The importance of the stomal therapy nurse for the care of children with intestinal stoma: the maternal perspective / v22.1492_PTA importância do enfermeiro estomaterapeuta para o cuidado com a criança com estomia intestinal: óptica materna / La importancia del enfermero estomaterapeuta en el cuidado del niño con ostomía intestinal: perspectiva materna

Objetivo: Analizar, desde la perspectiva de las madres, la importancia de las orientaciones brindadas por el enfermero estomaterapeuta para el cuidado de niños con ostomía intestinal. Método: Estudio descriptivo-exploratorio, cualitativo. Datos recolectados a través de entrevistas semiestructuradas, desde junio hasta noviembre de 2019, sometidas al análisis de contenido temático propuesto por Bardin. Resultados: Se entrevistaron nueve madres de niños con ostomía intestinal, quienes resaltaron la importancia de las orientaciones del enfermero estomaterapeuta para contribuir a la seguridad en la realización de cuidados específicos de la ostomía de sus hijos, y el correcto manejo de productos específicos, además de la evolución satisfactoria de las dermatitis peristomales. También hubo satisfacción al recibir información sobre el procedimiento quirúrgico. Conclusión: Las orientaciones recibidas por las madres fueron fundamentales ante la escasez de información sobre la enfermedad y los cuidados específicos de su niño con ostomía, resultando en un sentimiento de gratitud, especialmente en la reorientación por parte del estomaterapeuta de los cuidados necesarios ante las dificultades presentadas. (AU)

Objective: To analyze, from the maternal perspective, the importance of the guidance provided by stomal therapy nurses for the care of children with intestinal stomas. Method: This qualitative, descriptive-exploratory study collected data through semistructured interviews conducted from June to November 2019. The data were subjected to thematic content analysis as suggested by Bardin. Results: Nine mothers of children with stomas were interviewed. They emphasized the importance of guidance from stomal therapy nurses, which contributed to their confidence in performing specific stoma care and using specific products correctly. In addition, an improvement in peristomal dermatitis was noted. Mothers also expressed satisfaction with the information they received about the surgical procedure. Conclusion: The guidance received by the mothers was crucial due to the lack of information about the disease and the specific care required for their child with a stoma. This guidance fostered a sense of gratitude, especially for the redirection provided by the stomal therapy nurse in addressing care difficulties. (AU)

Objetivo:Analisar, por meio da óptica materna, a importância das orientações fornecidas pelo enfermeiro estomaterapeuta para o cuidado de crianças com estomia intestinal. Método:Estudo qualitativo, descritivo-exploratório. Dados produzidos por meio de entrevista semiestruturada, no período de junho a novembro de 2019, submetidos à análise de conteúdo temática proposta por Bardin. Resultados: Foram entrevistadas nove mães de crianças com estomias intestinais, as quais destacaram a importância das orientações do enfermeiro estomaterapeuta, as quais contribuíram para a segurança na execução dos cuidados específicos com a estomia das suas crianças e do manejo correto dos produtos específicos, além da evolução satisfatória das dermatites periestomais. Também se constatou satisfação em receber informações sobre o procedimento cirúrgico. Conclusão: As orientações recebidas pelas mães foram fundamentais diante da escassez de informações sobre a doença e o cuidado específico de sua criança com estomia, fazendo emergir o sentimento de gratidão, principalmente no redirecionamento pelo estomaterapeuta dos cuidados necessários na dificuldade apresentada. (AU)

Primary thromboprophylaxis in cancer outpatients - real-world evidence.

INTRODUCTION: Cancer-associated thrombosis (CAT) is a significant concern among patients with malignant diseases, leading to increased mortality. While current guidelines recommend primary thromboprophylaxis for venous thromboembolism (VTE) in medium-to-high-risk outpatients, this practice remains controversial. A better understanding of primary thromboprophylaxis is crucial, yet there is a lack of Real-World Evidence (RWE) in Portugal. AIMS: This RWE study aimed to elucidate primary thromboprophylaxis practices among cancer outpatients in Portugal. METHODS: A five-year observational multicentric study in eight Portuguese health institutions enrolled 124 adult cancer outpatients under primary thromboprophylaxis for VTE. The endpoints were CAT, bleeding, cancer progression and death. RESULTS: High thrombotic risk tumours were prevalent, with 57% (71) of the patients presenting with pancreatic and gastric cancers. Regarding primary thromboprophylaxis, 55% (68) received Low-Molecular-Weight Heparin (LMWH). VTE was presented in 11% (14) of the patients and major bleeding in 2% (2). Vascular compression, elevated D-dimer and previous VTE were significantly associated with VTE occurrence under primary thromboprophylaxis. The Onkotev model was shown to be the best risk assessment model (RAM) in this population (p = 0.007). CAT patients exhibited a lower progression-free survival than non-CAT patients (p = 0.021), while thrombosis did not influence overall survival (p = 0.542). CONCLUSION: Primary thromboprophylaxis in medium-to-high-risk cancer outpatients is a safe and effective practice in real-world settings. This study is the first Portuguese RWE on primary thromboprophylaxis, highlighting evidence for improving prophylactic strategies in this population.

Red seaweed biorefinery: The influence of sequential extractions on the functional properties of extracted agars and porphyrans.

Red seaweeds are exploited for their hydrocolloids, but other fractions are usually overlooked. In a novel approach, this study aimed to evaluate cold-water (CWE), ethanolic (EE), and alkaline (SE) extractions, alone and in sequence, to simultaneously: i) decrease the hydrocolloid extraction waste (valorizing bioactive side-streams and/or increasing extraction yield); and ii) increase the hydrocolloids' texturizing properties. It is the first time these extractions' synergetic and/or antagonistic effects will be accessed. For Porphyra dioica, a combination of CWE and EE was optimal: a positive influence on the melting temperature (increasing 5 °C to 74 °C) and sulphate content (a 3-fold reduction to 5 %) was observed, compared to a direct porphyran extraction. The same was observed for Gracilaria vermiculophyla, recovering two additional bioactive fractions without impacting the hydrocolloid's extraction (agar with 220 g/cm2 gelling strength and 14 % yield was obtained). The sequential use of CWE, EE, and SE was the most beneficial in Gelidium corneum processing: it enhanced agar's texturizing capacity (reaching 1150 g/cm2, a 1.5-fold increase when compared to a direct extraction), without affecting its 22 % yield or over 88 % purity. Ultimately, these findings clarified the effects of cascading biorefinery approaches from red seaweeds and their pertinence.

Thrombosis and cachexia in cancer: Two partners in crime?

Among cancer patients, thrombosis and cachexia are major causes of morbidity and mortality. Although the two may occur together, little is known about their possible relationship. Thus, a literature review was conducted by screening the databases PubMed, Scopus, SciELO, Medline and Web of Science. To summarize, cancer-associated thrombosis (CAT) and cancer-associated cachexia (CAC) seem to share several patient-, tumour- and treatment-related risk factors. Inflammation alongside metabolic and endocrine derangement is the potential missing link between CAT, CAC and cancer. Many key players, including specific pro-inflammatory cytokines, immune cells and hormones, appear to be implicated in both thrombosis and cachexia, representing attractive predictive markers and potential therapeutic targets. Altogether, the current evidence suggests a link between CAT and CAC, however, epidemiological studies are required to explore this potential relationship. Given the high incidence and negative impact of both diseases, further studies are needed for the better management of cancer patients.

Características sociodemográficas, laborais, de saúde relacionadas a pacientes submetidos à telenfermagem em estomaterapia / Sociodemographic, employment and health characteristics related to patients submitted to telemonitoring in a stomatherapy clinic / Características sociodemográficas, laborales y de salud relacionadas con los pacientes sometidos a teleenfermería en una clínica de estomaterapia

Objetivo: identificar as características sociodemográficas, laborais de saúde de pessoas submetidas à telenfermagem em uma clínica de estomaterapia. Método: pesquisa quantitativa, descritiva, transversal e de caráter documental, realizada em uma instituição pública de saúde no município do Rio de Janeiro. Resultados: usuários com idade entre 50 e 60 anos (34,79%); pardos (61,96%); homens (55,44%); moradores do município do Rio de Janeiro (69,56%); trabalham sob regime celetista (32,39%); se ausentaram do trabalho ao menos uma vez nos últimos 12 meses (40,85%); não trabalham à noite (81,63%); 18,37% possuem trabalho noturno, 55,85% não descansam ou dormem, e justificam o não descanso noturno pelas altas demandas laborais. Possuem doença crônica (79,75%); são hipertensos (60,31%); não apresentam doença como consequência do trabalho (53,96%). Conclusão: evidenciou-se a necessidade de um maior aprofundamento de práticas de atenção à saúde considerando o impacto das características individuais no processo saúde doença

Objective: to identify the sociodemographic and occupational health characteristics of people undergoing telenursing in a stomatherapy clinic. Method: quantitative, descriptive, cross-sectional and documentary research, carried out in a public health institution in the city of Rio de Janeiro. Results: users aged between 50 and 60 years (34.79%); browns (61.96%); men (55.44%); residents of the city of Rio de Janeiro (69.56%); work under a CLT regime (32.39%); were absent from work at least once in the last 12 months (40.85%); do not work at night (81.63%); 18.37% work at night, 55.85% do not rest or sleep, and they justify the lack of night rest due to the high work demands. They have a chronic disease (79.75%); are hypertensive (60.31%); do not have disease as a result of work (53.96%). Conclusion: the need for a deeper understanding of health care practices was evidenced, considering the impact of individual characteristics on the health-disease process

Objetivo: identificar las características sociodemográficas y de salud ocupacional de personas en teleenfermería en una clínica de estomaterapia. Método: investigación cuantitativa, descriptiva, transversal y documental, realizada en una institución de salud pública de la ciudad de Río de Janeiro. Resultados: usuarios con edad entre 50 y 60 años (34,79%); marrones (61,96%); hombres (55,44%); residentes de la ciudad de Río de Janeiro (69,56%); trabajar en régimen CLT (32,39%); se ausentó del trabajo al menos una vez en los últimos 12 meses (40,85%); no trabaja de noche (81,63%); El 18,37% trabaja de noche, el 55,85% no descansa ni duerme, y justifican la falta de descanso nocturno por las altas exigencias laborales. Tienen una enfermedad crónica (79,75%); son hipertensos (60,31%); no tienen enfermedad como consecuencia del trabajo (53,96%). Conclusión: se evidenció la necesidad de una mayor profundidad de las prácticas de atención a la salud, considerando el impacto de las características individuales en el proceso salud-enfermedad

Colon microbiota modulation by dairy-derived diet: new strategy for prevention and treatment of colorectal cancer.

An unbalanced diet is one of the well-known risk factors for the development of colorectal cancer (CRC). This type of cancer is currently the main cause of cancer-related deaths worldwide, urging the need for new and more effective preventive and therapeutic approaches. It is already known that CRC patients have alterations in the microbial community and metabolism. In this regard, a concept that has been recently attracting the attention of the scientific community is the development of functional food or nutraceuticals, as a new and more effective strategy to overcome CRC patient-associated dysbiosis. Particularly, dairy product enriched diets are the major dairy source of dietary calcium, vitamin D and folate intake, which are well-known to have a protective effect against CRC development. In addition, these products are rich in both pre- and probiotics, constituting a double strategy to modulate both the intestinal microbiota composition and the production of microbial metabolites. Short-chain fatty acids (SCFA), namely, acetate, butyrate, and propionate, are major contributors to colonic homeostasis since they regulate several biological and metabolic processes. In this review, we performed a state of art study concerning the use of dietary patterns, specifically the dairy-derived diet, in the modulation of the human microbiota and their potential use as pre-, pro- or synbiotics for the development of new preventive and therapeutic strategies for CRC.

Ruthenium(II)-Cyclopentadienyl-Derived Complexes as New Emerging Anti-Colorectal Cancer Drugs.

Colorectal cancer (CRC) is one of the most common malignancies and one of the leading causes of cancer-related death worldwide, urging the need for new and more efficient therapeutic approaches. Ruthenium complexes have emerged as attractive alternatives to traditional platinum-based compounds in the treatment of CRC. This work aims to evaluate anti-CRC properties, as well as to identify the mechanisms of action of ruthenium complexes with the general formula [Ru(η5-C5H4R)(PPh3)(4,4'-R'-2,2'-bipyridine)][CF3SO3], where R = CH3, CHO or CH2OH and R' = H, CH3, CH2OH, or dibiotin ester. The complexes (Ru 1-7) displayed high bioactivity, as shown by low IC50 concentrations against CRC cells, namely, RKO and SW480. Four of the most promising ruthenium complexes (Ru 2, 5-7) were phenotypically characterized and were shown to inhibit cell viability by decreasing cell proliferation, inducing cell cycle arrest, and increasing apoptosis. These findings were in accordance with the inhibition of MEK/ERK and PI3K/AKT signaling pathways. Ruthenium complexes also led to a decrease in cellular clonogenic ability and cell migration, which was associated with the disruption of F-actin cytoskeleton integrity. Here, we demonstrated that ruthenium complexes, especially Ru7, have a high anticancer effect against CRC cells and are promising drugs to be used as a new therapeutical strategy for CRC treatment.

In Vitro Modulation of Gut Microbiota and Metabolism by Cooked Cowpea and Black Bean.

Legumes are a rich source of a wide range of compounds that may represent an important tool to overcome gut dysbiosis. In this work, the prebiotic potential of two cooked legumes (cowpea and black bean) was investigated in comparison with potato:beef mixture, as substrates in batch faecal culture fermentation. Prior to the fermentation, all the samples were in vitro digested, passing through three phases, namely mouth, gastric and small intestine simulation, and then in vitro fermented for 6, 24 and 48 h. The shift of pH, production of gas and short-chain fatty acids (SCFAs) and changes in gut microbiota were evaluated along the fermentation time. The pH decreased significantly over time in all media with fermentable sources when compared with the negative control. Gas production was higher in the media containing fermentable source than in the negative control and decreased with fermentation time. The concentration of SCFAs increased over time and it was significantly higher for both legumes than in inulin (positive control) and potato:beef meal. Acetate was the major SCFAs produced during fermentation, particularly in media containing legumes. Both legumes presented a strong prebiotic effect on gut microbiota, showing a significant increase in Bifidobacterium and Lactobacillus. These results suggest that consumption of cooked cowpea and black bean, used alone or as an ingredient of novel functional foods, may contribute to improving intestinal health and therefore human health promotion.

The effects of whole green tea infusion on mouse urinary bladder chemical carcinogenesis.

OBJECTIVE(S): Green tea (GT) is one of the most popular beverages worldwide whose beneficial effects on health have been demonstrated. Recent studies suggest that GT may contribute to reduction of cancer risk and progression. The aim of this study was to evaluate the effects of whole GT on urinary bladder chemical carcinogenesis in male and female ICR mice. MATERIALS AND METHODS: The GT characterization was performed using spectrophotometric methods. Urinary bladder lesions were induced using N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) by gavage during 10 weeks and whole GT (0.5%) was provided ad libitum during 20 weeks. RESULTS: Animals from groups BBN+GT and BBN only developed preneoplastic lesions. CONCLUSION: We did not observe any effects by GT infusion administration on urinary bladder cancer development.

A liver schwannoma observed in a female Sprague-Dawley rat treated with MNU.

BACKGROUND: Schwannoma is a tumor of the nervous system composed by Schwann cells. It can occur naturally in several tissues of the body in both humans and animals. Diaphragmatic hernia can be congenital or acquired and is defined as a protrusion of abdominal viscera into the thoracic cavity. MATERIALS AND METHODS: The animal was a female rat from an experiment of mammary tumor chemically induced. It was injected with N-methyl-N-nitrosourea (MNU) and died spontaneously at 22 weeks of age. RESULTS: The animal had a diaphragmatic hernia and a hemorrhagic and multicystic mass in the liver herniated lobule. Microscopically the liver displayed a well circumscribed mass that was a tumor with hemorrhagic areas, necrosis and Antoni A and Antoni B patterns. It also displayed occasional positivity to vimentin and diffuse positivity to S-100 and NSE. CONCLUSION: The tumor was a schwannoma with the origin in the Glisson's capsule.

Estimation of rat mammary tumor volume using caliper and ultrasonography measurements.

Mammary tumors similar to those observed in women can be induced in rats by intraperitoneal administration of N-methyl-N-nitrosourea. Determining tumor volume is a useful and quantitative way to monitor tumor progression. In this study, the authors measured dimensions of rat mammary tumors using a caliper and using real-time compound B-mode ultrasonography. They then used different formulas to calculate tumor volume from these tumor measurements and compared the calculated tumor volumes with the real tumor volume to identify the formulas that gave the most accurate volume calculations. They found that caliper and ultrasonography measurements were significantly correlated but that tumor volumes calculated using different formulas varied substantially. Mammary tumors seemed to take on an oblate spheroid geometry. The most accurate volume calculations were obtained using the formula V = (W(2) × L)/2 for caliper measurements and the formula V = (4/3) × π × (L/2) × (L/2) × (D/2) for ultrasonography measurements, where V is tumor volume, W is tumor width, L is tumor length and D is tumor depth.

The effects of repeated oral gavage on the health of male CD-1 mice.

Oral gavage is a widely used method for administering substances to animals in pharmacological and toxicological studies. The authors evaluated whether oral gavage causes behavioral indicators of stress, increased mortality rate, alterations in food and water consumption and body weight or histological lesions in CD-1 mice. Gavage was carried out once per d for 5 d per week over 6 consecutive weeks. The mortality rate of mice in this study was 15%. Mice subjected to gavage did not undergo changes in food or water consumption during the study, and their mean body weights and relative organ weights were similar to those of mice in the control group. Serum cortisol levels at the time of euthanasia in mice in both groups were within the normal range. Histopathology showed acute esophagitis and pleurisy, indicative of perforation of the esophagus, in the two mice that died but no abnormalities in the other mice. The results suggest that animal stress and mortality related to oral gavage can be minimized when the procedure is carried out by an experienced technician.

Determination of antioxidant capacity using the biological system bacteriophage P22/bacterium Salmonella typhimurium.

Bacteriophage/bacterium systems have been employed in the past in assays for virucidal activity. A novel application of one such system is proposed here for the in vivo determination of antioxidant capacity. It was shown that an antioxidant such as gallic acid can effectively protect against oxidative damage brought about by H2O2-but only within a narrow range of concentrations (i.e., from 250 to 500 mg L-1); ascorbic acid, on the other hand, did not exhibit any protective effect against H2O2. Finally, neither ascorbic nor gallic acid demonstrated a virucidal effect. The P22/Salmonella typhimurium model system thus proved to be useful in the assessment of antioxidant capacity in vivo, at least using those two alternative model antioxidants.