Chemical Composition and Evaluation of Antibacterial, Antibiofilm, and Mutagenic Potentials of a Propolis Sample from the Atlantic Forest of Midwest Brazil.

Sixteen triterpenoids with various skeletal types, five phenylpropanoid derivatives, and two flavonoids were isolated from a propolis sample produced by Apis mellifera collected in the Atlantic Forest of Midwest Brazil. Among these compounds, six triterpenes, namely 3ß,20R-dihydroxylanost-24-en-3-yl-palmitate, (23E)-25-methoxycycloartan-23-en-3-one, 24-methylenecycloartenone, epi-lupeol, epi-α-amyrin, and epi-ß-amyrin are being reported for the first time in propolis, while cycloartenone, (E)-cinnamyl benzoate, and (E)-cinnamyl cinnamate are new findings in Brazilian propolis. The presence of cycloartane- and lanostane-type triterpenoids, the latter being a class of compounds of restricted distribution in propolis worldwide, has not been reported in propolis from Midwest Brazil until now. The ethyl acetate phase obtained from the ethanol extract was effective in preventing biofilm formation by Staphylococcus aureus, with an inhibition rate of about 96 % at 0.5 mg.mL-1 , and with quercetin isolated as one of its active constituents. In contrast, the hexane phase exhibited notable antibacterial activity against Pseudomonas aeruginosa, inhibiting bacterial growth by 92 % at 0.5 mg.mL-1 ; however, none of the triterpenoids isolated from this phase proved active against this pathogen. The ethanol extract was neither toxic nor mutagenic at the concentrations tested, as determined by the in vivo SMART assay on Drosophila melanogaster, even under conditions of high metabolic activation.

Construction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study.

OBJECTIVES: to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential. METHODS: a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis. RESULTS: four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context. FINAL CONSIDERATIONS: the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.

A qualitative approach on long-term indwelling catheter use in an outpatient setting. / Uma abordagem qualitativa sobre o uso do cateter urinário de longo prazo no contexto ambulatorial.

A long-term indwelling catheter may be indicated in clinical situations, such as chronic diseases of the genitourinary or neurological systems. In addition to the risks of infection, trauma, and bleeding, a catheter's permanence can affect psycho-emotional and socioeconomic dimensions. We aimed to understand how the need to use a long-term indwelling catheter affects this patient's self-perception, interrelationships, and self-care. We carried out a qualitative, descriptive study based on interviews with 17 patients, and applied thematic analysis and complex thinking. The different prognoses and expectations regarding the catheter influenced self-perception, adaptation, acceptance, or denial. The presence of a catheter, whether as a curative measure or for comfort, can affect self-image and sexuality, and generate insecurities and uncertainties, which require understanding the multidimensionality of situations that suffer interference from the personal, family, and social environment, as well as health systems' capacity to deal with it. Despite the challenges, the majority of participants reported a favorable disposition towards self-care, whether to enable catheter removal or to prevent injuries in lifelong indications.

O cateter vesical de longa permanência pode ser indicado em situações clínicas, como nas doenças crônicas do sistema genitourinário ou neurológico. Além dos riscos de infecção, traumas e sangramentos, a permanência do cateter pode afetar dimensões psicoemocionais e socioeconômicas. Objetivamos compreender como a necessidade de uso do cateter urinário por um longo prazo afeta a autopercepção, as interrelações e o autocuidado deste paciente. Realizamos um estudo qualitativo, descritivo, a partir da entrevista de 17 pacientes, e aplicamos a análise temática e o pensamento complexo. Os diferentes prognósticos e as expectativas em relação ao cateter influenciaram a autopercepção, a adaptação, sua aceitação ou negação. A presença do cateter, seja como medida curativa ou para conforto, pode afetar a autoimagem e a sexualidade, gerar inseguranças e incertezas, que requerem compreensão da multidimensionalidade das situações, que sofrem interferências do meio pessoal, familiar e social, bem como da capacidade dos sistemas de saúde para o seu enfrentamento. Apesar dos desafios, a maioria dos participantes relatou disposição favorável para o autocuidado, seja para viabilizar retirada do cateter, ou para prevenir agravos em indicações vitalícias.

The Organization of Home Palliative Cancer Care by Primary Health Care: A Systematic Review Protocol.

Greater longevity and chronic diseases, such as cancer, require (re)organization of care for the sustainability of health systems and better quality of life. Palliative care organized by primary health care has positive outcomes, changing standards of care at the end of life, reducing hospitalizations and health costs and contributing to people's autonomy to stay at home with controlled symptoms. However, in many countries, this is not possible because the provision of palliative cancer care is isolated or generalized, concentrated in the hospital, and without the strategic participation of primary care. In many developed countries, where palliative care is offered in an integrated way, home care has increased the people's chances of receiving dignified care at the end of life. The aim of this review is to evaluate the organization of home palliative cancer care by primary care to improve the use of health resources and the quality of life of such patients. This systematic review protocol follows the Cochrane methodology to provide a narrative synthesis, with the resulting report guided by the Preferred Reporting Items for Systematic Reviews (PRISMA).

Medicinal plant Miconia albicans synergizes with ampicillin and ciprofloxacin against multi-drug resistant Acinetobacter baumannii and Staphylococcus aureus.

BACKGROUND: Given the rising occurrence of antibiotic resistance due to the existence and ongoing development of resistant bacteria and phenotypes, the identification of new treatments and sources of antimicrobial agents is of utmost urgency. An important strategy for tackling bacterial resistance involves the utilization of drug combinations, and natural products derived from plants hold significant potential as a rich source of bioactive compounds that can act as effective adjuvants. This study, therefore, aimed to assess the antibacterial potential and the chemical composition of Miconia albicans, a Brazilian medicinal plant used to treat various diseases. METHODS: Ethanolic extracts from leaves and stems of M. albicans were obtained and subsequently partitioned to give the corresponding hexane, chloroform, ethyl acetate, and hydromethanolic phases. All extracts and phases had their chemical constitution investigated by HPLC-DAD-MS/MS and GC-MS and were assessed for their antibiofilm and antimicrobial efficacy against Staphylococcus aureus. Furthermore, their individual effects and synergistic potential in combination with antibiotics were examined against clinical strains of both S. aureus and Acinetobacter baumannii. In addition, 10 isolated compounds were obtained from the leaves phases and used for confirmation of the chemical profiles and for antibacterial assays. RESULTS: Based on the chemical profile analysis, 32 compounds were successfully or tentatively identified, including gallic and ellagic acid derivatives, flavonol glycosides, triterpenes and pheophorbides. Extracts and phases obtained from the medicinal plant M. albicans demonstrated synergistic effects when combined with the commercial antibiotics ampicillin and ciprofloxacin, against multi-drug resistant bacteria S. aureus and A. baumannii, restoring their antibacterial efficacy. Extracts and phases also exhibited antibiofilm property against S. aureus. Three key compounds commonly found in the samples, namely gallic acid, quercitrin, and corosolic acid, did not exhibit significant antibacterial activity when assessed individually or in combination with antibiotics against clinical bacterial strains. CONCLUSIONS: Our findings reveal that M. albicans exhibits remarkable adjuvant potential for enhancing the effectiveness of antimicrobial drugs against resistant bacteria.

Antimicrobial Activity of Extracts from the Humiria balsamifera (Aubl).

Humiria balsamifera (Aubl), commonly known as "mirim", is a plant of the Humiriaceae family, which consists of 39 species divided between eight genera: Duckesia, Endopleura, Humiria, Humiriastrum, Hylocara, Sacoglottis, Schistostemon, and Vantenea. This study aimed to characterize H. balsamifera extracts by LC-MS/MS and evaluate their antimicrobial potential through in vitro and in vivo assays. The leaves and stem bark of H. balsamifera were collected and dried at room temperature and then ground in a knife mill. The extracts were prepared with organic solvents in order to increase the polarity index (hexane, ethyl acetate, and methanol). The antimicrobial effects of these extracts were evaluated against the following bacterial strains: Escherichia coli ATCC 25922, Listeria monocytogenes ATCC 15313, Salmonella enterica Typhimurium ATCC 14028, and Staphylococcus aureus ATCC 6538. The best activity was observed in the ethyl acetate (EALE = 780 µg/mL), methanol (MLE = 780 µg/mL), and hexane (HLE = 1560 µg/mL) leaf extracts against S. aureus. Considering the results for both antimicrobial and antibiofilm activities, the EALE extract was chosen to proceed to the infection assays, which used Tenebrio molitor larvae. The EALE treatment was able to extend the average lifespan of the larvae (6.5 days) in comparison to S. aureus-infected larvae (1 day). Next, the samples were characterized by High-Performance Liquid Chromatography coupled to a mass spectrometer, allowing the identification of 11 substances, including seven flavonoids, substances whose antimicrobial activity is already well-reported in the literature. The number of bioactive compounds found in the chemical composition of H. balsamifera emphasizes its significance in both traditional medicine and scientific research that studies new treatments based on substances from the Brazilian flora.

The latex of Euphorbia tirucalli inhibits staphyloxanthin production and protects Tenebrio molitor larvae against Staphylococcus aureus infection.

The latex of Euphorbia tirucalli L. (LET) has great etnopharmacological relevance for several traditional communities. In this study, the in vitro and in vivo (using Tenebrio molitor larvae) antimicrobial effects of LET were evaluated. LET did not inhibit the growth of S. aureus, however, a reduction on staphyloxanthin production (an important virulence factor of S. aureus) was observed. LET (at 10 µL/kg) was also able to enhance the survival of larvae infected with a lethal dose of S. aureus, an effect associated with reduction in the numbers of haemocytes. Furthermore, haemocytes from LET-treated larvae exhibited dysfunctional lysosome activity. These results indicate the effectiveness of LET as an anti-infective agent which could be useful as source of lead molecules for the development of new therapies against S. aureus-induced infections.

Construction and enhancement of a prototype for a medical-hospital equipment for hypodermoclysis: a qualitative study / Construcción y mejora del prototipo de un equipo médico-hospitalario para hipodermoclisis: estudio cualitativo / Construção e aprimoramento do protótipo de um equipamento médico-hospitalar para hipodermóclise: estudo qualitativo

ABSTRACT Objectives: to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential. Methods: a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis. Results: four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context. Final Considerations: the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.

RESUMEN Objetivos: construir un prototipo semifuncional del Dispositivo de Hidratación Subcutánea y recopilar información inicial para mejorar el diseño de este prototipo y aprovechar su potencial de aceptación. Métodos: estudio cualitativo, descriptivo y exploratorio, que utilizó un grupo focal, siguiendo el Technology Acceptance Model. El grupo se llevó a cabo en la Escola Superior de Enfermagem de Coimbra, Portugal, en diciembre de 2022, estuvo compuesto por nueve participantes de seis áreas disciplinarias diferentes y siguió un análisis temático. Resultados: surgieron cuatro temas asociados a los componentes del dispositivo: bomba de infusión elastomérica; aguja/dispositivo de acceso; dispositivo de apertura/cierre (clamp); tuberías/equipos. A partir de estos temas se desencadenaron tópicos que resaltaron: características de la población objetivo; facilidad de uso y accesorios; comodidad y seguridad del paciente; y contexto de aplicación del dispositivo. Consideraciones Finales: el prototipo semifuncional del Dispositivo de Hidratación Subcutánea es viable e interesante para la clínica. Los resultados apoyan su mejora y dirigen futuras inversiones para estudios experimentales.

RESUMO Objetivos: construir protótipo semifuncional do Dispositivo de Hidratação Subcutânea e reunir informações iniciais para aprimorar o design desse protótipo e perceber seu potencial de aceitação. Métodos: estudo qualitativo, descritivo e exploratório, que utilizou o grupo focal, seguindo o Technology Acceptance Model. O grupo foi realizado na Escola Superior de Enfermagem de Coimbra, Portugal, em dezembro de 2022, composto por nove participantes de seis áreas disciplinares distintas, e seguiu a análise temática. Resultados: emergiram quatro temas associados aos componentes do dispositivo: bomba de infusão elastomérica; agulha/dispositivo de acesso; dispositivo de abrir/fechar (clamp); tubuladura/equipamento. A partir desses temas, foram desencadeados tópicos que destacaram: características acerca da população-alvo; facilidade de uso e acessórios; conforto e segurança do paciente; e contexto de aplicação do dispositivo. Considerações Finais: o protótipo semifuncional do Dispositivo de Hidratação Subcutânea é viável e interessante para a clínica. Os resultados subsidiam seu aprimoramento e direcionam futuros investimentos para estudo experimental.

Uma abordagem qualitativa sobre o uso do cateter urinário de longo prazo no contexto ambulatorial / A qualitative approach on long-term indwelling catheter use in an outpatient setting

Resumo O cateter vesical de longa permanência pode ser indicado em situações clínicas, como nas doenças crônicas do sistema genitourinário ou neurológico. Além dos riscos de infecção, traumas e sangramentos, a permanência do cateter pode afetar dimensões psicoemocionais e socioeconômicas. Objetivamos compreender como a necessidade de uso do cateter urinário por um longo prazo afeta a autopercepção, as interrelações e o autocuidado deste paciente. Realizamos um estudo qualitativo, descritivo, a partir da entrevista de 17 pacientes, e aplicamos a análise temática e o pensamento complexo. Os diferentes prognósticos e as expectativas em relação ao cateter influenciaram a autopercepção, a adaptação, sua aceitação ou negação. A presença do cateter, seja como medida curativa ou para conforto, pode afetar a autoimagem e a sexualidade, gerar inseguranças e incertezas, que requerem compreensão da multidimensionalidade das situações, que sofrem interferências do meio pessoal, familiar e social, bem como da capacidade dos sistemas de saúde para o seu enfrentamento. Apesar dos desafios, a maioria dos participantes relatou disposição favorável para o autocuidado, seja para viabilizar retirada do cateter, ou para prevenir agravos em indicações vitalícias.

Abstract A long-term indwelling catheter may be indicated in clinical situations, such as chronic diseases of the genitourinary or neurological systems. In addition to the risks of infection, trauma, and bleeding, a catheter's permanence can affect psycho-emotional and socioeconomic dimensions. We aimed to understand how the need to use a long-term indwelling catheter affects this patient's self-perception, interrelationships, and self-care. We carried out a qualitative, descriptive study based on interviews with 17 patients, and applied thematic analysis and complex thinking. The different prognoses and expectations regarding the catheter influenced self-perception, adaptation, acceptance, or denial. The presence of a catheter, whether as a curative measure or for comfort, can affect self-image and sexuality, and generate insecurities and uncertainties, which require understanding the multidimensionality of situations that suffer interference from the personal, family, and social environment, as well as health systems' capacity to deal with it. Despite the challenges, the majority of participants reported a favorable disposition towards self-care, whether to enable catheter removal or to prevent injuries in lifelong indications.