Vitamin D supplementation modulates autophagy in the pristane-induced lupus model.

INTRODUCTION/OBJECTIVES: Clinical evidence of skeletal muscle involvement is not uncommon in systemic lupus erythematosus (SLE). Because of the poor understanding of signaling pathways involved in SLE muscle wasting, the  aim of this study was to evaluate the effects of vitamin D supplementation on skeletal muscle in mice with pristane-induced lupus. METHODS: Balb/c mice with lupus-like disease induced by pristane injection were randomized into three groups: pristane-induced lupus (PIL; n = 10), pristane-induced lupus + vitamin D supplementation (PIL + VD; n = 10) and healthy controls (CO; n = 8). Physical function was evaluated on days 0, 60, 120 and 180. The tibialis anterior and gastrocnemius muscles were collected to evaluate myofiber cross-sectional area (CSA) and protein expression. RESULTS: The PIL + VD group showed lower muscle strength compared to the CO and PIL groups at different time points. PIL mice showed similar myofiber CSA compared to CO and PIL + VD groups. LC3-II expression was higher in PIL compared to CO and PIL + VD groups. MyoD expression was higher in PIL mice compared to PIL + VD, while myostatin expression was higher in PIL + VD than PIL group. Myogenin expression levels were decreased in the PIL + VD group compared with the CO group. The Akt, p62 and MuRF expressions and mobility assessment showed no significance. CONCLUSIONS: Changes in skeletal muscle in PIL model happen before CSA reduction, possibly due to autophagy degradation, and treatment with Vitamin D has a impact on physical function by decreasing muscle strength and time of fatigue.. Vitamin D supplementation has a potential role modulating physical parameters and signaling pathways in muscle during pristane-induced lupus model.

The effect of consumption of purple grape juice in the gestational period on oxidative stress parameters in Wistar rat foetuses.

This study aimed to evaluate the effects of purple grape juice consumption in pregnancy on oxidative stress parameters in Wistar rat fetuses. Twenty-four pregnant rats were divided into five groups: control group, indomethacin group (received a single dose of indomethacin in DG20), group grape juice DG14 (received an amount for 14 days/first and second gestational trim), group grape juice DG20 (received a dose throughout the gestational period), group grape juice two doses (received two doses, at morning and afternoon). On the 20th day of pregnancy (DG20), rats were anesthetized, and a cesarean section was performed to obtain the fetuses. A sample of liver, heart, and total brain of fetuses was collected for oxidative stress analyses. Values P<0.05 were considered significant. In fetuses' heart, we observed that the grape juice two dose group decreased sulfhydryl and increased SOD. In the liver, the grape juice decreased TBARS and SOD. There was a decrease in carbonyl and sulfhydryl in the indomethacin and grape juice one dose groups in the brain. We conclude that indomethacin altered oxidative stress parameters only in the fetal brain, and grape juice was presented as an important modulator of antioxidant capacity when consumed in a dose.

Identification of rare blood types in southern Brazil: impact on transfusion support.

CONCLUSIONS: The prevalence of blood group antigens and phenotypes varies significantly in Brazil. To ensure a proper rare blood supply, it is essential to establish a local and regional database of rare donors connected to the national registry. The objective of this study was to create a database of rare blood donors in the northern region of southern Brazil. From November 2011 to December 2018, red blood cell (RBC) phenotyping and genotyping were performed on common and high-prevalence antigens in donors and patients in southern Brazil. During this study period, 17 patients and 33 blood donors with rare phenotypes were identified. Six patients had already been alloimmunized to clinically significant antigens. Patients with the following phenotypes (i.e., negative for highprevalence antigens) were found: Yt(a-), Jk(a-b-), Lu(a-b-), Oh (Bombay), Tc(a-), k-, and Fy(a-b-). Among the donors, Kp(a+b-), Fy(a-b-), Lu(a-b-), and k- phenotypes were identified. We also found four donors with the weak D type 18 phenotype. In conclusion, we observed that the prevalence of rare blood phenotypes in our region corresponds more to the prevalence found in the Caucasian population when compared with other regions in Brazil. Our results show the importance of continuous screening for rare donors in different regions of the country and the creation of a local database to support RBC transfusions in patients who need rare blood.

THE IMPORTANCE OF BREAST SELF-EXAMINATION AS A DIAGNOSTIC METHOD OF BREAST CANCER / A importância do autoexame como método diagnóstico do câncer de mama

Method: An observational, retrospective, descriptive and cross - sectional study was carried out with data collected from Clínica Basegio, Brazil. The objective of this study was to analyze the importance of breast self-examination (BSE) as a diagnostic method for breast cancer in Passo Fundo, Rio Grande do Sul. A total of 320 patient records were selected from 1987 to 2017, among which 14 were excluded due to insufficient information. Results: BSE accounted for 48% of breast cancer diagnoses, followed by mammography and ultrasound. Imaging methods proved to be more effective in diagnosing early stage disease, while BSE detected more advanced tumors. This data was based on the histological characteristics of the tumors, with a significant difference (p<0.05) between tumor size and lymph node involvement when compared to BSE and imaging methods. Thus, the survival of the patients diagnosed by mammography and ultrasound was significantly higher than the patients diagnosed by BSE. Conclusion: Evidence from this retrospective study suggests that BSE is the prevalent diagnostic method for breast cancer in the State of Rio Grande do Sul. Despite detecting tumors in advanced stages, it is still a fundamental method within the Brazilian reality.

Método: Estudo observacional, retrospectivo, descritivo e transversal, com dados coletados na Clínica Basegio, Brasil. O objetivo deste estudo foi analisar a importância do autoexame das mamas (AEM) como método diagnóstico para o câncer de mama em Passo Fundo, Rio Grande do Sul. Um total de 320 registros de pacientes foram selecionados de 1987 a 2017, dos quais 14 foram excluídos devido a informações insuficientes. Resultados: O AEM foi responsável por 48% dos diagnósticos de câncer de mama, seguido pela mamografia e ultrassonografia. Os métodos de imagem mostraram-se mais eficazes no diagnóstico de doença em estágio inicial, enquanto o AEM detectou tumores mais avançados. Esses dados foram baseados nas características histológicas dos tumores, com diferença significativa (p<0,05) entre o tamanho do tumor e o comprometimento linfonodal quando comparados aos métodos de AEM e de imagem. Assim, a sobrevida dos pacientes diagnosticados por mamografia e ultrassonografia foi significativamente maior que a de pacientes diagnosticados por AEM. Conclusão: Evidências deste estudo retrospectivo sugerem que o AEM é o método diagnóstico prevalente para o câncer de mama no Estado do Rio Grande do Sul. Apesar de detectar tumores em estágios avançados, ainda é um método fundamental dentro da realidade brasileira.

MTA and biodentine for primary teeth pulpotomy: a systematic review and meta-analysis of clinical trials.

OBJECTIVE: This study aims to perform a systematic review and meta-analysis of clinical trials in order to evaluate the clinical and radiographic success rates of primary teeth pulpotomy performed with biodentine, when compared to MTA. METHODS: Search strategies were conducted in nine databases on August 5th, 2017, update on February 14th, 2018. Clinical articles were selected, which were in accordance with the inclusion and exclusion criteria and the research objective. They were analyzed by meta-analysis at three time points (6, 12, and 18 months). RESULTS: Out of the 233 publications initially identified, only 9 studies that fulfilled the inclusion criteria were included in the review. The 6-month overall clinical (RR = 0.99; 95% CI = 0.96-1.02, p = 0.92) and radiographic success rates (RR = 0.96; 95% CI = 0.92-1.00, p = 0.28) showed that biodentine vs. MTA did not differ statistically. The 12 and 18-month overall clinical success rates, respectively (RR = 1.01; 95% CI = 0.97-1.04, p = 0.77; RR = 0.98; 95% CI = 0.92-1.05, p = 0.74) and radiographic success rates, respectively (RR = 0.97; 95% CI = 0.92-1.02, p = 0.11; RR = 1.00; 95% CI = 0.91-1.10, p = 0.56) also showed that biodentine vs. MTA did not differ statistically. CONCLUSION: There is no superiority of one material over the other, MTA versus biodentine. CLINICAL RELEVANCE: This systematic review comparing the performance of biodentine in relation to the MTA when used in the pulpotomy technique in primary teeth. Although MTA is considered the gold standard material for pulpotomy procedures, it has some drawbacks (poor handling, staining potential, long setting time); thus, it is important to evaluate the clinical performance of other calcium silicate-based cements like biodentine that overcome this drawbacks.

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part II: Patient-Reported Outcomes.

BACKGROUND: Gingival recession (GR) might be associated with patient discomfort due to cervical dentin hypersensitivity (CDH) and esthetic dissatisfaction. The aim is to evaluate the effect of root coverage procedure with a xenogenous collagen matrix (CM) and/or enamel matrix derivative (EMD) in combination with a coronally advanced flap (CAF) on CDH, esthetics, and oral health-related quality of life (OHRQoL) of patients with GR. METHODS: Sixty-eight participants with single Miller Class I/II GRs were treated with CAF (n = 17), CAF + CM (n = 17), CAF + EMD (n = 17), and CAF + CM + EMD (n = 17). CDH was assessed by evaporative stimuli using a visual analog scale (VAS) and a Schiff scale. Esthetics outcome was assessed with VAS and the Questionnaire of Oral Esthetic Satisfaction. Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to assess OHRQoL. All parameters were evaluated at baseline and after 6 months. RESULTS: Intragroup analysis showed statistically significant reduction in CDH and esthetic dissatisfaction with no intergroup significant differences (P >0.05). The impact of oral health on QoL after 6 months was significant for CAF + CM, CAF + EMD, and CAF + CM + EMD (P <0.05). Total OHIP-14 score and psychologic discomfort, psychologic disability, social disability, and handicap dimensions showed negative correlation with esthetics. OHIP-14 physical pain dimension had positive correlation with CDH (P <0.05). OHIP-14 showed no correlation with percentage of root coverage, keratinized tissue width, or keratinized tissue thickness (P >0.05). CONCLUSION: Root coverage procedures improve patient OHRQoL by impacting on a wide range of dimensions, perceived after reduction of CDH and esthetic dissatisfaction of patients with GRs treated with CAF + CM, CAF + EMD, and CAF + CM + EMD.

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part I: Clinical Outcomes.

BACKGROUND: Considering xenogeneic collagen matrix (CM) and enamel matrix derivative (EMD) characteristics, it is suggested that their combination could promote superior clinical outcomes in root coverage procedures. Thus, the aim of this parallel, double-masked, dual-center, randomized clinical trial is to evaluate clinical outcomes after treatment of localized gingival recession (GR) by a coronally advanced flap (CAF) combined with CM and/or EMD. METHODS: Sixty-eight patients presenting one Miller Class I or II GRs were randomly assigned to receive either CAF (n = 17); CAF + CM (n = 17); CAF + EMD (n = 17), or CAF + CM + EMD (n = 17). Recession height, probing depth, clinical attachment level, and keratinized tissue width and thickness were measured at baseline and 90 days and 6 months after surgery. RESULTS: The obtained root coverage was 68.04% ± 24.11% for CAF; 87.20% ± 15.01% for CAF + CM; 88.77% ± 20.66% for CAF + EMD; and 91.59% ± 11.08% for CAF + CM + EMD after 6 months. Groups that received biomaterials showed greater values (P <0.05). Complete root coverage (CRC) for CAF + EMD was 70.59%, significantly superior to CAF alone (23.53%); CAF + CM (52.94%), and CAF + CM + EMD (51.47%) (P <0.05). Keratinized tissue thickness gain was significant only in CM-treated groups (P <0.05). CONCLUSIONS: The three approaches are superior to CAF alone for root coverage. EMD provides highest levels of CRC; however, the addition of CM increases gingival thickness. The combination approach does not seem justified.

Caracterización de diagnóstico tardío de cáncer oral en una ciudad brasileña / Characterization of late diagnosis of oral cancer in a Brazilian city

Introduction: oral cancer in Brazil still presents high incidence and mortality rates and has different characteristics throughout the national territory. Although in most cases the diagnosis is late, there is a great possibility for cure when patients are treated early. Objective: to describe the sociodemographic profile of patients with oral squamous cell carcinoma and the possible etiological factors associated. Methods: this was a descriptive prospective cross-sectional study carried out in Napoleão Laureano Hospital, state of Paraíba, from January 2012 to May 2013. The study included patients with advanced-stage oral squamous cell carcinoma identified during clinical examination and confirmed by histopathology. The following variables were assessed: age, sex, comorbidity, smoking, alcohol use, tumor location, time of development, clinical staging, histopathological grading and proposed treatment. Results: a total of 15 cases of patients with stage III and IV oral squamous cell carcinoma were found. Of these, 80 percent were males with a mean age of 62.59 years and lesions affecting predominantly the mouth floor, followed by the tongue. The most common sign was the presence of tumor greater than 3.0-cm diameter, including ulcerated, leukoplastic and erythroplastic areas, in addition to pain and difficulty in feeding and phonation. Conclusion: the majority of patients identified, with advanced-stage squamous cell carcinoma showed moderate cellular differentiation between stages III and IV, and was composed by males with smoking and alcohol drinking habits in the seventh decade of life(AU)

Introducción: el cáncer oral en Brasil todavía presenta altos niveles de incidencia y mortalidad y tiene diferentes rasgos en todo el territorio nacional. En la mayoría de los casos el diagnóstico es tardío. Sin embargo, hay una gran posibilidad de cura cuando es tratado desde el principio. Objetivo: describir el perfil sociodemográfico de los pacientes afectados por carcinoma bucal de células escamosas, así como los posibles factores etiológicos asociados. Métodos: se realizó un estudio descriptivo prospectivo transversal en el hospital Dr. Napoleão Laureano, estado de Paraíba, desde enero de 2012 a mayo de 2013. El estudio incluyó a pacientes con carcinoma oral de células escamosas en estadio avanzado identificado durante el examen clínico y confirmado por histopatología. Se evaluaron las siguientes variables: edad, sexo, comorbilidad, el tabaquismo, el consumo de alcohol, la ubicación del tumor, el tiempo de desarrollo, la estadificación clínica, clasificación histopatológica y el tratamiento propuesto. Resultados: se encontró un total de 15 casos de pacientes con estadio III y IV del carcinoma oral de células escamosas COCE . De estos, 80 por ciento eran hombres con una edad media de 62,59 años. Las lesiones afectaban predominantemente al piso de la boca, seguido de la lengua. El signo clínico más común fue la presencia de tumor mayor que 3,0 cm de diámetro, incluyendo las zonas ulceradas, áreas con leucoplasia y eritroplasia, además de dolor y dificultad en la alimentación y la fonación. Conclusión: la mayoría de los pacientes identificados con carcinoma de células escamosas en estadio avanzado mostró moderada diferenciación celular entre los estadios III y IV. Estos eran hombres con hábitos de fumar y beber en la séptima década de la vida(AU)

Densidade dos mastócitos em lesões de quelite actínica / Densidad de los mastocitos en las lesiones de la queilitis actínica / Density of mast cells in lesions of actinic cheilitis

Objetivo: analisar a densidade dos mastócitos em Queilite Actínica segundo as características histológicas da lesão comparando com a mucosa normal. Método: estudo descritivo onde a amostra foi composta por dois grupos, sendo o primeiro com 33 espécimes de casos de queilite actínica diagnosticados clinicamente, e o segundo composto por 9 espécimes de mucosa oral normal, registrados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Dr. Napoleão Laureano, João Pessoa, PB. Os blocos parafinados da amostra foram cortados e corados em Hematoxilina e Eosina para avaliar o grau de displasia epitelial e infiltrado inflamatório; e por azul de toluidina para quantificar os mastócitos. A contagem dos mastócitos foi realizada com o auxilio de um retículo quadrado em 8 campos por caso. A leitura final foi expressa com o valor médio de mastócitos por caso em células/µm². Os dados foram analisados pelo SPSS (Statistical Package for Social Sciences) versão 15.0. Resultados: em 57,6 porcento dos casos houve algum grau de displasia epitelial, sendo 39,4 porcento leve, 15,2 porcento moderada e 3 porento severa. Em 21,2 porcento havia carcinoma de células escamosas. A presença de infiltrado inflamatório e elastose solar foi observada em 84,9 porcento e 81,8 porcento dos casos, respectivamente. Os mastócitos foram identificados em 87,8 porcento da amostra. A densidade dos mastócitos nos casos de queilite actínica foi de 17,4±10,4 células/µm² e no tecido normal 1,78±1,64 células/µm² (p<0,001). Houve correlação estatisticamente significante entre densidade de mastócitos com os processos de displasia (p=0,004) e infiltrado inflamatório (p=0,000). Conclusão: o aumento da densidade dos mastócitos nas lesões de queilite actínica, em relação a mucosa normal, e sua correlação com os processos de displasia e inflamação sugerem participação dessas células na progressão da doença para Carcinoma de Células Escamosas de lábio(AU)

Objective: analyze the density of mast cells in Actinic cheilitis according to the histological characteristics of the lesion compared with the normal mucosa. Methods: descriptive study where the sample consisted of two groups, the first with 33 specimens of cases of actinic cheilitis diagnosed clinically, and the second consists of 9 specimens of normal oral mucosa, registered in the Service of Head and Neck Hospital Dr. Napoleon Laureano, João Pessoa, PB. The paraffin blocks of the sample were cut and stained with hematoxylin and eosin to assess the degree of dysplasia and inflammatory infiltrate, and toluidine blue to quantify mast cells. The count of mast cells was performed with the aid of a square grid in the case of field 8. The final reading was expressed with an average value of mast cells by case / µm². Data were analyzed by SPSS (Statistical Package for Social Sciences) version 15.0. Results: in 57.6 percent of cases there was some degree of dysplasia, and 39.4 percent mild, 15.2 percent moderate and 3 percent severe. 21.2 percent had squamous cell carcinoma. The presence of inflammatory infiltrate and solar elastosis was observed in 84.9 percent and 81.8 percent , respectively. Mast cells were identified in 87.8 percent of the sample. The density of mast cells in cases of Actinic Cheilitis was 17.4 ± 10.4 cells / µm² and 1.78 ± 1.64 normal tissue cells / µm² (p <0.001). There was a statistically significant correlation between mast cell density with the processes of dysplasia (p = 0.004) and inflammatory cell infiltration (p = 0.000). Conclusion: the increase in mast cell density in actinic cheilitis lesions and its correlation with the processes of inflammation and dysplasia suggest involvement of these cells in disease progression for Squamous Cell Carcinoma lip(AU)

Objetivo: analizar la densidad de los mastocitos en la queilitis actínica según las características histológicas de la lesión en comparación con la mucosa normal. Métodos: estudio descriptivo donde la muestra consistió en dos grupos, el primero con 33 muestras de casos de queilitis actínica diagnosticados clínicamente, y el segundo se compone de 9 muestras de mucosa oral normal. Los casos estaba registardos en el servicios de Cirugía de Cabeza y Cuello del Hospital Dr. Napoleón Laureano, Joao Pessoa, PB. Los bloques de parafina de la muestra fueron cortados y teñidos con hematoxilina y eosina para evaluar el grado de displasia epitelial e infiltrado inflamatorio; y azul de toluidina para cuantificar los mastocitos. El recuento de células cebadas se realizó con la ayuda de una red cuadrada en 8 campos por caso. La lectura final se expresó con valor medio de mastocitos por células / m² ·. Los datos fueron analizados con el programa SPSS (Statistical Package for Social Sciences) versión 15.0. Resultados: En el 57,6 por ciento de los casos hubo algún grado de displasia epitelial, y 39,4 por ciento leve, 15,2 por ciento moderada y el 3 por ciento severa. El 21,2 por ciento tenían carcinoma de células escamosas. Se observó la presencia de infiltrado inflamatorio y elastosis solar en 84,9 por ciento y 81,8 por ciento, respectivamente. Se identificaron células cebadas en 87,8 por ciento de la muestra. La densidad de los mastocitos en los casos de queilitis actínica fue 17,4 ± 10,4 células / m² · tejido normal y 1.78 ± 1.64 células / m² · (p <0,001). Hubo una correlación estadísticamente significativa entre la densidad de los mastocitos con procesos de displasia (p = 0,004) y el infiltrado inflamatorio (p = 0,000). Conclusión: El aumento de la densidad de los mastocitos en la queilitis actínica, en comparación con mucosa normal, y su correlación con los procesos de displasia y la inflamación sugiere el papel de estas células en la progresión de la enfermedad para el Carcinoma de células escamosas(AU)

Fatores relacionados ao surgimento e gradação da mucosite oral radioinduzida / Factores relacionados con la aparición y la clasificación de la mucositis oral inducida por la radiación / Factors related to the occurrence and classification of radiation-induced oral mucositis

Introdução: a mucosite Oral é considerada uma das complicações mais comuns da terapia antineoplásica de cabeça e pescoço. Caracteriza-se pelo eritema e edema da mucosa seguidos, geralmente, pela ulceração e descamação. Objetivo: avaliar os fatores relacionados ao surgimento e gradação da mucosite em pacientes submetidos à radioterapia na região de cabeça e pescoço. Métodos: foi realizado um estudo transversal, com amostra composta por 22 pacientes com diagnóstico de câncer de cabeça e pescoço, submetido a tratamento de radioterapia. Os pacientes foram avaliados durante 4 semanas para se observar o surgimento e gradação da mucosite durante o tratamento antineoplásico os fatores como idade, consumo de álcool e tabaco, comorbidades como diabetes, hipertensão, cardiopatias, assim como níveis de higiene oral. Resultados: de acordo com os resultados do Coeficiente ñ de Sperman, U Mann-Whitney e Kruskal-Wallis a mucosite oral se desenvolveu em 95,45 porcento dos pacientes submetidos à radioterapia de cabeça e pescoço, com maior gradação entre os fumantes quando comparados com os não fumantes, com diferença estatisticamente significativa (p = 0.034). Conclusão: estes resultados sugerem que não há associação entre idade, consumo de álcool, comorbidades como diabetes, hipertensão, cardiopatias e nível de higiene oral com o surgimento e gradação da mucosite. Já os pacientes tabagistas apresentam graus mais elevados de mucosite oral radioinduzida no momento do surgimento(AU)

Introducción: la mucositis oral es una de las complicaciones agudas más comunes que resulta de la terapia antineoplásica de cabeza y cuello. Se caracteriza por eritema y edema de la mucosa, seguidos comúnmente por ulceración y descamación. Objetivo: evaluar los factores relacionados con la aparición y la clasificación de la mucositis oral en pacientes sometidos a radioterapia de cabeza y cuello. Métodos: se realizó un estudio longitudinal incluyendo 22 pacientes con diagnóstico de cáncer en la cabeza y cuello sometidos a radioterapia. Los pacientes fueron evaluados por 4 semanas y se controló la aparición y la clasificación de la mucositis oral durante el tratamiento antineoplásico. Resultados: de acuerdo con las pruebas del coeficiente ñ de Spearman, U de Mann-Whitney y Kruskal Wallis, la mucositis oral estuvo presente en el 95,45 por ciento de los pacientes que se sometieron a radioterapia de cabeza y cuello, pero el grado de mucositis oral fue mayor entre los fumadores, en comparación con aquellos que no eran fumadores, con diferencia estadísticamente significativa (p = 0,034). Conclusión: los resultados sugieren que no hubo asociación entre la edad, el consumo de alcohol, comorbilidades y nivel de higiene oral con la aparición y la clasificación de la mucositis. Los fumadores tuvieron niveles más altos de mucositis oral radio-inducida en el momento de su aparición(AU)

Introduction: oral mucositis is considered the most common acute complication resulting from head and neck antineoplastic therapy. It is characterized by erythema and mucosa edema, commonly followed by ulceration and peeling. Objective: this study aimed to assess the factors related to the onset and grading of oral mucositis in patients undergoing radiotherapy for head and neck cancer. Methods: a longitudinal study was conducted, comprising 22 patients with a diagnosis of head and neck malignancy undergoing radiotherapy. These patients were evaluated during 4 weeks and they were checked for the onset and grading of oral mucositis during antineoplastic treatment. Results: according to coefficient ñ tests by Spearman, U Mann-Whitney and Kruskal-Wallis, oral mucositis developed in 95.45 percent of patients who underwent head and neck radiotherapy, with higher grading among smokers compared with those of non-smokers, with statistically significant difference (p = 0.034). Conclusion: these results suggest that there was no association between age, alcohol consumption and patients' oral hygiene with the onset and grading of mucositis. Smokers were found to show higher grading of radiation-induced oral mucositis on its onset(AU)

[Perceptions of the multi-professional team on the implementation of palliative care in intensive care units]. / Concepções da equipe multiprofissional sobre a implementação dos cuidados paliativos na unidade de terapia intensiva.

The scope of this paper was to analyze the perceptions of the multi-professional team on the implementation of palliative care in an adult intensive care unit. An exploratory-descriptive study using a qualitative approach was conducted with 14 health professionals from a public teaching hospital. The information was collected between February and April 2012, by means of semi-structured interviews and non-participatory observation interpreted using content analysis. Three thematic categories were identified: Care for terminal patients in an ICU fostering physical comfort; Lack of preparation of the team in dealing with terminal patients; and Challenges of palliative care practices in the intensive care environment. The interviewed parties reported having some knowledge of the proposal for palliative care though divergences were observed in the therapeutic conduct of the team in the care provided, demonstrating a lack of interaction and communication among the professionals. The drafting of a national policy to promote care for terminally ill patients is necessary, as well as ongoing training of professionals and the creation of care protocols for promoting the comfort of the patients and their families during the end of life phase.