Laser auriculotherapy associated with cupping therapy in chronic spinal pain: Randomized controlled clinical trial.

BACKGROUND: Musculoskeletal spine disorders are common causes of chronic pain and impair functionality. Laser auriculotherapy and cupping has played a significant role in the treatment of chronic pain. OBJECTIVE: to evaluate the effect of laser auriculotherapy associated with cupping at systemic acupuncture points on chronic spinal pain. METHODS: Randomized controlled clinical trial. Volunteers underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. The pain was identified using the numeric pain scale. The pain threshold was also evaluated against mechanical stimulation using a Digital Dynamometer at specific points in the cervical, thoracic and lumbar regions. Fifty individuals with chronic spinal pain, randomized into groups: experimental (n = 25), submitted to 10 sessions of auriculotherapy with laser and cupping therapy and control (n = 25). RESULTS: The experimental group achieved pain intensity reduction between pre and post and follow-up moments (p < 0.0001), of greatest pain in the last seven days among all moments (p < 0.0001), of least pain in the pre with post moment (p = 0.006) and follow-up (p = 0.002), and an increased pain threshold between pre and post (p = 0.023). The control group achieved a reduction in the nociceptive threshold between pre and post (p = 0.001) and follow-up (p < 0.0001). The experimental group showed reduced pain intensity (p = 0.027) and greater pain (p = 0.005) after intervention and in pain intensity (p = 0.018), greater (p < 0.0001) and less pain (p = 0.025) at follow-up, compared to the control group. CONCLUSION: Auriculotherapy with laser associated with cupping therapy may effectively reduce pain intensity and increase the nociceptive threshold.

Hypertonic Saline Solution Versus Mannitol for Brain Relaxation During Craniotomies: A Systematic Review and Updated Meta-Analysis.

BACKGROUND AND OBJECTIVES: The preferred osmotic agent used for brain relaxation during craniotomies remains unclear, either mannitol (MAN) or hypertonic saline (HTS). Hence, we sought to compare these solutions in this population. METHODS: MEDLINE, Embase, and Cochrane databases were systematically searched until August 02, 2023. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was assessed using I2 statistics. Meta-regression analysis was conducted to evaluate a possible link between Brain Relaxation Score and tumor volume. R, version 4.2.3, was used for statistical analysis. RESULTS: A total of 16 randomized controlled trials and 1031 patients were included, of whom 631 (61%) underwent surgery for supratentorial tumor resection. Compared with MAN, HTS achieved better rates of brain relaxation (80% vs 71%; odds ratio [OR] 1.68; 95% CI 1.22-2.33; P = .001; I2 = 0%), which was also demonstrated in the subgroup analysis of patients with supratentorial brain tumor (78% vs 65%; OR 2.02; 95% CI 1.36-2.99; P = .0005; I2 = 0%); a minor number of patients requiring a second dose of osmotic agent (14% vs 28%; OR 0.43; 95% CI 0.27-0.69; P = .0003; I2 = 0%); a lower fluid intake (mean difference -475.9341 mL; 95% CI -818.8952 to -132.9730; P = .007; I2 = 88%); and lower urine output (mean difference -462.0941 mL; 95% CI -585.3020 to -338.8862; P = <.001; I2 = 96%). Hospital length of stay and focal neurological deficits did not reach a statistically significant difference between groups. CONCLUSION: In this updated meta-analysis, consistent results suggest that HTS is associated with more beneficial outcomes than MAN in patients undergoing craniotomy.

Selection and validation of reference genes suitable for gene expression analysis by Reverse Transcription Quantitative real-time PCR in Acinetobacter baumannii.

Acinetobacter baumannii is a Gram-negative bacterium considered an emerging multi-drug-resistant pathogen. Furthermore, this bacterium can survive in extreme environmental conditions, which makes it a frequent cause of nosocomial infection outbreaks. Gene expression analyses by Reverse Transcription Quantitative real-time PCR (RT-qPCR) depend on a reference gene, also called an endogenous gene, which is used to normalize the generated data and thus ensure an accurate analysis with minimal errors. Currently, gene expression analyses in A. baumannii are compromised, as there are no reports in the literature describing the identification of validated reference genes for use in RT-qPCR analyses. For this reason, we selected twelve candidate reference genes of A. baumannii and assessed their expression profile under different experimental and culture conditions. The expression stability of the candidate genes was evaluated by using statistical algorithms such as BestKeeper, geNorm, NormFinder, Delta CT, and RefFinder, in order to identify the most suitable candidate reference genes for RT-qPCR analyses. The statistical analyses indicated rpoB, rpoD, and fabD genes as the most adequate to ensure accurate normalization of RT-qPCR data in A. baumannii. The accuracy of the proposed reference genes was validated by using them to normalize the expression of the ompA gene, encoding the outer membrane protein A, in A. baumannii sensible and resistant to the antibiotic polymyxin. The present work provides suitable reference genes for precise RT-qPCR data normalization on future gene expression studies with A. baumannii.

Lysicamine Reduces Protein Kinase B (AKT) Activation and Promotes Necrosis in Anaplastic Thyroid Cancer.

Anaplastic thyroid cancer (ATC) is an aggressive form of thyroid cancer (TC), accounting for 50% of total TC-related deaths. Although therapeutic approaches against TC have improved in recent years, the survival rate remains low, and severe adverse effects are commonly reported. However, unexplored alternatives based on natural compounds, such as lysicamine, an alkaloid found in plants with established cytotoxicity against breast and liver cancers, offer promise. Therefore, this study aimed to explore the antineoplastic effects of lysicamine in papillary TC (BCPAP) and ATC (HTH83 and KTC-2) cells. Lysicamine treatment reduced cell viability, motility, colony formation, and AKT activation while increasing the percentage of necrotic cells. The absence of caspase activity confirmed apoptosis-independent cell death. Necrostatin-1 (NEC-1)-mediated necrosome inhibition reduced lysicamine-induced necrosis in KTC-2, suggesting necroptosis induction via a reactive oxygen species (ROS)-independent mechanism. Additionally, in silico analysis predicted lysicamine target proteins, particularly those related to MAPK and TGF-ß signaling. Our study demonstrated lysicamine's potential as an antineoplastic compound in ATC cells with a proposed mechanism related to inhibiting AKT activation and inducing cell death.

Normalization of deviance in pediatric hospital: perception of health workers.

OBJECTIVE: To know the perception of health workers about the phenomenon of normalization of deviance in a pediatric hospital. METHOD: Exploratory, descriptive, and qualitative study conducted in a public pediatric hospital in northeastern Brazil in 2021. An in-depth interview was applied to 21 health workers, submitted to Thematic Categorical Content Analysis in the MAXQDA® Software. RESULTS: 128 context units emerged from the content analysis. These data were presented in three analytical categories, which address conceptions about normalization of deviance, examples and contributing factors. The omission of the practice of hand hygiene and the correct use of personal protective equipment,and turning off alarms stand out as the main deviance perceived by health workers. As contributing factors, human factors and organizational factors prevailed. CONCLUSION: Workers perceive the normalization of deviance as negligence, recklessness, and violations of good practices, with consequences for patient safety.

Normalization of deviance in pediatric hospital: perception of health workers / Normalización de la desviación en hospital pediátrico: percepción de trabajadores de salud / Normalização do desvio em hospital pediátrico: percepção de trabalhadores de saúde

ABSTRACT Objective: To know the perception of health workers about the phenomenon of normalization of deviance in a pediatric hospital. Method: Exploratory, descriptive, and qualitative study conducted in a public pediatric hospital in northeastern Brazil in 2021. An in-depth interview was applied to 21 health workers, submitted to Thematic Categorical Content Analysis in the MAXQDA® Software. Results: 128 context units emerged from the content analysis. These data were presented in three analytical categories, which address conceptions about normalization of deviance, examples and contributing factors. The omission of the practice of hand hygiene and the correct use of personal protective equipment,and turning off alarms stand out as the main deviance perceived by health workers. As contributing factors, human factors and organizational factors prevailed. Conclusion: Workers perceive the normalization of deviance as negligence, recklessness, and violations of good practices, with consequences for patient safety.

RESUMEN Objetivo: Conocer la percepción de los trabajadores de la salud sobre el fenómeno de la normalización de la desviación en un hospital pediátrico. Método: Estudio exploratorio, descriptivo y cualitativo realizado en un hospital pediátrico público en el noreste de Brasil en 2021. Se aplicó una entrevista en profundidad a 21 trabajadores de la salud, sometidos al Análisis de Contenido Categórico Temático en el Software MAXQDA®. Resultados: 128 unidades de contexto surgieron del análisis de contenido. Estos datos se presentaron en tres categorías analíticas, que abarcan conceptos sobre la normalización de la desviación, ejemplos y factores contribuyentes. La omisión de la práctica de la higiene de manos y el uso correcto de los equipos de protección personal y el apagado de alarmas se destacan como las principales desviaciones percibidas por los trabajadores de la salud. Como factores contribuyentes prevalecieron los factores humanos y los factores organizacionales. Conclusión: Los trabajadores perciben la normalización de la desviación como negligencia, imprudencia y violación de las buenas prácticas, con consecuencias para la seguridad del paciente.

RESUMO Objetivo: Conhecer a percepção de trabalhadores de saúde sobre o fenômeno da normalização do desvio em um hospital pediátrico. Método: Estudo exploratório, descritivo e qualitativo realizado em hospital público pediátrico do nordeste brasileiro em 2021. Aplicou-se entrevista em profundidade a 21 trabalhadores de saúde, submetida à Análise de Conteúdo Categorial Temática no Software MAXQDA®. Resultados: Emergiram 128 unidades de contexto da análise de conteúdo. Esses dados foram apresentados em três categorias analíticas, as quais abordam concepções sobre normalização do desvio, exemplos e fatores contribuintes. Destacam-se a omissão da prática de higienização das mãos e do uso correto dos equipamentos de proteção individual, e o desligamento de alarmes como principais desvios percebidos pelos trabalhadores de saúde. Como fatores contribuintes, preponderaram os fatores humanos e os fatores organizacionais. Conclusão: Os trabalhadores percebem a normalização do desvio como negligência, imprudência e violações de boas práticas, com consequências para a segurança do paciente.

Integrative and complementary practices to control nausea and vomiting in pregnant women: a systematic review.

OBJECTIVE: to synthesize the evidence available in the literature on the effects of integrative and complementary practices in nausea and vomiting treatment in pregnant women. METHOD: a systematic review, reported according to PRISMA and registered in PROSPERO. The search for studies was carried out in 11 databases. To assess risk of bias in randomized clinical trials, the Cochrane Collaboration Risk of Bias Tool (RoB 2) was used. RESULTS: the final sample consisted of 31 articles, divided into three categories: aromatherapy, phytotherapy and acupuncture. It was observed that aromatherapy with lemon essential oil, ginger capsules, pericardial 6 point acupressure were the interventions that proved to be effective. Less than half of studies reported adverse effects, with mild and transient symptoms predominating. Most articles were classified as "some concern" in risk of bias assessment. CONCLUSION: the three most effective interventions to control gestational nausea and vomiting were aromatherapy, herbal medicine and acupuncture, with significant results in the assessment of individual studies.

A saúde infantil frente ao fechamento de escolas na pandemia de covid-19 / Children's health in the face of school closures in the covid-19 pandemic / La salud infantil frente al cierre escolar en la pandemia covid-19

Objetivo: Investigar as repercussões do fechamento das escolas na saúde infantil, diante da pandemia de COVID-19. Métodos: Revisão de escopo, com busca eletrônica nas bases de dados National Library of Medicine and National Institutes of Health (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Scopus. Resultados: Ao total, 21 artigos foram incluídos no estudo e categorizados por domínios, de acordo com a taxonomia NANDA-I, elencando-se Nutrição, Atividade/repouso, Enfrentamento/tolerância ao estresse, Segurança/proteção e Percepção/cognição. Conclusão: O fechamento das escolas durante a pandemia de COVID-19 gerou aumento do risco de obesidade e sedentarismo, insegurança alimentar, estresse, transtornos de humor e ansiedade como repercussões na saúde infantil. (AU)

Objective: To investigate the repercussions of school closures on children's health in the face of the COVID-19 pandemic. Methods: Scoping review, with electronic search in the databases National Library of Medicine and National Institutes of Health (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Results: In total, 21 articles were included in the study and categorized by domains, according to the NANDA-I taxonomy, listing Nutrition, Activity/Residence, Stress Confrontation/Protection and Perception/Cognition. Conclusion: The closure of schools during the COVID-19 pandemic generated increased risk of obesity and sedentariness, food insecurity, stress, mood disorders and anxiety as repercussions on children's health. (AU)

Objetivo: Investigar las repercusiones del cierre de escuelas en la salud de los niños ante la pandemia de COVID-19. Métodos: Examen del alcance, con búsqueda electrónica en las bases de datos de la Biblioteca Nacional de Medicina y los Institutos Nacionales de Salud (MEDLINE/PubMed), el Índice Acumulativo de Literatura de Enfermería y Salud Aliada (CINAHL) y Scopus. Resultados: En total, se incluyeron 21 artículos en el estudio y se categorizaron por dominios, según la taxonomía NANDA-I, enumerando Nutrición, Actividad/Residencia, Confrontación/Protección del Estrés y Percepción/Cognición. Conclusión: El cierre de las escuelas durante la pandemia de VOCID-19 generó un mayor riesgo de obesidad y sedentarismo, inseguridad alimentaria, estrés, trastornos del estado de ánimo y ansiedad como repercusiones en la salud de los niños. (AU)

Análise comparativa das características demográficas, sintomatologia e comorbidades de adultos e idosos notificados e confirmados com covid-19 nas capitais brasileiras / Análisis comparativo de las características demográficas, la sintomatología y las comorbilidades de los adultos y ancianos notificados y confirmados con covid-19 en las capitales brasileñas / Comparative analysis of demographic characteristics, symptoms and comorbidities of adults and elderly people notified and confirmed with covid-19 in brazilian capitals

RESUMO Objetivo: comparar o perfil demográfico, a sintomatologia e as comorbidades de adultos e idosos notificados com COVID-19 nas capitais brasileiras e no Distrito Federal - DF. Métodos: estudo ecológico desenvolvido a partir dos dados da plataforma online e-SUS Notifica, preenchidos até dia 4 de janeiro de 2021, com amostra constituída por 1.416.252 indivíduos, utilizando como critérios de inclusão: ter idade > 20 anos; residir nas capitais brasileiras ou no Distrito Federal - DF; e apresentar resultado do teste positivo para COVID-19. A análise descritiva contou com a exposição das frequências absoluta e relativa e medidas de tendência central. Para a análise inferencial, aplicou-se o teste qui-quadrado de Pearson, considerando diferença significativa para valores de p<0,05. Resultados: predominou sexo masculino (52%), com média de idade de 43,29 ± 14,85 anos. Os indivíduos apresentaram tosse (45,4%), febre (38,8%) e outros sintomas (83,1%). As comorbidades mais prevalentes foram: doenças cardíacas (7,1%) e diabetes (4,5%). Houve diferença significativa (p<0,001) entre as regiões brasileiras, ao comparar sexo, idade, ser profissional da saúde, sintomas e comorbidades. Conclusão: os dados contribuíram para o conhecimento acerca do processo epidêmico de COVID-19 no Brasil no primeiro ano de pandemia e demonstraram a distribuição dos casos e as relações existentes entre perfil demográfico, sintomatologia e doenças preexistentes com os agrupados das capitais brasileiras.

RESUMEN Objetivo: comparar el perfil demográfico, la sintomatología y las comorbilidades de los adultos y ancianos notificados con COVID-19 en las capitales brasileñas y el Distrito Federal - DF. Métodos: estudio ecológico, desarrollado a partir de los datos de la plataforma online e-SUS Notifica, completados hasta el 4 de enero de 2021, con una muestra compuesta por 1.416.252 individuos, utilizando como criterios de inclusión: edad > 20 años; residir en capitales brasileñas o en el Distrito Federal - DF; y presentar un resultado positivo en la prueba de COVID-19. El análisis descriptivo incluyó la presentación de frecuencias absolutas y relativas y medidas de tendencia central. Para el análisis inferencial, se aplicó la prueba de chi-cuadrado de Pearson, considerando la diferencia significativa para valores p <0,05. Resultados: predominó el sexo masculino (52%), con una edad media de 43,29 ± 14,85 años. Los individuos presentaron tos (45,4%), fiebre (38,8%) y otros síntomas (83,1%). Las comorbilidades más prevalentes fueron las cardiopatías (7,1%) y la diabetes (4,5%). Hubo una diferencia significativa (p<0,001) entre las regiones brasileñas al comparar el género, la edad, ser profesional de la salud, los síntomas y las comorbilidades. Conclusión: los datos contribuyeron al conocimiento del proceso epidémico del COVID-19 en Brasil, en el primer año de pandemia, y demostraron la distribución de los casos y las relaciones existentes entre el perfil demográfico, la sintomatología y las enfermedades preexistentes con los agrupados de las capitales brasileñas.

ABSTRACT Objective: to compare the demographic profile, symptoms and comorbidities of adults and elderly people notified with COVID-19 in Brazilian capitals and the Distrito Federal - DF. Methods: ecological study developed from data from the online platform e-SUS Notifica, completed until January 4, 2021, with a sample consisting of 1,416,252 individuals, using as inclusion criteria: being > 20 years old; reside in Brazilian capitals or the Distrito Federal - DF; and present a positive test result for COVID-19. The descriptive analysis included the exposure of absolute and relative frequencies and measures of central tendency. For the inferential analysis, Pearson's chi-square test was applied, considering a significant difference for values of p<0.05. Results: males predominated (52%), with a mean age of 43.29 ± 14.85 years. Subjects had cough (45.4%), fever (38.8%) and other symptoms (83.1%). The most prevalent comorbidities were: heart disease (7.1%) and diabetes (4.5%). There was a significant difference (p<0.001) between Brazilian regions, when comparing sex, age, being a health professional, symptoms and comorbidities. Conclusion: the data contributed to the knowledge about the epidemic process of COVID-19 in Brazil in the first year of the pandemic and demonstrated the distribution of cases and the relationships between demographic profile, symptoms and pre-existing diseases with the groups of Brazilian capitals.

Integrative and complementary practices to control nausea and vomiting in pregnant women: a systematic review / Prácticas integradoras y complementarias para el control de náuseas y vómitos en gestantes: una revisión sistemática / Práticas integrativas e complementares para controle de náuseas e vômitos em gestantes: revisão sistemática

ABSTRACT Objective: to synthesize the evidence available in the literature on the effects of integrative and complementary practices in nausea and vomiting treatment in pregnant women. Method: a systematic review, reported according to PRISMA and registered in PROSPERO. The search for studies was carried out in 11 databases. To assess risk of bias in randomized clinical trials, the Cochrane Collaboration Risk of Bias Tool (RoB 2) was used. Results: the final sample consisted of 31 articles, divided into three categories: aromatherapy, phytotherapy and acupuncture. It was observed that aromatherapy with lemon essential oil, ginger capsules, pericardial 6 point acupressure were the interventions that proved to be effective. Less than half of studies reported adverse effects, with mild and transient symptoms predominating. Most articles were classified as "some concern" in risk of bias assessment. Conclusion: the three most effective interventions to control gestational nausea and vomiting were aromatherapy, herbal medicine and acupuncture, with significant results in the assessment of individual studies.

RESUMEN Objetivo: sintetizar las evidencias disponibles en la literatura sobre los efectos de las prácticas integradoras y complementarias en el tratamiento de náuseas y vómitos en gestantes. Método: revisión sistemática, reportada según PRISMA y registrada en PROSPERO. La búsqueda de estudios se realizó en 11 bases/bases de datos. Para evaluar el riesgo de sesgo en los ensayos clínicos aleatorios, se utilizó la herramienta Cochrane Collaboration Risk of Bias Tool (RoB 2). Resultados: la muestra final estuvo compuesta por 31 artículos, divididos en tres categorías: aromaterapia, fitoterapia y acupuntura. Se observó que la aromaterapia con aceite esencial de limón, las cápsulas de jengibre, la acupresión en el punto 6 del pericardio fueron las intervenciones que demostraron ser efectivas. Menos de la mitad de los estudios reportaron efectos adversos, predominando los síntomas leves y transitorios. La mayoría de los artículos se clasificaron como "cierta preocupación" en la evaluación del riesgo de sesgo. Conclusión: las tres intervenciones más efectivas para controlar las náuseas y los vómitos gestacionales fueron la aromaterapia, la fitoterapia y la acupuntura, con resultados significativos en la evaluación de los estudios individuales.

RESUMO Objetivo: sintetizar as evidências disponíveis na literatura sobre os efeitos das práticas integrativas e complementares no tratamento de náusea e vômito em gestantes. Método: revisão sistemática, relatada conforme o PRISMA e registrada no PROSPERO. A busca pelos estudos foi realizada em 11 bases/bancos de dados. Para avaliação do risco de viés dos ensaios clínicos randomizados, utilizou-se a ferramenta Cochrane Collaboration Risk of Bias Tool (RoB 2). Resultados: a amostra final foi composta por 31 artigos, divididos em três categorias: aromaterapia, fitoterapia e acupuntura. Observou-se que a aromaterapia com óleo essencial de limão, cápsulas de gengibre, acupressão no ponto pericárdio 6 foram as intervenções que se provaram eficazes. Menos da metade dos estudos relatou efeitos adversos, sendo que predominaram sintomas de leve intensidade e transitórios. A maioria dos artigos foi classificada como "alguma preocupação" na avaliação do risco de viés. Conclusão as três intervenções mais eficazes para controle de náusea e vômito gestacional foram aromaterapia, fitoterapia e acupuntura, com resultados significativos na avaliação dos estudos individuais.

The effects of auricular acupuncture on vascular parameters on the risk factors for diabetic foot: A randomized clinical trial.

AIMS AND OBJECTIVES: To evaluate the effects of auricular acupuncture on vascular parameters on the risk factors for Diabetic Foot. METHODS: Randomized and masked clinical trial. The sample was composed of 44 individuals with type 2 Diabetes Mellitus and they were randomly assigned to two groups: intervention (n = 22), which received five sessions of auricular acupuncture, and control (n = 22), which did not receive the therapy. Three evaluations were performed: before the intervention; one day after the last acupuncture session and 15 days after the second evaluation. For this, the subject's characterization instrument, the Ankle-Brachial Index measurement, and thermography were used. For data analysis, Mann-Whitney, Wilcoxon, Wilcoxon signed-rank, Fisher's Exact and Chi-Square tests were used. RESULTS: Auriculotherapy provided results in the Ankle-Brachial Index Test, as well as in thermography, which showed significant temperature improvement. CONCLUSIONS: The technique proved to be efficient in improving circulatory conditions and plantar temperature.

Cuidados à pessoa com câncer de mama metastático na atenção básica: relato de caso / Cuidados a la persona con cáncer de mama metastásico en atención primaria: reporte de caso / Care for the person with metastatic breast cancer in primary care: case report

Objetivo: relatar os cuidados prestados por estudantes de enfermagem a uma pessoa com câncer de mama metastático em um serviço da atenção básica, por meio da utilização do processo de enfermagem. Método: pesquisa qualitativa do tipo relato de caso desenvolvida, em maio de 2019, por meio de registros de duas visitas domiciliares e de levantamento de informações do prontuário familiar, sendo tais dados analisados de acordo com processo de enfermagem. Resultados: os cuidados definidos, por meio do processo de enfermagem, foram: incentivar hidratação, controlar náuseas e vômitos, melhorar integridade tissular, entre outros. Conclusão: destacou-se a importância da implementação do processo de enfermagem para a sistematização do cuidado compartilhado entre a equipe acadêmica, a equipe da unidade básica de saúde, a família e à pessoa, favorecendo a integralidade e longitudinalidade do cuidado, bem como o enfoque familiar das ações da atenção básica.(AU)

Objective: to report the care provided by nursing students to a person with metastatic breast cancer in a primary care service, through the use of the nursing process. Method: qualitative research of case report type developed in May 2019, through records of two home visits and survey of information from family records, with such data analyzed according to the nursing process. Results: the nursing process was carried out to define patient care, which were: encourage hydration, control nausea and vomiting, improve tissue integrity, among others. Conclusion: the importance of implementing the nursing process was highlighted for the systematization of shared care between the academic team, the team of the basic health unit, the family and the person, favoring the integrality and longitudinally of care, as well as the family focus of the primary care actions.(AU)

Objetivo: informar la atención brindada por estudiantes de enfermería a una persona con cáncer de mama metastásico en un servicio de atención primaria, mediante el uso del proceso de enfermería. Método: investigación cualitativa del tipo reporte de caso desarrollada en mayo de 2019, a través de registros de dos visitas domiciliarias y levantamiento de información de registros familiares, con dichos datos analizados según el proceso de enfermería. Resultados: se realizó el proceso de enfermería para definir la atención al paciente, los cuales fueron: fomentar la hidratación, controlar las náuseas y vómitos, mejorar la integridad de los tejidos, entre otros. Conclusión: se resaltó la importancia de implementar el proceso de enfermería para la sistematización del cuidado compartido entre equipo académico, equipo de la unidad básica de salud, familia y persona, favoreciendo la integralidad y longitudinalidad del cuidado, así como el enfoque familiar de las acciones de atención primaria.(AU)

Hydrodynamic and Performance Evaluation of a Porous Ceramic Membrane Module Used on the Water-Oil Separation Process: An Investigation by CFD.

Wastewater from the oil industry can be considered a dangerous contaminant for the environment and needs to be treated before disposal or re-use. Currently, membrane separation is one of the most used technologies for the treatment of produced water. Therefore, the present work aims to study the process of separating oily water in a module equipped with a ceramic membrane, based on the Eulerian-Eulerian approach and the Shear-Stress Transport (SST k-ω) turbulence model, using the Ansys Fluent® 15.0. The hydrodynamic behavior of the water/oil mixture in the filtration module was evaluated under different conditions of the mass flow rate of the fluid mixture and oil concentration at the entrance, the diameter of the oil particles, and membrane permeability and porosity. It was found that an increase in the feed mass flow rate from 0.5 to 1.5 kg/s significantly influenced transmembrane pressure, that varied from 33.00 to 221.32 kPa. Besides, it was observed that the particle diameter and porosity of the membranes did not influence the performance of the filtration module; it was also verified that increasing the permeability of the membranes, from 3 × 10-15 to 3 × 10-13 m2, caused transmembrane pressure reduction of 22.77%. The greater the average oil concentration at the permeate (from 0.021 to 0.037 kg/m3) and concentrate (from 1.00 to 1.154 kg/m3) outlets, the higher the average flow rate of oil at the permeate outlets. These results showed that the filter separator has good potential for water/oil separation.

Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis.

Background: Clinical impact of transcranial direct current stimulation (tDCS) alone for Parkinson's disease (PD) is still a challenge. Thus, there is a need to synthesize available results, analyze methodologically and statistically, and provide evidence to guide tDCS in PD. Objective: Investigate isolated tDCS effect in different brain areas and number of stimulated targets on PD motor symptoms. Methods: A systematic review was carried out up to February 2021, in databases: Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, and Web of science. Full text articles evaluating effect of active tDCS (anodic or cathodic) vs. sham or control on motor symptoms of PD were included. Results: Ten studies (n = 236) were included in meta-analysis and 25 studies (n = 405) in qualitative synthesis. The most frequently stimulated targets were dorsolateral prefrontal cortex and primary motor cortex. No significant effect was found among single targets on motor outcomes: Unified Parkinson's Disease Rating Scale (UPDRS) III - motor aspects (MD = -0.98%, 95% CI = -10.03 to 8.07, p = 0.83, I 2 = 0%), UPDRS IV - dyskinesias (MD = -0.89%, CI 95% = -3.82 to 2.03, p = 0.55, I 2 = 0%) and motor fluctuations (MD = -0.67%, CI 95% = -2.45 to 1.11, p = 0.46, I 2 = 0%), timed up and go - gait (MD = 0.14%, CI 95% = -0.72 to 0.99, p = 0.75, I 2 = 0%), Berg Balance Scale - balance (MD = 0.73%, CI 95% = -1.01 to 2.47, p = 0.41, I 2 = 0%). There was no significant effect of single vs. multiple targets in: UPDRS III - motor aspects (MD = 2.05%, CI 95% = -1.96 to 6.06, p = 0.32, I 2 = 0%) and gait (SMD = -0.05%, 95% CI = -0.28 to 0.17, p = 0.64, I 2 = 0%). Simple univariate meta-regression analysis between treatment dosage and effect size revealed that number of sessions (estimate = -1.7, SE = 1.51, z-score = -1.18, p = 0.2, IC = -4.75 to 1.17) and cumulative time (estimate = -0.07, SE = 0.07, z-score = -0.99, p = 0.31, IC = -0.21 to 0.07) had no significant association. Conclusion: There was no significant tDCS alone short-term effect on motor function, balance, gait, dyskinesias or motor fluctuations in Parkinson's disease, regardless of brain area or targets stimulated.

Increasing thermal stress with flight distance in stingless bees (Melipona subnitida) in the Brazilian tropical dry forest: Implications for constraint on foraging range.

The thoracic temperature (TTX) of foraging bees usually exceeds ambient air temperatures (TAIR) by several degrees. In hot tropical climate zones, therefore, individuals may reach body temperatures close to their critical thermal maxima, which might constrain their activity. In the present study, we tested the hypothesis that thermal stress increases with flight distance in nectar foragers of M. subnitida, a stingless bee species native to the hottest regions of the Brazilian tropical dry forest. Using infrared thermography, we recorded the body surface temperature of individuals foraging at distances of 15, 50, and 100 m. Closest to the nests, foragers stabilized TTX at 40 °C when collecting sugar solution at TAIR > 30 °C. The simultaneous decrease of the temperature excess ratio of head and abdomen suggests evaporative cooling at these body parts. With increasing foraging distance, foragers increased heat dissipation to the head and abdomen. Thus, despite more intensive heating of the thorax due to faster and longer flights, the bees maintained similar TTX as foragers at close feeding sites. However, at TAIR > 30 °C, bees could no longer compensate the elevated heat gain at the head (50 m) and abdomen (50, 100 m), which caused an increasing temperature excess in these body parts. Thus, foragers of M. subnitida suffer overheating of the head and abdomen instead of the thorax when foraging in high temperatures at far feeding sites. Consequently, to avoid heat stress in the Brazilian tropical dry forest, the bees should forage close to the nest.

Validação de um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral / Validación de un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral / Validation of a laser auriculotherapy protocol for chronic spinal pain

RESUMO Objetivo: validar um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral. Método: estudo metodológico realizado a partir de uma revisão sistemática, baseada no PRISMA Statement; validação de conteúdo por 21 experts e validação clínica do protocolo desenvolvido em pessoas com dor. Resultados: a partir da análise de 13 artigos foi observado o efeito positivo da acupuntura no alívio da dor e foi possível construir o seguinte protocolo: auriculoterapia com laser, em cinco sessões, com a proporção de uma sessão por semana, aplicação bilateral com alternância do pavilhão auricular nos pontos Shenmen, rim, simpático, bexiga, fígado, subcórtex e vértebras cervical, torácica e/ ou lombar, dependendo do local da dor. A avaliação desse conteúdo assumindo nível de concordância de 80% interavaliadores resultou em aprovação de todos os itens do protocolo. Na avaliação clínica, ao ser administrado em pessoas com dor na coluna vertebral, o protocolo desenvolvido demonstrou reduzir a média de dor, aumentar o limiar de tolerância e diminuir o impacto da dor nas atividades de vida diária. Conclusão: a acupuntura auricular, realizada com laser de baixa potência infravermelho no protocolo estudado, provou ser capaz de tratar com efetividade a dor crônica na coluna vertebral.

RESUMEN Objetivo: validar un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral. Método: estudio metodológico realizado a partir de una revisión sistemática, en base a la declaración PRISMA; validación de contenido por 21 expertos y validación clínica del protocolo de tratamiento en personas con dolor. Resultados: del análisis de 13 artículos se observó el efecto positivo de la acupuntura en el alivio del dolor y se pudo construir el siguiente protocolo: auriculoterapia láser, en cinco sesiones, con una sesión por semana, aplicación bilateral con alternancia de pabellón auricular en los puntos Shen Men, Riñón, Nervio simpático, Vejiga, Hígado, Subcórtex y vértebras cervicales, torácicas y / o lumbares, dependiendo de la localización del dolor. La evaluación de este contenido, asumiendo un nivel de acuerdo del 80% entre evaluadores, resultó en la aprobación de todos los ítems del protocolo. En la evaluación clínica, cuando se administró a personas con dolor en la columna, el protocolo de tratamiento demostró reducir el promedio de dolor, aumentar el umbral de tolerancia y disminuir el impacto del dolor en las actividades de la vida diaria. Conclusión: la acupuntura auricular, realizada con láser infrarrojo de baja potencia en el protocolo estudiado, demostró ser capaz de tratar eficazmente el dolor crónico de columna vertebral.

ABSTRACT Objective: to validate a laser auriculotherapy protocol for chronic spinal pain. Method: methodological study carried from a systematic review based on the PRISMA Statement; content validation carried out by 21 specialists and pilot test with clinical validation of the protocol developed in people with pain. Results: from the analysis of 13 articles, a positive effect of acupuncture on pain relief was noted and it was possible to develop the following protocol: laser auriculotherapy, in 5 sessions, with the proportion of one session a week, bilateral application with alternation of the auricular pavilion at Shenmen points, Kidney, Sympathetic Nervous System, Urinary Bladder, Liver, Subcortex and Cervical, Thoracic and/or Lumbar Vertebrae, depending on the location of the pain. The evaluation of this content, assuming a level of agreement of 80% interobserver, resulted in the approval of all items in the protocol. In the clinical evaluation, when it was administered in people with spinal pain, the protocol developed showed a reduction in the pain average, an improvement in the tolerance threshold and a reduction in the pain impact on daily activities. Conclusion: the auricular acupuncture, carried out using an infrared low-level laser, in the studied protocol, proved to be capable of effectively treating chronic spinal pain.

Comparative thermographic analysis at pre- and postcryolipolysis treatment: Clinical case report.

INTRODUCTION: Although the exact cryolipolysis mechanisms on adipose tissue remain unknown, the current literature indicates that it may occur a crystallization followed by an ischemic reaction which generates an inflammatory process. OBJECTIVE: To evaluate thermographically, the tissue's circulatory pattern of a patient submitted to the cryolipolysis technique and the beginning of the inflammatory process, through variations of temperature gradients and the evaluation of the pains degree of the patient in these same moments. METHODS: A descriptive study, of an interventional case report, performed in an 18-year-old patient who had clearly visible fat in the lower abdomen area, with a skin fold greater than 2 centimeters and body mass index ≤ 30 kg/m2 . RESULTS: Comparing the maximum temperatures showed on the last thermography with the pre-application image, an increase of 0.4°C was observed, which is suggestive of abnormality. Regarding the minimum temperatures verified, there was a significative decrease in the temperature with the procedure, which was observed on the last 5 minutes (ΔT = 9.8°C). However, in 48 hour, the minimum temperature began to recover (ΔT = 0.3°C). CONCLUSION: The observed data indicate that there was a significant decrease in the temperature during the cooling phase, whereas in the recovery phase, the inverse was found.

Maintenance of tobacco withdrawal by former smokers: a phenomenological study. / Manutenção da abstinência do tabaco por ex-fumantes: estudo fenomenológico.

OBJECTIVE To understand the experience of former smokers maintaining tobacco abstinence. METHODS Qualitative research using the theoretical-methodological reference of the Social Phenomenology, as defined by Alfred Schütz. The phenomenological interview was carried out in 2016 with 12 former smokers from a city in the state of Minas Gerais, Brazil. The statements were organized into categories and discussed based on the literature. RESULTS The maintenance of tobacco abstinence was revealed in the categories: "Health, sociability, and financial gains"; "Living with the urge to smoke and with the increase of body weight"; "Self-determination and use of replacement strategies"; and "Staying away from cigarettes." CONCLUSIONS These results alert health professionals to the need to provide support to former smokers so they can remain smoke-free. This implies considering not only the negative effects of the tobacco abstinence, but also the social context in which former smokers are inserted that might have an impact on the maintenance or not of the cigarette withdrawal.

Manutenção da abstinência do tabaco por ex-fumantes: estudo fenomenológico / Mantenimiento de la abstinencia del tabaco por los exfumadores: estudio fenomenológico / Maintenance of tobacco withdrawal by former smokers: a phenomenological study

Resumo OBJETIVO Compreender a vivência de ex-fumantes acerca da manutenção da abstinência do tabaco. MÉTODOS Pesquisa qualitativa que utilizou o referencial teórico-metodológico da Fenomenologia Social de Alfred Schütz. Realizou-se a entrevista fenomenológica em 2016 com 12 ex-fumantes de um município de Minas Gerais, Brasil. Os depoimentos foram organizados em categorias e discutidos com base na literatura. RESULTADOS A manutenção da abstinência do tabaco foi revelada nas categorias: "Ganhos na saúde, sociabilidade e finanças"; "Convívio com a vontade de fumar e com o aumento do peso corpóreo"; "Autodeterminação e utilização de estratégias substitutivas" e "Manter-se longe do cigarro". CONCLUSÕES Estes resultados alertam os profissionais de saúde para a necessidade de apoiar ex-fumantes a manter-se nesta condição. Isso implica considerar não só os efeitos negativos da abstinência tabágica, como também o contexto social em que o ex-fumante está inserido, que poderá influenciar na manutenção ou não da abstinência do cigarro.

Resumen OBJETIVOS Comprender la experiencia de ex-fumadores con respecto a mantener la abstinencia al tabaco. MÉTODOS Investigación cualitativa que utilizó la Fenomenología Social de Alfred Schütz. Se llevó a cabo la entrevista fenomenológica en 2016 con 12 ex-fumadores de una ciudad de Minas Gerais, Brasil. Los testimonios fueron organizados en categorías y discutidos con base en la literatura. RESULTADOS Se revelaron las categorías: "Las ganancias em la salud, la sociabilidad y la financiación"; "La convivencia com el deseo de fumar y aumento del peso corporal"; "La autodeterminación y el uso de estrategias sustitutivas" y "Para permanecer fuera de los cigarrillos". CONCLUSIONES Estos resultados llaman la atención de los profesionales de la salud hacia la necesidad de apoyar a los ex-fumadores parapermanecer libres de tabaco. Esto implica considerar no sólo los efectos negativos de la abstinencia de fumar sino el contexto social en el que se inserta el ex-fumador, el cualpuede influir en el mantenimiento o no de la abstinencia al cigarrillo.

Abstract OBJECTIVE To understand the experience of former smokers maintaining tobacco abstinence. METHODS Qualitative research using the theoretical-methodological reference of the Social Phenomenology, as defined by Alfred Schütz. The phenomenological interview was carried out in 2016 with 12 former smokers from a city in the state of Minas Gerais, Brazil. The statements were organized into categories and discussed based on the literature. RESULTS The maintenance of tobacco abstinence was revealed in the categories: "Health, sociability, and financial gains"; "Living with the urge to smoke and with the increase of body weight"; "Self-determination and use of replacement strategies"; and "Staying away from cigarettes." CONCLUSIONS These results alert health professionals to the need to provide support to former smokers so they can remain smoke-free. This implies considering not only the negative effects of the tobacco abstinence, but also the social context in which former smokers are inserted that might have an impact on the maintenance or not of the cigarette withdrawal.

Avaliação da eficácia da terapia de espelho na Síndrome de Pusher e da heminegligência em pacientes pós-acidente vascular encefálico / Evaluation of the effectiveness of mirror therapy in Pusher Syndrome and hemineglect in post-stroke patients

Introdução: Em pacientes com Acidente Vascular Cerebral (AVC) agudo, que experimentam déficits acentuados de equilíbrio, pode-se suspeitar da Síndrome de Pusher. Objetivo: Analisar eficácia do tratamento da Síndrome de Pusher (SP) e heminegligência através da Terapia de Espelho (TE). Material e métodos: Relata-se o caso de um paciente com 6 meses pós-AVC, 55 anos, do sexo masculino, com heminegligência e SP associadas ao quadro clínico de hemiplegia proporcionada à esquerda. O paciente foi avaliado pelas escalas: Escala de Equilíbrio de Berg (EEB), Escala de Fulg-Meyer (FM), Medida de Independência Funcional (MIF), Contraversive Pushing Scale (CPS) e teste do desenho para heminegligência (TDH). Foi realizada a TE de modo que todo o hemicorpo saudável ficava refletido na imagem. Foram realizadas 15 sessões de exercícios, com 50 minutos de duração. Resultados: Observa-se uma melhora considerável nas pontuações da FM - função sensorial e na MIF. A melhora da heminegligência e da SP também foi observada pelos testes aplicados. As pontuações da EEB e FM, seção membro superior e membro inferior obtiveram diferenças mínimas na comparação antes e após o tratamento. Conclusão: A TE aplicada sobre todo o hemicorpo afetado foi capaz de promover melhora na heminegligência e SP de paciente agudo pós-AVE.(AU)

Introduction: In patients with acute stroke, experiencing sharp balance deficits, can be suspected of Pusher syndrome. Objective: To evaluate the efficacy of treatment on Pusher Syndrome (PS) and hemineglect through mirror therapy (MT). Methods: A case report of six months post-stroke patient, 55 years-old, male, with hemineglect and PS in the hemiplegic left side. The patient was evaluated by Berg Balance Scale (BBS), Fulg-Meyer Scale (FM), the Functional Independence Measure (FIM), Contraversive Pushing Scale (CPS) and Heminegligence Drawing test (HDT). Fifteen mirror therapy sessions, with 50 minutes, were performed. Results: We observed a great improvement in the FM-sensorial section and FIM scores. Hemineglect and PS were also improved after MT training sessions. The scores of EEB and FM, upper limb and lower limb sections, had a minimal change in the comparison before and after the treatment. Conclusion: MT applied in the whole affected side was able to produce an improvement in the hemineglect and PS in acute post-stroke patient.(AU)