Protocolo clínico ­ Manejo das exacerbações pulmonares agudas da fibrose cística / Clinical protocol ­ Management of acute pulmonary exacerbations of cystic fibrosis

A fibrose cística é uma desordem genética de caráter multissistêmico originada por variações no gene CFTR, que é responsável pela síntese da proteína homônima conhecida como "cystic fibrosis transmembrane conductance regulator", localizado no cromossomo 7. A manifestação predominante da doença é pulmonar, que se mantém como a principal causa de morbidade e mortalidade entre os indivíduos acometidos. As crises de exacerbação pulmonar se caracterizam por episódios de agravamento abrupto do quadro respiratório, demandando intervenção médica imediata, visto que tais episódios podem ocasionar danos irreversíveis e deterioração da função pulmonar, mesmo após a resolução dos sintomas agudos. O propósito do presente estudo foi a elaboração de um protocolo clínico direcionado ao manejo da exacerbação pulmonar aguda em pacientes portadores de fibrose cística, para ser implementado Hospital do Servidor Público Municipal. O protocolo proposto repousa sobre quatro pilares: continuidade ou intensificação do tratamento crônico em curso, emprego criterioso de corticosteroides em situações específicas, utilização de suporte ventilatório apropriado e seleção de terapêuticas antivirais e antimicrobianas. Palavras-chave: Fibrose cística. Exacerbação pulmonar. Antimicrobianos. Antivirais. Suporte ventilatório.

Desarrollo de una plataforma virtual para el entrenamiento de razonamiento clínico en estudiantes de fonoaudiología / Development of a Virtual Platform for Clinical Reasoning Training of Speech-Therapy Students

Objetivo. Desarrollar una plataforma virtual de aprendizaje (PVA) para el entrena-miento de razonamiento clínico en estudiantes de fonoaudiología. Método. Investigación aplicada en base al desarrollo de software; se utilizó lenguaje de programación PHP en su versión 7.3.26, gráficas y transiciones en framework Laravel 8 y Vue 2 con Vuetify. El manejo de base de datos se ejecutó en MySql 5.5. Resultados. Se creó una PVA para el almacenamiento y uso de guiones clínicos basados en la teoría de concordancia de guiones (scripts). La operatividad de la plataforma contempló tres perfiles diferenciados para docentes, estudiantes y gestores. Los estudiantes accedieron a un corpus aleatorio de guiones clínicos previamente validados. El profesor contó con acceso a las estadísticas de usabilidad y notas de los estudiantes y el gestor pudo cargar nuevos guiones, revisar estadísticas, resolver dificultades de soporte y asignar roles. Conclusiones. La PVA desarrollada ofrece un soporte informático para la metodología de entrenamiento del RC scripts en fonoaudiología. Los procesos de innovación educativa diversifican las estrategias de aprendizaje y promueven el desarrollo de competencias relevantes para la toma de decisiones clínicas en los ámbitos de diagnóstico, estudio e intervención

Objective. To develop a virtual learning platform (VLP) for CR training in speech therapy students. Method. Applied research based on software development. PHP programming language version 7.3.26, graphics and transitions in framework Laravel 8 and Vue 2 with Vuetify were used. The database management of the project was executed in MySql 5.5. Results. A VLP was created for storage and use of clinical scripts based on script concordance test. The operative functions of platform included three profiles: teachers, students, and managers. Students accessed a random corpus of previously validated scripts. Teachers had access to usability statistics and student grades, and the manager could upload new scripts, review statistics, resolve support issues, and assign roles. Conclusions. The VLP developed offers support for scripts training methodology in speech therapy. Educational innovation processes diversify learning strategies and promote the development of relevant skills for decision-making in the fields of diagnosis, study, and intervention.

Spending Estimates for Gastric Cancer in Central Brazil

Abstract Stomach cancer is the second leading cause of death by cancer worldwide and is even more pronounced in South America. In Brazil, it is estimated that an increase in the number of cases due to this cancer occurred in the biennium 2018-2019. In this study, we investigated the expenditures of the State Health Department of Goiás on hospitalizations and treatment of gastric cancer for the Unified Health System (SUS) from 2008-2016. This is a cross-sectional, descriptive, and analytical study based on secondary data from the Unified Health System computing department (DATASUS) and the System of Management of the Table of Procedures, Medications, Orthosis, Prosthesis, and Special Materials of SUS through CONECTA-SUS related to International Classification of Diseases-10/C16 (ICD-10/C16) procedures for gastric neoplasms. A total of I$ 5,697,958.20 was spent on gastric tumor in the last nine years in Goiás, I$ 4,492,916.67 (0.3%) on hospitalizations, and I$ 1,997,120.91 on treatment. This study presents a current and relevant estimate of the costs of gastric cancer patients in Goiás. Moreover, we provide information on the extent of the cancer issue to public health. Our analysis offers components for service management and studies that reduce resource allocation in more rational ways

Heart Failure Care Dyadic Typology: Initial Conceptualization, Advances in Thinking, and Future Directions of a Clinically Relevant Classification System.

BACKGROUND: Heart failure (HF) dyadic self-care science is advancing rapidly, as evidenced by recent theoretical work, literature reviews, and multiple empiric studies. Typologies, once considered archaic, are now viewed as person-oriented classification systems that allow a whole-system view of information patterns. This whole-system view is particularly needed to understand complex tasks like dyadic HF self-care. PURPOSE: The purpose of this article is to review the initial conceptualization of an HF care dyadic typology and the present advances in our thinking and suggest future directions for this clinically relevant classification system. CONCLUSIONS: Development and testing of the typology across 5 studies resulted in a well-characterized, pragmatic and parsimonious, person-oriented classification system for understanding how patients and informal caregivers conduct patients' HF self-care at home. The 4 types are characterized as 2 individually oriented types-type I, patient oriented; type II, caregiver oriented; and 2 relationally oriented types-type III, collaboratively oriented; and type IV, incongruently oriented. We have devised a single-item measure of typology group that can be assessed in the clinical setting. Once this information is ascertained, the clinician can personalize the plan of care to the realities of the dyad. IMPLICATIONS: Dyads that disagree on who is responsible for self-care may forego or delay action, resulting in self-care failures with subsequent HF advancement, hospitalization, and mortality. As the HF dyadic self-care science has advanced, we have come to appreciate the complexity that arises when 2 individuals work together on 1 complex task-HF self-care.

Protective effects of salidroside on chronic heart failure in rats and the underlying mechanisms

The present study aimed to investigate the protective effects of salidroside on chronic heart failure (CHF) in rats and to explore the underlying mechanisms. One hundred SD rats were randomly divided into sham-operated, model, and low-, medium- and high-dose salidroside groups. The CHF model was established in later 4 groups. The later 3 groups were intragastrically administrated with 6, 12 and 24 mg/kg salidroside, respectively, once a day, for continuous 4 weeks. Finally, the serum levels of brain natriuretic peptide (BNP) and interleukin 6 (IL-6), cardiac function indexes, and expression levels of myocardial cysteinyl aspartate-specific proteinase (Caspase)-3, Caspase-9, matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) protein were determined. Results showed that, after treatment, compared with model group, in high-dose salidroside group the heart function indexes were significantly improved (P < 0.05), the serum levels of BNP and IL-6 were significantly decreased (P < 0.05), the expression levels of myocardial Caspase-3, Caspase-9 and MMP-1 protein were significantly decreased (P < 0.05), and the expression level of TIMP-1 protein was significantly increased (P < 0.05). In conclusion, salidroside has obvious protective effects on CHF in rats. The mechanisms may be related to its regulation of cardiomyocyte apoptosis and ventricular remodelingregulation related protein expressions

Evaluation of the simplified therapeutic intervention scoring system: Chinese version.

OBJECTIVE: To prepare the Simplified Therapeutic Intervention Scoring System (TISS-28) to measure nursing workload in Intensive Care Units in Guangdong Province of China. METHODS: A non-experimental descriptive study was conducted in the intensive care units in the Province. TISS-28, TISS-76, Acute Physiology and Chronic Health Evaluation (APACHE II) were all measured. RESULTS: There were significant positive correlations between TISS-28 and APACHE II (n=91, r=0.432, p<0.001), TISS-76 scores (n=83, r=0.764, p<0.001). A significant difference was found between the mean TISS-28 score in the first day of the intensive care stay and the last day (30.76±6.86 vs 24.67±5.48, p<0.001). A significant intra-class correlation was found between TISS-28 scores collected by the researcher and research associates (ICC=0.959, p<0.001). CONCLUSION: The reliability and validity of TISS-28 were shown in Chinese intensive care units. It is a practical tool for estimating the nursing workload and providing opportunities to compare the data between intensive care units in different facilities. The TISS-28 Chinese version is recommended to guide the allocation of nursing manpower in Chinese intensive care units.

Trombólisis fármaco-mecánica: una técnica a considerar en el tratamiento de la trombosis venosa profunda iliofemoral aguda / Pharmaco-mechanical thrombolysis: A technique to consider in the treatment of acute iliofemoral deep vein thrombosis

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Cirugía abdominal híbrida para el tratamiento de los aneurismas toracoabdominales complejos / Abdominal hybrid procedures for treatment of complex thoracoabdominal aortic aneurysms

La cirugía abierta de los aneurismas toracoabdominales (ATA) aún hoy presenta una alta morbimortalidad, habiendo surgido distintas alternativas. El tratamiento híbrido renovisceral, rodeado de controversia, es una de ellas. Los datos disponibles en la bibliografía con respecto a morbimortalidad muestran gran disparidad. Sin embargo, la mayoría de las series incluyen un elevado porcentaje de pacientes de alto riesgo y de ATA extensos, considerando por ello que los procedimientos híbridos renoviscerales todavía juegan un papel en el tratamiento de los ATA

Abdominal hybrid procedures have arisen as an alternative to conventional open surgery for thoracoabdominal aortic aneurysms (TAA), although they are surrounded by controversy. Data available in the literature about morbidity and mortality show a great disparity. However, most series include a large number of high risk patients and of extensive TAA. Considering this, renovisceral debranching still has a role in the treatment of TAA

Protocolo de actuación ante la rosácea en la farmacia comunitaria / Course of action for rosacea in community pharmacy

La rosácea es una dermatosis facial inflamatoria, recidivante y crónica, que con frecuencia demanda consulta en la farmacia comunitaria. Orientado hacia la práctica clínica del farmacéutico comunitario, este artículo revisa y sintetiza los conceptos clásicos y los avances más recientes en la comprensión y el tratamiento de esta enfermedad cutánea. Finalmente, propone un protocolo para la asistencia de pacientes con rosácea en la farmacia comunitaria (AU)

Rosacea is a chronic relapsing inflammatory facial dermatosis that demands often attention in the Community Pharmacy. Keeping in mind what could be useful in the clinical practice for the community pharmaceutist, this paper reviews and synthesizes clasical concepts and the most recent advances in the understanding and management of this skin disease. Finally, a protocol for the assistence of patients with rosacea in the Community Pharmacy is proposed (AU)

Manejo de la axila en el cáncer de mama: menos es más, más es menos o todo lo contrario / Management of the axilla in breast cancer: less is more, more is less or the other way around

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Agonista del receptor de trombopoyetina como tratamiento de trombocitopenia asociada a lupus eritematoso sistémico / Thrombopoietin-receptor agonist as a treatment of thrombocytopenia associated with systemic lupus erythematosus

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Reducción de ingresos y visitas a Urgencias en pacientes frágiles con insuficiencia cardíaca: resultados del programa asistencial UMIPIC / Reduction in hospitalisations and emergency department visits for frail patients with heart failure: results of the UMIPIC healthcare programme

Objetivos. La insuficiencia cardíaca (IC) es una enfermedad con una elevada morbimortalidad. Evaluamos la utilidad del programa de Unidades de Manejo Integral para Pacientes con IC (UMIPIC). Pacientes y método. Se analizaron los datos de los pacientes incluidos en el programa UMIPIC, recogidos en el registro de IC (RICA) de la Sociedad Española de Medicina Interna. Se compararon las visitas a Urgencias y las hospitalizaciones por cualquier causa y por IC durante el año anterior a la inclusión en el programa, con las que tuvieron durante el año de seguimiento posterior, usando el test de la chi-cuadrado. Resultados. Se incluyeron 258 pacientes (edad media 80 años, 51,9% mujeres). Durante el año previo hubo 693 hospitalizaciones por cualquier causa y 174 durante el seguimiento (reducción del 75%, p<0,001); 613 hospitalizaciones por IC el año antes y 92 durante el seguimiento (reducción del 85%, p<0,001); 655 vs 302 en cuanto a las visitas a Urgencias por cualquier causa (reducción del 53,9%, p<0,001); 440 vs 120 para las visitas a Urgencias por IC (reducción del 72%, p<0,001). No hubo diferencias significativas en el número de hospitalizaciones o visitas a Urgencias por otras causas diferentes a la IC. Conclusiones. El programa UMIPIC basado en la atención integral a pacientes ancianos con IC y comorbilidad reduce el porcentaje de reingresos hospitalarios y visitas a Urgencias durante el primer año de seguimiento (AU)

Objectives. Heart failure (HF) is a disease with high morbidity and mortality. We evaluated the usefulness of the Comprehensive Management Units for Patients with HF (Unidades de Manejo Integral para Pacientes con IC [UMIPIC]) programme. Patients and method. We analysed the patient data from the UMIPIC programme, which was recorded in the HF registry (RICA) of the Spanish Society of Internal Medicine. We compared emergency department visits and hospitalisations for any cause and for HF during the year prior to inclusion in the programme against those that occurred during the subsequent follow-up year, using the chi-squared test. Results. A total of 258 patients (mean age, 80years; 51.9% women) were included in the study. During the previous year, there were 693 hospitalisations for all causes and 174 hospitalisations during the follow-up (75% reduction, P<.001). There were 613 hospitalisations for HF during the previous year and 92 during the follow-up (85% reduction, P<.001); 655 vs. 302 in terms of emergency department visits for any cause (53.9% reduction, P<.001); and 440 vs. 120 for emergency department visits for HF (72% reduction, P<.001). There were no significant differences in the number of hospitalisations or emergency department visits for causes other than HF. Conclusions. The UMIPIC programme based on the comprehensive care of elderly patients with HF and comorbidity reduces the rate of hospital readmissions and emergency department visits during the first year of follow-up (AU)

Derrame pleural unilateral tras perforación vascular por catéter venoso central de inserción periférica: utilidad del verde de indocianina en el diagnóstico / Unilateral pleural effusion caused by vessel perforation due to peripherally inserted central catheter: Indocyanine green as a diagnostic tool

Varón de 44 años con desnutrición calórico-proteica grave en el contexto de una estenosis pilórica benigna, a quien se decidió colocar un catéter central de inserción periférica (CCIP) para tratamiento con nutrición parenteral. Al quinto día de la inserción del catéter, presentó un derrame pleural derecho masivo de color blanco e insuficiencia respiratoria tras la realización de una endoscopia digestiva alta para el tratamiento de la estenosis pilórica. Ante la sospecha inicial de quilotórax el paciente ingresó en la Unidad de Reanimación. Se administró verde de indocianina a través del CCIP, obteniendo a los 30 min una coloración verdosa del contenido del derrame pleural; este resultado nos hizo sospechar que el derrame pleural era secundario a una perforación vascular por el CCIP con extravasación de la nutrición parenteral al espacio pleural. Se realizó una tomografía computarizada toracoabdominal, que confirmó la existencia de una perforación a nivel de la vena innominada. La colocación de un CCIP puede asociarse a complicaciones graves, como la perforación de una vena central, por tanto, la correcta posición de un catéter central debe ser siempre comprobada. La prueba diagnóstica de elección de perforación vascular a nivel central es la tomografía computarizada con contraste; sin embargo, ante la existencia de derrame pleural en este contexto, es posible emplear un colorante que, administrado de forma intravenosa, oriente su diagnóstico in situ. En este caso se empleó el verde de indocianina con este objetivo (AU)

A peripherally inserted central catheter (PICC) was inserted into a 44-year-old man to provide parenteral nutrition in a protein-calorie malnutrition secondary to a benign pyloric stenosis. On the fifth day while monitoring the catheter, the patient presented with a massive whitish pleural effusion after undergoing gastric endoscopy in order to treat pyloric stenosis. Chylothorax was initially suspected, and the patient was admitted to a recovery unit. Indocyanine green was administered through the PICC, obtaining a greenish discoloration in the pleural effusion 30 min later. This led to the diagnosis of a pleural effusion caused by a vessel perforation due to the PICC, leading to parenteral nutrition extravasation. Thoraco-abdominal computed tomography was performed, which confirmed an innominate vein perforation due to the PICC. PICC insertion may be associated with severe complications, such as central vessel perforation, and therefore the correct position of a central catheter should be always checked. Intravenous computed tomography contrast is the gold standard for central vascular perforation diagnosis. However if a pleural effusion occurs in this context, it is possible to use a dye, which administered intravenously can lead us to the correct diagnosis in situ. Indocyanine green was used for this purpose in this case (AU)

Classificação para aplicações terapêuticas gamificadas para pacientes com Alzheimer / Rating for therapeutic applications gamifying for patients with Alzheimer's

Desenvolver e apresentar uma classificação taxonômica para auxiliar e reduzir a probabilidade de insucesso do projeto e desenvolvimento de aplicações terapêuticas para pacientes com Alzheimer. Foram levantadas publicações nas bases de periódico IEEE, ACM, Springer, Science Direct, SciELO e Google Scholar que suportam e definem a forma de utilização dos elementos de jogos em aplicações de pacientes com Alzheimer. Identificados 17 elementos de jogos nos 3 níveis (Dinâmicas, Mecânicas e Componentes) utilizáveis em aplicações de apoio a terapias cognitivas para pacientes com Alzheimer. A taxonomia proposta é uma ferramenta de aplicação direta permitindo identificar os elementos de gamificação mínimos necessários para o desenvolvimento de aplicações voltadas a pacientes com DA.

To develop and present a taxonomic classification to assist and reduce the risk of failure in project and development of therapeutic applications for patients with Alzheimer. Papers from IEEE journal databases, ACM, Springer, Science Direct, SciELO and Google Scholar were searched to support and define the use of game elements in applications for patients with Alzheimer. We identified 17 game elements in 3 levels (Dynamic, and Mechanical Components) usable in applications to support cognitive therapies for Alzheimer's patients. The proposed taxonomy is a direct application tool allowing to identify the elements of gamification minimum necessary for the development of applications aimed at patients with Alzheimer's Disease.

Hidatidosis paravesical. Presentación de un caso clínico / Bladder hidatidosis. Presentation of a clinical case

La hidatidosis primaria pélvica o paravesical es una forma excepcional de presentación de la enfermedad, mucho más común en pulmón, hígado y riñón. La clínica suele corresponder a trastornos irritativos miccionales. El diagnóstico de imagen es por ecografía, TAC y RNM. La serología es complementaria. El tratamiento médico es con albendazol pero la solución definitiva del quiste hidatídico paravesical es la cirugía. Se presenta un caso clínico de quiste hidatídico paravesical tratado con cirugía abierta, con una breve revisión de la literatura (AU)

Primary pelvic or paravesical hydatid disease is an exceptional presentation of the disease, more common in lung, liver and kidney. The symptoms are typically for irritative micturition disorders. The image diagnosis is by ultrasound, CT and MRI. The serology is complementary. Albendazole is pharmacological treatment but the final solution for the paravesical hydatid cyst is surgery. We present a case of paravesical hydatid cyst treated with open surgery, with a brief review of the literatura (AU)

Exposició a tuberculosi pulmonar en una unitat neonatal: decisions diagnòstiques i terapèutiques / Exposición a tuberculosis pulmonar en una unidad neonatal: decisiones diagnósticas y terapéuticas / Exposure to pulmonary tuberculosis in a neonatal unit: diagnostic and therapeutic decisions

Fonament: els nounats tenen un risc incrementat de patir malaltia tuberculosa greu a causa de la seva condició d'immunosupressió. Objectiu: avaluar la incidència d'infecció tuberculosa o malaltia latent en una cohort de nounats exposats a un treballador sanitari d'una unitat neonatal diagnosticat de malaltia tuberculosa pulmonar, així com descriure les estratègies per al seu diagnòstic i tractament. Mètode: per al cribratge inicial es va fer una prova de tuberculina (PT) i una radiografia (Rx) toràcica. En cas de dubte, es practicaria una tomografia axial computada (TC) i un QuantiFERON(R)-TB Gold test. Descartada la infecció, es va iniciar tractament amb isoniazida fins als 6 mesos. A aquesta edat, es va fer una segona PT. Resultats: seixanta nounats van estar exposats al cas índex. La PT va ser negativa tant a l'inici com als 6 mesos. Un nadó presentava una imatge dubtosa en la radiografia toràcica, però la TC i el QuantiFERON(R)-TB Gold test van ser normals. El 88,6% dels nounats van iniciar profilaxi, es va contraindicar en el 3% i hi va haver negativa dels pares en el 8%. Tan sols un pacient va presentar efectes secundaris per isoniazida. El 78% dels casos va completar la profilaxi. Als 12 mesos no es va detectar cap cas de tuberculosi. Conclusions: la incidència d'infecció tuberculosa en nounats hospitalitzats exposats és baixa, però, a causa de la gravetat potencial, la profilaxi amb isoniazida fins als 6 mesos i un cribratge precoç amb una PT i una Rx toràcica poden ser una estratègia vàlida per minimitzar el risc

Fundamento. Los neonatos tienen un riesgo incrementado de sufrir enfermedad tuberculosa grave dada su condición de inmunosupresión. Objetivo. Evaluar la incidencia de infección tuberculosa o enfermedad latente en una cohorte de neonatos expuestos a un trabajador sanitario de una unidad neonatal diagnosticado de enfermedad tuberculosa pulmonar, así como describir las estrategias para su diagnóstico y tratamiento. Método. Para el cribado inicial se realizó una prueba de tuberculina (PT) yuna radiografía (Rx) torácica. En caso de duda, se practicaría tomografía axial computerizada (TC) y prueba del QuantiFERON®-TB Gold test. Descartada la infección, se inició tratamiento con isoniazida hasta los 6 meses. A esta edad se practicó una segunda PT. Resultados. Sesenta neonatos fueron expuestos. La PT fue negativa tanto al inicio como a los 6 meses. Un neonato presentaba una imagen dudosa en la radiografía torácica, pero la TC y el QuantiFERON®-TB Gold test fueron normales. El 88,6% de los neonatos iniciaron profilaxis, se contraindicó en el 3% y hubo negativa de los padres en el 8%. Tan sólo un paciente presentó efectos secundarios por isoniazida. El 78% de los casos completó la profilaxis. A los 12 meses no se detectó ningún caso de tuberculosis. Conclusiones. La incidencia de infección tuberculosa en neonatos hospitalizados expuestos es baja, pero, debido a la potencial gravedad, la profilaxis con isoniazida hasta los 6 meses y un cribado precoz con una PT y una Rx torácica pueden ser una estrategia válida para minimizar el riesgo (AU)

Background. Neonates have an increased risk to suffer severe tuber culosis due to their immunosuppressed condition. Objective. To assess the incidence of tuberculosis infection or latent disease in a cohort of newborns exposed to a healthcare worker of the neonatal unit, diagnosed with pulmonary tuberculosis disease, as well as describe diagnostic and treatment strategies. Method. Tuberculin skin test (TST) and chest X-rays were performed at the initial screening. Chest computed tomography (CT) and QuantiFERON®-TB Gold test were performed on cases where chest X-ray was not clear. Once all diagnostic tests were negative, infants were treated with isoniazid up to 6 months of age. At this age, a second TST was performed. Results. 60 newborns were exposed. TST were negative at baseline and at 6 months. One infant had an abnormal chest X-ray, with normal findings on CT and QuantiFERON®-TB Gold test. 88.6% neonates started with prophylaxis, it was contraindicated in 3% and was refused by the parents in 8%. Isoniazid was withdrawn due to side effects in only 1 infant. Prophylaxis was completed by 78% of patients. At 12 months, no cases of tuberculosis were reported. Conclusions. The tuberculous infection incidence in hospitalized neonates exposed is low but, due to the potential severity, prophylaxis with isoniazid until 6 months and an early screening with TST and chest X-ray is a valid strategy to minimized risks (AU)

Pimentas do gênero Capsicum: propriedades e ações terapéuticas / Pimientos del género Capsicum: propiedades y acciones terapéuticas / Capsicum peppers: properties and therapeutic actions

As especies do genero Capsicum L. vem sendo estudadas por pesquisadores do mundo inteiro. A pungencia e o atributo principal das pimentas e as substancias responséveis por esta ardencia sao denominadas de capsaicinoides. O mais estudado ea capsaicina, sua rota biossintetica e atraves da via dos fenilpropanoides e écidos graxos. A capsaicina e um agonista exogeno do receptor TRPV1(transient receptor potential vanilloid type-7). O TRPV1 contem uma subunidade sensivel ao calor responsével pela sensaçao de queimadura causada pela capsaicina. Quando aplicada na pele, promove uma resposta analgesica devido a dessensibilizaçao dos neuronios sensoriais causados pelo esgotamento da substancia P. A meia vida da capsaicina e vinte e quatro horas quando utilizada por via oral. Sua concentraçao maxima atinge o figado, rins e intestino ern uma hora apos administraçao oral. A capsaicina e principalmente eliminada pelos rins, com uma pequena proporçao nao transformada excretada nas fezes e na urina. Na aplicagao topica, a biotransformaçao da capsaicina foi considerada lenta e a maior parte da mesma permaneceu inalterada. A capsaicina e seus anélogos tem sido utilizados em cremes e patches para tratar sindromes de dor cronica como neuralgia pos-herpetica, dores musculoesqueleticas, neuropatia diabetica, osteoartrite e artrite reumatoide. A capsaicina tambem tem atividade antihiperlipidemica, propiedades anti-inflamatorias, antioxidantes e e efetiva no tratamento da dor associada com artrite e cistite. O capsiato, presente nas pimentas vermelhas nao pungentes tambem estimula o receptor TRPV1, sendo capaz de aumentar o metabolismo por estimulagao do sistema nervoso simpético, alem de ser provido de agao antiinflamatoria, porem por mecanismo ainda desconhecido (AU)

Las especies del género Capsicum, han sido estudiadas por los investigadores de todo el mundo. La pungencia es el principal atributo de los pimientos picantes y las sustancias responsables son los capsaicinoides. La capsaicina es la mas estudiada, su ruta biosintética es a través de la vía de fenilpropanoides y ácidos grasos. La capsaicina es un receptor TRPV1 agonista exógeno (receptor de potencial transitorio vaniloide tipo 1). El TRPV1 contiene una subunidad sensible al calor responsable de la sensación de ardor causada por la capsaicina. Cuando se aplica a la piel se promueve una respuesta analgésica debido a la desensibilización de las neuronas sensoriales causadas por el agotamiento de la sustancia P. La Vida media de la capsaicina es de 24 horas cuando se usa por via oral. Su distribución máxima alcanza el hígado, el riñón y el intestino en una hora después de la administración oral. La capsaicina se elimina principalmente por via renal, con una pequefia proporción no transformada excretada en las heces y en la orina. En la aplicación tópica de capsaicina la biotransformación se consideró lenta, y la mayor parte de la misma permaneció inalterada. La capsaicina y sus análogos han sido utilizados en cremas y apósitos para el tratamiento de síndromes de dolor crónico, tales como neuralgia postherpética, dolor musculo esquelético, neuropatía diabética, la osteoartritis y artritis reumatoide. La capsaicina también tiene actividad hipolipemiante, antiinflamatoria, antioxidante y es eficaz en el tratamiento del dolor asociado a artritis y cistitis. El capsiato, presente en pimientos rojos no picantes, también estimula el receptor TRPV1, siendo capaz de aumentar el metabolismo mediante la estimulación del sistema nervioso simpático, y presentando, además, acción antiinflamatoria, por un mecanismo aun desconocido (AU)

The species of the genus Capsicum have been studied by researchers worldwide. Pungency is the main attribute of peppers and it is due to the capsaicinoids. The most studied is capsaicin, biosynthetised through the phenylpropanoid and fatty acid pathway. Capsaicin is an exogenous agonist of TRPV1 receptor (transient receptor potential vanilloid type-1). The TRPV1 contains a subunit sensitive to heat, responsible for the burning sensation caused by capsaicin. When applied to the skin it promotes an analgesic response due to desensitization of sensory neurons caused by the depletion of substance P. The half-life of capsaicin is twenty-four hours when used orally. Its maximum concentration reaches the liver, kidney and intestine one hour after oral administration. Capsaicin is eliminated primarily by kidneys, with a small proportion of untransformed excreted in faeces and urine. After topical application, the biotransformation of capsaicin was considered slow, and it was mostly unchanged. Capsaicin and its analogues have been used in creams and patches to treat chronic pain syndromes, such as postherpetic neuralgia, musculoskeletal pain, diabetic neuropathy, osteoarthritis and rheumatoid arthritis. Capsaicin also has antihyperlipidemic, anti-inflammatory and antioxidant activities, being effective in the treatment of pain associated with arthritis and cystitis. The capsiate, present in non-pungent red peppers, also stimulates the TRPV1 receptor, being able to increase metabolism by stimulating the sympathetic nervous system, and showing, in addition, anti-inflammatory activity by a mechanism still unknown (AU)