Biodegradable starch foams reinforced by food-chain side streams.

Biodegradable starch foam trays offer an eco-friendly substitute for petroleum-based single-use packaging, notably polystyrene foams. However, they lack flexibility, tensile strength, and water-sensitivity, addressable through lignocellulosic reinforcement. This study aimed to develop biodegradable starch foam trays filled with different food-chain side streams for sustainable alternative packaging. Corncob, soybean straw, cassava peel, araucaria seed hull, yerba mate stalks and yerba mate leaves petiole were collected, dried and ground to <250 µm. The trays were filled with 13 % (w/w) of each food-chain side streams and produced by hot molding. The trays morphology, moisture, water activity (aw), thickness, bulk density, tensile strength, elongation at break, Young's modulus, bending strength, maximum deflection, and sorption isotherms were investigated. Reinforcements slightly increased the foams bulk density, reduced the tensile strength and maximum deflection and while bending strength increased from 0.20 MPa to 1.17-1.80 MPa. The elasticity modulus decreased by adding any filling, that resulted in ductility improvement; however, these packaging have moisture-sensitive material especially for aw higher than 0.52, which drives the use recommendation for dry products storage or shipping/transport. The biodegradable starch foam trays filled with side streams were successfully produced and offer excellent alternative to petroleum-based packaging low-density material with bending strength improved.

Efficient Anthocyanin Recovery from Black Bean Hulls Using Eutectic Mixtures: A Sustainable Approach for Natural Dye Development.

There is a growing interest in exploring new natural sources of colorants. This study aimed to extract anthocyanins from broken black bean hulls (Phaseolus vulgaris L.) by modifying water with a eutectic mixture (choline chloride:citric acid (ChCl:Ca)). Ultrasound-assisted extraction (UAE) was employed and optimized in terms of temperature (30-70 °C), ultrasound power (150-450 W), and eutectic mixture concentration in water (1-9% (w/v)), resulting in an optimal condition of 66 °C, 420 W, and 8.2% (w/v), respectively. The main quantified anthocyanins were delphinidin-3-O-glycoside, petunidin-3-O-glycoside, and malvidin-3-O-glycoside. The half-life of the anthocyanins at 60 °C increased twelvefold in the eutectic mixture extract compared to the control, and when exposed to light, the half-life was 10 times longer, indicating greater resistance of anthocyanins in the extracted eutectic mixture. Additionally, the extracts were concentrated through centrifuge-assisted cryoconcentration, with the initial cycle almost double the extract value, making this result more favorable regarding green metrics. The first concentration cycle, which showed vibrant colors of anthocyanins, was selected to analyze the color change at different pH levels. In general, the technology that uses eutectic mixtures as water modifiers followed by cryoconcentration proved to be efficient for use as indicators in packaging, both in quantity and quality of anthocyanins.

Dietary Polyphenols: What is the Estimated Intake in Population Studies With Adults and Elderly People?

Estimates of dietary intake of polyphenols have been limited to specific samples from certain population groups, and different databases have been used to quantify the levels of these compounds, which makes it difficult to compare results. PURPOSE OF REVIEW: This review collated estimates of polyphenol intake from population studies including adults and elderly from different parts of the world by using a single database: Phenol-Explorer. RECENT FINDINGS: Through seven population-based studies performed in five different countries, it was possible to identify that Brazil was the country with the lowest intake of polyphenols, whereas Poland had the highest dietary intake. The most ingested subclasses of polyphenols in different countries were phenolic acids and flavonoids, and non-alcoholic beverages (coffee, tea, and orange juice) were the foods that most contributed to the intake of polyphenols. Despite the attempt to standardize this study to obtain worldwide intake estimates that could be comparable, gaps were found regarding the assessment of food consumption, standardization to obtain the polyphenol content of foods in Phenol-Explorer, calculation in aglycone equivalents, and caloric adjustment of the estimates. There is a need for more studies on the dietary polyphenols intake of representative samples of populations from different countries to collate more data on the quantities consumed and the main contributing foods.

Lumbalgia cronica como presentacion de mieloma múltiple de cadenas ligeras / Chronic low back pain as a presentation of multiple light chain myeloma

El mieloma múltiple es un cáncer de células plasmáticas que producen una inmunoglobulina monoclonal, las manifestaciones incluyen lesiones líticas óseas, insuficiencia renal, hipercalcemia anemia; el diagnostico exige demostrar la proteína M y/o proteinuria de cadenas ligeras y exceso de células plasmáticas en medula ósea, el tratamiento a menudo es una combinación de la quimioterapia convencional, corticoides y uno o más de los agentes nuevos. Paciente femenina de 48 años con un cuadro clínico de siete meses de evolución caracterizado por dolor en región lumbar irradiado a región sacra, el cual fue exacerbándose en el transcurso de los meses y recibió tratamiento con corticoides y analgésicos antiinflamatorios no esteroideos, catalogada como lumbalgia crónica. Se realizó TAC de columna lumbar con lesión expansiva osteolítica en el por lo cual se realiza biopsia guiada por tac, encontrándose tejido friable, con una anatomía patológica e inmunohistoquímico el cual reporta plasmocitoma óseo. En base a las normas de diagnósticos y tratamiento de la ASSUS se estratifica a la paciente con el diagnóstico de mieloma múltiple EC IIA *Durie y Salmon/IPS Esta paciente es elegible para trasplante antólogo de células madre hematopoyéticas, por el grupo etario se inicia protocolo CYBORD* y radioterapia coadyuvante para las lesiones más representativas, actualmente paciente ha cumplido 5to ciclo alcanzando una muy buena respuesta parcial, a la espera del trasplante autólogo. En la literatura médica existen pocos reportes en cuanto a la asociación entre lumbalgia como síntoma sospechoso de MM y el de cadenas ligeras es de hecho un desafío diagnóstico.

Multiple myeloma is a cancer of plasma cells that produce a monoclonal immunoglobulin, manifestations include lytic bone lesions, renal failure, hypercalcemia, anemia; Diagnosis requires demonstration of M protein and/or light chain proteinuria and excess bone marrow plasma cells. Treatment is often a combination of conventional chemotherapy, corticosteroids, and one or more of the newer agents. A 48-year-old female patient with a clinical picture of seven months of evolution characterized by pain in the lumbar region radiating to the sacral region, which was exacerbated over the months and received treatment with corticosteroids and non-steroidal anti-inflammatory analgesics, classified as chronic low back pain. Scan of the lumbar spine was performed with an expansive osteolytic lesion in which a CT-guided biopsy was performed, finding friable tissue, with a pathological and immunohistochemical anatomy which reported bone plasmacytoma. Based on the ASSUS diagnosis and treatment standards, the patient was stratified with the diagnosis of multiple myeloma CD IIA *Durie and Salmon/IPS This patient is eligible for an autologous hematopoietic stem cell transplant. Due to the age group, the CYBORD* protocol and adjuvant radiotherapy are started for the most representative lesions. Currently, the patient has completed the 5th cycle, achieving a very good partial response, waiting for the autologous transplant. There are few reports in the medical literature regarding the association between low back pain as a suspicious symptom of MM and that of light chains, which is in fact a diagnostic challenge.

Yerba Mate (Ilex paraguariensis) Processing and Extraction: Retention of Bioactive Compounds.

Ilex paraguariensis is a native tree from South America known for the presence of bioactive compounds, and its processed leaves are consumed as hot and cold infusions. After harvest (step 1), the leaves are subjected to flame blanching to inactive the enzymes (step 2), followed by drying and milling (step 3). The impacts of I. paraguariensis processing on leaf composition were investigated by extracting the major compounds (chlorogenic and isochlorogenic acids (3-CQA, 4-CQA, 5-CQA, 3,4-DQA, 3,5-DQA and 4,5-DQA), p-coumaric acid, caffeine and rutin) using different ratios of ethanol and water as extraction solvent (EW 25:75, 50:50, and 75:25 (w/w)). The solvent ratio of EW 50:50 was more effective in extracting the chlorogenic acids isomers, with retention of chlorogenic acids of 3463, 9485, and 9516 µg mL- 1 for steps 1, 2, and 3, respectively. Rutin and p-coumaric acid exhibited similar behavior with the increment of processing steps; however, p-coumaric acid was only detected in steps 2 and 3 for the solvent ratios EW 50:50 and 25:50. The caffeine extraction from I. paraguariensis varied from 936 to 1170 µg mL- 1 for all processing steps, with emphasis on its concentration extracted in step 1. The evolution of processing steps led to a higher retention of phenolic compounds from I. paraguariensis, which was not observed when using different solvent ratios, and the solvent ratio EW 50:50 was more effective for the extraction of chlorogenic acids. The successful extraction of chlorogenic acids from I. paraguariensis in this study proved to be a promising alternative for the use of yerba mate beyond the cuia cup.

Fruit pomace as a promising source to obtain biocompounds with antibacterial activity.

The demand for natural compounds to replace synthetic additives has aroused the interest of different sectors of society, especially the scientific community, due to their safety, biocompatibility, biodegradability and low toxicity. Alternative sources for antimicrobial compounds have been explored, such as fruit pomace. These by-products have essential compounds in their composition with different potential for application in food and packaging. In this context, this review systematizes the use of pomace from different fruits as a source of antibacterial compounds. Also, it summarizes the extraction methods and the applications of these compounds. Grape pomace, cranberry, and apple extracts are the most explored for antibacterial control, especially against genus Listeria, Salmonella, Staphylococcus, and Escherichia. In addition, phenolic acids, anthocyanins, flavonoids, and proanthocyanins are the main compounds identified in the studied fruit pomace extracts. In the reviewed articles, the biocompounds recovery is performed by methods with the absence of high temperatures (>80 °C); in some studies, the solid-liquid extraction method at mild temperatures (<30 °C) was well explored, using ethanol and water as solvent. The use of fruit processing by-products for bacterial control highlights the possibility of favoring the three pillars of sustainability (social, economic, and environmental) in the food industry.

Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study.

BACKGROUND: The restrictions imposed by the COVID-19 pandemic reduced health service access by patients with chronic diseases. The discontinuity of care is a cause of great concern, mainly in vulnerable regions. OBJECTIVE: This study aimed to assess the impact of the COVID-19 pandemic on people with hypertension and diabetes mellitus (DM) regarding the frequency of consultations and whether their disease was kept under control. The study also aimed to develop and implement a digital solution to improve monitoring at home. METHODS: This is a multimethodological study. A quasiexperimental evaluation assessed the impact of the pandemic on the frequency of consultations and control of patients with hypertension and DM in 34 primary health care centers in 10 municipalities. Then, an implementation study developed an app with a decision support system (DSS) for community health workers (CHWs) to identify and address at-risk patients with uncontrolled hypertension or DM. An expert panel assessment evaluated feasibility, usability, and utility of the software. RESULTS: Of 5070 patients, 4810 (94.87%) had hypertension, 1371 (27.04%) had DM, and 1111 (21.91%) had both diseases. There was a significant reduction in the weekly number of consultations (107, IQR 60.0-153.0 before vs 20.0, IQR 7.0-29.0 after social restriction; P<.001). Only 15.23% (772/5070) of all patients returned for a consultation during the pandemic. Individuals with hypertension had lower systolic (120.0, IQR 120.0-140.0 mm Hg) and diastolic (80.0, IQR 80.0-80.0 mm Hg) blood pressure than those who did not return (130.0, IQR 120.0-140.0 mm Hg and 80.0, IQR 80.0-90.0 mm Hg, respectively; P<.001). Also, those who returned had a higher proportion of controlled hypertension (64.3% vs 52.8%). For DM, there were no differences in glycohemoglobin levels. Concerning the DSS, the experts agreed that the CHWs can easily incorporate it into their routines and the app can identify patients at risk and improve treatment. CONCLUSIONS: The COVID-19 pandemic caused a significant drop in the number of consultations for patients with hypertension and DM in primary care. A DSS for CHW has proved to be feasible, useful, and easily incorporated into their routines.

Micropigmentação Dérmica na Reconstrução do Complexo Aréolo-papilar: Revisão Integrativa da Literatura / Dermal Micropigmentation for the Nipple-areolar Complex Reconstruction: Integrative Literature Review / Micropigmentación Dérmica en la Reconstrucción del Complejo Areola-papilar: Revisión Integradora de la Literatura

Introdução: A micropigmentação dérmica comumente conhecida como tatuagem é uma técnica de reconstrução do complexo aréolo- -papilar desde 1986. Objetivo: Identificar na literatura científica evidências sobre a prática de micropigmentação dérmica à reconstrução do complexo aréolo-papilar em mulheres tratadas por câncer de mama. Método: Revisão integrativa com busca nas bases de dados PubMed, SciELO e LILACS. A partir dos critérios de elegibilidade, foram selecionados 14 artigos. A revisão foi relatada segundo os critérios do PRISMA e o nível de evidência classificado segundo o Centro para Medicina Baseada em Evidências de Oxford. Resultados: Na literatura consultada, 71,4% dos estudos são de nível quatro de evidência. Foram sintetizados os achados em quatro categorias: 1) micropigmentação dérmica como método de escolha; 2) período recomendado para realização da micropigmentação; 3) etapas da micropigmentação dérmica; 4) reações esperadas e adversas da micropigmentação. Conclusão: A micropigmentação dérmica é uma técnica que tem proporcionado benefícios psicossociais para as mulheres e oferece à paciente uma aréola com aspecto próximo ao natural, por meio de um procedimento seguro, rápido, raramente doloroso e com baixo risco de complicações, quando garantidas as medidas de biossegurança. As decisões no processo devem ser baseadas por evidências e tomadas em conjunto com as pacientes, respeitando desejos e informando riscos e benefícios

Introduction: Since 1986, dermal micropigmentation commonly known as tattooing has been a technique for reconstruction of the nipple-areola complex. Objective: To identify scientific evidence in the literature on the practice of dermal micropigmentation for reconstruction of the nipple-areola complex in women treated for breast cancer. Method: Integrative review upon search in the databases PubMed, SciELO and LILACS resulting in 14 articles selected according to the eligibility criteria. The review was reported according to PRISMA criteria, and the level of evidence classified according to the Oxford Center for Evidence-Based Medicine criteria. Results: 71.4% of the studies presented level four of evidence. The findings were synthesized in four categories: 1) dermal micropigmentation as the method of choice; 2) recommended period for micropigmentation; 3) steps of dermal micropigmentation; 4) expected and adverse reactions from micropigmentation. Conclusion: Dermal micropigmentation is a technique that has provided psychosocial benefits for women and offers the patient an areola with a natural appearance through a safe, fast, rarely painful procedure with low risk of complications, if biosafety measures are in place. Decisions in the process should be evidence-based and taken together with patients, respecting their wishes and sharing risks and benefits

Introducción: La micropigmentación dérmica comúnmente conocida como tatuaje ha sido una técnica para reconstruir el complejo areola-pezón desde 1986. Objetivo: Identificar evidencia en la literatura científica sobre la práctica de la micropigmentación dérmica para la reconstrucción del complejo areola-pezón en mujeres tratadas por cáncer de mama. Método: Revisión integrativa con búsqueda en bases de datos PubMed, SciELO y LILACS. Con base en los criterios de elegibilidad, se seleccionaron 14 artículos. La revisión se informó de acuerdo con los criterios PRISMA y el nivel de evidencia clasificado de acuerdo con el Centro de Medicina basada en la evidencia de Oxford. Resultados: En la literatura consultada, el 71,4% de los estudios tienen nivel de evidencia cuatro. Fueron sintetizados los hallazgos en cuatro categorías: 1) micropigmentación dérmica como método de elección; 2) período recomendado de micropigmentación; 3) pasos de micropigmentación dérmica; 4) reacciones adversas y esperadas por micropigmentación. Conclusión: La micropigmentación dérmica es una técnica que ha brindado beneficios psicosociales para la mujer y ofrece a la paciente una areola con apariencia natural, a través de un procedimiento seguro, rápido, rara vez doloroso y con bajo riesgo de complicaciones, cuando las medidas de bioseguridad están garantizadas. Las decisiones en el proceso deben basarse en pruebas y tomarse junto con los pacientes, respetando los deseos e informando los riesgos y beneficios

Bioactive Compounds from Jambolan (Syzygium cumini (L.)) Extract Concentrated by Ultra- and Nanofiltration: a Potential Natural Antioxidant for Food.

Jambolan is an unexplored fruit rich in bioactive compounds like anthocyanins, catechin, and gallic acid. Thus, the extraction of bioactive compounds allows adding value to the fruit. In this context, the present study reports the recovery and concentration of jambolan fruit extract by ultra and nanofiltration for the first time. Acidified water was used to extract polyphenols from the pulp and peel of jambolan. The extracts were concentrated using ultrafiltration and nanofiltration membranes with nominal molecular weight cut-off ranging from 180 to 4000 g mol-1. Total monomeric anthocyanin, total phenolic compounds, and antioxidant capacity were analyzed. Phenolic compounds were quantified, and anthocyanins were identified by high-performance liquid chromatography coupled to diode-array detection and mass spectrometry (HPLC-DAD-MS). Concentration factors higher than 4.0 were obtained for anthocyanins, gallic acid, and catechin after nanofiltration of the extracts. Other compounds such as epicatechin, p-Coumaric acid, and ferulic acid were quantified in the concentrated extract, and the main anthocyanins identified were 3,5-diglucoside: petunidin, malvidin, and delphinidin. Therefore, jambolan extract showed a high potential to be used as a natural dye and antioxidant in food products.

Development and Implementation of a Decision Support System to Improve Control of Hypertension and Diabetes in a Resource-Constrained Area in Brazil: Mixed Methods Study.

BACKGROUND: The low levels of control of hypertension and diabetes mellitus are a challenge that requires innovative strategies to surpass barriers of low sources, distance, and quality of health care. OBJECTIVE: The aim of this study is to develop a clinical decision support system (CDSS) for diabetes and hypertension management in primary care, to implement it in a resource-constrained region, and to evaluate its usability and health care practitioner satisfaction. METHODS: This mixed methods study is a substudy of HealthRise Brazil Project, a multinational study designed to implement pilot programs to improve screening, diagnosis, management, and control of hypertension and diabetes among underserved communities. Following the identification of gaps in usual care, a team of clinicians established the software functional requirements. Recommendations from evidence-based guidelines were reviewed and organized into a decision algorithm, which bases the CDSS reminders and suggestions. Following pretesting and expert panel assessment, pilot testing was conducted in a quasi-experimental study, which included 34 primary care units of 10 municipalities in a resource-constrained area in Brazil. A Likert-scale questionnaire evaluating perceived feasibility, usability, and utility of the application and professionals' satisfaction was applied after 6 months. In the end-line assessment, 2 focus groups with primary care physicians and nurses were performed. RESULTS: A total of 159 reminders and suggestions were created and implemented for the CDSS. At the 6-month assessment, there were 1939 patients registered in the application database and 2160 consultations were performed by primary care teams. Of the 96 health care professionals who were invited for the usability assessment, 26% (25/96) were physicians, 46% (44/96) were nurses, and 28% (27/96) were other health professionals. The questionnaire included 24 items on impressions of feasibility, usability, utility, and satisfaction, and presented global Cronbach α of .93. As for feasibility, all professionals agreed (median scores of 4 or 5) that the application could be used in primary care settings and it could be easily incorporated in work routines, but physicians claimed that the application might have caused significant delays in daily routines. As for usability, overall evaluation was good and it was claimed that the application was easy to understand and use. All professionals agreed that the application was useful (score 4 or 5) to promote prevention, assist treatment, and might improve patient care, and they were overall satisfied with the application (median scores between 4 and 5). In the end-line assessment, there were 4211 patients (94.82% [3993/4211] with hypertension and 24.41% [1028/4211] with diabetes) registered in the application's database and 7960 consultations were performed by primary health care teams. The 17 participants of the focus groups were consistent to affirm they were very satisfied with the CDSS. CONCLUSIONS: The CDSS was applicable in the context of primary health care settings in low-income regions, with good user satisfaction and potential to improve adherence to evidence-based practices.

Carioca bean starch upon synergic modification: characteristics and films properties.

BACKGROUND: The use of damaged beans for starch isolation comprises an end-use alternative for a product that is not accepted by the consumer. For that reason, isolation and modification of Carioca bean starch should be explored and evaluated as a suitable source for biodegradable material. The present study aimed to evaluate the synergism of physical and chemical modifications on Carioca bean starch with respect to improving the properties of biodegradable films. A heat-moisture treatment (HMT) followed by oxidation by sodium hypochlorite was performed and vice versa. RESULTS: Synergism was noted in the starch properties compared to the single modification. When the oxidation was applied first, a higher amylose and carbonyl content was noted. HMT, isolated and as a second modification, caused a more pronounced effect on viscosity profile than the oxidized starch, with an increase in paste temperature and a decrease in viscosity, breakdown and final viscosity. CONCLUSION: The results obtained in the present study reflect a decrease in water vapor permeability, although a higher tensile strength was noted when oxidation was applied, as a single and as a first modification. © 2020 Society of Chemical Industry.

Red araçá pulp microencapsulation by hydrolyzed pinhão starch, and tara and arabic gums.

BACKGROUND: Red araçá is a Brazilian native species whose fruits are rich in phenolic acids, flavonoids, anthocyanins, and carotenoids. To preserve the properties of compounds during processing, red araçá pulp (RAP) was encapsulated by hydrolyzed pinhão starch (PS), tara gum (TG), and arabic gum (AG) in different blends in equal proportions, serving as a coating material. RESULTS: Fresh RAP had a gallic acid equivalent of 3098 mg per 100 g of dry weight, 156.29 µg ß-carotene per gram of dry weight, total anthocyanins of 18 mg per 100 g of dry weight and exhibited high antioxidant activity. The highest encapsulation efficiency achieved with the PS, TG, and AG blend was 80.4% for the total carotenoids, and that for the total anthocyanins was 76% with the TG and AG blend. Only one step of antioxidant activity degradation was identified, and the carrier system PSTG was efficient at maintaining the antioxidant activity, with half-life of 23.60-37.27 days. CONCLUSION: The use of PS alone as a coating material or associated with TG and AG gums resulted in improved retention of bioactive compounds, these being an excellent alternative coating material since they improved the stability of the antioxidant activity of RAP. © 2020 Society of Chemical Industry.

Xerostomia e câncer de mama / Xerostomia and breast cancer / Xerostomía y cáncer de mama

Objetivo: Identificar os estudos que descrevem a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia. Método: Revisão integrativa, partindo da questão norteadora << Quais as evidências científicas sobre a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia? >>. Foi realizada uma busca nas bases de dados: US National Library of Medicine and National Institute of Health, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library Online por meio dos Descritores em Ciências da Saúde. Foram encontrados 63 artigos, analisados por dois pesquisadores seguindo os critérios de inclusão e exclusão. Resultados: A prevalência de xerostomia foi descrita em 10 artigos que utilizaram como método de avaliação escalas, questionários com respostas dicotômicas e sialometria. Conclusão: Identificou-se uma prevalência de 47% a 77,3% de xerostomia durante a quimioterapia

Objective: To identify studies describing the prevalence of xerostomia in breast cancer patients undergoing chemotherapy. Method: Integrative review based on the guiding question << What is the scientific evidence on the prevalence of xerostomia in breast cancer patients undergoing chemotherapy? >>. We searched the US National Library of Medicine and National Institute of Health, Latin American and Caribbean Health Sciences Literature and Scientific Electronic Library Online databases using the Health Sciences Descriptors. We found 63 articles, which were analyzed by two researchers, following the inclusion and exclusion criteria. Results: The prevalence of xerostomia was described in 10 articles that used scales, questionnaires with dichotomous answers, and sialometry as evaluation methods. Conclusion: A prevalence of 47% to 77.3% of xerostomia during chemotherapy was identified

Objetivo: Identificar estudios que describen la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia. Método: Revisión integradora, basada en la pregunta guía << ¿Cuál es la evidencia científica sobre la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia? >>. Se realizaron búsquedas en las bases de datos US National Library of Medicine and National Institute of Health, Literatura Latino-Americana y del Caribe en Ciencias de la Salud y Scientific Electronic Library Online utilizando los Descriptores de Ciencias de la Salud. Encontramos 63 artículos, que fueron analizados por dos investigadores siguiendo los criterios de inclusión y exclusión. Resultados: La prevalencia de xerostomía se describió en 10 artículos que utilizaron escalas, cuestionarios con respuestas dicotómicas y sialometría como método de evaluación. Conclusión: Se identificó una prevalencia de xerostomía del 47% al 77,3% durante la quimioterapia

Prevalence of xerostomia in women during breast cancer chemotherapy.

OBJECTIVE: To identify the prevalence of xerostomia in women undergoing chemotherapy for breast cancer. METHOD: Prospective cohort with 27 women who underwent up to 16 sessions of intravenous chemotherapy. Data collection was performed at the outpatient clinic of a university hospital in the city of São Paulo, where two forms were applied before the start of treatment and the Xerostomia Inventory before and after each chemotherapy session. RESULTS: Complaints of dry mouth were present in 48.1% of women before chemotherapy, and they were approximately 28 times more likely to develop dry mouth during treatment. It was observed that the use of antiemetics contributed to the occurrence of xerostomia, and the anti-ulcerous were presented as a protective factor. CONCLUSION: The study identified both a high prevalence of xerostomia regardless of the chemotherapy used and the need to create protocols to improve the quality of life of these patients.

Community-based interventions for detection and management of diabetes and hypertension in underserved communities: a mixed-methods evaluation in Brazil, India, South Africa and the USA.

INTRODUCTION: As non-communicable disease (NCD) burden rises worldwide, community-based programmes are a promising strategy to bridge gaps in NCD care. The HealthRise programme sought to improve hypertension and diabetes management for underserved communities in nine sites across Brazil, India, South Africa and the USA between 2016 and 2018. This study presents findings from the programme's endline evaluation. METHODS: The evaluation utilises a mixed-methods quasi-experimental design. Process indicators assess programme implementation; quantitative data examine patients' biometric measures and qualitative data characterise programme successes and challenges. Programme impact was assessed using the percentage of patients meeting blood pressure and A1c treatment targets and tracking changes in these measures over time. RESULTS: Almost 60 000 screenings, most of them in India, resulted in 1464 new hypertension and 295 new diabetes cases across sites. In Brazil, patients exhibited statistically significant reductions in blood pressure and A1c. In Shimla, India, and in South Africa, country with the shortest implementation period, there were no differences between patients served by facilities in HealthRise areas relative to comparison areas. Among participating patients with diabetes in Hennepin and Ramsey counties and hypertension patients in Hennepin County, the percentage of HealthRise patients meeting treatment targets at endline was significantly higher relative to comparison group patients. Qualitative analysis identified linking different providers, services, communities and information systems as positive HealthRise attributes. Gaps in health system capacities and sociodemographic factors, including poverty, low levels of health education and limited access to nutritious food, are remaining challenges. CONCLUSIONS: Findings from Brazil and the USA indicate that the HealthRise model has the potential to improve patient outcomes. Short implementation periods and strong emphasis on screening may have contributed to the lack of detectable differences in other sites. Community-based care cannot deliver its full potential if sociodemographic and health system barriers are not addressed in tandem.

Prevalence of xerostomia in women during breast cancer chemotherapy / Prevalencia de la xerostomía en mujeres durante la quimioterapia por cáncer de mama / Prevalência da xerostomia em mulheres durante a quimioterapia por câncer de mama

ABSTRACT Objective: To identify the prevalence of xerostomia in women undergoing chemotherapy for breast cancer. Method: Prospective cohort with 27 women who underwent up to 16 sessions of intravenous chemotherapy. Data collection was performed at the outpatient clinic of a university hospital in the city of São Paulo, where two forms were applied before the start of treatment and the Xerostomia Inventory before and after each chemotherapy session. Results: Complaints of dry mouth were present in 48.1% of women before chemotherapy, and they were approximately 28 times more likely to develop dry mouth during treatment. It was observed that the use of antiemetics contributed to the occurrence of xerostomia, and the anti-ulcerous were presented as a protective factor. Conclusion: The study identified both a high prevalence of xerostomia regardless of the chemotherapy used and the need to create protocols to improve the quality of life of these patients.

RESUMEN Objetivo: Identificar la prevalencia de la xerostomía en las mujeres en tratamiento quimioterápico por cáncer de mama. Método: Cohorte prospectiva con 27 mujeres que realizaron hasta 16 sesiones de quimioterapia endovenosa. La recogida de datos ha sido realizada en el ambulatorio de un hospital universitario en la ciudad São Paulo, donde han sido aplicados dos formularios antes del inicio del tratamiento y el Xerostomia Inventory antes y después de cada sesión de quimioterapia. Resultados: La queja de boca seca estuvo presente en 48,1% de las mujeres antes de la quimioterapia, y ellas tuvieron aproximadamente 28 veces más chance de desarrollar la xerostomía durante el tratamiento. Se observó que el uso de antieméticos contribuyó para la ocurrencia de xerostomía, y los antiulcerosos se presentaron como factor de protección. Conclusión: El estudio identificó tanto una alta prevalencia de xerostomía independientemente de la quimioterapia empleada cuanto la necesidad de la creación de protocolos visando a la mejoría de la calidad de vida de esas pacientes.

RESUMO Objetivo: Identificar a prevalência da xerostomia nas mulheres em tratamento quimioterápico por câncer de mama. Método: Coorte prospectiva com 27 mulheres que realizaram até 16 sessões de quimioterapia endovenosa. A coleta de dados foi realizada no ambulatório de um hospital universitário na cidade de São Paulo, onde foram aplicados dois formulários antes do início do tratamento e o Xerostomia Inventory antes e após cada sessão de quimioterapia. Resultados: A queixa de boca seca esteve presente em 48,1% das mulheres antes da quimioterapia, e elas tiveram aproximadamente 28 vezes mais chance de desenvolver a xerostomia durante o tratamento. Observou-se que o uso de antieméticos contribuiu para a ocorrência de xerostomia, e os antiulcerosos se apresentaram como fator de proteção. Conclusão: O estudo identificou tanto uma alta prevalência de xerostomia independentemente da quimioterapia empregada quanto a necessidade da criação de protocolos visando à melhoria da qualidade de vida dessas pacientes.

Prevalence of xerostomia in women during breast cancer chemotherapy / Prevalencia de la xerostomía en mujeres durante la quimioterapia por cáncer de mama / Prevalência da xerostomia em mulheres durante a quimioterapia por câncer de mama

ABSTRACT Objective: To identify the prevalence of xerostomia in women undergoing chemotherapy for breast cancer. Method: Prospective cohort with 27 women who underwent up to 16 sessions of intravenous chemotherapy. Data collection was performed at the outpatient clinic of a university hospital in the city of São Paulo, where two forms were applied before the start of treatment and the Xerostomia Inventory before and after each chemotherapy session. Results: Complaints of dry mouth were present in 48.1% of women before chemotherapy, and they were approximately 28 times more likely to develop dry mouth during treatment. It was observed that the use of antiemetics contributed to the occurrence of xerostomia, and the anti-ulcerous were presented as a protective factor. Conclusion: The study identified both a high prevalence of xerostomia regardless of the chemotherapy used and the need to create protocols to improve the quality of life of these patients.

RESUMEN Objetivo: Identificar la prevalencia de la xerostomía en las mujeres en tratamiento quimioterápico por cáncer de mama. Método: Cohorte prospectiva con 27 mujeres que realizaron hasta 16 sesiones de quimioterapia endovenosa. La recogida de datos ha sido realizada en el ambulatorio de un hospital universitario en la ciudad São Paulo, donde han sido aplicados dos formularios antes del inicio del tratamiento y el Xerostomia Inventory antes y después de cada sesión de quimioterapia. Resultados: La queja de boca seca estuvo presente en 48,1% de las mujeres antes de la quimioterapia, y ellas tuvieron aproximadamente 28 veces más chance de desarrollar la xerostomía durante el tratamiento. Se observó que el uso de antieméticos contribuyó para la ocurrencia de xerostomía, y los antiulcerosos se presentaron como factor de protección. Conclusión: El estudio identificó tanto una alta prevalencia de xerostomía independientemente de la quimioterapia empleada cuanto la necesidad de la creación de protocolos visando a la mejoría de la calidad de vida de esas pacientes.

RESUMO Objetivo: Identificar a prevalência da xerostomia nas mulheres em tratamento quimioterápico por câncer de mama. Método: Coorte prospectiva com 27 mulheres que realizaram até 16 sessões de quimioterapia endovenosa. A coleta de dados foi realizada no ambulatório de um hospital universitário na cidade de São Paulo, onde foram aplicados dois formulários antes do início do tratamento e o Xerostomia Inventory antes e após cada sessão de quimioterapia. Resultados: A queixa de boca seca esteve presente em 48,1% das mulheres antes da quimioterapia, e elas tiveram aproximadamente 28 vezes mais chance de desenvolver a xerostomia durante o tratamento. Observou-se que o uso de antieméticos contribuiu para a ocorrência de xerostomia, e os antiulcerosos se apresentaram como fator de proteção. Conclusão: O estudo identificou tanto uma alta prevalência de xerostomia independentemente da quimioterapia empregada quanto a necessidade da criação de protocolos visando à melhoria da qualidade de vida dessas pacientes.

Impact of the use of saccharides in the encapsulation of Ilex paraguariensis extract.

The yerba mate (Ilex paraguariensis A.St.-Hil.) is abundant on phenolic compounds and their preservation by encapsulation can promote increased stability. The objective was to produce mate extract with a high concentration of bioactive compounds, microencapsulate and characterize them. A commercial yerba mate was used to produce the extracts and select the best extraction solvent (ethanol, water, and ethanol:water (1:1). The ethanol:water extract was encapsulated at 1:1 (w/w) by fructooligosaccharide (FOS) and gum arabic (GA), in different combinations: FOS, GA:FOS (1:3), GA:FOS (1:1), GA:FOS (3:1) and GA. The encapsulation of chlorogenic acids was around 80%, considering the major phenolic compounds by HPLC. Thermal stability, by DSC, increased at treatments FOS, GA:FOS (1:3), and GA:FOS (1:1) compare to the unencapsulated extract, and changes were noticed in ATR-FTIR bands and antioxidant activity. The encapsulated phenolic compounds from I. paraguariensis can be stable in food under heat processing.

Thermal and irradiation resistance of folic acid encapsulated in zein ultrafine fibers or nanocapsules produced by electrospinning and electrospraying.

The objectives of this study were to characterize zein fibers and capsules prepared by electrospinning and electrospraying techniques, respectively, and then use them to encapsulate folic acid. Folic acid containing fibers and capsules (0.5, 1.0, and 1.5%, w/v) were submitted to thermal treatment (100, 140, and 180 °C) and ultraviolet A light (UVA) irradiation to evaluate the resistance of folic acid. Zein fibers and capsules containing folic acid showed high encapsulation efficiency (>80%). Unencapsulated folic acid showed a reduction in folic acid content from 17.17 µg/mL to 5.44 µg/mL (approximately 70%) when exposed to 180 °C. Photodegradation of unencapsulated folic acid lowered its concentration from 17.17 µg/mL to 12.58 µg/mL (~26% of reduction), when exposed for 1 h to UVA irradiation. However, folic acid concentration when encapsulated in fibers (1.5%) was maintained or only slightly reduced from 9.73 µg/mg to 8.88 µg/mg after thermal treatment at 180 °C. The capsules containing 1.5% of folic acid also presented a slight reduction in folic acid concentration from 8.84 µg/mg to 7.88 µg/mg when exposed to 24 h of UVA irradiation. Zein fibers and capsules containing folic acid present promising characteristics for application in foods that require thermal processing or exposure to irradiation.

Pulverização pneumática eletrostática em videiras Niágara Branca e Rosada / Electrostatic pneumatic spraying on Niagara Branca and Rosada grapevines

O cultivo de videira é alvo de diversos agentes patogênicos, como os fungos, para controle geralmente são utilizados fungicidas sintéticos, então pesquisas tem testado métodos para diminuir o volume de defensivos agrícolas para reduzir problemas como fitotoxidez, custos e danos ambientais. Assim, objetivou-se com este trabalho verificar o efeito da pulverização pneumática eletrostática em videiras cultivares Niágara Branca e Rosada em Laranjeiras do Sul, PR. Realizou-se tratamento fungicida em cultivares de videira (Niágara Branca e Rosada), aplicando-os com carga presente e ausente. Foi avaliado o volume de calda de aplicação, cobertura da calda, severidade de doenças nas plantas e cachos, número de cachos e de cachos com lesões por planta, número de bagas por cacho, comprimento e diâmetro de cacho, massa fresca, sólidos solúveis, acidez titulável, coloração da epiderme do fruto, compostos fenólicos totais, antocianinas totais, perda de massa e a determinação da aparência. O delineamento foi em blocos inteiramente casualizados, para variáveis respostas de campo e caracterização físico-química e fitoquímica das frutas, constou de dois fatores (2x2), um fator carga e outro cultivar. Para as variáveis perda de massa e determinação da aparência o esquema fatorial foi 2x2x5, sendo um fator carga, cultivar de Niágara e períodos de armazenamento (0, 2, 4, 6 e 8 dias). Os dados foram...(AU)

Vine cultivation is the target of several pathogens such as fungi, against which synthetic fungicides are commonly used, so studies have been made on methods to decrease the volume of pesticides to reduce problems such as phytotoxicity, costs and environmental damage. Thus, the objective of this research was to verify the effect of electrostatic pneumatic spraying on Niagara Branca and Rosada grapevines in Laranjeiras do Sul, PR. Fungicidal treatment was carried out on grapevine cultivars (Niagara Branca and Rosada), applying them with present and absent load. The application volume, the seed coat, the severity of diseases in plants and bunches, number of bunches and bunches with lesions per plant, number of berries per bunch, length and bunch diameter, fresh mass, soluble solids, titratable acidity, fruit epidermal coloring, total phenolic compounds, total anthocyanins, loss of mass, and determination of appearance. This study was conducted under a completely randomized blocks design, for field variable responses and physical-chemical and phytochemical characterization of fruits, consisting of two factors (2x2), a load factor and another cultivar. For the variables loss of mass and determination of appearance, the factorial scheme was 2x2x5, where Niagara cultivar and storage periods (0, 2, 4, 6 and 8 days) were a load factor. The data were subjected to analysis of variance...(AU)