Effect of replacing Bis-GMA with a biobased trimethacrylate on the physicochemical and mechanical properties of experimental resin composites.

OBJECTIVES: To analyze the incorporation of cardanol trimethacrylate monomer (CTMA), derived from the cashew nut shell liquid, as a substitute for Bis-GMA in acrylic resins formulations and its effect on experimental resin composites' physicochemical and mechanical properties. MATERIALS AND METHODS: The intermediary cardanol epoxy was synthesized via cardanol epoxidation, followed by the synthesis of CTMA through methacrylic anhydride solvent-free esterification. Experimental resin composites were formulated with an organic matrix composed of Bis-GMA/TEGDMA (50/50 wt %) (control). CTMA was gradually added to replace different proportions of Bis-GMA: 10 wt % (CTMA-10), 20 wt % (CTMA-20), 40 wt % (CTMA-40), and 50 wt % (CTMA-50). The composites were characterized by degree of conversion, water sorption and solubility, viscosity, thermogravimetric analysis, dynamic mechanical analysis, flexural strength and elastic modulus. Data were analyzed with one-way ANOVA and Tukey's post-hoc test (α = 0.05), except for water sorption data, which were analyzed by Kruskall-Wallis and Dunn's method. RESULTS: CTMA-based and control composites did not show statistically significant differences regarding degree of conversion, flexural strength and elastic modulus. CTMA reduced the viscosity and solubility compared to the Bis-GMA-based composite. The CTMA-40 and CTMA-50 exhibited significantly lower water sorption compared to the control. Also, acceptable thermal stability and viscoelastic properties were obtained for safe use in the oral cavity. CONCLUSIONS: Incorporating CTMA into composites resulted in similar chemical and mechanical properties compared to Bis-GMA-based material while reducing viscosity, water sorption and solubility. CLINICAL RELEVANCE: CTMA could be used as a trimethacrylate monomer replacing Bis-GMA in resin composites, thereby minimizing BPA exposure.

Effectiveness of a formulation based on Ocimum gratissimum essential oil and cashew gum as inhibitors of quality loss and melanosis in shrimp.

In this study, two nanoemulsions were formulated with essential oil (EO) of Ocimum gratissimum with (EON) or without (EOE) cashew gum (CG). Subsequently, inhibition of melanosis and preservation of the quality of shrimp stored for 16 days at 4 ± 0.5 °C were evaluated. A computational approach was performed to predict the system interactions. Dynamic light scattering (DLS) and atomic force microscopy (AFM) were used for nanoparticle analysis. Gas chromatography and flame ionization detector (GC-FID) determined the chemical composition of the EO constituents. Shrimps were evaluated according to melanosis's appearance, psychrotrophic bacteria's count, pH, total volatile basic nitrogen, and thiobarbituric acid reactive substances. EON exhibited a particle size three times smaller than EOE. The shrimp treated with EON showed a more pronounced sensory inhibition of melanosis, which was considered mild by the 16th day. Meanwhile, in the other groups, melanosis was moderate (EOE) or severe (untreated group). Both EON and EOE treatments exhibited inhibition of psychrotrophic bacteria and demonstrated the potential to prevent lipid oxidation, thus extending the shelf life compared to untreated fresh shrimp. EON with cashew gum, seems more promising due to its physicochemical characteristics and superior sensory performance in inhibiting melanosis during shrimp preservation.

Molecular Docking and GC/MS-Based Approach for Identification of Anxiolytic Alkaloids from Griffinia (Amaryllidaceae) Species in a Zebrafish Model.

Griffinia gardneriana Ravenna, Griffinia liboniana Morren and Griffinia nocturna Ravenna (Amarillydaceae) are bulbous plants found in tropical regions of Brazil. Our work aimed to determine the alkaloid profiles of Griffinia spp. and evaluate their anxiolytic potential through in vivo and in silico assays. The plants grown in greenhouses were dried and their ground bulbs were subjected to liquid-liquid partitions, resulting in alkaloid fractions that were analyzed by gas chromatography coupled to mass spectrometry (GC-MS). Anxiolytic activity was evaluated in zebrafish (Danio rerio) through intraperitoneal injection at doses of 40, 100 and 200 mg/kg in light-dark box test. GC-MS analyses revealed 23 alkaloids belonging to different skeleton types: lycorine, homolychorine, galanthamine, crinine, haemanthamine, montanine and narcisclasine. The chemical profiles were relatively similar, presenting 8 alkaloids common to the three species. The major component for G. gardneriana and G. liboniana was lycorine, while G. nocturna consisted mainly of anhydrolycorine. All three alkaloid fractions demonstrated anxiolytic effect. Furthermore, pre-treatment with diazepam and pizotifen drugs was able to reverse the anxiolytic action, indicating involving the GABAergic and serotonergic receptors. Molecular docking showed that the compounds vittatine, lycorine and 11,12-dehydro-2-methoxyassoanine had high affinity with both receptors, suggesting them to be responsible for the anxiolytic effect.

Pediatric incontinence questionnaire (PINQ): translation and transcultural adaptation to Brazilian Portuguese.

OBJECTIVE: Lower urinary tract symptoms (LUTS) affect approximately 10% of children worldwide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recommended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). MATERIAL AND METHODS: This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consistency was assessed using Cronbach's alpha. RESULTS: The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. CONCLUSIONS: The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents.

In vitro anthelmintic activity of Lippia alba essential oil chemotypes against Haemonchus contortus.

The aim of the present study was to evaluate the effects of the essential oils of Lippia alba chemotypes carvone and citral on H. contortus. Chemical characterization was performed by means of gas chromatography coupled to mass spectrometry (GC/MS). The anthelmintic effects of the essential oils were assessed through the egg hatch test (EHT) and the adult worm motility test (AWMT) using a multidrug-resistant H. contortus Kokstad isolate. Confocal laser scanning microscopy (CLSM) of eggs and adults of H. contortus and scanning electron microscopy (SEM) of adults were performed after treatment with oils for qualitative observations of their effects. The carvone chemotype of L. alba (LaCV) presented 70% carvone, and the citral chemotype of L. alba (LaCT) presented 29.4% geranial and 20.4% neral, respectively. In the EHT, the EC50 values of LaCV and LaCT were 0.2 and 0.3 mg/mL, respectively. In AWMT, after 12 h of exposure to 2 mg/mL LaCV and 2 mg/mL LaCT, 100% of adult nematodes were immobile. CLSM showed changes in larval motility inside the egg caused by LaCV, while LaCT promoted changes in larval formation. In adults exposed to both chemotypes, alterations in the anterior portion of the oesophagus were observed. In SEM, morphological changes were observed in the buccal capsule and in the medial portion of H. contortus adults. It is concluded that the two essential oils of L. alba, the chemotypes carvone and citral, caused morphological changes and inhibited the hatching of eggs and the motility of adult H. contortus nematodes.

Pediatric incontinence questionnaire (PINQ): translation and transcultural adaptation to Brazilian Portuguese

Abstract Objective Lower urinary tract symptoms (LUTS) affect approximately 10% of children worldwide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recommended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). Material and methods This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consistency was assessed using Cronbach's alpha. Results The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. Conclusions The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents.

Análise da tendência espaço-temporal da hepatite B no estado do Pará, 2006 a 2018 / Analysis of the Spatio-temporal trend of hepatitis B in the state of Pará, 2006 to 2018

Objetivo: o presente estudo tem por objetivo realizar uma análise do perfil espaço-temporal da hepatite B no estado do Pará, entre os anos de 2006 e 2018. Métodos: trata-se de um trabalho epidemiológico, ecológico e descritivo, realizado no estado do Pará por meio de seus municípios e regiões de saúde. A base de dados foi levantada perante consulta ao Departamento de Informática do SUS (DATASUS). Foram calculadas as variações percentuais anuais (APC) nas taxas de incidência de hepatite B, mediante a modelagem pelo método Jointpoint, usando o ano calendário como variável de regressão. Resultados: no estado do Pará, foram notificados, no período do estudo, 3,228 casos, sendo, 48,3% em homens e 51,7% em mulheres, com média de 248,3 casos por ano (61,8 de desvio padrão). A taxa de incidência média entre os anos de 2006 a 2018, nos 144 municípios no estado do Pará, obteve uma grande variação de 0 a 21,54 casos por 100.000 mil habitantes. Conclusão: apesar da dispersão nas taxas de incidência, obteve-se uma tendência crescente da ocorrência de casos de hepatite B no período estudado, sugerindo a necessidade de medidas de saúde pública mais eficazes no combate ao HBV.

Objective: this study aims to analyze the spatiotemporal profile of hepatitis B in the State of Pará from 2006 to 2018. Methods: this is an ecological and descriptive epidemiological study carried out in the State of Pará through its municipalities and health regions. The database was collected from the consultation with the SUS Computer Department (DATASUS). The annual percentage changes (APC) in the hepatitis B incidence rates were calculated through modeling by the Jointpoint method, using the calendar year as a regressive variable. Results: in the state of Pará, 3,228 cases were reported, of which 48.3% were men and 51.7% were women, with an average of 248.3 cases per year (61.8 standard deviations). The average incidence rate between the years 2006 to 2018 in the 144 municipalities in the state of Pará obtained a wide variation from 0 to 21.54 cases per 100,000 inhabitants. Conclusions: despite the dispersion in incidence rates, there was an incre

Biotechnological potential of essential oils from different chemotypes of Lippia alba(Mill.) N.E.Br. ex Britton & P. Wilson / Potencial biotecnológico de los aceites esenciales de diferentes quimiotipos de Lippia alba(Mill.) N.E.Br. ex Britton y P. Wilson

This study reports the biotechnological importance of seven Lippia albaspecimens collected in different places in Brazil, and evaluation of some activities as larvicidal against Aedes spp., antifungal against dermatophytes; cytotoxicity against SNB-19 (astrocytoma), HCT-116 (human colon) and PC-3 (human prostate) cancer cell lines, and inhibition of the enzyme acetylcholinesterase (AChE). The essential oils, whose extraction yield was about 1.24 w/w ± 0.9%, showed differences in their chemical composition and considered as chemotypes. The essential oils containing neral and geranial as main constituents showed better action against HCT-116 cell lines (IC50 value was 9.22 µg/mL), larvicidal activity against arbovirus vectors (LC50 value against A. aegypti was 1.59 µg/mL) and inhibition of AChE (halo inhibition zone was 1 cm). The essential oils containing mainly monoterpenoids showed better antifungal action with MIC values range from 0.15 to 1.25 mg/mL. This chemical and biological characterization may be useful for biotechnological applications.

Este estudio reporta la importancia biotecnológica de siete especímenes de Lippia alba recolectados en diferentes lugares de Brasil, y evaluación de algunas actividades como larvicida contra Aedes spp., Antifúngico contra dermatofitos; citotoxicidad contra líneas celulares de cáncer SNB-19 (astrocitoma), HCT-116 (colon humano) y PC-3 (próstata humana), e inhibición de la enzima acetilcolinesterasa (AChE). Los aceites esenciales, cuyo rendimiento de extracción fue de aproximadamente 1,24 p/p ± 0,9%, mostraron diferencias en su composición química y se consideraron quimiotipos. Los aceites esenciales que contienen neral y geranial como constituyentes principales mostraron una mejor acción contra las líneas celulares HCT-116 (el valor de CI50 fue de 9.22 µg/mL), actividad larvicida contra los vectores de arbovirus (el valor de LC50 contra A. aegypti fue de 1.59 µg/mL) e inhibición de AChE (la zona de inhibición del halo era de 1 cm). Los aceites esenciales que contienen principalmente monoterpenoides mostraron una mejor acción antifúngica con valores de CMI en el rango de 0.15 a 1.25 mg/mL. Esta caracterización química y biológica puede ser útil para aplicaciones biotecnológicas.

Methacrylic monomer derived from cardanol incorporated in dental adhesive as a polymerizable collagen crosslinker.

OBJECTIVES: The aim of this study was to evaluate the influence on MMP inhibition, dentin adhesion and physicochemical properties of an adhesive system incorporated with polymerizable collagen crosslinker monomer derived from cardanol. METHODS: The intermediary cardanol epoxy (CNE) was synthesized through cardanol epoxidation, followed by synthesis of cardanol methacrylate through methacrylic acid solvent-free esterification. Zymographic analysis was performed to evaluate the substances' ability to inhibit gelatinolytic enzymes. Collagen crosslinkers were added into adhesives systems according to the following groups: Ybond Universal® (Control), Ybond® + 2 % proanthocyanidin (PAC), Ybond® + 2 % unsaturated cardanol (Cardanol) and Ybond® + 2 % cardanol methacrylate (CNMA). Degree of conversion (DC) of the adhesives was assessed by FT-IR. Disk-shaped specimens were prepared for water sorption (WS) and solubility (SL) tests. Human third molars were sectioned to expose medium dentin and restored according to the different adhesives used (n = 5). Then, the specimens were cut into 1 mm2 sticks to evaluate, after 24 h and 6-month aging, microtensile bond strength (µTBS) and nanoleakage by scanning electron microscopy. Data were analysed with ANOVA and Tukey's post-test (α = 0.05). RESULTS: CNMA and PAC completely inhibited all forms of gelatinolytic enzymes. Cardanol achieved a significantly lowest DC, while the other groups did not differ from each other (p > 0.05). PAC achieved significantly higher water sorption, while CNMA solubility was significantly lower when compared to the other adhesives (p < 0.05). PAC provided a statistically higher 24 h and 6-month aging bond strength. Intermediary similar µTBS were presented by control and CNMA (p = 0.108). All adhesives applied attained significantly reduced bond strength after aging (p < 0.05). Interfaces created using CNMA were almost devoid of silver deposits initially, however all groups showed large amounts of silver deposits on resin-dentin interface subjected to water aging. SIGNIFICANCE: Although CNMA was effective in inhibiting gelatinolytic enzymes, when incorporated into a universal adhesive it could not promote less degradation of the adhesive interface after water aging. Since it is a hydrophobic monomer, CNMA did not interact well with dentin collagen, however it reduced the solubility of the adhesive system besides not interfering in its polymerization.

Comunicação aumentativa e alternativa: ações do terapeuta ocupacional em um hospital público de ensino / Augmentative and alternative communication: occupational therapist actions in a public teaching hospital

No contexto hospitalar, as características clínicas e/ou terapêuticas podem comprometer a comunicação verbal A Comunicação Aumentativa e Alternativa é uma estratégia que possibilita ampliar o repertório de comunicação. Este estudo analisou o processo terapêutico ocupacional após pedidos de consulta para a implementação desse tipo de comunicação com pacientes hospitalizados. Trata-se de uma pesquisa observacional, descritiva e retrospectiva, com dados bibliográficos e documentais (pedidos de consulta e respectivos prontuários). Foram incluídos na amostra 16 pedidos de consulta e os seus prontuários correspondentes. Verificaram-se os prejuízos na comunicação verbal, principalmente pelo uso de traqueostomia (31,2%). O principal recurso prescrito pelos terapeutas ocupacionais foi a prancha de comunicação (50%). Foi constatada comunicação parcial em 37,5% dos casos e efetiva em 12,5%. A demora no envio dos pedidos de consultas durante a internação inviabilizou ações mais diretas relacionadas à comunicação, e à elaboração de registros mais adequados. A dificuldade de acesso aos prontuários foi uma limitação para este estudo. (AU)

In the hospital context, clinical and/or therapeutic characteristics may negatively influence verbal communication. Augmentative and Alternative Communication is a strategy that expands the communication repertoire. This study examined the occupational therapy process directed to hospitalized patients for whom was requested an implementation plan of Augmentative and Alternative Communication. A retrospective descriptive observational study was conducted and included consultation requests sent to the Occupational Therapy Service of a public hospital based in Curitiba, Paraná/Brazil and their respective health-care records. Sixteen consultation requests and their health-care records were obtained. It was found that impair in verbal communication was caused mainly due to the use of tracheostomy (31.2%) and the main devices of Augmentative and Alternative Communication prescribed were communication boards (50%). Partial communication was found in 37.5% of cases and effective communication in 12.5%. The delay in sending consultation requests during hospitalization made actions related to communication and the preparation of more adequate records unfeasible. The difficulty of access to healthcare records was a limitation of this study. (AU)

A importância da odontogeriatria na formação de cirurgiões-dentistas

A formação do profissional da saúde, atualmente, busca torná-lo um indivíduo preocupado com o bem-estar geral e a qualidade de vida dos seus pacientes. A formação generalista de cirurgiões-dentistas possibilita o profissional a lidar com as mudanças que ocorrem no perfil sociodemográfico dos pacientes, pois, a medida que a população brasileira envelhece, o atendimento odontológico deve ser suficientemente abrangente para suprir as necessidades específicas da terceira idade. Assim, o estudo objetivou, por meio da revisão da literatura, analisar a importância do conhecimento e da prática em Odontogeriatria na formação de Cirurgiões-Dentistas, além do impacto da inclusão desta disciplina nos cursos de Graduação em Odontologia. Observou-se em diversos estudos a existência de relativo conteúdo sobre Odontogeriatria fragmentado dentre algumas disciplinas da graduação como Prótese Dentária, Periodontia e Estomatologia. Outro fato relevante é que, em estudo realizado nas regiões sul e centro-oeste do Brasil, os graduandos demonstraram preferência para o atendimento ao idoso e apontaram a necessidade de maior conhecimento, devido ao aumento da demanda na população. A inclusão de projetos de extensão universitária visando o atendimento odontológico domiciliar ou institucional de idosos também tem mostrado resultados satisfatórios para a promoção de saúde bucal do idoso, além de permitir ao aluno vivenciar as peculiaridades do cuidado e assistência dirigidos a população idosa. Deste modo, conclui-se que a Odontogeriatria deve apresentar-se como disciplina obrigatória nos cursos de graduação para formação de Cirurgiões-Dentistas capacitados para o mercado de trabalho atual que exige humanização no atendimento e resolutividade das ações em saúde.

Noninvasive Neuromodulation Techniques in Difficult Tracheostomy Weaning of Patients With Spinal Cord Injury: Report of Two Cases.

High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.

Untargeted GC/MS-based approach for identification of anti-inflammatory alkaloids from Hippeastrum elegans (Amaryllidaceae) using a human neutrophil model.

Hippeastrum elegans is an Amaryllidaceae species producing alkaloids with pharmaceutical potential including lycorine and galanthamine. Herein, we developed a non-targeted metabolomic study associated to chemometrics and biological evaluations to identify the H. elegans constituents that were able to reduce the human neutrophils proinflammatory mechanisms. The alkaloid fractions were extracted from bulbs cultivated for 15 months (m) and harvested in six harvest periods (5, 7, 9, 11, 13, and 15 m). The GC-MS analysis allowed the detection of 41 alkaloids being 31 identified. All alkaloid components varied over the cultivation and most of them were lycorine-type skeletons. Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA) distinguished three groups according to the chemical profile (group I: 5, 7, and 9 m; group II: 11 m and group III: 13 and 15 m). Therefore, the biological assays were only performed with one of the representative samples of each group: 7 m, 11 m and 15 m. None of them was toxic to human neutrophils by LDH activity and MTT test. The 7 m and 15 m-alkaloid fractions showed anti-inflammatory effects by reducing human neutrophil degranulation. However, the former one was more effective in inhibiting the cell activation based on the reduction of myeloperoxidase (MPO) release and reactive oxygen species (ROS) production. Afterwards, Partial Least Squares analysis (PLS) indicated lycorine and 11,12-dehydro-2-methoxy-assoanine as the compounds responsible for the anti-inflammatory activity of the bioactive fraction. Thus, the 7 m-alkaloid fraction of H. elegans seems to be a promising anti-inflammatory drug that deserves additional research.

Dez anos da residência multiprofissional do complexo hospital de clínicas da universidade federal do paraná / Diez años de la residencia multiprofesional en el complejo hospital de clínicas de la universidad federal de paraná / Ten years of the multiprofessional residency of the clinical hospital complex of the federal university of paraná

RESUMO Objetivo: relatar a experiência dos dez anos de implementação do Programa de Residência Multiprofissional em Atenção Hospitalar no Complexo Hospital de Clínicas da Universidade Federal do Paraná. Desenvolvimento: reporte de experiencia de los diez años de implementación del programa de residencia. Los datos se obtuvieron de documentos internos e informes de coordinadores y tutores. Se capacitó a trescientos setenta y dos profesionales. Entre los avances del programa, cabe destacar el incremento en el número de vacantes y especialidades, la consolidación del Reglamento Interno, la gestión computarizada de la información académica, el incentivo a la investigación y el mejoramiento de la asistencia en el ámbito hospitalario. Considerações finais: los diez años del programa estuvieron marcados por el desafío de deconstruir la mirada uniprofesional de un proyecto que contempló la diversidad de múltiples profesiones, propiciando la construcción de nuevos paradigmas, la transformación de prácticas profesionales, el desarrollo de habilidades de trabajo en equipo, la integración enseñanza-trabajo y avance en la formación.

RESUMEN Objetivo: relatar la experiencia de los diez años de implementación del Programa de Residencia Multiprofesional en Atención Hospitalaria en el Complejo Hospital de Clínicas de la Universidad Federal de Paraná. Desarrollo: estudio descriptivo y transversal, realizado en el año 2019 con 100 adultos mayores en un hospital público de Paraíba - Brasil. Se utilizó un instrumento semiestructurado y el Índice de Barthel, y los diagnósticos se listaron a partir de la clasificación CIPE®. Para el análisis de los dados se utilizó estadística descriptiva. Conclusión: los diagnósticos identificados proporcionan apoyos para planificar e implementar medidas de atención de Enfermería con vistas a reducir los tiempos de hospitalización, previniendo así consecuencias desfavorables para la salud y garantizando asistencia integral e individualizada para la población.

ABSTRACT Objective: to report the experience of the ten years since the implementation of the Multiprofessional Residency Program in Hospital Care at the Clinical Hospital Complex of the Federal University of Paraná. Development: an experience report on the ten years since the implementation of the residency program. The data were collected from internal documents and from the coordinators' and preceptors' reports. Three hundred and seventy-two professionals were trained. Among the advances of the program, the increase in the number of vacancies and specialties, consolidation of the Internal Regulations, computerized management of the Academic information, incentive to research, and improvement of the assistance provided in the hospital environment stand out. Final Considerations: the ten years of the program were marked by the challenge of deconstructing the uniprofessional perspective towards a project that contemplated the diversity of the multiple professions, providing the construction of new paradigms, transformation of the professional practices, development of teamwork skills, teaching-service integration, and advancement in training.

Projeto de ensino como apoio ao telemonitoramento dos casos de Covid-19 / Teaching project to support telemonitoring of Covid-19 cases

Resumo: Introdução: Em janeiro de 2020, a OMS reconheceu a pandemia do novo coronavírus no mundo, chegando os casos ao Brasil em fevereiro e ao Acre em março. Uma das respostas para enfrentamento da pandemia no estado foi o telemonitoramento dos casos suspeitos e confirmados de Covid-19, que se viabilizou a partir da parceria entre o Núcleo Telessaúde Acre, as Secretarias de Saúde e os cursos Medicina da Universidade Federal do Acre (Ufac) e do Centro Universitário Uninorte. O objetivo do artigo é relatar a experiência do projeto de ensino de apoio ao telemonitoramento dos casos de covid-19 em Rio Branco. Relato de experiência: O telemonitoramento tem sido realizado por uma equipe composta de 210 alunos de Medicina dos últimos períodos do curso e por um grupo de oito professores. Atenta às necessidades de fortalecimento das ações de enfrentamento do novo coronavírus, a Pró-Reitoria de Graduação da Ufac lançou um edital para projetos de ensino que pudessem cumprir esse papel social por meio da sistematização de conhecimentos sobre o tema. Discussão: A partir daí, o projeto foi executado através de reuniões virtuais sistemáticas da equipe executora do telemonitoramento pela plataforma Zoom, com discussões dos casos acompanhados, de rodas de conversa com especialistas sobre temas clínicos específicos, apresentação de artigos, discussão de dados epidemiológicos e aulas expositivas sobre a Covid-19. Além disso, têm sido articulados trabalhos de conclusão de curso a partir dos dados trabalhados na estratégia. Conclusão: Apesar do desafio que é trabalhar a partir do ensino remoto, o projeto tem contribuído de maneira substancial para o aprofundamento dos conhecimentos sobre a pandemia de Covid-19 e para o acompanhamento dos casos em Rio Branco.

Abstract: Introduction: In January 2020, the WHO recognized the new Coronavirus pandemic, reaching Brazil in February, and the state of Acre in March. One of the actions employed to tackle the pandemic in Acre is the telemonitoring of suspected and confirmed Covid-19 cases, enabled though a partnership between the Acre Telehealth Center, the Health Departments and the two local medical courses. The purpose of this article is to report the experience of the teaching project to support telemonitoring of Covid-19 cases in Rio Branco. Experience report: The telemonitoring was performed by a team of 210 final year medical student and a group of eight professors. Aware of the need to strengthen actions to tackle the new Coronavirus, the UFAC central administration issued a public notice for teaching projects that could fulfill this social role by systematizing knowledge on the subject. Discussion: The project has been carried out through systematic virtual meetings of the telemonitoring executive team on the Zoom platform, with discussions of the monitored cases, discussions with specialists on specific clinical topics, the presentation of articles, discussion of epidemiological data and lectures on Covid-19. Furthermore, course conclusion papers have been developed based on the telemonitoring data. Conclusion: Despite the challenge of working through distance learning, the project has contributed substantially to deepening knowledge about the Covid-19 pandemic and to monitoring cases in Rio Branco.

NIR and 1H qNMR methods coupled to chemometrics discriminate the chemotypes of the gastroprotective herb Egletes viscosa.

Egletes viscosa is a Brazilian medicinal herb consumed as flower bud tea due to its gastroprotective properties. This plant possesses two essential oil-based chemical varieties: trans-pinocarveyl acetate-rich chemotype A and cis-isopinocarveyl acetate- rich chemotype B. Therefore, we developed two simple, fast and reliable methods for discrimination of E. viscosa chemotypes using NIR and 1H qNMR spectroscopies combined with the chemometrics tools (iPLS and PLS-DA). Both methods showed high sensitivity, precision and specificity in the cross-validation tests. The NIR method has the advantages of being non-destructive and analyzable by portable devices, enabling its application for field and industrial evaluations. Meanwhile, the 1H qNMR method allows the quantification of the bioactive components ternatin, tanabalin, and centipedic acid. These aforementioned compounds were found higher in the chemotype A. Accordingly, our methods showed to be complimentary approaches for authenticity and/or quality control of E. viscosa-derived raw materials and herbal products.

Custo de processamento de produtos para saúde: uma revisão integrativa / Cost of healthcare products processing: an integrative review / Costo de procesamiento de productos de salud: una revisión integrativa

Objetivo: Analisar o conhecimento produzido na última década sobre custos hospitalares relacionados ao processamento de produtos para saúde (PPS) reutilizáveis em Centros de Material e Esterilização (CME) e empresas processadoras. Método: Revisão integrativa da literatura, com buscas nas bases de dados Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System On-line (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus e Scientific Electronic Library Online (SciELO). Os artigos selecionados foram publicados entre 2009 e abril de 2019. A busca inicial resultou em 782 artigos e, após a aplicação dos critérios de inclusão e exclusão, a amostra final compôs-se de 15 estudos, que foram analisados na íntegra. Resultados: A maioria dos trabalhos comparou o custo de diferentes tecnologias empregadas no processamento de PPS para obter economia, ou avaliou a redução de gastos com desperdício, principalmente com a diminuição do tamanho de bandejas cirúrgicas para redução de custo com o processo. Conclusão: O processamento de PPS mostrou ser medida que gera economia quando se selecionam adequadamente as tecnologias envolvidas no processo e se evitam os desperdícios.

Objective: To analyze the knowledge produced in the last decade on hospital costs related to the processing of reusable healthcare products (HP) performed in Sterile Processing Departments (SPD) and processing companies. Method: Integrative literature review, with searches in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Health Sciences Literature (LILACS), Scopus, and Scientific Electronic Library Online (SciELO). The selected articles were published between 2009 and April 2019. The initial search resulted in 782 articles and, after applying the inclusion and exclusion criteria, the final sample consisted of 15 studies, which were analyzed in full. Results: Authors of most studies compared the cost of different technologies employed in the processing of HP to achieve savings, or evaluated the reduction of waste-related expenditures, mainly with the reduction of the size of surgery trays to reduce the processing cost. Conclusion: The processing of HP proved to be a measure that promotes economy when properly selecting the technologies involved in the process and avoiding waste.

Objetivo: Analizar el conocimiento producido, en la última década, sobre los costos hospitalarios relacionados con el procesamiento de productos de salud (PS) reutilizables en los Centros de Materiales y Esterilización (CME) y las empresas de procesamiento. Método: revisión integral de la literatura, búsqueda en las bases de datos CINAHL, MEDLINE, LILACS, SCOPUS y SciELO. Los artículos seleccionados se publicaron entre 2009 y abril de 2019. La búsqueda inicial resultó en 782 artículos y, después de aplicar los criterios de inclusión y exclusión, la muestra final consistió en 15 estudios, que se analizaron en su totalidad. Resultados: La mayoría de los estudios compararon el costo de diferentes tecnologías utilizadas en el procesamiento de PS para obtener ahorros o evaluaron la reducción de los gastos de residuos, principalmente con la reducción del tamaño de las bandejas quirúrgicas, para reducir el costo del proceso. Conclusión: El procesamiento de PS demostró ser una medida que genera ahorros, cuando las tecnologías involucradas en el proceso se seleccionan adecuadamente y se evitan los desperdicios

Pedido do consulta como reflexo da compreensão sobre o trabalho do terapeuta ocupacional / Pedido de consulta sobre reflexión de la comprensión del trabajo de Terapeuta Ocupacional / Request for consultation as a reflection of the understanding on the work of the occupational therapy

O objetivo do presente estudo foi identificar a compreensão da equipe assistencial de um hospital geral sobre o trabalho do terapeuta ocupacional. Estudo de caráter qualitativo, por meio da análise documental. A amostra constituiu-se de 30 pedidos de consulta para o Serviço de Terapia Ocupacional e as respectivas avaliações contidas nos prontuários em resposta a eles. Foi realizada análise dos motivos de solicitação e sua correspondência com a avaliação da Terapia Ocupacional. Foram considerados os pedidos de consultadas unidades atendidas pelo Programa de Atenção à Saúde do Adulto e do Idoso, da Residência Multiprofissional. O projeto seguiu todos os trâmites éticos. A Clínica Médica foi a unidade que mais solicitou pedidos de consulta. Não houve nenhuma solicitação das unidades de Urologia e Nefrologia e Cabeça e Pescoço. Dentre as áreas profissionais solicitantes, sobressaíram-se a Fisioterapia e a Psicologia, possivelmente por terem maior proximidade de atuação com terapeutas ocupacionais. A análise dos pedidos de consulta possibilitou classificá-los em categorias, sendo Funções e estrutura do corpo e Atividades de vida diária as mais prevalentes. Concluiu-se que a equipe, de modo geral, tem compreensão adequada sobre o trabalho desenvolvido pelos terapeutas ocupacionais. Os motivos elencados na grande maioria dos pedidos de consulta corresponderam ao registrado na avaliação inicial. Constata-se ainda a necessidade de educação continuada dos profissionais e estudantes, considerando que o referido hospital é um espaço de ensino, e que as equipes de acadêmicos, residentes e profissionais contratados se renovam constantemente.

El objetivo del presente estudio fue identificar la comprensión del equipo asistencial de un hospital general sobre el trabajo de la Terapia Ocupacional. Estudio de carácter cualitativo-cuantitativo, por medio del análisis documental. La muestra se constituyó de 30 PCs para el Servicio de Terapia Ocupacional y las respectivas evaluaciones contenidas en los prontuarios en respuesta a ellos. Se realizó un análisis de los motivos de solicitud y su correspondencia con la evaluación de la Terapia Ocupacional. Se consideraron los PCS de las unidades atendidas por el Programa de Atención a la Salud del Adulto y del Anciano, de la Residencia Multiprofesional. El proyecto siguió todos los trámites éticos. La Clínica Médica fue la unidad que más solicitó PCs. No hubo ninguna de las unidades de Urología y Nefrología y Cabeza y Cuello. Entre las áreas profesionales solicitantes sobresalieron Fisioterapia y Psicología, posiblemente por tener mayor proximidad de actuación con terapeutas ocupacionales. El análisis de los PCs posibilitó clasificarlos en categorías, siendo "Funciones y estructura del cuerpo y" Actividades de Vida Diaria "las más prevalentes. Se concluyó que el equipo, en general, tiene una comprensión adecuada sobre el trabajo desarrollado por los terapeutas ocupacionales. Los motivos enumerados en la gran mayoría de los PCs correspondieron al registrado en la evaluación inicial. Se constata además la necesidad de educación y concientización continuada de los profesionales y estudiantes, considerando que el referido hospital es un espacio de enseñanza, y que los equipos de académicos, residentes y profesionales contratados se renuevan constantemente.

The aim of the present study was to identify the understanding of the care team, in a general hospital, regarding the role of the occupational therapist. This identification was carried out by means of a qualitative study through document analysis. The sample consisted of 30 consultation requests to Occupational Therapy Service, as well as the respective assessments contained in the medical records in response to them. Furthermore, an analysis of the reasons for the request and its correspondence with the Occupational Therapy evaluation was performed. The requests from consulted units attended by the Multi-Professional Residency Health Care Program for Adult and Elderly were considered. The project followed all ethical procedures. The Medical Clinic was the unit that most requested consultation requests. There was no request from the Urology and Nephrology and Head and Neck units. Among the requesting professional areas, Physiotherapy and Psychology stood out, possibly due to their greater proximity to occupational therapists. The analysis of the consultation requests made it possible to classify them into categories, with Functions and Body Structure and Activities of Daily Living being the most prevalent. It was concluded that the team, in general, has adequate understanding about the work developed by occupational therapists. The reasons listed in the majority of query requests corresponded to those recorded in the initial assessment. It is also noted the need for continuing education of professionals and students, considering that the hospital is a teaching space, and that the teams of academics, residents and professionals hired is constantly renewed.

Use of the LI-RADS classification in patients with cirrhosis due to infection with hepatitis B, C, or D, or infected with hepatitis B and D.

OBJECTIVE: To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists. MATERIALS AND METHODS: We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) . RESULTS: Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23 (61%) of the 38 patients had at least one liver lesion; 13 (34%) and 12 (32%) had a LI-RADS 5 lesion (κ = 0.821); 19 (50%) and 16 (42%) had a hypervascular lesion (κ = 0.668); and 30 (79%) and 24 (63%) had splenomegaly (κ = 0.503). Both radiologists identified chronic liver disease in 31 (82%) of the patients (κ = 1.00). CONCLUSION: Lesions categorized as LI-RADS 5 were detected in approximately 32% of the patients, with almost perfect agreement between the radiologists. The level of agreement was substantial or moderate for the other LI-RADS categories.

Use of the LI-RADS classification in patients with cirrhosis due to infection with hepatitis B, C, or D, or infected with hepatitis B and D / Uso da classificação LI-RADS em pacientes com cirrose por hepatite B, C e/ou D ou com infecção pelos vírus B e D

Abstract Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists. Materials and Methods: We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) . Results: Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23 (61%) of the 38 patients had at least one liver lesion; 13 (34%) and 12 (32%) had a LI-RADS 5 lesion (κ = 0.821); 19 (50%) and 16 (42%) had a hypervascular lesion (κ = 0.668); and 30 (79%) and 24 (63%) had splenomegaly (κ = 0.503). Both radiologists identified chronic liver disease in 31 (82%) of the patients (κ = 1.00). Conclusion: Lesions categorized as LI-RADS 5 were detected in approximately 32% of the patients, with almost perfect agreement between the radiologists. The level of agreement was substantial or moderate for the other LI-RADS categories.

Resumo Objetivo: Avaliar lesões hepáticas de acordo com a classificação LI-RADS nas tomografias computadorizadas de pacientes com hepatite B, co-infectados ou não com vírus delta, e com hepatite C crõnica, e o grau de concordância entre os radiologistas. Materiais e Métodos: Foram incluídos 38 pacientes com hepatite B, co-infectados ou não com vírus delta, e/ou com hepatite C crônica, que realizaram tomografia computadorizada. Dois radiologistas selecionaram até três lesões hepáticas classificadas pelo LI-RADS e avaliaram sinais de hepatopatia crônica e de hipertensão portal. Foi utilizado o teste kappa (κ) para avaliar o grau de concordância entre os radiologistas. Resultados: Foram selecionadas 56 observações pelo radiologista 1 e 48 pelo radiologista 2. Verificou-se que 71% e 61% dos pacientes apresentaram pelo menos uma observação hepática, segundo o radiologista 1 e o radiologista 2, respectivamente. Dos 38 pacientes, 13 (34%), segundo o radiologista 1, e 12 (32%), segundo o radiologista 2, apresentaram observações LI-RADS 5 (κ = 0,821). Hipervascularização foi detectada em 50% e 42% dos pacientes (κ = 0,668), esplenomegalia em 79% e 63% (κ = 0,503) e sinais de hepatopatia crônica em 82% (κ = 1,00), segundo o radiologista 1 e o radiologista 2, respectivamente. Conclusão: Detectaram-se, aproximadamente, 32% de observações LI-RADS 5 nos pacientes, com concordância quase perfeita entre os radiologistas. Houve concordância substancial/moderada entre as demais categorias LI-RADS.