Sentimentos da mulher frente a gestação de alto risco / Sentimientos de la mujer frente al embarazo de alto riesgo / Women's feelings facing High-Risk pregnancy

Resumo Introdução: A gestação configura-se como um acontecimento único e memorável para a vida de uma mulher. A gravidez de alto risco é uma experiência estressante em razão dos riscos a que estão submetidos a mãe e o bebê e devido às mudanças que afetam negativamente o seu equilíbrio emocional. Objetivo: Identificar os sentimentos vivenciados pela gestante frente à gravidez de alto risco. Método: Descritivo e exploratório com abordagem qualitativa, com amostra por conveniência composta por mulheres com gestação de alto risco, selecionadas de acordo com a disponibilidade do serviço de internamento, até a saturação das entrevistas. A coleta dos dados foi realizada em um período de dois meses através de entrevistas guiadas por um roteiro. Os dados foram analisados por meio da técnica de análise de conteúdo segundo Minayo. Resultados: Fizeram parte 37 mulheres. Os resultados foram oeganizados nas categorias: Como se deu o diagnóstico de alto risco; Sentimentos ao descobrir que a gestação é/era de risco; Sentimentos em relação ao apoio familiar acerca da gestação de alto risco. Os sentimentos relatados pelas gestantes e puérperas que conviveram com a gravidez de alto risco, deixam evidentes os impactos que este evento traz não somente na saúde física sobretudo para a emocional, deixando as gestantes fragilizadas. Conclusão: Assim, o estudo nos permitiu perceber que os sentimentos vivenciados nesse processo podem interfir na vida dessas mulheres, e de forma negativa. Mas, que apesar dessa situação, estas expressam sentimentos ambíguos, pois mesmo com o risco gestacional, muitas mostram-se felizes pela dádiva de ser mãe.

Resumen Introducción: El embarazo se considera un evento único y memorable en la vida de una mujer. El embarazo de alto riesgo es una experiencia estresante debido a los riesgos a los que están expuestas tanto la madre como su bebé y a los cambios que afectan negativamente su equilibrio emocional. Objetivo: Identificar los sentimientos experimentados por las mujeres embarazadas frente a un embarazo de alto riesgo. Metodología: Descriptivo y exploratorio con enfoque cualitativo, con una muestra a conveniencia compuesta por mujeres con embarazos de alto riesgo, seleccionadas según la disponibilidad del servicio de hospitalización, hasta la saturación de las entrevistas. La recopilación de datos se llevó a cabo durante un período de dos meses a través de entrevistas guiadas. Los datos fueron analizados utilizando la técnica de análisis de contenido según Minayo. Resultados: Participaron 37 mujeres y los resultados se organizaron en las siguientes categorías: cómo se realizó el diagnóstico de alto riesgo; sentimientos al descubrir que el embarazo era de riesgo; sentimientos con respecto al apoyo familiar en relación con el embarazo de alto riesgo. Los sentimientos relatados por las mujeres embarazadas y posparto que vivieron un embarazo de alto riesgo evidencian los impactos que tiene este evento no solo en la salud física sino, especialmente, en el bienestar emocional, pues deja a las mujeres embarazadas en un estado de vulnerabilidad. Conclusión: El estudio nos permitió darnos cuenta de que los sentimientos experimentados en este proceso pueden interferir en la vida de estas mujeres de manera negativa. Sin embargo, a pesar de esta situación, muchas de ellas expresan sentimientos ambiguos, porque, incluso con el riesgo gestacional, están agradecidas por el regalo de la maternidad.

Abstract Introduction: Pregnancy is considered a unique and memorable event in a woman's life. High-risk pregnancy is a stressful experience due to the risks to which the mother and the baby are exposed, and due to the changes that negatively affect their emotional balance. Objective: To identify the feelings experienced by pregnant women facing high-risk pregnancy. Method: Descriptive and exploratory, employing a qualitative approach, the study featured a convenience sample of women with high-risk pregnancies, selected based on inpatient service availability, until interview saturation was achieved. Data collection was conducted over a two-month period through scripted interviews. Data analysis was performed utilizing Minayo's content analysis technique. Results: Thirty-seven women participated in the study. The results were categorized as follows: How the high-risk diagnosis was determined; Feelings upon discovering the pregnancy was high-risk; Feelings regarding family support regarding the high-risk pregnancy. The feelings reported by pregnant and postpartum women who experienced high-risk pregnancies clearly reveal the impacts this event has, not only on physical health, but especially on emotional well-being, leaving the pregnant women in a vulnerable state. Conclusion: The study allowed us to realize that the feelings experienced in this process can negatively interfere in the lives of these women. However, despite this situation, many of them express mixed feelings, because even with the gestational risk, they are grateful for the gift of motherhood.

Photobiomodulation mitigates Bothrops jararacussu venom-induced damage in myoblast cells by enhancing myogenic factors and reducing cytokine production.

BACKGROUND: Photobiomodulation has exhibited promise in mitigating the local effects induced by Bothrops snakebite envenoming; however, the mechanisms underlying this protection are not yet fully understood. Herein, the effectiveness of photobiomodulation effects on regenerative response of C2C12 myoblast cells following exposure to Bothrops jararacussu venom (BjsuV), as well as the mechanisms involved was investigated. METHODOLOGY/PRINCIPAL FINDINGS: C2C12 myoblast cells were exposed to BjsuV (12.5 µg/mL) and irradiated once for 10 seconds with laser light of 660 nm (14.08 mW; 0.04 cm2; 352 mW/cm2) or 780 nm (17.6 mW; 0.04 cm2; 440 mW/ cm2) to provide energy densities of 3.52 and 4.4 J/cm2, and total energies of 0.1408 and 0.176 J, respectively. Cell migration was assessed through a wound-healing assay. The expression of MAPK p38-α, NF-Кß, Myf5, Pax-7, MyoD, and myogenin proteins were assessed by western blotting analysis. In addition, interleukin IL1-ß, IL-6, TNF-alfa and IL-10 levels were measured in the supernatant by ELISA. The PBM applied to C2C12 cells exposed to BjsuV promoted cell migration, increase the expression of myogenic factors (Pax7, MyF5, MyoD and myogenin), reduced the levels of proinflammatory cytokines, IL1-ß, IL-6, TNF-alfa, and increased the levels of anti-inflammatory cytokine IL-10. In addition, PBM downregulates the expression of NF-kB, and had no effect on p38 MAKP. CONCLUSION/SIGNIFICANCE: These data demonstrated that protection of the muscle cell by PBM seems to be related to the increase of myogenic factors as well as the modulation of inflammatory mediators. PBM therapy may offer a new therapeutic strategy to address the local effects of snakebite envenoming by promoting muscle regeneration and reducing the inflammatory process.

Photobiomodulation in promoting increased Skin Flap Viability: a systematic review of animal studies.

Necrosis is common in skin flap surgeries. Photobiomodulation, a noninvasive and effective technique, holds the potential to enhance microcirculation and neovascularization. As such, it has emerged as a viable approach for mitigating the occurrence of skin flap necrosis. The aim of this systematic review was to examine the scientific literature considering the use of photobiomodulation to increase skin-flap viability. The preferred reporting items for systematic reviews and meta-analyses (PRISMA), was used to conducted systematic literature search in the databases PubMed, SCOPUS, Elsevier and, Scielo on June 2023. Included studies investigated skin-flap necrosis employing PBMT irradiation as a treatment and, at least one quantitative measure of skin-flap necrosis in any animal model. Twenty-five studies were selected from 54 original articles that addressed PBMT with low-level laser (LLL) or light-emitting diode (LED) in agreement with the qualifying requirements. Laser parameters varied markedly across studies. In the selected studies, the low-level laser in the visible red spectrum was the most frequently utilized PBMT, although the LED PBMT showed a similar improvement in skin-flap necrosis. Ninety percent of the studies assessing the outcomes of the effects of PBMT reported smaller areas of necrosis in skin flap. Studies have consistently demonstrated the ability of PBMT to improve skin flap viability in animal models. Evidence suggests that PBMT, through enhancing angiogenesis, vascular density, mast cells, and VEGF, is an effective therapy for decrease necrotic tissue in skin flap surgery.

Evidence for the druggability of aldosterone targets in heart failure: A bioinformatics and data science-driven decision-making approach.

BACKGROUND: Aldosterone plays a key role in the neurohormonal drive of heart failure. Systematic prioritization of drug targets using bioinformatics and database-driven decision-making can provide a competitive advantage in therapeutic R&D. This study investigated the evidence on the druggability of these aldosterone targets in heart failure. METHODS: The target disease predictability of mineralocorticoid receptors (MR) and aldosterone synthase (AS) in cardiac failure was evaluated using Open Targets target-disease association scores. The Open Targets database collections were downloaded to MongoDB and queried according to the desired aggregation level, and the results were retrieved from the Europe PMC (data type: text mining), ChEMBL (data type: drugs), Open Targets Genetics Portal (data type: genetic associations), and IMPC (data type: genetic associations) databases. The target tractability of MR and AS in the cardiovascular system was investigated by computing activity scores in a curated ChEMBL database using supervised machine learning. RESULTS: The medians of the association scores of the MR and AS groups were similar, indicating a comparable predictability of the target disease. The median of the MR activity scores group was significantly lower than that of AS, indicating that AS has higher target tractability than MR [Hodges-Lehmann difference 0.62 (95%CI 0.53-0.70, p < 0.0001]. The cumulative distributions of the overall multiplatform association scores of cardiac diseases with MR were considerably higher than with AS, indicating more advanced investigations on a wider range of disorders evaluated for MR (Kolmogorov-Smirnov D = 0.36, p = 0.0009). In curated ChEMBL, MR had a higher cumulative distribution of activity scores in experimental cardiovascular assays than AS (Kolmogorov-Smirnov D = 0.23, p < 0.0001). Documented clinical trials for MR in heart failures surfaced in database searches, none for AS. CONCLUSIONS: Although its clinical development has lagged behind that of MR, our findings indicate that AS is a promising therapeutic target for the treatment of cardiac failure. The multiplatform-integrated identification used in this study allowed us to comprehensively explore the available scientific evidence on MR and AS for heart failure therapy.

Recognize the epidemiological and geospatial profile of the Mobile Emergency Care Service: a strategy to optimize response time

Epidemiological, cross-sectional, descriptive, retrospective study of a quantitative nature, to trace the epidemiological and geospatial profile of the occurrences assisted by the Mobile Emergency Care Service. For that purpose, secondary data from the documents of the Mobile Emergency Care Service of a city in the interior of Rio Grande do Norte were used, considering the frequency of the variables: sex, age group, nature of occurrences, days of the week, ambulance sent, removal inter-hospital care and patient destination. Of the 363 occurrences, most were due to clinical causes, followed by traumatic, psychiatric, and gynecological/obstetric causes, with an emphasis on cardiovascular diseases and transport accidents. aged 19 to 59 years and over 60 years, with the Basic Support Unit providing the majority of care. Among the calls for clinical causes, women stood out, while for traumatic and psychiatric causes, men. The information contributes to the organization and planning of the service and the understanding of the morbidity profile. The geographic distribution highlights the need for integration between health agencies, for the institution of preventive actions, and the redirection of human and financial resources.

Estudio epidemiológico, transversal, descriptivo, retrospectivo, de carácter cuantitativo que tiene como objetivo trazar el perfil epidemiológico y geoespacial de los incidentes atendidos por el Servicio Móvil de Atención de Urgencias. Para ello se utilizan datos secundarios de dos documentos del Servicio Móvil de Atención de Emergencias de un municipio del interior de Rio Grande do Norte; considera la frecuencia de las variables: sexo, edad, naturaleza de los eventos, días de la semana, ambulancia enviada, retiro interhospitalario y destino del paciente. De los 363 sucesos, la mayoría se debió a causas clínicas, seguidas de causas traumáticas, psiquiátricas y ginecológicas/obstétricas, incluidas las enfermedades cardiovasculares y los accidentes de transporte. La frecuencia de ocurrencia fue ligeramente mayor en individuos masculinos con predominio de mujeres y edades entre los 19 y 59 años y mayores de 60 años; la Unidad Básica de Apoyo fue la responsable de la mayoría de los servicios. Entre los lesionados por causas clínicas destacan las mujeres, mientras que los hombres tienen causas traumáticas y psiquiátricas. Esta información contribuye a la organización y planificación de los servicios y a la comprensión del perfil de morbilidad. La distribución geográfica resalta la necesidad de integración entre las organizaciones de salud para implementar acciones preventivas y redireccionar recursos humanos y financieros.

Update in Immunotherapy for Advanced Non-Small Cell Lung Cancer: Optimizing Treatment Sequencing and Identifying the Best Choices.

The introduction of immunotherapy has brought about a paradigm shift in the management of advanced non-small cell lung cancer (NSCLC). It has not only significantly improved the prognosis of patients but has also become a cornerstone of treatment, particularly in those without oncogenic driver mutations. Immune checkpoint inhibitors (ICIs) play a crucial role in the treatment of lung cancer and can be classified into two main groups: Anti-cytotoxic T lymphocyte antigen-4 (Anti-CTLA-4) and anti-T-cell receptor programmed cell death-1 or its ligand (Anti-PD-1 and Anti-PD-L1). Certainly, the landscape of approved first line immunotherapeutic approaches has expanded to encompass monotherapy, immunotherapy-exclusive protocols, and combinations with chemotherapy. The complexity of decision-making in this realm arises due to the absence of direct prospective comparisons. However, a thorough analysis of the long-term efficacy and safety data derived from pivotal clinical trials can offer valuable insights into optimizing treatment for different patient subsets. Moreover, ongoing research is investigating emerging biomarkers and innovative therapeutic strategies that could potentially refine the current treatment approach even further. In this comprehensive review, our aim is to highlight the latest advances in immunotherapy for advanced NSCLC, including the mechanisms of action, efficacy, safety profiles, and clinical significance of ICI.

Accuracy of wearable electronic device compared to manual and automatic methods of blood pressure determination.

Blood pressure (BP) is the main biomarker for monitoring patients, as its lack of control above values considered normal is a modifiable risk factor for target organ damage. The aim of this study is to evaluate the accuracy of the wearable electronic device photoplethysmography technology (PPG) Samsung Galaxy Watch 4 in determining BP in young patients compared to manual and automatic methods of BP determination. This is a quantitative and cross-sectional study, following validation protocols for wearable devices and BP measurement. It was carried out with twenty healthy young adults, in which BP was measured using four instruments, namely, standard sphygmomanometer device (manual), automatic arm oscillometric device (reference), wrist oscillometric device, and Smartwatch PPG. Eighty systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings were observed. SBP means manual 118 ± 2.20,arm 113 ± 2.54, wrist 118 ± 2.51, and PPG (smartwatch) 113 ± 2.58. Among means, arm and PPG difference is 0.15, arm and wrist 4.95, arm and manual 4.45 wrist with PPG. The mean DBP manual 76.7 ± 1.84, arm 73.6 ± 1.92, wrist 79.3 ± 1.87, and PPG 72.2 ± 1.38. Among means, the difference between the arm and PPG is 1.4 and arm and hand 3.5 mmHg. The correlation shows PPG with manual, arm, and wrist. There was a strong SBP correlation and a moderate DBP correlation between the methods tested, evidencing the accuracy of the PPG smartwatch in relation to the reference method.

Sexual Dimorphism in the Expression of Cardiac and Hippocampal Renin-Angiotensin and Kallikrein-Kinin Systems in Offspring from Mice Exposed to Alcohol during Gestation.

Prenatal alcohol exposure (PAE) impairs fetal development. Alcohol consumption was shown to modulate the renin-angiotensin system (RAS). This study aimed to analyze the effects of PAE on the expression of the renin-angiotensin system (RAS) and kallikrein-kinin system (KKS) peptide systems in the hippocampus and heart of mice of both sexes. C57Bl/6 mice were exposed to alcohol during pregnancy at a concentration of 10% (v/v). On postnatal day 45 (PN45), mouse hippocampi and left ventricles (LV) were collected and processed for messenger RNA (mRNA) expression of components of the RAS and KKS. In PAE animals, more pronounced expression of AT1 and ACE mRNAs in males and a restored AT2 mRNA expression in females were observed in both tissues. In LV, increased AT2, ACE2, and B2 mRNA expressions were also observed in PAE females. Furthermore, high levels of H2O2 were observed in males from the PAE group in both tissues. Taken together, our results suggest that modulation of the expression of these peptidergic systems in PAE females may make them less susceptible to the effects of alcohol.

Aspectos do coping em pacientes adultos e idosos com câncer / Aspects of coping in adult and elderly patients with cancer

O objetivo do estudo foi comparar o enfrentamento emocional, racional, espiritual ou de busca por suporte social dos portadores de câncer nas diferentes fases de estadiamento entre adultos e idosos. Tratou-se de um estudo transversal, exploratório de abordagem quantitativa. Os dados foram coletados utilizando a Escala Modo de Enfrentamento de Problemas, com 182 participantes. O escore dos pacientes mais jovens foi superior, tanto para o foco no problema (p=0,031), quanto para a busca por suporte social (p=0,011). No que se refere à busca por suporte social, a média dos escores na doença localizada foi inferior à média dos escores na ausência de estadiamento (pacientes que há vários anos estavam sem nova progressão da doença ou os que já haviam terminado o tratamento) (p=0,039). Os achados evidenciaram a importância do conhecimento das estratégias de enfrentamento dos portadores de câncer e que a resposta aos estressores depende do contexto individual, coletivo e institucional onde os pacientes estão inseridos.

The aim of the study was to compare the emotional, rational, spiritual coping or the search for social support of cancer patients in the different stages between adults and the elderly. This is a cross-sectional, exploratory study with a quantitative approach. Data were collected using the Problem Coping Mode Scale, with 182 participants. The score of younger patients was higher, both for the focus on the problem (p=0.031) and for the search for social support (p=0.011). Regarding the search for social support, the mean scores for localized disease were lower than the mean scores in the absence of staging (patients who had not progressed further in the disease for several years or those who had already completed treatment) (p. =0.039). The findings evidenced the importance of knowing the coping strategies of cancer patients and that the response to stressors depends on the individual, collective and institutional context in which patients are inserted.

Violência sexual: conhecimentos, atitudes e práticas de profissionais da Atenção Primária / Sexual violence: knowledge, attitudes and practices of Primary Care professionals

Investigar conhecimentos, atitudes e práticas de profissionais da Atenção Primária à Saúde no atendimento à mulher em situação de violência sexual. Estudo transversal, com 359 profissionais da Atenção Primária à Saúde. Os dados foram analisados mediante estatísticas descritivas e teste razão de risco (p ≤ 0,05). Dos 71,8% apresentaram conhecimentos, atitudes (72,7%) e práticas preventivas (92,2%), avaliativas (85,5%), de acompanhamento (72,1%) e assistenciais (46,8%) inadequadas. Profissionais com conhecimentos inadequados tiveram risco aumentado para atitudes, práticas assistenciais e de acompanhamento inadequadas. Entre profissionais com práticas preventivas, assistenciais e de acompanhamento inadequadas, foi percebido risco maior para atitudes inadequadas. A maioria declarou não ter atendido casos de violência sexual. Evidenciaram-se fragilidades relacionadas ao atendimento da mulher em situação de violência sexual, indicando a necessidade de apropriada capacitação profissional, com ênfase na superação da invisibilidade do problema.

To investigate knowledge, attitudes, and practices of Primary Health Care professionals in the care of women in situations of sexual violence. Cross-sectional study, with 359 Primary Health Care professionals. Data were analyzed using descriptive statistics and risk ratio test (p≤0.05). 71.8% had knowledge, attitudes (72.7%) and preventive practices (92.2%), evaluative (85.5%), monitoring (72.1%) and assistance (46.8%) inappropriate. Professionals with inadequate knowledge were at increased risk for inappropriate attitudes, care practices and monitoring. Among professionals with inadequate preventive, care and monitoring practices, a higher risk for inappropriate attitudes was perceived. Most declared that they had not dealt with cases of sexual violence. Weaknesses were evidenced with regard to the care of women in situations of sexual violence, indicating the need for appropriate professional training, with an emphasis on overcoming the invisibility of the problem.

COVID-19 e a assistência multiprofissional às pessoas com síndrome gripal: relato de experiência de Residentes Multiprofissionais em Atenção Básica

Objetivo: descrever as experiências vivenciadas pelos residentes do Programa de Residência em Atenção Básica da Escola Multicampi de Ciências Médicas da Universidade Federal do Rio Grande do Norte, no decorrer do período de enfrentamento à pandemia, em um Centro de Referência para COVID-19. Métodos: trata-se de um relato de experiência, descritivo com abordagem qualitativa, baseado na atuação e em ações realizadas pelos residentes, entre os meses de maio a julho de 2021, no município de Caicó, no Rio Grande do Norte. Resultados: durante esse período, os residentes atuaram na realização de testes por RT-PCR, testes rápidos e sorologias, além da detecção e acompanhamento dos casos suspeitos/confirmados da doença e, além disso, informações, consultas e resultados expressos. Considerações finais: essa experiência proporcionou aos residentes a socialização do conhecimento apreendido nesse cenário da pandemia da COVID-19, como agentes propagadores de informações, além de possibilitar a atuação dos residentes tanto na assistência direta quanto no gerenciamento das atividades do serviço de saúde em questão.

Impact of Prenatal Alcohol Exposure on the Development and Myocardium of Adult Mice: Morphometric Changes, Transcriptional Modulation of Genes Related to Cardiac Dysfunction, and Antioxidant Cardioprotection.

The impact of prenatal alcohol exposure (PAE) varies considerably between individuals, leading to morphological and genetic changes. However, minor changes usually go undetected in PAE children. We investigated PAE's effects on gene transcription of genes related to cardiac dysfunction signaling in mouse myocardium and morphological changes. C57Bl/6 mice were subjected to a 10% PAE protocol. In postnatal days 2 and 60 (PN2 and PN60), morphometric measurements in the offspring were performed. Ventricular samples of the heart were collected in PN60 from male offspring for quantification of mRNA expression of 47 genes of nine myocardial signal transduction pathways related to cardiovascular dysfunction. Animals from the PAE group presented low birth weight than the Control group, but the differences were abolished in adult mice. In contrast, the mice's size was similar in PN2; however, PAE mice were oversized at PN60 compared with the Control group. Cardiac and ventricular indexes were increased in PAE mice. PAE modulated the mRNA expression of 43 genes, especially increasing the expressions of genes essential for maladaptive tissue remodeling. PAE animals presented increased antioxidant enzyme activities in the myocardium. In summary, PAE animals presented morphometric changes, transcription of cardiac dysfunction-related genes, and increased antioxidant protection in the myocardium.

Assistência de enfermagem a pessoas com feridas crônicas: uma experiência na atenção primária à saúde / Nursing care for people with chronic wounds: an experience in primary health care / Asistencia de enfermería a personas con heridas crónicas em atención primaria de salud: informe de experiencia

Objetivo: relatar a experiência de enfermeiros residentes na assistência de pessoas com feridas crônicas no âmbito da Atenção Primária à Saúde. Método: Trata-se de um relato de experiência de enfermeiros residentes de um Programa Multiprofissional duas Unidades Básicas de Saúde no estado do Rio Grande do Norte, no período dos meses de março de 2020 a fevereiro de 2021. Resultados: Os principais tipos de feridas crônicas atendidas durante o período dessa experiência foram: úlceras vasculogênicas, lesões oncológicas, lesões por pressão e úlceras de pé diabético. Como dificuldade foram identificadas a ausência de educação permanente dos profissionais e de insumos/estrutura física adequada das Unidades Básicas de Saúde, apesar disso observou-se a colaboração da equipe multiprofissional ao enfermeiro, favorecendo o cuidado integral destes pacientes. Conclusões: A atuação dos enfermeiros residentes foi perceptível, especialmente na promoção do autocuidado, cuidados com o paciente e na capacitação de outros profissionais, para melhoria e continuidade da assistência (AU).

Objective: to report the experience of resident nurses in assisting people with chronic wounds in the context of Primary Health Care. Method: This is an experience report of nurses residing in a Multiprofessional Program at two Basic Health Units in the state of Rio Grande do Norte, from March 2020 to February 2021. Results: The main types of wounds Chronic diseases attended during the period of this experience were: vasculogenic ulcers, oncological lesions, pressure lesions and diabetic ulcers. As a difficulty, the absence of permanent education of professionals and adequate inputs/physical structure of the Basic Health Units were identified, despite this, the collaboration of the multidisciplinary team with the nurse was observed, favoring the integral care of these patients. Conclusions: The performance of resident nurses was noticeable, especially in promoting self-care, patient care and training other professionals to improve and continue care (AU).

Objetivo: relatar la experiencia de enfermeros residentes en la asistencia a personas con heridas crónicas en el contexto de la Atención Primaria de Salud. Método: Se trata de un relato de experiencia de enfermeros residentes en un Programa Multiprofesional en dos Unidades Básicas de Salud del estado de Rio Grande do Norte, de marzo de 2020 a febrero de 2021. Resultados: Las heridas crónicas atendidas fueron: úlceras vasculogénicas, lesiones oncológicas, lesiones por presión y úlceras diabéticas. Como dificultad, se identificó la ausencia de educación permanente y adecuados insumos/estructura física de las Unidades Básicas de Salud, a pesar de eso, se observó la colaboración del equipo multidisciplinario con el enfermero, favoreciendo el cuidado integral de esos pacientes. Conclusiones: Se destacó la actuación de los enfermeros, sobre todo en la promoción del autocuidado, el cuidado del paciente y la formación de otros profesionales para mejorar y continuar el cuidado (AU).

Discentes de enfermagem e o conhecimento sobre papilomavirus humano e seu imunizante: um estudo transversal / Estudiantes de enfermería y conocimientos sobre el papilomavirus humano y su inmunización: un estudio transversal / Nursing students and knowledge about human papillomavirus and its immunizing: a cross-sectional study

Objetivo: identificar os fatores associados ao conhecimento dos discentes de Enfermagem acerca do Papiloma Vírus Humano e seu imunizante. Método: trata-se de um estudo transversal, de abordagem quantitativa, com uma amostra de 112 participantes. Os dados foram coletados em junho de 2017 mediante um questionário estruturado, aplicado aos discentes de todos os períodos do curso. Foi realizada análise bivariada entre o conhecimento acerca da infecção causada pelo Papiloma Vírus Humano e seu imunizante e as variáveis acadêmicas. Resultados: houve conhecimento satisfatório quanto a temática investigada, com destaque para o conhecimento acerca do imunizante mais expressivo entre os discentes. Os discentes de períodos mais avançados tinham significativo conhecimento sobre a sintomatologia da infecção pelo Papiloma Vírus Humano e a disponibilidade do seu imunizante. Conclusões: de modo geral, os participantes apresentaram conhecimento satisfatório, com destaque para os discentes com mais tempo de curso e mais experiência na atenção à saúde da mulher.

Objetivo: identificar los factores asociados al conocimiento de los estudiantes de Enfermería acerca del Papiloma Virus Humano y su inmunizante. Método: se trata de un estudio transversal, de enfoque cuantitativo, con una muestra de 112 participantes. Los datos fueron recogidos en junio de 2017 mediante un cuestionario estructurado, aplicado a los estudiantes de todos los períodos del curso. Se realizó un análisis bivariado entre el conocimiento acerca de la infección causada por el Virus del Papiloma Humano y su inmunizante y las variables académicas. Resultados: hubo conocimiento satisfactorio en cuanto a la temática investigada, con destaque para el conocimiento acerca del inmunizante más expresivo entre los discentes. Los estudiantes de períodos más avanzados tenían conocimiento significativo sobre la sintomatología de la infección por el Virus del Papiloma Humano y la disponibilidad de su inmunizante. Conclusiones: de modo general, los participantes presentaron conocimiento satisfactorio, con destaque para los discentes con más tiempo de curso y más experiencia en la atención a la salud de la mujer.

Objective to identify the factors associated with the knowledge of nursing students about the Human Papilloma Virus and its immunization. Method: this is a cross-sectional study, with a quantitative approach, with a sample of 112 participants. Data were collected in June 2017 through a structured questionnaire, applied to students of all periods of the course. Bivariate analysis was performed between the knowledge about the infection caused by the Human Papilloma Virus and its immunization and the academic variables. Results: there was satisfactory knowledge about the theme investigated, especially the knowledge about the most expressive immunization among students. Students from more advanced periods had significant knowledge about the symptomatology of infection by Human Papilloma Virus and the availability of its immunizer. Conclusions: in general, the participants presented satisfactory knowledge, especially students with more course time and more experience in women's health care.

Photobiomodulation therapy on local effects induced by juvenile and adult venoms of Bothrops alternatus.

Bothrops snake envenomation is characterized by severe local manifestations such as pain, edema, inflammation, hemorrhage, and myonecrosis. Furthermore, it is described that venom from juvenile and adult snakes may have differences in their composition that can lead to differences in the evolution of the clinical manifestation of the victim. Photobiomodulation (PBM) has been shown to be an effective adjuvant therapy to serum therapy to reduce the local effects induced by bothropic snake venom. This study evaluated the effect of PBM on the local reaction, after Bothrops alternatus snake venom (BaV) injection, in its juvenile (BaJV) and adult (BaAV) stages. Balb/C mice were injected with the juvenile or adult venoms of BaV or saline solution (control group). PBM at a wavelength of 660 nm, 100 mW, 0.33 W/cm2, 40 s, and a 0.028 cm2 beam was applied transcutaneous to a single point with a radiant exposure of 4 J/cm2, 30 min after venom injection. Edema, inflammatory infiltrate, hyperalgesia, and myonecrosis were analyzed. Both venoms induced significant edema and myonecrosis in the gastrocnemius muscle. Hyperalgesia in the mice paw and a prominent leukocyte infiltrate into the peritoneum were also observed. PBM significantly reduced all evaluated parameters. In conclusion, PBM treatment was effective in reducing the local effects induced by B. alternatus venom at different stages of snake development and could be a useful tool as an adjuvant treatment for bothropic envenomation.

Saúde dos homens: processo de trabalho do enfermeiro na atenção primária à saúde / Men's health: nursing work process in primary health care / Salud del hombre: proceso de trabajo de las enfermeras en la atención primaria de salud

Objetivo: conhecer sobre o processo de trabalho do enfermeiro acerca da saúde dos homens na atenção primária à saúde. Método: estudo qualitativo realizado por meio de entrevista aplicada a dez enfermeiras em Unidades Básicas de Saúde de um município do nordeste brasileiro, no mês de outubro de 2018. Para análise de dados utilizou-se Análise de Conteúdo de Bardin, que resultou em duas categorias de análise: "Desvelando o processo de trabalho dos enfermeiras acerca da saúde do homem" e "Conhecimento e perspectiva dos enfermeiras acerca da saúde do homem". Resultados: evidenciou-se que não acontece na atualidade aplicação do processo de trabalho em enfermagem voltado para saúde do homem. No entanto, existe interesse dos profissionais para implementar estratégias de saúde direcionadas para esse público. Conclusão: necessita-se de maior atenção dos gestores aos serviços, para capacitação dos profissionais e infraestrutura adequada da assistência ao homem

Objective: know about the work process of the nurses concerning of men's health. Method: qualitative study performed by interview applied to ten nurses in Basic Health Units of a Brazilian Northeastern Municipality in October 2018. Data analysis was used the "Bardin ́s Content Analysis" which resulted in two categories of analysis: "Exhibiting the nurses work process on man ́s health" and "Knowledge and perspective of nurses about man ́s health". Results: it was evidenced that it is not currently the application of the work process in nursing for the health of man. However, there is interest of professionals to implement health strategies aimed at this public. Conclusions: needs greater attention from managers to the services for the training of professionals and effective infrastructure for men ́s health care

Objetivo: conocer acerca del proceso de trabajo del enfermero acerca de la salud masculina. Metodo: estudio cualitativo realizado por medio de entrevista con diez enfermeras en Unidades Básicas de Salud de un municipio del nordeste brasileño, en octubre de 2018. Para análisis fue utilizado Análisis del Contenido de Bardin, con dos categorías de análisis: "Desvelando el proceso del trabajo de los enfermeros acerca de la salud masculina" y "Conocimiento y perspectiva de los enfermeros acerca da la salud masculina". Resultados: fue evidenciado que no ocurre en la actualidade aplicación del proceso de trabajo en enfermería volviendo para la salud masculina. Existe interés de los profesionales para implementar estrategias de salud direccionadas para ese público. Conclusión: hace necesario atención de los gestores a los servicios, para entrenamiento de los profesionales e infraestructura adecuada de la asistencia al hombre

Photobiomodulation Therapy on Myocardial Infarction in Rats: Transcriptional and Posttranscriptional Implications to Cardiac Remodeling.

BACKGROUND AND OBJECTIVES: Induction of myocardial infarction (MI) in rats by occlusion of the left anterior descending coronary artery is an experimental model used in research to elucidate functional, structural, and molecular modifications associated with ischemic heart disease. Photobiomodulation therapy (PBMT) has become a therapeutic alternative by modulating various biological processes eliciting several effects, including anti-inflammatory and pro-proliferative actions. The main objective of this work was to evaluate the effect of PBMT in the modulation of transcriptional and post-transcriptional changes that occurred in myocardium signal transduction pathways after MI. STUDY DESIGN/MATERIALS AND METHODS: Continuous wave (CW) non-thermal laser parameters were: 660 nm wavelength, power 15 mW, with a total energy of 0.9 J, fluence of 1.15 J/cm2 , spot size of 0.785 cm2 , and time of 60 seconds. Using in silico analysis, we selected and then, quantified the expression of messenger RNA (mRNA) of 47 genes of 9 signaling pathways associated with MI (angiogenesis, cell survival, hypertrophy, oxidative stress, apoptosis, extracellular matrix, calcium kinetics, cell metabolism, and inflammation). Messenger RNA expression quantification was performed in myocardial samples by polymerase chain reaction real-time array using TaqMan customized plates. RESULTS: Our results evidenced that MI modified mRNA expression of several well-known biomarkers related to detrimental cardiac activity in almost all signaling pathways analyzed. However, PBMT reverted most of these transcriptional changes. More expressively, PBMT provoked a robust decrease in mRNA expression of molecules that participate in post-MI inflammation and ECM composition, such as IL-6, TNF receptor, TGFb1, and collagen I and III. Global microRNA (miRNA) expression analysis revealed that PBMT decreased miR-221, miR-34c, and miR-93 expressions post-MI, which are related to deleterious effects in cardiac remodeling. CONCLUSION: Thus, the identification of transcriptional and post-transcriptional changes induced by PBMT may be used to interfere in the molecular dynamics of cardiac remodeling post-MI.

Determinantes sociais da saúde relacionados à gravidez na adolescência / Social determinants of health related to teenage pregnancy

O objetivo foi revisar e descrever na literatura nacional e internacional os determinantes sociais da saúde relacionados à gravidez na adolescência. Trata-se de uma revisão integrativa da literatura, realizada entre os meses de agosto e novembro de 2019. A busca dos artigos foi realizada nas bases de dados eletrônicas PubMed, SciELO e Portal Regional da Biblioteca Virtual em Saúde. A amostra final constituiu-se de 15 artigos, sendo agrupados em categorias temáticas: determinantes sociais da saúde e gravidez na adolescência, associação entre educação e a gravidez na adolescência, conhecimento dos adolescentes e pais relacionado à saúde sexual e reprodutiva.Os determinantes sociais da saúde têm uma relação com a gravidez na adolescência e precisam ser mais explorados nos estudos para maiores intervenções, sendo importantes para formulação de políticas com o objetivo de melhorar as condições de saúde da população. (AU)

The aim was review and describe in the national and international literature the social determinants of health related to teenage pregnancy. This is an integrative literature review, carried out between the months of August and November 2019. The search for the articles was carried out in the electronic databases PubMed, SciELO and Regional Portal of the Virtual Health Library. The final sample consists of 15 articles, being grouped into thematic categories; Social determinants of adolescent health and pregnancy, association Beethoven education and adolescent pregnancy, knowledge of adolescents and parents related to sexual and productive health. Social determinants of health are related to teenage pregnancy and need to be further explored in studies for greater interventions, being important for the formulation of policies in order to improve the health conditions of the population. (AU)

Perfil de fragilidade de idosos atendidos na atenção primária à saúde / Fragility profile of elderly care in primary health care / Perfil de fragilidad de atención a personas mayores en atención primaria de salud

Objetivo: avaliar a prevalência e os graus da fragilidade em idosos atendidos na Atenção Primária à Saúde, através da Edmonton Frail Scale. Método: os dados foram obtidos por meio de um questionário previamente elaborado. Excetuando-se as perdas e recusas amostrais, participaram do estudo 118 idosos. A coleta de dados foi realizada na Unidade Básica de Saúde ou no domicílio dos idosos. Resultados: obteve-se predominância de pessoas do sexo feminino (72%), a idade média foi de aproximadamente 71,55 anos. No tocante a fragilidade de forma geral, 28% (n=3) dos entrevistados obtiveram escores comuns à fragilidade, 32,2% (n=38) foram considerados aparentemente vulneráveis e 39,8% (n=47) não frágeis. Conclusão: considerando as alterações que o idoso fragilizado pode enfrentar com o avanço desse problema, são necessárias intervenções precoces, as quais a Atenção Primária à Saúde é capaz de priorizar, contudo são necessários estudos maiores para avaliarem variáveis relacionadas à fragilidade em diferentes realidades

Objective: to evaluate the prevalence and degrees of frailty in the elderly cared for in Primary Health Care, through the Edmonton Frail Scale. Method: The data were obtained through a previously prepared questionnaire. Except for sample losses and refusals, 118 elderly people participated in the study. Data collection was performed at the Basic Health Unit or at the elderly's home. Results: Among the 118 elderly people interviewed, there was a predominance of females (72%), the average age was approximately 71.55, corroborating also with other studies. Over these, the low level of education stood out. Regarding frailty in general, 28% (n = 3) of the interviewees obtained scores common to frailty, 32.2% (n = 38) were considered apparently vulnerable and 39.8% (n = 47) were not fragile. Conclusion: In view of the changes that the frail elderly can undergo with the progress of this problem, early interventions are needed that Primary Health Care is able to prioritize, however further studies are needed to assess variables related to frailty in different types of people

Objetivo: evaluar la prevalencia y grados de fragilidad en ancianos atendidos en Atención Primaria de Salud, a través de la Edmonton Frail Scale. Método: Los datos se obtuvieron mediante un cuestionario elaborado previamente. A excepción de las pérdidas y negativas de la muestra, 118 personas mayores participaron en el estudio. La recogida de datos se realizó en la Unidad Básica de Salud o en el domicilio del anciano. Resultados: Entre los 118 ancianos entrevistados, hubo predominio del sexo femenino (72%), la edad promedio fue de aproximadamente 71,55 años, corroborando también con otros estudios. Sobre estos, se destacó el bajo nivel educativo. En cuanto a la fragilidad en general, el 28% (n = 3) de los entrevistados obtuvo puntuaciones comunes a la fragilidad, el 32,2% (n = 38) se consideró aparentemente vulnerable y el 39,8% (n = 47) no frágil. Conclusión: Considerando los cambios que pueden enfrentar los ancianos frágiles con el avance de esta problemática, se necesitan intervenciones tempranas, las cuales la Atención Primaria de Salud es capaz de priorizar, sin embargo, se necesitan estudios más amplios para evaluar variables relacionadas con la fragilidad en diferentes realidades