Effects of cancer-induced cachexia and administration of L-glutathione on the intestinal mucosa in rat.

Walker-256 tumor is an experimental model known to promote cachexia syndrome, oxidative stress, and systemic inflammation. This study evaluated the duodenal mucosa of rats with Walker-256 tumor administered with 1% L-glutathione, intending to evaluate the damage caused by cancer-associated cachexia in the gastrointestinal tract and the effects of antioxidant administration on mucosal protection. Twenty-four 55-day-old male Wistar rats were distributed into four groups: control (C); control administered with 1% L-glutathione (C-GSH); Walker-256 tumor (W) and Walker-256 tumor administered with 1% L-glutathione (W-GSH). After 14 days of treatment, the duodenum was harvested for morphometric analysis of the mucosa, proliferation, apoptosis, immunostaining of varicosities immunoreactive (IR) to vasoactive intestinal peptide (VIP) and 5-HT-IR cells, and quantification of mast cells and goblet cells. Walker-256 tumor-bearing rats showed cachexia syndrome, mucosal atrophy, reduced cell proliferation, reduced 5-HT-IR cells, and increased goblet cells and VIPergic varicosities, which were not reversed by L-glutathione. On the other hand, L-glutathione caused a reduction of cells in apoptosis and mast cell recruitment, demonstrating a partial recovery of the damage detected in the intestinal mucosa.

Cancer-induced morphological changes in enteric glial cells in the jejunum of Walker-256 tumor-bearing rats.

Cancer-induced cachexia is associated with systemic inflammation and gastrointestinal dysfunction. How changes to cells of the enteric nervous system contribute to gut dysfunction in tumor development and cancer cachexia is unknown. Here, we tested the hypothesis that changes to enteric glia, a type of peripheral glia that surround enteric neurons and regulate gut homeostasis, are associated with tumor development and that supplementing with the antioxidant L-glutathione is protective against the changes induced. Immunohistochemistry for neurons, enteric glial cells and immune cells was performed in whole-mount preparations and frozen histological sections of the jejunum from 20 Wistar rats, distributed in 4 groups: control, tumor of Walker-256, control administered with 1 % L-glutathione, and tumor of Walker-256 administered with 1 % L-glutathione. Morphoquantitative analyses were made using Image-Pro® Plus 4.5 and ImageJ® 1.43° software. Tumor development significantly reduced neuronal and glial cell populations in the myenteric and submucosal plexuses and enlarged glial cell body area in the submucosal plexus. In contrast, tumors increased glia in the jejunal mucosa and this effect was accompanied by B-lymphocyte recruitment. GSH-supplemented diet was not sufficient to protect against changes to neurons and glia in the submucosal plexus but was partially protective in the myenteric plexus. L-glutathione had no effect on physiological parameters of cachexia but was sufficient to preserve enteric glial cell density in the myenteric plexus. These results suggest that changes to both enteric neurons and glia likely contribute to the gastrointestinal effects of tumor development and that oxidative stress contributes to these effects in the enteric nervous system.

L-glutathione 1% promotes neuroprotection of nitrergic neurons and reduces the oxidative stress in the jejunum of rats with Walker-256-bearing tumor.

AIMS: Our main goals were to investigate the effects of L-glutathione (1%) treatment in Walker-256 tumor-bearing rats by analyzing immunoreactive neurons (IR), responsive to the nNOS enzyme and 3-Nitrotyrosine, in their jejunum myenteric plexus. Moreover, the oxidative state and inflammatory process in these animals were investigated. METHODS: Four experimental groups were utilized: control (C), control treated with L-glutathione (CGT), Walker-256 tumor-bearing rats (TW), and Walker-256 tumor-bearing rats treated with L-glutathione (TWGT). After 14 days of tumor inoculation, the jejunum was collected for immunohistochemical techniques and assessment of oxidative status. Plasma was collected to evaluate oxidative status and measure cytokines. RESULTS: The TW group exhibited a decrease of reduced glutathione in their jejunum, which was prevented in the L-glutathione treated TWGT group. TW animals presented pronounced oxidative stress by increasing levels of lipoperoxidation in their jejunum and malondialdehyde in their plasma; however, the L-glutathione treatment in TWGT group was not able to avoid it. The total antioxidant capacity was altered in groups TW and TWGT, yet the last one had a better index in their plasma. The IL-10, and TNF-α levels increased in TWGT animals. The nNOS-IR neuron density decreased in the jejunum myenteric plexus of the TW group, which was avoided in the TWGT group. The nNOS +3-Nitrotyrosine neurons quantification did not show significative alterations. CONCLUSION: The treatment with L-glutathione (1%) imposed an important defense to some parameters of oxidative stress induced by TW-256, leading to neuroprotection to the loss in the nNOS-IR neuron density.

Clinical Aspects and Etiologic Investigation of Pediatric Patients With Acute Liver Failure.

A new outbreak of hepatitis of unknown origin raised awareness in the international community. A few reports have attempted to associate new cases with adenovirus infection and the immunologic effects of previous SARS-CoV-2 infections through a superantigen mechanism. Moreover, according to a case series, viral isolates were identified in 7 of 10 cases of pediatric patients with hepatitis of unknown origin and acute liver failure. Adenovirus was detected by respiratory secretion polymerase chain reaction in 2 patients, with neither presenting with SARS-CoV-2 acute infection. Clinical and laboratory descriptions and cross-referencing epidemiologic and pathophysiological data can help identify possible disease etiologies.

A review of the role of zinc finger proteins on hematopoiesis.

The bone marrow is responsible for producing an incredible number of cells daily in order to maintain blood homeostasis through a process called hematopoiesis. Hematopoiesis is a greatly demanding process and one entirely dependent on complex interactions between the hematopoietic stem cell (HSC) and its surrounding microenvironment. Zinc (Zn2+) is considered an important trace element, playing diverse roles in different tissues and cell types, and zinc finger proteins (ZNF) are proteins that use Zn2+ as a structural cofactor. In this way, the ZNF structure is supported by a Zn2+ that coordinates many possible combinations of cysteine and histidine, with the most common ZNF being of the Cys2His2 (C2H2) type, which forms a family of transcriptional activators that play an important role in different cellular processes such as development, differentiation, and suppression, all of these being essential processes for an adequate hematopoiesis. This review aims to shed light on the relationship between ZNF and the regulation of the hematopoietic tissue. We include works with different designs, including both in vitro and in vivo studies, detailing how ZNF might regulate hematopoiesis.

Zinc and aging: a narrative review of the effects on hematopoiesis and its link with diseases.

There has been a global increase in the older population in recent decades and, as age advances, complex metabolic and epigenetic changes occur in the organism, and these may trigger some health complications commonly found among this population. Additionally, several changes occur in older people that can reduce the dietary intake or the process of nutrient absorption. In this way, tissues with high nutrient requirements are more affected. Hematopoiesis is the process of formation, development, and maturation of blood cells and is a process with a high turnover. This high demand makes the integrity of the hematopoietic process susceptible to various factors that impair physiological function, such as aging and micronutrient bioavailability. Among these micronutrients, Zinc is considered an important micronutrient, playing diverse roles across various tissues and cell types. Some of the alterations in hematopoiesis that appear as a consequence of aging and due to insufficient micronutrient intake are well described in the literature; however, not much is known about how zinc deficiency contributes towards the development of diseases seen in aging. Considering the importance of zinc to act on several biological processes, this narrative review discusses several studies related to the physiological requirements, deficiency, or excess of zinc, including studies in experimental models and humans, and aimed to shed light on the relationship between zinc and the regulation of hematopoietic tissue, exploring possible links between this mineral with common disorders that appear during aging.

Poly(butylene adipate-co-terephthalate)/Poly(lactic acid) Polymeric Blends Electrospun with TiO2-R/Fe3O4 for Pollutant Photodegradation.

This work aimed to use the electrospinning technique to obtain PBAT/PLA polymer fibers, with the semiconductors rutile titanium dioxide (TiO2-R) and magnetite iron oxide (Fe3O4), in order to promote the photocatalytic degradation of environmental contaminants. The parameters used in the electrospinning process to obtain the fibers were distance from the needle to the collecting target of 12 cm, flow of 1 mL h-1 and voltage of 14 kV. The best mass ratio of semiconductors in the polymeric fiber was defined from a 22 experimental design, and the values obtained were 10% TiO2-R, 1% Fe3O4 at pH 7.0. Polymer fibers were characterized by Scanning Electron Microscopy (SEM), Differential Scanning Calorimetry (DSC), X-ray Diffraction (XRD), Thermogravimetric Analysis (TGA) and Fourier Transform Infrared (FTIR) techniques. SEM measurements indicated a reduction in fiber diameter after the incorporation of semiconductors; for the PBAT/PLA fiber, the average diameter was 0.9466 ± 0.2490 µm, and for the fiber with TiO2-R and Fe3O4 was 0.6706 ± 0.1447 µm. In the DSC, DRX, TGA and FTIR analyses, it was possible to identify the presence of TiO2-R and Fe3O4 in the fibers, as well as their interactions with polymers, demonstrating changes in the crystallinity and degradation temperature of the material. These fibers were tested against Reactive Red 195 dye, showing an efficiency of 64.0% within 24 h, showing promise for photocatalytic degradation of environmental contaminants.

Modeling of Listeria innocua, Escherichia coli, and Salmonella Enteritidis inactivation in milk treated by gamma irradiation.

Measuring microbial inactivation in food is useful for food technology as it allows for predicting the growth or death of microorganisms. This study aimed to investigate the effect of gamma irradiation on the lethality of microorganisms inoculated in milk, estimate the mathematical model of inactivation of each microorganism, and evaluate kinetic indices to determine the efficient dose in the treatment of milk. Raw milk samples were inoculated with cultures of Salmonella enterica subsp. enterica serovar Enteritidis (ATCC 13076), Escherichia coli (ATCC 8739), and Listeria innocua (ATCC 3309), irradiated at doses of 0, 0.5, 1, 1.5, 2, 2.5, and 3 kGy. The fitting of the models to the microbial inactivation data was performed using the GinaFIT software. The results demonstrated a significant effect of irradiation doses on the population of microorganisms, with the application of a dose of 3 kGy, a reduction of approximately 6 logarithmic cycles is observed for L. innocua and 5 for S. Enteritidis and E. coli. The model with the best fit was different for each microorganism studied: for L. innocua, the model was log-linear + shoulder; for S. Enteritidis and E. coli, the model that showed the best fit was the biphasic. The studied model fitted well (R2 ≥ 0.9; R2 adj. ≥ 0.9 and smallest RMSE values) for the inactivation kinetics. The lethality of the treatment, considering a reduction in the 4D value, was achieved with the predicted dose of doses of ±2.22, ±2.10, and ±1.77 kGy, for L. innocua, S. Enteritidis, and E. coli, respectively.

Presenteísmo e sua influência sobre a capacidade para o trabalho em profissionais de saúde / Presenteeism and its influence on health personnel's capacity for work / El presentismo y su influencia en la capacidad para el trabajo en profesionales de la salud

Objetivo: identificar a prevalência de presenteísmo em profissionais de saúde e analisar a influência de variáveis sociodemográficas e ocupacionais sobre esse fenômeno, bem como sua influência sobre o índice de capacidade para o trabalho. Método: estudo observacional, transversal com abordagem quantitativa, realizado com 299 profissionais de saúde de um hospital público de ensino. Utilizou-se os instrumentos: Índice de Capacidade para o Trabalho e a Escala de Presenteísmo de Stanford. Aplicaram-se testes de Regressão linear múltipla e de regressão logística. Resultados: a análise de regressão logística revelou que as mulheres tiveram chance 1,88 vezes maior (1,06-3,32 e p=0,03) de apresentar presenteísmo. A regressão linear múltipla mostrou influência dos seguintes preditores na capacidade para o trabalho: presenteísmo (ß=-0,35, p<0,001), sexo (ß=-0,28, p<0,001) e categoria profissional (ß=-0,12, p=0,03). Conclusão: o presenteísmo prevaleceu entre os profissionais de saúde e exerceu influência na sua capacidade para o trabalho.

Objective: to identify the prevalence of presenteeism among health personnel and to examine the influence of sociodemographic and occupational variables on this phenomenon, as well as its influence on the work ability index. Method: this quantitative, observational, cross-sectional study was conducted with 299 health personnel from a public teaching hospital. The Work Ability Index and the Stanford Presenteeism Scale were used. Multiple linear regression and logistic regression tests were applied. Results: logistic regression analysis revealed that women were 1.88 times more likely (1.06-3.32 and p=0.03) to display presenteeism. Multiple linear regression showed following predictors influenced work ability: presenteeism (ß ¬= 0.35, p<0.001), gender (ß= 0.28, p<0.001) and professional category (ß= 0.12, p=0.03). Conclusion: presenteeism was prevalent among health personnel and influenced their ability to work.

Objetivo: identificar la prevalencia del presentismo entre profesionales de la salud y analizar la influencia de variables sociodemográficas y ocupacionales sobre este fenómeno, así como su influencia en el índice de capacidad para el trabajo. Método: estudio observacional transversal con enfoque cuantitativo, realizado con 299 profesionales de la salud de un hospital público de enseñanza. Se utilizaron los siguientes instrumentos: Índice de Capacidad para el Trabajo y la Escala de Presentismo de Stanford. Se aplicaron pruebas de regresión lineal múltiple y regresión logística. Resultados: El análisis de regresión logística reveló que las mujeres tenían 1,88 veces más probabilidades (1,06-3,32 y p=0,03) de presentismo. La regresión lineal múltiple mostró la influencia de los siguientes predictores sobre la capacidad laboral: presentismo (ß=-0.35, p<0.001), género (ß=-0.28, p<0.001) y categoría profesional (ß=-0,12, p=0.03). Conclusión: el presentismo prevaleció entre los profesionales de la salud e influyó en su capacidad de trabajo.

Comunicação entre profissionais e familiares durante internação de recém-nascidos e lactentes: revisão integrativa / Communication between professionals and family members during hospitalization of newborns and infants: an integrative review / La comunicación entre los profesionales y los familiares durante la hospitalización de los recién nacidos y los lactantes: revisión integradora

Objetivo: analisar o conhecimento produzido em relação à comunicação entre familiares e profissionais de saúde, na assistência aos recém-nascidos e lactentes internados em Unidades de Terapia Intensiva Neonatal e de Cuidados Intermediários Neonatais, na percepção de familiares. Método: revisão integrativa, realizada no período de janeiro de 2009 a fevereiro de 2021, em bases virtuais de dados. Foram selecionados sete artigos. Resultados: predominaram estudos qualitativos desenvolvidos por enfermeiros, com maior proporção no ano de 2010. Emergiram duas categorias temáticas: "Experiência com a internação dos filhos em Unidade de média e alta densidade tecnológica" e "Inconsistência na comunicação". Conclusão: a percepção familiar diante da comunicação sobre a saúde do filho internado recebe reações positivas e negativas. Para os pais, quando os profissionais transmitem adequadamente as notícias sobre seus filhos hospitalizados, isto conduz a sentimentos de esperança, gerando na família a perspectiva de sobrevida e recuperação dos seus filhos.

Objective: to analyze the knowledge produced regarding the communication between family members and health professionals in the care of newborns and infants admitted to Neonatal Intensive Care Units and Neonatal Intermediate Care Units, in the perception of family members. Methodology: integrative review, carried out from January 2009 to February 2021, in virtual databases. Seven articles were selected. Results: There was a predominance of qualitative studies developed by nurses, with a higher proportion in 2010. Two thematic categories emerged: "Experience with the hospitalization of children in medium and high technology units" and "Inconsistency in communication". Conclusion: The family perception regarding communication about the health of their hospitalized child suffers positive and negative reactions. For parents, when professionals adequately transmit the news about their hospitalized children, this leads to feelings of hope generating in the family the perspective of survival and recovery of their children.

Objetivo: analizar el conocimiento producido en relación a la comunicación entre familiares y profesionales de la salud, en la atención de recién nacidos y lactantes hospitalizados en Unidades de Cuidados Intensivos Neonatales y Cuidados Intermedios Neonatales, en la percepción de los familiares. Metodología: revisión integradora, realizada de enero de 2009 a febrero de 2021, en bases de datos virtuales. Se seleccionaron siete artículos. Resultados: Predominó los estudios cualitativos desarrollados por enfermeras, con mayor proporción en 2010. Surgieron dos categorías temáticas: "Experiencia con la hospitalización de niños en una unidad de densidad tecnológica media y alta" e "Inconsistencia en la comunicación". Conclusión: La percepción familiar sobre la comunicación sobre la salud de su hijo hospitalizado sufre reacciones positivas y negativas. Para los padres, cuando los profesionales transmiten adecuadamente las noticias sobre sus hijos hospitalizados, esto genera sentimientos de esperanza, generando en la familia la perspectiva de supervivencia y recuperación de sus hijos.

Liver disease accompanied by enteropathy in common variable immunodeficiency: Common pathophysiological mechanisms.

Common variable immunodeficiency (CVID) is one of the inborn errors of immunity that have the greatest clinical impact. Rates of morbidity and mortality are higher in patients with CVID who develop liver disease than in those who do not. The main liver disorder in CVID is nodular regenerative hyperplasia (NRH), the cause of which remains unclear and for which there is as yet no treatment. The etiology of liver disease in CVID is determined by analyzing the liver injury and the associated conditions. The objective of this study was to compare CVID patients with and without liver-spleen axis abnormalities in terms of clinical characteristics, as well as to analyze liver and duodenal biopsies from those with portal hypertension (PH), to elucidate the pathophysiology of liver injury. Patients were divided into three groups: Those with liver disease/PH, those with isolated splenomegaly, and those without liver-spleen axis abnormalities. Clinical and biochemical data were collected. Among 141 CVID patients, 46 (32.6%) had liver disease/PH; 27 (19.1%) had isolated splenomegaly; and 68 (48.2%) had no liver-spleen axis abnormalities. Among the liver disease/PH group, patients, even those with mild or no biochemical changes, had clinical manifestations of PH, mainly splenomegaly, thrombocytopenia, and esophageal varices. Duodenal celiac pattern was found to correlate with PH (p < 0.001). We identified NRH in the livers of all patients with PH (n = 11). Lymphocytic infiltration into the duodenal mucosa also correlated with PH. Electron microscopy of liver biopsy specimens showed varying degrees of lymphocytic infiltration and hepatocyte degeneration, which is a probable mechanism of lymphocyte-mediated cytotoxicity against hepatocytes and enterocytes. In comparison with the CVID patients without PH, those with PH were more likely to have lymphadenopathy (p < 0.001), elevated ß2-microglobulin (p < 0.001), low B-lymphocyte counts (p < 0.05), and low natural killer-lymphocyte counts (p < 0.05). In CVID patients, liver disease/PH is common and regular imaging follow-up is necessary. These patients have a distinct immunological phenotype that may predispose to liver and duodenal injury from lymphocyte-mediated cytotoxicity. Further studies could elucidate the cause of this immune-mediated mechanism and its treatment options.

Non-invasive methods for iron overload evaluation in dysmetabolic patients.

INTRODUCTION: Although hyperferritinemia may reflect the inflammatory status of patients with non-alcoholic fatty liver disease (NAFLD), approximately 33% of hyperferritinemia cases reflect real hepatic iron overload. AIM: To evaluate a non-invasive method for assessing mild iron overload in patients with NAFLD using 3T magnetic resonance imaging (MRI) relaxometry, serum hepcidin, and the expression of ferritin subunits. METHODS: This cross-sectional study assessed patients with biopsy-proven NAFLD. MRI relaxometry was performed using a 3T scanner in all patients, and the results were compared with iron content determined by liver biopsy. Ferritin, hepcidin, and ferritin subunits were assessed and classified according to ferritin levels and to siderosis identified by liver biopsy. RESULTS: A total of 67 patients with NAFLD were included in the study. MRI revealed mild iron overload in all patients (sensitivity, 73.5%; specificity, 70%). For mild (grade 1) siderosis, the transverse relaxation rate (R2*) threshold was 58.9 s-1 and the mean value was 72.5 s-1 (SD, 33.9), while for grades 2/3 it was 88.2 s-1 (SD, 31.9) (p < 0.001). The hepcidin threshold for siderosis was > 30.2 ng/mL (sensitivity, 87%; specificity, 82%). Ferritin H and ferritin L subunits were expressed similarly in patients with NAFLD, regardless of siderosis. There were no significant differences in laboratory test results between the groups, including glucose parameters and liver function tests. CONCLUSIONS: MRI relaxometry and serum hepcidin accurately assessed mild iron overload in patients with dysmetabolic iron overload syndrome.

Dietary Supplements and the Skin: Focus on Photoprotection and Antioxidant Activity-A Review.

Skin health is not only significantly affected by ageing, but also by other lifestyle-related factors, such as sun exposure, exercise and eating habits, smoking or alcohol intake. It is known that the cutaneous tissue can exhibit visible signs of senescence, in the form of, for example, dull complexion, loss of firmness, or changes in pigmentation. Consumers attempt to improve skin health and appearance not only by cosmetic products, but also with the consumption of food supplements. Recently, there has been an increase in the amount of food supplements with claims that are related to skin and hair health. Nevertheless, the literature is still scarce in evidence of the efficacy of this type of products. Considering this scenario, we aim in this review to assemble studies and methodologies that are directed at the substantiation of the cutaneous health claims of food supplements. For example, we reviewed those that were indicative of antioxidant properties, improvement in pigmentation disorders, increased hydration or protection against the damages caused by ultraviolet radiation.

Inter-professional relationships in the Family Health Strategy: perception of health management.

OBJECTIVES: to analyze the teamwork in the Family Health Strategy from the perspective of professionals from the Primary Care Department and the municipal manager/secretary of health of a Municipal Health Secretariat. METHODS: an exploratory/qualitative study. All professionals of the Department and municipal manager/municipal health secretary/interior of Minas Gerais participated. Data collection was through semi-structured interviews/May to November/2019. Data analysis: Content analysis/thematic mode and work process theoretical referential. RESULTS: three categories emerged: Inter-professional relations permeated by non-material instruments of work; Professional training, experience, and profile influence teamwork; and Proposals for the realization of teamwork in the Family Health Strategy. Results revealed assumptions for teamwork in the referred Strategy, facilitators/difficulties/strategies for its realization, according to the professionals. Final Considerations: collaboration/communication/proactivity to facilitate teamwork. Need for approximation between municipal management and Family Health Strategy to achieve teamwork.

JumpSTART Triage Protocol in Disaster Pediatric Patients: A Systematic Literature Review.

INTRODUCTION: In a mass-casualty incident (MCI) involving children, there is a need to apply accurate triage tools in order to help those who require important care, and at the same time, to avoid unnecessary use of resources. Thus, it is discussed which would be the best triage device to use in these situations. One of the most used is a modification of Simple Triage and Rapid Treatment, JumpSTART, whose performative quality this review focuses on. STUDY OBJECTIVE: This review sought to compare the performance parameters of JumpSTART with other triage algorithms used in pediatric disaster victims. METHODS: This systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021258415. The last update of the search in the databases was on August 12, 2021 and resulted in six documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages, and the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health), Web of Science, and CINAHL, which executes the query on the topic, keywords, or abstracts. Also to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria. The Joanna Briggs Institute (JBI) checklists were used to evaluate the methodological quality of the retrieved studies. The results were presented through narrative synthesis. This review was not funded. RESULTS: Of the collected publications, five articles were used to carry out this review, with the addition of an extra article captured by citation tracking. The findings from the obtained results were that JumpSTART was the preferred tool and presented the fastest speed of use. Only one of the five studies that dealt with accuracy showed JumpSTART as the most accurate algorithm, while three of the other four showed its inferiority in most aspects. In one study, no significant difference was observed amongst the chosen protocols. CONCLUSIONS: There is insufficient evidence to validate JumpSTART as a universal triage tool, given the disparities in the results obtained from the comparisons. No tool performed satisfactorily well, therefore there is an urgent need to create a reliable algorithm.

Inter-professional relationships in the Family Health Strategy: perception of health management / Relaciones Interprofesionales en Estrategia de Salud Familiar: percepción de la gestión en salud / Relações interprofissionais na Estratégia Saúde da Família: percepção da gestão em saúde

ABSTRACT Objectives: to analyze the teamwork in the Family Health Strategy from the perspective of professionals from the Primary Care Department and the municipal manager/secretary of health of a Municipal Health Secretariat. Methods: an exploratory/qualitative study. All professionals of the Department and municipal manager/municipal health secretary/interior of Minas Gerais participated. Data collection was through semi-structured interviews/May to November/2019. Data analysis: Content analysis/thematic mode and work process theoretical referential. Results: three categories emerged: Inter-professional relations permeated by non-material instruments of work; Professional training, experience, and profile influence teamwork; and Proposals for the realization of teamwork in the Family Health Strategy. Results revealed assumptions for teamwork in the referred Strategy, facilitators/difficulties/strategies for its realization, according to the professionals. Final Considerations: collaboration/communication/proactivity to facilitate teamwork. Need for approximation between municipal management and Family Health Strategy to achieve teamwork.

RESUMEN Objetivos: analizar trabajo en equipo en Estrategia de Salud Familiar, en la perspectiva de profesionales del Departamento de Atención Básica y gestor municipal/secretario municipal de salud de una Secretaría Municipal de Salud. Métodos: estudio exploratorio/cualitativo. Participaron todos los profesionales del Departamento y gestor municipal/secretario municipal de salud/interior de Minas Gerais. Recolecta de datos por medio de entrevistas semiestructuradas/mayo hasta noviembre/2019. Análisis de datos: Análisis de Contenido/modalidad temática y referencial teórico de proceso de trabajo. Resultados: emergieron tres categorías: Relaciones interprofesionales permeadas por instrumentos no materiales del trabajo; Formación, experiencia y perfil profesionales influencian el trabajo en equipo; Propuestas para realización del trabajo en equipo en la Estrategia de Salud Familiar. Resultados revelaron presupuestos para trabajo en equipo en dicha Estrategia, facilitadores/dificultadores/estrategias para efectuación, según los profesionales. Consideraciones Finales: colaboración/ comunicación/proactividad facilitan trabajo en equipo. Necesidad de acercamiento entre gestión municipal y Estrategia de Salud Familiar para realización del trabajo en equipo.

RESUMO Objetivos: analisar o trabalho em equipe na Estratégia Saúde da Família, na perspectiva de profissionais do Departamento de Atenção Básica e do gestor municipal/secretário municipal de saúde de uma Secretaria Municipal de Saúde. Métodos: estudo exploratório/qualitativo. Participaram todos os profissionais do Departamento e gestor municipal/secretário municipal de saúde/interior de Minas Gerais. Coleta de dados por meio de entrevistas semiestruturadas/maio a novembro/2019. Análise de dados: Análise de Conteúdo/modalidade temática e referencial teórico de processo de trabalho. Resultados: emergiram três categorias: Relações interprofissionais permeadas por instrumentos não materiais do trabalho; Formação, experiência e perfil profissionais influenciam o trabalho em equipe; Propostas para concretização do trabalho em equipe na Estratégia Saúde da Família. Resultados revelaram pressupostos para trabalho em equipe na referida Estratégia, facilitadores/dificultadores/estratégias para efetivação, segundo os profissionais. Considerações Finais: colaboração/ comunicação/proatividade facilitam trabalho em equipe. Necessidade de aproximação entre gestão municipal e Estratégia Saúde da Família para concretização do trabalho em equipe.

RP-HPLC simultaneous quantification of rutin, avobenzone, and octyl methoxycinnamate in the presence of hydroxypropyl β-cyclodextrin (HPβCD) and sulfobutyl ether β-cyclodextrin (SBEβCD)

Abstract Development and validation of a simple and fast method of high-performance liquid chromatography with diode array detection (HPLC-DAD) for the simultaneously analysis of rutin, avobenzone, and octyl p-methoxycinnamate is presented. These substances were separated using a Kromasil C18 (250×4.6 mm, 5 μm) column, methanol: water (88:12 v/v) as the mobile phase, and a flow rate of 0.8 mL min−1. The experiment was performed at room temperature and elution was under isocratic conditions. Quantification was performed by external calibration at the wavelength of 325 nm. The validated parameters included linearity, selectivity, precision (repeatability), intermediate precision, accuracy, limit of detection, limit of quantification and robustness. The results of validation were statistically treated using the Action Stat version 3.5.152.34. The selectivity was also evaluated in the presence of two cyclodextrins (2-hydroxypropyl-β-cyclodextrin and β-cyclodextrin sulfobutyl ether sodium). The absence of parallelism between the curves of octyl p-methoxycinnamate in the absence and presence of the β-cyclodextrin sulfobutyl ether sodium in the mobile phase revealed interference from this matrix, thereby indicating the necessity of validating the method in the presence of this, and other matrices. The proposed method was selective, linear, precise, accurate, and robust for the simultaneous determination of rutin, avobenzone, and octyl p-methoxycinnamate.

A prática da educação em saúde na perspectiva de profissionais da zona rural de um município do interior de Minas Gerais / Health education in practice from the perspective of professionals in rural areas of a small municipality in Minas Gerais / La práctica de la educación en salud en la perspectiva de profesionales de la zona rural de un municipio de Minas Gerais

Objetivo: descrever as ações de educação em saúde realizadas por profissionais da Estratégia Saúde da Família da zona rural de um município do interior de Minas Gerais. Método: estudo exploratório, abordagem qualitativa. Envolveu 16 profissionais da Estratégia Saúde da Família da zona rural. Coleta de dados realizada por meio de entrevistas semiestruturadas em 2019, com dados analisados empregando técnica de análise de conteúdo. Resultados: emergiram três categorias temáticas: Educação em saúde, prevenção de doenças e transmissão de informações; Educação em saúde como sinônimo de educação em serviço; e, A gestão do trabalho como ferramenta para a educação em saúde. Conclusão: a educação em saúde é realizada por meio de palestras, grupos ou individualmente, focada na doença, ancorada no repasse de saberes profissionais. Ainda é percebida como educação em serviço, revelando desconhecimento dos profissionais frente à temática. Constatou-se necessidade de investimento da gestão na viabilização de recursos e agentes para a educação em saúde.

Objective: to describe the health education actions performed by Family Health Strategy personnel in rural area of a town in Minas Gerais. Method: this exploratory, qualitative study involved 16 Family Health Strategy personnel from a rural area. Data were collected through semi-structured interviews in 2019 and analyzed using content analysis. Results: three thematic categories emerged: Health education, disease prevention and information transmission; Health education as a synonym for inservice education; and Work management as a tool for health education. Conclusion: health education is carried out through group or individual lectures. It is disease-focused and rests on conveying professional knowledge. It is still perceived as in-service education, revealing health personnel's lack of knowledge on the subject. There was found to be a need to invest in management when enabling funding and agents for health education.

Objetivo: describir las acciones de educación en salud realizadas por profesionales de la Estrategia Salud de la Familia en el área rural de un municipio del interior de Minas Gerais. Método: estudio exploratorio, abordaje cualitativo. Involucró a 16 profesionales de la Estrategia Salud de la Familia, en áreas rurales. La recolección de datos se realizó a través de entrevistas semiestructuradas en 2019, los datos se analizaron mediante la técnica de análisis de contenido. Resultados: surgieron tres categorías temáticas: educación en salud, prevención de enfermedades y transmisión de información; Educación en salud como sinónimo de educación en servicio y la Gestión del trabajo como herramienta de educación en salud. Conclusión: la educación en salud se realiza a través de conferencias, en grupo o individualmente, enfocada a la enfermedad, anclada en la transferencia de conocimientos profesionales. Todavía se percibe como educación en servicio, lo que revela la falta de conocimiento de los profesionales sobre el tema. Se percibió la necesidad de invertir de la gestión en hacer viables los recursos y agentes para la educación en salud.

Unidade de média e alta densidade tecnológica: a comunicação como tecnologia para o cuidado / Medium and high technological density unit: communication as technology for care / Unidad de densidad tecnológica mediana y alta: la comunicación como tecnología para el cuidado

Objetivo: analisar as percepções dos familiares de recém-nascidos e lactentes internados em uma unidade neonatal sobre a comunicação com os profissionais de saúde. Metodologia: estudo exploratório de abordagem qualitativa, realizado com cinco mães que possuíam filhos internados na Unidade de Terapia Intensiva Neonatal e Unidade de Cuidados Intermediários Neonatal. Coleta de dados ocorreu por meio de grupo focal e a técnica utilizada para tratamento dos dados foi a análise temática de conteúdo. Resultados: a comunicação impacta no vínculo entre familiares e equipe de saúde, sendo essencial no aspecto técnico e emocional durante a hospitalização de seus filhos. Os familiares precisam ser informados quanto a notícias potencialmente negativas de forma delicada e acolhedora, bem como esclarecidos quanto aos equipamentos presentes no setor, amenizando o medo e receio. Conclusão: a comunicação revela-se como potente tecnologia em saúde e deve ocorrer de maneira clara e simples, contribuindo para uma assistência equânime e humanizada.

Objective: to analyze the perceptions of relatives of newborns and nursing infants hospitalized in a neonatal unit about communication with health personnel. Methodology: this exploratory, qualitative study with was conducted with five mothers with children hospitalized in the Neonatal Intensive Care Unit and Neonatal Intermediate Care Unit. Data were collected in a focus group and treated using thematic content analysis. Results: communication affects bonding between family and health team, and is essential technically and emotionally during the children's hospitalization. Family members need to be informed of potentially bad news delicately and comfortingly, as well about the equipment in the sector, so as to alleviate fear and reluctance. Conclusion: communication was found to be a powerful health technology and should occur clearly and simply, so as to contribute to equitable, humanized care.

Objetivo: analizar las percepciones de los familiares de neonatos y lactantes, hospitalizados en una unidad neonatal, sobre la comunicación con los profesionales de la salud. Metodología: estudio exploratorio con abordaje cualitativo realizado junto a cinco madres que tenían hijos hospitalizados en la Unidad de Cuidados Intensivos Neonatales y Unidad de Cuidados Intermedios Neonatales. La recolección de datos se realizó a través de un grupo focal y la técnica utilizada para el tratamiento de los datos fue el análisis de contenido y temático. Resultados: la comunicación impacta en el vínculo entre los familiares y el equipo de salud, siendo fundamental en el aspecto técnico y emocional, durante la hospitalización de sus hijos. Los familiares necesitan estar informados sobre noticias potencialmente negativas de forma delicada y acogedora, así como se les debe aclarar dudas en cuanto a los equipos presentes en el sector, amenizando miedos y preocupaciones. Conclusión: la comunicación resulta ser una tecnología poderosa en salud y debe ocurrir de manera clara y sencilla, contribuyendo a una asistencia equitativa y humanizada.

Children's Health Care in Mass-Casualty Incidents: A Systematic Literature Review.

OBJECTIVES: Considering the pediatric peculiarities and the difficulty of assisting this population in mass-casualty situations, this study aims to identify the main topics regarding children's health care in mass-casualty incidents (MCIs) that are discussed in the Emergency Medicine area. METHODS: This systematic review was performed according to the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021229552. The last update of the search in the databases was on May 27, 2021 and resulted in 45 documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages; the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health - VLH), and Web of Science, which execute the query on the topic, keywords, or abstracts. Also, to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria. RESULTS: From the resulting papers, 21 articles served as the basis for this analysis. Revealed were the year of publication, the first author's institution nationality, topic, and disaster management phase for each study, which allow other researchers to understand the main topics regarding children's health care in MCIs. CONCLUSIONS: The topics regarding child's health care in MCIs found in the primary studies of this review, in order of frequency, were: Disaster Response (including the following sub-topics: simulation, education, quality of care, use of technological tools, and damage analysis); Triage; and Disaster Planning. The Emergency Medicine operation was focused on harm reduction after the occurrence of an MCI. Further studies focusing on the pre-disaster and post-disaster phases are needed.