A mobile application to guide healthcare professionals in the correct technique for personal protective equipment use during the COVID-19 pandemic

Objectives: The present study aimed to develop an application to guide healthcare professionals on using personal protective equipment (PPE) during the COVID-19 pandemic and prevent and treat skin lesions caused by these devices. Methods: This is a study on technological production. The framework for application development consisted in the following phases: Phase 1-"Design: identification of application development requirements;" Phase 2-"Application prototype development": including an integrative literature review in major databases; Phase 3-"Application construction": elaboration of the decision tree, algorithm, database structuring, and software development; Phase 4-"Transition": application functionality test. Result: Our application Simplifica EPI is an innovative technology; this software is a tool to assist healthcare professionals in using PPE. In addition, it describes how to prevent and care for skin lesions caused by PPE. Simplifica EPI has 25 screens and 32 images. It will be available on the Google Play Store after its registration with the Brazilian National Institute of Industrial Property. Conclusions: After an integrative literature review, the application Simplifica EPI was developed as an innovative technology with great potential for use by healthcare professionals. (AU)

Elaboration and validation of flowchart for the prevention and treatment of intestinal peristomal skin complications

Objective: To build and validate a flowchart for the prevention and treatment of intestinal peristomal skin complications. Method: For the construction of the algorithms, a systematic reviewwas carried out in health sciences databases comprising the last 10 years. The evaluation of the algorithms was carried out by 38 nurses. For the validation of the algorithms, theDelphi technique was used. The statistical analysis used was the content validity index and the Cronbach alpha coefficient. The questionnaire was sent by e-mail and in person after approval by the Ethics and Research Committee. Results: In the first evaluation of the algorithms, there was no agreement among the experts. However, after making the corrections suggested by the evaluators, the algorithms were resent, with a 100% consensus among the evaluators. The questions used to validate the algorithms contributed favourably to the internal consistency and content validation of the instrument, since the respective Cronbach alpha was 0.9062 and the global content validity index (g-CVI) was 0.91 in the first validation and 1.0 in the second validation. Conclusion: After an integrative literature review, the flowcharts were built and validated by a professional with experience in the area, showing 100% agreement among the experts in the second evaluation. (AU)

Peristomal dermatitis: treatment with green banana peel (Musa sapientum) powder / Dermatite periestomal: tratamento com pó de casca de banana verde (Musa sapientum)

Objective: To develop green banana peel (Musa sapientum) powder for the treatment of peristomal dermatitis, and to evaluate its effectiveness and healing time. Methods: A clinical, analytical and longitudinal study. In total, 44 volunteers of both genders, aged>18 years, with intestinal ostomy, who presented peristomal dermatitis, participated in the research. The sample was divided into two groups: the study group used a powder containing 10% of green banana peel, and the control group used ostomy powder. The research was approved by the Ethics in Research Committees (Comitês de Ética em Pesquisa, CEP, in Portuguese) under opinion n° 2.381.904. Results: The healing time of the study group was shorter than that of the control group (p=0.022). To analyze the results, we used the two-sample t-test (mean days until healing for both study groups). Conclusion: The powder containing 10% of green banana peel was developed, and effective healing of the peristomal dermatitis was observed. Compared to the ostomy powder, it presented a shorter healing time. (AU)

Objetivo: Desenvolver o pó composto da casca da banana verde (Musa sapientum) para o tratamento de dermatite periestomal, e avaliar a eficácia e o tempo de cicatrização. Métodos: Estudo clínico, analítico e longitudinal. Participaram da pesquisa 44 voluntários, de ambos os gêneros, maiores de 18 anos, com estomias intestinais, e que apresentavam dermatite periestomal. A amostra foi dividida em dois grupos: o grupo de estudo usou umpó que continha 10% de casca de banana verde, e o grupo de controle usou pó para estomia. A pesquisa foi aprovada pelos Comitês de Ética em Pesquisa (CEP), sob o parecer n° 2.381.904. Resultados: O tempo de cicatrização do grupo de estudo foimenor do que o do grupo de controle (p=0.022). Para a análise dos resultados, empregou-se o teste t para duas amostras (média de dias de cicatrização de ambos os grupos). Conclusão: Desenvolveu-se o pó contendo 10% de casca de banana verde, e observouse cicatrização eficaz da dermatite periestomal. Em comparação com o pó para estomia, apresentou tempo menor até a cicatrização. (AU)

Terminalidade da vida: reflexão bioética sobre a formação médica / End of life: bioethical reflection on medical education / Terminalidad de la vida: reflexión bioética sobre la formación médica

Resumo Nesta pesquisa qualitativa, utilizou-se o método do discurso do sujeito coletivo para conhecer os significados, sentimentos e percepções de estudantes de medicina sobre o tema morte e pacientes terminais. Foram entrevistados 60 alunos de uma universidade do Sul de Minas Gerais. Para os significados sobre terminalidade da vida, a ideia central mais frequente foi "fechamento da vida". Quando o tema abordado foi o sentimento a respeito do paciente terminal, emergiram as ideias centrais "insegurança", "impotência", "frustração" e "angústia". Quanto ao preparo para lidar com a morte e o morrer, prevaleceu a ideia "não estou preparado". Já com relação à presença desses temas na formação, surgiram as ideias "abordagem superficial", "deveriam ser abordados com mais frequência" e "não abordados". Conclui-se que a formação médica não trata da inexorabilidade da morte, o que afasta a possibilidade de repensar o cuidado como forma terapêutica.

Abstract This qualitative study used the collective subject discourse method to identify the meanings, feelings and perception of medical students about death and terminally ill patients. In total, 60 students from a medical school in southern Minas Gerais were interviewed. For the meanings about end of life, the most common idea was "closure of life." When the topic addressed was the feeling about terminal patients, the central ideas were "insecurity," "impotence," "frustration" and "anguish." Regarding the preparation to deal with death and dying, "unpreparedness" was the most common. When considering how these themes are approached during training, "superficial approach," "not very frequent" and "not addressed" emerged as ideas. We can thus conclude that the inexorability of death is not part of medical training, removing the possibility of rethinking care as a therapeutic form.

Resumen En esta investigación cualitativa se utilizó el método del discurso del sujeto colectivo para conocer los significados, sentimientos y percepciones de los estudiantes de medicina sobre el tema muerte y pacientes terminales. Se entrevistó a 60 alumnos de una universidad del sur del estado de Minas Gerais, Brasil. En lo que respecta a los significados sobre la terminalidad de la vida, la idea central más frecuente fue "cierre de la vida". Cuando se abordó el sentimiento respecto al paciente terminal, surgieron como ideas centrales: "inseguridad", "impotencia", "frustración" y "angustia". En cuanto a la preparación para enfrentarse a la muerte y al morir, prevaleció la idea "no estoy preparado". A su vez, respecto a la presencia de estos temas durante la formación, surgieron las ideas "enfoque superficial", "deberían abordarse con más frecuencia", y "no abordados". Se concluye que la formación médica no aborda la inexorabilidad de la muerte, lo que aparta la posibilidad de repensar el cuidado como forma terapéutica.

Algoritmos para prevenção e tratamento de lesão por fricção / Algoritmos para prevención y tratamiento de lesión por fricción / Algorithms for the prevention and treatment of friction injury

Resumo Objetivo: Elaborar e validar o conteúdo de algoritmos para prevenção e tratamento de lesão por fricção. Métodos: Para a construção dos algoritmos, foi realizada uma revisão integrativa da literatura após busca nas bases de dados: SciELO, LILACS e MEDLINE. A avaliação dos algoritmos foi realizada por 26 juízes, sendo 10 médicos e 16 enfermeiros, utilizando-se a técnica Delphi. Os resultados foram analisados por meio do Índice de Validade de Conteúdo. Resultados: No primeiro ciclo de avaliação, os itens dos algoritmos foram considerados pelos juízes de "inadequados" a "totalmente adequados". Após as correções sugeridas pelos juízes, os algoritmos foram reenviados para o segundo ciclo de avaliação, no qual todos os itens foram julgados "adequados" ou "totalmente adequados", resultando em um Índice de Validade do Conteúdo de 1,0. Conclusão: Os algoritmos desenvolvidos possuem validade de conteúdo e podem auxiliar profissionais de saúde na avaliação, prevenção e tratamento da lesão por fricção.

Resumen Objetivo: Elaborar y validar el contenido de algoritmos para prevención y tratamiento de lesión por fricción. Métodos: Para la construcción de los algoritmos, se realizó una revisión integradora de la literatura luego de una búsqueda en las bases de datos: SciELO, LILACS y MEDLINE. La evaluación de los algoritmos fue realizada por 26 jueces, de los cuales 10 eran médicos y 16 enfermeros, con la utilización del método Delphi. Los resultados fueron analizados mediante el Índice de Validez de Contenido. Resultados: En el primer ciclo de evaluación, los ítems de los algoritmos fueron considerados desde "inadecuados" a "totalmente adecuados" por los jueces. Luego de las correcciones sugeridas por los jueces, se enviaron los algoritmos para el segundo ciclo de evaluación, en el que todos los ítems fueron considerados "adecuados" o "totalmente adecuados", lo que tuvo como resultado un Índice de Validez de Contenido de 1,0. Conclusión: Los algoritmos elaborados tienen validez de contenido y pueden ayudar a profesionales de la salud en la evaluación, prevención y tratamiento de la lesión por fricción.

Abstract Objective: Develop and validate the content of algorithms for the prevention and treatment of friction injury. Methods: For the construction of algorithms, an integrative literature review was conducted after searching SciELO, LILACS and MEDLINE databases. The algorithms were evaluated by 26 raters - 10 physicians and 16 nurses - using the Delphi technique. The results were analyzed by the Content Validity Index (CVI). Results: In the first evaluation cycle, the items of the algorithms were considered "inadequate" to "totally adequate" by the raters. After adjustments suggested by the raters, the algorithms were submitted to a second evaluation cycle, when all items were considered "adequate" or "totally adequate," resulting in a content validity index of 1.0. Conclusion: The algorithms have valid content and can help health professionals in the evaluation, prevention and treatment of friction injuries.

Vacinação no Brasil: reflexão bioética sobre acessibilidade / Vaccination in Brazil: bioethical reflection on accessibility / Vacunación en Brasil: una reflexión bioética sobre la accesibilidad

Resumo As vacinas têm grande influência na saúde pública por sua efetividade e relação custo-benefício favorável. Entretanto, com o surgimento de novos imunizantes indisponíveis na rede pública, torna-se necessário discutir o acesso da sociedade em geral. O objetivo deste trabalho foi identificar o significado da vacinação para profissionais e população, assim como abordar a questão do acesso à imunização fora da rede pública de saúde, enfatizando a vulnerabilidade social. Foram entrevistados médicos e cidadãos leigos, e os dados foram analisados a partir de metodologia qualitativa exploratória e do discurso do sujeito coletivo. O sistema vacinal brasileiro foi entendido pelos entrevistados como bom de maneira geral, sendo as principais críticas voltadas à falta de informações e insumos. Quanto ao acesso, os dados sugerem correlação com fatores econômicos, abrindo espaço para discussões bioéticas sobre a vulnerabilidade social da maior parte da população, que não tem condições de pagar por essas imunizações.

Abstract Vaccines have a strong influence on public health because of their effectiveness and favorable cost-benefit ratio. However, with new vaccines unavailable in the public system, the access by society in general must be discussed. This study aimed to identify the meaning of vaccination for the population and physicians, and address the issue of access to vaccines outside the public health system, emphasizing social vulnerability. Physicians and members of society were interviewed, and the data was analyzed using an exploratory qualitative methodology and the collective subject speech. The Brazilian immunization system was seen by respondents as good in general, with the main criticisms directed at information and the lack of vaccines. As for accessibility, data suggests a correlation with economic factors, generating bioethical discussions about the social vulnerability of most of society that cannot afford vaccination.

Resumen Las vacunas ejercen una gran influencia sobre la salud pública debido a su efectividad y a una relación costo-beneficio favorable. Sin embargo, con el surgimiento de nuevas vacunas indisponibles en la red pública, se hace necesario discutir el acceso de la sociedad a este servicio. El objetivo de este trabajo fue identificar el significado de la vacunación para la población y los médicos, y abordar la cuestión del acceso a la inmunización fuera de la red pública de salud, haciendo hincapié en la vulnerabilidad social. Con base en una metodología cualitativa exploratoria y en el discurso del sujeto colectivo, se entrevistó a médicos y a ciudadanos legos. El sistema brasileño de vacunas fue considerado por los entrevistados como bueno de manera general. Las principales críticas se refieren a la información y a la falta de insumos. Respecto al acceso, los datos sugieren que existe una correlación con factores económicos, lo que crea un espacio para discusiones bioéticas sobre la vulnerabilidad social de la mayor parte de la sociedad, que no tiene condiciones de pagar por estas inmunizaciones.

A new APP for prevention and treatment of complications of intestinal peristomal skin / Aplicativo para prevenção e tratamento das complicações da pele periestoma intestinal

ABSTRACT Objectives To develop an application program for prevention and treatment of complications of intestinal peristomal skin. Method The framework of the application software development were: Phase 1 - "Design, identification of the needs for the application development": In this phase, the authors identified during their clinical practice that some professionals and caregivers find it difficult to provide care for at-risk ostomized patients or those with some kind of peristomal skin complication; Phase 2 - "Application prototype development": this phase included the integrative literature review in the main databases; Phase 3 - "Creating the application": this phase was intended to generate a decision tree algorithms, structure the database, and develop the software; Phase 4 - "Transition": performing the application functionality testing. Results The application "Dermatite Periestoma App" has 36 screens and 21 figures describing the procedures for prevention and treatment of complications of intestinal peristomal skin. It is freely available from the Play Store and has been registered with the Instituto Nacional da Propriedade Industrial Ministério do Desenvolvimento, indústria e Comércio Exterior (Brazilian Ministry of Development, Industry and Foreign Trade, National Institute of Industrial Property). Conclusion This study made it possible to describe the stages of planning and development of the mobile application "Dermatite Periestoma App". The steps taken indicate that the "Dermatite Periestoma App" has great potential for clinical practice in the evaluation of patients with stomal complications or at risk for developing peristomal skin complications, preventive measures, therapeutic approaches, and for nursing education through the use of technology.

RESUMO Objetivos Desenvolver um aplicativo para prevenção e tratamento de complicações da pele periestoma intestinal. Método As fases de desenvolvimento da estrutura do aplicativo foram: Fase 1 - "Concepção, identificação das necessidades do desenvolvimento do aplicativo": nessa fase os autores identificaram, durante sua prática clínica, que alguns profissionais e cuidadores têm dificuldade em prestar assistência aos ostomizados com risco ou que adquirirem algum tipo de complicação da pele periestoma; Fase 2 - "Elaboração do protótipo do aplicativo": essa fase contemplou a revisão integrativa da literatura nas principais bases de dados; Fase 3 - "Construção do aplicativo": essa fase consistiu na elaboração da árvore de decisão dos algoritmos, estruturação do banco de dados e desenvolvimento do software; Fase 4 - "Transição": foram realizados os testes de funcionalidade do aplicativo. Resultados O aplicativo "Dermatite Periestoma App" tem 36 telas e 21 figuras descrevendo os procedimentos para prevenção e tratamento das complicações da pele periestoma intestinal. O mesmo está disponível gratuitamente naPlay Store e foi registrado no Instituto Nacional da Propriedade Industrial Ministério do Desenvolvimento, indústria e Comércio Exterior. Conclusão Este estudo possibilitou descrever as etapas do planejamento e desenvolvimento do aplicativo móvel "Dermatite Periestoma App". As etapas percorridas indicam que o "Dermatite Periestoma App" tem grande utilidade potencial para a prática clínica na avaliação do ostomizado com complicação ou que apresenta risco para desenvolver complicações da pele periestoma, medidas preventivas, condutas terapêuticas, e para o ensino de Enfermagem por meio do uso de tecnologia.

Applicability of eucalyptus wood waste extracts for the histological staining of connective tissue.

Biological staining of tissue is a crucial procedure in histotechnology. Rudimentary methods for section preparation have often used stains from natural products, although use of synthetic dyes has become the contemporary standard. Artificial dyes increase the operating costs of a laboratory as well as increase the environmental and personnel risks during manufacturing and usage. These considerations have stimulated research to find alternative natural stains from the wide diversity of plant species. The present study investigated the effect of Eucalyptus sp. (Myrtaceae) wood waste extract on histological staining of animal tissues, using a series of pigment concentrations, pH conditions, and temperatures. Eucalyptus wooden slivers were dried, milled, and 1 g, 2 g, and 4 g of the fine powder was subjected to 50% ethanol extraction for 2 days. Staining tests were then performed on formalin fixed paraffin embedded (FFPE) sections. Increasing acetic acid concentrations (1%, 2% and 4%) were added to the extracts and compared to an acid-free extract. Staining was performed at both ambient room temperature (RT) and 60°C. Connective tissue acidophilic components were well-contrasted and a hematoxylin counterstain demonstrated distinct structural differences between matrix and cell nuclei. Therefore, the present findings demonstrate the potential utility of the eucalyptus wood extracts application as a natural stain alternative for routine histology.

Reflections on the Terminality of Life with Undergraduate Medical Students / Reflexões sobre a Terminalidade da Vida com Acadêmicos de Medicina

Abstract: Introduction: Death and dying are daily relevant themes for health care professionals and medical students. Nonetheless, since their first years of graduation, students are contrived to supplant the holistic conception of human beings and life in favor of enhancing the technical aspects of the medical profession. Methods: Therefore, in face of the few opportunities to enquire about these future professionals' feelings and comprehensions toward life terminality, we pursued their perceptions through the application of a semi-structured questionnaire. Ten students from each year of the medical course at UNIVAS were interviewed, encompassing 60 scholars. Students should be regularly enrolled in the medical course, as well as give their consent, by signing the Consent Term, to participate in the study. The interviews took place at the institution and the material containing students' responses was fully destroyed afterwards. Their responses were analyzed based on the Discourse of the Collective Subject Method. Results: The idea of terminality being properly the "end of life" was paramount among the years, situation with which a great amount of the scholars (58%) admitted not being prepared to deal with, due to the lack of reflections about death, its psychological aspects and repercussions in the academic context. Interestingly, about 16% of the scholars considered themselves prepared to deal with someone's death, although they were not prepared to intervene in the actual process. This is reinforced by the fact that students must deal with the real scenario of giving undesirable news without previously being prepared to do so, by means of reflecting upon a hypothetical related to the "life-death binomial". Conclusion: Thus, it seems necessary to create spaces in the curriculum that yield not only theoretical-practical but also affective support in situations related to terminality. The proposal of a theoretical-practical education based on palliative care amid the learning programs would shape confident attitudes of future health care professionals towards care.

Resumo Introdução: A morte e o morrer são temas pertinentes ao cotidiano de profissionais de saúde e ao processo de aprendizagem de acadêmicos de Medicina; entretanto, desde os primeiros anos da graduação, o estudante é obrigado a suplantar a concepção holística do ser humano e da vida em prol da supervalorização dos fundamentos técnico-científicos da profissão. Métodos: Nesse sentido, diante das poucas oportunidades de questionar os sentimentos e a compreensão desses futuros profissionais com relação à terminalidade da vida, buscou-se conhecer suas percepções por meio da aplicação de um questionário semiestruturado. Foram entrevistados dez acadêmicos de cada ano do curso de Medicina da Univás, totalizando 60 alunos. Para inclusão no estudo, os estudantes deveriam estar regularmente matriculados no curso, aceitando, por livre-arbítrio, participar da pesquisa por meio da assinatura do Termo de Consentimento Livre e Esclarecido (TCLE). As entrevistas foram gravadas nas dependências da instituição e o material contendo a fala dos participantes foi posteriormente descartado. Para análise das respostas, utilizou-se o método do Discurso do Sujeito Coletivo. Resultados: Foi suscitada, de maneira preponderante em todos os anos, a concepção de terminalidade como sendo propriamente o "fim da vida", situação com a qual parcela considerável dos entrevistados (58%) dizia não se sentir preparada para lidar por conta da escassez de reflexões sobre a morte, seus aspectos psicológicos e suas repercussões no contexto médico-acadêmico. Curiosamente, cerca de 16% dos acadêmicos consideravam-se preparados para vivenciar a morte de alguém, mas não para serem intervencionistas no processo; isso é sustentado pelo fato de que os estudantes têm de lidar com o cenário real de transmissão de más notícias, sem antes passar por situações hipotéticas e reflexivas envolvendo o "binômio vida e morte". Conclusão: Sendo assim, parece necessária a criação de espaços na grade curricular que forneçam apoio não apenas teórico-prático, mas também afetivo das questões envolvendo a terminalidade. A proposta de educação teórico-prática relativa aos cuidados paliativos inserida na grade curricular lapidaria a confiança e atitude dos futuros profissionais perante o cuidado.

In Vitro and In Vivo Antimicrobial Activity of Cymbopogon citratus (DC.) Stapf. Against Staphylococcus spp. Isolated from Newborn Babies in an Intensive Care Unit.

Phytotherapy is an emerging topic of health research, with particular focus on studying the efficiency of essential oils as antimicrobials. In this study, we investigated the in vitro and in vivo susceptibility of Staphylococcus strains isolated from newborns to Cymbopogon citratus oil. The in vitro susceptibility of the microorganisms to C. citratus essential oil was compared with the activities of standard antibiotics administered to newborns using disk diffusion and microdilution methods. For in vivo assessment, 30 Wistar rats were wounded and subjected to infection of Staphylococcus aureus strain DRJ080, followed by treatment with the antibiotic vancomycin, C. citratus, or carbopol polymer gel (control) for 11 days. S. aureus accounted for 23.36% of the 107 Staphylococcus sp. strains isolated. Both vancomycin and the essential oil of C. citratus inhibited the growth of all microorganisms in vitro. The minimum inhibitory and bactericidal concentrations for the C. citratus oil were 0.625 mg/mL in all strains tested. The oil had the same therapeutic effectiveness as vancomycin against S. aureus DRJ080 in rats. Thus, Staphylococcus strains of newborns are sensitive to C. citratus oil, both in vitro and in vivo, demonstrating its potential as an antibiotic alternative.

Microbiota de úlceras venosas pós uso de "Bota de Unna" / Microorganisms present after use of Unna's boot from ulcers venous patient

Modelo do Estudo: Foi realizado um estudo individual, analítico, observacional, longitudinal prospectivo, controlado, estudo de coortes concorrente, realizado no período de abril de 2013 a novembro de 2014. Objetivo: Avaliar a microbiota presente no exudato da úlcera venosa de pacientes com "Bota de Unna" e a sua resistência aos antimicrobianos. Métodos: Foram coletadas amostras do exudato de feridas de pacientes com o uso de "Bota de Unna" e de terapia tópica durante a troca do curativo e após sete dias. Os micro-organismos isolados foram identificados e testados quanto à susceptibilidade a antimicrobianos: Resultado: Os micro-organismos Gram positivos isolados foram: S. aureus, E. faecalis, S. xylosus e S. haemolyticus. Os micro-organismos Gram negativos foram: E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A.baumannii, E. cloacae e Tatumella sp. O percentual de crescimento e a microbiota no exudato da úlcera após sete dias não foi significante entre os dois tipos de curativo. O aumento de resistência dos cocos Gram positivos aos antimicrobianos testados nos pacientes que utilizam a "Bota de Unna" foi maior do que nos pacientes sem bota (p=0,0093). Conclusão: O número de micro-organismos na microbiota do exudato da úlcera venosa após troca do curativo é maior independentemente do tipo do curativo. Os cocos Gram-positivos apresentam aumento de resistência aos antimicrobianos nos pacientes que utilizam a "Bota de Unna" (AU)

Model Study: A special analytical observational prospective longitudinal and controlled study of concurrent cohort was conducted from April 2013 to November 2014. Objective: To evaluate the microbiota present in the secretion of venous ulcer patients with "Unna Boot" and their resistance to antimicrobials. Methods: secretion samples were collected from wounds of patients with and without the use of "Unna Boot" and topic therapy during the dressing change and after seven days. The isolated microorganisms were identified and tested for antimicrobial susceptibility: Result: The isolated Gram-positive microorganisms were: S. aureus, E. faecalis, S. haemolyticus and S. xylosus. Gram-negative microorganisms were E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A. baumannii, E. cloacae and Tatumella sp. The growth percentage and the microbiota in the secretion of the ulcer after seven days was not significant between the two types of dressing. The resistance of Gram-positive cocci to antimicrobials in patients using the "Unna Boot" was higher than in patients without boot (p = 0.0093). Conclusion: The number of microorganisms in microbial secretion venous ulcer after dressing change is higher regardless of the type of dressing. The positive cocci increased antimicrobial resistance in patients using the "Unna Boot".(AU)

Repair of surgical wounds in rats using a 10% unripe Musa sapientum peel gel.

PURPOSE: To investigate the efficacy of a 10% gel of unripe banana (Musa sapientum) peel in treating surgical wounds in rats. METHODS: A longitudinal, prospective, randomized triple-blind study was conducted with 60 Wistar rats (Rattus norvegicus albinus) weighing approximately 400g. The animals were randomly divided into: control group (treated with gel containing no active ingredient) and study group (treated with 10% gel of unripe banana peel). The gel was applied every three days to a 4x4-cm surgical wound created on the back of each animal (day 0) in both groups. Tissue samples were collected for histological analysis on days 14, 21 and 28. RESULTS: On day 14, more extensive vascular proliferation (p=0.023), presence of mononuclear cells (p=0.000), fibroblast proliferation (p=0.012), re-epithelialization (p=0.000), and decreased presence of polymorphonuclear cells (p=0.010) were observed in the study group than in controls. No significant between-group difference in the presence of polymorphonuclear cells was found on day 21. Fibroblast proliferation was significantly greater (p=0.006) in the study group than in the control group on day 28. CONCLUSION: The 10% gel of unripe banana peel showed anti-inflammatory activity and stimulated wound healing in rat skin when compared with a gel containing no active ingredient.

Repair of surgical wounds in rats using a 10% unripe Musa sapientum peel gel

PURPOSE:To investigate the efficacy of a 10% gel of unripe banana (Musa sapientum) peel in treating surgical wounds in rats.METHODS:A longitudinal, prospective, randomized triple-blind study was conducted with 60 Wistar rats (Rattus norvegicus albinus) weighing approximately 400g. The animals were randomly divided into: control group (treated with gel containing no active ingredient) and study group (treated with 10% gel of unripe banana peel). The gel was applied every three days to a 4x4-cm surgical wound created on the back of each animal (day 0) in both groups. Tissue samples were collected for histological analysis on days 14, 21 and 28.RESULTS:On day 14, more extensive vascular proliferation (p=0.023), presence of mononuclear cells (p=0.000), fibroblast proliferation (p=0.012), re-epithelialization (p=0.000), and decreased presence of polymorphonuclear cells (p=0.010) were observed in the study group than in controls. No significant between-group difference in the presence of polymorphonuclear cells was found on day 21. Fibroblast proliferation was significantly greater (p=0.006) in the study group than in the control group on day 28.CONCLUSION:The 10% gel of unripe banana peel showed anti-inflammatory activity and stimulated wound healing in rat skin when compared with a gel containing no active ingredient.

Síndrome de Mõbius: significados na vida dos portadores / Mõbius syndrome: the meaning in the life of the carriers

JUSTIFICATIVA E OBJETIVO: A síndrome de Mõbius, evento raro, resulta de uma desordem neurológica que se caracteriza por paralisia congênita do sétimo par de nervos cranianos, acompanhada de mal formações límbicas e das demais estruturas orofaciais. Caracteriza-se clinicamente pela ausência de expressão facial e distúrbios da fala, principalmente. Tais alterações influenciam diretamente na vida social do portador. Trata-se de uma síndrome rara, por isso pouco estudada, sendo o aspecto emocional não abordado pela literatura atual. O objetivo deste estudo foi identificar o sentimento e o significado da síndrome na vida de seus portadores. MÉTODOS: Foram entrevistados portadores da síndrome e, por meio do Discurso do Sujeito Coletivo, buscou-se avaliar o significado da síndrome. RESULTADOS: Evidenciou-se que, apesar das malformações e das dificuldades na fala, que impõem dificuldades no dia a dia, há adaptação por parte dos sindrômicos, que vivem normalmente. CONCLUSÃO: Os portadores da síndrome de Mõbius reconhecem as dificuldades impostas por sua condição, mas se adaptam bem a elas vivendo normalmente.

BACKGROUND AND OBJECTIVE: The Moebius syndrome, a rare disorder, results from a neurological disorder that is characterized by congenital paralysis of the seventh cranial nerve accompanied by limbic and other orofacial structures malformations. It is clinically characterized by the absence of facial expression and speech disorders, especially. These changes directly influence the social life of the patient. This is a rare syndrome, so, little studied, and the emotional aspect not addressed by the current literature. The objective of this article was to identify the feeling and the meaning of the syndrome in the lives of their carriers. METHODS: Patients with the syndrome were interviewed and through the Collective Subject Discourse, we seek to assess the significance of this syndrome. RESULTS: The results showed that despite the defects and difficulties in speech, which imposes difficulties in day-to-day, there is adaptation by the syndromic, which normally live. CONCLUSION: Moebius syndrome carriers recognize the difficulties imposed by their condition, but they adapt well to living normally.

Religião no tratamento da doença renal crônica: comparação entre médicos e pacientes / Religion in the treatment of chronic kidney disease: a comparison between doctors and patients

A insuficiência renal crônica é uma doença de elevada morbimortalidade. O cotidiano dos pacientes acometidos reveste-se de sentimentos negativos, medo do prognóstico, incapacidade, dependência econômica, além daqueles relacionados à alteração da autoimagem. A religião e a espiritualidade podem ser recursos importantes para lidar com essas dificuldades. Para verificar essa hipótese, realizou-se no Hospital das Clínicas Samuel Libânio de Pouso Alegre/MG estudo qualitativo descritivo, objetivando avaliar, do ponto de vista do médico e do paciente, em que medida a religião influi no tratamento da doença. Para os médicos, a religião representa força e conforto no enfrentamento de qualquer doença. Já os pacientes, todavia, depositam na religião a esperança de que irão melhorar. O significado da religião em suas vidas foi distinto entre os dois grupos analisados; entretanto, ambos concordam que a religião configura um fator benéfico na vida do paciente, propiciando alívio, suporte e otimismo...

Chronic kidney disease is a disease with high morbidity and mortality. The daily life of affected patients includes negative feelings, fear of prognosis, disability, and economic dependence, as well as challenges related to changes in self-image. Religion and spirituality can be important resources in dealing with these difficulties. To test this hypothesis a qualitative, descriptive study was undertaken at the Hospital das Clínicas Samuel Libânio, Pouso Alegre/MG, in order to verify from the point of view of both doctors and patients if they believe that religion influences the treatment of the disease. For doctors, religion represents a strength and a comfort when facing any disease. Patients, however, identify religion with the hope that they will get better. While the significance of religion in their lives was different between the groups, both agreed that it represents a beneficial factor in the life of patients, providing relief, support and optimism...

La insuficiencia renal crónica es una enfermedad con una elevada morbilidad y mortalidad. La vida diaria de los pacientes afectados es de sentimientos negativos, el miedo ante el pronóstico, la incapacidad, la dependencia económica, además de aquello relacionado con el cambio de imagen de sí mismo. La religión y la espiritualidad pueden ser recursos importantes para hacer frente a estas dificultades. Para comprobar esta hipótesis, se llevó a cabo en el Hospital das Clínicas Samuel Libânio, de Pouso Alegre/MG un estudio cualitativo, descriptivo, con el fin de verificar, desde el punto de vista del médico y del paciente en qué medida la religión influye en el tratamiento de la enfermedad. Para los médicos, la religión representa fuerza y bienestar para hacer frente a cualquier enfermedad. Los pacientes, por su parte, depositan en la religión la esperanza de que van a mejorar. El significado de la religión en sus vidas fue diferente en los dos grupos analizados, sin embargo, ambos coinciden en que ésta configura un factor beneficioso en la vida del paciente, proporcionando apoyo, alivio y optimismo...

Espiritualidade e qualidade de vida em pacientes com diabetes / Espiritualidad y calidad de vida en pacientes con diabetes / Spirituality and quality of life in diabetic patien

As implicações da espiritualidade na saúde vêm sendo cientificamente avaliadas e documentadas em centenas de artigos. O diabetes é uma doença que vem apresentando incidência com proporções cada vez maiores. Nosso objetivo foi conhecer o significado de espiritualidade para pacientes diabéticos, correlacionando-o com sua qualidade de vida. Esta pesquisa desenvolveu-se no Centro de Educação em Diabetes da Prefeitura Municipal de Pouso Alegre (MG). A amostra foi constituída por 20 pacientes portadores de diabetes. O discurso do sujeito coletivo constituiu o método escolhido para a construção dos significados. Foi aplicado um questionário composto de três perguntas, gravadas e transcritas na íntegra. O perfil dos entrevistados, na maioria, era de mulheres, casadas, com ensino fundamental incompleto e desempregadas. O estudo demonstrou que para elas o significado de espiritualidade está ligado a aspectos religiosos, aos quais se apegam para conseguir conviver com o diabetes e melhorar, assim, sua qualidade de vida.

Las implicaciones de la espiritualidad en la salud han sido científicamente evaluadas y documentados en cientos de artículos. La Diabetes es una enfermedad que presenta incidencia con proporciones cada vez más grandes. Nuestro objetivo era comprender el significado de la espiritualidad para los pacientes diabéticos, en correlación con su calidad de vida. Esta investigación se desarrolló en el Centro de Educación sobre la Diabetes de la Alcaldía Municipal de Pouso Alegre, Minas Gerais. La muestra consistió en 20 pacientes con diabetes. El discurso del sujeto colectivo fue el método elegido para la construcción de los significados. Se aplicó cuestionario que constaba de tres preguntas, grabadas y transcritas integralmente. El perfil de los encuestados, en su mayoría eran mujeres, casadas, desempleadas y con estudios primarios incompletos. El estudio demostró que el significado de la espiritualidad para ellas está vinculado a aspectos religiosos, que se aferran a ser capaces de vivir con diabetes y así mejorar su calidad de vida.

The spirituality implications in health have been scientifically evaluated and documented in hundreds of articles. Diabetes is a disease that has increasing incidence. Our goal was to understand the implication of spirituality on diabetic patients, correlating it with their life quality. This research was developed at Diabetes Education Center in the Pouso Alegre, Minas Gerais. The sample consisted of 20 patients presenting Diabetes. A questionnaire consisting of three questions was applied, data were recorded and transcribed. In the universe of 20 people interviewed, they consisted mostly of women, married, unemployed, and with incomplete primary education. The study demonstrated that, for the group included, the meaning of spirituality is related to religious aspects, as they showed attachment to them in order to be able to carry their lives with Diabetes and imporve, therefore, their quality of life.

Evaluating the effectiveness of the customized Unna boot when treating patients with venous ulcers.

BACKGROUND: Lower limb ulcers are a serious medical and socioeconomic problem throughout the world. One type of chronic wound of the lower extremities is the venous ulcer. Therapeutic methods for treating venous ulcer include the use of the Unna boot. OBJECTIVES: To evaluate the effectiveness of the customized Unna boot in the treatment of venous ulcers and to monitor the subsequent development and healing of the lesions. METHODS: Prospective exploratory and quantitative longitudinal study, conducted at the "Outpatients Department (Wound Care) of the Grupo da Fraternidade Espírita Irmão Alexandre" in the city of Pouso Alegre (MG), Brazil, in 2008. The sample consisted of 32 patients with venous ulcers who underwent treatment with the Unna boot and 11 patients (control group), who used a simple bandage application. The patients'lesions were monitored over a three month period. RESULTS: The average age of the predominently female (65.1%) patients was 61.88. From observing the differences in healing times at the three evaluation stages, it was clear that after the initial evaluation the wound area decreased in Groups 1 and 2 (p>0.05). CONCLUSION: The use of the customized Unna boot contributes to quicker healing. However, over a period of three months the simple bandage applications were seen to be just as effective as the Unna boot method.

Evaluating the effectiveness of the customized Unna boot when treating patients with venous ulcers* / A avaliação da eficácia da bota de Unna artesanal no tratamento de pacientes portadores de úlceras venosas

Lower limb ulcers are a serious medical and socioeconomic problem throughout the world. One type of chronic wound of the lower extremities is the venous ulcer. Therapeutic methods for treating venous ulcer include the use of the Unna boot. To evaluate the effectiveness of the customized Unna boot in the treatment of venous ulcers and to monitor the subsequent development and healing of the lesions. Prospective exploratory and quantitative longitudinal study, conducted at the "Outpatients Department (Wound Care) of the Grupo da Fraternidade Espírita Irmão Alexandre" in the city of Pouso Alegre (MG), Brazil, in 2008. The sample consisted of 32 patients with venous ulcers who underwent treatment with the Unna boot and 11 patients (control group), who used a simple bandage application. The patients'lesions were monitored over a three month period. The average age of the predominently female (65.1%) patients was 61.88. From observing the differences in healing times at the three evaluation stages, it was clear that after the initial evaluation the wound area decreased in Groups 1 and 2 (p>0.05). The use of the customized Unna boot contributes to quicker healing. However, over a period of three months the simple bandage applications were seen to be just as effective as the Unna boot method. .

As úlceras de membros inferiores constituem um sério problema médico e socioeconómico mundial. Um tipo de ferida crónica dos membros inferiores é a úlcera venosa. Dentre os métodos terapêuticos encontra-se o curativo bota de Unna artesanal. Avaliar a eficácia do uso da bota de Unna artesanal no tratamento de úlceras venosas e acompanhar o desenvolvimento da cicatrização das feridas. Estudo do tipo longitudinal e prospectivo, de caráter exploratório e quantitativo, realizado no ambulatório de feridas do Grupo da Fraternidade Espírita Irmão Alexandre na cidade de Pouso Alegre - MG, no ano de 2008. A amostra foi composta de 32 pacientes portadores de úlceras venosas que realizavam o tratamento com bota de Unna e de 11, grupo controle, que utilizaram curativo simples. As lesões dos pacientes foram acompanhadas por um período de três meses. A idade média das pessoas foi de 61,88 anos, predominando o sexo feminino (65,1%). Observando-se as diferenças nos tempos de cicatrização das feridas, em relação aos três momentos de avaliação, evidenciou-se que após a avaliação inicial houve diminuição da área da ferida, semelhante tanto para o grupo 1 como para o grupo 2 (p>0,05). A utilização da Bota de Unna artesanal contribui para aceleração no processo cicatricial, porém quando comparada com o curativo simples apresentou semelhante eficiência que este, quando analisada por um período de três meses. .

Unripe Musa sapientum peel in the healing of surgical wounds in rats.

PURPOSE: To assess the effects of unripe Musa sapientum peel on the healing of surgical wounds in rats. METHODS: One hundred and twenty Wistar rats were divided into two treatment groups of 60 animals each: the control group (gel without the active ingredient) and experimental group (4% Musa sapientum peel gel). A 4 x 4 cm surgical wound was created on the back of each animal. The wound was cleaned daily with 0.9% saline, treated with 4% gel or natrosol gel (control), and covered with gauze. Animals from both groups were sacrificed after seven, 14 and 21 days of treatment; the tissue from the wound site was removed together with a margin of normal skin for histological analysis. RESULTS: No significant differences in wound contraction rates (p=0.982) were found between time points (seven, 14 and 21 days of treatment) in both groups. However, a significantly higher wound contraction rate was observed in the control group on day 21 compared with the experimental group (p=0.029). There were no significant differences in histomorphological features between groups. The experimental group showed an increased number of polymorphonuclear cells on day 7, with a significant reduction on day 21 (p=0.026). CONCLUSION: The use of 4% unripe Musa sapientum peel gel on surgical wounds in rats resulted in an increased number of polymorphonuclear cells on day 7, reduced wound contraction, reduced vascular proliferation and increased concentration of collagen fibers on day 21.

Unripe Musa sapientum peel in the healing of surgical wounds in rats

PURPOSE: To assess the effects of unripe Musa sapientum peel on the healing of surgical wounds in rats. METHODS: One hundred and twenty Wistar rats were divided into two treatment groups of 60 animals each: the control group (gel without the active ingredient) and experimental group (4% Musa sapientum peel gel). A 4 x 4 cm surgical wound was created on the back of each animal. The wound was cleaned daily with 0.9% saline, treated with 4% gel or natrosol gel (control), and covered with gauze. Animals from both groups were sacrificed after seven, 14 and 21 days of treatment; the tissue from the wound site was removed together with a margin of normal skin for histological analysis. RESULTS: No significant differences in wound contraction rates (p=0.982) were found between time points (seven, 14 and 21 days of treatment) in both groups. However, a significantly higher wound contraction rate was observed in the control group on day 21 compared with the experimental group (p=0.029). There were no significant differences in histomorphological features between groups. The experimental group showed an increased number of polymorphonuclear cells on day 7, with a significant reduction on day 21 (p=0.026). CONCLUSION: The use of 4% unripe Musa sapientum peel gel on surgical wounds in rats resulted in an increased number of polymorphonuclear cells on day 7, reduced wound contraction, reduced vascular proliferation and increased concentration of collagen fibers on day 21.