Fatores que influenciam a decisão da via do parto / Factors that influence the decision of the parturition method

Objetivos: Verificar os fatores que influenciam a parturiente na decisão da via de parturição e identificar a preferência da via de parto em uma próxima gestação. Metodologia: Trata-se de uma revisão integrativa da literatura com artigos datados de 2010 a 2020, retirado nas bases da SCIELO (Scientific Electronic Library Online) e LILACS (Literatura Latino-Americana e do Caribe em Ciências e Saúde). Resultados: Sete dimensões refletem os fatores que influenciam a parturiente no momento da decisão da via de parto: dor ou ausência de dor no momento do parto; dor ou ausência de dor no pós-parto; recuperação no pós-parto; risco de infecção e de hemorragia; experiência prévia; influência da família e médicos, e pelo desejo de realizar a laqueadura. As perguntas norteadoras da pesquisa estão expressas em: quais são os fatores que influenciam a parturiente no momento da decisão da via de parto? E, qual é a via de parto em uma nova gestação? Considerações finais: Os fatores que mais influenciam as gestantes na decisão da via de parto são o medo da dor no parto e a recuperação no pós parto. Em uma nova gestação, acabam optando pela mesma via de parto anterior, devido à segurança, por já terem vivenciado a experiência

Objectives: This study aims to verify the factors that influence the decision of the parturition method and identify the preferred route of parturition in the next pregnancy. Methodology: This is an integrative literature review with articles dated from 2010 to 2020, taken from the SCIELO (Scientific Electronic Library Online) and LILACS (Latin American and Caribbean Literature in Science and Health) databases. Results: Seven dimensions reflect the factors that influence the parturient when deciding the parturition method: pain or absence at the time of parturition; postpartum pain or absence; postpartum recovery; risk of infection and bleeding; previous experience; influence of family and doctors and tubal ligation. The guiding questions of this research are expressed in: What are the factors that influence the parturient when deciding the parturition method? And what is the preferred parturition method a new pregnancy? Final considerations: The factors that most influence pregnant women while deciding the mode of parturition are fear of pain during childbirth and postpartum recovery. In a new pregnancy, they end up opting for the same birth route as the previous one due to the safety of having lived through the experience

Quedas de pacientes idosos atendidos em uma unidade de pronto atendimento na cidade de Goianésia-GO / Falls of elderly patients served at na emergency care unit in the city of Goianesia-GO

Objetivo: Identificar as causas e consequências das quedas de pacientes idosos, ocorridas fora do âmbito hospitalar, antes da internação em uma Unidade de Pronto Atendimento (UPA) de Goianésia, no estado de Goiás. Métodos: Trata-se de uma pesquisa quantitativa, de natureza retrospectiva e descritiva, realizada em uma UPA. Foram coletadas informações de 55 prontuários de pacientes idosos que sofreram quedas. Resultados: Foram 55 pacientes idosos, que sofreram quedas fora da UPA, na cidade de Goianésia, no mês de janeiro de 2020. Desses pacientes, 23 eram mulheres e 32 homens; a faixa etária variou entre 60 e 92 anos. O local com maior incidência de quedas foi o domicílio dos pacientes, representando 76,36%; das quedas, 85,45% apresentaram como causa ambiente inadequado, no domicílio ou na rua. Cada paciente teve uma ou mais consequências, que ficaram entre leves, moderadas ou graves. Todos os 55 pacientes apresentaram algum tipo de algia. Considerações finais: A partir desse estudo, foi possível identificar as características das quedas sofridas pelos idosos, atendidos na UPA de Goianésia. Devido ao evento adverso, os pacientes tiveram algia, trauma, escoriações, edemas, traumatismo cranioencefálico, fraturas e hematomas. O único protocolo implantado no hospital é o protocolo de Manchester

Objective: Identify the causes and consequences of falls in elderly patients that occurred outside the hospital environment, before admission to an Emergency Care Unit (UPA) in Goianésia, in the State of Goiás. Identify the characteristics of falls that occurred outside the hospital environment of elderly patients, before admission to an Emergency Care Unit (UPA) in Goianésia, in the state of Goiás. Methods: This was a quantitative research of a nature retrospective and descriptive study carried out in an Emergency Care Unit. Information was collected from 55 medical records of elderly patients who suffered falls. Results: There were 55 patients over the age of 60 who suffered a fall outside the Emergency Care Unit in the city of Goianésia in January 2020. Of these 55 patients, 23 were women and 32 men, the age range of patients ranged from 60 and 92 years. The place with the highest incidence of falls was at the patients' homes, representing 76.36%, and 85.45% of the falls had an inappropriate environment at home or on the street as a cause. Each patient had one or more consequences, which were mild, moderate or severe. All 55 patients had some type of pain. Final considerations: From this study, it is possible to identify the characteristics of falls suffered by the elderly, seen at the UPA in Goianésia. Due to the adverse event, patients had pain, trauma, abrasions, edema, traumatic brain injury, fractures and bruises. The only protocol implanted in the hospital is the Manchester protocol

IMMUNOMODULATING EFFECTS OF THE PURIFIED HEV B 13 FRACTION ON SEPTIC RATS.

BACKGROUND: Sepsis is a potentially life-threatening complication of an infection that occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body, especially in the acute phase of the disease, producing excessive pro-inflammatory cytokines, leading to multiple organ injury and death. The Hev b 13 fraction has demonstrated biological activity capable of inducing IL-10 production and shrinking inflammatory disease lesions. AIM: To investigate the immunomodulating effects of the Hev b 13 fraction on septic rats. METHODS: Acinetobacter baumannii was injected into the peritoneal cavity of the animals after sustaining a lesion in the pancreas, with the stomach as an entry point. After 10 h of infection, they were euthanized for blood and lung collection, followed by total and differential leukocyte count, determination of cytokine level and histopathological analysis. RESULTS: Administering a single dose of the Hev b 13 fraction 2 h after sepsis induction significantly decreased total leukocyte count. Higher IL-10 and IL-4 and lower IL-6 production shrank the lung tissue lesions compared to the control groups. CONCLUSION: The Hev b 13 fraction exhibits an anti-inflammatory tendency, with potential for sepsis treatment.

Immunomodulating effects of the purified hev b 13 fraction on septic rats / Efeitos imunomoduladores da fração purificada hev b 13 em ratos com sepse

ABSTRACT Background: Sepsis is a potentially life-threatening complication of an infection that occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body, especially in the acute phase of the disease, producing excessive pro-inflammatory cytokines, leading to multiple organ injury and death. The Hev b 13 fraction has demonstrated biological activity capable of inducing IL-10 production and shrinking inflammatory disease lesions. Aim: To investigate the immunomodulating effects of the Hev b 13 fraction on septic rats. Methods: Acinetobacter baumannii was injected into the peritoneal cavity of the animals after sustaining a lesion in the pancreas, with the stomach as an entry point. After 10 h of infection, they were euthanized for blood and lung collection, followed by total and differential leukocyte count, determination of cytokine level and histopathological analysis. Results: Administering a single dose of the Hev b 13 fraction 2 h after sepsis induction significantly decreased total leukocyte count. Higher IL-10 and IL-4 and lower IL-6 production shrank the lung tissue lesions compared to the control groups. Conclusion: The Hev b 13 fraction exhibits an anti-inflammatory tendency, with potential for sepsis treatment.

RESUMO Racional: Sepse se correlaciona com a ruptura do complexo equilíbrio entre os mediadores inflamatórios, que principalmente na fase aguda da doença, produz exacerbadamente citocinas pró-inflamatórias levando a lesão de múltiplos órgãos e morte. A fração Hev b 13 tem demonstrado atividade biológica capaz de induzir a produção de IL-10 e regredir lesões de doenças inflamatórias. Objetivo: Investigar os efeitos imunomoduladores da fração Hev b 13 em ratos com sepse. Métodos: Foi injetado Acinetobacter baumannii na cavidade peritoneal dos animais após lesão no pâncreas e estômago como porta de entrada. Após 10 h de infecção, foi realizada eutanásia para coleta de sangue e pulmões, em seguida, contagem total e diferencial de leucócitos, dosagem de citocinas e histopatologia para análise. Resultados: A administração de dose única da fração Hev b 13, 2 h após a indução de sepse, diminuiu significativamente a contagem total de leucócitos. Associado a maior produção de IL-10 e IL-4, e menor de IL-6, atenuou as lesões nos tecidos pulmonares em comparação com os grupos controles. Conclusão: A fração Hev b 13 apresenta tendência anti-inflamatória, com potencialidades no tratamento da sepse.

Evaluation of wound healing treated with latex derived from rubber trees and Aloe Vera extract in rats.

PURPOSE:: To compare the use of latex derivative and Aloe vera extract to wound healing. METHODS:: Twenty one rats were randomly divided into three groups and each one had a wound made by incision. The treatment consisted in: derivative of latex (GL), Aloe vera extract (GA) and saline solution (GC). The wound area was measured on the 7th, 14th and 21st days and macroscopic and microscopic evaluation were done. RESULTS:: The comparison between the measurements of the wounds presented statistical difference in GC and GA from the 7th day of evaluation and GL from the 14th day. The extent of the wound was significantly smaller by the 7th day in GL. Histologically, in GL, the neovascularization was significant on the 7th, 14th and 21st days. On the 21st day the scar was large and little mature. In GA and GC, the findings were similar on the 7th, 14th and 21st days with a slight better organization of skin and collagen on the 21st in GA. CONCLUSIONS:: Statistical analysis did not allow for the definition of the best topical agent. The latex had the highest angiogenesis, but a possible foreign body granuloma. Aloe vera has revealed a healing process adequated temporally in histology.

Evaluation of wound healing treated with latex derived from rubber trees and Aloe Vera extract in rats

ABSTRACT PURPOSE: To compare the use of latex derivative and Aloe vera extract to wound healing. METHODS: Twenty one rats were randomly divided into three groups and each one had a wound made by incision. The treatment consisted in: derivative of latex (GL), Aloe vera extract (GA) and saline solution (GC). The wound area was measured on the 7th, 14th and 21st days and macroscopic and microscopic evaluation were done. RESULTS: The comparison between the measurements of the wounds presented statistical difference in GC and GA from the 7th day of evaluation and GL from the 14th day. The extent of the wound was significantly smaller by the 7th day in GL. Histologically, in GL, the neovascularization was significant on the 7th, 14th and 21st days. On the 21st day the scar was large and little mature. In GA and GC, the findings were similar on the 7th, 14th and 21st days with a slight better organization of skin and collagen on the 21st in GA. CONCLUSIONS: Statistical analysis did not allow for the definition of the best topical agent. The latex had the highest angiogenesis, but a possible foreign body granuloma. Aloe vera has revealed a healing process adequated temporally in histology.

EFFECTS OF TOPICAL TREATMENT WITH EUPHORBIA TIRUCALLI LATEX ON THE SURVIVAL AND INTESTINAL ADHESIONS IN RATS WITH EXPERIMENTAL PERITONITIS / EFEITOS DO TRATAMENTO TÓPICO COM O LÁTEX DA EUPHORBIA TIRUCALLI NA SOBREVIDA E NAS ADERÊNCIAS INTESTINAIS DE RATOS COM PERITONITE EXPERIMENTAL

Background: The use of plants of the family Euphorbiaceae, particularly Euphorbia tirucalli (avelós) has been popularly widespread for treating a variety of diseases of infectious, tumoral, and inflammatory. Aim: To demonstrated antimicrobial and immunomodulatory effects of these extracts, evaluating the effect of a topical treatment with an aqueous solution of avelós latex on the survival and on intestinal adhesions in rats with experimental peritonitis. Methods: Peritonitis was induced in 24 Wistar rats, that were randomized into four groups of six as follows: (1) Control group (n=6), no treatment; (2) Antibiotic group (n=6), treatment with a single intramuscular dose of antibiotic Unasyn; (3) Saline group (n=6), the abdominal cavity was washed with 0.9% saline; and (4) E.tirucalli group (n=6), the abdominal cavity was washed with E. tirucalli at a concentration of 12 mg/ml. The animals that died were necropsied, and the time of death was recorded. The survivors were killed on postoperative day 11, and necropsy was subsequently performed for evaluation of the intestinal adhesions. Results: Significant differences were observed in the control and antibiotic groups (p<0.01) with respect to the survival hours when compared with the saline and E. tirucalli groups. There was no significant difference (p>0.05) in the survival of animals in the saline andE. tirucalli groups; however, one animal died in the saline group. Necropsy of the animals in the saline and E. tirucalligroups showed strong adhesions resistant to manipulation, between the intestinal loops and abdominal wall. The remaining groups did not show any adhesions. Conclusions: Topical treatment with E. tirucalli latex stimulated an increased formation of intestinal adhesions and prevented the death of all animals with peritonitis.

Racional: O uso de plantas da família Euphorbiaceae, principalmente a Euphorbia tirucalli (avelós), tem sido popularmente difundido para o tratamento de uma variedade de doenças de natureza infecciosa, tumoral e inflamatória. Objetivo: Avaliar o efeito do tratamento tópico com a solução aquosa do látex do avelós na sobrevida e nas aderências intestinas de ratos com peritonite experimental. Métodos: Foi induzido peritonite em 24 ratos Wistar e randomizados em quatro grupos de seis, assim distribuídos: 1) Controle - (n=6), nenhum tratamento; 2) Antibiótico - (n=6), tratamento com dose única intramuscular de antibiótico Unasyn (Pfizer - São Paulo); 3) Salina - (n=6), lavagem da cavidade abdominal com solução fisiológica 0,9%; 4) E.Tirucalli - (n=6), lavagem da cavidade abdominal com E. tirucalli na concentração de 12 mg/ml. Os animais que morreram foram submetidos à necropsia e o horário do óbito anotado. Os sobreviventes foram submetidos à eutanásia no 11odia de pós-operatório e, posteriormente, realizou-se a necropsia para avaliação da formação de aderências. Resultados: Os grupos controle e antibiótico obtiveram diferença significativa (p<0,01) com relação às horas de vida entre os grupos salina e E. tirucalli. Não houve diferença significativa (p>0,05) na sobrevida dos animais dos grupos salina e E. tirucalli, no entanto, houve um óbito no grupo salina. A necropsia dos animais dos grupos salina e E. tirucalli mostrou aderências firmes e resistentes à manipulação entre alças intestinais e parede abdominal. Os demais grupos não tiveram formação de aderências. Conclusão: O tratamento tópico com o látex da E. tirucalli estimulou maior formação de aderências intestinais e evitou o óbito de todos animais com peritonite até o período avaliado.

Angiogenic activity of sucupira (Pterodon emarginatus) oil / Atividade angiogênica do óleo de sucupira (Pterodon emarginatus)

Aims: To assess the angiogenic activity of sucupira (Pterodon emarginatus) oil, popularly used as an antirheumatic, analgesic, antimicrobial, and anti-inflammatory agent. Methods: The chick (Gallus domesticus) embryo chorioallantoic membrane (CAM) assay was used as an experimental model, incubated in a temperature- and humidity- controlled automatic incubator during the first five days. A circular hole was made at the wider base of the eggshell on the fifth day. After 13 days of incubation, filter paper discs containing sucupira oil and control substances were inserted into the CAM. Subsequently, the CAMs were removed and submitted to analysis and quantification of the vascular network. The nonparametric KruskalWallis test, followed by Dunn's test, was used for the statistical analysis, and differences between the samples were set at a 5% level (p<0.05). Results: Sucupira oil at a concentration of 1g/mL induced a significant increase in the percentage area of the CAM vascular network of the embryonated chicken eggs, when compared with the neutral control (water) and inhibitory control (dexamethasone) groups (p<0.001). However, no significant difference in the induction of the CAM vascular network (p>0.05) was demonstrated between the oil and the positive control (Biocure) groups. Conclusions: The sucupira (Pterodon emarginatus) bean oil induced the formation of new blood vessels under the experimental conditions of the present study.

Objetivos: Avaliar a atividade angiogênica do óleo de sucupira (Pterodon emarginatus), popularmente utilizado como antirreumático, analgésico, antimicrobiano e anti-inflamatório. Métodos: Foi aplicado como modelo experimental o ensaio na membrana corioalantóidea (MCA) de ovo embrionado de galinha (Gallus domesticus). Os ovos foram incubados em estufa automática com temperatura e umidade controladas durante os primeiros cinco dias. No quinto dia foi realizada uma abertura circular na base maior da casca do ovo. No 13º dia de incubação, discos de papel de filtro contendo óleo de sucupira e as substâncias controle foram inseridos sobre vasos da MCA. Posteriormente, as MCAs foram removidas e passaram por análise e quantificação da rede vascular. Para análise estatística foi utilizado o teste não paramétrico de Kruskal-Wallis, seguido de Dunn, sendo os valores aceitáveis para diferenças significativas entre as amostras de p<0.05. Resultados: O óleo da fava de sucupira na concentração de 1g/mL induziu um aumento significativo na área de porcentagem da rede vascular na MCA do ovo embrionado de galinha, quando comparados aos grupos controles neutro (água) e inibidor (dexametasona) (p<0.001). Porém, não foi demonstrada diferença significativa entre o óleo e o controle positivo (Biocure) na indução da rede vascular na MCA (p>0.05). Conclusões: O óleo da fava de sucupira (Pterodon emarginatus), nas condições deste experimento, foi responsável pela formação de novos vasos sanguíneos.