Influence of spontaneous and inoculated fermentation of açai on simulated digestion, antioxidant capacity and cytotoxic activity.

This work describes the kinetic study of different types (spontaneous, lactic and alcoholic) of açai fermentation in terms of total phenolics and total anthocyanins, as well as antioxidant capacity, before and after simulated digestion (SD). Cytotoxicity (A549, HCT8 and IMR90 cells) and formation of reactive oxygen species (A549 cells) were also evaluated. The results revealed that spontaneous fermentation (SF) for 24 h, followed by SD, generated a product with greater bioaccessibility of phenolics (52.68%) and cyanidin-3-glucoside (27.01%) than unfermented açai. Likewise, lactic fermentation (LF) for 72 h improved the bioavailability of phenolics (64.49%) and cyanidin-3-rutinoside (20.00%). On the other hand, alcoholic fermentation (AF) decreased the bioaccessibility of phenolic compounds and anthocyanins after SD. The SF 24 h (10.16 ± 1.25 µmol Trolox /g) and LF 72 h (15.90 ± 0.51 µmol Trolox /g) significantly increased the antioxidant capacity after SD, when compared to unfermented açai (SF 0 h, 4.00 ± 0.09 µmol Trolox /g; LF 0 h, 10.57 ± 0.91 µmol Trolox /g). It was concluded that the samples did not show cytotoxicity in the cell lines tested and, in addition, AF 24 h showed antioxidant and antimutagenic effects in vitro, reducing about 40% of chromosomal aberrations. The results obtained provide important information that can be used to produce foods with greater bioaccessibility of bioactive compounds.

The impact of early-life exposure to three agrochemicals on survival, behavior, and gut microbiota of stingless bees (Partamona helleri).

Over the last few decades, agrochemicals have been partially associated with a global reduction in bees' population. Toxicological assessment is therefore crucial for understanding the overall agrochemical risks to stingless bees. Therefore, the lethal and sublethal effects of agrochemicals commonly used in crops (copper sulfate, glyphosate, and spinosad) on the behavior and gut microbiota of the stingless bee, Partamona helleri, were assessed using chronic exposure during the larval stage. When used at the field-recommended rates, both copper sulfate (200 µg of active ingredient/bee; a.i µg bee-1) and spinosad (8.16 a.i µg bee-1) caused a decrease in bee survival, while glyphosate (148 a.i µg bee-1) did not show any significant effects. No significant adverse effects on bee development were observed in any treatment with CuSO4 or glyphosate, but spinosad (0.08 or 0.03 a.i µg bee -1) increased the number of deformed bees and reduced their body mass. Agrochemicals changed the behavior of bees and composition of the gut microbiota of adult bees, and metals such as copper accumulated in the bees' bodies. The response of bees to agrochemicals depends on the class or dose of the ingested compound. In vitro rearing of stingless bees' larvae is a useful tool to elucidate the sublethal effects of agrochemicals.

Effect of capacitive radiofrequency on the dermis of the abdominal region.

The purpose of this study is to evaluate the effects of radiofrequency (RF) on sagging skin. This is a case series study with five volunteers who received a single application of capacitive RF (BTL-6000 TR-Therapy Pro®) in the right infraumbilical abdominal region, with epidermal temperature above 40°C, for 10 min (2 min per applicator area), and the skin of the contralateral region was used as control. After 30 days, on average, the skin of the abdominal region was collected for histological analysis and stained with hematoxylin and eosin, Picro-sirus, and Verhoff. The percentage of collagen and elastic fibers found was marked by the Image J®. The statistical analysis was performed in the SPSS program (version 20), with a significance level of 95%. This was registered with the ethics and research comitee of UFTM n 3.461.688 on Jul 12, 2019 and clinical trial registration n. NCT04182542, retrospectively registered. Morphometric analysis demonstrated a remodeling of collagen and elastic fibers on the side treated with RF; however, the morphometry for collagen showed no significant difference, with an average percentage of 60.94 ± 0.32 for the control side and 61.97 ± 2.80 for the treated with p=0.32. Similarly, elastic fibers also showed no significant difference between groups, with a mean percentage of 5.67 ± 2.70 for control and 6.21 ± 2.01 for treated with p=0.19. The RF with the parameters used in this study was able to cause morphological changes in collagen and elastic fibers of the abdominal region skin; however, it showed no change in the percentage of these fibers.

A mobile application to guide healthcare professionals in the correct technique for personal protective equipment use during the COVID-19 pandemic

Objectives: The present study aimed to develop an application to guide healthcare professionals on using personal protective equipment (PPE) during the COVID-19 pandemic and prevent and treat skin lesions caused by these devices. Methods: This is a study on technological production. The framework for application development consisted in the following phases: Phase 1-"Design: identification of application development requirements;" Phase 2-"Application prototype development": including an integrative literature review in major databases; Phase 3-"Application construction": elaboration of the decision tree, algorithm, database structuring, and software development; Phase 4-"Transition": application functionality test. Result: Our application Simplifica EPI is an innovative technology; this software is a tool to assist healthcare professionals in using PPE. In addition, it describes how to prevent and care for skin lesions caused by PPE. Simplifica EPI has 25 screens and 32 images. It will be available on the Google Play Store after its registration with the Brazilian National Institute of Industrial Property. Conclusions: After an integrative literature review, the application Simplifica EPI was developed as an innovative technology with great potential for use by healthcare professionals. (AU)

Elaboration and validation of flowchart for the prevention and treatment of intestinal peristomal skin complications

Objective: To build and validate a flowchart for the prevention and treatment of intestinal peristomal skin complications. Method: For the construction of the algorithms, a systematic reviewwas carried out in health sciences databases comprising the last 10 years. The evaluation of the algorithms was carried out by 38 nurses. For the validation of the algorithms, theDelphi technique was used. The statistical analysis used was the content validity index and the Cronbach alpha coefficient. The questionnaire was sent by e-mail and in person after approval by the Ethics and Research Committee. Results: In the first evaluation of the algorithms, there was no agreement among the experts. However, after making the corrections suggested by the evaluators, the algorithms were resent, with a 100% consensus among the evaluators. The questions used to validate the algorithms contributed favourably to the internal consistency and content validation of the instrument, since the respective Cronbach alpha was 0.9062 and the global content validity index (g-CVI) was 0.91 in the first validation and 1.0 in the second validation. Conclusion: After an integrative literature review, the flowcharts were built and validated by a professional with experience in the area, showing 100% agreement among the experts in the second evaluation. (AU)

Peristomal dermatitis: treatment with green banana peel (Musa sapientum) powder / Dermatite periestomal: tratamento com pó de casca de banana verde (Musa sapientum)

Objective: To develop green banana peel (Musa sapientum) powder for the treatment of peristomal dermatitis, and to evaluate its effectiveness and healing time. Methods: A clinical, analytical and longitudinal study. In total, 44 volunteers of both genders, aged>18 years, with intestinal ostomy, who presented peristomal dermatitis, participated in the research. The sample was divided into two groups: the study group used a powder containing 10% of green banana peel, and the control group used ostomy powder. The research was approved by the Ethics in Research Committees (Comitês de Ética em Pesquisa, CEP, in Portuguese) under opinion n° 2.381.904. Results: The healing time of the study group was shorter than that of the control group (p=0.022). To analyze the results, we used the two-sample t-test (mean days until healing for both study groups). Conclusion: The powder containing 10% of green banana peel was developed, and effective healing of the peristomal dermatitis was observed. Compared to the ostomy powder, it presented a shorter healing time. (AU)

Objetivo: Desenvolver o pó composto da casca da banana verde (Musa sapientum) para o tratamento de dermatite periestomal, e avaliar a eficácia e o tempo de cicatrização. Métodos: Estudo clínico, analítico e longitudinal. Participaram da pesquisa 44 voluntários, de ambos os gêneros, maiores de 18 anos, com estomias intestinais, e que apresentavam dermatite periestomal. A amostra foi dividida em dois grupos: o grupo de estudo usou umpó que continha 10% de casca de banana verde, e o grupo de controle usou pó para estomia. A pesquisa foi aprovada pelos Comitês de Ética em Pesquisa (CEP), sob o parecer n° 2.381.904. Resultados: O tempo de cicatrização do grupo de estudo foimenor do que o do grupo de controle (p=0.022). Para a análise dos resultados, empregou-se o teste t para duas amostras (média de dias de cicatrização de ambos os grupos). Conclusão: Desenvolveu-se o pó contendo 10% de casca de banana verde, e observouse cicatrização eficaz da dermatite periestomal. Em comparação com o pó para estomia, apresentou tempo menor até a cicatrização. (AU)

Terminalidade da vida: reflexão bioética sobre a formação médica / End of life: bioethical reflection on medical education / Terminalidad de la vida: reflexión bioética sobre la formación médica

Resumo Nesta pesquisa qualitativa, utilizou-se o método do discurso do sujeito coletivo para conhecer os significados, sentimentos e percepções de estudantes de medicina sobre o tema morte e pacientes terminais. Foram entrevistados 60 alunos de uma universidade do Sul de Minas Gerais. Para os significados sobre terminalidade da vida, a ideia central mais frequente foi "fechamento da vida". Quando o tema abordado foi o sentimento a respeito do paciente terminal, emergiram as ideias centrais "insegurança", "impotência", "frustração" e "angústia". Quanto ao preparo para lidar com a morte e o morrer, prevaleceu a ideia "não estou preparado". Já com relação à presença desses temas na formação, surgiram as ideias "abordagem superficial", "deveriam ser abordados com mais frequência" e "não abordados". Conclui-se que a formação médica não trata da inexorabilidade da morte, o que afasta a possibilidade de repensar o cuidado como forma terapêutica.

Abstract This qualitative study used the collective subject discourse method to identify the meanings, feelings and perception of medical students about death and terminally ill patients. In total, 60 students from a medical school in southern Minas Gerais were interviewed. For the meanings about end of life, the most common idea was "closure of life." When the topic addressed was the feeling about terminal patients, the central ideas were "insecurity," "impotence," "frustration" and "anguish." Regarding the preparation to deal with death and dying, "unpreparedness" was the most common. When considering how these themes are approached during training, "superficial approach," "not very frequent" and "not addressed" emerged as ideas. We can thus conclude that the inexorability of death is not part of medical training, removing the possibility of rethinking care as a therapeutic form.

Resumen En esta investigación cualitativa se utilizó el método del discurso del sujeto colectivo para conocer los significados, sentimientos y percepciones de los estudiantes de medicina sobre el tema muerte y pacientes terminales. Se entrevistó a 60 alumnos de una universidad del sur del estado de Minas Gerais, Brasil. En lo que respecta a los significados sobre la terminalidad de la vida, la idea central más frecuente fue "cierre de la vida". Cuando se abordó el sentimiento respecto al paciente terminal, surgieron como ideas centrales: "inseguridad", "impotencia", "frustración" y "angustia". En cuanto a la preparación para enfrentarse a la muerte y al morir, prevaleció la idea "no estoy preparado". A su vez, respecto a la presencia de estos temas durante la formación, surgieron las ideas "enfoque superficial", "deberían abordarse con más frecuencia", y "no abordados". Se concluye que la formación médica no aborda la inexorabilidad de la muerte, lo que aparta la posibilidad de repensar el cuidado como forma terapéutica.

Clinical Management of Nasal Skin Necrosis Caused by Hyaluronic Acid Filler.

ABSTRACT: Nose augmentation with Hyaluronic acid (HA) fillers has been considered the preferred technique for minimally invasive cosmetic procedures. Despite severe complications related to HA injection are rare, none of the existing treatment protocols has been established as standard. The aim of this report is to present an alternative approach to treat nasal skin necrosis related to HA injection. A high dose of hyaluronidase - 6000 IU was applied in the nose, for the purpose of reversing a necrotic process. The present findings suggest that a high dose of hyaluronidase could be a promising approach to treat severe nasal skin necrosis caused by HA filler.

KAP-COVIDGLOBAL: a multinational survey of the levels and determinants of public knowledge, attitudes and practices towards COVID-19.

OBJECTIVE: The adherence to public health recommendations to control COVID-19 spread is influenced by public knowledge, attitudes and practices (KAP). We performed this cross-sectional study to assess the levels and determinants of public KAP towards COVID-19 in a large, multinational sample. DESIGN: Cross-sectional study (survey). SETTING: The questionnaire was distributed to potential respondents via online platforms. PARTICIPANTS: 71 890 individuals from 22 countries. METHODS: We formulated a four-section questionnaire in English, followed by validation and translation into seven languages. The questionnaire was distributed (May to June 2020) and each participant received a score for each KAP section. RESULTS: Overall, the participants had fair knowledge (mean score: 19.24±3.59) and attitudes (3.72±2.31) and good practices (12.12±1.83) regarding COVID-19. About 92% reported moderate to high compliance with national lockdown. However, significant gaps were observed: only 68.2% knew that infected individuals may be asymptomatic; 45.4% believed that antibiotics are an effective treatment; and 55.4% stated that a vaccine has been developed (at the time of data collection). 71.9% believed or were uncertain that COVID-19 is a global conspiracy; 36.8% and 51% were afraid of contacting doctors and Chinese people, respectively. Further, 66.4% reported the pandemic had moderate to high negative effects on their mental health. Female gender, higher education and urban residents had significantly (p≤0.001) higher knowledge and practice scores. Further, we observed significant correlations between all KAP scores. CONCLUSIONS: Although the public have fair/good knowledge and practices regarding COVID-19, significant gaps should be addressed. Future awareness efforts should target less advantaged groups and future studies should develop new strategies to tackle COVID-19 negative mental health effects.

Bioactive Male-Produced Volatiles from Anastrepha obliqua and their Role in Attraction of Conspecific Females.

The study of insect semiochemicals, especially pheromones, is of fundamental importance for the development of strategies for controlling agricultural pests. In this study, volatile compounds involved in the communication between males and females of the fruit fly, Anastrepha obliqua (Diptera: Tephritidae), for mating purposes were characterized to develop attractant formulations for females of this species. Extracts containing volatile compounds released by males of A. obliqua were obtained by the dynamic headspace technique and analyzed by gas chromatography coupled with an electroantennographic detector (GC-EAD) and gas chromatography coupled with mass spectrometry (GC-MS). Twenty-one volatile compounds were identified in the aeration extracts of males. Five of them caused EAD responses from the antennae of females: 1-heptanol, linalool, (Z)-3-nonen-1-ol, (E,Z)-3,6-nonadien-1-ol, and (Z,E)-α-farnesene. Six synthetic mixtures of these compounds, including the five-component blend and all possible four-component blends, were formulated in a biopolymer and used in behavioral bioassays conducted in the laboratory arena with conspecific virgin females. One blend of 1-heptanol, linalool, (Z)-3-nonen-1-ol, and (Z,E)-α-farnesene attracted more females than the collection of volatiles from virgin males used as control. The other mixtures were as attractive to A. obliqua females as the control treatment. This study indicates potential for use of these compounds in monitoring and control strategies for this pest.

Algoritmos para prevenção e tratamento de lesão por fricção / Algoritmos para prevención y tratamiento de lesión por fricción / Algorithms for the prevention and treatment of friction injury

Resumo Objetivo: Elaborar e validar o conteúdo de algoritmos para prevenção e tratamento de lesão por fricção. Métodos: Para a construção dos algoritmos, foi realizada uma revisão integrativa da literatura após busca nas bases de dados: SciELO, LILACS e MEDLINE. A avaliação dos algoritmos foi realizada por 26 juízes, sendo 10 médicos e 16 enfermeiros, utilizando-se a técnica Delphi. Os resultados foram analisados por meio do Índice de Validade de Conteúdo. Resultados: No primeiro ciclo de avaliação, os itens dos algoritmos foram considerados pelos juízes de "inadequados" a "totalmente adequados". Após as correções sugeridas pelos juízes, os algoritmos foram reenviados para o segundo ciclo de avaliação, no qual todos os itens foram julgados "adequados" ou "totalmente adequados", resultando em um Índice de Validade do Conteúdo de 1,0. Conclusão: Os algoritmos desenvolvidos possuem validade de conteúdo e podem auxiliar profissionais de saúde na avaliação, prevenção e tratamento da lesão por fricção.

Resumen Objetivo: Elaborar y validar el contenido de algoritmos para prevención y tratamiento de lesión por fricción. Métodos: Para la construcción de los algoritmos, se realizó una revisión integradora de la literatura luego de una búsqueda en las bases de datos: SciELO, LILACS y MEDLINE. La evaluación de los algoritmos fue realizada por 26 jueces, de los cuales 10 eran médicos y 16 enfermeros, con la utilización del método Delphi. Los resultados fueron analizados mediante el Índice de Validez de Contenido. Resultados: En el primer ciclo de evaluación, los ítems de los algoritmos fueron considerados desde "inadecuados" a "totalmente adecuados" por los jueces. Luego de las correcciones sugeridas por los jueces, se enviaron los algoritmos para el segundo ciclo de evaluación, en el que todos los ítems fueron considerados "adecuados" o "totalmente adecuados", lo que tuvo como resultado un Índice de Validez de Contenido de 1,0. Conclusión: Los algoritmos elaborados tienen validez de contenido y pueden ayudar a profesionales de la salud en la evaluación, prevención y tratamiento de la lesión por fricción.

Abstract Objective: Develop and validate the content of algorithms for the prevention and treatment of friction injury. Methods: For the construction of algorithms, an integrative literature review was conducted after searching SciELO, LILACS and MEDLINE databases. The algorithms were evaluated by 26 raters - 10 physicians and 16 nurses - using the Delphi technique. The results were analyzed by the Content Validity Index (CVI). Results: In the first evaluation cycle, the items of the algorithms were considered "inadequate" to "totally adequate" by the raters. After adjustments suggested by the raters, the algorithms were submitted to a second evaluation cycle, when all items were considered "adequate" or "totally adequate," resulting in a content validity index of 1.0. Conclusion: The algorithms have valid content and can help health professionals in the evaluation, prevention and treatment of friction injuries.

Vacinação no Brasil: reflexão bioética sobre acessibilidade / Vaccination in Brazil: bioethical reflection on accessibility / Vacunación en Brasil: una reflexión bioética sobre la accesibilidad

Resumo As vacinas têm grande influência na saúde pública por sua efetividade e relação custo-benefício favorável. Entretanto, com o surgimento de novos imunizantes indisponíveis na rede pública, torna-se necessário discutir o acesso da sociedade em geral. O objetivo deste trabalho foi identificar o significado da vacinação para profissionais e população, assim como abordar a questão do acesso à imunização fora da rede pública de saúde, enfatizando a vulnerabilidade social. Foram entrevistados médicos e cidadãos leigos, e os dados foram analisados a partir de metodologia qualitativa exploratória e do discurso do sujeito coletivo. O sistema vacinal brasileiro foi entendido pelos entrevistados como bom de maneira geral, sendo as principais críticas voltadas à falta de informações e insumos. Quanto ao acesso, os dados sugerem correlação com fatores econômicos, abrindo espaço para discussões bioéticas sobre a vulnerabilidade social da maior parte da população, que não tem condições de pagar por essas imunizações.

Abstract Vaccines have a strong influence on public health because of their effectiveness and favorable cost-benefit ratio. However, with new vaccines unavailable in the public system, the access by society in general must be discussed. This study aimed to identify the meaning of vaccination for the population and physicians, and address the issue of access to vaccines outside the public health system, emphasizing social vulnerability. Physicians and members of society were interviewed, and the data was analyzed using an exploratory qualitative methodology and the collective subject speech. The Brazilian immunization system was seen by respondents as good in general, with the main criticisms directed at information and the lack of vaccines. As for accessibility, data suggests a correlation with economic factors, generating bioethical discussions about the social vulnerability of most of society that cannot afford vaccination.

Resumen Las vacunas ejercen una gran influencia sobre la salud pública debido a su efectividad y a una relación costo-beneficio favorable. Sin embargo, con el surgimiento de nuevas vacunas indisponibles en la red pública, se hace necesario discutir el acceso de la sociedad a este servicio. El objetivo de este trabajo fue identificar el significado de la vacunación para la población y los médicos, y abordar la cuestión del acceso a la inmunización fuera de la red pública de salud, haciendo hincapié en la vulnerabilidad social. Con base en una metodología cualitativa exploratoria y en el discurso del sujeto colectivo, se entrevistó a médicos y a ciudadanos legos. El sistema brasileño de vacunas fue considerado por los entrevistados como bueno de manera general. Las principales críticas se refieren a la información y a la falta de insumos. Respecto al acceso, los datos sugieren que existe una correlación con factores económicos, lo que crea un espacio para discusiones bioéticas sobre la vulnerabilidad social de la mayor parte de la sociedad, que no tiene condiciones de pagar por estas inmunizaciones.

Effect of radiofrequency on patellar ligament repair of Wistar rats.

This study aimed to evaluate the effects of radiofrequency (RF) on patellar ligament repair through the analysis of type I and III collagens and immunostaining for TGF-ß3. To evaluate the effect of RF on patellar ligament repair of Wistar rats, cross-sectional incision (60% of the width - grade I) was performed in patellar ligaments of the groups: lesion (L, n = 7), treated with RF on the 5-day (5RF, n = 7) and 7-day (7RF, n = 7) post injury were compared to control group (C, n = 7). Histological evaluation, immunohistochemistry, morphometry and statistical analysis were performed. At 10 days post injury, ligament rupture were observed only in L. Active fibroblasts, type 3 collagen and TGF-ß3 in L, 5RF and 7RF was significantly (p < 0.05) higher than control (C). Type 1 collagen was significantly (p < 0.05) higher in C than L, 5RF and 7RF. A positive correlation (p < 0.05) was observed: TGF-ß3 vs active fibroblasts and TGF-ß3 vs type 3 collagen; otherwise, negative correlation (p < 0.05): type I collagen vs TGF-ß3. These results suggest that RF seemed to accelerate the wound healing process of the patellar ligament and may be used as a non-invasive treatment of partial ligament injuries.

Thermographic Characterization of Cutaneous Ulcers of Different Etiologies.

The characterization of the temperature of skin ulcers may provide preliminary diagnostic evidence. The aim of this study was to characterize cutaneous ulcers of different etiologies by infrared thermography. 122 cutaneous ulcers of 87 patients (age 60.1 ± 15.7 years) were evaluated, allocated into five groups: venous ulcers (VU) n = 26, arterial ulcers (AU) n = 20, mixed ulcers (MU) n = 25, pressure ulcers (PU) n = 29, and neuropathic ulcers (NU) n = 22. The cutaneous temperature was recorded by infrared thermography (FLIR-450™); we also evaluated the ulcer area, the ankle brachial index (ABI), the range of motion (ROM) of the ankle, and pain. For the different variables, the statistical analysis was performed using the Kruskal Wallis test, ANOVA, the chi-squared test, and the Spearman test (SPSS™ software version 20, p < 0.05). A significant difference was found between the temperatures of PU and NU. The ABI was significantly lower in the MU and AU groups, and pain was also higher in these groups. The ROM was decreased in all groups, and the MU and VU groups had the lowest ROM. There was no correlation between temperature and the clinical findings (ABI, ROM, and pain). There was a moderate correlation in the analysis between the temperature and the area of the ulcer in the PU group, as larger ulcers had lower temperatures. It is possible to characterize cutaneous ulcers by infrared thermography, and there are temperature differences among ulcers with different etiologies.

A new APP for prevention and treatment of complications of intestinal peristomal skin / Aplicativo para prevenção e tratamento das complicações da pele periestoma intestinal

ABSTRACT Objectives To develop an application program for prevention and treatment of complications of intestinal peristomal skin. Method The framework of the application software development were: Phase 1 - "Design, identification of the needs for the application development": In this phase, the authors identified during their clinical practice that some professionals and caregivers find it difficult to provide care for at-risk ostomized patients or those with some kind of peristomal skin complication; Phase 2 - "Application prototype development": this phase included the integrative literature review in the main databases; Phase 3 - "Creating the application": this phase was intended to generate a decision tree algorithms, structure the database, and develop the software; Phase 4 - "Transition": performing the application functionality testing. Results The application "Dermatite Periestoma App" has 36 screens and 21 figures describing the procedures for prevention and treatment of complications of intestinal peristomal skin. It is freely available from the Play Store and has been registered with the Instituto Nacional da Propriedade Industrial Ministério do Desenvolvimento, indústria e Comércio Exterior (Brazilian Ministry of Development, Industry and Foreign Trade, National Institute of Industrial Property). Conclusion This study made it possible to describe the stages of planning and development of the mobile application "Dermatite Periestoma App". The steps taken indicate that the "Dermatite Periestoma App" has great potential for clinical practice in the evaluation of patients with stomal complications or at risk for developing peristomal skin complications, preventive measures, therapeutic approaches, and for nursing education through the use of technology.

RESUMO Objetivos Desenvolver um aplicativo para prevenção e tratamento de complicações da pele periestoma intestinal. Método As fases de desenvolvimento da estrutura do aplicativo foram: Fase 1 - "Concepção, identificação das necessidades do desenvolvimento do aplicativo": nessa fase os autores identificaram, durante sua prática clínica, que alguns profissionais e cuidadores têm dificuldade em prestar assistência aos ostomizados com risco ou que adquirirem algum tipo de complicação da pele periestoma; Fase 2 - "Elaboração do protótipo do aplicativo": essa fase contemplou a revisão integrativa da literatura nas principais bases de dados; Fase 3 - "Construção do aplicativo": essa fase consistiu na elaboração da árvore de decisão dos algoritmos, estruturação do banco de dados e desenvolvimento do software; Fase 4 - "Transição": foram realizados os testes de funcionalidade do aplicativo. Resultados O aplicativo "Dermatite Periestoma App" tem 36 telas e 21 figuras descrevendo os procedimentos para prevenção e tratamento das complicações da pele periestoma intestinal. O mesmo está disponível gratuitamente naPlay Store e foi registrado no Instituto Nacional da Propriedade Industrial Ministério do Desenvolvimento, indústria e Comércio Exterior. Conclusão Este estudo possibilitou descrever as etapas do planejamento e desenvolvimento do aplicativo móvel "Dermatite Periestoma App". As etapas percorridas indicam que o "Dermatite Periestoma App" tem grande utilidade potencial para a prática clínica na avaliação do ostomizado com complicação ou que apresenta risco para desenvolver complicações da pele periestoma, medidas preventivas, condutas terapêuticas, e para o ensino de Enfermagem por meio do uso de tecnologia.

Effects of carboxytherapy on skin laxity.

BACKGROUND: Carboxytherapy is capable of inducing tissue repair which results in an increase in elastic and collagen fibers. OBJECTIVES: To evaluate the effects of carboxytherapy upon human skin collagen and elastic fiber synthesis. METHODS: Case study of nine volunteers who received a single application of carboxytherapy in the left infraumbilical region, with infusion rate of 100 mL/min and 0.6 mL/kg weight over an area of 25 cm2 . After 60 days on average, the skin was collected for histological analysis and stained with picrosirius red for collagen and Verhoeff for elastic fibers. The percentage of fibers found was marked by the Image J® program and recorded in a Microsoft Excel spreadsheet. Statistical analysis was performed using SPSS (version 20), with a significance level of 95%. RESULTS: An increase in the collagen and elastic fibers sample was observed in the treated group. Morphometrically, a significant increase in the percentage of collagen in the Carboxytherapy group (41.44 ± 4.50%) was observed compared with the control group (37.44 ± 3.87%) with P = .04; for elastic fibers, the percentage showed no significant difference between the control group (10.55 ± 4.33%) and the carboxytherapy group (10.44 ± 3.71%). CONCLUSIONS: Carboxytherapy with the parameters used in this study was able to stimulate collagen and elastic fiber synthesis, with significant differences in the morphometry for collagen fibers.

Effect of four sessions of aerobic exercise with abdominal radiofrequency in adipose tissue in healthy women: Randomized control trial.

BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To analyze the effect of four intervention sessions on abdominal adipose tissue. METHODOLOGY: The study analyzes the effect of four sessions of aerobic exercise combined with radiofrequency. Participants were 28 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and a placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed four sessions of abdominal radiofrequency followed by moderate aerobic exercise, assessing body mass, body mass index, fat mass, waist circumference, waist/height ratio, subcutaneous adipose thickness, and horizontal abdominal adipose fold at the first and fourth sessions. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40°C and 42°C to the epidermis. In the placebo group, the power of the radiofrequency was 0 W. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There was a statistically significant decrease in waist circumference, abdominal subcutaneous adipose thickness, and horizontal abdominal fold in the experimental group compared to the placebo group (P < 0.05). CONCLUSION: Combined exercise intervention with radiofrequency has been shown to be effective in reducing abdominal adiposity.

Effect of an aerobic exercise session combined with abdominal radiofrequency on lipolytic activity in women: Randomized control trial.

BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To understand whether an aerobic physical exercise session associated with abdominal radiofrequency increases the level of lipolytic activity. METHODOLOGY: The study analyzes the effect of a combined aerobic exercise session with radiofrequency. Participants were 30 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed an abdominal radiofrequency session followed by moderate aerobic exercise, assessing glycerol concentration and lipid profile values before and after the intervention. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40º C and 42º C to the epidermis. In the placebo group, the power of the radiofrequency was 0 Watt. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There were no significant changes in glycerol concentrations between groups (P > 0.05). There were no changes in the lipid profile of both groups after the intervention (P > 0.05). CONCLUSION: The association of exercise with radiofrequency did not present an increased effect on lipolytic activity when compared to the isolated exercise. The application of this technique is a safe intervention.

Applicability of eucalyptus wood waste extracts for the histological staining of connective tissue.

Biological staining of tissue is a crucial procedure in histotechnology. Rudimentary methods for section preparation have often used stains from natural products, although use of synthetic dyes has become the contemporary standard. Artificial dyes increase the operating costs of a laboratory as well as increase the environmental and personnel risks during manufacturing and usage. These considerations have stimulated research to find alternative natural stains from the wide diversity of plant species. The present study investigated the effect of Eucalyptus sp. (Myrtaceae) wood waste extract on histological staining of animal tissues, using a series of pigment concentrations, pH conditions, and temperatures. Eucalyptus wooden slivers were dried, milled, and 1 g, 2 g, and 4 g of the fine powder was subjected to 50% ethanol extraction for 2 days. Staining tests were then performed on formalin fixed paraffin embedded (FFPE) sections. Increasing acetic acid concentrations (1%, 2% and 4%) were added to the extracts and compared to an acid-free extract. Staining was performed at both ambient room temperature (RT) and 60°C. Connective tissue acidophilic components were well-contrasted and a hematoxylin counterstain demonstrated distinct structural differences between matrix and cell nuclei. Therefore, the present findings demonstrate the potential utility of the eucalyptus wood extracts application as a natural stain alternative for routine histology.

Reflections on the Terminality of Life with Undergraduate Medical Students / Reflexões sobre a Terminalidade da Vida com Acadêmicos de Medicina

Abstract: Introduction: Death and dying are daily relevant themes for health care professionals and medical students. Nonetheless, since their first years of graduation, students are contrived to supplant the holistic conception of human beings and life in favor of enhancing the technical aspects of the medical profession. Methods: Therefore, in face of the few opportunities to enquire about these future professionals' feelings and comprehensions toward life terminality, we pursued their perceptions through the application of a semi-structured questionnaire. Ten students from each year of the medical course at UNIVAS were interviewed, encompassing 60 scholars. Students should be regularly enrolled in the medical course, as well as give their consent, by signing the Consent Term, to participate in the study. The interviews took place at the institution and the material containing students' responses was fully destroyed afterwards. Their responses were analyzed based on the Discourse of the Collective Subject Method. Results: The idea of terminality being properly the "end of life" was paramount among the years, situation with which a great amount of the scholars (58%) admitted not being prepared to deal with, due to the lack of reflections about death, its psychological aspects and repercussions in the academic context. Interestingly, about 16% of the scholars considered themselves prepared to deal with someone's death, although they were not prepared to intervene in the actual process. This is reinforced by the fact that students must deal with the real scenario of giving undesirable news without previously being prepared to do so, by means of reflecting upon a hypothetical related to the "life-death binomial". Conclusion: Thus, it seems necessary to create spaces in the curriculum that yield not only theoretical-practical but also affective support in situations related to terminality. The proposal of a theoretical-practical education based on palliative care amid the learning programs would shape confident attitudes of future health care professionals towards care.

Resumo Introdução: A morte e o morrer são temas pertinentes ao cotidiano de profissionais de saúde e ao processo de aprendizagem de acadêmicos de Medicina; entretanto, desde os primeiros anos da graduação, o estudante é obrigado a suplantar a concepção holística do ser humano e da vida em prol da supervalorização dos fundamentos técnico-científicos da profissão. Métodos: Nesse sentido, diante das poucas oportunidades de questionar os sentimentos e a compreensão desses futuros profissionais com relação à terminalidade da vida, buscou-se conhecer suas percepções por meio da aplicação de um questionário semiestruturado. Foram entrevistados dez acadêmicos de cada ano do curso de Medicina da Univás, totalizando 60 alunos. Para inclusão no estudo, os estudantes deveriam estar regularmente matriculados no curso, aceitando, por livre-arbítrio, participar da pesquisa por meio da assinatura do Termo de Consentimento Livre e Esclarecido (TCLE). As entrevistas foram gravadas nas dependências da instituição e o material contendo a fala dos participantes foi posteriormente descartado. Para análise das respostas, utilizou-se o método do Discurso do Sujeito Coletivo. Resultados: Foi suscitada, de maneira preponderante em todos os anos, a concepção de terminalidade como sendo propriamente o "fim da vida", situação com a qual parcela considerável dos entrevistados (58%) dizia não se sentir preparada para lidar por conta da escassez de reflexões sobre a morte, seus aspectos psicológicos e suas repercussões no contexto médico-acadêmico. Curiosamente, cerca de 16% dos acadêmicos consideravam-se preparados para vivenciar a morte de alguém, mas não para serem intervencionistas no processo; isso é sustentado pelo fato de que os estudantes têm de lidar com o cenário real de transmissão de más notícias, sem antes passar por situações hipotéticas e reflexivas envolvendo o "binômio vida e morte". Conclusão: Sendo assim, parece necessária a criação de espaços na grade curricular que forneçam apoio não apenas teórico-prático, mas também afetivo das questões envolvendo a terminalidade. A proposta de educação teórico-prática relativa aos cuidados paliativos inserida na grade curricular lapidaria a confiança e atitude dos futuros profissionais perante o cuidado.