosos permite um conhecimento sobre seus impasses na realização de suas necessidades básicas e mostra as dificuldades enfrentadas por eles.(AU)

Objective: to evaluate the functional capacity of older elderly people in the urban area of a municipality in theState of Amazonas. Method: Descriptive, cross-sectional and quantitative study, conducted with 135 long-lived elderly registered in Basic Health Units in a municipality in Amazonas, from December 2019 to February 2020. Results: The results showed a predominance of females (61.5 %) and the age group between 80 and 89 (79.3%). Regarding the Basic Activities, there was a higher frequency of independence in intestinal eliminations (88.1 %) and a lower frequency for dependence on stairs (38.5%). As for instrumental activities, there was a high degree of independence on the part of the elderly in administering medication consumption (51.1 %), while total dependence was greater for washing and ironing clothes (44.4%). Conclusion: evaluating the functional capacity of the elderly allows a better understanding of their impasses in meeting their basic needs and shows the difficulties faced them.(AU)

Objetivo: evaluar la capacidad funcional de adultos mayores longevos en el área urbana de un município dei Estadode Amazonas. Método: Estudio descriptivo, transversal y cuantitativo, realizado con 135 adultos mayores longevos registrados en Unidades Básicas de Salud de un município de Amazonas, de diciembre de 2019 a febrero de 2020. Resultados: Los resultados mostraron un predomínio dei sexo femenino (61,5%) y el grupo de edad entre 80 y 89 (79,3%). Con respecto a las Actividades Básicas, hubo mayor frecuencia de independencia en las eliminaciones intestinales (88, 1 %) y menor frecuencia por dependencia de escalera (38,5%). En cuanto a las actividades instrumentales, hubo un alto grado de independencia por parte de los ancianos en la administración dei consumo de medicamentos (51, 1 %), mientras que la dependencia total fue mayor para el lavado y planchado de rapa (44,4%). Conclusión: evaluar la capacidad funcional de los ancianos permite conocer sus impasses en la satisfacción de sus necesidades básicas y muestra las dificultades que enfrentan(AU)

Avaliação do pé nos portadores de diabetes melitus / Evaluation of the foot in melitus diabetes

Objetivo: Avaliar o pé dos indivíduos portadores de Diabetes Melitus atendidos na atenção básica de um município do interior paulista. Método: Trata-se de um estudo quantitativo. Foram examinados 100 pés dos portadores de diabetes, no período de 1 a 31 de julho de 2019, aos usuários dos serviços de saúde do município (Estratégia Saúde da Família (ESF) e Unidade Básicas de Saúde (UBS)). Resultados: Houve predominância do sexo feminino, 56% declararam que continham ensino fundamental incompleto. A hipertensão arterial foi a comorbidade mais citada. Na avaliação da história clinica associada aos cuidados com os pés, 87% dos entrevistados, declararam que nunca tiveram nenhum tipo de ulceração nos pés. Na inspeção e avaliação dos pés dos entrevistados, constatou-se que 94% não tinham nenhum tipo de lesões nos pés. Conclusão: O estudo reforçou a importância da participação dos profissionais de saúde atuando na prevenção do pé diabético.(AU)

Objective: To evaluate the foot of individuals with Diabetes Melitus assisted in primary care in a city in the interior of São Paulo. Method: This is a quantitative study. One hundred feet of people with diabetes were examined, between the 1st and 31st of July, 2019, users of health services in the municipality (Family Health Strategy (ESF) and Basic Health Units (UBS). Results: There was a predominance of females, 56% declared that they had incomplete primary education. Hypertension was the most cited comorbidity. In the evaluation of the clinical history associated with foot care, 87% of the interviewees stated that they had never had any type of foot ulceration. Upon inspection and assessment of the respondents' feet, it was found that 94% did not have any type of foot injury. Conclusion: The study reinforced the importance of the participation of health professionals working in the prevention of diabetic foot.(AU)

Objetivo: Evaluar el pie de personas con Diabetes Melitus atendidas en atención primaria en una ciudad del interior de São Paulo. Método: Este es un estudio cuantitativo. Se examinaron cien pies de personas con diabetes, del 1 al 31 de julio de 2019, usuarios de los servicios de salud del municipio (Estrategia Salud de la Familia (ESF) y Unidades Básicas de Salud (UBS). Resultados: Predominó el sexo femenino, el 56% declaró tener educación primaria incompleta. La hipertensión fue la comorbilidad más citada. En la evaluación de la historia clínica asociada al cuidado de los pies, el 87% de los entrevistados afirmó no haber tenido nunca ningún tipo de ulceración del pie. Tras la inspección y evaluación de los pies de los encuestados, se encontró que el 94% no tenía ningún tipo de lesión en el pie. Conclusión: El estudio reforzó la importancia de la participación de los profesionales sanitarios que trabajan en la prevención del pie diabético.(AU)

Training in robotic surgery: initial experience using the Brazilian College of Surgeons model.

OBJECTIVE: to present the initial experience of the first tier of surgeons trained in the new model of robotic surgery training proposed by the CBC. METHODS: we retrospectively collected data and information on training with the Da Vinci SI robotic system. The variables analyzed were, in the pre-clinical phase, time of completion of each step by surgeon and number of hours in the simulator, and in the clinical phase, operations carried out by the training group, number of surgeons who performed nine procedures in ninety days ("9 in 90"), time of docking, time of console, and results surgical. RESULTS: we interviewed 39 surgeons before training started; 20 (51.3%) reached the clinical phase. The average age of surgeons was 47.9 years (38-62). The average time between the first interview and the delivery of the online certificate was 64 days (15-133). The surgeons have made an average of 51h and 36 minutes of robot simulation (40-83 hours). The total number of cases in which the training surgeons participated as first assistant was 418, with an average of 20.9 per surgeon. The time of pre-clinical training had an average of 116 days (48-205). CONCLUSION: the new model proposed had good acceptance by all surgeons trained and proved safe in the initial sample.

Pressões respiratórias máximas em indivíduos obesos antes e após cirurgia bariátrica / Maximum respiratory pressure in obese individuals before and after bariatric surgery

A obesidade é uma doença crônica e multifatorial que leva a alterações sistêmicas e é considerada um problema de saúde pública mundial. Entre as alterações respiratórias decorrentes da obesidade se discute como o ganho de peso ou a perda deste pode interferir nas pressões respiratórias máximas (PRM), não existindo consenso na literatura. Objetivo: Analisar o poder preditivo das equações de referência para PMR em obesos antes e após perda de peso. Métodos: Estudo transversal no qual foram incluídos vinte pacientes obesos dos Programas de Cirurgia Bariátrica de hospitais de referência em Manaus/Amazonas, que tiveram as PRM avaliadas por meio de manuvacuometria antes e aproximadamente um ano e meio após a cirurgia bariátrica. Resultados: O peso médio diminuiu de 138,5 ± 21,7 kg para 82,7 ± 8,2 kg após a cirurgia. As PRM foram supranormais antes da cirurgia e reduzidas após a cirurgia. Entre as equações analisadas, apenas as propostas por Sanchez et al. foram capazes de predizer os valores medidos. Conclusão: As PRM foram aumentadas nos obesos mórbidos avaliados e reduzidas após a cirurgia. As equações mais utilizadas na prática clínica brasileira parecem não ser capazes de predizer valores de PRM nessa população, sendo as mais adequadas as propostas por Sanchez et al. (AU)

Obesity is a chronic and multifactorial disease and is considered a global public health problem. Among the respiratory changes due to obesity, weight gain or loss of body weight can interfere with maximal respiratory pressures, and there is no consensus in the literature. Objective: To analyze the predictive power of the reference equations for maximal respiratory pressures in obese before and after weight loss. Methods: A crosssectional study was carried out in which 20 obese patients were included in the Bariatric Surgery Programs of reference hospitals in Manaus/Amazonas. The maximal respiratory pressures were assessed by manuvacuometry before and approximately one year after bariatric surgery. Results: The mean weight decreased from 138.5 ± 21.7 kg to 82.7 ± 8.2 kg after surgery. The maximal respiratory pressures were supranormal before surgery and reduced after surgery. Among the analyzed equations, only those proposed by Sanchez et al. were able to predict the measured values. Conclusion: The maximal respiratory pressures were increased in the morbidly obese evaluated and reduced after the surgery. The most used equations in Brazilian clinical practice seem not to be able to predict maximal respiratory pressures values in this population, being the most adequate those proposed by Sanchez et al. (AU)

Saúde indígena no contexto da Amazônia Legal / Indigenous health in the context of the Legal Amazon / La salud indígena en el contexto de la Amazonía Legal

Objetivo: conhecer as evidências científicas na literatura nacional sobre a saúde indígena no contexto da Amazônia Legal. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa de literatura. Encontraram-se, após a pesquisa nas bases de dados LILACS e BDENF e na Biblioteca Virtual SciELO, 99 artigos, dos quais dez atenderam aos critérios de inclusão. Utilizaramse os descritores 'saúde das populações indígenas', 'serviço de saúde indígena' e 'assistência aos índios', além do cruzamento dos Descritores em Ciências da Saúde combinados com o uso do operador booleano AND: "saúde indígena" AND "Amazônia" e "comunidade indígena" AND "saúde". Resultados: destacaram-se, na análise, os estados do Amazonas e Mato Grosso em relação aos estudos selecionados de abordagem quantitativa. Publicou-se a maioria na revista Caderno Saúde Pública, sendo 26 com autoria de doutores. Conclusão: constatou-se a necessidade de novos estudos sobre a saúde indígena na Amazônia Legal com o intuito de se conhecer as adversidades enfrentadas por essas populações.(AU)

Objective: to know the scientific evidence on indigenous health in the Brazilian literature in the context of the Legal Amazon. Method: this is a bibliographic, descriptive, integrative literature review type study. After searching the LILACS and BDENF databases, as well as the SciELO Virtual Library, 99 articles were found, ten of which met the inclusion criteria. The descriptors 'health of indigenous populations', 'indigenous health service' and 'assistance to indians' were used, in addition to the crossover of the Descriptors in Health Sciences combined with the use of the Boolean operator AND: "indigenous health" AND "Amazon" and "indigenous community" AND "health". Results: in the analysis, the states of Amazonas and Mato Grosso stood out in relation to the quantitative approach selected studies, most of which were published in the Caderno Saúde Pública journal, with 26 authored by PhDs. Conclusion: the need for new studies on indigenous health in the Legal Amazon was verified in order to know the adversities faced by these populations.(AU)

Objetivo: conocer la evidencia científica en la literatura nacional sobre la salud indígena en el contexto de la Amazonía Legal. Método: se trata de una revisión bibliográfica, descriptiva e integradora de la literatura. Después de buscar en las bases de datos LILACS y BDENF y en la Biblioteca Virtual SciELO, se encontraron 99 artículos, de los cuales diez cumplieron con los criterios de inclusión. Se utilizaron los descriptores 'salud de poblaciones indígenas', 'servicio de salud indígena' y 'asistencia a indígenas', además del cruce de Descriptores de Ciencias de la Salud combinado con el uso del operador booleano AND: "salud indígena" AND "Amazonia "y" comunidad indígena "AND" salud ". Resultados: los estados de Amazonas y Mato Grosso se destacaron en el análisis en relación a los estudios seleccionados con enfoque cuantitativo. La mayoría fue publicada en la revista Caderno Saúde Pública, 26 de las cuales fueron escritas por médicos. Conclusión: era necesario realizar más estudios sobre la salud indígena en la Amazonia Legal para comprender las adversidades que enfrentan estas poblaciones.(AU)

Evaluation of the In Vivo Acute Toxicity and In Vitro Hemolytic and Immunomodulatory Activities of the Moringa oleifera Flower Trypsin Inhibitor (MoFTI).

BACKGROUND: Protease inhibitors have been isolated from plants and present several biological activities, including immunomodulatory action. OBJECTIVE: This work aimed to evaluate a Moringa oleifera flower trypsin inhibitor (MoFTI) for acute toxicity in mice, hemolytic activity on mice erythrocytes and immunomodulatory effects on mice splenocytes. METHODS: The acute toxicity was evaluated using Swiss female mice that received a single dose of the vehicle control or MoFTI (300 mg/kg, i.p.). Behavioral alterations were observed 15-240 min after administration, and survival, weight gain, and water and food consumption were analyzed daily. Organ weights and hematological parameters were analyzed after 14 days. Hemolytic activity of MoFTI was tested using Swiss female mice erythrocytes. Splenocytes obtained from BALB/c mice were cultured in the absence or presence of MoFTI for the evaluation of cell viability and proliferation. Mitochondrial membrane potential (Δψm) and reactive oxygen species (ROS) levels were also determined. Furthermore, the culture supernatants were analyzed for the presence of cytokines and nitric oxide (NO). RESULTS: MoFTI did not cause death or any adverse effects on the mice except for abdominal contortions at 15-30 min after administration. MoFTI did not exhibit a significant hemolytic effect. In addition, MoFTI did not induce apoptosis or necrosis in splenocytes and had no effect on cell proliferation. Increases in cytosolic and mitochondrial ROS release, as well as Δψm reduction, were observed in MoFTI-treated cells. MoFTI was observed to induce TNF-α, IFN-γ, IL-6, IL-10, and NO release. CONCLUSION: These results contribute to the ongoing evaluation of the antitumor potential of MoFTI and its effects on other immunological targets.

Training in robotic surgery: initial experience using the Brazilian College of Surgeons model / Treinamento em cirurgia robótica: experiência inicial pelo modelo do Colégio Brasileiro de Cirurgiões

ABSTRACT Objective: to present the initial experience of the first tier of surgeons trained in the new model of robotic surgery training proposed by the CBC. Methods: we retrospectively collected data and information on training with the Da Vinci SI robotic system. The variables analyzed were, in the pre-clinical phase, time of completion of each step by surgeon and number of hours in the simulator, and in the clinical phase, operations carried out by the training group, number of surgeons who performed nine procedures in ninety days ("9 in 90"), time of docking, time of console, and results surgical. Results: we interviewed 39 surgeons before training started; 20 (51.3%) reached the clinical phase. The average age of surgeons was 47.9 years (38-62). The average time between the first interview and the delivery of the online certificate was 64 days (15-133). The surgeons have made an average of 51h and 36 minutes of robot simulation (40-83 hours). The total number of cases in which the training surgeons participated as first assistant was 418, with an average of 20.9 per surgeon. The time of pre-clinical training had an average of 116 days (48-205). Conclusion: the new model proposed had good acceptance by all surgeons trained and proved safe in the initial sample.

RESUMO Objetivo: apresentamos nesse artigo o resultado da experiência inicial do nosso programa durante o treinamento dos primeiros cirurgiões no novo modelo de treinamento em cirurgia robótica proposto pelo CBC. Métodos: avaliamos retrospectivamente por coleta de dados e informações sobre treinamento no sistema robótico Da Vinci SI. As variáveis analisadas foram: Fase Pré-clínica: tempo de conclusão de cada uma das etapas por cirurgião, número de horas no simulador; Fase clínica: operações realizadas pelo grupo em treinamento, número de cirurgiões que realizaram nove procedimentos em noventa dias ("9 em 90"), tempo de docking, tempo de console, resultados cirúrgicos. Resultados: trinta e nove cirurgiões foram entrevistados para início do treinamento, 20 (51,3%) chegaram à fase clínica. A média de idade dos cirurgiões foi de 47,9 (38 a 62) anos. O tempo médio entre a primeira entrevista e a entrega do certificado online foi de 64 dias (15 a 133). Os cirurgiões fizeram média de 51h e 36 minutos de simulação robótica (40 a 83 minutos). O número total de casos em que os cirurgiões em treinamento participaram do ato cirúrgico como primeiro assistente foi de 418 casos, com média de 20,9 por cirurgião. O tempo de treinamento pré-clínico teve média de 116 dias (48 a 205 dias). Conclusão: o novo modelo proposto teve boa aceitação por todos os cirurgiões treinados e se mostrou seguro na amostra inicial.

Conhecimento de médicos e enfermeiros atuantes no pré-natal sobre toxoplasmose / Conocimiento de médicos y enfermeros actuantes en prenatal sobre la toxoplasmosis / Knowledge of toxoplasmosis among doctors and nurses who provide prenatal care

RESUMO Objetivo: descrever o conhecimento de médicos e enfermeiros pré-natalistas sobre a toxoplasmose. Método: estudo transversal, analítico, realizado entre outubro de 2018 e fevereiro de 2019, com 89 profissionais de 43 Unidades Básicas de Saúde de Aracaju, Sergipe, Brasil, por meio de questionário autoaplicado. Foram calculadas as frecuências absolutas, relativas e os odds ratios. Utilizaram-se os testes Exato de Fischer e Qui-quadrado para análise dos dados. Resultados: os médicos e enfermeiros atuantes no pré-natal apresentaram pouco conhecimento sobre toxoplasmose relacionado às formas infectantes (p=1,000), vias de transmissão (p=1,000), grupo vulnerável (p=0,290), período de transmissão (p=1,000), maior risco para sequelas no recémnascido (p=0,828), quando realizar exames (p=0,015), indicação e interpretação do teste de avidez (p=0,355). Conclusão: este estudo identificou lacunas de conhecimento e poderá contribuir para planejamento de educação continuada para profissionais pré-natalistas, a fim de prevenir a toxoplasmose congênita.

RESUMEN: Objetivo: Describir el conocimiento de médicos y enfermeros de prenatal sobre la toxoplasmosis. Método: Estudio transversal, analítico, realizado entre octubre de 2018 y febrero de 2019, con 89 profesionales de 43 Unidades Básicas de Salud de Aracaju, Sergipe, Brasil, mediante cuestionario autocompletado. Se calcularon las frecuencias absolutas, relativas, y los odds ratios. Fueron utilizados para análisis de los datos los tests Exacto de Fischer y Chi-cuadrado. Resultados: Los médicos y enfermeros actuantes en el prenatal demostraron poco conocimiento sobre toxoplasmosis respecto a sus vías de infección (p=1,000), modos de transmisión (p=1,000), grupo vulnerable (p=0,290), período de contagiosidad (p=1,000), riesgo mayor de secuelas en el recién nacido (p=0,828), momento de realización de análisis (p=0,015), indicación e interpretación del test de avidez (p=0,355). Conclusión: El estudio identificó brechas de conocimiento, y contribuirá a planificar una educación continua para profesionales de prenatal, a efectos de prevenir la toxoplasmosis congénita.

ABSTRACT Objective: To describe the knowledge of doctors and nurses who provide prenatal care about toxoplasmosis. Method: Cross-sectional analytical study, conducted between October 2018 and February 2019, with 89 professionals from 43 Basic Health Units in Aracaju, State of Sergipe, in Brazil, through a self-administered questionnaire. Absolute and relative frequencies and odds ratios were calculated. Fischer Exact test and Chi-square test were used for data analysis. Results: Doctors and nurses who provide prenatal care have shown little knowledge about toxoplasmosis related to infectious forms (p = 1,000), transmission routes (p = 1,000), vulnerable group (p = 0,290), transmission period (p = 1,000), greater risk for complications in newborns (p = 0.828), when tests should be performed (p = 0.015), indication for performing and interpretation of the avidity test (p = 0.355). Conclusion: The present study identified knowledge gaps and may contribute to planning continuing education for prenatal care professionals, in order to prevent congenital toxoplasmosis.