Dietary glycemic and energy load differentially modulates Schistosoma mansoni-induced granulomatous inflammation and response to antiparasitic chemotherapy.

The impact of diet composition and energy content on schistosomiasis evolution and treatment efficacy is still controversial. This study compared the impact of sucrose-rich diet and intermittent fasting on Schistosoma mansoni infection and praziquantel (PZQ)-based chemotherapy response in mice. BALB/c mice were infected with S. mansoni and followed for 15 weeks. The animals were randomized into nine groups receiving high glycemic load (high-sucrose diet - HSD), low caloric load (standard chow alternate-day fasting - ADF), and standard chow ad libitum (AL). Eight weeks after S. mansoni infection, these groups remained untreated or were treated with PZQ (300 mg/kg/day) for 3 days. Our results indicated that parasite load (S. mansoni eggs and parasite DNA levels), granulomatous inflammation (granulomas number and size), and liver microstructural damage (reduction in hepatocytes number, increase in nucleus-cytoplasm ratio, connective stroma expansion and fibrosis) were increased in ADF-treated animals. These animals also showed decreased eggs retention, granulomatous inflammation and collagen accumulation in the small intestine. Conversely, HSD diet and PZQ treatment attenuated all these parameters and stimulated hepatic regenerative response. PZQ also stimulated fibrosis resolution in HSD-treated mice, effect that was limited ADF-exposed mice. Our findings indicate that dietary glycemic and energy load can modulate schistosomiasis progression and the severity of hepatic and intestinal granulomatous inflammation in untreated and PZQ-treated mice. Thus, lower intestinal eggs retention may potentially be linked to worsening liver disease in ADF, while attenuation of hepatic and intestinal granulomatous inflammation is consistent with reduced parasite load in HSD- and PZQ-treated animals.

Alternate-day fasting, a high-sucrose/caloric diet and praziquantel treatment influence biochemical and behavioral parameters during Schistosoma mansoni infection in male BALB/c mice.

Schistosoma mansoni-induced granulomas result in severe damage to the host's liver, as well as neurological and metabolic disorders. We evaluated the biochemical and behavioral changes during schistosomiasis under three diet protocols: ad libitum (AL), alternate-day fasting (ADF) and a high-sucrose/caloric diet (HSD). Healthy male BALB/c mice were divided into noninfected, matched infected and infected/treated [praziquantel (PZQ)] groups. Caloric intake and energy efficiency coefficients associated with diets were measured. Behavioral (exploratory and locomotor) and biochemical (glucose, triglycerides, total cholesterol, AST, ALT, ALP, and γ-GT) tests and histological analysis were performed. Fifteen weeks postinfection, HSD and PZQ promoted weight gain, with higher caloric consumption than ADF (p < 0.05), reflecting serum glucose levels and lipid profiles. HSD and PZQ prevented liver dysfunction (AST and ALT) and significantly prevented increases in granuloma area (p < 0.05). HSD and PZQ also significantly improved mouse physical performance in exploratory and locomotor behavior (p < 0.05), reversing the impaired motivation caused by infection. These findings showed that ADF worsened the course of S. mansoni infection, while HSD and PZQ, even with synergistic effects, prevented and/or attenuated biochemical and behavioral impairment from infection.

Efeito do resveratrol associado a sacarose em protocolo de vitrificação de tecido ovariano de vacas / Effect of resveratrol associated with sacarosis on ovarian tissue vitrification protocol in cows

The objective of this work was to evaluate the effect of the association of the antioxidant resveratrol with sucrose in a vitrification protocol of ovarian tissue in cows, on the morphology of preantral follicles. Ten ovaries of cows were used, collected in local slaughterhouses, fragmented and distributed to the following treatments: fresh control (Co); toxicity (T); (T0) zero toxicity/ only with base vitrification solution (SBV), (TS) toxicity with SBV plus sucrose, (TR) toxicity with SBV plus resveratrol, (TS+R) toxicity with SBV and sucrose plus resveratrol; and for glazing (V); (VS) vitrification with SBV and sucrose, (VR) vitrification with SBV and resveratrol, (VS+R) vitrification with SBV and sucrose plus resveratrol. Preantral follicles were quantified and classified according to morphology into normal and degenerated. The mean percentages between normal and degenerated follicles did not differ (p>0.05) in the following percentages, normal 51.4% and degenerated 48.60%. In the toxicity test there was a difference (p0.05), demonstrating that the vitrification technique is efficient, but the concentration of cryoprotectants used needs to be re-evaluated. Concluding that the natural antioxidant association resveratrol to sucrose in vitrification and rewarming protocols contributes with reservations for the morphological preservation of preantral follicles in cows.

Uso de apósitos con TLC-NOSF en el manejo de la úlcera de pie diabético, basado en la revisión de la evidencia y la práctica clínica.

Management of diabetic foot ulcers with a TLC-NOSF dressing, based on evidence and clinical practice The incidence of diabetic foot ulcers (DFU) has increased in the past decade, both in Chile and worldwide, as a result of the progressive growth in diabetes prevalence. Because DFU are associated with a high risk of infection and amputation, it is crucial to choose effective and evidence-based treatments. A dressing combining technology lipidocolloid with nano-oligo saccharide factor (TLC-NOSF) has demonstrated its effectiveness in managing DFU. This article reviews the evidence around TLC-NOSF and its implementation in clinical practice.

CONFLICTO DE INTERÉS: FSS recibió pagos personales de Laboratorios UrgoMedical por ponencias y actividades. RCG es empleada de Laboratorios UrgoMedical. APP declara no tener conflicto de interés.

Effectiveness of sucroferric oxyhydroxide in patients on on-line hemodiafiltration in real-world clinical practice: A retrospective study / Eficácia do oxihidróxido sucroférrico em pacientes em hemodiafiltração on-line na realidade da prática clínica: um estudo retrospectivo

Abstract Introduction: Hyperphosphatemia is a serious consequence of chronic kidney disease and has been associated with an increased risk for cardiovascular disease. Controlling serum phosphorus levels in patients on dialysis is a challenge for the clinicians and implies, in most cases, the use of phosphate binders (PB). Part of the reason for this challenge is poor adherence to treatment because of the high pill burden in this patient group. Objective: To assess the real-world effectiveness of sucroferric oxyhydroxide (SO) in controlling serum phosphorus levels and determine the associated pill burden. Methods: A multicenter, quantitative, retrospective, before-after study was conducted with patients receiving online hemodiafiltration. Patients who switched to SO as a part of routine care were included in the study. PB treatment, number of pills, serum phosphorus levels, and intravenous iron medication and dosage were collected monthly during the six months of treatment with either PB or SO. Results: A total of 42 patients were included in the study. After switching from a PB to SO, the prescribed pills/day was reduced 67% from 6 pills/day to 2 pills/day (p < 0.001) and the frequency of pill intake was lowered from 3 times/day to 2 times/day (p < 0.001). During the treatment with SO, the proportion of patients with serum phosphorus ≤ 5.5 mg/dL increased from 33.3% at baseline to 45% after six months of treatment. Conclusion: During the six-month follow-up with SO, serum phosphorus levels were controlled with one third of the pills/day compared to other PB.

Resumo Introdução: A hiperfosfatemia é uma grave consequência da doença renal crônica associada a risco aumentado de doença cardiovascular. O controle dos níveis séricos de fósforo dos pacientes em diálise é um desafio que requer, na maioria dos casos, o uso de quelantes de fosfato (QF). Parte da dificuldade se deve à baixa adesão ao tratamento oriunda do grande número de medicamentos receitados para esse grupo de pacientes. Objetivo: Avaliar a real eficácia do oxihidróxido sucroférrico (OHS) no controle dos níveis séricos de fósforo e determinar a carga de comprimidos associada. Métodos: Estudo multicêntrico, quantitativo, retrospectivo, antes e depois conduzido com pacientes em hemodiafiltração on-line. Pacientes remanejados para OHS como parte dos cuidados de rotina foram incluídos no estudo. Tratamento com QF, número de comprimidos, níveis séricos de fósforo, reposição férrica endovenosa e dosagens foram registrados mensalmente durante seis meses de tratamento com QF ou OHS. Resultados: Foram incluídos 42 pacientes no estudo. Após a mudança de QF para OHS, o número de comprimidos prescritos por dia caiu em 67%, de seis para duas unidades diárias (p < 0,001). A frequência de ingestão de comprimidos caiu de três para duas vezes ao dia (p < 0,001). Durante o tratamento com OHS, o percentual de pacientes com fósforo sérico ≤ 5,5 mg/dL aumentou de 33,3% no início para 45% após seis meses de tratamento. Conclusão: Durante os seis meses de seguimento com OHS, os níveis séricos de fósforo foram controlados com um terço dos comprimidos por dia em relação aos tratamentos com outros QF.

Effectiveness of sucroferric oxyhydroxide in patients on on-line hemodiafiltration in real-world clinical practice: A retrospective study.

INTRODUCTION: Hyperphosphatemia is a serious consequence of chronic kidney disease and has been associated with an increased risk for cardiovascular disease. Controlling serum phosphorus levels in patients on dialysis is a challenge for the clinicians and implies, in most cases, the use of phosphate binders (PB). Part of the reason for this challenge is poor adherence to treatment because of the high pill burden in this patient group. OBJECTIVE: To assess the real-world effectiveness of sucroferric oxyhydroxide (SO) in controlling serum phosphorus levels and determine the associated pill burden. METHODS: A multicenter, quantitative, retrospective, before-after study was conducted with patients receiving online hemodiafiltration. Patients who switched to SO as a part of routine care were included in the study. PB treatment, number of pills, serum phosphorus levels, and intravenous iron medication and dosage were collected monthly during the six months of treatment with either PB or SO. RESULTS: A total of 42 patients were included in the study. After switching from a PB to SO, the prescribed pills/day was reduced 67% from 6 pills/day to 2 pills/day (p < 0.001) and the frequency of pill intake was lowered from 3 times/day to 2 times/day (p < 0.001). During the treatment with SO, the proportion of patients with serum phosphorus ≤ 5.5 mg/dL increased from 33.3% at baseline to 45% after six months of treatment. CONCLUSION: During the six-month follow-up with SO, serum phosphorus levels were controlled with one third of the pills/day compared to other PB.

Critical vitrification steps towards survival of Garcinia hombroniana (Clusiaceae) shoot tips after cryopreservation / Etapas críticas de vitrificación para la supervivencia de ápices caulinares de Garcinia hombroniana (Clusiaceae) después de crioconservación

Abstract A cryopreservation protocol was developed for in vitro shoot tips of Garcinia hombroniana using the vitrification technique. Four critical steps in the technique were investigated, namely preculture, loading, dehydration with Plant Vitrification Solution 2 (PVS2), and unloading. Shoot tips precultured for 48 h gave significantly higher survival (75 %) compared to 24 h preculture (50 %) after cryopreservation. Treatment with 1 M glycerol plus 0.4 M sucrose as a loading solution gave higher survival (45.83 %) compared to the other treatments (0.4 M sucrose + 2 M glycerol; 0.4 M sucrose). Shoot tips dehydrated with PVS2 for 25 min gave the highest survival after immersion in liquid nitrogen. Stepwise PVS2 treatment for 15 min with 50 % PVS2 followed by 10 min with 100 % PVS2 solution improved survival of the shoot tips after cryopreservation (41.67 %). Murashige and Skoog medium with 0.4 M sucrose gave significantly higher survival (66.67 %) than MS with 1.2 M sucrose (25 %) as an unloading solution. Water content was shown to decrease throughout the whole vitrification steps from 6.83 ± 1.66 g g-1 dw for fresh shoot tips down to 2.93 ± 0.28 g g-1 dw after PVS2 treatment. Further study on each step including recovery medium is required to improve the survival. Nevertheless, the present study showed the potential of using the vitrification technique for cryopreservation of G. hombroniana. Rev. Biol. Trop. 66(3): 1314-1323. Epub 2018 September 01.

Resumen Se desarrolló un protocolo de crioconservación in vitro para ápices caulinares de Garcinia hombroniana mediante la técnica de vitrificación, con cuatro etapas críticas: precultivo, carga de crioprotector, deshidratación con solución de vitrificación vegetal 2 (PVS2), y descarga. Ápices precultivados por 48 h sobrevivieron más (75 %) que los de 24 h (50 %) después de la crioconservación. El tratamiento con glicerol 1 M más sacarosa 0.4 M como solución de carga permitió mayor sobrevivencia (45.83 %) que los otros tratamientos (sacarosa 0.4 M + glicerol 2 M; sacarosa 0.4 M). Los ápices deshidratados con PVS2 por 25 min registraron la mayor sobrevivencia tras inmersión en nitrógeno líquido. El tratamiento gradual por 15 min con solución de PVS2 al 50 %, seguido por 10 min al 100 %, mejoró la sobrevivencia de ápices tras la crioconservación (41.67 %). El medio Murashige-Skoog (MS) con sacarosa 0.4 M produjo una sobrevivencia significativamente mayor (66.67 %) que MS con sacarosa 1.2 M (25 %) como solución de descarga. El contenido de agua disminuyó a lo largo del proceso de vitrificación desde 6.83 ± 1.66 g g-1 peso seco, en ápices frescos, hasta 2.93 ± 0.28 g g-1 peso seco después del tratamiento con PVS2. Se requiere de más investigación sobre cada etapa, incluyendo el medio de recuperación, para mejorar la tasa de sobrevivencia. Sin embargo, este estudio muestra el potencial de la vitrificación para la crioconservación de G. hombroniana.

Noncaloric Sweeteners in Children: A Controversial Theme.

Noncaloric sweeteners (NCS) are food additives used to provide sweetness without adding calories. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to show the state of the art about the intake of noncaloric sweeteners in children, as well as their benefits and consumption risk. Scientific searchers were used (PUBMED, Scopus, and Scielo) to analyze articles that included keywords (noncaloric sweeteners/saccharin/cyclamate/acesulfame potassium/aspartame/sucralose/stevia/children) in English, Spanish, and Portuguese. Authors conclude that it is imperative that health professionals judiciously and individually evaluate the overall benefits and risks of NCS use in consumers before recommending their use. Different subgroups of the population incorporate products containing NCS in their diet with different objectives, which should be considered when recommending a diet plan for the consumer. In childhood, in earlier age groups, this type of additives should be used as a dietary alternative when other forms of prevention in obesity are not sufficient.

Uso da sacarose para o alívio da dor: repercussão na amamentação materna durante a internação do recém-nascido a termo / Use of sucrose for pain relief: consequences on breastfeeding of fullterm newborns during hospitalization

Introdução: Durante o período de internação, o recém-nascido (RN) é submetido a uma série de procedimentos dolorosos ou não, que podem incidir sobre o seu comportamento e sobre a confiança da mãe para o cuidado e para a amamentação materna. Temos como questionamento, se sacarose 25% que é oferecida como medida de alivio da dor em RN a termo internado em alojamento conjunto interfere negativamente na amamentação materna exclusiva durante a internação. Objetivo: Verificar a associação entre uso da sacarose 25% que é oferecida como medida de alívio dor aguda em RN a termo, e a amamentação materna durante a internação em alojamento conjunto. Métodos: Trata-se de um estudo observacional, transversal, descritivo e analítico. A amostra foi constituída por 215 binômios cujo nascimento e internação ocorreram entre os meses de Junho a Setembro de 2017 em uma maternidade do interior paulista intitulada "Amiga da Criança". Os binômios foram incluídos no estudo somente após autorização da mãe, com assinatura de um termo de consentimento livre e esclarecido. Os dados foram coletados por meio do prontuário e planilhas especificas. Os RN foram divididos em dois grupos: RN expostos e não expostos ao uso da sacarose durante a internação. Como houve diferença estatística entre os grupos para o tempo de internação, para analisar a influência do uso da sacarose na amamentação durante toda internação, foi feita uma relativização das variáveis de aleitamento materno pelo total de dias de internação do RN. As associações foram verificadas pelo teste "U" de Mann-Whitney, com valor de p significativo para ? <= 0,05. Resultado: Dos 215 RN estudados durante toda internação, 111 (51,6%) RN foram expostos ao uso da sacarose. Foi utilizado sacarose para 188 (60,1%) dos procedimentos dolorosos, sendo que a mesma foi usada associada a outros métodos como o colo em 18 (5,7%) e sucção não nutritiva 64 (20,4%) dos procedimentos. Somando-se o uso isolado ou em associação a outras medidas, a sacarose foi utilizada 270 (86,2%) vezes sendo a medida mais aplicada na prática clínica da maternidade. No grupo que utilizou sacarose as médias de frequência de mamadas, uso de copo, translactação, tempo médio por mamada e amamentação assistida foram respectivamente: 7,9, 0,2, 0,5, 11,4 e 1,0 . No grupo que não utilizou a sacarose, respectivamente, as a médias das mesmas variáveis foram de 8,7, 0,03, 0,06, 18,6 e 0,8. Houve diferença estatisticamente significativa entre os grupos para as variáveis de alimentação: frequência de mamada (p=0,03), utilização de copo (p=0,01), realização de translactação (p=0,00), tempo médio por mamada (p=0,00) e amamentação assistida (p=0,02). Conclusão: As associações dos dados encontrados comprovaram a hipótese do presente estudo, ou seja o uso da sacarose a 25% para alívio da dor aguda influenciou negativamente na amamentação materna do RN durante a internação, pois, o grupo de RN que recebeu esta substância adocicada durante os procedimentos de punção arterial, venosa e capilar, apresentou menor frequência de mamada, menor tempo médio por mamada, maior uso de complemento lácteo, mais necessidade de translactação e necessitou de mais amamentação assistida por um profissional de enfermagem, quando comparado ao grupo de RN não expostos a ela. Faz-se necessária a inclusão de medidas não farmacológicas com a participação da mãe em substituição à sacarose, uma vez que tratou-se de pesquisa em uma Maternidade Amiga da Criança

Introduction: During the period of hospitalization, full-term newborns (NB) undergo a series of painful procedures, which may affect his behavior and the mother's confidence in both taking care of and breastfeeding the baby. We question whether 25% sucrose, which is offered as a measure of pain relief in hospitalized NB infants, negatively interferes with exclusive mother's breastfeeding during hospitalization in rooming-in care. Aim: Verify the association between the use of 25% sucrose offered as pain relief in full-term newborns and exclusive mother's breastfeeding during hospitalization in shared rooms. Methods: This is a study based on observation, and it is transversal, descriptive and analytical study. The sample consisted of 215 binomials whose birth and hospitalization occurred between June and September of 2017 in a maternity hospital in the countryside of São Paulo, in a Child-Friendly Maternity. The binomials were included in the study only after authorization obtained from the mother, with the signing of a free and previously informed consent form. The data were collected through medical records and specific worksheets. The NB were divided into two groups: NB exposed and not exposed to the use of sucrose during hospitalization, respectively. There was a statistical difference between the groups due to the hospitalization period; thus, to analyze the influence of sucrose use on breastfeeding during all hospitalization, a relative analysis of the variables of breastfeeding by the total number of days of hospitalization of the newborn was made. Associations were verified by the Mann-Whitney "U" test, with a significant p value for ? <= 0.05. Results: From 215 NBs studied during all hospitalization, 111 (51.6%) were exposed to the use of sucrose. Sucrose was applied for 188 (60.1%) of the painful procedures, and it was used in association with other methods such as lap in 18 (5.7%) and non-nutritive suction in 64 (20.4%) of the procedures. Added the isolate use or in association with other measures, sucrose was used 270 (86.2%) times, being the most applied measure in clinical practice of maternity. In the sucrose group, the average of frequency of feeding, cupping, translactation, average time per feeding and assisted breastfeeding were respectively: 7.9, 0.2, 0.5, 11.4 and 1.0. In the nonsucrose group, the average of the same variables were 8.7, 0.03, 0.06, 18.6 and 0.8, respectively. There was a statistically significant difference between the groups for feeding variables: feeding frequency (p = 0.03), cup use (p = 0.01), translactation (p = 0.00), average time per feed (p = 0.00) and assisted breastfeeding (p = 0.02). Conclusion: The associations of the data confirmed the hypothesis of the present study, that is, the use of sucrose at 25% for acute pain relief influenced negatively the maternal breastfeeding of newborns during hospitalization, since the group of newborns who received this sugary substance during the venous and capillary puncture procedures, presented lower breastfeeding frequency, lower average time for breastfeeding, greater use of milky complement, higher need for translactation and required more breastfeeding assisted by a nursing professional, when compared to the NB group who was not exposed to it. It is necessary to include non-pharmacological measures with the participation of the mother instead of sucrose, since it was a research in a Child-Friendly Maternity

Sacarosoterapia en heridas infectadas / Sugar therapy for infected wounds

Introducción: existen medicamentos que favorecen la cicatrización, pero tienen un impacto económico alto. La sacarosa, debido a sus propiedades fisicoquímicas, se considera bactericida, bacteriostática y estimulante de la cicatrización. Objetivo: evaluar las acciones de la sacarosa sobre las heridas infectadas.Métodos: estudio prospectivo, longitudinal y analítico en ratas Wistar con lesiones de piel infectadas que se trataron con sacarosa, suero fisiológico, yodo povidona, facdermín y nitrofurazona. Mediante estudio comparativo de los resultados, se evaluó la efectividad del tratamiento en las lesiones infectadas. Resultados: la sacarosa resultó efectiva para curar la infección de las heridas y estimular la cicatrización en ratas, específicamente sobre las lesiones contaminadas con Estafilococo dorado. En el grupo de estudio, el tejido de granulación se observó precozmente, lo que permitió la epitelización completa de las heridas con 6 días de antelación con respecto a los demás grupos. Conclusiones: se demuestra un mayor efecto cicatrizante de la sacarosa al epitelizar por completo el área de las heridas, más rápido que en los otros grupos, y se comprueba su actividad antimicrobiana más intensa sobre el Staphilococcus aureus(AU)

Introduction: there are drugs that stimulate wound healing, but their cost is high. Due to its physico-chemical properties, saccharose is considered to have bactericidal and bacteriostatic properties and stimulate wound healing. Objective: evaluate the action of saccharose on infected wounds. Methods: analytical prospective longitudinal study of Wistar rats with infected skin lesions treated with saccharose, saline solution, povidone-iodine, facdermin and nitrofurazone. Effectiveness of the treatment of infected lesions was evaluated through a comparative study of results. Results: saccharose was effective in rats to cure wound infection and stimulate healing, especially of lesions contaminated with Staphylococcus aureus. Granulation tissue was observed early in the study group, and complete epithelization of the wounds occurred six days before the other groups. Conclusions: it was shown that saccharose has a greater healing effect, since the wound area was completely epithelized sooner than in the other groups, and its antimicrobial action against Staphylococcus aureus was found to be more intense(AU)

[Human milk for neonatal pain relief during ophthalmoscopy]. / O leite humano no alívio da dor neonatal no exame de fundo de olho.

Ophthalmoscopy performed for the early diagnosis of retinopathy of prematurity (ROP) is painful for preterm infants, thus necessitating interventions for minimizing pain. The present study aimed to establish the effectiveness of human milk, compared with sucrose, for pain relief in premature infants subjected to ophthalmoscopy for the early diagnosis of ROP. This investigation was a pilot, quasi-experimental study conducted with 14 premature infants admitted to the neonatal intensive care unit (NICU) of a university hospital. Comparison between the groups did not yield a statistically significant difference relative to the crying time, salivary cortisol, or heart rate (HR). Human milk appears to be as effective as sucrose in relieving acute pain associated with ophthalmoscopy. The study's limitations included its small sample size and lack of randomization. Experimental investigations with greater sample power should be performed to reinforce the evidence found in the present study.

Importancia de la sacarosa para la cicatrización de heridas infectadas / Importance of sucrose for healing infected wounds

Introducción: la sacarosa es un producto natural que por sus propiedades se considera bacteriostática, bactericida y estimulante de la cicatrización. En el mercado mundial la venta de medicamentos y otros productos está dominada por los monopolios, por lo que se hace necesario evaluar un producto barato, capaz de disminuir importaciones y que se pueda generalizar su empleo. Objetivos: evaluar la magnitud de la epitelización total de las heridas e identificar las acciones de la sacarosa sobre los grados de maduración de la dermis. Métodos: se realizó un estudio clinicoterapéutico aleatorizado, controlado y no enmascarado en ratas Wistar con lesiones de piel provocadas e infectadas, que permitiera evaluar, desde el punto de vista histológico, los resultados del tratamiento con sacarosa de las heridas infectadas. Resultados: la sacarosa resultó efectiva para curar la infección de las heridas y estimular la cicatrización. Se produjo la completa epitelización de las heridas con seis días de antelación, con respecto a los grupos controles. Con la sacarosa se logró una mejor calidad en la cicatrización al alcanzar un mayor número de heridas el grado III de maduración de la dermis.Conclusiones: se demostró un mejor efecto cicatrizante del azúcar. Se comprobó su actividad antimicrobiana por la capacidad de limpiar las heridas y eliminar el tejido necrótico de estas. Se logró un mayor grado de maduración de la dermis en los animales tratados con azúcar, lo que evidencia una mayor calidad en la cicatrización en las heridas tratadas con azúcar(AU)

Introduction: sucrose is a natural product that is considered for its bacteriostatic, bactericidal and stimulating healing characteristics. On the world market the sale of drugs and other products is dominated by monopolies, so it is necessary to evaluate an inexpensive alternative, which is able to reduce imports and which can be generally used. Objectives: to assess the extent of total wound epithelialization and to identify sucrose actions on the dermis maturation degrees. Methods: a clinical therapeutic randomized, controlled, unblinded study was performed in Wistar rats with induced infected skin lesions and, to assess the histological results of sucrose treatment of infected wounds. Results: sucrose was effective in curing the infection in wounds and in promoting healing. There was complete wound epithelization six days in advance, in comparison with the control groups. better healing quality was achieved to reach with sucrose since a greater number of injuries reached grade III of dermis maturing. Conclusions: better healing effect of sugar was demonstrated, as well as its antimicrobial activity due to its ability to clean wounds and to remove necrotic tissue. Higher degree of dermis maturation was achieved in those animals treated with sugar, which shows higher quality of healing in wounds treated with sugar(AU)

Sacarose em feridas infectadas: fundamentação científica e especulações / Sucrose in infected wounds: a scientific basis and speculations

O uso de sacarose na terapêutica de feridas é uma prática comum que parece favorecer a cicatrização tissular e reduzir a carga microbiana. Objetivou-se, desta forma analisar as evidências científicas por meio da revisão integrativa a fim de determinar a indicação e contraindicação do uso da sacarose (nas apresentações de açúcar cristal, mascavo e/ou refinado) em feridas infectadas e assim auxiliar o profissional na tomada de decisão clínica. Selecionaram-se 10 estudos publicados na íntegra, no período de 2002 a 2012 e indexados no PubMed, Cinahl, Lilacs e Cochrane. Considerando a análise dos estudos, em sua maioria experimentais no modelo animal, verificou-se a efetividade do açúcar na reparação tecidual e modulagem positiva na resposta inflamatória. Com vistas a elucidar os mecanismos ou ação da sacarose na ferida, recomendam-se ensaios clínicos adicionais para padronizar a concentração, volume e periodicidade da sacarose nas trocas de coberturas.

Emprego de soluções adocicadas no alívio da dor neonatal em recém-nascido prematuro: uma revisão integrativa / Use of sweet solutions for neonatal pain relief in premature newborns: an integrative review / Empleo de soluciones edulcoradas en el manejo del dolor neonatal en recién nacido prematuro: una revisión integrativa

As experiências dolorosas repetida em recém-nascidos podem ter efeito a curto e a longo prazo, especialmente nos prematuros. Como uma medida de alívio da dor, tem sido recomendado o uso de soluções adocicadas em procedimentos dolorosos. Este estudo objetiva avaliar as evidências do efeito da sacarose e da glicose oral no alívio da dor aguda em recém-nascidos prematuros. Realizou-se uma revisão integrativa, nas bases de dados MEDLINE e LILACS, no período de 2005 a 2010, foram selecionados oito artigos. A análise destes revelou o efeito analgésico da glicose e da sacarose em procedimentos agudos. Nenhum efeito colateral foi encontrado nos recém-nascidos que receberam a glicose/sacarose. Ressalta-se a importância do uso da escala de avaliação da dor que mais se identifique com a população predominante nas unidades neonatais, que seja de fácil aplicação e manuseio pelos profissionais de saúde.

The repeated painful experiences in newborns may have short- and long-time effects, especially in premature infants. The use of sweetened solutions during painful procedures has been recommended as a measure of pain relief. This study aims to evaluate the evidence of the effect of oral sucrose or glucose for acute pain relief in premature infants. An integrative review was conducted in the MEDLINE and LILACS databases. Eight articles were selected from 2005 to 2010. The analyzis of these articles revealed the analgesic effect of glucose and sucrose in acute procedures. No significant side effects were found in infants who received glucose/sucrose. We emphasize the importance of the use of the pain assessment scale most closely related to the predominant population in the Neonatal Intensive Care Unit, a scale easy to be used and handled by health professionals.

Repetidas experiencias dolorosas en los recién nacidos pueden tener un efecto en el corto y largo plazo, especialmente en recién nacidos prematuros. Como una medida de aliviar el dolor, se ha recomendado el uso de soluciones azucaradas durante los procedimientos dolorosos. Así, este estudio tiene como objetivo evaluar la evidencia del efecto de la sacarosa o glucosa oral en el alivio del dolor agudo en niños recién nacidos prematuros. Se realizó una revisión integrativa en las bases de datos: MEDLINE y LILACS en el período 2005 a 2010, habiendo sido seleccionados ocho artículos. El análisis reveló el efecto analgésico de la glucosa y la sacarosa en los procedimientos agudos. No se encontró ningún efecto colateral significativo en los recién nacidos que recibieron la glucosa/sacarosa. Se resalta la importancia del uso de la escala de evaluación del dolor que más se identifique con la población predominante en la Unidad de Cuidados Intensivos Neonatales y que sea de fácil aplicación y manipulación para los profesionales de la salud.

[Use of sweet solutions for neonatal pain relief in premature newborns: an integrative review]. / Emprego de soluções adocicadas no alívio da dor neonatal em recém-nascido prematuro: uma revisão integrativa.

The repeated painful experiences in newborns may have short- and long-time effects, especially in premature infants. The use of sweetened solutions during painful procedures has been recommended as a measure of pain relief. This study aims to evaluate the evidence of the effect of oral sucrose or glucose for acute pain relief in premature infants. An integrative review was conducted in the MEDLINE and LILACS databases. Eight articles were selected from 2005 to 2010. The analyzis of these articles revealed the analgesic effect of glucose and sucrose in acute procedures. No significant side effects were found in infants who received glucose/sucrose. We emphasize the importance of the use of the pain assessment scale most closely related to the predominant population in the Neonatal Intensive Care Unit, a scale easy to be used and handled by health professionals.

[The use of sucrose for the prevention of pain during venipuncture in neonates]. / Efectividad del uso de la sucrosa en la prevención del dolor durante la punción venosa en neonatos.

OBJECTIVE: To evaluate the effectiveness of sucrose use in the prevention of pain during venipuncture in neonates. METHOD: Double blind randomized control trial. The population consisted of hospitalized neonates subjected to venipuncture. Sample size was calculated with a 95% confidence level, 80% power, minimum proportion of neonates with pain 40% in the study group and 70% in the control group. The minimum sample size was 49 newborns per group. Five minutes before venipuncture, the neonates received 1cc of oral solution of 12% sucrose (study group) or distilled water (control group). During the procedure the pain level was evaluated with NIPS (Neonatal Infant Pain Scale). A data base was created, and the information processed and analysed using the SPSS program. RESULTS: A total of 111 neonates were analysed, (55 in study group and 56 in control group). Bivariate analysis showed a smaller NIPS score in the group that received sucrose. Linear regression model explained that the significant variables for pain during the procedure were: hours since birth and the absence of non-nutritious suction, not being related to the sucrose administration. CONCLUSION: Neonates that received the oral solution of sucrose before venipuncture had an average pain score lower than the placebo controlled group.

Éster de sacarose no controle do Varroa destructor em abelhas africanizadas / Sucrose ester in the control of Varroa destructor in Africanized honeybees

O presente trabalho teve como objetivo verificar o efeito do éster de sacarose no controle da infestação do ácaro Varroa destructor em abelhas africanizadas. Nos testes “in vitro”, testou-se o produto em abelhas e ácaros com cinco concentrações diluídas em água (T0: 100% de água destilada; T1: 0,5%; T2: 1%; T3: 2,0%; T4: 5% e T5: 10% de éster de sacarose). Nos testes de campo, o delineamento experimental utilizado foi inteiramente casualizado, com quatro tratamentos e sete repetições, totalizando 28 colônias, sendo sete delas como controle, sete com 0,1% de éster de sacarose, sete com 0,2% de éster de sacarose e sete colmeias com 0,5% éster de sacarose, diluídas em água. Nos testes “in vitro” com concentração de 0,5%, o éster de sacarose promoveu a mortalidade dos ácaros e das abelhas. Os testes em campo demonstraram que o produto reduziu a infestação do Varroa destructor em abelhas na concentração de 0,2% e pode ser uma ferramenta no controle dessa praga. Nas concentrações de 0,1; 0,2 e 0,5%, não prejudicou o desenvolvimento de área de cria aberta, operculada e de alimento estocado na colmeia, sugerindo que não é tóxico para as abelhas.

This study aimed to determine the effect of sucrose ester on the control of Varroa destructor mite infestation in Africanized honeybees. For the in vitro experiments, the product was tested in bees and mites at five concentrations obtained through dilution in water (T0: 100% distilled water; T1: 0.5%; T2: 1%; T3: 2%; T4: 5%; and T5: 10% sucrose ester). For the field studies, the experimental design was completely randomized, with four treatments and seven replicates, totaling 28 colonies, from which seven were the controls, seven were treated with 0.1% sucrose ester, seven with 0.2% sucrose ester, and seven hives with 0.5% sucrose ester diluted in water. In the in vitro study, the sucrose ester at 0.5% concentration caused mite and bee mortality. In the field tests, the product at 0.2% concentration reduced Varroa destructor infestation in Africanized honeybees and, therefore, may be used as a tool to control this pest. At 0.1, 0.2, and 0.5% concentrations, sucrose ester did not impair the establishment of open and capped brood areas, as well as stored food areas in the hive, suggesting it is not toxic to Africanized honeybees.

Éster de sacarose no controle do Varroa destructor em abelhas africanizadas / Sucrose ester in the control of Varroa destructor in Africanized honeybees

O presente trabalho teve como objetivo verificar o efeito do éster de sacarose no controle da infestação do ácaro Varroa destructor em abelhas africanizadas. Nos testes “in vitro”, testou-se o produto em abelhas e ácaros com cinco concentrações diluídas em água (T0: 100% de água destilada; T1: 0,5%; T2: 1%; T3: 2,0%; T4: 5% e T5: 10% de éster de sacarose). Nos testes de campo, o delineamento experimental utilizado foi inteiramente casualizado, com quatro tratamentos e sete repetições, totalizando 28 colônias, sendo sete delas como controle, sete com 0,1% de éster de sacarose, sete com 0,2% de éster de sacarose e sete colmeias com 0,5% éster de sacarose, diluídas em água. Nos testes “in vitro” com concentração de 0,5%, o éster de sacarose promoveu a mortalidade dos ácaros e das abelhas. Os testes em campo demonstraram que o produto reduziu a infestação do Varroa destructor em abelhas na concentração de 0,2% e pode ser uma ferramenta no controle dessa praga. Nas concentrações de 0,1; 0,2 e 0,5%, não prejudicou o desenvolvimento de área de cria aberta, operculada e de alimento estocado na colmeia, sugerindo que não é tóxico para as abelhas.(AU)

This study aimed to determine the effect of sucrose ester on the control of Varroa destructor mite infestation in Africanized honeybees. For the in vitro experiments, the product was tested in bees and mites at five concentrations obtained through dilution in water (T0: 100% distilled water; T1: 0.5%; T2: 1%; T3: 2%; T4: 5%; and T5: 10% sucrose ester). For the field studies, the experimental design was completely randomized, with four treatments and seven replicates, totaling 28 colonies, from which seven were the controls, seven were treated with 0.1% sucrose ester, seven with 0.2% sucrose ester, and seven hives with 0.5% sucrose ester diluted in water. In the in vitro study, the sucrose ester at 0.5% concentration caused mite and bee mortality. In the field tests, the product at 0.2% concentration reduced Varroa destructor infestation in Africanized honeybees and, therefore, may be used as a tool to control this pest. At 0.1, 0.2, and 0.5% concentrations, sucrose ester did not impair the establishment of open and capped brood areas, as well as stored food areas in the hive, suggesting it is not toxic to Africanized honeybees. (AU)

Sugar (sucrose) and fatty acid compounds with triglycerides on the treatment of wounds: experimental study in rats.

BACKGROUND: In the last 10 years, the use of essential fatty acids (EFA) compounds for the treatment of wounds has increased in Brazil, while there has been reducing indication for the use of sugar. OBJECTIVE: The aim of this study was to evaluate the response to saline, sugar and EFA on induced wounds in rats. METHODS: A wound of 400 mm(2) was produced on the back of each Wistar rat. The rats were divided into three groups, each being treated with either saline, sugar or EFA. All the animals received a closed dressing on the wounds, changed daily. Measures were taken in four moments, and the values of wound area reduction by healing, cellular inflammatory response, collagen ordering and types I and III collagen density were assessed. RESULTS: The wound healing was equal in all the three groups, but sugar promoted an inflammatory response modulation between the 7th and 14th days. On the 20th post-operative day, there were no differences between the three treated groups concerning types I and III collagen. CONCLUSIONS: The wounds healed in the three groups. The sugar group promoted effective cellular inflammatory response modulation. There were no differences between all the treated groups regarding types I and III collagen at the end of this study.

Açúcar (sacarose) e triglicerídeos de cadeia média com ácidos graxos essenciais no tratamento de feridas cutâneas: estudo experimental em ratos / Sugar (sucrose) and fatty acid compounds with triglycerides on the treatment of wounds: experimental study in rats

FUNDAMENTOS: Na última década, as indicações de uso tópico de compostos com ácidos graxos essenciais (AGE-TG) para o tratamento de feridas aumentaram no Brasil, e houve declínio das indicações do açúcar. OBJETIVOS: Estudar o efeito da aplicação de solução fisiológica de cloreto de sódio a 0,9 por cento, de açúcar e de AGE-TG sobre feridas experimentalmente induzidas em ratos. MÉTODOS: Foi induzida uma ferida de 400 mm2 no dorso de cada rato Wistar, constituindo três grupos tratados separadamente com solução fisiológica de cloreto de sódio a 0,9 por cento, açúcar e AGE-TG. Todos os animais receberam curativo oclusivo sobre a lesão, trocado a cada 24 horas. As aferições realizadas em quatro momentos consistiram na determinação do percentual de redução das áreas das feridas, da reação inflamatória celular, da ordenação do colágeno e da densidade de colágeno dos tipos I e III nas cicatrizes. RESULTADOS: A cicatrização ocorreu igualmente nos grupos estudados, mas o açúcar modulou positivamente a reação inflamatória entre o 7º e 14º dias. No 20º dia, não houve diferenças na quantidade de colágeno dos tipos I e III entre os grupos tratados. CONCLUSÕES: As feridas cicatrizaram nos três grupos. O grupo açúcar apresentou uma modulação positiva da resposta inflamatória celular. Não houve diferenças na quantidade de colágeno dos tipos I e III ao final do experimento nos grupos tratados.

BACKGROUND: In the last 10 years, the use of essential fatty acids (EFA) compounds for the treatment of wounds has increased in Brazil, while there has been reducing indication for the use of sugar. OBJECTIVE: The aim of this study was to evaluate the response to saline, sugar and EFA on induced wounds in rats. METHODS: A wound of 400 mm2 was produced on the back of each Wistar rat. The rats were divided into three groups, each being treated with either saline, sugar or EFA. All the animals received a closed dressing on the wounds, changed daily. Measures were taken in four moments, and the values of wound area reduction by healing, cellular inflammatory response, collagen ordering and types I and III collagen density were assessed. RESULTS: The wound healing was equal in all the three groups, but sugar promoted an inflammatory response modulation between the 7th and 14th days. On the 20th post-operative day, there were no differences between the three treated groups concerning types I and III collagen. CONCLUSIONS: The wounds healed in the three groups. The sugar group promoted effective cellular inflammatory response modulation. There were no differences between all the treated groups regarding types I and III collagen at the end of this study.