Práticas de assistência ao parto e nascimento na perspetiva de gestantes com COVID-19 / Perspectives of pregnant women with COVID-19 on childbirth care practices / Prácticas de asistencia al parto y nacimiento desde la perspectiva de gestantes con COVID-19

Resumo Enquandramento: A pandemia de COVID-19 agravou as práticas de cuidar das mulheres no momento do parto. Objetivo: Compreender a perceção das grávidas com COVID-19 acerca da aplicabilidade das boas práticas de assistência ao parto e nascimento. Metodologia: Estudo exploratório e descritivo, com abordagem mista, realizado com 23 gestantes com COVID-19, num hospital público brasileiro. Resultados: O corpus geral consistia em 23 textos, com aproveitamento de 249 Segmentos de Texto (ST). O conteúdo analisado foi categorizado em cinco classes: COVID-19 no contexto da saúde do RN, com 56 STs (22,49%); Parto humanizado e COVID-19, com 51 STs (20,48%); A incerteza dos riscos maternos e fetais, com 39 STs (15,66%); Experiência do parto na pandemia por COVID-19, com 67 STs (26,91%); e Conhecimento sobre sintomas e prevenção contra a COVID-19, com 36 STs (14,46%). Conclusão: Foram encontradas gestantes com pouco conhecimento sobre a política e o seu direito à autonomia no trabalho de parto e pós-parto, evidenciando diversas práticas inadequadas durante a pandemia.

Abstract Background: The COVID-19 pandemic has aggravated childbirth care practices. Objective: To understand the perception of pregnant women with COVID-19 on the applicability of best childbirth care practices. Methodology: Exploratory and descriptive study, with a mixed methods approach, carried out with 23 pregnant women with COVID-19 in a Brazilian public hospital. Results: The general corpus comprised 23 texts with 249 Text Segments (TS). The analyzed content was categorized into five classes: COVID-19 in the context of NB health, with 56 TS (22.49%); Humanized childbirth and COVID-19, with 51 TS (20.48%); The uncertainty of maternal and fetal risks, with 39 TS (15.66%); Childbirth experience in the COVID-19 pandemic, with 67 TS (26.91%); and Knowledge about symptoms and prevention against COVID-19, with 36 TS (14.46%). Conclusion: Pregnant women have little knowledge about the policy and their right to autonomy in labor and postpartum, evidencing inadequate practices during the pandemic.

Resumen Marco contextual: La pandemia de COVID-19 ha empeorado las prácticas asistenciales de las mujeres en el momento del parto. Objetivo: Comprender la percepción de las mujeres embarazadas con COVID-19 sobre la aplicabilidad de las buenas prácticas en la atención al parto. Metodología: Estudio exploratorio y descriptivo, con enfoque mixto, realizado con 23 gestantes con COVID-19 en un hospital público brasileño. Resultados: El corpus general constó de 23 textos, y se utilizaron 249 segmentos de texto (ST). El contenido analizado se clasificó en cinco clases: COVID-19 en el contexto sanitario del RN, con 56 ST (22,49%); parto humanizado y COVID-19, con 51 ST (20,48%); la incertidumbre de los riesgos maternos y fetales, con 39 ST (15,66%); experiencia del parto en la pandemia por COVID-19, con 67 ST (26,91%), y conocimientos sobre los síntomas y la prevención de la COVID-19, con 36 ST (14,46%). Conclusión: Se observó que las gestantes tenían pocos conocimientos sobre la política y su derecho a la autonomía en el parto y el posparto, lo que puso de manifiesto varias prácticas inadecuadas durante la pandemia.

School-Based meditation in adolescents: an integrative literature review.

OBJECTIVES: Utility of cognitive-behavioral practice interventions in school settings have been discussed by the scientific community regarding their possibility of insertion in the educational field. In this way, this review article analyzes the scientific production on the practice of meditation offered at school in adolescents, since the appropriation of studies that point to reflections and perspectives of meditative practice can favor the development of new pedagogical trajectories in the school environment. CONTENT: The electronic databases VHL, PubMed, and CAPES were consulted, using the combination of the terms related to meditation, adolescents, and school. This analysis resulted in eight articles, including field research and reviews, published between 2010 and 2021. SUMMARY: The articles showed improvement in emotional coping skills, social relationships, self-regulation, control of mood levels, stress, depression, and anger, and significant gains in self-reflection and academic attention. They pointed out that elementary and high school students present more significant responses, and these factors, such as duration, frequency, and systematization of the session, can interfere with these responses. OUTLOOK: These results indicate that meditation practice in adolescents can be a valuable strategy for health promotion and educational training in the school environment.

Perinatal outcomes of adolescent and adult mothers: a systematic review / Resultados perinatais de mães adolescentes e adultas: uma revisão sistemática / Resultados perinatales de madres adolescentes y adultas: una revisión sistemática

Objective: To identify and analyze studies published in the literature that researched adverse perinatal outcomes in live births to adolescent and adult mothers. Methods: The electronic databases PubMed and VHL (LILACS and MEDLINE) were consulted, using the MeSH descriptors with Boolean operators were used, which were grouped as follows: ("maternal age") AND ("risk factors") AND ("Pregnancy Complica- tions OR "Adverse Birth Outcomes" OR "Perinatal outcome"). This analysis resulted in eight articles published between 2018 and 2022. Results: Studies presented a strong as- sociation between young maternal age (<20 years) and unfavorable neonatal outcomes, such as low birth weight, premature delivery, need for oxygen therapy and admission to the Neonatal Intensive Care Unit. No significant data were found on adverse outcomes in pregnancies in the optimum age range (20>35 years). Conclusion: The analyzed studies point to a strong association between young maternal age and some clinical-obstetric complications.

Objetivo: Identificar e analisar estudos publicados na literatura que pesquisaram desfechos perinatais adversos em nascidos vivos de mães adolescentes e adultas. Métodos: Foram consultadas as bases de dados eletrônicas PubMed e BVS (LILACS e MEDLINE), utilizando-se os MeSH descritores com operadores booleanos, os quais foram agrupados da seguinte forma: ("maternal age") AND ("risk factors") AND ("Pregnancy Complications OU "Resultados adversos do parto" OU "Resultados perinatais"). Essa análise resultou em oito artigos publicados entre 2018 e 2022. Resultados: Os estudos apresentaram forte associação entre a idade materna jovem (<20 anos) e os desfechos neonatais desfavoráveis, como baixo peso ao nascer, parto prematuro, necessidade de oxigenoterapia e internação na UTI neonatal. Não foram encontrados dados significativos sobre resultados adversos em gestações na faixa etária ideal (20>35 anos). Conclusão: Os estudos analisados apontam para uma forte associação entre idade materna jovem e algumas complicações clínico-obstétricas.

Objetivo: Identificar y analizar estudios publicados en la literatura que investigaran resultados perinatales adversos en nacidos vivos de madres adolescentes y adultas. Métodos: Se realizaron búsquedas en las bases de datos electrónicas PubMed y BVS (LILACS y MEDLINE) utilizando los descriptores MeSH con operadores booleanos, que se agruparon de la siguiente manera: ("edad materna") AND ("factores de riesgo") AND ("complicaciones del embarazo OR "resultados adversos del parto" OR "resultados perinatales"). Este análisis dio como resultado ocho artículos publicados entre 2018 y 2022. Resultados: Los estudios mostraron una fuerte asociación entre la edad materna joven (<20 años) y los resultados neonatales desfavorables, como bajo peso al nacer, parto prematuro, necesidad de oxigenoterapia e ingreso en la UCI neonatal. No se encontraron datos significativos sobre resultados adversos en embarazos en el grupo de edad ideal (20>35 años). Conclusión: Los estudios analizados apuntan a una fuerte asociación entre la edad materna joven y algunas complicaciones clínico-obstétricas.

Um estudo da prevalência e da caracterização da mortalidade em crianças e adolescentes por leucemia no Nordeste do Brasil / A study of the prevalence and characterization of mortality in children and adolescents due to leukemia in Northeastern Brazil / Estudio de prevalencia y caracterización de la mortalidad por leucemia en niños y adolescentes del Nordeste Brasileño

Objetivo: Caracterizar a prevalência da mortalidade por leucemias em crianças e adolescentes no Nordeste Brasileiro e sua relação com determinantes sociais da saúde no período de 2008 a 2018. Método: A pesquisa foi um estudo epidemiológico, do tipo ecológico, cujas unidades de análisede área foram os 9 (nove) estados brasileiros da Região Nordeste. Os dados desse estudo foram do tipo secundário, obtidos através do Departamento de Informática do Sistema Único de Saúde (DATASUS), provenientes do Sistema de Informação sobre Mortalidade (SIM). Para esta investigação elegeu-se, crianças e adolescentes, com faixa etária entre 0 (zero) e 19 (dezenove) anos, com óbitos no período de 2008 a 2018, cujo, a leucemia foi a causa básica mencionada na Declaração de Óbito (DO) por meios de códigos conforme a 10o Classificação Internacional de Doenças (CID-10). Resultados: foram registrados 3.025 óbitos por leucemias durante o período analisado. O CID-91 foi o primeiro colocado em número de óbitos (54,9%), em segundo lugar, CID-92 apresentando 30% das notificações e em seguida CID-95 (14,6%), CID-93 (0,3%), CID-94 (0,2%) dos óbitos. Sendo que desses, 57,6% foram do sexo masculino e 42,4% do sexo feminino. A faixa etária mais prevalente foi de 15 a 19 anos de idade (26,1%). A cor parda foi a mais autodeclarada (58,0%). O estado da Bahia foi o mais acometido por óbitos durante o período. Conclusão: O CID-91 teve maior prevalência entre óbitos notificados, que os maiores números de óbitos foram no sexo masculino com faixa etária dos adolescentes entre 15 e 19 anos e de cor parda, e que a mortalidade por leucemia ainda é um sério problema de saúde pública que pode ser reparado com medidas de prevenção e de promoção em saúde.

Objective: to characterize the prevalence of mortality of leukemia in children and adolescents in Brazilian's Northeast and the relationship with social determinants of health in the period from 2008 to 2018. Methods: It is an ecological epidemiological study that analyzed 9 (nine) Brazilian states of the Northeast Region. Data were collected through the Department of Informatics of the Unified Health System (DATASUS), from the Mortality Information System (SIM). For this, children and adolescents, aged between 0 (zero) and 19 (nineteen) years old, with deaths in the period from 2008 to 2018, that leukemia was the cause mentioned in the Death Certificate (DO) according to the 10th International Classification of Diseases (ICD-10) were included. Results: 3,025 deaths from leukemia were recorded during the analyzed period. ICD-91 was ranked first in number of deaths (54.9%), secondly, ICD-92 with 30% of notifications and then ICD-95 (14.6%), ICD-93 (0. 3%), ICD-94 (0.2%) of deaths. Regarding this, 57.6% were male and 42.4% female. The most prevalent aged group was 15 to 19 years old (26.1%). The brown color was the most self-declared (58.0%). The state of Bahia was the most affected by deaths during this period. Conclusion: The ICD-91 had a higher prevalence among notified deaths, that the highest number of deaths were in males aged between 15 and 19 years and of brown skin color, and that mortality from leukemia is still a serious problem of public health that can be repaired with prevention and health promotion measures.

Objetivo: caracterizar la prevalencia de mortalidad por leucemia en niños y adolescentes del Nordeste brasileño y la relación con los determinantes sociales de la salud en el período de 2008 a 2018. Métodos: Se trata de un estudio epidemiológico ecológico que analizó 9 (nueve) estados brasileños de la Región Nordeste. Los datos fueron recolectados a través del Departamento de Informática del Sistema Único de Salud (DATASUS), a partir del Sistema de Información de Mortalidad (SIM). Para eso, fueron incluidos niños y adolescentes, con edad entre 0 (cero) y 19 (diecinueve) años, con muerte en el período de 2008 a 2018, que la leucemia fuese la causa mencionada en el Certificado de Defunción (DME) según la 10ª Clasificación Internacional de Enfermedades (CIE-10). Resultados: Se registraron 3.025 defunciones por leucemia durante el periodo analizado. La CIE-91 ocupó el primer lugar en número de defunciones (54,9%), en segundo lugar, la CIE-92 con un 30% de notificaciones y a continuación la CIE-95 (14,6%), CIE-93 (0. 3%), CIE-94 (0,2%) de defunciones. El 57,6% eran varones y el 42,4% mujeres. El grupo de edad más prevalente fue el de 15 a 19 años (26,1%). El color castaño fue el más autodeclarado (58,0%). El estado de Bahia fue el más afectado por muertes durante este período. Conclusiones: La CIE-91 tuvo una mayor prevalencia entre las muertes notificadas, que el mayor número de muertes se produjo en varones de 15 a 19 años y de color de piel morena, y que la mortalidad por leucemia sigue siendo un grave problema de salud pública que puede ser reparado con medidas de prevención y promoción de la salud.

Inflammatory and hyperalgesic effects of oxidized multi-walled carbon nanotubes in rats.

We evaluated local inflammatory activity of oxidized multiwalled carbon nanotubes in rat experimental models of acute inflammation (paw edema and hyperalgesia) by analyzing their toxicity in non-mesoendothelial tissues. Subcutaneous injection of the nanotubes induced paw edema, that was maximal in the first 2 h after administration at 0.1 mg/kg (43.25 +/- 3.8 AUC) and 1 mg/kg (30.1 +/- 1.8 AUC) compared to saline (18.32 +/- 02.05 AUC). The histopathological analysis showed acute inflammation characterized by vasodilatation, edema formation, neutrophil infiltrate and tissue damage. The nanotubes also elicited hyperalgesic response, seen by the increase of animal paw withdrawal that was maximal in the first 3 hours. The data obtained at the 3rd h was: 75 +/- 9.3% (0.01 mg/kg), 58 +/- 8.3% (0.1 mg/kg) and 53 +/- 6.69% (1 mg/kg) in relation with saline (28 +/- 3.5%). In conclusion, the oxidized multiwalled carbon nanotubes elicit inflammatory and hyperalgesic effects associated to severe tissue damage in rats.

Effects of Canavalia lectins on acute inflammation in sensitized and non-sensitized rats.

The anti-inflammatory activity of Canavalia seed lectins (Canavalia gladiata [CGL], Canavalia maritima [ConM] and Canavalia brasiliensis [ConBr]) was evaluated by intravenous administration in rats. In non-sensitized rats, cellular edema elicited by carrageenan was reduced (45-51 %) by ConM and (44-59 %) by CGL. Osmotic edema elicited by dextran was reduced by ConM and CGL in 27 % and 29 %. ConM and CGL reduced the edema elicited by L-arginine in 53 % and that of prostaglandin E2 in 48 % and 36 %. Leukocyte migration elicited by carrageenan was reduced in 49 % by ConM and in 55 % by CGL (attenuated in 4× by glucose) and peritoneal TNF-α content in 82 %. In rats sensitized, ConM inhibited the paw edema and leukocyte migration elicited by ovalbumin in 34 % and 70 %. ConM and CGL are anti-inflammatory, mainly in cellular events mediated by prostaglandin E2, nitric oxide and TNF-α in non-sensitized rats. However, only ConM is anti-inflammatory in sensitized rats. CGL effect involves the lectin domain.

Homologous Canavalia lectins elicit different patterns of antinociceptive responses.

Canavalia gladiata (CGL), C. maritima (ConM) and C. brasiliensis (ConBr) lectins were evaluated in nociception models. ConBr inhibited first (32%) and second (100%) phases of the formalin test; CGL inhibited only the first (74%) and ConM only the second (59%) phase. Hypernociception evaluated in the Von Frey test was inhibited by ConM (55%), CGL (41%) and ConBr (38%). Acetic acid-induced abdominal writhing was reduced by ConBr (66%), CGL (52%) and ConM (60%). ConBr and CGL effects were reversed by the lectin association with its ligand sugar. The antinociceptive activity of the structural homologous lectins was differentiated by potency, efficacy and mechanisms.

Purification and biological activities of Abelmoschus esculentus seed lectin.

The Abelmoschus esculentus (Malvaceae) plant originated in Africa and has spread across a number of tropic countries, including northeastern Brazil. The plant has been used to treat various disorders, such as cancer, microbial infections, hypoglycemia, constipation, urine retention and inflammation. The lectin of A. esculentus (AEL) was isolated by precipitation with ammonium sulfate at a saturation level of 30/60 and purified by ion exchange chromatography (Sephacel-DEAE). The electrophoresis (SDS-PAGE) profile of the AEL showed two protein bands of apparent molecular mass of approximately 15.0 and 21.0 kDa. The homogenity of the protein was confirmed by electrospray mass spectrometry (ESI-MS), which revealed the presence of a 10.29-kDa monomer and a 20.58-kDa dimer. The AEL exhibits agglutinating activity against rabbit (74.41 UH/mP) and human type ABO erythrocytes (21.00 UH/mP). This activity does not require the presence of divalent cations and is specifically inhibited by lactose, fructose and mannose. The intravenous treatment with 0.01, 0.1 and 1 mg/kg of AEL inhibited the paw edema elicited by carrageenan by approximately 15, 22 and 44 %, respectively, but not that induced by dextran. In addition, treatment with 0.1, 1 and 10 mg/kg of AEL also inhibited the abdominal writhing induced by acetic acid by approximately 52, 57 and 69 %, respectively. In conclusion, AEL is a new lectin with a molecular mass of 20.0 kDa, which is -composed of a 10.291-Da monomer and a 20.582-kDa dimer, that exhibits anti-inflammatory, antinociceptive and hemagglutinating activities. In addition, the lectin hemagglutinating property is both metallo-independent and associated with the lectin domain.

Vascular smooth muscle relaxation by a lectin from Pisum arvense: evidences of endothelial NOS pathway.

The vasorelaxant effect of the lectin of Pisum arvense (PAL) seeds was investigated in rat aorta. PAL (10-100 µg/ml) was applied on aorta rings, with or without endothelium, pre-contracted with phenylephrine (Phe; 0.1 µM). Participation of endothelium derived relaxant factors was evaluated incubating the tissue with indomethacin (10 µM), L-nitro arginine methyl ester (L-NAME, 100 µM) and tetraethylammonium (TEA, 5 mM) before addition of PAL. The role of the lectin domain was investigated by addition of PAL into tissue in presence of glucose (3x 10⁻5 M), or N-acetyl Dglucosamine (GlcNAc; 3 x 10⁻4 M). The importance of extracellular calcium (Ca²âºe) or interaction with muscarinic receptors in the relaxant effect was evaluated by addition of PAL into aorta rings containing calcium free solution (OCa) and atropine (1 µ M), respectively. PAL induced concentration-dependent relaxation in endothelized aorta (IC50 =58.38 ± 1.87 µg/ml), which was reversed by L-NAME and glucose. The lectin effect was totally inhibited when the preparation was inserted in OCa, but not in presence of atropine. Summarizing, our data showed a relaxant effect of PAL in isolated rat aorta rings in presence of endothelium, suggestive of interaction between the lectin carbohydrate binding sites with specific receptors located in vascular endothelial cells leading to nitric oxide synthase activation. This effect seems to require Ca²âºe but is independent on muscarinic receptors interaction.

Native crystal structure of a nitric oxide-releasing lectin from the seeds of Canavalia maritima.

Here, we report the crystallographic study of a lectin from Canavalia maritima seeds (ConM) and its relaxant activity on vascular smooth muscle, to provide new insights into the understanding of structure/function relationships of this class of proteins. ConM was crystallized and its structure determined by standard molecular replacement techniques. The amino acid residues, previously suggested incorrectly by manual sequencing, have now been determined as I17, I53, S129, S134, G144, S164, P165, S187, V190, S169, T196, and S202. Analysis of the structure indicated a dimer in the asymmetric unit, two metal binding sites per monomer, and loops involved in the molecular oligomerization. These confer 98% similarity between ConM and other previously described lectins, derived from Canavalia ensiformis and Canavalia brasiliensis. Our functional data indicate that ConM exerts a concentration-dependent relaxant action on isolated aortic rings that probably occurs via an interaction with a specific lectin-binding site on the endothelium, resulting in a release of nitric oxide.