A review on natural biopolymers in external drug delivery systems for wound healing and atopic dermatitis.

Despite the advantages of topical administration in the treatment of skin diseases, current marketed preparations face the challenge of the skin's barrier effect, leading to low therapeutic effectiveness and undesirable side effects. Hence, in recent years the management of skin wounds, the main morbidity-causing complication in hospital environments, and atopic dermatitis, the most common inflammatory skin disease, has become a great concern. Fortunately, new, more effective, and safer treatments are already under development, with chitosan, starch, silk fibroin, agarose, hyaluronic acid, alginate, collagen, and gelatin having been used for the development of nanoparticles, liposomes, niosomes and/or hydrogels to improve the delivery of several molecules for the treatment of these diseases. Biocompatibility, biodegradability, increased viscosity, controlled drug delivery, increased drug retention in the epidermis, and overall mitigation of adverse effects, contribute to an effective treatment, additionally providing intrinsic antimicrobial and wound healing properties. In this review, some of the most recent success cases of biopolymer-based drug delivery systems as part of nanocarriers, semi-solid hydrogel matrices, or both (hybrid systems), for the management of skin wounds and atopic dermatitis, are critically discussed, including composition and in vitro, ex vivo and in vivo characterization, showing the promise of these external drug delivery systems.

Novel Therapeutic Hybrid Systems Using Hydrogels and Nanotechnology: A Focus on Nanoemulgels for the Treatment of Skin Diseases.

Topical and transdermal drug delivery are advantageous administration routes, especially when treating diseases and conditions with a skin etiology. Nevertheless, conventional dosage forms often lead to low therapeutic efficacy, safety issues, and patient noncompliance. To tackle these issues, novel topical and transdermal platforms involving nanotechnology have been developed. This review focuses on the latest advances regarding the development of nanoemulgels for skin application, encapsulating a wide variety of molecules, including already marketed drugs (miconazole, ketoconazole, fusidic acid, imiquimod, meloxicam), repurposed marketed drugs (atorvastatin, omeprazole, leflunomide), natural-derived compounds (eucalyptol, naringenin, thymoquinone, curcumin, chrysin, brucine, capsaicin), and other synthetic molecules (ebselen, tocotrienols, retinyl palmitate), for wound healing, skin and skin appendage infections, skin inflammatory diseases, skin cancer, neuropathy, or anti-aging purposes. Developed formulations revealed adequate droplet size, PDI, viscosity, spreadability, pH, stability, drug release, and drug permeation and/or retention capacity, having more advantageous characteristics than current marketed formulations. In vitro and/or in vivo studies established the safety and efficacy of the developed formulations, confirming their therapeutic potential, and making them promising platforms for the replacement of current therapies, or as possible adjuvant treatments, which might someday effectively reach the market to help fight highly incident skin or systemic diseases and conditions.

Leiomyoma and the importance of genetic variation on genes related to the vasculature system - CßS, MTHFR, NOS3, CYBA, and ACE1.

OBJECTIVE: The link between the systemic vasculature system and tumor biology is here investigated by studying the contribution of CßS (844ins68), MTHFR (677C > T), NOS3 (4a/4b), CYBA (C242T), and ACE1 (I/D) genes to leiomyoma onset, uterus and leiomyoma volumes. METHODS: DNA samples from 130 women with leiomyomas and 527 from healthy women were genotyped by PCR or PCR-RFLP. Qui-square (χ2) or Fisher's exact test were used to test associations. All the mentioned tests were performed in IBM® SPSS® Statistics Version 28. Statistical significance was defined as a p-value < 0.05. RESULTS: Results revealed that CßS (in the codominant and allelic models, p = 0.044 and, p = 0.015, OR = 1.791 [1.114-2.879], respectively), MTHFR (in the codominant, allelic and dominant models, p = 0.009, p = 0.002, OR = 0.585 [0.416-0.824] and p = 0.003, OR = 0.527 [0.346-0.802], respectively) and ACE1 (dominant model, p = 0.045, OR = 0.639 [0.411-0.992]) genes are associated with leiomyoma onset. NOS3 4a4a genotype is associated with a lower uterus volume (p = 0.004). This study also uncovers intriguing epistatic interactions among some genes that further accentuate their roles in disease modulation. Indeed, the epistatic interactions between the CC genotype (MTHFR) and (+/+) (CßS; p = 0.003), 4b4b (NOS3; p = 0.006, OR = 2.050 [1.223-3.439]) or DD (ACE1; p < 0.001, OR = 2.362 [1.438-3.880]) were shown to be associated with the disease, while 4a presence (NOS3) in epistasis with I presence (ACE1), increased the effect protection having just the I allele presence (p = 0.029, OR = 0.446 [0.214-0.930]). CONCLUSIONS: We conclude that variation in genes related to the systemic vascular system can play a role in the onset and development of leiomyoma.

Antiedema and antinociceptive potential of the essential oil of Pectis elongata Kunt (Asteraceae) from the Brazilian Amazon.

ETHNOPHARMACOLOGICAL RELEVANCE: Pectis elongata, a herbaceous species that is known in northern Brazil as "cominho" or "limãozinho", is traditionally used in the region for the treatment of fevers, colds, hypotension, genitourinary and gastric disorders, and pain. AIM OF THE STUDY: Determine the chemical composition and acute oral toxicity and evaluate whether Pectis elongata essential oil (PeEO) has antiedema and antinociceptive activity. MATERIALS AND METHODS: The chemical composition was determined using gas chromatography coupled to mass spectrometry (GC/MS) and the degree of toxicity determined by the LD50. The antiedema and antinociceptive potential was evaluated via the λ-carrageenan-induced paw edema test and formalin test, respectively. RESULTS: Citral (geranial and neral) was characterized as a major component of the PeEO, representing 89% of the total identified compounds. According to OECD criteria (2002), the EO was considered non-toxic since it presented LD50 values over 2000 mg kg-1. Its antiedema potential was observed at doses of 200 and 400 mg kg-1 (p ≤ 0.05). At a dose of 400 mg kg-1, PeEO also showed antinociceptive potential (p ≤ 0.05), both in the neurogenic phase and in the inflammatory phase. CONCLUSIONS: PeEO, which is rich in citral, did not induce any characteristic signs of acute oral toxicity and was also efficient in reducing carrageenan-induced paw edema, in addition to presenting antinociceptive potential and acting on both central and peripheral pain. It is thus a promising candidate for the development of a new herbal medicine with anti-inflammatory and analgesic action.

Postoperative Pain Management in Coronary Artery Bypass Grafting: An Integrative Review.

PURPOSE: To identify pharmacological and nonpharmacological interventions adopted for pain relief in the postoperative period of coronary artery bypass graft surgery. DESIGN: Integrative review. METHODS: Studies published in English, Spanish, and Portuguese from January 2010 to December 2019 in Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature on Health Science, PubMed, and Web of Science. Two hundred studies were identified and eleven were included. Methodological analysis was performed using the Medical Education Research Study Quality Instrument. FINDINGS: The studies found were organized into three thematic categories: pharmacological interventions (methadone, morphine, lidocaine gel, remifentanil, sufentanil, and nefopam), nonpharmacological interventions (low-level laser therapy, light-emitting diode, Class IV laser, and transcutaneous nerve stimulation) and anesthetic techniques (dexmedetomidine, ultrasound-guided pectoral nerve block, high thoracic epidural analgesia, and perioperative parasternal block with levobupivacaine). CONCLUSIONS: A greater tendency to use drug strategies for postoperative pain relief was identified. The drugs used demonstrated efficacy and safety in the treatment of pain, with the exception of nefopam, which showed little benefit in this population. Nonpharmacological interventions, used as adjuvants to drug treatment, were shown to be safe, effective, and well tolerated by the patients.

Genetic Modulation of HPV Infection and Cervical Lesions: Role of Oxidative Stress-Related Genes.

Human papillomavirus (HPV) infection is a necessary but not sufficient factor for the development of invasive cervical cancer (ICC) and high-grade intraepithelial lesion (HSIL). Oxidative stress is known to play a crucial role in HPV infection and carcinogenesis. In this study, we comprehensively investigate the modulation of HPV infection, HSIL and ICC, and ICC through an exploration of oxidative stress-related genes: CßS, MTHFR, NOS3, ACE1, CYBA, HAP, ACP1, GSTT1, GSTM1, and CYP1A1. Notably, the ACE1 gene emerges as a prominent factor with the presence of the I allele offering protection against HPV infection. The association of NOS3 with HPV infection is perceived with the 4a allele showing a protective effect. The presence of the GSTT1 null mutant correlates with increased susceptibility to HPV infection, HSIL and ICC, and ICC. This study also uncovers intriguing epistatic interactions among some of the genes that further accentuate their roles in disease modulation. Indeed, the epistatic interactions between the BB genotype (ACP1) and DD genotype (ECA1) were shown to increase the risk of HPV infection, and the interaction between BB (ACP1) and 0.0 (GSTT1) was associated with HPV infection and cervical lesions. These findings underscore the pivotal role of four oxidative stress-related genes in HPV-associated cervical lesions and cancer development, enriching our clinical understanding of the genetic influences on disease manifestation. The awareness of these genetic variations holds potential clinical implications.

Liposome-Derived Nanosystems for the Treatment of Behavioral and Neurodegenerative Diseases: The Promise of Niosomes, Transfersomes, and Ethosomes for Increased Brain Drug Bioavailability.

Psychiatric and neurodegenerative disorders are amongst the most prevalent and debilitating diseases, but current treatments either have low success rates, greatly due to the low permeability of the blood-brain barrier, and/or are connected to severe side effects. Hence, new strategies are extremely important, and here is where liposome-derived nanosystems come in. Niosomes, transfersomes, and ethosomes are nanometric vesicular structures that allow drug encapsulation, protecting them from degradation, and increasing their solubility, permeability, brain targeting, and bioavailability. This review highlighted the great potential of these nanosystems for the treatment of Alzheimer's disease, Parkinson's disease, schizophrenia, bipolar disorder, anxiety, and depression. Studies regarding the encapsulation of synthetic and natural-derived molecules in these systems, for intravenous, oral, transdermal, or intranasal administration, have led to an increased brain bioavailability when compared to conventional pharmaceutical forms. Moreover, the developed formulations proved to have neuroprotective, anti-inflammatory, and antioxidant effects, including brain neurotransmitter level restoration and brain oxidative status improvement, and improved locomotor activity or enhancement of recognition and working memories in animal models. Hence, albeit being relatively new technologies, niosomes, transfersomes, and ethosomes have already proven to increase the brain bioavailability of psychoactive drugs, leading to increased effectiveness and decreased side effects, showing promise as future therapeutics.

Innovative Aqueous Nanoemulsion Prepared by Phase Inversion Emulsification with Exceptional Homogeneity.

Formulating low-solubility or low-permeability drugs is a challenge, particularly with the low administration volumes required in intranasal drug delivery. Nanoemulsions (NE) can solve both issues, but their production and physical stability can be challenging, particularly when a high proportion of lipids is necessary. Hence, the aim of the present work was to develop a NE with good solubilization capacity for lipophilic drugs like simvastatin and able to promote the absorption of drugs with low permeability like fosphenytoin. Compositions with high proportion of two lipids were screened and characterized. Surprisingly, one of the compositions did not require high energy methods for high droplet size homogeneity. To better understand formulation factors important for this feature, several related compositions were evaluated, and their relative cytotoxicity was screened. Optimized compositions contained a high proportion of propylene glycol monocaprylate NF, formed very homogenous NE using a low-energy phase inversion method, solubilized simvastatin at high drug strength, and promoted a faster intranasal absorption of the hydrophilic prodrug fosphenytoin. Hence, a new highly homogeneous NE obtained by a simple low-energy method was successfully developed, which is a potential alternative for industrial application for the solubilization and protection of lipophilic actives, as well as (co-)administration of hydrophilic molecules.

Rosacea Topical Treatment and Care: From Traditional to New Drug Delivery Systems.

Rosacea is a multifactorial chronic inflammatory dermatosis characterized by flushing, nontransient erythema, papules and pustules, telangiectasia, and phymatous alterations accompanied by itching, burning, or stinging, the pathophysiology of which is not yet fully understood. Conventional topical treatments usually show limited efficacy due to the physical barrier property of the skin that hinders skin penetration of the active ingredients, thereby hampering proper drug skin delivery and the respective therapeutic or cosmetic effects. New advances regarding the physiopathological understanding of the disease and the underlying mechanisms suggest the potential of new active ingredients as promising therapeutic and cosmetic approaches to this dermatosis. Additionally, the development of new drug delivery systems for skin delivery, particularly the potential of nanoparticles for the topical treatment and care of rosacea, has been described. Emphasis has been placed on their reduced nanometric size, which contributes to a significant improvement in the attainment of targeted skin drug delivery. In addition to the exposition of the known pathophysiology, epidemiology, diagnosis, and preventive measures, this Review covers the topical approaches used in the control of rosacea, including skin care, cosmetics, and topical therapies, as well as the future perspectives on these strategies.

Nanogel Containing Gamma-Oryzanol-Loaded Nanostructured Lipid Carriers and TiO2/MBBT: A Synergistic Nanotechnological Approach of Potent Natural Antioxidants and Nanosized UV Filters for Skin Protection.

The human skin is a recurring target of external aggressions, such as UV radiation, leading to exacerbation of the aging process and the occurrence of skin diseases, such as cancer. Hence, preventive measures should be taken to protect it against these aggressions, consequently decreasing the chance of disease development. In the present study, a topical xanthan gum nanogel containing gamma-oryzanol-loaded nanostructured lipid carriers (NLCs) and nanosized UV filters TiO2 and methylene bis-benzotriazolyl tetramethylbutylphenol (MBBT) was developed to assess their synergistic potential in having multifunctional skin beneficial properties. The developed NLCs contained the natural-based solid lipids shea butter and beeswax, liquid lipid carrot seed oil, and the potent antioxidant gamma-oryzanol, with an optimum particle size for topical application (<150 nm), good homogeneity (PDI = 0.216), high zeta potential (-34.9 mV), suitable pH value (6), good physical stability, high encapsulation efficiency (90%), and controlled release. The final formulation, a nanogel containing the developed NLCs and the nano UV filters, showed high long-term storage stability and high photoprotection ability (SPF = 34) and resulted in no skin irritation or sensitization (rat model). Hence, the developed formulation showed good skin protection and compatibility, demonstrating promise as a new platform for the future generation of natural-based cosmeceuticals.

Impacto da pandemia da COVID-19 no estado funcional dos idosos: revisão de escopo / Impact of the COVID-19 pandemic on functional status in the elderly: scoping review.

Introdução: O processo de envelhecimento vem acompanhado de mudanças fisiológicas e estruturais, o isolamento social apresenta impacto negativo na vida dos longevos. Objetivo: Mapear as evidências sobre o impacto da pandemia da COVID-19 no estado funcional dos idosos. Métodos: Trata-se de uma revisão de escopo, cuja pesquisa foi realizada até dia 27 de janeiro de 2022, em cinco bases de dados. Foram incluídos 22 estudos nesta revisão, majoritariamente, os artigos foram desenvolvidos na Espanha, Itália, Israel e Polônia. Quanto aos periódicos eram especializados em saúde do idoso, como também saúde pública, medicina geral e nutrição. Os estudos eram do tipo coorte, ensaio clínico randomizados, observações clínicas, exploratório, retrospectivos e prospectivos. Participaram desses estudos 8741 pessoas. Resultados: Esta revisão permitiu mapear os principais impactos da pandemia COVID-19 sobre o estado funcional dos idosos, ficou evidente nos estudos a vulnerabilidade dessa população à doença, foi identificado que a idade é um fator de risco para aumento da mortalidade e os idosos que apresentavam o estado funcional preservado pré-COVID-19 tiveram um melhor desfecho em relação à recuperação hospitalar como também pós-COVID.

Norcantharidin Nanoemulsion Development, Characterization, and In Vitro Antiproliferation Effect on B16F1 Melanoma Cells.

Melanoma is a highly lethal type of cancer that has had an increase in incidence in the last decades. Nevertheless, current therapies lack effectiveness and have highly disabling side effects, which calls for new therapeutic strategies. Norcantharidin (NCTD) is an acid derivative with potential antitumor activity isolated from natural blister beetles. However, its solubility limitations restrict its use. To address this issue, we developed an oil-in-water nanoemulsion using commonly available cosmetic ingredients, which increased NCTD solubility 10-fold compared to water. The developed nanoemulsion showed a good droplet size and homogeneity, with adequate pH and viscosity for skin application. In vitro drug release studies showed a sustained release profile, ideal for prolonged therapeutic effects. Accelerated stability studies proved that the formulation was reasonably stable under stress conditions, with particle separation fingerprints, instability index, particle size, and sedimentation velocity analyses being conducted. To assess the therapeutic potential of the developed formulation, in vitro studies were conducted on melanoma B16F1 cells; results showed an IC50 of 1.026 +/- 0.370 mg/kg, and the cells' metabolic activity decreased after exposure to the NCTD nanoemulsion. Hence, a new "easy-to-make" nanoformulation with therapeutic potential on melanoma cells was developed, as a possible adjuvant for future melanoma treatment.

Nanosystems, Drug Molecule Functionalization and Intranasal Delivery: An Update on the Most Promising Strategies for Increasing the Therapeutic Efficacy of Antidepressant and Anxiolytic Drugs.

Depression and anxiety are high incidence and debilitating psychiatric disorders, usually treated by antidepressant or anxiolytic drug administration, respectively. Nevertheless, treatment is usually given through the oral route, but the low permeability of the blood-brain barrier reduces the amount of drug that will be able to reach it, thus consequently reducing the therapeutic efficacy. Which is why it is imperative to find new solutions to make these treatments more effective, safer, and faster. To overcome this obstacle, three main strategies have been used to improve brain drug targeting: the intranasal route of administration, which allows the drug to be directly transported to the brain by neuronal pathways, bypassing the blood-brain barrier and avoiding the hepatic and gastrointestinal metabolism; the use of nanosystems for drug encapsulation, including polymeric and lipidic nanoparticles, nanometric emulsions, and nanogels; and drug molecule functionalization by ligand attachment, such as peptides and polymers. Pharmacokinetic and pharmacodynamic in vivo studies' results have shown that intranasal administration can be more efficient in brain targeting than other administration routes, and that the use of nanoformulations and drug functionalization can be quite advantageous in increasing brain-drug bioavailability. These strategies could be the key to future improved therapies for depressive and anxiety disorders.

Avaliação de prescrições médicas de medicamentos em uma emergência hospitalar / Evaluation of drug prescriptions in a hospital emergency department / Evaluación de la prescripción de medicamentos en un servicio de urgencias hospitalario

RESUMO Objetivo: avaliar a adesão das prescrições médicas de medicamentos às recomendações para segurança do paciente por meio do checklist - Lista de Verificação de Segurança na Prescrição de Medicamentos. Método: trata-se de um estudo observacional, transversal, realizado entre maio a junho de 2022, com 341 prescrições médicas de medicamentos, numa emergência hospitalar no interior da Bahia - Brasil, cujos dados foram analisados através de análise descritiva. Resultados: 80% a 89% das prescrições tiveram adesão às recomendações de segurança; o item de maior adesão foi identificação da data da prescrição, menor adesão foi possuir medicamentos com nomes semelhantes identificados com caixa alta ou negrito. Cerca de 18,63% (n=514) dos medicamentos prescritos fazem parte da lista de medicamentos potencialmente perigosos de uso hospitalar. Conclusão: a avaliação das prescrições médicas de medicamentos evidenciou barreiras existentes na prática clínica, o que possibilita a elaboração de mecanismos mais efetivos para promoção da segurança do paciente.

ABSTRACT Objective: To evaluate the adherence of medical prescriptions to patient safety recommendations using the Medication Prescription Safety Checklist. Method: This is an observational, cross-sectional study carried out between May and June 2022, with 341 medical prescriptions for medicines in a hospital emergency room in the interior of Bahia - Brazil, whose data were analyzed through descriptive analysis. Results: 80% to 89% of the prescriptions adhered to the safety recommendations; the item with the highest adherence was identification of the date of the prescription, and the lowest adherence was having drugs with similar names identified in upper case or bold. Around 18.63% (n=514) of the drugs prescribed are on the list of potentially dangerous drugs for hospital use. Conclusion: The evaluation of medical prescriptions for medicines highlighted existing barriers in clinical practice, which makes it possible to develop more effective mechanisms to promote patient safety.

RESUMEN Objetivo: Evaluar la adhesión de las prescripciones médicas a las recomendaciones de seguridad del paciente utilizando la checklist - Lista de verificación de la Seguridad de la Prescripción de Medicamentos. Método: Se trata de un estudio observacional, transversal, realizado entre mayo y junio de 2022, con 341 prescripciones médicas de medicamentos, en la sala de urgencias de un hospital del interior de Bahia - Brasil, cuyos datos fueron analizados mediante análisis descriptivo. Resultados: Entre el 80% y el 89% de las prescripciones cumplieron las recomendaciones de seguridad; el punto con mayor cumplimiento fue la identificación de la fecha de la prescripción, y el de menor cumplimiento, que los medicamentos con nombres similares se identificaran en mayúsculas o en negrita. Alrededor del 18,63% (n=514) de los medicamentos prescriptos figuran en la lista de medicamentos potencialmente peligrosos de uso hospitalario. Conclusiones: La evaluación de las prescripciones médicas de medicamentos puso de manifiesto los obstáculos existentes en la práctica clínica, lo que permite desarrollar mecanismos más eficaces para promover la seguridad de los pacientes.

Nanosystems for Brain Targeting of Antipsychotic Drugs: An Update on the Most Promising Nanocarriers for Increased Bioavailability and Therapeutic Efficacy.

Orally administered antipsychotic drugs are the first-line treatment for psychotic disorders, such as schizophrenia and bipolar disorder. Nevertheless, adverse drug reactions jeopardize clinical outcomes, resulting in patient non-compliance. The design formulation strategies for enhancing brain drug delivery has been a major challenge, mainly due to the restrictive properties of the blood-brain barrier. However, recent pharmacokinetic and pharmacodynamic in vivo assays confirmed the advantage of the intranasal route when compared to oral and intravenous administration, as it allows direct nose-to-brain drug transport via neuronal pathways, reducing systemic side effects and maximizing therapeutic outcomes. In addition, the incorporation of antipsychotic drugs into nanosystems such as polymeric nanoparticles, polymeric mixed micelles, solid lipid nanoparticles, nanostructured lipid carriers, nanoemulsions, nanoemulgels, nanosuspensions, niosomes and spanlastics, has proven to be quite promising. The developed nanosystems, having a small and homogeneous particle size (ideal for nose-to-brain delivery), high encapsulation efficiency and good stability, resulted in improved brain bioavailability and therapeutic-like effects in animal models. Hence, although it is essential to continue research in this field, the intranasal delivery of nanosystems for the treatment of schizophrenia, bipolar disorder and other related disorders has proven to be quite promising, opening a path for future therapies with higher efficacy.

Unveiling the membrane bound dihydroorotate: Quinone oxidoreductase from Staphylococcus aureus.

Staphylococcus aureus is an opportunistic pathogen and one of the most frequent causes for community acquired and nosocomial bacterial infections. Even so, its energy metabolism is still under explored and its respiratory enzymes have been vastly overlooked. In this work, we unveil the dihydroorotate:quinone oxidoreductase (DHOQO) from S. aureus, the first example of a DHOQO from a Gram-positive organism. This protein was shown to be a FMN containing menaquinone reducing enzyme, presenting a Michaelis-Menten behaviour towards the two substrates, which was inhibited by Brequinar, Leflunomide, Lapachol, HQNO, Atovaquone and TFFA with different degrees of effectiveness. Deletion of the DHOQO coding gene (Δdhoqo) led to lower bacterial growth rates, and effected in cell morphology and metabolism, most importantly in the pyrimidine biosynthesis, here systematized for S. aureus MW2 for the first time. This work unveils the existence of a functional DHOQO in the respiratory chain of the pathogenic bacterium S. aureus, enlarging the understanding of its energy metabolism.

Cephalometric determinants of facial attractiveness: A quadratic correlation study.

INTRODUCTION: This research aimed to determine the nonlinear correlation between lateral cephalometric measurements and facial attractiveness, evaluated in the frontal and profile views. A quadratic correlation was studied, in which the vertex of the function indicates the cephalometric value corresponding to the maximum attractiveness. METHODS: Frontal and profile facial attractiveness of 60 patients with Class I (n = 20), Class II (n = 20), or Class III malocclusion (n = 20) aged 18-35 years without previous orthodontic treatment was evaluated by 14 laypersons (7 men and 7 women) with a visual analog scale. Soft- and hard-tissue measurements were collected on lateral cephalometric radiographs. Pearson and nonlinear quadratic correlations between the attractiveness of the face and cephalometric measurements were calculated. Maximum attractiveness values (MxAt) were determined for the significant cephalometric variables. RESULTS: Significant quadratic correlations were found between frontal facial attractiveness and the following variables: Ls-SnPog' (r = 0.45; MxAt = 3.1 mm), Li-SnPog' (r = 0.41; MxAt = 3.8 mm), the ANB angle (r = 0.42; MxAt = 0.2°) and MPA (r = 0.51; MxAt = 31.9°). Profile attractiveness correlated nonlinearly with Ls-SnPog' (r = 0.42; MxAt = 3.2 mm), Li-SnPog' (r = 0.41; MxAt = 3.9 mm) and MPA (r = 0.46; MxAt = 32.4°). CONCLUSIONS: Significant quadratic correlations were found between facial attractiveness and cephalometric measurements, which were stronger than linear correlations. The maximum attractiveness points indicated a tendency for laypeople to consider a more protrusive lower lip and an ANB angle lower than the norm as the most attractive.

Complications after percutaneous transluminal coronary angioplasty and associated factors

This study aimed to analyze the incidence of vascular complications and associated factors in patients undergoing elective percutaneous transluminal coronary angioplasty. This study is observational, quantitative, and longitudinal, and followed 50 patients undergoing elective percutaneous transluminal coronary angioplasty. An instrument for the sociodemographic, clinical, procedure, and vascular complications characterization was used for data collection. And descriptive statistics, bivariate analysis, and multiple binomial logistic regression were used for data analysis. The level of statistical significance considered was 95%. It was detected the prevalence of male patients (70%), elderly (54%), and diagnosed with systemic arterial hypertension (72%). As for the percutaneous access route prevailed the radial approach (64%). Age and body mass index were identified as possible risk factors for vascular complications. In the 50 procedures performed, there was a prevalence of hematomas (20%) and bleeding (10%). Among the complications prevailed radial Early Discharge After Transradial Stenting of Coronary (60%), large femoral hematoma (20%), small femoral hematoma (20%), and bleeding (Bleeding Academic Research Consortium 2) (100%). The results concluded an elevated incidence of vascular complications in the first 24 hours after elective percutaneous transluminal coronary angioplasty. This study contributes to research, assistance, and training in health and nursing by identifying post-PTCA vascular complications, minimizing their progression, handling their management, and developing health care safety protocols.

Aspiração endotraqueal em paciente crítico: elaboração e validação de um checklist / Endotracheal aspiration in critically ill patients: development and validation of a checklist / Aspiración endotraqueal en pacientes críticos: desarrollo y validación de una lista de verificación

Objetivo: Elaborar e validar um instrumento, tipo checklist, para identificar a adesão às recomendações, no procedimento de aspiração endotraqueal, em pacientes críticos sob ventilação mecânica, segundo as Diretrizes de Práticas Clínicas da American Association for Respiratory Care. Método: Estudo metodológico, transversal e com abordagem quantitativa. Realizou-se a elaboração de um checklist para procedimentos de aspiração endotraqueal, em pacientes críticos sob ventilação mecânica, submetidos ao processo de validação aparente e de conteúdo. Foi aplicado pré-teste, com dez procedimentos e análise de confiabilidade interobservadores, com a amostra de 116 procedimentos, no período de janeiro a outubro de 2021. Resultados: Na fase de validação aparente e de conteúdo, cinco juízes avaliaram o instrumento. No pré-teste, não se identificou a necessidade de adequabilidade dos itens, permanecendo, assim, a segunda versão como a versão final do instrumento, com 35 itens. Foi realizada análise de confiabilidade interobservadores, por dois enfermeiros, sendo que a maioria dos itens apresentou força de concordância ótima, com índice acima de 81%, demonstrando exato acordo nas leituras pelos dois observadores. Os valores do coeficiente Kappa variaram de regular a perfeito (0,338 a 0,982; p<0,001), e a confiabilidade foi considerada excelente (ICC= 0,918). Conclusão: O checklist é considerado válido e confiável (AU).

Objective: To develop and validate a checklist-type instrument to identify adherence to recommendations in the endotracheal aspiration procedure in critically ill patients under mechanical ventilation, according to the Clinical Practice Guidelines of the American Association for Respiratory Care. Method: Methodological, cross-sectional study with a quantitative approach. A checklist was elaborated for endotracheal aspiration procedures in critically ill patients under mechanical ventilation and submitted to the apparent and content validation process. Applied pre-test, with ten procedures and inter-observer reliability analysis, with a sample of 116 procedures from January to October 2021. Results: In the apparent and content validation phase, five judges evaluated the instrument. In the pre-test, the need for adequacy of the items was not identified, thus remaining the second version as the final version of the instrument, with 35 items. An inter-observer reliability analysis was carried out by two nurses, most of the items showed excellent agreement, with an index above 81%, demonstrating exact agreement in the readings by the two observers. Kappa coefficient values ranged from fair to perfect (0.338 to 0.982; p<0.001), and reliability was considered excellent (ICC= 0.918). Conclusion: The checklist is considered valid and reliable (AU).

Objetivo: Desarrollar y validar un instrumento tipo lista de verificación para identificar la adherencia a las recomendaciones en el procedimiento de aspiración endotraqueal en pacientes críticos bajo ventilación mecánica, según las Guías de Práctica Clínica de la Asociación Americana de Cuidados Respiratorios. Método: Estudio metodológico, transversal con enfoque cuantitativo. Se elaboró una lista de verificación para los procedimientos de aspiración endotraqueal en pacientes críticos bajo ventilación mecánica y se sometió al proceso de validación aparente y de contenido. Pretest aplicado, con diez procedimientos y análisis de confiabilidad interobservador, con una muestra de 116 procedimientos de enero a octubre de 2021. Resultados: En la fase de validación aparente y de contenido, cinco jueces evaluaron el instrumento. En el pre-test no se identificó la necesidad de adecuación de los ítems, quedando la segunda versión como la versión final del instrumento, con 35 ítems. Se realizó un análisis de confiabilidad interobservador por dos enfermeros, la mayoría de los ítems presentaron excelente fuerza de concordancia, con índice superior al 81%, demostrando concordancia exacta en las lecturas de los dos observadores. Los valores del coeficiente Kappa variaron de regular a perfecto (0,338 a 0,982; p<0,001), y la confiabilidad fue considerada excelente (ICC= 0,918). Conclusión: La lista de verificación se considera válida y confiable (AU).

Lipid and Polymeric Nanoparticles: Successful Strategies for Nose-to-Brain Drug Delivery in the Treatment of Depression and Anxiety Disorders.

Intranasal administration has gained an increasing interest for brain drug delivery since it allows direct transport through neuronal pathways, which can be quite advantageous for central nervous system disorders, such as depression and anxiety. Nanoparticles have been studied as possible alternatives to conventional formulations, with the objective of improving drug bioavailability. The present work aimed to analyze the potential of intranasal nanoparticle administration for the treatment of depression and anxiety, using the analysis of several studies already performed. From the carried-out analysis, it was concluded that the use of nanoparticles allows the drug's protection from enzymatic degradation, and the modulation of its components allows controlled drug release and enhanced drug permeation. Furthermore, the results of in vivo studies further verified these systems' potential, with the drug reaching the brain faster and leading to increased bioavailability and, consequently, therapeutic effect. Hence, in general, the intranasal administration of nanoparticles leads to a faster onset of action, with increased and prolonged brain drug concentrations and, consequently, therapeutic effects, presenting high potential as an alternative to the currently available therapies for the treatment of depression and anxiety.