Feelings about birth by a group of high-risk pregnant women.

OBJECTIVE: to understand feelings about birth among a group of high-risk pregnant women. METHOD: a descriptive and qualitative study, using Alfred Schütz's social phenomenology as a philosophical theoretical framework. The study included 25 pregnant women undergoing high-risk prenatal care. The interview had the following guiding questions: tell me about your feelings regarding the moment of birth/childbirth; How do you deal with the high-risk diagnosis? What are your expectations for birth/childbirth? RESULTS: five categories emerged: Fear of obstetric care; Fear of complications with the baby; Fear of cesarean section; Resilience in the face of high-risk pregnancy; and Expectations for birth. CONSIDERATIONS: high-risk pregnant women are afraid of the care they will receive, the risks and concern about the baby's vitality at birth. The importance of care is emphasized, with a welcoming environment, bonding and communication between health team and pregnant woman.

Antiparasitic properties of 4-nerolidylcatechol from Pothomorphe umbellata (L.) Miq. (Piperaceae) in vitro and in mice models with either prepatent or patent Schistosoma mansoni infections.

ETHNOPHARMACOLOGICAL RELEVANCE: Roots of Pothomorphe umbellata (L.) Miq. are used in traditional medicine of Africa and South America for the treatment of malaria and helminthiasis. However, neither P. umbellata nor its isolated compounds have been evaluated against Schistosoma species. AIMS OF THIS STUDY: To investigate the antischistosomal effects of P. umbellata root extracts and the isolated compound 4-nerolidylcatechol (4-NC) against Schistosoma mansoni ex vivo and in murine models of schistosomiasis. MATERIALS AND METHODS: The crude hydroalcoholic (PuE) and hexane (PuH) extracts of P. umbellata roots were prepared and initially submitted to an ex vivo phenotypic screening against adult S. mansoni. PuH was analyzed by HPLC-DAD, characterized by UHPLC-HRMS/MS, and submitted to chromatographic fractionation, leading to the isolation of 4-NC. The anthelmintic properties of 4-NC were assayed ex vivo against adult schistosomes and in murine models of schistosomiasis for both patent and prepatent S. mansoni infections. Praziquantel (PZQ) was used as a reference compound. RESULTS: PuE (EC50: 18.7 µg/mL) and PuH (EC50: 9.2 µg/mL) kill adult schistosomes ex vivo. The UHPLC-HRMS/MS analysis of PuH, the most active extract, revealed the presence of 4-NC, peltatol A, and peltatol B or C. After isolation from PuH, 4-NC presented remarkable in vitro schistosomicidal activity with EC50 of 2.9 µM (0.91 µg/mL) and a selectivity index higher than 68 against Vero mammalian cells, without affecting viability of nematode Caenorhabditis elegans. In patent S. mansoni infection, the oral treatment with 4-NC decreased worm burden and egg production in 52.1% and 52.3%, respectively, also reducing splenomegaly and hepatomegaly. 4-NC, unlike PZQ, showed in vivo efficacy against juvenile S. mansoni, decreasing worm burden in 52.4%. CONCLUSIONS: This study demonstrates that P. umbellata roots possess antischistosomal activity, giving support for the medicinal use of this plant against parasites. 4-NC was identified from P. umbellata roots as one of the effective in vitro and in vivo antischistosomal compound and as a potential lead for the development of novel anthelmintics.

Photo-Fenton process applied for the treatment of industrial wastewaters containing diclofenac: optimization with low iron ions concentrations and without pH control.

Diclofenac (DCF) can cause several adverse effects in the environment and it should be removed from industrial pharmaceutical wastewaters. Advanced oxidation processes (AOPs) are promising methods for the DCF degradation. But, in many cases, AOPs require acidic pH. However, at this condition, DCF precipitates, which may hinder its oxidation. Thus, in this work, some AOP were studied for the DCF degradation, especially the photo-Fenton process, applying the experimental design technique (Doehlert matrix), operating without and with pH control (between 6.5 and 7.0). As independent variables, the initial ferrous ion concentration ([Fe2+]) and the molar addition rate of H2O2 (FH2O2) were evaluated. Empirical models were proposed and optimized conditions were determined without ([Fe2+] = 0.27 mmol L-1 and FH2O2 = 1.64 mmol min-1) and with pH control ([Fe2+] = 1.0 mmol L-1 and FH2O2 = 1.64 mmol L-1), with the following predicted mineralization percentages: 93% and 68%, respectively. So, photo-Fenton process without pH control presented the best performances. Furthermore, at this condition, iron concentration respects the limit value established by the Brazilian environmental legislation. That is, in this condition, additional processes, in order to remove iron ions, would not be necessary, that is very interesting for applications on an industrial scale.

Feelings about birth by a group of high-risk pregnant women / Sentimientos sobre el parto de un grupo de gestantes de alto riesgo / Sentimentos a respeito do nascimento por um grupo de gestantes de alto risco

ABSTRACT Objective: to understand feelings about birth among a group of high-risk pregnant women. Method: a descriptive and qualitative study, using Alfred Schütz's social phenomenology as a philosophical theoretical framework. The study included 25 pregnant women undergoing high-risk prenatal care. The interview had the following guiding questions: tell me about your feelings regarding the moment of birth/childbirth; How do you deal with the high-risk diagnosis? What are your expectations for birth/childbirth? Results: five categories emerged: Fear of obstetric care; Fear of complications with the baby; Fear of cesarean section; Resilience in the face of high-risk pregnancy; and Expectations for birth. Considerations: high-risk pregnant women are afraid of the care they will receive, the risks and concern about the baby's vitality at birth. The importance of care is emphasized, with a welcoming environment, bonding and communication between health team and pregnant woman.

RESUMEN Objetivo: comprender los sentimientos sobre el parto de un grupo de gestantes de alto riesgo. Método: estudio descriptivo y cualitativo, utilizando como marco teórico filosófico la fenomenología social de Alfred Schütz. El estudio incluyó a 25 mujeres embarazadas que se sometían a atención prenatal de alto riesgo. La entrevista tuvo las siguientes preguntas orientadoras: cuénteme sobre sus sentimientos con respecto al momento del nacimiento/parto; ¿Cómo lidia con el diagnóstico de alto riesgo? ¿Cuáles son sus expectativas para el nacimiento/parto? Resultados: surgieron cinco categorías: Miedo a la atención obstétrica; Miedo a las complicaciones con el bebé; Miedo a la cesárea; Resiliencia ante el embarazo de alto riesgo; y Expectativas de nacimiento. Consideraciones: las gestantes de alto riesgo tienen miedo de la asistencia que recibirán, de los riesgos y aprensión en cuanto a la vitalidad del bebé al nacer. Se destaca la importancia de la asistencia con ambiente acogedor, vínculo y comunicación entre el equipo de salud y la gestante.

RESUMO Objetivo: compreender os sentimentos a respeito do nascimento por um grupo de gestantes de alto risco. Método: estudo descritivo e qualitativo, tendo a fenomenologia social de Alfred Schütz como referencial teórico filosófico. Participaram do estudo 25 gestantes em acompanhamento de pré-natal de alto risco. A entrevista contou com as seguintes questões norteadoras: fale-me sobre seus sentimentos em relação ao momento do nascimento/parto; Como você lida com o diagnóstico de alto risco? Quais suas expectativas para o nascimento/parto? Resultados: emergiram cinco categorias: Medo da assistência obstétrica; Medo das complicações com o bebê; Medo da cesariana; A resiliência diante da gestação de alto risco; e Expectativas para o nascimento. Considerações: as gestantes de alto risco sentem medo da assistência que receberão, dos riscos e apreensividade quanto à vitalidade do bebê no nascimento. Ressalta-se a importância de assistência com ambiente acolhedor, efetivação de vínculo e comunicação entre equipe de saúde e gestante.

Effects of inspiratory muscle training on walking capacity of individuals after stroke: A double-blind randomized trial.

OBJECTIVES: Identify the effects of inspiratory muscle training (IMT) on walking capacity, strength and inspiratory muscle endurance, activities of daily living, and quality of life poststroke. DESIGN: Double-blind randomized trial. SETTING: The Sarah Network of Rehabilitation Hospitals. SUBJECTS: Adult poststroke inpatients with inspiratory muscle weakness. INTERVENTIONS: The Experimental Group (EG) (n = 23) underwent IMT for 30 minutes/day, five times/week over six weeks. The Control Group (CG) (n = 27) performed sham IMT. Both groups underwent standard rehabilitation. MAIN MEASURES: Primary outcome was post-intervention six-minute walking test (6MWT) distance. We also measured maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), inspiratory muscle endurance, activities of daily living (functional independence measure - FIM), and quality of life at baseline and post-intervention. Three months after intervention, we measured MIP, walking capacity and quality of life. RESULTS: Baseline characteristics were similar, with mean age 53 ± 11 years and FIM 74 ± 10p. Both groups similarly increased the walking capacity at six weeks (63 vs 67 m, P = 0.803). Compared to the CG, the EG increased the inspiratory endurance (22 vs 7 cmH2O, P = 0.034) but there was no variation in MEP (14 vs 5 cmH2O, P = 0.102), MIP (27 vs 19 cmH2O, P = 0.164), FIM (6 vs 6, P = 0.966) or quality of life (0 vs 0.19, P = 0.493). Gains in both groups were sustained at three months. CONCLUSION: Adding IMT to a rehabilitation program improves inspiratory muscle endurance, but does not further improve MIP, 6-MWT distance, activities of daily living or quality of life of individuals after stroke beyond rehabilitation alone.Registered in Clinical Trials, NCT03171272.

Subconjunctival Loa loa worm: first case report in Brazil.

We report the first case of ocular infestation by Loa loa in Brazil. Loiasis is caused by infestation with Loa loa, a filarial parasite originally found in the rainforests of western and central Africa. It is transmitted by the bite of the fly Chrysops and has been recently described in other places other than Africa, in African immigrants or travellers. Our case is a 33 year-old woman from Cameroon who was living in São Paulo, Brazil, for 5 years. She was asymptomatic until one morning she started feeling "something moving" in the left eye. Under topical anesthesia, on the slit lamp, a moving worm was removed from the subconjunctival space, which later was confirmed to be a male Loa loa adult specimen. Blood tests revealed microfilaraemia of 129 mf/mL. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. This report illustrates an unusual ocular disease, which is extremely rare outside of Africa, but easily diagnosed and treated. Ophthalmologists should be aware of it, in face of an increasingly globalized world.

Subconjunctival Loa loa worm: first case report in Brazil / Verme subconjuntival da espécie Loa loa: primeiro caso no Brasil

We report the first case of ocular infestation by Loa loa in Brazil. Loiasis is caused by infestation with Loa loa, a filarial parasite originally found in the rainforests of western and central Africa. It is transmitted by the bite of the fly Chrysops and has been recently described in other places other than Africa, in African immigrants or travellers. Our case is a 33 year-old woman from Cameroon who was living in São Paulo, Brazil, for 5 years. She was asymptomatic until one morning she started feeling "something moving" in the left eye. Under topical anesthesia, on the slit lamp, a moving worm was removed from the subconjunctival space, which later was confirmed to be a male Loa loa adult specimen. Blood tests revealed microfilaraemia of 129 mf/mL. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. This report illustrates an unusual ocular disease, which is extremely rare outside of Africa, but easily diagnosed and treated. Ophthalmologists should be aware of it, in face of an increasingly globalized world.

Este é o primeiro relato na literatura nacional e internacional de infestação ocular por Loa loa no Brasil. A loíase é uma filariose causada pelo parasita Loa loa, encontrado nas florestas tropicais da África equatorial. A transmissão se dá pela picada do mosquito Chrysops e casos têm sido descritos em países não africanos, em imigrantes e viajantes. O presente caso trata-se de uma paciente de 33 anos natural de Camarões e residente em São Paulo, Brasil, há 5 anos. Até então assintomática, uma manhã sentiu algo "se mexendo" em seu olho esquerdo. Sob anestesia tópica, na lâmpada de fenda, um verme altamente móvel foi removido do espaço subconjuntival e enviado para identificação, que confirmou tratar-se de um espécime macho adulto de Loa loa. Testes sanguíneos revelaram microfilaremia de 129 mf/mL. A paciente foi tratada com albendazol 400 mg e prednisona 60 mg esquema regressivo por 3 semanas. Este relato ilustra uma doença excepcionalmente rara no Brasil, e praticamente desconhecida dos oftalmologistas em nosso país.

Oral taste recognition in health volunteers.

CONTEXT: Taste food recognition has an important role in the nutritional conditions and also allows protection of the organism integrity against foods potentially dangerous. OBJECTIVE: To investigate the presence of the selective taste regions on the tongue and also the palate participation in the oral taste definition. METHODS: A standard tongue divided in six regions was exposed with the four basic tastes (sweet, salted, sour and bitter), 10 times each. Thirteen volunteers were studied from both side and 34 only from one side, performing 240 tests with opened mouth and 240 with closing mouth, just after tongue sapid stimulation. A second group, with 12 volunteers, had its taste recognition studied, with and without palate isolation, using silicone prosthesis (n = 120). RESULTS: From results, chi-square (3x2) and (2x2), nonparametric independency test with P = 0.05 were obtained. CONCLUSIONS: Anterior, medium and posterior regions of the tongue, at both sides, had the same taste discriminative capacity. Nevertheless, closed mouth increased immediate and late recognition capacity by palate participation. It was possible to admit that palate participation increase the sapid perception in the mouth, by recruitment of the palate taste receptors and also by fluid compression and its scattering over tongue surface.

Oral taste recognition in health volunteers / Reconhecimento oral do gosto em voluntários sadios

CONTEXT: Taste food recognition has an important role in the nutritional conditions and also allows protection of the organism integrity against foods potentially dangerous. OBJECTIVE: To investigate the presence of the selective taste regions on the tongue and also the palate participation in the oral taste definition. METHODS: A standard tongue divided in six regions was exposed with the four basic tastes (sweet, salted, sour and bitter), 10 times each. Thirteen volunteers were studied from both side and 34 only from one side, performing 240 tests with opened mouth and 240 with closing mouth, just after tongue sapid stimulation. A second group, with 12 volunteers, had its taste recognition studied, with and without palate isolation, using silicone prosthesis (n = 120). RESULTS: From results, chi-square (3×2) and (2×2), nonparametric independency test with P = 0.05 were obtained. CONCLUSIONS: Anterior, medium and posterior regions of the tongue, at both sides, had the same taste discriminative capacity. Nevertheless, closed mouth increased immediate and late recognition capacity by palate participation. It was possible to admit that palate participation increase the sapid perception in the mouth, by recruitment of the palate taste receptors and also by fluid compression and its scattering over tongue surface.

CONTEXTO: O reconhecimento dos gostos tem importante papel para as condições nutricionais e também para a proteção da integridade do organismo contra a ingestão de alimentos potencialmente perigosos. OBJETIVO: Investigar a presença na língua de regiões com capacidade seletiva para percepção dos gostos básicos e também verificar se e como o palato participa da definição dos gostos na cavidade oral. MÉTODOS: Uma língua padrão hipotética dividida em 6 regiões teve cada umas destas, exposta 10 vezes a cada um dos quatro sabores básicos (doce, salgado, azedo e amargo). Treze voluntários tiveram sua lingual estudada dos dois lados (a direita e a esquerda) e outros 34 foram estudados somente em um dos lados, perfazendo 240 testes com a boca mantida aberta e 240 com a boca sendo fechada, imediatamente após a exposição da língua à substância sápida. Um segundo grupo com 12 voluntários teve o reconhecimento do gosto estudado com e sem o palato isolado pelo uso de uma prótese de silicone (n = 120). RESULTADOS: A partir dos resultados, testes não-paramétricos de independência, foram obtidos qui ao quadrado (3×2) e 2×2, com P = 0.05. CONCLUSÕES: As regiões anterior, média e posterior da língua, dos dois lados, tem a mesma capacidade discriminativa para os gostos. No entanto, com a boca fechada e a participação do palato, ocorre expressivo aumento da capacidade discriminativa oral, com aumento das percepções, tanto da imediata quanto da tardia. Foi possível admitir que a participação do palato aumenta a percepção sápida da boca, pelo recrutamento de receptores do gosto no palato e também pela compressão e espalhamento das soluções de teste sobre a superfície da língua envolvendo maior número de receptores.

Aspectos psicológicos da relação cirurgião-dentista-paciente no tratamento ortodôntico / Psychological aspects of dentist-patient relationship in orthodontic treament

O presente trabalho tem por objetivo abordar os diversos aspectos psicológicos encontrados na relação cirurgião-dentista-paciente visando ao processo de motivação e cooperação do paciente em tratamento ortodôntico. Muita ênfase têm sido dada aos aspectos estéticos e oclusais que influenciam no sucesso ou fracasso do tratamento ortodôntico. Porém, pouca atenção é dada aos aspectos psicológicos relacionais e motivacionais que levariam a uma maior ou menor cooperação por parte do paciente, determinando, assim, os resultados do tratamento ortodôntico

Metodologia da assistência: um estudo para informatização / Assistance Methodology - A Study for Computer Automation

A metodologia da assistência de enfermagem vem sendo realizada por muitos enfermeiros como procedimento de difícil aplicação e implantação. Por isso, observa-se certa morosidade na estruturação de instrumentos que prestigiem a comunicação entre os profissionais de saúde e a pesquisa para melhoria dos níveis de Assistência e Avaliação de determinada população. Dessa forma se implantou um Programa de Assistência de Enfermagem numa comunidade carente utilizando-se um prontuário. Após um período de aplicação do mesmo, se pretendeu avaliá-lo, com o objetivo de detectar os desvios de normalidade desta população com possíveis intervenções de enfermagem e viabilizar a uniformização da coleta de dados para elaboração de um programa de informática. A metodologia consiste em realizar consulta de enfermagem com o instrumento proposto para alcance dos objetivos já mencionados. Os dados revelaram,dentre vários itens, um alto índice de alcoolistas os quais relataram ter doenças respiratórias. Quanto à aplicação e à tabulação dos dados alguns itens não foram coletados com devida significância pelos entrevistadores, o que dificultou detectar alguns desvios de normalidades, levando, assim, à confirmação da necessidade da uniformização de termos e ao questionamento para a padronização de dados, permitindo melhor caracterização da população e promovendo uma Assistência mais qualificada.