Optimizing the Vanillin-Acid Sulfuric Method to Total Saponin Content in Leaves of Yerba Mate Clones.

Yerba mate (Ilex paraguariensis) is a forest species consumed in the form of non-alcoholic beverages in South America, with applications in foods, cosmetics, and pharmaceutical industries. The species leaves are globally recognized for their important bioactive compounds, including, saponins. We adjusted the vanillin-acid sulfuric method for determining spectrophotometrically the total saponin in yerba mate leaves. Seeking to maximize the extraction of saponins from leaves, a Doehlert design combined with Response Surface Methodology (RSM) was used, considering ethanol:water ratios and ultrasound times. In addition, the same methodology was used for the analysis of times and temperatures in the vanillin-sulfuric acid reaction heating. The contents of total saponin in mature leaves were compared in four yerba mate clones. The extraction was maximized using 40 % ethanol:60 % water and 60 minutes of ultrasound assisted extraction (UAE) without heating. For the reaction conditions, 70 °C for 10 minutes heating is recommended, and UV/Vis reading from 460 to 680 nm. Using the optimized methodology, total saponin contents ranged from 28.43 to 53.09 mg g-1 in the four yerba mate clones. The significant difference in saponin contents between clones indicate great genetic diversity and potential for clones' selection and extraction of these compounds from yerba mate leaves.

Tomada de decisão compartilhada enquanto estratégia para vulnerabilidade em saúde / Shared decision making as a strategy for vulnerability in health / La toma de decisiones compartida como estrategia para la vulnerabilidad sanitaria

Resumo A premissa de que todo ser humano é vulnerável por natureza advém da noção de vulnerabilidade enquanto suscetibilidade ao dano, assim como da inter-relação e interdependência intrínseca do ser humano com seu contexto socioambiental, cabendo à sociedade estabelecer instituições capazes de promover tanto a proteção quanto a autonomia das pessoas, em equidade de condições. Para além do dever profissional de informar benefícios e malefícios das intervenções possíveis, incluindo as consequências de negar qualquer intervenção, o cuidado centrado no paciente integra uma abordagem colaborativa que considera fundamental a tomada de decisão compartilhada. A partir de uma revisão teórica, neste artigo analisa-se o conceito de vulnerabilidade e sua relação com o respeito e a promoção dos direitos humanos dos pacientes, propondo e justificando a tomada de decisão compartilhada no que se refere a uma boa estratégia de mitigação de vulnerabilidades acrescidas.

Abstract The premise that every human being is vulnerable by nature stems from the notion of vulnerability as susceptibility to harm, as well as the interrelations and intrinsic interdependence of human beings with their socio-environmental context. It is up to society to establish institutions capable of promoting both the protection and autonomy, under equal conditions. Besides the professional duty to inform patients of the benefits and harms from possible interventions, including the consequences of denying any intervention, patient-centered care integrates a collaborative approach that considers shared decision-making essential. This theoretical review analyzes the concept of vulnerability and its relations with respect for and promotion of patient rights, proposing and justifying shared decision-making as a good strategy for mitigating increased vulnerabilities.

Resumen La premisa de que todo ser humano es vulnerable por naturaleza parte de la noción de vulnerabilidad como susceptibilidad al daño, así como de la interrelación e interdependencia intrínseca del ser humano con su contexto socioambiental, y a la sociedad le corresponde establecer instituciones capaces de promover tanto la protección como la autonomía de las personas en igualdad de condiciones. Además del deber profesional de informar de los beneficios y perjuicios de las posibles intervenciones, incluyendo las consecuencias de negar cualquier intervención, la atención centrada en el paciente integra un enfoque colaborativo que considera fundamental la toma de decisiones compartida. A partir de una revisión teórica, este artículo analiza el concepto de vulnerabilidad y su relación con el respeto y la promoción de los derechos humanos de los pacientes, proponiendo y justificando la toma de decisiones compartida como una buena estrategia para mitigar el aumento de las vulnerabilidades.

A importância do programa saúde na escola (pse) para a formação do médico humanizado / The importance of the health at school programme (pse) for the training of humanised physicians / La importancia del programa de salud escolar (pse) para la formación de médicos centrados en humanización

Introdução: O desenvolvimento de ações assistenciais e promocionais a saúde, podem atuar como estratégia para superar atividades meramente curativas e individuais. Nesse ínterim, tem-se o Programa Saúde na Escola que age na prevenção, promoção e atenção à saúde e, a exemplo o de promoção da Cultura da Paz, desenvolve uma formação humanizada aos estudantes, por meio da articulação entre a educação e a saúde. Objetivo: Relatar a experiência vivenciada de acadêmicos de Medicina através do Programa de Saúde na Escola e a relação na formação humanizada do médico. Material e Método: Trata-se de um estudo descritivo, tipo relato de experiência, que teve a participação de acadêmicos de Medicina e contou com a realização de uma ação a fim de propagar a Cultura da Paz em uma escola infantil. Resultados: Através da ação realizada, os acadêmicos aprenderam sobre saúde pública, política nacional de humanização e cumpriram com um dos itens preconizados pelo Programa Saúde na Escola, que é promover saúde por meio de ações sociais, além de permitir uma reflexão a respeito da vivência diante da futura profissão. Conclusão: Experiências como essa, contribuem de forma significativa e valorosa para a formação médica, tornando a Medicina mais humanizada.(AU)

Introduction: The development of assistance and health promotion actions can act as a strategy to overcome merely curative and individual activities. The School Health Program acts to prevent, promote, and deliver health care in the same way the peace culture promotes, developing training humanized-centered medical students through the articulation between education and health. Objective: To report the lived experience of medical students through the School Health Program and the relationship in the humanized training of physicians. Material and Method: This is a descriptive study, experience report type, which had medical students' participation and action to propagate the peace culture in a kindergarten. Results: Through the action taken, the students learned about public health, national humanization policy and complied with one of the items recommended by the School Health Program, which is to promote health through social actions, in addition to allowing a reflection on the experience before of the future profession. Conclusion: Experiences like this contribute significantly and value to medical education, making medicine more humanized.(AU)

Introducción: El desarrollo de acciones asistenciales y de promoción de la salud puede actuar como una estrategia para superar las actividades meramente curativas e individuales. El Programa de Salud Escolar actúa para prevenir, promover y brindar atención en salud de la misma manera que promueve la cultura de paz, desarrollando la formación de estudiantes de Medicina con enfoque humanizado a través de la articulación entre educación y salud. Objetivo: Informar la experiencia vivida por los estudiantes de medicina a través del PSE y la relación en la formación humanizada de los médicos. Material y Método: Se trata de un estudio descriptivo, tipo relato de experiencia, que contó con la participación y acción de estudiantes de Medicina para difundir la cultura de paz en un jardín de infancia. Resultados: A través de la acción realizada, los estudiantes aprendieron sobre salud pública, política nacional de humanización y cumplieron con uno de los ítems recomendados por el PSE, que es promover la salud a través de acciones sociales, además de permitir una reflexión sobre la experiencia de cara a la futura profesión. Conclusión: Experiencias como esta aportan de manera significativa y valiosa a la educación médica, humanizando la Medicina.(AU)

Projeto aplicativo e a humanização no SUS: a experiência de acadêmicos de medicina / Application project and humanization at SUS: the experience of undergraduate medical students / Proyecto de aplicación y proceso de humanización de sistema único de salud (SUS): la experiencia de los estudiantes de medicina de pregrado

Introdução: Problemas de comunicação entre usuários e profissionais das unidades de saúde evidenciam comprometimento no atendimento de qualidade à população. Nesse sentido, acadêmicos de medicina, do interior paulista, aplicaram um Projeto Aplicativo, que consiste num método de intervenção na realidade, buscando aprimorar essa relação e vínculo entre usuários do sistema de saúde e profissionais da unidade de saúde. Objetivo: Avaliar a efetividade de uma capacitação feita por estudantes de medicina, por meio do Projeto Aplicativo, associado aos Procedimentos Operacionais Padrões (POPs), em uma Unidade Básica de Saúde da família (UBSF), visando melhorar o atendimento e a escuta qualificada no ambiente das unidades e promover saúde de forma mais humanizada. Método: Pela disciplina "Programa de Integração Comunitária", em uma Unidade Básica de Saúde da Família, estudantes de medicina aplicaram uma atividade prática intitulada "dinâmica do barco", a partir da explicação dos POPs administrativos, viabilizando formular o Projeto Aplicativo. A dinâmica buscou demonstrar a importância da escuta qualificada para um bom trabalho em equipe entre os funcionários da unidade, a partir de procedimentos de padronização dos atendimentos...(AU)

Introduction: Communication problems between users and professionals of health units show commitment to quality care to the population. In this sense, medical academics from the interior of São Paulo State applied an Application Project, which consists of a method of intervention in reality, seeking to improve this relationship and bond between health system users and health unit professionals. Objective: To evaluate the effectiveness of a training done by medical students, through the Application Project, associated with Standard Operating Procedures (Pops), in a Basic Family Health Unit (UBSF), aiming to improve the service and qualified listening in the environment of the units and promote health in a more humanized way. Method: By the discipline "Community Integration Program", in a Basic Family Health Unit, medical students applied a practical activity entitled "boat dynamics", from the explanation of the administrative Pops, making it possible to formulate the Application Project. The dynamic sought to demonstrate the importance of qualified listening for good teamwork among employees of the unit, from procedures of standardization of administrative care that the management of the unit would already have to apply in UBSF, to facilitate user scheduling and queries, known as Pops. Result: There was a greater understanding and consequent social responsibility of the employees and workers of UBSF regarding the importance of welcoming and qualified listening offered to the users of the unit, by the dynamics and the application of Pops in an interactive way among them. Conclusion: The employees realized the importance of the bond created between the user and the worker and revealed an empathic way of dealing with the difficulty of understanding the other employee at the time of the dynamics, demonstrating the importance of the Primary Care Application Project (PC). Thus, it is inferred that the Application Project is an essential training for Health users, because it aims to promote a better means of coexistence in the health unit, based on welcoming and qualified listening, providing responsibility and commitment to health in an equal way between employee and patient of the Unified Health System (SUS).(AU)

Introducción: Los problemas de comunicación entre usuarios y profesionales en las unidades de salud muestran un compromiso con la calidad del servicio que se brinda a la población. En este sentido, estudiantes de medicina del interior paulista desarrollaron un Proyecto de Aplicación, que consiste en un método para realizar una intervención en la vida de esta población buscando mejorar esta relación y el vínculo entre usuarios del sistema de salud y profesionales. Objetivo: Evaluar la...(AU)

Changes in metabolic profiling of sugarcane leaves induced by endophytic diazotrophic bacteria and humic acids.

Plant growth-promoting bacteria (PGPB) and humic acids (HA) have been used as biostimulants in field conditions. The complete genomic and proteomic transcription of Herbaspirillum seropedicae and Gluconacetobacter diazotrophicus is available but interpreting and utilizing this information in the field to increase crop performance is challenging. The identification and characterization of metabolites that are induced by genomic changes may be used to improve plant responses to inoculation. The objective of this study was to describe changes in sugarcane metabolic profile that occur when HA and PGPB are used as biostimulants. Inoculum was applied to soil containing 45-day old sugarcane stalks. One week after inoculation, the methanolic extracts from leaves were obtained and analyzed by gas chromatography coupled to time-of-flight mass spectrometry; a total of 1,880 compounds were observed and 280 were identified in all samples. The application of HA significantly decreased the concentration of 15 metabolites, which generally included amino acids. HA increased the levels of 40 compounds, and these included metabolites linked to the stress response (shikimic, caffeic, hydroxycinnamic acids, putrescine, behenic acid, quinoline xylulose, galactose, lactose proline, oxyproline and valeric acid) and cellular growth (adenine and adenosine derivatives, ribose, ribonic acid and citric acid). Similarly, PGPB enhanced the level of metabolites identified in HA-treated soils; e.g., 48 metabolites were elevated and included amino acids, nucleic acids, organic acids, and lipids. Co-inoculation (HA+PGPB) boosted the level of 110 metabolites with respect to non-inoculated controls; these included amino acids, lipids and nitrogenous compounds. Changes in the metabolic profile induced by HA+PGPB influenced both glucose and pentose pathways and resulted in the accumulation of heptuloses and riboses, which are substrates in the nucleoside biosynthesis and shikimic acid pathways. The mevalonate pathway was also activated, thus increasing phytosterol synthesis. The improvement in cellular metabolism observed with PGPB+HA was compatible with high levels of vitamins. Glucuronate and amino sugars were stimulated in addition to the products and intermediary compounds of tricarboxylic acid metabolism. Lipids and amino acids were the main compounds induced by co-inoculation in addition to antioxidants, stress-related metabolites, and compounds involved in cellular redox. The primary compounds observed in each treatment were identified, and the effect of co-inoculation (HA+PGPB) on metabolite levels was discussed.

Prevalence and severity of molar incisor hypomineralization in students of Belém, Brazil

To measure the prevalence of Molar Incisor Hypomineralization (MIH), its severity and association with dental caries among public school children from Belém/PA, Brazil.Material and Methods:This is a cross-sectional study conducted with children enrolled in three public schools of Belém, which were selected by simple random sampling. MIH diagnosis was carried out according tocriteria of the European Academy of Pediatric Dentistry.Results:Among the 260 students that met the inclusion criteria, 56.92% were male and 43.07% female. The average age was 10.22 years. Of these, 8.84% (n = 23) had MIH, but there was no statistically significant difference in this prevalence between sexes (p = 0.6244). The most affected teeth were the upper first permanent molars, followed by lower first permanent molars and upper permanent central incisors. About 43.48% of students had at least one tooth with severe defect in enamel and 30.43% of students with MIH presented dental caries in the affected teeth. Conclusion:Severe MIH was not the most prevalent among schoolchildren, but the relationship with dental caries found demonstrates the importance of knowledge about diagnosis and treatment of enamel defects, which should be part of promotion and prevention actions in oral health due to its epidemiological impact in the demographic change of dental caries...

Molecular characteristics of humic acids isolated from vermicomposts and their relationship to bioactivity.

Vermitechnology is an effective composting method, which transforms biomass into nutrient-rich organic fertilizer. Mature vermicompost is a renewable organic product containing humic substances with high biological activity. The aim of this study was to assess the chemical characteristics and the bioactivity of humic acids isolated from different vermicomposts produced with either cattle manure, sugar cane bagasse, sunflower cake from seed oil extraction, or filter cake from a sugar cane factory. More than 200 different molecules were found, and it was possible to identify chemical markers on humic acids according to the nature of the organic source. The large hydrophobic character of humic extracts and the preservation of altered lignin derivatives confer to humic acids the ability to induce lateral root emergence in maize seedlings. Humic acid-like substances extracted from plant biomass residues represent an additional valuable product of vermicomposting that can be used as a plant growth promoter.

Avaliação in vitro da atividade de fosfolipase e proteinase de cepas de candida albicans isolada da cavidade bucal de pacientes diabéticos / In vitro evaluation of phospholipase and proteinase of candida albicans isolated from oral cavity of diabetic patients

Leveduras do gênero Candida são comuns na cavidade bucal e podem causar candidose na presença de fatores predisponentes, especialmente em paciente diabético, o qual é caracterizado por um aumento anormal da glicose no sangue. A manifestação da doença está relacionada a este conjunto de fatores locais, tais como a presença de próteses dentárias, pH salivar, fluxo salivar e tabaco. A redução da saliva é um dos principais fatores de risco para o aparecimento de infecção e o controle glicêmico inadequado causado por diabetes, em associação com todos estes fatores, pode aumentar a incidência de infecções. Os objetivos deste estudo foram: 1) isolar e identificar cepas de Candida albicans da mucosa bucal de pacientes diabéticos 2) avaliar os fatores de virulência: proteinase e fosfolipase. Amostras microbiológicas foram coletadas a partir de locais da mucosa bucal e semeadas em CHROMagar para posterior identificação de C. albicans por PCR. Foram realizados testes da atividade de proteinase e fosfolipase para todos os isolados de C. albicans. Neste estudo, 22 isolados foram identificados como C. albicans. Em relação às atividades de proteinases, todas as cepas de C. albicans foram capazes de produzir proteinase, enquanto que para fosfolipase, apenas 4,5% dos isolados não produziram esta exoenzima. Portanto, C. albicans presente na cavidade bucal de pacientes diabéticos tem potencial patogênico e pode participar de processos infecciosos e inflamatórios, causando lesões e invadindo os tecidos orais.

Candida yeasts are common in the oral cavity and can cause candidosis in the presence of predisposing factors, especially diabetes, which is characterized by an abnormal increasing in blood glucose concentration. The manifestation of the disease is related to a set of local factors such as the presence of dental prostheses, salivary pH, salivary flow and tobacco. The reduction in saliva is a major risk factor for the onset of infection and poor glycemic control caused by diabetes in association with all these factors further increases the incidence of candidosis. The objectives of this study were: 1) to isolate and identify Candida albicans strains from oral mucosa sites of diabetic patients 2) to evaluate the virulence factors: proteinase and phospholipase. Thus, microbial samples were collected from oral mucosa sites and seeded in CHROMagar for subsequent identification of C. albicans by PCR. For the phenotypic tests, all strains of C. albicans were evaluated for their proteinase and phospholipase productions. In this study, 22 isolates were identified as C. albicans. In regard to the proteinase activities, all strains of C. albicans were able to produce proteinase, while only 4.5% from those isolates were not able to produce phospholipase activity. In conclusion, C. albicans present in the oral cavity of diabetic patients is potentially pathogenic and can participate in infectious and inflammatory processes, causing injury and invading oral tissues.

Changes in labile phosphorus forms during maturation of vermicompost enriched with phosphorus-solubilizing and diazotrophic bacteria.

The aim of this study was to assess the effect of N(2)-fixing and P-solubilizing bacteria during maturation of vermicompost on phosphorus availability. A bacterial suspension containing Burkholderia silvatlantica, Burkholderia spp. and Herbaspirillum seropedicae was applied at the initial stage of vermicomposting. At the end of the incubation time (120days), the nitrogen content had increased by18% compared to uninoculated vermicompost. Water-soluble P was 106% higher in inoculated vermicompost while resin-extractable P increased during the initial vermicomposting stage and was 21% higher at 60days, but was the same in inoculated and uninoculated mature compost. The activity of acid phosphatase was 43% higher in inoculated than uninoculated vermicompost. These data suggest that the introduction of the mixed culture had beneficial effects on vermicompost maturation.

Bioactivity of chemically transformed humic matter from vermicompost on plant root growth.

Chemical reactions (hydrolysis, oxidation, reduction, methylation, alkyl compounds detachment) were applied to modify the structure of humic substances (HS) isolated from vermicompost. Structural and conformational changes of these humic derivatives were assessed by elemental analyses, size exclusion chromatography (HPSEC), solid-state nuclear magnetic resonance ((13)C CPMAS-NMR), and diffusion ordered spectroscopy (DOSY-NMR), whereas their bioactivity was evaluated by changes in root architecture and proton pump activation of tomato and maize. All humic derivatives exhibited a large bioactivity compared to original HS, both KMnO(4)-oxidized and methylated materials being the most effective. Whereas no general relationship was found between bioactivity and humic molecular sizes, the hydrophobicity index was significantly related with proton pump stimulation. It is suggested that the hydrophobic domain can preserve bioactive molecules such as auxins in the humic matter. In contact with root-exuded organic acids the hydrophobic weak forces could be disrupted, releasing bioactive compounds from humic aggregates. These findings were further supported by the fact that HS and all derivatives used in this study activated the auxin synthetic reporter DR5::GUS.