Infantile hemangiomas: risk factors for complications, recurrence and unaesthetic sequelae

Abstract Background: Infantile hemangiomas (IH) occur in approximately 4% to 10% of the pediatric population. The identification of clinical subtypes and conditions that indicate increased risk for complications is essential for therapeutic success. Objectives: To identify risk factors for complications, recurrence and unaesthetic sequelae. Methods: Retrospective cohort of patients with infantile hemangiomas undergoing follow-up at the Dermatology Service of Universidade Federal de Ciências da Saúde de Porto Alegre, between 2006 and 2018. Results: 190 patients were included; 24% had some type of complication, ulceration being the most frequent, and 86% required treatment. On correlation, ulceration was statistically related to mixed IH (p = 0.004), segmental IH (p < 0.01) and location in the gluteal region (p = 0.001). The mean time of treatment with propranolol was 12.7 months. Patients with PHACES syndrome and segmental infantile hemangioma required longer treatment (p < 0.001 and p = 0.0407, respectively), as well as those who started treatment after five months of life (p < 0.0001). Recurrence occurred in 16.6% of the treated patients, all-female; 94% were located on the head and neck (mainly on the upper eyelid, cyrano, S3 segment, and with parotid involvement); 61% and 38.8% were of the mixed and deep subtypes, respectively. Approximately 1/3 of the patients had some unaesthetic sequelae. Study limitations: As this is a retrospective study, data and photos of some patients were lost. Conclusions: Mixed and segmental hemangiomas are risk factors for ulceration and sequelae. Recurrence occurs more often in females and segmental hemangiomas. Segmental infantile hemangioma and PHACES syndrome require a longer time of treatment. Specific protocols are required for infantile hemangiomas with a high risk of recurrence.

"Real-world" effectiveness of methylphenidate in improving the academic achievement of Attention-Deficit Hyperactivity Disorder diagnosed students-A systematic review.

WHAT IS KNOWN AND OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD) symptoms usually impairs academic achievement and can trigger the onset of medication. Methylphenidate is a drug widely prescribed to treat ADHD. However, systematic reviews of randomized clinical trials suggest that it does not lead to great improvements in academic performance. Thus, we aimed to evaluate the evidence on the "real-world" effectiveness of methylphenidate in improving the academic achievement of ADHD students. METHODS: We conducted a systematic review of observational studies retrieved from five electronic databases, besides a manual search and search in grey literature. Studies evaluating treatment with methylphenidate compared to no treatment or other pharmacological/non-pharmacological alternatives used in ADHD were included. The risk of bias of the selected studies was assessed using adapted versions of the Newcastle-Ottawa Scale. RESULTS AND DISCUSSION: Nine studies (from ten reports) were included in the review: four cohorts, two before-and-after designs and three cross-sectional studies. They involved 12,269 children and adolescents aged 6-18 years. The doses of methylphenidate ranged from 10 to 72 mg/day, and the duration of the treatment from 2.6 months to 4.25 years. Five of these studies concluded that methylphenidate improves academic performance. However, three of the four lowest-bias risk studies concluded that the drug is ineffective. Five studies assessed the long-term use of methylphenidate, and four of them concluded that it does not result in better outcomes in the school setting. Most included studies had considerable limitations and significant heterogeneity regarding methodological design and academic performance measurement criteria. WHAT IS NEW AND CONCLUSION: Although some studies indicate that the short-term use of methylphenidate may improve outcomes in the school environment, the available evidence does not support the establishment of adequate conclusions about the real benefits of methylphenidate in the academic improvement of ADHD students.

Infantile hemangiomas: risk factors for complications, recurrence and unaesthetic sequelae.

BACKGROUND: Infantile hemangiomas (IH) occur in approximately 4% to 10% of the pediatric population. The identification of clinical subtypes and conditions that indicate increased risk for complications is essential for therapeutic success. OBJECTIVES: To identify risk factors for complications, recurrence and unaesthetic sequelae. METHODS: Retrospective cohort of patients with infantile hemangiomas undergoing follow-up at the Dermatology Service of Universidade Federal de Ciências da Saúde de Porto Alegre, between 2006 and 2018. RESULTS: 190 patients were included; 24% had some type of complication, ulceration being the most frequent, and 86% required treatment. On correlation, ulceration was statistically related to mixed IH (p = 0.004), segmental IH (p < 0.01) and location in the gluteal region (p = 0.001). The mean time of treatment with propranolol was 12.7 months. Patients with PHACES syndrome and segmental infantile hemangioma required longer treatment (p < 0.001 and p = 0.0407, respectively), as well as those who started treatment after five months of life (p < 0.0001). Recurrence occurred in 16.6% of the treated patients, all-female; 94% were located on the head and neck (mainly on the upper eyelid, cyrano, S3 segment, and with parotid involvement); 61% and 38.8% were of the mixed and deep subtypes, respectively. Approximately 1/3 of the patients had some unaesthetic sequelae. STUDY LIMITATIONS: As this is a retrospective study, data and photos of some patients were lost. CONCLUSIONS: Mixed and segmental hemangiomas are risk factors for ulceration and sequelae. Recurrence occurs more often in females and segmental hemangiomas. Segmental infantile hemangioma and PHACES syndrome require a longer time of treatment. Specific protocols are required for infantile hemangiomas with a high risk of recurrence.

Development and evaluation of topical formulations that contain hydroethanolic extract from Schinus terebinthifolia against HSV-1 infection

Abstract The therapeutic drugs to treat Herpes simplex virus (HSV) infections have toxic side effects and there has been an emergence of drug-resistant strains. Therefore, the search for new treatments for HSV infections is mounting. In the present study, semi-solid formulations containing a crude hydroethanolic extract (CHE) from Schinus terebinthifolia were developed. Skin irritation, cutaneous permeation, and in vivo therapeutic efficacy of the formulations were investigated. Treatment with the ointment formulations did not result in any signs of skin irritation while the emulsions increased the thickness of the epidermis in Swiss mice. The cutaneous permeation test indicated that the CHE incorporated in the formulations permeated through the skin layers and was present in the epidermis and dermis even 3 h after topical application. In vivo antiviral activity in BALB/c mice treated with the CHE ointments was better than those treated with the CHE emulsions and did not significantly differ from an acyclovir-treated group. Taken together, this suggests that the incorporation of CHE in the ointment may be a potential candidate for the alternative topical treatment of herpetic lesions.

Photochemoprotective Potential of the Ethyl Acetate Fraction from Eugenia hiemalis Leaves and Its 2,6-Di-O-galloylarbutin Isolate Against UVB-Induced Photodamage.

Intense and constant exposure to UVB radiation can lead to inflammation and oxidative stress, which are associated with many cutaneous disorders, including photoaging and skin cancer. Antioxidant plant materials that are rich in polyphenols, such as the ethyl acetate fraction (EAF) from Eugenia hiemalis leaves, and phenolic compounds represent a promising approach to protect the skin against UVB-induced damage. The present study evaluated the photochemoprotective potential of the EAF and its 2,6-di-O-galloylarbutin (1) isolate. The EAF and the phenolic antioxidant (1) reduced UVB-induced L929 fibroblast death. The EAF prevented UVB-induced damage in fibroblasts by inhibiting the intracellular production of reactive oxygen species and lipid peroxidation, especially in pretreated cells. Topical treatment with an emulsion with 1% EAF prevented/attenuated UVB-induced inflammation and oxidative stress in the skin in hairless mice by controlling the increase in myeloperoxidase activity, reducing superoxide anion production, maintaining radical-scavenging ability and ferric reducing power, and controlling the depletion of reduced glutathione and catalase levels. The EAF also inhibited the increase in epidermal thickness, mast cell infiltration, the number of sunburn cells and collagen fiber destruction that were triggered by UVB. The in vitro and in vivo results indicated that the EAF is a bioactive agent that is able to protect the skin against the harmful effects of UVB.

Os saberes corporais na Educação Física escolar: reflexões acerca dos processos avaliativos / Body knowledge in Physical Education: reflections on evaluation processes / Conocimiento corporal en la Educación Física escolar: reflexiones sobre los procesos de evaluación

Na Educação Física escolar a avaliação dos saberes corporais vem se mostrando como um campo ainda pouco explorado pelo debate acadêmico. Neste sentido, o objetivo desta pesquisa foi analisar um processo avaliativo, envolvendo a utilização de fichas nas aulas de Educação Física no ensino médio, dos saberes corporais dos estudantes acerca do handebol. Pautada pela pesquisa-ação, a investigação foi desenvolvida ao longo de seis meses com uma turma de 30 estudantes do ensino médio. As coletas foram realizadas por meio de diário de aula (produzido pela professora) e questionários aplicados aos estudantes. A utilização das fichas avaliativas possibilitou a captação expressiva de elementos correspondentes aos aspectos técnicos, táticos, volitivos e físicos do jogo de handebol, individual e coletivamente. A avaliação entre pares permitiu a partilha de saberes e trouxe aos estudantes a oportunidade de 'olhar' o jogo atentamente e aprender com isso. Esta dinâmica também contribuiu para o entendimento e a sensibilização da/com a história de vida do outro em relação às experiências esportivas, promovendo maior respeito entre os discentes. Os resultados dos recursos utilizados para avaliar os saberes corporais dos estudantes nas aulas de Educação Física expressam a necessidade de uma reorientação das práticas pedagógicas, o que envolve, dentre outros aspectos, um conhecimento sobre as estruturas, dinâmicas e interações características de cada prática corporal

In school Physical Education, the evaluation of body knowledge has been showing itself as a field still little explored by the academic debate. In this sense, the objective of this research was to analyze na evaluative process, involving the use of cards in Physical Education classes in high school, of the students' body knowledge about handball. Based on action research, the investigation was carried out over six months with a group of 30 high school students. Collections were carried out through a class diary (produced by the teacher) and questionnaires applied to students. The use of the evaluations forms enabled the expressive capture of elements corresponding to the technical, tactical, volitional and physical aspects of the handball game, individually and collectively. Peer review allowed for the sharing of knowledge and provided students with the opportunity to 'wacht' the game closely and learn from it. This dynamic also contributed to the understanding and awareness of/whith the life's history of the other in relation to sports experiences, promoting greater respect among students. The results of the resources used to assess students' body knowledge in Physical Education classes express the need for a reorientation of pedagogical practices, which involves, among other aspects, a knowledge of the structures, dynamics and interactions characteristic of each body practice.

En la Educación Física en la escuela, la evaluación del conocimiento corporal se há mostrado como um campo aún poco explorado por el debate académico. En este sentido, el objetivo de esta investigación fue analizar um proceso evaluativo, que implica el uso de tarjetas en las clases de Educación Fisica en la escuela secundaria, del conocimiento del cuerpo de los estudiantes sobre el balonmano. Basado en una investigación-acción, la investigación se llevó a cabo durante seis meses con una classe de 30 estudiantes de secundaria. Las colecciones se llevaron a cabo a través de un diário de classe (producido por el professor) y cuestionarios aplicados a los estudiantes. El uso de los formularios de evaluación permitió la captura expresiva de elementos correspondientes a los aspectos técnicos, táctcos, volitivos y físicos del juego de balonmano, individual y colectivamente. La revisión por pares permitió el intercambio de conocimientos y brindó a los estudiantes la oportunidade de 'observar' el juego de cerca y aprender de él. Esta dinámica también contribuyó a la comprensión y consciência de/com la histora de vida del outro en relación con las experiências deportivas, promovendo um mayor respeto entre los estudiantes. Los resultados de los recursos utilizados para evaluar el conocimiento del cuerpo de los estudiantes en las classes de Educación Física expresan la necesidad de uma reorientación de las prácticas pedagógicas, lo que implica, entre otros aspectos, un conocimiento de las estructuras, dinâmicas e interacciones características de cada práctica corporal.

Nectandra cuspidata fraction and the isolated polyphenols protect fibroblasts and hairless mice skin from UVB-induced inflammation and oxidative stress.

Excessive exposure to UVB radiation can lead to oxidative and inflammatory damage that compromises the cutaneous integrity. The application on the skin of photochemoprotective products is considered a relevant approach for the prevention of oxidative damage. In this study the in vitro and in vivo photochemoprotective effects of antioxidant plant materials obtained from the leaves of Nectandra cuspidata Nees following UVB irradiation were evaluated. The cytoprotective effect, reactive oxygen species (ROS) production and lipid peroxidation (LPO) were assessed in L-929 fibroblasts treated with the ethyl acetate fraction (EAF) or isolated compounds (epicatechin, isovitexin and vitexin) before or after irradiation with UVB (500 mJ/cm2). EAF substantially reduced the dead of cells and inhibited the UVB-induced ROS production and LPO in both treatments, compared with the irradiated untreated fibroblasts, presenting effects similar or better than pure compounds. The in vivo photochemoprotective effects of a topical emulsion containing 1% EAF (F2) were evaluated in hairless mice exposed to UVB. F2 improved all evaluated parameters in the skin of animals, inhibited ROS production, increased antioxidant defenses by decreasing reduced glutathione (GSH) and catalase depletion, reduced the activities of metalloproteinases (MMP-2 and MMP-9) and myeloperoxidase, decreased epidermal thickness and skin edema, and inhibited the appearance of sunburn cells as well as the recruitment of neutrophils and mast cell inflammatory infiltrates. These findings show that EAF presents high photochemoprotective effects, and that a topical formulation containing it may have potential for skin care.

Os esportes coletivos na escola: reflexões sobre as atividades curriculares desportivas / Collective sports in school: reflections on sports curricular activities

Na educação escolar pública do estado de São Paulo, além do momento de aprendizagem do esporte nas aulas regulares de Educação Física, desde o ano de 2001 os alunos também têm a possibilidade de participar das turmas de Atividades Curriculares Desportivas (ACDs). Imerso no contexto do esporte escolar, os objetivos do presente estudo foram identificar e analisar as ACDS de esportes coletivos, desenvolvidas nas escolas pertencentes a uma diretoria de ensino do interior de São Paulo, em relação: às modalidades ofertadas/aos gêneros das turmas/às faixas etárias, às práticas de ensino dos docentes e às expectativas de professores e alunos. A pesquisa, de abordagem qualitativa, envolveu análise documental, entrevista semiestruturada com 17 professores e aplicação de questionário a 292 alunos, todos estes envolvidos nas turmas de ACDs. Os resultados foram organizados em três categorias de análise, a saber: i. Circunscrevendo as ACDs (modalidades, gênero e faixa etária); ii. Metodologias de ensino; iii. Expectativas em relação às ACDs. O futsal é a modalidade mais presente nas escolas (51%), as turmas masculinas são mais frequentes (71,1%) e existem mais turmas para as faixas etárias de 13 a 17 anos (95%). As metodologias de ensino baseiam-se majoritariamente em práticas tradicionais/técnicas de ensino (88%). As expectativas dos docentes estão mais relacionadas à obtenção de bons resultados nos jogos escolares (70%), enquanto as dos alunos se assentam no gosto pelo esporte que praticam (89%). Considerando que a legislação paulista correspondente às ACDs defende uma formação cidadã, entendemos que os dados expressam reduzida variedade de ofertas de modalidades, precário atendimento do gênero feminino e de determinadas faixas etárias dos alunos, carência de metodologias de ensino inovadoras e divergência entre as expectativas dos professores e dos alunos....(AU)

In São Paulo state public schools, apart from learning about a sport in regular Physical Education classes, since 2001 the students also have the possibility to participate in the classes of Sports Curricular Activities (SCA). According to the context of school sports, the aims of the present study were to identify and to analyze the SCA of team sports developed at schools which belongs to a teaching board of interior of São Paulo in relation to: the modalities offered / to the gender of the classes /to the age groups/to the teaching practices and the expectations of teachers and students. This study was based on a qualitative research involving a documental analysis, a semistructured interview with 17 teachers and a questionnaire to 292 students, all of them involved in the classes of SCA. The results were organized into three categories of analysis, namely: i. Circumscribing the SCA (modalities, gender and age group); ii. Teaching methodologies; iii. Expectations regarding to SCA. The indoor soccer is the most present form of sport in schools (51%), male classes are more frequent (71.1%), and there are more classes for the ages of 13 to 17 years old (95%). The teaching methodologies are mostly based on traditional/technical teaching practices (88%). The expectations of teachers are more related to obtaining good results in school games (70%), while the expectations of the students are based on the taste for the sport they practice (89%). Considering that São Paulo legislation which corresponds to the SCA advocates a citizen education, we believe that the data express a reduced variety of modality offers, precarious attendance of the female gender and determined age range of the students, a lack of innovative teaching methodologies and divergence between the teachers and students' expectations....(AU)

In vitro antioxidant potential and in vivo effects of Schinus terebinthifolia Raddi leaf extract in diabetic rats and determination of chemical composition by HPLC-ESI-MS/MS.

The present study investigated the in vitro and in vivo antioxidant potential and phytochemical composition of Schinus terebinthifolia, which is widely used in folk medicine for various therapeutic purposes. The in vitro analyses indicated that the hydroethanolic extract (HE) had 312.50 ± 0.50 mg GAE/g of total phenols. It also presented anti-DPPH• and anti-ABTS•+ activity, reduced phosphomolybden and metal ions and blocked the bleaching of ß-carotene. The HE at concentrations of 3.0 and 2.0 µg/mL had TRAP values of 2.223 ± 0.018 and 1.894 ± 0.026 µM Trolox, respectively. The HE increased the availability of antioxidants in plasma in treated animals in vivo. HPLC-ESI-MS/MS indicated the presence of 11 phenols: cumaric acid, (+)-catechin, myricetin-3-O-glicuronide, kaempferol-3-O-glucoside, myricetin, myricitrin, quercetin, gallic acid, methyl galate, pentagalloyl glucose and ethyl galate. Thus, S. terebinthifolia has potential for the prevention or treatment of diseases that are related to oxidative stress, such as diabetes mellitus.

Influência do estatuto posicional sobre o comportamento tático de jogadores de futebol / Influence of the positional role on the tactical actions of soccer players / Influencia del rango posicional sobre el comportamiento táctico de los jugadores de fútbol

Este estudo comparou o comportamento tático de jogadores de futebol da categoria Sub-15, de acordo com o estatuto posicional. Vinte e cinco jogadores de dois clubes portugueses foram avaliados através do Sistema de Avaliação Tática no Futebol. Utilizou-se estatística descritiva e o teste Qui-quadrado (χ²), com o nível de significância de p<0,05. Os resultados apresentaram diferença significativa nas variáveis: Unidade ofensiva, Contenção e Concentra- ção (Defensores); Mobilidade (Meio-campistas); Ações táticas ofensivas no meio de campo defensivo (Defensores); Cometer faltas, ceder lateral ou escanteio (Meio-campistas e Atacantes); Continuar sem a posse de bola (Defensores). Conclui-se que o comportamento tático dos jogadores apresentou níveis de especialização nas suas posições.

This study compared the tactical behavior of U-15 soccer players according to the positional role. Twenty-five players from two Portuguese clubs were evaluated through the System of Tactical Assessment in Soccer (FUT-SAT). Descriptive statistics and chi-square test (χ²) were used, with significance level of p<0.05. Results displayed significant statistical differences for the following variables: Offensive Unit, Delay and Concentration (Defenders); Depth Mobility (Midfielders); Offensive tactical actions in defensive midfield (Defenders); Commit a foul, give away a corner or throw-in (Midfielders and Forwards); Ball possession of the opponent (Defenders). We conclude that the tactical behavior of the players presented levels of specialization in their positions.

Este estudio comparó el comportamiento táctico de los jugadores de fútbol de la categoría Sub-15 en relación al rango posicional. Evaluamos a 25 jugadores de dos clubes Portugueses por medio del Sistema de Evaluación de la Táctica en Fútbol (FUT-SAT). Usamos la estadística descriptiva y el test de Chi-cuadrado (χ²), con elnivel de significancia de p<0,05. Los resultados presentaron diferencia significativa en las variables: Unidad ofensiva, Contención y Concentración (Defensas); Movilidad (Mediocampistas); Acciones tácticas ofensivas en el medio de campo defensivo (Defensas); Cometer faltas, ceder un saque de banda o córner (Mediocampistas y Atacantes); continuar sin la posesión del balón (Defensas). Se concluyó que el comportamiento táctico de los jugadores presentó niveles de especialización en sus posiciones.

Conhecimentos declarativos técnico-táticos de handebol manifestados por estudantes em aulas de Educação Física / Technical-tactical declarative knowledge of handball expressed by students in Physical Education classes / Conocimientos declarativos técnico-tácticos de balonmano manifestados por estudiantes en clases de Educación Física

Os objetivos deste estudo foram identificar e analisar os conhecimentos declarativos técnico-táticos de handebol manifestados por estudantes quando observam e analisam jogos de handebol. O estudo, assentado na abordagem qualitativa, utilizou entrevista e observações de aula para a coleta dos dados. Os participantes foram 30 estudantes de uma turma de sexto ano. Os resultados demonstraram uma série de manifestações de conhecimentos declarativos técnico-táticos do handebol, como o conhecimento das regras básicas necessárias para jogar; o entendimento da dinâmica do jogo (posicionamento em quadra) e a compreensão do jogo oficial da modalidade. Assim, foi possível verificar que os estudantes acessaram, mobilizaram e manifestaram o conhecimento declarativo técnico-tático acerca do handebol, dentre esses conhecimentos: o conhecimento das regras básicas (que dão a possibilidade de conseguir jogar); os objetivos do jogo necessários para o entendimento de seu funcionamento; as características especificas do handebol, bem como aquelas que podem ser transferidas para outros esportes.

The objectives of this study were to identify and analyze the technical-tactical declarative knowledge of handball expressed by students when observing and analyzing handball games. The study, based on the qualitative approach, used interview and class observations to collect the data. The participants were thirty students from a sixth grade class. The results demonstrated a series of declarations of technical-tactical declarative knowledge of handball, such as knowledge of the basic rules necessary to play; the understanding of the dynamics of the game (positioning on the court) and the understanding of the official game of the modality. Thus, it was possible to verify that the students accessed and mobilized the declarative technical-tactical knowledge about handball, among these knowledge: knowledge of the basic rules (which give the possibility of being able to play); the objectives of the game necessary for the understanding of its functioning; the specific characteristics of handball, as well as those that may be transferable to other sports.

Los objetivos de este estudio fueron identificar y analizar los conocimientos declarativos técnico-tácticos de balonmano manifestados por estudiantes cuando observan y analizan juegos de balonmano. El estudio, asentado en el abordaje cualitativo, utilizó entrevista y observaciones de clase para la recolección de los datos. Los participantes fueron treinta estudiantes de una clase de sexto año. Los resultados demostraron una serie de manifestaciones de conocimientos declarativos técnico-tácticos del balonmano, como el conocimiento de las reglas básicas necesarias para jugar; el entendimiento de la dinámica del juego (posicionamiento en cuadra) y la comprensión del juego oficial de la modalidad. Así, fue posible verificar que los estudiantes accedieron y movilizaron el conocimiento declarativo técnico-táctico acerca del balonmano, entre esos conocimientos: el conocimiento de las reglas básicas (que dan la posibilidad de conseguir jugar); los objetivos del juego necesarios para el entendimiento de su funcionamiento; las características específicas del balonmano, así como las que pueden ser transferibles para otros deportes.

A eficácia do ácido tranexâmico tópico no tratamento do melasma: evidências clínicas / Efficacy of topical tranexamic acid in the treatment of melasma: clinical evidence

Introdução: o melasma é uma desordem hiperpigmentar adquirida, crônica, clinicamente caracterizada como máculas acastanhadas com contornos irregulares e limites claros. O tratamento apresenta diferentes modalidades que incluem a eliminação de possíveis fatores causais, como o uso de protetor solar, além de agentes despigmentantes. O ácido tranexâmico, fármaco tradicionalmente antifibrinolítico, tem sido utilizado nas lesões do melasma devido ao seu efeito hipopigmentador e também na prevenção da hiperpigmentação induzida por UV. Objetivo: realizar uma investigação qualitativa bibliográfica acerca do mecanismo de ação do ácido tranexâmico e sua eficácia no tratamento tópico do melasma, baseada em evidências clínicas. Metodologia: foi realizada uma busca nas bases Pubmed e Embase limitada aos últimos 10 anos, na língua inglesa, utilizando os termos 'melasma' e 'tranexamic acid'. Resultados: foram encontrados sete ensaios clínicos que avaliaram a eficácia do ácido tranexâmico em formulações tópicas com concentração variando de 2 a 5%. O AT exerce seu mecanismo de ação bloqueando reversivelmente a conversão de plasminogênio em plasmina. Como os ativadores de plasminogênio são gerados pelos queratinócitos, o ácido tranexâmico afeta a função dos queratinócitos. Conclusão: o ácido tranexamico mostrou-se seguro e promissor no tratamento de melasma, tanto em comparação ao placebo quanto em relação a outros despigmentantes, sendo bem tolerado e sem ocorrências de reações adversas severas. Contudo, ensaios clinicos controlados e randomizados com avaliação em larga escala e estudos observacionais de longo prazo são necessários para que a terapia a longo prazo e a ação em combinação a outras terapias e outros medicamentos fiquem bem esclarecidos.

Introduction: melasma is an acquired hyperpigmentation disorder, chronic, clinically characterized as brownish macules with irregular contours and clear boundaries. The treatment presents different modalities that include the elimination of possible causal factors, like the use of sunscreen, besides depigmenting agents. Tranexamic acid, a traditional antifibrinolytic drug, has been used in the lesions of melasma due to its hypopigmenting effect and also in the prevention of UV-induced hyperpigmentation. Objective: to conduct a qualitative bibliographic investigation about the mechanism of action of tranexamic acid and its efficacy in the topical treatment of melasma, based on clinical evidence. Methodology: a search was peformed in the Pubmed database limited to the last 10 years, in the English language, using the terms 'melasma' and 'tranexamic acid'. Results: we found seven clinical trials evaluating the efficacy of tranexamic acid in topical formulations with concentrations ranging from 2 to 5%. AT exerts its mechanism of action by reversibly blocking the conversion of plasminogen to plasmin. As plasminogen activators are generated by keratinocytes, tranexamic acid affects the function of keratinocytes. Conclusion: tranexamic acid was safe and promising in the treatment of melasma, both compared to placebo as compared to other lighteners, being well tolerated and without incidents of severe adverse reactions. However, controlled and randomized clinical trials with large-scale evaluation and long-term observational studies are necessary for long-term therapy and action in combination with other therapies and other medications can be well understood.

Antileishmanial and antioxidant potential of fractions and isolated compounds from Nectandra cuspidata.

The effects on the viability of promastigote and amastigote forms of Leishmania (Leishmania) amazonensis and citotoxicity in J774.A1 macrophages of ethanolic extract, fractions and isolated compounds that were obtained from the leaves of Nectandra cuspidata were determined. The total phenolics content (TP) and antioxidant activity were assessed using different assays. The ethyl acetate fraction (EAF) had the best antiproliferative activity (amastigote IC50: 4.42 ± 0.60 µg/mL, promastigote IC50: 33.33 ± 0.78) and presented no cytotoxicity at the highest concentration tested (1000 µg/mL). The EAF also had the greatest antioxidant capacity, which was comparable to butylated hydroxytoluene and quercetin (DPPH IC50 6.54 ± 0.10 µg/mL, ABTS 4.75 ± 0.11 mmol ET/g; FRAP 2.37 ± 0.03 mmol ET/g; ORAC = 33.52 ± 1.99 mmol ET/g; TP 387.11 ± 0.25 mg GAE/g). Vitexin, epicatechin and isovitexin isolated from EAF contribute to both activities.

Episódios marcantes das aulas de educação física: valorizando as experiências dos alunos por meio de narrativas / Important episodes of physical education classes: valuing students’ experiences through narratives / Episodios destacados de las clases de educación física: valorizando las experiencias de los alumnos a través de narrativas

A escola, lugar no qual os estudantes passam um tempo considerável e intenso de relações, se constitui como um cenário de possibilidades de construção de experiências. Este estudo buscou identificar e analisar os episódios, em formato de casos de ensino, escritos por alunos do ensino médio sobre suas experiências nas aulas de Educação Física. As experiências narradas pelos alunos trouxeram indagações aos professores de Educação Física no sentido de mobilizar o saber orgânico para um saber verbalizado, constituindo com isso uma pedagogia que reconheça efetivamente a experiência discente como um saber.

School – where students spend considerable time and live intense relationships – is a scenario of possibilities for experience-building. This study aimed to identify and analyze episodes written by high school students about their experiences in Physical Education classes, in the format of teaching cases. The experiences narrated by the students raised questions to Physical Education teachers by mobilizing organic knowledge towards verbalized knowledge, thus establishing a pedagogy that effectively recognizes students’ experience as knowledge.

La escuela, el lugar donde los estudiantes pasan un tiempo considerable e intenso de relaciones, se constituye como un escenario de posibilidades de construcción de experiencias. Este estudio tuvo como objetivo identificar y analizar los episodios en la forma de casos de enseñanza, escritos por estudiantes de secundaria acerca de sus experiencias en las clases de Educación Física. Las experiencias narradas por los alumnos trajeron preguntas a los profesores de Educación Física en el sentido de movilizar el saber orgánico hacia un conocimiento verbalizado, formando con ello una pedagogía que reconozca efectivamente la experiencia de los estudiantes como un saber.

Consumo de carotenoides e polifenóis em indivíduos com risco cardiometabólico / Carotenoid and polyphenol consumption in subjects with cardiometabolic risk

Introdução: Os compostos bioativos possuem um importante papel antioxidante e proporcionam um tratamento adjuvante no combate às Doenças Crônicas Não Transmissíveis. Objetivo: Determinar o consumo atual de compostos bioativos (carotenoides e polifenóis) em indivíduos com risco cardiometabólico. Metodologia: Estudo transversal com 227 sujeitos participantes do Programa de Atenção à Saúde Cardiovascular da Universidade Federal de Viçosa. Foram coletados dados de ingestão alimentar atual para determinação do consumo de carotenoides, polifenóis, micro e macronutrientes utilizando um recordatório 24 horas. Dados antropométricos, de composição corporal, sociodemográficos e de estilo de vida também foram avaliados. O teste de Mann Whitney e correlação de Spearman foram realizados no SPSS v.20.0, com significância de p2,52 mg/dia) obtiveram menores valores de gordura corporal total (p<0,001). Conclusão: Nossos resultados indicam que um maior consumo de quempferol esteve relacionado com menores valores de indicadores de adiposidade total. Porém, mais estudos são necessários para se estabelecer os mecanismos envolvidos em seus potenciais benefícios em relação à adiposidade e resposta metabólica (AU)

Introduction: The bioactive compounds play an important antioxidant role and provide an adjuvant treatment to fight Chronic Noncommunicable Diseases. Objective: To determine the current intake of bioactive compounds (carotenoids and polyphenols) in subjects with cardiometabolic risk. Methods: Cross-sectional study of 227 subjects who participated in the Cardiovascular Health Care Program of the Federal University of Viçosa. Data of current dietary intake were collected for the determination of carotenoids, polyphenols, micronutrients and macronutrients consumption using a 24-hour recall. Data of anthropometry, body composition, sociodemographic conditions and lifestyle were also evaluated. The Mann Whitney test and Spearman correlation were performed using SPSS v.20.0, with significance of p 2.52 mg / day) had lower values of total body fat (p< 0.001). Conclusion: Our results indicate that a higher intake of kaempferol was associated with lower values of total adiposity indicators. However, more studies are necessary to establish the mechanisms involved in their potential benefits regarding adiposity and metabolic response (AU)

Avaliação dos níveis de depressão em idosos praticantes de diferentes exercícios físicos / Evaluation of depression levels in elderly practitioners of different physical exercise

Introdução: A população de idosos vem aumentando em todo o mundo, assim como a preocupação com a qualidade de vida, que abrange aspectos físicos, psicológicos e sociais. Objetivo: Avaliar o nível de depressão em idosos praticantes de diferentes tipos de exercícios físicos. Métodos: A amostra foi composta de 116 idosos, praticantes regulares de exercícios físicos: G1-Musculação (n=23), G2-Hidroginástica (n=22), G3-Ginástica (n=25), G4-Pilates (n=22), além do grupo G5-Controle (n=24), sendo aplicada a escala GDS (Geriatric Depression Scale), em forma de entrevista, para avaliar os níveis de depressão. Foi utilizada estatística descritiva (média±DP) e Anova One Way para comparação da variável dependente entre os grupos, sendo adotado um α =0,05. Resultados: Apenas o G5 obteve pontuação para depressão (n=12, 50%). O G3 apresentou os escores mais baixos para depressão em relação aos demais grupos (p≤0,01). Conclusão: A prática regular de exercícios físicos pode contribuir para redução de sintomas depressivos em idosos, independente da atividade escolhida.

Introduction: The elderly population is increasing worldwide, as the concern for quality of life, which includes physical, psychological and social aspects. Objective: To evaluate the level of depression in elderly practicing different exercise. Methods: The sample consisted of 116 elderly, regular physical exercise practitioners: Strength training-G1 (n=23), G2-Hydrogymnastis (n=22), G3-Gymnastics (n=25), G4-Pilates (n=22) besides G5-Control (n=24) group. GDS (Geriatric Depression Scale) scale was used as an interview to assess depression levels. Descriptive statistics (average±SD) and One Way Anova was used to compare the dependent variable between groups, and adopted a α =0.05. Results: Only the G5 obtained scores for depression (n=12, 50%). The G3 had the lowest scores for depression in relation to the other groups (p≤0.01). Conclusion: Regular physical exercise may contribute to reduction of depressive symptoms in the elderly, regardless of the chosen activity.

Biochemical and microbiological characteristics of in situ biofilm formed on materials containing fluoride or amorphous calcium phosphate.

PURPOSE: To evaluate the biochemical and microbiological characteristics of in situ biofilm formed on materials that release fluoride (F-) or calcium (Ca++) and phosphate (Pi). METHODS: This study comprised an in situ and in vitro experiment, utilizing three materials [Auralay XF and Fuji IX GP, containing fluoride, and Aegis containing amorphous calcium phosphate (ACP)] and bovine dental enamel slabs. For the in situ: 10 volunteers wore palatal devices, each containing four material specimens or enamel slabs that were treated with 20% sucrose solution. The biofilm had pH measurements on Day 7 and the composition was analyzed on Day 8 by assessing the following: F-, Ca++, Pi and insoluble extracellular polysaccharides (EPS) concentrations, and then identification of the microbiota. For the in vitro: materials/enamel were subjected to a 7-day pH-cycling regimen to determine F, Ca++ and Pi release. RESULTS: The biofilm formed on F(-)-releasing materials was richer in F, Ca++ and Pi and had lower mutans streptococci counts than enamel biofilm. The biofilm on the ACP-containing material exhibited similar Ca++ and Pi concentrations to biofilm on F(-)-releasing materials. The materials showed buffering action compared with enamel. Biochemical and microbiological characteristics showed a less cariogenic biofilm on materials containing fluoride or amorphous calcium phosphate.

[High prevalence of off-label and unlicensed drug prescribing in a Brazilian intensive care unit]. / A alta prevalência de prescrições de medicamentos off-label e não licenciados em unidade de terapia intensiva pediátrica Brasileira.

OBJECTIVE: To describe the use and determine the prevalence of off-label and unlicensed drug use prescribing in a pediatric intensive care unit in a Southeastern Brazilian hospital METHODS: Cross-sectional study of inpatients in a pediatric intensive care unit from May 2008 through January 2009. The classification according to the Brazilian regulatory agency (Agência de Vigilância Sanitária - Anvisa) approval criteria was based on the Anvisa electronic package insert list, Pharmaceuticals Dictionary, and the analysis was conducted through R software. RESULTS: We analysed 1,054 prescription items for 73 patients. Females predominated (52%), and the patients' age ranged from 0 to 16 years. Among the prescribed items, 23.4% were off-label, 12.6% were unlicensed, 1.4% were both off-label and unlicensed, 86% had at least one item off-label, and 67% had at least one unlicensed drug. The most frequently prescribed therapeutic groups were systemic anti-bacterial, analgesic, psycholeptic, and antiasmathic agents. CONCLUSION: The current study results confirm the high prevalence of unlicensed and off-label drug use in a pediatric intensive care unit.

A alta prevalência de prescrições de medicamentos off-label e não licenciados em unidade de terapia intensiva pediátrica brasileira / High prevalence of off-label and unlicensed drug prescribing in a Brazilian intensive care unit

OBJETIVO: Descrever o uso e determinar a prevalência de medicamentos de uso off-label enão licenciados em prescrições na unidade de terapia intensiva pediátrica de um hospital no sudeste do Brasil. MÉTODOS: Estudo transversal envolvendo os pacientes internados na unidade de terapia intensiva pediátrica durante o período de maio de 2008 a janeiro de 2009. A classificação quanto aos critérios de aprovação da Agência de Vigilância Sanitária (Anvisa) foi baseada em seu bulário eletrônico e no Dicionário de Especialidades Farmacêuticas e as análises realizadas no software R. RESULTADOS: Foram analisados 1.054 itens de prescrição de 73 pacientes. O gênero feminino foi o mais frequente (52 por cento) e a idade dos pacientes variou de zero a 16 anos. Observou-se que 23,4 por cento dos medicamentos foram prescritos de modo off-label, 12,6 por cento não licenciados e 1,4 por cento foram classificados em ambas as razões; 86 por cento receberam ao menos um item de uso off-label e 67 por cento ao menos um item de uso não licenciado. Os grupos terapêuticos mais prescritos foram os antibacterianos de uso sistêmico, os analgésicos, psicolépticos e antiasmáticos. CONCLUSÃO: Os resultados do presente trabalho confirmam a alta prevalência do uso off-label e não licenciados dos medicamentos em unidade de terapia intensiva pediátrica.

OBJECTIVE: To describe the use and determine the prevalence of off-label and unlicensed drug use prescribing in a pediatric intensive care unit in a Southeastern Brazilian hospital METHODS: Cross-sectional study of inpatients in a pediatric intensive care unit from May 2008 through January 2009. The classification according to the Brazilian regulatory agency (Agência de Vigilância Sanitária - Anvisa) approval criteria was based on the Anvisa electronic package insert list, Pharmaceuticals Dictionary, and the analysis was conducted through R software. RESULTS: We analysed 1,054 prescription items for 73 patients. Females predominated (52 percent), and the patients' age ranged from 0 to 16 years. Among the prescribed items, 23.4 percent were off-label, 12.6 percent were unlicensed, 1.4 percent were both off-label and unlicensed, 86 percent had at least one item off-label, and 67 percent had at least one unlicensed drug. The most frequently prescribed therapeutic groups were systemic anti-bacterial, analgesic, psycholeptic, and antiasmathic agents. CONCLUSION: The current study results confirm the high prevalence of unlicensed and off-label drug use in a pediatric intensive care unit.

Hábitos de consumo de medicamentos entre idosos usuários do SUS e de plano de saúde / Habits of medication consumption among elderly SUS and health insurance users

Este estudo teve como objetivos identificar o perfil sociodemográfico e os hábitos de consumo de medicamentos por 214 idosos usuários do Sistema Único de Saúde (SUS) e de Plano de Saúde no município de Sorocaba (SP), com ênfase na automedicação. Os resultados mostraram que a maioria dos entrevistados estava na faixa de 60 ? 79 anos e possuía ensino fundamental incompleto; porém, 17% de idosos usuários do SUS não eram alfabetizados e, entre idosos usuários de Plano de Saúde, a renda familiar maior do que três salários mínimos predominou. A procura por duas consultas médicas no mês que antecedeu as entrevistas foi preponderante nos dois grupos. As neoplasias e doenças cardiovasculares foram as mais prevalentes, respectivamente, entre usuários do SUS e de Plano de Saúde; os anti-hipertensivos foram os fármacos mais utilizados nos dois grupos. Não foram encontradas diferenças significativas entre os grupos nos hábitos de consumo de medicamentos. Os hábitos de reutilizar antigas receitas, compartilhar com outros membros da família, utilizar sobras de medicamentos, foram os mais frequentes. Alguns idosos usuários do SUS não possuem hábitos definidos quanto aos cuidados para evitar erros no consumo de medicamentos e, por serem menos privilegiados quanto à renda e escolaridade, são mais vulneráveis aos riscos da automedicação.