Vigipé®: tecnologia de estratificação de risco dos pés de pacientes com diabetes mellitus / Vigipé®: foot risk stratification technology for patients with diabetes mellitus / Vigipé®: tecnología de estratificación de riesgo para pies de pacientes con diabetes mellitus

RESUMO Objetivo: construir e validar um aplicativo que estabeleça o grau de risco do pé diabético associando suas condições de saúde. Metodologia: estudo metodológico realizado entre março de 2019 a dezembro de 2021, em Crato - CE - Brasil, dividido em três fases: 1) Revisão das diretrizes nacionais e internacionais; 2) Construção da tecnologia educativa e 3) Validação do conteúdo e aparência da tecnologia. Este estudo seguiu as diretrizes do guia Revised Standards for Quality Improvement Reporting Excellence. Resultados: na fase de revisão, identificou-se conteúdo semelhante entre as diretrizes para o delineamento e a organização do constructo. A tecnologia construída possibilitou a coleta de dados, avaliação e classificação de risco do pé diabético. Na etapa de validação, 18 juízes avaliaram o instrumento, que teve o IVC 0,96. Conclusão: o estudo poderá contribuir para melhorar os indicadores referente as hospitalizações, amputações, mobilidade diminuída, dependência, fragilidade e mortalidade advindos do pé diabético.

ABSTRACT Objective: to create and validate an app that establishes the diabetic foot risk degree by associating the patients' health conditions. Methodology: a methodological study conducted between March 2019 and December 2021 in Crato - CE - Brazil, and divided into three phases: 1) Review of the national and international guidelines; 2) Creation of the educational technology; and 3) Face and content validation of the technology. This study followed the guidelines set forth in the Revised Standards for Quality Improvement Reporting Excellence guide. Results: in the review phase, similar content was identified between the guidelines for designing and organizing the content. The technology that was created enabled data collection, as well as diabetic foot risk assessment and classification. A total of 18 judges evaluated the instrument in the validation stage, obtaining a CVI value of 0.96. Conclusion: the study may contribute to improving the indicators referring to hospitalizations, amputations, reduced mobility, dependence, frailty and mortality resulting from diabetic foot.

RESUMEN Objetivo: crear y validar una aplicación que establezca el grado de riesgo del pie diabético asociándolo a sus condiciones de salud. Metodología: estudio metodológico realizado entre marzo de 2019 y diciembre de 2021, en Crato, CE, Brasil, dividido en tres fases: 1) Revisión de directrices nacionales e internacionales; 2) Creación de la tecnología educativa y 3) Validación del contenido y la apariencia de la tecnología. Este estudio siguió los lineamientos de la guía Revised Standards for Quality Improvement Reporting Excellence. Resultados: en la fase de revisión, se identificaron contenidos similares entre las directrices para el diseño y la organización del constructo. La tecnología creada permitió recolectar datos, evaluar y clasificar el riesgo del pie diabético. En la etapa de validación, 18 jueces evaluaron el instrumento, que contó con un IVC de 0,96. Conclusión: el estudio puede contribuir a mejorar los indicadores de hospitalización, amputación, movilidad reducida, dependencia, fragilidad y mortalidad derivados del pie diabético.

Ferulic acid derivatives inhibiting Staphylococcus aureus tetK and MsrA efflux pumps.

Background: Bacterial resistance to multiple drugs has recently emerged as a serious health problem. Concomitantly, the characterization of new substances with potential antimicrobial activity has been less frequent in the drug development industry. The overexpression of genes encoding efflux pumps that expel antimicrobial drugs from the intracellular environment, lowering these to subinhibitory concentrations, are among the resistance mechanisms predisposing microorganisms to high drug resistance. Staphylococcus aureus is a bacterium found in the normal microbiota of the skin and mucous membranes, and is an opportunistic microorganism capable of causing infections with high rates of morbidity and mortality. TetK is an efflux pump characterized by its ability to provide bacterial resistance to antibiotics from the tetracycline class. This study aimed to evaluate the inhibitory effect of ferulic acid and four of its esterified derivatives against resistant Staphylococcus aureus strains. Method: Ferulic acid derivatives were obtained by esterification and then characterized by hydrogen and carbon-13 nuclear magnetic resonance analysis. The minimum inhibitory concentrations (MIC) of ferulic acid and its esterified derivatives, ethidium bromide, and antibiotics were obtained using the microdilution test, while the efflux pump inhibition test was conducted by examining reduction in the MICs. Results: Propylferulate was seen to reduce the minimum inhibitory concentration (MIC) of both the control substance ethidium bromide and the tested antibiotic, indicating that this compound is promising for the use of efflux pump inhibition of IS-58 strains. Conclusions: This study provides strong evidence that the molecular basis for this activity is potentially due to the MsrA and TetK efflux pumps. However, further investigations are necessary to prove this hypothesis and elucidate the potentiating mechanism of the modulatory effect.

Murraya paniculata (L.) (Orange Jasmine): Potential Nutraceuticals with Ameliorative Effect in Alloxan-Induced Diabetic Rats.

Orange jasmine, Murraya paniculata (Rutaceae), is a plant from India widely used in folk medicine as antinociceptive, antiinflammatory, and antioxidant. Although oral hypoglycemic agents and insulin are the mainstays of treatment of diabetes mellitus (DM), there is a significant demand for new natural products to reduce the development of diabetic complications. Alloxan-induced diabetic rats were treated for 60 days with a hydroalcoholic extract of M. paniculata (MPE), at doses of 100, 200, and 400 mg/kg. MPE decreased glycemia and also cholesterol and triglyceride levels, starting 1 week after treatments, as compared with the same group before treatments. Glucose values were reduced toward normality after 1 week of treatment. MPE hypoglycemic effects were potentiated by glibenclamide and metformin. MPE also decreased fructosamine and glycated hemoglobin values. MPE reduced diabetes-induced morphological alterations of the kidney, pancreas, and liver. MPE acts similarly to glibenclamide and metformin, and its glucose-lowering action is partly a consequence of ATP-sensitive K+ channel inhibition. MPE may be a potential therapeutic alternative for the treatment of diabetes and its complications. Copyright © 2017 John Wiley & Sons, Ltd.

Ethnopharmacological study of Stryphnodendron rotundifolium in two communities in the semi-arid region of northeastern Brazil

This work describes the local knowledge of the medicinal use of Stryphnodendron rotundifolium Mart., Fabaceae, according to informants in two areas of the Araripe bioregion, in the Northeast Region of Brazil. We used interviews to investigate the ethnomedicinal use of the local species to determine the mode of use, frequency of administration, duration of treatment and restrictions of use. In traditional medicine, the use of S. rotundifolium is associated with the treatment of inflammatory and infectious diseases. The part of the plant most used was the stem bark (86.11%), the predominant mode of preparation was immersion in water (52.83%), and oral administration was the most cited (48.43%). For inflammatory and infectious diseases, the treatment lasted 3-10 days and the frequency of administration was 2-3 times/day. For gastroprotective effects, treatment lasted up to 30 days, and the herb was administered 1-3 times/day. For pain complaints, the therapy varied from 2-3 days to continuous administration.The informants (46.87%) did not mention restrictions of use, except for pregnant women, with a rate of 25%. A comparison of these results with the ethnopharmacological information from other studies showed that some of the traditional indications are scientifically supported by the literature or clinical studies. Nevertheless, the results showed that pharmacologists have not fully investigated all the possible bioactivities that healers credit to this plant. .