Key Nanotechnology Breakthroughs in Cardiovascular Disease Therapy

Abstract Background It is justified by the high population's morbidity and mortality rate, as well as the increasing present use of nanoparticles in this pathological context. Objectives To describe the main nanotechnology breakthroughs in the field of cardiovascular disease (CVD) and disseminate pertinent information in the literature. Methods This is a systematic review conducted between September and October 2021. The review was carried out through basic nature, following the initial script for the selective reading of articles in chronological order to collect relevant and consistent data related to the theme. Results It is evidenced the main advances of nanotechnology in the field of CVDs, namely, acute coronary syndromes (ACSs), heart failure (HF), and systemic arterial hypertension (SAH). Conclusion The importance of further and deeper studies in this area is emphasized, in order to make the already approved treatments feasible, so they can reach all publics at a low cost.

Principais complicações cardíacas em idosos infectados pelo SARS-CoV-2: uma revisão sistemática / Principales complicaciones cardíacas en ancianos infectados por SARS-CoV-2: una revisión sistemática / Main cardiac complications in elderly infected by SARS-CoV-2: a systematic review

Objetivo: compreender as principais complicações ocasionadas pelo vírus SARS-CoV-2 no sistema cardíaco do público idoso. Métodos: trata-se de uma revisão sistemática da literatura de abordagem qualitativa e característica descritivo-exploratória realizada no ano de 2020. Resultados: as complicações cardíacas mais prevalentes na população idosa foram miocardite, arritmias, insuficiência cardíaca, infarto agudo, choque cardiogênico, lesão miocárdica aguda e parada cardiorrespiratória. O principal biomarcador cardíaco foi a troponina, apresentando elevação superior ao percentil 99°, evidenciando a necessidade de tratamento em Unidade de Terapia Intensiva. Considerações Finais: o aparecimento desse vírus causou grande prejuízo no campo da saúde, especialmente a população idosa, que apresenta risco elevado de óbito ao contrair essa doença. Destarte, é de extrema importância se ater a mensuração da troponina sérica no público alvo e realizar monitorização longitudinal, utilizando para tal a telecardiologia, uma vez que diminuem as chances de contaminação entre infectado e profissional de saúde

Objective: to understand the main complications of SARS-CoV-2 in the elderly cardiac system. Methods: systematic literature review conducted in 2020. Results: the most prevalent cardiac complications in the elderly population were myocarditis, arrhythmias, heart failure, acute infarction, cardiogenic shock, acute myocardial injury and cardiorespiratory arrest. The main cardiac biomarker was troponin, showing an elevation above the 99th percentile, evidencing the need for treatment in the Intensive Care Unit. Final Considerations: the appearance of this virus has caused great damage in the health field, especially the elderly population, who is at high risk of death when contracting this disease. Therefore, it is important to stick to the measurement of serum troponin in the target audience and perform longitudinal monitoring, using telecardiology for this purpose, since they reduce the chances of contamination between infected and health professionals

Objetivo: comprender las principales complicaciones del SARS-CoV-2 en el sistema cardíaco anciano. Métodos: revisión sistemática de la literatura realizada en 2020. Resultados: las complicaciones cardíacas más prevalentes en la población anciana fueron miocarditis, arritmias, insuficiencia cardíaca, infarto agudo, shock cardiogénico, lesión miocárdica aguda y parada cardiorrespiratoria. El principal biomarcador cardíaco fue la troponina, mostrando una elevación por encima del percentil 99, evidenciando la necesidad de tratamiento en la Unidad de Cuidados Intensivos. Consideraciones finales: la aparición de este virus ha provocado un gran daño en el campo de la salud, especialmente en la población anciana, que se encuentra en alto riesgo de muerte al contraer esta enfermedad. Por tanto, es importante ceñirse a la medición de troponina sérica en el público objetivo y realizar un seguimiento longitudinal, utilizando para ello la telecardiología, ya que reducen las posibilidades de contaminación entre los infectados y los profesionales sanitarios

Cine­picc: satisfaction and knowledge following a video and hands-on training on peripherally inserted central catheter

Introduction: This study assessed the knowledge and satisfaction of a nursing staff regarding peripherally inserted central catheter (PICC) care before and after a combined training strategy consisting of a video and hands-on practice.Methods: A cross-sectional and prospective study with data collection held at a public university hospital from March 2018 to May 2018 and in March 2019. Participants answered a pre-test about PICC lines, watched a video on PICC care and maintenance, attended hands-on sessions, and answered a post-test.Results: A total of 520 professionals participated in the study, of which 87.4% were from the nursing staff. The pre-test was answered by 211 individuals and the post-test questions were answered by 203 people. The satisfaction research showed 97% of satisfied respondents.Conclusions: Our results indicate that a change from the traditional training model to an active educational approach reached more participants, representing an innovative pedagogical tool in the training of critical and reflexive professionals.

Evolutive study of rheumatic carditis cases treated with corticosteroids in a Public Hospital / Estudo evolutivo de casos de cardite reumática tratados com corticosteróides em um hospital público

Background: Rheumatic carditis is a challenge for treatment and secondary prophylaxis, due to severe valve sequelae. Objective: To evaluate the cases of rheumatic carditis in patients under 18 years old treated with corticosteroids.Methods: An observational, longitudinal and retrospective study was carried out on the profile of patients, in the period of 2000-2015. We selected those who received corticosteroid therapy at immunosuppressive doses, for the treatment of carditis and were aged 5 to 18 years. Data were extracted from medical records. Calculations of: averages, standard deviations, medians and interquartile ranges, ratios and 95% confidence intervals were obtained. Chi-square and Wilcoxon tests were applied for comparisons. The level of significance was 5%. Results: Of the 93 cases, 93.53% developed moderate or severe carditis. Mitral regurgitation was detected in 100% of the sample. Pulse therapy was administered in 11.83%. Surgery was performed in 23.69% of patients: mitral, aortic and/or tricuspid valve repair or replacement. The evolution of the cases was favorable in 70.96%. There was a good response among those who received only clinical treatment and those who belonged to the surgical group. The comparison of the initial and posterior valve lesions to the corticoid use was statistically significant (p < 0.001). A difference between the ejection fraction medians was observed (p = 0.048). Hospitalization was required twice or more for 45.16% of the patients. The mortality rate was 5.38%.Conclusions: The patients showed significant clinical improvement. The treatment was effective, reducing trivalvular impairment

Aquisição de habilidades em cirurgia videolaparoscópica por residentes em cirurgia geral após treinamento em um simulador de alta fidelidade / Acquisition of skills in videolaparoscopic surgery by residents in general surgery after training in a high fidelity simulator

OBJETIVOS: Observar a aquisição de habilidades em cirurgia videolaparoscópica em um grupo de residentes de cirurgia geral após o treinamento em simulador de alta fidelidade. MÉTODOS: Série de casos com abordagem qualitativa, descritiva e aplicada. Os participantes foram residentes de cirurgia geral que já haviam cursado o módulo de técnicas cirúrgicas e realizado o treinamento em um simulador de videolaparoscopia de alta fidelidade. A coleta de dados foi realizada por meio de um questionário semiestruturado aplicado aos residentes após o treinamento e de entrevistas com os preceptores cirurgiões, gravadas entre um ano e um ano e meio após o treinamento, quando os residentes já estavam realizando o procedimento em pacientes reais. RESULTADOS: De acordo com os critérios de inclusão, foram analisadas as respostas de sete residentes de cirurgia geral. Após o treinamento em simulador os residentes relataram adquirir habilidades em procedimentos videolaparoscópicos. Dois dos residentes entrevistados mencionaram que tiveram dificuldades na execução das tarefas devido à alta sensibilidade exigida pelo simulador em alguns procedimentos. A metodologia dos "seis passos", utilizada durante o treinamento no simulador, foi bem aceita pelos residentes. Foi apontada a importância da presença de um tutor durante o uso do simulador. Os preceptores de cirurgia videolaparoscópica relataram que as habilidades adquiridas pelos residentes após o treinamento no simulador de alta fidelidade foram transferidas para o mesmo procedimento em pacientes reais. CONCLUSÕES: O presente estudo permite concluir que, de acordo com a percepção técnica e críticas dos residentes e dos preceptores do programa de residência médica em cirurgia geral, o treinamento padronizado utilizando o simulador de cirurgia videolaparoscópica de alta fidelidade mostrou-se eficiente para aquisição de habilidades por esse grupo de residentes, inclusive em posteriores procedimentos cirúrgicos em pacientes reais.

AIMS: To observe the acquisition of skills in videolaparoscopic surgery in a group of residents of general surgery, after training in a high fidelity simulator. METHODS: Case series with a qualitative, descriptive and applied approach. The participants were residents of general surgery who had already completed the surgical techniques module and accomplished the training in a high-fidelity simulator of videolaparoscopy. Data were collected through a semi-structured questionnaire applied to the residents after the training and interviews with the preceptors surgeons, recorded between one year and a year and a half after the training, when the residents were already performing the procedure in real patients. RESULTS: According to the inclusion criteria, the responses of seven general surgery residents were analyzed. After simulator training, they reported to have acquired skills in videolaparoscopic procedures. Two among the interviewed residents mentioned that they have had difficulties in performing the tasks due to the high sensitivity required by the simulator in some procedures. The "Six-Steps" methodology used during simulator training was well accepted by the residents. The importance of the presence of a tutor during the use of the simulator was pointed out. The videolaparoscopic surgery preceptors reported that skills acquired by the residents after training in the high-fidelity simulator were transferred to the same procedure in real patients. CONCLUSIONS: The present study allows to conclude that, according to the technical perception and criticals of residents and preceptors of the medical residency program in general surgery, the standardized training using the high-fidelity videolaparoscopic surgery simulator has proved to be effective for skills acquisition by this group of residents, including future surgical procedures in real patients.

Identification of dysregulated microRNA expression and their potential role in the antiproliferative effect of the essential oils from four different Lippia species against the CT26.WT colon tumor cell line

ABSTRACT In spite of advances in colorectal cancer treatments, approximately 1.4 million new global cases are estimated for 2015. In this sense, Brazilian plant diversity offers a multiplicity of essential oils as prospective novel anticancer compounds. This study aimed to evaluate the antiproliferative effect of the essential oils from four Lippia species in CT26.WT colon tumor cells, as a measurement of cell cycle phase distribution and microRNA expression. CT26.WT showed cell cycle arrest at G2/M phase after treatment with 100 µg/ml of Lippia alba (Mill.) N.E.Br. ex Britton & P. Wilson, Lippia sidoides Cham., and Lippia lacunosa Mart. & Schauer, Verbenaceae, essential oils and, at the same concentration, Lippia rotundifolia Cham. essential oil caused an augment of G0/G1 phase. The miRNA expression profiling shows change of expression in key oncogenic miRNAs genes after treatment. Our findings suggest growth inhibition mechanisms for all four essential oils on CT26.WT cells involving direct or indirect interference on cell cycle arrest and/or oncogenic miRNAs expression.

Biodistribution, pharmacokinetics and toxicity of a Vasconcellea cundinamarcensis proteinase fraction with pharmacological activity

Abstract Prior studies demonstrate that a proteinase fraction from Vasconcellea cundinamarcensis V.M. Badillo, Caricaceae, exhibits wound healing activity in gastric and cutaneous models and antitumoral/antimetastatic effects. Here, we present the toxicity, pharmacokinetics and biodistribution data for this proteinase fraction following a single dose into Swiss mice by i.v., s.c. or p.o. routes. The i.v. and s.c. toxicity assays demonstrate that proteinase fraction at ≤20 mg/kg is non-lethal after single injection, while parental administration (p.o.) of ≤300 mg/kg does not cause death. Based on p.o. acute toxicity dose using Organisation for Economic Cooperation and Development protocols, proteinase fraction ranks as Class IV “harmful” substance. Proteinase fraction shows high uptake determined as Kp (distribution tissue/blood) in organs linked to metabolism and excretion. Also, high bioavailability (≈100%) was observed by s.c. administration. The blood contents following i.v. dose fits into a pharmacokinetic bi-compartmental model, consisting of high removal constants – kel 0.22 h−1 and kd 2.32 h−1and a half-life – t½ = 3.13 h. The Ames test of proteinase fraction (0.01–1%) demonstrates absence of mutagenic activity. Likewise, genotoxic evaluation of proteinase fraction (5 or 10 mg/kg, i.p.) shows no influence in micronuclei frequency. In conclusion, the acute doses for proteinase fraction lack mutagenic and genotoxic activity, clearing the way for clinical assays.

Comparação da contenção farmacológica com cetamina e xilazina, administradas pela via intramuscular no membro torácico ou pélvico, em jacarés-do-papo-amarelo juvenis / Comparison of pharmacological restraint with ketamine and xylazine, administered intramuscularly in the forelimb or hindlimb, in broad-snouted caiman juveniles

Os répteis possuem um sistema porta-renal, o qual pode desviar parte do sangue proveniente das porções caudais do corpo aos rins antes que a mesma atinja a circulação sistêmica. Em vista disto, vem sendo aconselhada a administração de medicamentos injetáveis nos membros torácicos, para que se evite a filtração imediata pelo parênquima renal, causando redução do efeito esperado. O objetivo do presente estudo foi comparar aspectos qualitativos e quantitativos da associação de cetamina (30 mg/kg) e xilazina (1 mg/kg), injetada no membro torácico ou pélvico, em jacarés-do-papo-amarelo (Caiman latirostris) juvenis. Oito animais machos com peso médio (±DP) de 1,3 (±0,3) kg e, aproximadamente, dois anos de idade foram anestesiados em duas ocasiões distintas com intervalo de sete dias. Em cada ocasião, os animais receberam, de forma aleatória, a associação anestésica por via intramuscular em membro torácico (tratamento MT) ou pélvico (tratamento MP). Foram avaliados os intervalos de tempo entre a administração do tratamento e a perda do reflexo de endireitamento (período de indução), entre a perda e o retorno desse reflexo (duração do efeito clínico importante) e entre o retorno do reflexo de endireitamento e os primeiros movimentos de deambulação (duração do efeito residual), as frequências cardíaca e respiratória e as temperaturas ambiental e cloacal. Os escores de sedação/anestesia foram avaliados através de uma escala com variação de 0 (alerta/consciente) a 10 (anestesia profunda/sobredosagem). No tratamento MP, dois animais não apresentaram perda de reflexo de endireitamento. Considerando somente aqueles que apresentaram a perda desse reflexo, o tempo de indução (21±9 e 17±5 minutos) e a duração do efeito clínico importante (35±19 e 43±21 minutos) e residual (28±31 e 12±11 minutos) foram similares entre os tratamentos MT e MP (média±desvio padrão)...

Reptiles possess a renal portal system which can divert part of the blood from the caudal portions of the body to the kidney before it reaches the systemic circulation. In view of this, it has been recommended the administration of injectable medications in the forelimbs, in order to avoid immediate glomerular filtration, which might result in a reduction of the expected effect. The aim of this study was to compare qualitative and quantitative aspects of the pharmacological restraint provided by the combination of ketamine (30mg/kg) and xylazine (1mg/kg), injected into the forelimb or hindlimb, in broad-snouted caiman juveniles (Caiman latirostris). Eight male animals, with a mean weight (±SD) of 1.3 (±0.3) kg, and aged about 2 years old, were anesthetized on two separate occasions with an interval of 7 days. On each occasion, the animals were randomly assigned to receive the anesthetic combination intramuscularly into the forelimb (FL treatment) or hindlimb (HL treatment). The time intervals between administration of treatment and loss of the righting reflex (induction time), between the loss and return of this reflex (duration of important clinical effect), and between the return of the righting reflex and first movements of ambulation (duration of residual effect) were measured as well as heart and respiratory rates and cloacal and environmental temperatures. Sedation/anesthesia scores were evaluated using a scale ranging from 0 (alert/conscious) to 10 (deep anesthesia/overdose). In the HL treatment, loss of righting reflex was not observed in two animals. Considering only those animals whose loss of righting reflex was observed, the induction time (21±9 and 17±5 minutes), the duration of important clinical effect (35±19 and 43±21 minutes), and the duration of residual effect (28±31 and 12±11 minutes) were similar between the FL and HL treatments, respectively (mean±SD). Sedation/anesthesia scores were significantly higher than at baseline...

The effect of the essential oils from five different Lippia species on the viability of tumor cell lines

Several Lippia species have been used in folk medicine mainly for gastrointestinal and respiratory diseases. Their biological properties have been partially associated to the terpenoids found in their essential oils. According to the World Health Organization, cancer is the leading cause of death worldwide and is described as a complex group of diseases with several hallmarks. One of its acceptable defining features is the cell proliferation beyond their boundaries forming the tumors. Importantly, some drugs currently available were discovered by the investigation of plant secondary metabolites. Thus, this study aimed to evaluate in vitro cytotoxic effect of the essential oils extracted from five Lippia species against tumor cell lines. The results indicated that mouse colon carcinoma CT26.WT cell line viability was significantly reduced showing an IC50 of 19.05, 30.20 and 36.30 µg/ml when treated with the essential oils of L. sidoides, L. salviifolia and L. rotundifolia, respectively. Human lung carcinoma A549 cell line also had a compromised viability to the action of L. alba carvone chemotype essential oil. The tested essential oils did not compromise viability of the normal cell line CHO. These finds suggest that the studied Lippia essential oils might be good candidates for further in-depth studies.

The influence of low dose of doxycycline on induced periodontitis associated with occlusal overload / A influência de baixas doses de doxicilina sobre a periodontite induzida associada à sobre carga oclusal

A degradação dos tecidos de suporte periodontal é o principal evento biológico da doença periodontal. O objetivo deste estudo foi avaliar a influência do uso sistêmico de baixas doses de doxiciclina (BDD) sobre o suporte ósseo periodontal (SOP) e a perda de inserção (PI) na periodontite induzida associada à sobrecarga oclusal em ratas. Neste estudo foram utilizadas 25 ratas Wistar pesando 250g, divididas em 5 grupos (n=5): GC (controle), GL (ligadura);GO (sobrecarga oclusal); GLO (ligadura e sobrecarga oclusal); GLOD (ligadura sobrecarga oclusal e doxiciclina). A periodontite foi induzida pela inserção de uma ligadura ao redor do 1º molar inferior (1MI) permanecendo por 28 dias. Para que o 1MI ficasse em sobrecarga oclusal, as superfícies oclusais do 2º e 3º molares superiores foram desgastadas. Os animais do grupo GLOD receberam 0,14 mg de doxiciclina por via oral diariamente por todo o período experimental. Os animais foram sacrificados e as hemimandíbulas direitas foram analisadas por meio de radiografias digitais quanto ao SOP (%) e as hemi-mandíbulas direitas foram processadas para a análise histopatológica da PI (mm). Os valores médios foram submetidos à análise de variância (ANOVA/Tukey) ao nível de 5%. Os resultados para SOP em GC (55.49±4.86) e GO (60.03±3.37) foram iguais entre si e diferentes de GL(46.73±4.80), GLO (51.69±2.84) e GLOD (57.76±4.50)(p=0.001). Considerando a PI, GC (0.11±0.07) and GO(0.12±0.10mm) foram semelhantes entre si e diferentes de GL (0.41±0.09), GLO (0.58±0.12) e GLOD (0.54±0.12)(p=0.0001). Em conclusão, o uso de BDD pareceu não modular a redução de SOP ou PI em ratas com periodontite induzida e sobrecarga oclusal.

Periodontium support degradation is the main biologica levent in periodontal disease. The aim of this study was to evaluate the influence of systemic use of a low-dose of doxycycline (LDD) on periodontal bone support (PBS) and attachment loss (AL) in induced periodontitis associated with occlusal overload in rats. This study used 25 female Wistar rats weighing 250g, divided into 5 groups (n=5): CG(control group), LG (ligature group); OG (occlusal overload); LOG (ligature and occlusal overload); LOGD (ligature, occlusal overload and doxycycline). Periodontitis was induced by inserting a ligature around the first mandibular molar (1MDM) for 28 days. In order to obtain occlusal overload at the 1MDM, the occlusal surfaces of the second and third maxillary molars (2MXM and 3MXM) were flattened. 0.14mg of doxycycline was orally administered every day to the LOGD group rats during the experimental period. The rats were sacrificed and the righthemi-mandibles were analyzed by digital radiograph of the PBS(%), whereas the left hemi-mandible was processed for histopathological analysis of AL(mm). The mean values were treated using ANOVA and the Tukey test at 5% level. Results for PBS in the CG (55.49±4.86%) and OG (60.03±3.37%) groups were similar to each other and statistically different from the LG (46.73±4.80%), LOG (51.69±2.84%) and LOGD (57.76±4.50%) groups (p=0.001). For AL, CG(0.11±0.07mm) and OG (0.12±0.10mm) were similar to eachother and statistically different from LG (0.41±0.09mm), LOG 0.58±0.12mm) and LOGD (0.54±0.12mm) (p=0.0001). In conclusion, the use of LDD appears not to modulate PBS orAL reduction in rats with periodontitis associated with occlusal overload

Spatial variation of five co-existing siluriformes in an atlantic rain forest drainage

Five species of Siluriformes were registered in the Ubatiba system. Pimelodella lateristriga was the dominant one, followed by Hypostomus gr. punctatus, Rineloricaria sp., Callichthys callichthys and Rhamdia sp. Simple correlation analysis between species density and habitat parameters indicated that hydrology explained density patterns of four species. Pimelodella densities were negatively correlated with pools, Callichthys and Hypostomus densities were positively correlated with runs and Rhamdia densities were positively correlated with riffles; Rineloricaria densities did not respond to any hydrological parameter. Substrata were an important factor to all species, but specific preferences were observed. Marginal vegetation was positively correlated only to Pimelodella densities. Sorensen dissimilarity analysis indicated that site groups, based on both species composition and habitat parameters, were very similar and corroborated the correlation analysis suggesting that Siluriformes composition should be explained by many habitat parameters. Analysis of co-variation of species densities at each sampling occasion showed to be statistically similar in at least all (100 percent) analysed cases indicating that Siluriformes composition was strongly persistent in time.

Cinco espécies de Siluriformes foram registradas no sistema fluvial do rio Ubatiba, Pimelodella lateristriga foi a espécie dominante seguida de Hypostomus gr. punctatus, Rineloricaria sp., Callichthys callichthys e Rhamdia sp. Análises de correlação simples entre as densidades das espécies e as variáveis de hábitat indicaram que a hidrologia explicou os padrões de densidade de quatro espécies; as densidades de Pimelodella foram negativamente correlacionadas com a presença de poças, as densidades de Callichthys e Hypostomus foram positivamente correlacionadas com os rápidos e as densidades de Rhamdia foram positivamente correlacionadas com as corredeiras; as densidades de Rineloricaria não responderam a nenhum dos parâmetros hydrológicos analisados. O substrato foi um importante fator para todas as espécies, mas preferências específicas foram observadas. A vegetação marginal foi positivamente correlacionada apenas com as densidades de Pimelodella. A análise de dissimilaridade de Sorensen indicou que os grupos de localidades que se formaram com base tanto na composição de espécies como nas variáveis de hábitat foram muito semelhantes e corroboraram os resultados das análises de correlação, sugerindo que a composição de Siluriformes do rio Ubatiba pode ser explicada por várias características do hábitat. As análises de co-variância das densidades das espécies em cada momento amostral mostraram-se significativamente similares em todos (100 por cento) os casos analisados, indicando que a composição de Siluriformes é persistente e se mantém em escala temporal.

Assistência à criança e ao adolescente com câncer: a fase da quimioterapia intratecal / Caring for children and adolescents with cancer: the intrathecal chemotherapy phase

O objetivo do presente trabalho é explorar as vivências de crianças e adolescentes com câncer, durante a fase de quimioterapia intratecal, através de abordagem qualitativa com coleta de dados empíricos realizada a partir de entrevista semi-estruturada. Participaram do estudo onze crianças/adolescentes que receberam quimioterapia intratecal, na faixa etária de 07 a 16 anos, de ambos os sexos, atendidos em um hospital-escola do interior do estado de São Paulo. Os resultados convergiram para os seguintes temas: rotina da intratecal; medo, dor e fantasias e estratégias de alívio. Este trabalho possibilitou o acesso a informações de real interesse para a assistência às crianças/adolescentes, durante a fase da quimioterapia intratecal, situação tida como uma das mais estressantes. Quanto às implicações para a enfermagem, identificou-se que a informação é vital para crianças/adolescentes com câncer, pois ela poderá minimizar incertezas e sentimentos negativos, levando-os a colaborar e a participar do tratamento