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.

UPLC-QTOF-MS/MS-based metabolomic approach and gastroprotective effect of two chemotypes of Egletes viscosa (L.) less. against ethanol-induced gastric ulcer in mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Egletes viscosa (L.) (macela) is a native wild herb that can be found in different states of northeastern Brazil. The infusions of its flower buds are traditionally used for the treatment of gastrointestinal disorders. E. viscosa possesses two chemotypes (named A and B), distinguishable by the composition of the essential oil from the flower buds. Although there are previous studies of the gastroprotective effect of the isolated constituents of E. viscosa, its infusions have not been investigated yet. AIM OF THE STUDY: The present study aimed to evaluate and compare the chemical composition and the gastroprotective effect of flower bud infusions of E. viscosa from chemotype A (EVCA) and chemotype B (EVCB). MATERIALS AND METHODS: Sixteen infusions were brewed with flower buds according to the traditional preparation mode and were analyzed through a UPLC-QTOF-MS/MS based metabolomic approach for determination of their metabolic fingerprints and quantification of bioactive compounds. Afterward, these data were analyzed by chemometric methods (OPLS-DA) for discrimination of the two chemotypes. Additionally, infusions of EVCA and EVCB (50, 100 and 200 mg/kg, p.o.) were evaluated on gastric ulcers induced by absolute ethanol (96%, 0.2 mL, p.o.) in mice. To elucidate the gastroprotective mechanisms, the effect of EVCA and EVCB on gastric acid secretion and gastric wall mucus was determined and the role of TRPV1 channels, prostaglandins, nitric oxide and KATP channels were assessed. Moreover, the oxidative stress-related parameters and the histological aspects of the stomach tissue were analyzed. RESULTS: The chemotypes can be discriminated from each other using UPLC-QTOF-MS/MS chemical fingerprints. Both chemotypes presented similar chemical compositions, consisting basically of caffeic acid derivatives, flavonoids and diterpenes. The quantification of bioactive compounds demonstrated that chemotype A possesses more ternatin, tanabalin and centipedic than chemotype B. EVCA and EVCB (50, 100 and 200 mg/kg, p.o.) significantly decreased the severity of ethanol-induced gastric lesions, as shown by a reduction in histological alterations and leucocyte infiltration in gastric tissue. The gastroprotective mechanism of both infusions involves an antioxidant effect, maintenance of gastric mucus and reduction gastric secretion. Stimulation of endogenous prostaglandins and nitric oxide release, activation of TRPV1 channels, and KATP channels are also involved in the gastroprotection of the infusions. CONCLUSION: The gastroprotective effect of EVCA and EVCB was equivalent and mediated through antioxidant and antisecretory actions, including the activation of TRPV1 receptors, stimulation of endogenous prostaglandins and nitric oxide, and opening of KATP channels. The presence of caffeic acid derivatives, flavonoids and diterpenes in both infusions is involved in mediating this protective effect. Our findings support the traditional use of infusions of E. viscosa for gastric disorders regardless of the chemotype.

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

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.

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.

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.

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.

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.

Printing 3D models of canine jaw fractures for teaching undergraduate veterinary medicine.

PURPOSE: To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. METHODS: A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. RESULTS: The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. CONCLUSION: The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.

Development of a UPLC-ESI-MS method for simultaneous determination of flavonoids and diterpenes in Egletes viscosa (L.) Less herbal products.

Egletes viscosa (L.) Less (Asteraceae) is a tropical aromatic herb whose flower buds are used for gastrointestinal disorders. Its gastroprotective properties have been attributed to the flavonoid ternatin and the furan diterpenes tanabalin and centipedic acid. The aim of this study was to develop a method of ultra-performance liquid chromatography coupled to electrospray ionization and mass spectrometry (UPLC-ESI-MS) for identifying the constituents from E. viscosa flower buds as well as quantifying its bioactive compounds in herbal products. Infusions and tincture from wild and commercial E. viscosa materials were directly injected on a UPLC-quadrupole-time-of-flight system (UPLC-q-TOF). Afterwards, reference standards were used to quantify ternatin, tanabalin and centipedic acid in these samples, employing a UPLC-single quadrupole system set up for positive mode and Selected Ion Monitoring (SIM). Seventeen compounds were identified, including caffeic acid derivatives, flavonoids and diterpenes, from which seven have been reported for the first time in this specie. The quantification method showed good linearity (R > 0.99), accuracy, precision and sensitivity. The intra-day and inter-day precisions presented relative standard deviations inferior to 6.04 and 8.78%, respectively. The recoveries of all the analytes varied 82.25-117.87%. The limits of detection and quantification ranged between 10-25 µg/L and 25-75 µg/L, respectively. For the samples, the contents of ternatin, tanabalin and centipedic acid ranged from 0.89 to 8.03 mg/L, 0.84-16.8 mg/L and 3.21-16.8 mg/L, respectively. The method demonstrated to be rapid, sensitive and reliable for the quality control of E. viscosa-based products, besides being applicable to other plant extracts containing flavonoids and diterpenes.

Printing 3D models of canine jaw fractures for teaching undergraduate veterinary medicine

Abstract Purpose To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. Methods A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. Results The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. Conclusion The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.

The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial.

PURPOSE: To analyze whether a viscoelastic mattress support surface can reduce the incidence of stage 2 pressure injuries compared to a standard hospital mattress with pyramidal overlay in critically ill patients. METHOD: A randomized clinical trial with intention-to-treat analysis was carried out recruiting patients with Braden scale ≤14 on intensive care unit admission from April 2016 to April 2017. Patients were allocated into two groups: intervention group (viscoelastic mattress) and control group (standard mattress with pyramidal overlay). The level of significance adopted was 5%. RESULTS: A total of 62 patients were included in the study. There was a predominance of males (53%) and the mean age was 67.9 (SD 18.8) years. There were no differences in clinical or severity characteristics between the patients in the control group and the intervention group. Pressure injuries occurred in 35 patients, with a median time of 7 days (ITQ 4-10) from admission. The frequency of pressure injuries was higher in the control group (80.6%) compared to the intervention group (32.2%; p < 0.001). CONCLUSIONS: Viscoelastic support surfaces reduced the incidence of pressure injuries in moderate or higher risk critically ill patients when compared to pyramidal support surfaces.

Decrease in Dengue virus-2 infection and reduction of cytokine/chemokine production by Uncaria guianensis in human hepatocyte cell line Huh-7.

BACKGROUND: Dengue fever may present hemorrhages and cavitary effusions as result of exacerbated immune responses. We investigated hydro-alcoholic extracts from leaves (UGL) and bark (UGB) of the medicinal species Uncaria guinanensis with respect to antiviral effects in Dengue virus (DENV) infection and in immunological parameters associated with in vivo physiopathological features. METHODS: Chemical profiles from UGB or UGL were compared in thin layer chromatography and 1H nuclear magnetic resonance using flavonoid compounds and a pentacyclic oxindole alkaloid-enriched fraction as references. DENV-2-infected hepatocytes (Huh-7) were treated with extracts. Cell viability, DENV antigens and immunological factors were detected by enzyme-linked immunosorbent assay (ELISA) or flow cytometry. FINDINGS: The UGL mainly differed from UGB by selectively containing the flavonoid kaempferitrin. UGB and UGL improved hepatocyte viability. Both extracts reduced intracellular viral antigen and inhibited the secretion of viral non-structural protein (NS1), which is indicative of viral replication. Reduction in secretion of macrophage migration inhibitory factor was achieved by UGB, of interleukin-6 by UGL, and of interleukin-8 by both UGB and UGL. MAIN. CONCLUSIONS: The U. guianensis extracts presented, antiviral and immunomodulatory effects for DENV and possibly a hepatocyte-protective activity. Further studies may be performed to consider these products as potential candidates for the development of an herbal product for the future treatment of dengue.

Decrease in Dengue virus-2 infection and reduction of cytokine/chemokine production by Uncaria guianensis in human hepatocyte cell line Huh-7

ABSTRACT BACKGROUND Dengue fever may present hemorrhages and cavitary effusions as result of exacerbated immune responses. We investigated hydro-alcoholic extracts from leaves (UGL) and bark (UGB) of the medicinal species Uncaria guinanensis with respect to antiviral effects in Dengue virus (DENV) infection and in immunological parameters associated with in vivo physiopathological features. METHODS Chemical profiles from UGB or UGL were compared in thin layer chromatography and 1H nuclear magnetic resonance using flavonoid compounds and a pentacyclic oxindole alkaloid-enriched fraction as references. DENV-2-infected hepatocytes (Huh-7) were treated with extracts. Cell viability, DENV antigens and immunological factors were detected by enzyme-linked immunosorbent assay (ELISA) or flow cytometry. FINDINGS The UGL mainly differed from UGB by selectively containing the flavonoid kaempferitrin. UGB and UGL improved hepatocyte viability. Both extracts reduced intracellular viral antigen and inhibited the secretion of viral non-structural protein (NS1), which is indicative of viral replication. Reduction in secretion of macrophage migration inhibitory factor was achieved by UGB, of interleukin-6 by UGL, and of interleukin-8 by both UGB and UGL. MAIN CONCLUSIONS The U. guianensis extracts presented, antiviral and immunomodulatory effects for DENV and possibly a hepatocyte-protective activity. Further studies may be performed to consider these products as potential candidates for the development of an herbal product for the future treatment of dengue.

Effect of Accessions and Environment Conditions on Coumarin, O-Coumaric and Kaurenoic Acids Levels of Mikania laevigata.

Coumarin, o-coumaric, and kaurenoic acid are bioactive compounds usually found in the leaves of Mikania laevigata. Genetic and environmental variations in the secondary metabolites of plants may have implications for their biological effects. Three different accessions of M. laevigata cultivated in four sites between the Equator and the Tropic of Capricorn in Brazil were evaluated aiming to present potential raw materials and discuss relationships among these three bioactive compounds. The results revealed effects of plant accessions and environmental factors and suggested two contrasting chemical phenotypes of M. laevigata. The first phenotype presented the highest levels of kaurenoic acid (2283 ± 316 mg/100 g) besides lower levels of coumarin (716 ± 61 mg/100 g), which was also stimulated by the environment and mild climate at the site nearest to the Tropic of Capricorn. The other phenotype presented the lowest levels of kaurenoic acid (137 ± 17 mg/100 g) besides higher levels of coumarin (1362 ± 108 mg/100 g), which was also stimulated by the environment and tropical climate at the site nearest to the Equatorial beach.

The antimicrobial efficacy of Lippia alba essential oil and its interaction with food ingredients

The objective of this study was to evaluate the antimicrobial potential of Lippia alba essential oil (EOLa) and to investigate the effect of food ingredients on its efficacy. The antimicrobial potential of the oil was determined by the presence or absence of inhibition zones, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against Escherichia coli, Listeria innocua, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella choleraesuis and Staphylococcus aureus. The effect of food ingredients and the pH on the antimicrobial efficacy of oil was assessed by monitoring the maximum growth rate of Listeria monocytogenes in model media. The model media included potato starch (0, 1, 5 or 10%), beef extract (1, 5, 3, 6 or 12%), sunflower oil (0, 5 or 10%) and TSB broth at pH levels of 4, 5, 6 or 7. The EOLa showed efficacy at all concentrations (50%, 25%, 6.25%, 3%, 1.5%, 0.8%, 0.4% and 0.2%) evaluated, against all bacterial species, Gram-positive and Gram-negative. The antimicrobial efficacy of EO was found to be a function of ingredient manipulation. Proteins and lipids had a negative impact on the oil effectiveness, indicating the protective action of both on the microbial specie tested. On the contrary, at the highest concentration of starch (10%), the lower rate growth of L. monocytogenes was detected, therefore indicating a positive effect of carbohydrates on the oil effectivenes. Regarding the pH, the studies showed that the rate of microbial growth increased with increasing pH. It was concluded that the use of EOLa is more effective control pathogenic and spoilage bacteria when applied to starchy foods under an acidic pH.

Depressão e bem-estar em individuo idoso com úlcera venosa / Depression and wellness in elderly patients with venous ulcers

INTRODUÇÃO: A úlcera venosa assume grande importância na vida dos pacientes, pois a ocorrência de deformidade causada por este tipo de ferida pode gerar consequência advensas as causais inclui distúrbios psicossocial. Avaliar bem-estar subjetivo e depressão em pessoas idosas com úlcera venosa. MÉTODOS: Estudo clínico, primário, descritivo, analítico e multicêntrico. Participaram 55 indivíduos idosos com úlcera venosa, atendidos no Núcleo de Assistência e Ensino em Enfermagem do Hospital das Clínicas Samuel Libânio, no Ambulatório São João da Universidade do Vale do Sapucaí e nas Unidades Básicas de Saúde da cidade de Pouso Alegre. Foram incluídos pacientes com idade acima de 60 anos, ambos os sexos, índice tornozelo/braço entre 0,8 e 1,0. Os dados foram coletados no período compreendido entre dezembro de 2012 a maio de 2013, após aprovação Comitê de Ética em Pesquisa da Faculdade de Ciências da Saúde Dr. José Antônio Garcia Coutinho sob parecer 3.090.46. Os instrumentos utilizados foram: dado sócio demográfico, Escala de Depressão Geriátrica em versão reduzida de Yesavage e Escala de Bem-estar Subjetivo. Para análise estatística foi realizado os testes: Qui-Quadrado, t de Student. RESULTADOS: A Maioria, dos indivíduos, era do sexo feminino, 22(40%) tinham entre 60 e 65 anos, 27(49,10%) entre 66 e 70 anos, tinham de 1 a 2 salários mínimos e viúvo. Foram identificados 23 (41,82%) idosos com úlcera venosa nível da depressão leve ou moderada, e 26(47,28%) depressão severa. Relacionado à Escala Bem-estar Subjetivo a maioria dos participantes do estudo apresentaram alteração nos domínios: 43(78,20%), satisfação com a vida, e 40 (72,70%). CONCLUSÃO: Através deste estudo concluímos que os indivíduos que participaram da pesquisa apresentam depressão entre leve a severa e queda na qualidade de vida. Sentem-se infelizes, e insatisfeitos com a vida.

INTRODUCTION: Venous ulcers play an important role in patients' lives, as the deformities caused by this type of wound can lead to various adverse effects, including psychosocial disorders. OBJECTIVE: To evaluate subjective wellness and depression in elderly patients with venous ulcers. METHODS: This is a primary, descriptive, analytical, and multicenter clinical study involving 55 elderly patients with venous ulcers, undergoing treatment at the Nursing Assistance and Training Center of Clínicas Samuel Libânio Hospital, at the São João Outpatient Clinic of the University of Vale do Sapucaí and at the Primary Healthcare Units of Pouso Alegre city. The study included male and female patients, aged 360 years, and with an ankle-brachial index between 0.8 and 1.0. Data were collected between December 2012 and May 2013, after approval by the research ethics committee of the Faculty of Health Sciences Dr. José Antônio Garcia Coutinho, under recommendation 3.090.46. Sociodemographic data, Yesevage's reduced version of the Geriatric Depression Scale, and the Subjective Wellness Scale were used. Statistical analyses were carried out with the chi-square and Student's t tests. RESULTS: Most of the study participants were female; 22 (40%) of the patients were aged 60-65 years and 27 (49.10%) were aged 66-70 years. Their income ranged between 1 and 2 minimum wages, and most of them are widowers. Twenty-three (41.82%) elderly patients with venous ulcers had mild to moderate depression levels, and 26 (47.28%) showed severe depression. In the Subjective Wellness Scale, most study participants revealed changes in items 43 (satisfaction with life; 78.20%) and 40 (72.70%). CONCLUSION: This study revealed that study participants had mild to severe depression and decreased quality of life.

Avaliação da qualidade de vida em pacientes com diabetes mellitus e pé ulcerado / Assessment of the quality of life of patients with diabetes mellitus and foot ulcers

INTRODUÇÃO: O pé diabético é uma das mais devastadoras complicações crônicas do diabetes mellitus, em função do grande número de casos que evoluem para amputação. O objetivo deste estudo é avaliar a qualidade de vida de pessoas diabéticas com pé ulcerado comparativamente às pessoas diabéticas sem úlceras. MÉTODO: Realizado estudo analítico, transversal, controlado e comparativo, com pacientes atendidos em 2 centros de tratamento de feridas de São Paulo. Foram selecionadas 50 pessoas para compor o grupo controle, com diabetes mellitus sem pé ulcerado, e 50 para o grupo estudo, composto de pacientes diabéticos com pé ulcerado. O instrumento usado para avaliar a qualidade de vida foi o questionário Short Form-36 Health Survey (SF-36). A inclusão dos pacientes no estudo obedeceu à ordem de chegada. RESULTADOS: Na avaliação dos pacientes do grupo controle, o escore médio do SF-36 foi 69,38 ± 21,90 e do grupo estudo, 30,34 ± 14,45 (P < 0,001). A média dos escores em todos os domínios do SF-36 do grupo estudo foi mais baixa em relação ao grupo controle (P < 0,001). CONCLUSÕES: Os pacientes diabéticos com pé ulcerado apresentam alterações na qualidade de vida, repercutindo nos domínios físico, social e psicoemocional.

BACKGROUND: Diabetic foot is considered as one of the most devastating chronic complications of diabetes mellitus due to the large number of cases that eventually require amputation. In the present study, we aimed to assess the quality of life of patients with diabetes and foot ulcers compared to that of patients with diabetes but without foot ulcers. METHODS: An analytical, cross-sectional, controlled, and comparative study of patients who visited 2 wound clinics in São Paulo was performed. Fifty patients with diabetes mellitus but without foot ulcers were selected as the control group and 50 patients with diabetes and foot ulcers were selected as the study group. The Short Form-36 Health Survey (SF-36) questionnaire was used to assess the quality of life. Patients were included consecutively in the same order that they visited the clinic. RESULTS: The mean SF-36 score was 69.38 ± 21.90 in the control group and 30.34 ± 14.45 in the study group (P < 0.001). Mean scores across all SF-36 domains were lower in the study group than in the control group (P < 0.001). CONCLUSIONS: Patients with diabetes and foot ulcers experience changes in the quality of life in the physical, social, and psychoemotional domains.