Effect of Carbamylated Erythropoietin in a Chronic Model of TNBS-Induced Colitis.

BACKGROUND: Inflammatory bowel disease (IBD) is a public health issue with a growing prevalence, which can be divided into two phenotypes, namely Crohn's disease (CD) and ulcerative colitis (UC). Currently, used therapy is based only on symptomatic and/or palliative pharmacological approaches. These treatments seek to induce and maintain remission of the disease and ameliorate its secondary effects; however, they do not modify or reverse the underlying pathogenic mechanism. Therefore, it is essential to investigate new potential treatments. Carbamylated erythropoietin (cEPO) results from the modification of the Erythropoietin (EPO) molecule, reducing cardiovascular-related side effects from the natural erythropoiesis stimulation. cEPO has been studied throughout several animal models, which demonstrated an anti-inflammatory effect by decreasing the production of several pro-inflammatory cytokines. AIM: This study aimed to evaluate the efficacy and safety of cEPO in a chronic TNBS-induced colitis model in rodents. METHODS: Experimental colitis was induced by weekly intrarectal (IR) administrations of 1% TNBS for 5 weeks in female CD-1 mice. Then, the mice were treated with 500 IU/kg/day or 1000 IU/kg/day of cEPO through intraperitoneal injections for 14 days. RESULTS: cEPO significantly reduced the concentration of alkaline phosphatase (ALP), fecal hemoglobin, tumor necrosis factor (TNF)-α, and interleukin (IL)-10. Also, it demonstrated a beneficial influence on the extra-intestinal manifestations, with the absence of significant side effects of its use. CONCLUSION: Considering the positive results from cEPO in this experiment, it may arise as a new possible pharmacological approach for the future management of IBD.

Characterization of polyphenols in the methanol leaf extract of Bathysa gymnocarpa (Rubiaceae) by HPLC-DAD-ESI-MS/MS.

The species Bathysa gymnocarpa K.Schum is a tree belonging to the Rubiaceae family, endemic in Brazil. So far, there are reports neither of phytochemical work nor of biological evaluation of it. The analysis by High Performance Liquid Chromatography coupled to a Diode Array Detector and a tandem Mass Spectrometer with an Electrospray Ionization source (HPLC-DAD-ESI-MS/MS) of its crude extract allowed to characterize in a complex mixture, without isolation, fourteen compounds, being two as cinnamic acid derivatives, and the others as mono-, di- and triglycosilated derivatives of the flavonols quercetin and kaempferol. These compounds are reported for the first time in Bathysa spp.

Isohemigossypolone: Antiophidic properties of a naphthoquinone isolated from Pachira aquatica Aubl.

We investigated the antiophidic properties of isohemigossypolone (ISO), a naphthoquinone isolated from the outer bark of the Pachira aquatic Aubl. The inhibition of phospholipase A2, coagulant, fibrinogenolytic, hemorrhagic and myotoxic activities induced by Bothrops pauloensis venom (Pb) was investigated. For this, we use samples resulting from the incubation of Pb with ISO in different concentrations (1:1, 1:5 and 1:10 w/w), we also evaluated the condition of treatment using ISO after 15 min of venom inoculation. The activities of phospholipase A2, coagulant, fibrinogenolytic, hemorrhagic and myotoxic induced by the B. pauloensis venom were significantly inhibited when the ISO was pre-incubated with the crude venom. For in vivo neutralization tests, the results were observed even when the ISO was applied after 15 min of inoculation of the venom or metalloprotease (BthMP). Also, to identify the inhibition mechanism, we performed in silico assays, across simulations of molecular coupling and molecular dynamics, it was possible to identify the modes of interaction between ISO and bothropic toxins BmooMPα-I, Jararacussin-I and BNSP-7. The present study shows that naphthoquinone isohemigossypolone isolated from the P. aquatica plant inhibited part of the local and systemic damage caused by venom proteins, demonstrating the pharmacological potential of this compound in neutralizing the harmful effects caused by snakebites.

Cyclotides from Brazilian Palicourea sessilis and Their Effects on Human Lymphocytes.

Cyclotides are plant-derived peptides found within five families of flowering plants (Violaceae, Rubiaceae, Fabaceae, Solanaceae, and Poaceae) that have a cyclic backbone and six conserved cysteine residues linked by disulfide bonds. Their presence within the Violaceae species seems ubiquitous, yet not all members of other families produce these macrocyclic peptides. The genus Palicourea Aubl. (Rubiaceae) contains hundreds of neotropical species of shrubs and small trees; however, only a few cyclotides have been discovered hitherto. Herein, five previously uncharacterized Möbius cyclotides within Palicourea sessilis and their pharmacological activities are described. Cyclotides were isolated from leaves and stems of this plant and identified as pase A-E, as well as the known peptide kalata S. Cyclotides were de novo sequenced by MALDI-TOF/TOF mass spectrometry, and their structures were solved by NMR spectroscopy. Because some cyclotides have been reported to modulate immune cells, pase A-D were assayed for cell proliferation of human primary activated T lymphocytes, and the results showed a dose-dependent antiproliferative function. The toxicity on other nonimmune cells was also assessed. This study reveals that pase cyclotides have potential for applications as immunosuppressants and in immune-related disorders.

A voz no limiar entre a carne e a palavra no teatro de Valère Novarina / The voice on the threshold between flesh and word in the theater of Valère Novarina / La voz en el umbral entre la carne y la palabra en el teatro de Valère Novarina / La voix sur le seuil entre chair et parole dans le théâtre de Valère Novarina

RESUMO Este artigo tenta fazer uma aproximação entre o teatro de Valère Novarina e a psicanálise lacaniana através da abordagem do objeto voz. No teatro de Novarina, vemos uma profusão da palavra no intuito de extrair não o seu sentido, mas a sua voz, como um pedaço de corpo que é lançado no espaço cênico. Na psicanálise, a voz desponta não como um veículo ou um instrumento da palavra, mas como aquilo que se subtrai dela na constituição do sujeito e permanece enquanto resto. O resto vocálico é o que retorna à cena, seja no teatro do dramaturgo francês, seja na própria sessão analítica, como um real do corpo que insiste em transmitir algo para além do sentido. Dessa forma, o objeto voz é o pivô dessa aproximação justamente por ser o inexorável do sujeito, a libra de carne que o sujeito perde para se constituir e retorna para o palco da vida numa insistente presença.

ABSTRACT This article attempts to approximate Valère Novarina's theater and Lacanian psychoanalysis by approaching the voice object. In Novarina's theater we see a profusion of the word in order to extract not its meaning but its voice as a part of the body that is thrown into the scenic area. In psychoanalysis, the voice emerges not as a vehicle or instrument of the word, but that which is subtracted from it in the constitution of the subject and remains as remnant. The vowel remnant is what returns to the scene, whether in the theater of the French playwright or in the analytic session itself, as a real body that insists on conveying something beyond meaning. Thus, the voice object is the pivot of this approach precisely because it is the inexorable of the subject, the pound of flesh that the subject loses to be constituted and returns to the stage of life in an insistent presence.

RESUMEN Este artículo intenta aproximarse al teatro de Valère Novarina y al psicoanálisis lacaniano al acercarse al objeto voz. En el teatro de Novarina vemos una profusión de la palabra para extraer no su significado, sino su voz como una pieza de cuerpo que se arroja al espacio escénico. En el psicoanálisis, la voz emerge no como un vehículo o instrumento de la palabra, sino como aquello que se le resta en la constitución del sujeto y permanece como un resto. El resto de las vocales es lo que vuelve a la escena, ya sea en el teatro del dramaturgo francés o en la sesión analítica misma, como un cuerpo real que insiste en transmitir algo más allá del significado. Por lo tanto, el objeto voz es el eje de este enfoque precisamente porque es lo inexorable del sujeto, la libra de carne que el sujeto pierde para constituirse y regresa a la escena de la vida en una presencia insistente.

RÉSUMÉ Cet article tente de rapprocher le théâtre de Valère Novarina et la psychanalyse lacanienne au moyen de l'objet vocal. Dans le théâtre de Novarina, nous voyons une profusion de mots dans le dessein d'extraire non pas son sens mais sa voix, tel un morceau de corps lancé dans l'espace scénique. En psychanalyse, la voix n'émerge pas comme un véhicule ou un instrument de la parole, mais comme ce qui s'en soustrait dans la constitution du sujet et demeure en tant qu'un reste. Le reste vocal est ce qui revient sur la scène, que ce soit sur le théâtre du dramaturge français soit dans la session analytique elle-même, comme un corps réel qui insiste pour transmettre quelque chose qui dépasse le sens. Ainsi, l'objet vocal est le pivot de cette approche, précisément parce qu'il est l'inexorable du sujet, la livre de chair que le sujet perd pour se constituer et revient sur la scène de la vie dans une présence insistante.

Sustainability in the dairy industry: a systematic literature review.

The dairy industry can contribute to global food security in a sustainable way by efficiently converting milk into dairy ingredients and products, even though they are polluting on a large scale. In this context, this study aimed to conduct a systematic literature review on sustainable indicators and dairy industries. The methodology used has a qualitative and quantitative approach and its technical procedure was the systematic literature review. The bases of journals consulted, using the keywords "sustainability indicator" and "dairy industry" which resulted in 130 valid scientific articles. The main results show that the sustainability indicators in the dairy industry are emerging and lacking research; being found seven papers, that highlight 12 indicators of the environmental, 11 of the social and eight economic dimensions, that may be considered fragile and initial. The studied problems are related to wastewater treatment methods, electric power consumption, efficiency of the industrial plant, among others, and the benefits on the theme are related to solutions to the difficulties, such as electricity reduction, sustainable practices. Among others, it is concluded that the dairy industries address the sustainability theme since 2011, with an ambiguous trend, being found evidence of the fragility of the sustainability indicators was found, mainly in the initial stage of their conception, when considering holistic approach (triple bottom line).

Using online databases to produce comprehensive accounts of the vascular plants from the Brazilian protected areas: The Parque Nacional do Itatiaia as a case study.

BACKGROUND: Brazil is one of the most biodiverse countries in the world, with about 37,000 species of land plants. Part of this biodiversity is within protected areas. The development of online databases in the last years greatly improved the available biodiversity data. However, the existing databases do not provide information about the protected areas in which individual plant species occur. The lack of such information is a crucial gap for conservation actions. This study aimed to show how the information captured from online databases, cleaned by a protocol and verified by taxonomists allowed us to obtain a comprehensive list of the vascular plant species from the "Parque Nacional do Itatiaia", the first national park founded in Brazil. All existing records in the online database JABOT (15,100 vouchers) were downloaded, resulting in 11,783 vouchers identified at the species level. Overall, we documented 2,316 species belonging to 176 families and 837 genera of vascular plants in the "Parque Nacional do Itatiaia". Considering the whole vascular flora, 2,238 species are native and 78 are non-native. NEW INFORMATION: The "Parque Nacional do Itatiaia" houses 13% of the angiosperm and 37% of the fern species known from the Brazilian Atlantic Forest. Amongst these species, 82 have been cited as threatened, following IUCN categories (CR, EN or VU), seven are data deficient (DD) and 15 have been classified as a conservation priority, because they are only known from a single specimen collected before 1969.

No-shows at public secondary dental care for pediatric patients: a cross-sectional study in a large Brazilian city.

Missed appointments have a great economic, social and administrative impact on the management of public health services. This research aimed to study factors associated with non-attendance to the first appointments of pediatric patients in secondary dental care services in the city of Curitiba, Brazil. A cross-sectional study was performed using secondary data from the electronic health records of the Curitiba Municipal Secretary of Health. The study included all children (0-12 years) referred to secondary dental clinics in the years 2010 to 2013. Data were analyzed by the chi-square test and Pearson linear trend chi-square (α = 0.05). Binary logistic regression models were built. Data from 1,663 children were assessed and the prevalence of non-attendance was 28.3%. The variables associated with the non-attendance in inferential analysis (p < 0.05) and in the final model were the household income per capita (95% CI: 1.93-2.82) and the waiting time in virtual queue (95% CI: 1.000-1.002). Socioeconomic aspects and the waiting time in virtual queue, should be considered in the strategic planning of health services as they may influence the attendance of pediatric patients in secondary dental referral service.

Subproteome of Lachesis muta rhombeata venom and preliminary studies on LmrSP-4, a novel snake venom serine proteinase.

BACKGROUND: Lachesis muta rhombeata is one of the venomous snakes of medical importance in Brazil whose envenoming is characterized by local and systemic effects which may produce even shock and death. Its venom is mainly comprised of serine and metalloproteinases, phospholipases A2 and bradykinin-potentiating peptides. Based on a previously reported fractionation of L. m. rhombeata venom (LmrV), we decided to perform a subproteome analysis of its major fraction and investigated a novel component present in this venom. METHODS: LmrV was fractionated through molecular exclusion chromatography and the main fraction (S5) was submitted to fibrinogenolytic activity assay and fractionated by reversed-phase chromatography. The N-terminal sequences of the subfractions eluted from reversed-phase chromatography were determined by automated Edman degradation. Enzyme activity of LmrSP-4 was evaluated upon chromogenic substrates for thrombin (S-2238), plasma kallikrein (S-2302), plasmin and streptokinase-activated plasminogen (S-2251) and Factor Xa (S-2222) and upon fibrinogen. All assays were carried out in the presence or absence of possible inhibitors. The fluorescence resonance energy transfer substrate Abz-KLRSSKQ-EDDnp was used to determine the optimal conditions for LmrSP-4 activity. Molecular mass of LmrSP-4 was determined by MALDI-TOF and digested peptides after trypsin and Glu-C treatments were analyzed by high resolution MS/MS using different fragmentation modes. RESULTS: Fraction S5 showed strong proteolytic activity upon fibrinogen. Its fractionation by reversed-phase chromatography gave rise to 6 main fractions (S5C1-S5C6). S5C1-S5C5 fractions correspond to serine proteinases whereas S5C6 represents a C-type lectin. S5C4 (named LmrSP-4) had its N-terminal determined by Edman degradation up to the 53rd amino acid residue and was chosen for characterization studies. LmrSP-4 is a fibrinogenolytic serine proteinase with high activity against S-2302, being inhibited by PMSF and benzamidine, but not by 1,10-phenantroline. In addition, this enzyme exhibited maximum activity within the pH range from neutral to basic and between 40 and 50 °C. About 68% of the LmrSP-4 primary structure was covered, and its molecular mass is 28,190 Da. CONCLUSIONS: Novel serine proteinase isoforms and a lectin were identified in LmrV. Additionally, a kallikrein-like serine proteinase that might be useful as molecular tool for investigating bradykinin-involving process was isolated and partially characterized.

Whitening toothpastes effect on nanoparticle resin composite roughness after a brushing challenge: An in vitro study.

BACKGROUND: Nowadays, the use of whitening toothpastes is a common habit, especially among young adults, due to aesthetic appeal. On the other hand, little is known regarding the effects of brushing with those newly dentifrices on wear properties of resin composites. MATERIAL AND METHODS: Thirty specimens of nanoparticle composite resin were fabricated and stored in distilled water for 24 h at 370C. After this, the roughness analysis was performed and submitted to the simulated brushing technique using three types of toothpastes: conventional (GI), and two with whitening effect (GII and GIII) for a period of 15 days, with 2 brushing sessions per day for 2 minutes each. The final surface roughness was analyzed after completing all the brushing cycles and stereoscopic images were taken for each group. The data was analyzed by one-way ANOVA and Tukey-test post hoc for intergroup comparison and the T-test for dependent samples as well (α = 0.05). RESULTS: However showing an increase of roughness for all groups after the brushing cycles (p = 0.01), no statistically significant differences among the groups after simulated brushing was verified (p = 0.17). Yet, just some cracks of the stereoscopic images were shown, demonstrating no distinct visual effects among the studied groups. CONCLUSIONS: After simulated brushing with the whitening toothpastes, similar degree of roughness was verified on the composite resin tested. Key words:Composite resin, toothpastes, whitening.

No-shows at public secondary dental care for pediatric patients: a cross-sectional study in a large Brazilian city / Não comparecimento na atenção secundária pública em saúde bucal de pacientes pediátricos: estudo transversal em uma grande cidade brasileira

Abstract Missed appointments have a great economic, social and administrative impact on the management of public health services. This research aimed to study factors associated with non-attendance to the first appointments of pediatric patients in secondary dental care services in the city of Curitiba, Brazil. A cross-sectional study was performed using secondary data from the electronic health records of the Curitiba Municipal Secretary of Health. The study included all children (0-12 years) referred to secondary dental clinics in the years 2010 to 2013. Data were analyzed by the chi-square test and Pearson linear trend chi-square (α = 0.05). Binary logistic regression models were built. Data from 1,663 children were assessed and the prevalence of non-attendance was 28.3%. The variables associated with the non-attendance in inferential analysis (p < 0.05) and in the final model were the household income per capita (95% CI: 1.93-2.82) and the waiting time in virtual queue (95% CI: 1.000-1.002). Socioeconomic aspects and the waiting time in virtual queue, should be considered in the strategic planning of health services as they may influence the attendance of pediatric patients in secondary dental referral service.

Resumo O não comparecimento a consultas tem um grande impacto no gerenciamento dos serviços de saúde pública. O objetivo foi avaliar os fatores associados ao não comparecimento às primeiras consultas de pacientes pediátricos nos serviços de atenção secundária em saúde bucal na cidade de Curitiba, Brasil. Um estudo transversal foi desenvolvido com dados secundários obtidos de cadastros eletrônicos da Secretaria Municipal de Saúde de Curitiba. Participaram crianças de 0 a 12 anos de idade encaminhadas para atenção secundária nos anos de 2010 a 2013. Os dados foram analisados pelos testes de qui-quadrado de Pearson e qui-quadrado de tendência linear (α = 0,05). Foram constituídos modelos de regressão logística binária. Foram analisados os dados de 1.663 crianças. A prevalência de não comparecimento às primeiras consultas foi de 28,3%. As variáveis que estiveram associadas ao não comparecimento na análise inferencial (p < 0,05) e no modelo final foram a renda per capita familiar (95% CI: 1,93-2,82) e o tempo de espera em fila virtual (95% CI: 1,000-1,002). Aspectos econômicos e o tempo de espera em fila virtual devem ser considerados no planejamento estratégico dos serviços públicos de saúde bucal, pois podem influenciar o comparecimento de pacientes na atenção secundária.

Comprehensive characterisation of polyphenols in leaves and stems of three anti-dengue virus type-2 active Brazilian Faramea species (Rubiaceae) by HPLC-DAD-ESI-MS/MS.

INTRODUCTION: The methanol (MeOH) leaf extracts of the species Faramea bahiensis, F. hyacinthina and F. truncata (Rubiaceae) have previously shown in vitro non-cytotoxic and anti-dengue virus serotype 2 (DENV2) activities in human hepatocarcinoma cell lineage (HepG2). Chemical studies have led to the isolation of major flavonoids, but quite complex fractions of phenolic compounds still remain. OBJECTIVE: To complete the study of phenolic compounds in the leaves and to access the presence of these compounds in the stems of these Faramea spp. by online high-performance liquid chromatography-diode array detector-electrospray ionisation tandem mass spectrometry (HPLC-DAD-ESI-MS/MS), as well as to evaluate the in vitro cytotoxic and anti-DENV2 activities of their MeOH stem extracts. METHODOLOGY: The identification was performed by comparing retention times, UV and mass spectra with those of available standards and by using the mechanisms and fragmentation patterns established in previous studies. The effects of the extracts in DENV2 infected HepG2 cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The virus titer was quantified by plaque assay. RESULTS: The study led to the characterisation of 31 phenolic compounds including flavonoid O- and C-glycosides, phenolic acids and one coumarin. The stem extracts from F. hyacinthina and F. bahiensis presented a similar bioactivity to those of their leaves but a loss of cytoprotective activity of F. bahiensis and a higher cytotoxicity of F. truncata were observed. CONCLUSIONS: This research allowed a detailed phenolic composition of three bioactive Faramea species to be achieved, thus contributing to the study of this genus and providing valuable information for further phytotherapeutic applications.

Doehlert design in the optimization of ultrasound assisted dissolution of fish fillet samples with tetramethyl ammonium hydroxide for metals determination using FAAS.

Doehlert design and desirability function were used in the optimization of an ultrasound assisted dissolution method of fish fillet samples with tetramethyl ammonium hydroxide (TMAH) for the determination of Ca, Fe, Zn and Mg by flame atomic absorption spectrometry. The variables values after optimization were 620 µL (volume of TMAH), 25 min (sonication time) and 46 °C (bath temperature). The quantification limits for Ca, Mg, Fe and Zn were 56, 107, 23 and 2.9 µg g-1, respectively. Accuracy was evaluated by comparing the results generated from the analysis of the samples treated by the proposed method and by wet digestion. Additionally, accuracy for Fe and Zn was assessed by the analysis of certified reference materials Tort-3 (Lobster hepatopancreas), ERM-CE 278 (mussel tissue) and Dolt-4 (Fish liver). There were no significant differences between the results obtained at a 95% confidence level when results were evaluated by t-test application.

Subproteome of Lachesis muta rhombeata venom and preliminary studies on LmrSP-4, a novel snake venom serine proteinase

Lachesis muta rhombeata is one of the venomous snakes of medical importance in Brazil whose envenoming is characterized by local and systemic effects which may produce even shock and death. Its venom is mainly comprised of serine and metalloproteinases, phospholipases A2 and bradykinin-potentiating peptides. Based on a previously reported fractionation of L. m. rhombeata venom (LmrV), we decided to perform a subproteome analysis of its major fraction and investigated a novel component present in this venom. Methods: LmrV was fractionated through molecular exclusion chromatography and the main fraction (S5) was submitted to fibrinogenolytic activity assay and fractionated by reversed-phase chromatography. The N-terminal sequences of the subfractions eluted from reversed-phase chromatography were determined by automated Edman degradation. Enzyme activity of LmrSP-4 was evaluated upon chromogenic substrates for thrombin (S-2238), plasma kallikrein (S-2302), plasmin and streptokinase-activated plasminogen (S-2251) and Factor Xa (S-2222) and upon fibrinogen. All assays were carried out in the presence or absence of possible inhibitors. The fluorescence resonance energy transfer substrate Abz-KLRSSKQ-EDDnp was used to determine the optimal conditions for LmrSP-4 activity. Molecular mass of LmrSP-4 was determined by MALDI-TOF and digested peptides after trypsin and Glu-C treatments were analyzed by high resolution MS/MS using different fragmentation modes. Results: Fraction S5 showed strong proteolytic activity upon fibrinogen. Its fractionation by reversed-phase chromatography gave rise to 6 main fractions (S5C1-S5C6). S5C1-S5C5 fractions correspond to serine proteinases whereas S5C6 represents a C-type lectin. S5C4 (named LmrSP-4) had its N-terminal determined by Edman degradation up to the 53rd amino acid residue and was chosen for characterization studies. LmrSP-4 is a fibrinogenolytic serine proteinase with high activity against S-2302, being inhibited by PMSF and benzamidine, but not by 1,10-phenantroline. In addition, this enzyme exhibited maximum activity within the pH range from neutral to basic and between 40 and 50 °C. About 68% of the LmrSP-4 primary structure was covered, and its molecular mass is 28,190 Da. Conclusions: Novel serine proteinase isoforms and a lectin were identified in LmrV. Additionally, a kallikrein-like serine proteinase that might be useful as molecular tool for investigating bradykinin-involving process was isolated and partially characterized.(AU)

Peripheral Facial Palsy and Communicating Hydrocephalus as a Clinical Presentation of Hemorrhagic Vestibular Schwannoma: Case Report

The vestibular schwannoma is the most common extra-axial tumor of the posterior fossa. Hemorrhage associated with vestibular schwannomas has been described in less than 1% of the cases. The etiology remains unknown; however, some risk factors have been suggested, such as tumor size and tumor growth rate, the vascularity and histopathology of the tumor or even previous treatment with radiosurgery. The present case is of a 74-year-old female patient, who presented to our clinic in December of 2015 after a mild traumatic brain injury. In that context, she did a brain computed tomography (CT) scan and was diagnosed with a vestibular schwannoma­ an incidentaloma. It was decided at that time to treat the patient conservatively because of her comorbidities and the presentation of the disease. In March of 2017, the patient presented again to our clinic with a right peripheral facial paralysis (House-Brackmann [HB] grade IV-VI) and confusion. The CT scan revealed that bleeding around the vestibular schwannoma had caused the clinical presentation. We decided to treat the hydrocephalus with a ventriculoperitoneal shunt. At the time of her last follow-up visit, the confusion symptoms had resolved, and her right-sided facial function had improved to a HB grade II-VI.

La comodidad del paciente en cuidados intensivos - una revisión integradora / O conforto do doente em cuidados intensivos. revisão integrativa / Comfort care of the patient in intensive care - an integrative review

Objetivo - Identificar las necesidades y las medidas de comodidad del paciente internado en cuidados intensivos. Material y Método - Las preguntas de la investigación son: ¿cuáles son las necesidades de comodidad del paciente internado en cuidados intensivos? Y¿cuáles las medidas que promueven comodidad al paciente internado en cuidados intensivos? Se procedió al análisis de las palabras clave del DeCS y MeSH en el ámbito de la comodidad del paciente mayor en cuidados intensivos. Búsqueda booleana en los motores de búsqueda de bases de datos: EBSCO, PubMed, B-ON, RCAAP, BVS, Cochrane Library, SciELO. Se obtuvo un total de 6488 artículos, constituyendo la muestra 10 artículos. Se procedió al análisis del contenido del corpus (corresponde a los cuidados de enfermería), del que se obtuvieron 2 categorías con un total de 55 unidades de registro. Resultados - La distribución de los datos ha sido hecha de acuerdo con los presupuestos teóricos de la Teoría de Kolcaba: en la categoría de las Necesidades de Comodidad (28 unidades de registro) - 28% son de contexto fisico, 14% ambiental, 56% psico-espiritual y 14% social; de las Medidas de Comodidad (27 unidades de registro) - 18% son tipo alivio, 56% tranquilidad y 26% transcendencia. Conclusión - Las necesidades de comodidad derivan esencialmente del contexto fisico y psico-espiritual y las medidas de comodidad más a menudo adoptadas son para el alivio y la tranquilidad. La disciplina de Enfermería es la que más preocupación demostra por los cuidados de comodidad

Objetivo - Identificar as necessidades e as medidas de conforto do internado em cuidados intensivos. Material e Método - As questões de investigação são: quais as necessidades de conforto do doente internado em cuidados intensivos? e quais as medidas que promovem o conforto do doente internado em cuidados intensivos? Procedeu-se à análise dos descritores no DeCS e MeSH no âmbito do conforto do idoso nos cuidados intensivos. Pesquisa booleana nos motores de busca de bases de dados: EBSCO, PubMed, B-ON, RCAAP, BVS, Cochrane Library, SciELO. Obteve-se uma população de 6488 artigos, constituindo a amostra 10 artigos. Realizada análise de conteúdo ao corpus (corresponde aos cuidados enfermagem), do qual se obteve 2 categorias com um total de 55 unidades de registo. Resultados - A distribuição dos dados foi de acordo com os pressupostos teóricos da Teoria de Kolcaba: na categoria das Necessidades de Conforto (28 unidades registo) - 28% são do contexto físico, 14% do ambiental, 56% psico-espiritual e 14% do social; das Medidas de Conforto (27 unidades de registo) - 18% são do tipo alivio, 56% de tranquilidade e 26% transcendência. Conclusão - As necessidades de conforto decorrem essencialmente do contexto físico e psico-espiritual e as medidas de conforto mais frequentemente adotadas destinam-se ao alívio e à tranquilidade. A disciplina de Enfermagem é a que mais preocupação demonstra pelos cuidados de conforto

Aims - To identify comfort needs and measures of the patient admitted in intensive care units. Material and Method - The investigation questions are: wthat are the comfort needs of the patient admitted in intensive care and which measures should be undertaken to promote comfort to the patient admitted in intensive care units? It was carried out an analysis of the descriptors (keywords) in DeCS and MeSH within the scope of comfort care to elderly patient in intensive care units. Boolean research through data base searching engines: EBSCO, PubMed, B-ON, RCAAP, BVS, Cochrane Library, SciELO. It was obtained a 6488 article population of which 10 articles composed the sample. It was analysed the content of the corpus (corresponding to nursing care) allowing to obtain 2 categories totalizing 55 registration unities. Results - Data distribution was according to theoretical assumptions of Kolcaba Theory: in the category of Comfort Needs (28 registration unities) - 28% are of physical order, 14% environmental, 56% psycho-spiritual and 14% of social order; as far as Comfort Measures are concerned (27 registration unities) - 18% concern suffering relieve, 56% peaceful atmosphere and 26% transcendence. Conclusion - Comfort needs concern essentially physical and psycho-spiritual context and the comfort measures more frequently adopted are aim to relieve suffering and promote a peaceful atmosphere. Nursing disciplin is the one that shows more concern towards comfort care

Antiviral Activity of Faramea hyacinthina and Faramea truncata Leaves on Dengue Virus Type-2 and Their Major Compounds.

The defatted fractions of the Faramea hyacinthina and F. truncata (Rubiaceae) leaf MeOH extracts showed in vitro non-cytotoxic and anti-dengue virus serotype 2 (DENV2) activity in human hepatocarcinoma cell lineage (HepG2). Submitting these fractions to the developed RP-SPE method allowed isolating the antiviral flavanone (2S)-isosakuranetin-7-O-ß-d-apiofuranosyl-(1→6)-ß-d-glucopyranoside (1) from both species and yielded less active sub-fractions. The new diastereoisomeric epimer pair (2S) + (2R) of 5,3',5'-trihydroxyflavanone-7-O-ß-d-apiofuranosyl-(1→6)-ß-d-glucopyranoside (2a/2b) from F. hyacinthina; the known narigenin-7-O-ß-d-apiofuranosyl-(1→6)-ß-d-glucopyranoside (3) from both species; rutin (4) and quercetin-4'-ß-d-O-glucopyranosyl-3-O-rutinoside (5) from F. hyacinthina, and kaempferol-3-O-rutinoside (6), erythroxyloside A (7) and asperuloside (8) from F. truncata have been isolated from these sub-fractions. Compounds 4 - 8 are reported for the first time in Faramea spp.

Supratentorial hemangioblastomas in von Hippel-Lindau wild-type patients - case series and literature review.

BACKGROUND: Supratentorial hemangioblastoma is an uncommon lesion with few data available. Resemblance to other tumours represents a struggle concerning pre-operative diagnosis and management. OBJECTIVES: The aim of this study was to review the current literature, integrating two new cases with uncommon features. METHODS: A search of English language peer-reviewed articles in PubMed®, Cochrane Library®, Google Scholar® and summary of the current knowledge. RESULTS: A total of 162 cases, with no predominance between von Hippel-Lindau disease and wild-type sporadic lesions. The frontal lobe is the most common topography, followed by the pituitary stalk, with image resemblance to a glioma or a metastasis. From these, 20 cases revealed dural attachment, mimicking a meningioma. Symptoms are due to mass effect or epilepsy, with low haemorrhagic risk. Clinical outcome on supratentorial hemangioblastoma depends on resection extension, with no recognised complementary treatment. Post-operative follow-up is essential, even in wild-type, sporadic cases, concerning recent reports of tumour dissemination. CONCLUSIONS: This review compiles the main characteristics of supratentorial hemangioblastoma, that despite its rarity, should be a concern on differential diagnosis, treatment planning and expected prognosis.

Yolk Sac Tumor of the Temporal Lobe: Case Report

Germ cell tumors of the central nervous system (CNS) are usually located along the midline. Yolk sac tumor is a rare germ cell tumor very uncommonly located outside the midline, and, in such cases, it can be mistaken with other primary tumors. We report a case of a 32-year-old male patient who presented with a right temporal lobe tumor suggestive of a high grade glioma. He was submitted to a right temporal lobectomy with complete tumor removal. The histological exam revealed a germ cell tumor (later confirmed to be a yolk sac tumor). The search for a primary tumor outside of the CNS (including a positron emission tomography scan) was negative, making this a primary temporal lobe yolk sac tumor. The patient was submitted to chemotherapy and radiotherapy, but died 7 months after the surgery.

Surgical Management of Ruptured Posterior Circulation Aneurysms ­ A Single Center Experience

Objective The treatment of ruptured aneurysms of the posterior circulation is a controversy in neurosurgery. The aim of this work is to describe the experience and results of the early surgical treatment of this pathology at Centro Hospitalar do Porto. Method We retrospectively analyzed the medical records of all patients aged over 18 who, in the period between 1999­2013, were admitted to our center with the diagnosis of ruptured saccular posterior circulation aneurysm. The patients were clinically staged at admission using the Hunt & Hess (H&H) scale. The modified Glasgow Outcome Scale (mGOS) was used to assess the outcome at discharge and after 6 months. Results Between 1999­2013, 59 patients underwent surgery for ruptured posterior circulation aneurysms. Eighty percent of the patients were female, and their average age was 58.7 years. Posterior-inferior cerebellar artery aneurysms accounted for 49.2% of surgeries, while basilar aneurysms accounted for 28.8%. Upon admission, 86.4% of patients were classified as H&H1­3, and 13.6% as H&H4­5. The outcomes at discharge and at 6 months were as follows: at discharge, mGOS1 in 5.1%, mGOS2­3 in 18.6%, and mGOS4­5 in 76.3%; at 6 months, mGOS1 in 10.2%, mGOS2­3 in 10.2%, and mGOS4­5 in 79.6%. There was a statistically significant correlation between basilar aneurysms and worse outcomes (p » 0.011). No correlation was found between the values of the H&H scale upon admission and outcome. Conclusions The functional outcome of our group of patients is mainly in line with what is described in other series from the literature. However, there is a trend toward lower mortality but higher morbidity rates.

Objetivo O tratamento dos aneurismas rotos da circulação posterior é uma controvérsia neurocirúrgica. Pretende-se com este trabalho relatar a experiência e os resultados do tratamento cirúrgico precoce desta patologia no Centro Hospitalar do Porto. Métodos Foram analisados retrospectivamente os processos clínicos dos pacientes com idade > 18 anos que, no período entre 1999­2013, foram admitidos no nosso centro com o diagnóstico de aneurisma sacular roto da circulação posterior. Utilizou-se a escala de Hunt & Hess (H&H) para aferir a gravidade clínica dos pacientes, e a Escala de Outcome de Glagow modificada (mGOS) para aferir o outcome dos pacientes à data da alta e aos 6 meses. Resultados Entre 1999­2013, foram operados 59 pacientes com aneurismas rotos da circulação posterior. Oitenta por centro dos pacientes eram do sexo feminino, com uma média de idade média de 58.7 anos. Aneurismas da artéria cerebelosa posteroinferior foram responsáveis por 49,2% das cirurgias, ao passo que os da artéria basilar, por 28,8%. À admissão, 86,4% dos pacientes eram H&H1­3, e 13,6%, H&H4­5. O outcome à data da alta e aos 6 meses foi o seguinte: à data de alta, mGOS1 em 5,1%, mGOS2­3 em 18,6%, e mGOS4­5 em 76,3%; aos 6 meses, mGOS1 em 10,2%, mGOS2­ 3 em 10,2%, e mGOS4­5 em 79,6%. Verificou-se uma correlação estatisticamente significativa entre aneurismas da basilar e um pior outcome (p » 0,011). Não se verificou qualquer correlação entre os valores da escala de H&H à admissão e o outcome. Conclusões O outcome funcional do nosso grupo de pacientes está em linha com o descrito noutras séries da literatura. Contudo, destaca-se uma tendência para uma mortalidade mais baixa, mas uma morbilidade mais alta no nosso grupo de pacientes.