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1.
Rev. bras. ter. intensiva ; 34(1): 96-106, jan.-mar. 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1388047

ABSTRACT

RESUMO Introdução: A reversão precoce da hipoperfusão tecidual induzida é essencial para a sobrevida no choque séptico. No entanto, falta consenso sobre a melhor estratégia de ressuscitação inicial, uma vez que intervenções destinadas a toda a população com choque séptico podem produzir administração desnecessária de líquidos. Este artigo relata a justificativa, o delineamento e o plano de análise do estudo ANDROMEDA-2, que visa determinar se uma estratégia guiada por perfusão periférica, que consiste na ressuscitação guiada pelo tempo de enchimento capilar com base em fenótipos clínicos e hemodinâmicos, está associada a uma diminuição no desfecho composto de mortalidade, tempo até a interrupção ao suporte de órgãos e tempo de internação em comparação com o atendimento padrão em pacientes com choque séptico precoce (< 4 horas do diagnóstico). Metódos: O estudo ANDROMEDA-2 é um ensaio clínico randomizado controlado multinacional e multicêntrico. No grupo de intervenção, o tempo de enchimento capilar será medido a cada hora, durante 6 horas. Se estiver anormal, os pacientes serão alocados em um algoritmo, começando com a avaliação da pressão de pulso. Pacientes com pressão de pulso inferior a 40mmHg serão testados quanto à capacidade de resposta a líquidos e receberão líquidos de acordo. Em pacientes com pressão de pulso > 40mmHg, norepinefrina será titulada para manter a pressão arterial diastólica > 50mmHg. Os pacientes que não normalizarem o tempo de enchimento capilar após as etapas anteriores serão submetidos à ecocardiografia de cuidados intensivos para avaliação da disfunção cardíaca e posterior manejo. Por fim, serão realizados testes com vasopressores e inodilatadores para otimizar ainda mais a perfusão. Um tamanho de amostra de 1.500 pacientes fornecerá 88% de poder para demonstrar a superioridade da estratégia direcionada ao tempo de enchimento capilar. Conclusão: Se for demonstrado que o direcionamento ao tempo de enchimento capilar é uma estratégia melhor, os processos de atendimento na ressuscitação do choque séptico podem ser otimizados com ferramentas usadas à beira do leito.


ABSTRACT Background: Early reversion of sepsis-induced tissue hypoperfusion is essential for survival in septic shock. However, consensus regarding the best initial resuscitation strategy is lacking given that interventions designed for the entire population with septic shock might produce unnecessary fluid administration. This article reports the rationale, study design and analysis plan of the ANDROMEDA-2 study, which aims to determine whether a peripheral perfusion-guided strategy consisting of capillary refill time-targeted resuscitation based on clinical and hemodynamic phenotypes is associated with a decrease in a composite outcome of mortality, time to organ support cessation, and hospital length of stay compared to standard care in patients with early (< 4 hours of diagnosis) septic shock. Methods: The ANDROMEDA-2 study is a multicenter, multinational randomized controlled trial. In the intervention group, capillary refill time will be measured hourly for 6 hours. If abnormal, patients will enter an algorithm starting with pulse pressure assessment. Patients with pulse pressure less than 40mmHg will be tested for fluid responsiveness and receive fluids accordingly. In patients with pulse pressure > 40mmHg, norepinephrine will be titrated to maintain diastolic arterial pressure > 50mmHg. Patients who fail to normalize capillary refill time after the previous steps will be subjected to critical care echocardiography for cardiac dysfunction evaluation and subsequent management. Finally, vasopressor and inodilator tests will be performed to further optimize perfusion. A sample size of 1,500 patients will provide 88% power to demonstrate superiority of the capillary refill time-targeted strategy. Conclusions: If hemodynamic phenotype-based, capillary refill time-targeted resuscitation demonstrates to be a superior strategy, care processes in septic shock resuscitation can be optimized with bedside tools.

2.
Braz. oral res. (Online) ; 36: e109, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1394166

ABSTRACT

Abstract This study evaluated the orofacial antinociceptive effect of (S)-(-)-perillyl alcohol (PA) associated with codeine (C) and investigated the possible molecular anchorage mechanisms of PA. Mice (n = 5 per group) were treated with PA alone and associated with codeine and assigned to the following groups: 75.0 mg/kg PA; 75.0 mg/kg PA + C 30 mg/kg; PA 37.5 mg/kg + C 15.0 mg/kg; C 30.0 mg/kg; and control. Nociception was induced by formalin, capsaicin, and glutamate, and was quantified based on the duration (in seconds) of face grooming. The possible mechanisms of action were evaluated by molecular docking study. In the formalin test, PA75/C30 presented an effect in the neurogenic (p < 0.0001) and inflammatory (p < 0.005) phases. Mice treated with PA75 (p < 0.0001) and PA75/C30 (p < 0.0005) showed a reduced nociceptive behavior in the capsaicin test. Glutamate-induced nociception also was blocked by PA75 (p < 0.0005) and C30 (p < 0.0005). The molecular anchorage analysis indicated high negative binding energy values for the evaluated receptors, especially glutamate receptors (AMPA -79.57 Kcal/mol, mGLUR6 -71.25, and NMDA -66.33 Kcal/mol). PA associated with codeine showed orofacial antinociceptive activity, with theoretical evidence of interaction with glutamate receptors.

3.
Bol. latinoam. Caribe plantas med. aromát ; 20(3): 215-225, may. 2021. ilus, tab
Article in English | LILACS | ID: biblio-1342813

ABSTRACT

This review describes the geographical distribution, botanical data, popular use, chemical composition, pharmacological activities and genetic aspects related to Eugenia luschnathiana, a native Brazilian plant popularly known as "bay pitomba". E. luschnathiana leaves are characterized morphologically by the presence of a petiole, an attenuated base, acuminated apex, elliptical shape, and parallel venation. The major chemical compounds found in E. luschnathiana are sesquiterpenes. Literature reports showed that E. luschnathiana extracts have antioxidant properties and antimicrobial activity against Gram-negative and Gram-positive bacteria. The extractsfrom the leaf, fruit and stem, and a concentrated residual solution of its essential oil, displayed negligible toxicity. Lastly, a cytogenetic analysis indicated that some markers can be used for the study of genetic diversity, population structure, and genetic improvements. The information available on E. luschnathiana supports the hypothesis that this plant may be a source of compounds with promising pharmacological activity.


Esta revisión describe la distribución geográfica, datos botánicos, uso popular, composición química, actividad farmacológica y el análisis genético de Eugenia luschnathiana, una planta originaria del Brasil conocida popularmente como "pitomba da baía". Las hojas de E. luschnathiana se caracterizan por la presencia de pecíolo, base atenuada, ápice acuminado, forma elíptica y venación paralela. Su composición química presenta mayormente sesquiterpenos. Los informes en la literatura muestran que los extractos de E. luschnathiana presentan propiedades antioxidantes y actividad antimicrobiana contra las bacterias Gram-negativas y Gram-positivas. Los extractos de la hoja, fruto y tallo, y una solución residual concentrada del aceite esencial, presentaron baja toxicidad. Por último, un análisis citogenético indicó que algunos marcadores pueden utilizarse para estudios de diversidad genética, estructura poblacional y mejoramiento genético. Las informaciones disponibles acerca de E. luschnathiana proponen la hipótesis de que esta planta puede ser una fuente de compuestos con actividad farmacológica prometedora.


Subject(s)
Oils, Volatile/pharmacology , Plant Extracts/pharmacology , Eugenia/chemistry , Anti-Infective Agents/pharmacology , Terpenes/analysis , Bacteria/drug effects , Oils, Volatile/chemistry , Plant Extracts/genetics , Plant Extracts/chemistry , Plant Leaves/chemistry , Eugenia/genetics , Medicine, Traditional , Anti-Infective Agents/chemistry
4.
Rev. méd. Chile ; 148(3): 393-398, mar. 2020.
Article in Spanish | LILACS | ID: biblio-1115804

ABSTRACT

The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health (equitable and effective policies) and at the clinical level. At the clinical level, the issues are the fulfillment of medical care demand with adequate health care teams, infrastructure, and supplies, and to cover critical care demands that surpass the available resources. Therefore, ethically correct approaches are required for the allocation of life sustaining resources. There are recommendations for the allocating life support during disasters based on multiple considerations, including ethical ones. However, the ethical criteria of existing guidelines are variable. Ethical principles usually considered are saving the greatest number of lives, saving the greatest number of years of life and the principle of the life cycle or the goal to give each individual equal opportunity to live through the various phases of life. However, the centrality of the human being and the search for the common good should be considered. Knowledge of public perspectives and moral benchmarks on these issues is essential. A successful assignment effort will require everyone's trust and cooperation. Decision making should be planned and discussed in advance, since in-depth deliberation will be extremely complex during the disaster. Our goal is to help the health care teams to wisely allocate resources in shortage periods.


Subject(s)
Humans , Pneumonia, Viral/therapy , Pneumonia, Viral/epidemiology , Health Care Rationing/ethics , Coronavirus Infections/therapy , Coronavirus Infections/epidemiology , Pandemics , Clinical Decision-Making/ethics , Chile/epidemiology , Practice Guidelines as Topic
5.
Rev. Ciênc. Plur ; 6(2): 44-65, 2020. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1100307

ABSTRACT

Introdução: O alto consumo de medicamentos no Brasil impulsiona o desenvolvimento de estratégias para promoção do uso racional dos mesmos, especialmente em população mais vulneráveis. Objetivo: Traçar o perfil socioeconômico, demográfico e farmacoterapêutico dos alunos incluídos na presente pesquisa; bem como, promover atividades de educação em saúde.Metodologia: Trata-se de uma pesquisa epidemiológica transversal, quantitativa e descritiva realizada com 33 alunos do terceiro e quarto ciclos do programa de Educação de Jovens e Adultos de uma escola pública de João Pessoa-PB. Os dados foram coletados através de formulário, ficha de medicamentos e atividades de educação em saúde. Resultados:A maioria dos estudantes jovens e adultos com idade abaixo de 60 anos(75,7%), predominando o sexo feminino(69,6%)e parda(63,3%). Quase metade dos participantes é constituída de desempregados(45,5%). Parte dos alunos(39,9%) afirmaram ter renda mensal de até um salário mínimo. Para realização desse projeto foram efetuadas atividades que proporcionavam, através de metodologias ativas, a educação e promoção do uso racional de medicamentos e o autocuidado. Quanto ao perfil farmacoterapêutico observa-se interações medicamentosas entre anti-hipertensivos, hipoglicemiantes, anti-tireoidiano e medicamentos isentos de prescrição, apresentando presença de automedicação. As classes medicamentosas predominantes foram os analgésicos, anti-hipertensivos, anti-inflamatórios,antiácidos e hipoglicemiantes. Conclusões:O desenvolvimento de práticas educativas no âmbito da Educação de Jovens e Adultos incentivam o diálogo e a participação dos envolvidos, com grande potencial para ampliação do acesso às informações associadas ao autocuidado em saúde em suas famílias, escola e comunidade (AU).


Introduction:The high consumption of medicines in Brazil drives the development of strategies to promote their rational use, especially in the most vulnerable populations. Objective:Draw the socioeconomic, demographic and pharmacotherapeutic profile of the students included in this research; as well as promoting health education activities. Methodology:This is a cross-sectional, quantitative and descriptive epidemiological research carried out with 33 students from the third and fourth cycles of the Youth and Adult Education program of a public school in João Pessoa-PB. The data were collected through a form, medication form and health education activities. Results:The majority of young and adult students under the age of 60 (75.7%), predominantly female (69.6%) and brown (63.3%). Almost half of the participants are unemployed (45.5%). Part of the students (39.9%) said they had a monthly income of up to one minimum wage. In order to carry out this project, activities were carried out that provided, through active methodologies, education and promotion of the rational use of medicines and self-care. Regarding the pharmacotherapeutic profile, drug interactions are observed between antihypertensive drugs, hypoglycemic agents, anti-thyroid agents and non-prescription drugs, with the presence of self-medication. The predominant drug classes were analgesics, antihypertensives, anti-inflammatories, antacids and hypoglycemic agents. Conclusions:The development of educational practices within the scope of Youth and Adult Education encourages dialogue and the participation of those involved, with great potential for expanding access to information associated with self-care in health in their families, school and community (AU).


Introducción: El alto consumo de medicamentos en Brasil impulsa el desarrollo de estrategias para promover su uso racional, especialmente en las poblaciones más vulnerables. Objetivo:Dibujar el perfil socioeconómico, demográficoy farmacoterapéutico de los estudiantes incluidos en esta investigación; así como promover actividades de educación para la salud. Metodología:Esta es una investigación epidemiológica transversal, cuantitativa y descriptiva realizada con 33 estudiantes del tercer y cuarto ciclo del programa de Educación para Jóvenes y Adultos de una escuela pública en João Pessoa-PB. Los datos fueron recolectados a través de un formulario, formulario de medicamentos y actividades de educación para la salud.Resultados:La mayoría de los estudiantes jóvenes y adultos menores de 60 años (75.7%), predominantemente mujeres (69.6%) y marrones (63.3%). Casi la mitad de los participantes están desempleados (45,5%). Parte de los estudiantes (39.9%) dijeron que tenían un ingreso mensual de hasta un salario mínimo. Para llevar a cabo este proyecto, se llevaron a cabo actividades que proporcionaron, a través de metodologías activas, educación y promoción del uso racional de medicamentos y autocuidado. En cuanto al perfil farmacoterapéutico, se observan interacciones farmacológicas entre fármacos antihipertensivos, agentes hipoglucemiantes, agentes antitiroideos y medicamentos sin receta, con presencia de automedicación. Las clases de drogas predominantes fueron analgésicos, antihipertensivos, antiinflamatorios, antiácidos y agentes hipoglucemiantes. Conclusiones:El desarrollo de prácticas educativas en el ámbito de la educación de jóvenes y adultos fomenta el diálogo y la participación de los involucrados, con un gran potencial para ampliar el acceso a la información asociada con el autocuidado en salud en sus familias, escuelas y comunidades (AU).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Socioeconomic Factors , Mainstreaming, Education/methods , Health Education , Prescription Drug Overuse , Health Promotion , Brazil , Epidemiologic Studies , Demography
6.
Braz. oral res. (Online) ; 34: e094, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132678

ABSTRACT

Abstract We aimed to evaluate the orofacial antinociceptive effect of geraniol in mice and its molecular anchorage mechanism. Seven mice per group (probabilistic sample) were treated with geraniol (12.5, 25 and 50 mg/kg, i.p.), morphine (6 mg/kg, i.p.) and vehicle (saline + Tween 80 at 0.2%, i.p.) 30 minutes prior to the beginning of the experiment. Injecting glutamate (25 μM), capsaicin (2.5 μg) and formalin (2%) into the right upper lip (perinasal) of the mouse induced nociception. Behavioral analysis of the animals considered the friction time (in seconds) of the mentioned region using hind or front paws by a researcher blinded to the treatment groups. The statistical analysis was performed blindly, considering α = 5%. The results showed that in the glutamate and capsaicin tests, concentrations of 25 mg/kg and 50 mg/kg presented antinociceptive activity (p < 0.005, power> 80%). In the formalin test, geraniol was able to reduce nociception at a concentration of 50 mg/kg (p < 0.005, power> 80%). In the molecular anchorage study, high values of binding between the evaluated substance and receptors of glutamate were observed (metabotropic glutamate receptor, -87.8501 Kcal/mol; N-methyl-D-aspartate, -86.4451 Kcal/mol; α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, -85.6755 Kcal/mol). Geraniol presented orofacial antinociceptive activity, probably by interacting with glutamate-related receptors.


Subject(s)
Animals , Mice , Facial Pain , Terpenes , Pain Measurement , Acyclic Monoterpenes , Analgesics
7.
J. appl. oral sci ; 28: e20190020, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056587

ABSTRACT

Abstract Objective: This study sought to identify the differences between the oral changes presented by patients with solid and hematologic tumors during chemotherapeutic treatment. Methodology: This is an observational, prospective and quantitative study using direct documentation by follow-up of 105 patients from 0 to 18 years using the modified Oral Assessment Guide (OAG). Of the 105 patients analyzed, 57 (54.3%) were boys with 7.3 years (±5.2) mean age. Hematologic neoplasms accounted for 51.4% of all cases. Results: Voice, lips, tongue, and saliva changes were not significantly different (p>0.05) between patients with solid or hematologic tumors and during the follow-up. From the 6th until the 10th week of chemotherapeutic treatment alterations in swallowing function, in the mucous membrane (buccal mucosa and palate), in the labial mucosa, and in the gingiva occurred and were distributed differently between the two tumors groups (p<0.05). The main alterations were observed in patients with hematologic tumors. Conclusion: It was concluded that the oral changes during the chemotherapeutic treatment occurred especially in swallowing function, in the mucous membrane, in the labial mucosa and in the gingiva, and these alterations were found mainly in patients with hematologic tumors.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Mouth Diseases/chemically induced , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Deglutition Disorders/chemically induced , Prospective Studies , Longitudinal Studies , Hematologic Neoplasms/complications , Hematologic Neoplasms/drug therapy , Mouth Diseases/classification , Mouth Mucosa/pathology , Antineoplastic Agents/therapeutic use
8.
J. appl. oral sci ; 28: e20190519, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1101254

ABSTRACT

Abstract Natural products have emerged as a rich source of bioactive compounds for adjunctive treatments of many infectious and inflammatory conditions, including periodontitis. Among the monoterpenes with significant biological properties, there is the perillyl alcohol (POH), which can be found in several essential oils and has shown immunomodulatory properties in recent studies, which may be interesting in the treatment of non-neoplastic inflammatory disorders. Objective To determine the antibacterial and immune modulatory activities of the POH. Methodology The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of the POH for two significant Gram-negative periodontal pathogens were determined by macrodilution and subculture, respectively. Cell proliferation and cytotoxicity in RAW 264.7 macrophages were determined by Trypan Blue and mitochondrial enzymatic activity assay. The modulation of reactive oxygen species (ROS) was analyzed by flow cytometry and expression of TNF and arginase-1 by real-time PCR. Results The POH was effective against P. gingivalis (ATCC 33277) and F. nucleatum (ATCC 25586) with MIC= MBC=1600 μM. No cytotoxicity up to 100 µM was observed on macrophages. The cell proliferation was inhibited from 48 hours at 100 μM (p<0.05) and 250 μM (p<0.01). The POH increased ROS production at both 10 μM and 100 μM (p<0.05) in unstimulated cells. The PMA-induced ROS production was not affected by POH, whereas 100 μM significantly reduced lipopolysaccharide-induced (LPS-induced) ROS. The expression of TNF was not affected by POH in unstimulated cells or in cells polarized to M1 phenotype, whereas both concentrations of POH reduced (p<0.05) the expression of arginase-1 in M2-polarized macrophages. Conclusion The POH has antibacterial activity against periodontal pathogens and reduced proliferation of murine macrophages without significant cytotoxicity at concentrations up to 100 μM. In addition, the POH reduced the LPS-induced ROS and the expression of arginase-1 in M2-polarized macrophages.


Subject(s)
Animals , Mice , Fusobacterium nucleatum/drug effects , Reactive Oxygen Species/analysis , Porphyromonas/drug effects , Monoterpenes/pharmacology , Macrophages/drug effects , Anti-Bacterial Agents/pharmacology , Arginase/analysis , Time Factors , Biological Products/pharmacology , Microbial Sensitivity Tests , Gene Expression , Lipopolysaccharides/pharmacology , Reproducibility of Results , Tumor Necrosis Factor-alpha/analysis , Fusobacterium nucleatum/growth & development , Reactive Oxygen Species/metabolism , Porphyromonas/growth & development , Cell Proliferation/drug effects , Real-Time Polymerase Chain Reaction , Flow Cytometry , RAW 264.7 Cells , Macrophages/metabolism
9.
Biota Neotrop. (Online, Ed. ingl.) ; 20(1): e20180683, 2020. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1055257

ABSTRACT

Abstract: We introduce the work providing a synthetic description of the diversity and phyletic structure of freshwater fish in the Neotropical Region, especially emphasizing that of Brazil. This is accompanied by a discussion about environments of fish from small to medium sized to large, taking into account how it shaped their respective biologies/ecologies, as well as what they imply for their use by humans. We present, as figures, the results of our exploratory analysis of Brazilian Red Book of Threatened Species of Fauna (2018), focusing on the small-sized ones, with up to 15 cm of standard length. We continue to present the main human impacts in small fish environments, along with those suffered by medium to large fish environments, and then follow by their respective deleterious effects. Finally, we present a general synthesis, reinforcing the enormous importance of small fish conservation and their respective preferred environments, followed by our main conclusions, and possible conservation strategies.


Resumo: Iniciamos o trabalho fornecendo uma descrição sintética da diversidade e estrutura filética dos peixes de água doce da Região Neotropical, com ênfase naquela do Brasil, acompanhada de uma exposição sobre onde vivem os peixes de pequeno porte e os de porte médio a grande, levando em conta como isso moldou suas respectivas biologias/ecologias, e o que as mesmas implicam para seu uso pelos seres humanos. São apresentados, sob a forma de figuras, os resultados de uma análise exploratória dos dados sobre as 311 espécies de peixes ósseos de água doce contidos no Livro Vermelho da Fauna Brasileira Ameaçada de Extinção (2018), com ênfase naquelas de pequeno porte, com até 15 cm de comprimento padrão. Continuamos apresentando os principais impactos antrópicos nos ambientes de peixes de pequeno porte, juntamente com aqueles sofridos pelos ambientes de peixes de portes médio a grande, seguidos dos seus respectivos efeitos deletérios. Finalmente, concluímos com uma síntese geral, reforçando a enorme importância da conservação dos peixes de pequeno porte e seus ambientes preferenciais, e estratégias possíveis para conservação dos mesmos.

10.
Pesqui. bras. odontopediatria clín. integr ; 20(supl.1): e0131, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1135584

ABSTRACT

Abstract Objective: To describe and compare how three dental schools from different countries (Australia, Brazil, and the USA) have managed experiences in dental education during the COVID-19 crisis. Material and Methods: It is a descriptive study reporting the experience that three distinct dental schools faced during the COVID-19 pandemic. They represent countries that adopted different measures to tackle the pandemic and were undergoing different stages of the disease. Results: After the WHO declared the COVID-19 pandemic, the Federal University of Paraíba suspended all on-site teaching, research, and service activities. For the return to teaching activities, the use of information and communications technology resources for distance learning was recommended. At the School of Dental Medicine (University of Pittsburgh), all research activities were suspended or, otherwise, could not be interrupted because of the employment of unique materials or supplies. When the pandemic started, Australia was one of the first countries to introduce strong regulations related to social distancing, travel restrictions, testing and tracking of infected patients. As such, the universities started to be closed from mid-March, cancelling all clinical and pre-clinical activities, maintaining online theoretical activities, such as seminars, lectures, and journal clubs. Conclusion: Numerous and critical difficulties have arisen as a result of the pandemic for individuals, communities and institutions that will have long-lasting effects. Our students face disruption to their education and career; our professional colleagues will be challenged rebuilding their practices, while staff at all Dental Schools are experiencing various hardships.


Subject(s)
Social Isolation/psychology , Coronavirus/immunology , Educational Technology/methods , SARS Virus , Education, Dental , Schools, Dental , Australia/epidemiology , United States/epidemiology , World Health Organization , Brazil/epidemiology , Epidemiology, Descriptive , Education, Distance/methods , Pandemics/prevention & control
11.
Pesqui. prát. psicossociais ; 14(3): 1-18, jul.-set. 2019.
Article in Portuguese | LILACS | ID: biblio-1040701

ABSTRACT

Este artigo propõe aproximações entre a Psicologia Social Comunitária, as pesquisas narrativas (auto)biográficas e a perspectiva decolonial. Reconhece-se, nesse sentido, que os efeitos da colonização latina seguem nutrindo lugares de enunciação muito distintos para sujeitos marcados pela diferença/desigualdade colonial na sociedade brasileira, o que tem produzido movimentos epistêmico-políticos decoloniais que interpelam o projeto de sujeito e sociedade construído a partir das lógicas coloniais. Dessa forma, é importante que possamos colaborar no endereçamento de que os sujeitos colonizados, a partir de suas narrativas, fazem à comunidade latina e brasileira em busca de elaboração denúncia e combate às desigualdades coloniais. É fundamental, portanto, que retomemos as alianças históricas que permitiram que os colonizados (re)inventassem outros mundos possíveis, rompendo com a posição subalterna, apenas, como lugar da vitimização. Devemos, assim, valorizar, eticamente, não sem (auto)críticas, os deslocamentos que as narrativas decoloniais proporcionam às narrativas comunitárias, historicamente, legitimadas como local de produção da transformação social.


This article builds approximations between Community Social Psychology, narrative (self) biographical research and the decolonial perspective. In this sense, it is recognized that the effects of the Latin colonization still harbor very distinct places of enunciation for subjects marked by the colonial difference / inequality in Brazilian society. What has produced decolonial epistemic-political movements which challenge the project of subject and society built from the colonial logics. Thus, it is important that we can collaborate in the addressing that the colonized subjects, from their narratives, make to the Latin and Brazilian community in search of elaboration, denunciation and combat to the colonial inequalities. It is therefore essential that we retake the historical alliances that allowed the colonized to (re)invent other possible worlds, breaking with the subaltern position, only, as a place of victimization. We must therefore ethically value, not without (self) criticism, the displacements that the decolonial narratives provide for historically legitimized community narratives as the place of production of social transformation.


Este artículo construye aproximaciones entre la Psicología Social Comunitaria, las investigaciones narrativas (auto) biográficas y la perspectiva decolonial. Se reconoce, en ese sentido, que los efectos de la colonización latina todavía nutren lugares de enunciación muy distintos para sujetos marcados por la diferencia / desigualdad colonial en la sociedad brasileña. Lo que ha producido movimientos epistémico-políticos decoloniales que interpelan el proyecto de sujeto y sociedad construido a partir de las lógicas coloniales. De esta forma, es importante que podamos colaborar en el direccionamiento que los sujetos colonizados, a partir de sus narrativas, hacen a la comunidad latina y brasileña en busca de elaboración, denuncia y combate a las desigualdades coloniales. Es fundamental, por lo tanto, que retomamos las alianzas históricas que permitieron que los colonizados (re) inventasen otros mundos posibles, rompiendo con la posición subalterna, apenas, como lugar de la victimización. Debemos, así, valorar, éticamente, no sin (auto) críticas, los desplazamientos que las narrativas decoloniales proporcionan a las narrativas comunitarias, históricamente, legitimadas como lugar de producción de la transformación social


Subject(s)
Psychology, Social , Community Participation , Colonialism , Socioeconomic Factors
13.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 3819, 01 Fevereiro 2019. tab
Article in English | LILACS, BBO | ID: biblio-998189

ABSTRACT

Objective: To identify the profiles of patients with special needs attended at a Center for Dental Specialties. Material and Methods: This was a cross-sectional and quantitative study using an inductive approach, and a comparative and statistical procedure for analysis of the patients with special needs. Information concerning socioeconomic, medical and dental conditions was collected. The data were analyzed using IBM SPSS, adopting a significance level of 5%. Results: It was observed that 58.6% of the users were males, single (54.7%), in the age group from 19 to 59 years (41.1%), being 97.4% without schooling. The most frequent clinical diagnoses were: deviations in intelligence (18.4%), behavioral deviations (18.4%) and physical defects (17.9%). We observed for oral health the presence of gingivitis (33.0%), and healthy gums (47.8%); the presence of caries (64.9%), with restored teeth (28.5%), and edentulism (12.3%). Dental intervention procedures were initiated with emphasis on: fluoride applications (39.7%) and subgingival scraping (34.9%). Topical fluoride applications (p=0.010) and prophylaxis (p=0.010) were realized in patients without autism. Also, prophylaxis (p=0.007) was more frequently performed and gingival alterations were more often verified (p=0.020) in patients without Down's syndrome. Conclusion: The users of the patients with special needs dental service can be generally described as male, single, aged between 19 and 54 years, with the special conditions of intelligence and behavioral deviation.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Specialties, Dental , Brazil , Oral Health , Disabled Persons/psychology , Dental Health Services , Health Services for Persons with Disabilities , Socioeconomic Factors , Health Profile , Cross-Sectional Studies/methods
14.
Article in English | LILACS, BBO | ID: biblio-1056863

ABSTRACT

Abstract Objective: To perform chemical analysis and to evaluate the anti-biofilm and hemolytic effect of the essential oil of Cymbopogon citratus. Material and Methods: Gaseous chromatography coupled to mass spectrometer was performed for chemical characterization of the essential oil. To verify the antimicrobial action, the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) were determined. From MIC, MBC and MFC data, concentrations were established to verify the anti-biofilm effect and for the hemolysis test on human erythrocytes. A multispecies biofilm was developed in vitro and mouthwash applications were simulated to determine the inhibition of biofilm formation or its removal. Results were analyzed through ANOVA statistical test, complemented by the Tukey test, considering a significance level of 5% Results: The major component of the essential oil is citral. MIC verified for Streptococcus mutans was 1mg / mL, while for Candida albicans, it was 125 μg/mL, presenting microbicidal effect for both microorganisms tested. The essential oil was able to inhibit biofilm formation (p<0.001), presenting non-toxic hemolysis percentage in concentration below 500 μg/mL Conclusion: The essential oil of Cymbopogon citratus is antimicrobial, antibiofilm and non-toxic to human erythrocytes, representing a natural product with potential for use in Dentistry.


Subject(s)
Plants, Medicinal , Oils, Volatile , Biofilms , Cymbopogon , Anti-Bacterial Agents/immunology , Streptococcus mutans , In Vitro Techniques , Brazil , Microbial Sensitivity Tests , Analysis of Variance , Chromatography , Statistics, Nonparametric
15.
Rev. CEFAC ; 20(5): 613-620, Sept.-Oct. 2018. tab
Article in English | LILACS-Express | LILACS | ID: biblio-976878

ABSTRACT

ABSTRACT Objective: to ascertain the profile of home care service (HCS) users with speech and language complaints in João Pessoa, Paraíba (PB). Methods: a descriptive and quantitative study using an indirect documentation technique based on an analysis of primary source documents, characterized as a documentary study, conducted at a HCS, in João Pessoa, PB, that stores user information in the form of medical records. All patient records included by the HCS from June 2012 to June 2016 were analyzed. After the eligibility criteria were applied, the sample consisted of 114 medical records. The collected data were entered into a Microsoft Excel spreadsheet to generate descriptive statistics using IBM SPSS (version 21.0). Results: most patients were males (59.6%), elderly (62.3%), had been diagnosed with a stroke (57.9%),had histories of dysphagia (76.3%), speech problems (58.8%), swallowing disorders (80.7%), and abnormal chewing (77.2%). Dysphagia is often associated with stroke, predominantly among males and the elderly. Conclusion difficulty in swallowing, or dysphagia, is often associated with stroke, predominantly in the presence of the sociodemographic and clinical variables associated with men and the elderly.


RESUMO Objetivo: verificar o perfil dos usuários com queixas fonoaudiológicas do serviço de atenção domiciliar do município de João Pessoa, Paraíba. Métodos: trata-se de um estudo transversal, descritivo, natureza quantitativa, mediante técnica de documentação indireta a partir da análise de documentos de fontes primárias, sendo caracterizado, portanto, como estudo documental. A pesquisa foi realizada junto ao serviço de atenção domiciliar (SAD) do município de João Pessoa/PB, que dispõe de informações dos usuários armazenadas em forma de prontuários. Todos os prontuários dos pacientes atendidos pelo SAD no período de junho de 2012 a junho de 2016 foram analisados, e após os critérios de elegibilidade, amostra ficou constituída por 114 prontuários. Os dados coletados foram inseridos em uma planilha do Microsoft Excel para realização de estatística descritiva no Software IBM SPSS (versão 21.0). Resultados: verificou-se que a maioria dos pacientes atendidos foi do sexo masculino (59,6%), idosos (62,3%) e diagnosticados com acidente vascular encefálico (57,9%). Além disso, apresentaram histórico de disfagia (76,3%), problemas de fala (58,8%), deglutição alterada (80,7%) e mastigação alterada (77,2%). A disfagia está frequentemente associada aos AVE's apresentando predomínio de indivíduos do sexo masculino e idosos. Conclusão: concluiu-se que a alteração de dificuldade de deglutição, ou seja, a disfagia está frequentemente associada aos AVE's apresentando o predomínio das variáveis sociodemográficas e clínicas de homens e idosos.

16.
Rev. cuba. estomatol ; 55(3): 1-13, jul.-set. 2018. tab
Article in Portuguese | LILACS | ID: biblio-991067

ABSTRACT

Introdução: o câncer de cabeça e pescoço apresenta alta incidência no Brasil, e requer um estudo constante de sua distribuição, o que motiva a estudá-lo detalhadamente, buscando entender de que forma esse câncer se comporta na população, avaliando sua distribuição temporal no Brasil, além dos seus principais agravos. Objetivo: identificar as localizações anatômicas e classificações histológicas dos cânceres em cabeça e pescoço, registrados no Brasil, entre os anos de 2000 e 2014. Métodos: trata-se de estudo seccional, com abordagem indutiva, técnica de documentação indireta e procedimento estatístico descritivo, a partir da análise de 220.391 dados secundários dos Registros Hospitalares de Câncer, disponíveis pelo Instituto Nacional de Câncer. As variáveis de interesse foram: a localização do tumor primário e tipo histológico. A escolha pela localização do local do tumor primário foi feita de acordo com a Classificação Internacional das Doenças. Resultados: os locais de maior acometimento do câncer em cabeça e pescoço foram: pele da face (44,2 percento); cavidade oral (16,7 percento); glândula tireoide (8,9 percento); laringe (8,8 percento); encéfalo (5,4 percento) e linfonodos localizados na região de cabeça e pescoço (3,8 percento). Os tipos histológicos mais prevalentes foram: carcinoma de células escamosas (38,0 percento); carcinoma basocelular (27,0 percento); carcinoma papilar (3,70 percento); carcinoma basocelular nodular (2,50 percento) e tumor epitelial maligno (2,50 percento). Conclusão: ocarcinoma de células escamosas foi o tipo histológico mais prevalente de câncer em cabeça e pescoço entre os anos de 2000 e 2014, no Brasil, sendo o sítio de maior acometimento a pele da face(AU)


Introducción: el cáncer de cabeza y cuello presenta alta incidencia en Brasil, y requiere un estudio constante de su distribución, lo que motiva a estudiarlo detalladamente, buscando entender de qué forma ese cáncer se presenta en la población, y evaluando su distribución temporal en Brasil , además de sus principales problemas. Objetivo: identificar las localizaciones anatómicas y clasificaciones histológicas de los cánceres en cabeza y cuello, registrados en Brasil, entre los años 2000 y 2014. Métodos: se trata de estudio seccional, con abordaje inductivo, técnica de documentación indirecta y procedimiento estadístico descriptivo, a partir del análisis de 220 391 datos secundarios de los Registros Hospitalarios de Cáncer disponibles por el Instituto Nacional del Cáncer. Las variables de interés fueron: la localización del tumor primario y tipo histológico. La elección por la localización del lugar del tumor primario se realizó de acuerdo con la Clasificación Internacional de las Enfermedades. Resultados: los lugares de mayor afectación del cáncer en cabeza y cuello fueron: piel de la cara (44,2 por ciento); la cavidad bucal (16,7 por ciento); glándula tiroidea (8,9 por ciento); laringe (8,8 por ciento); encéfalo (5,4 por ciento) y ganglios linfáticos localizados en la región de cabeza y cuello (3,8 por ciento). Los tipos histológicos más prevalentes fueron: carcinoma de células escamosas (38,0 por ciento); carcinoma basocelular (27,0 por ciento); carcinoma papilar (3,70 por ciento); carcinoma basocelular nodular (2,50 por ciento) y tumor epitelial maligno (2,50 por ciento). Conclusiones: el carcinoma de células escamosas fue el tipo histológico más prevalente de cáncer en cabeza y cuello entre los años 2000 y 2014, en Brasil, siendo el sitio de mayor afección la piel de la cara(AU)


Introduction: due to its high incidence in Brazil, head and neck cancer requires permanent study of its distribution, which has motivated the conduct of detailed analyses aimed at understanding the way it manifests in the population, its temporal distribution in the country and the main problems it poses. Objective: identify the anatomical locations and histological classifications of head and neck cancers registered in Brazil between the years 2000 and 2014. Methods: an inductive cross-sectional study was conducted with an indirect documentation technique and descriptive statistical processing. The study was based on the analysis of 220 391 secondary data from Cancer Hospital Registries available from the National Cancer Institute. The variables of interest were location of the primary tumor and histological type. Sorting by primary tumor location followed the International Classification of Diseases. Results: the sites most commonly affected by head and neck cancer were facial skin (44.2 percent), oral cavity (16.7 percent), thyroid gland (8.9 percent), larynx (8.8 percent), brain (5.4 percent) and lymph nodes located in the head and neck region (3.8 percent). The most common histological types were squamous-cell carcinoma (38.0 percent), basal-cell carcinoma (27.0 percent), papillary carcinoma (3.70 percent), nodular basal-cell carcinoma (2.50 percent) and malignant epithelial tumor (2.50 percent). Conclusions: squamous-cell carcinoma was the most prevalent histological type of head and neck cancer between the years 2000 and 2014 in Brazil, facial skin being the most commonly affected site(AU)


Subject(s)
Humans , Health Classifications/methods , Data Interpretation, Statistical , Head and Neck Neoplasms/epidemiology , Carcinoma, Squamous Cell
17.
Rev. bras. ter. intensiva ; 30(3): 253-263, jul.-set. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-977971

ABSTRACT

RESUMO Fundamentação: O estudo ANDROMEDA-SHOCK é um estudo internacional, multicêntrico, randomizado e controlado comparando ressuscitação guiada pela perfusão periférica com ressuscitação guiada pelo lactato em pacientes com choque séptico, com a finalidade de testar a hipótese de que a ressuscitação guiada pela perfusão periférica associa-se a menor morbidade e mortalidade. Objetivo: Relatar o plano de análise estatística para o estudo ANDROMEDA-SHOCK. Métodos: Descrevemos o delineamento do estudo, os objetivos primário e secundários, pacientes, métodos de randomização, intervenções, desfechos e tamanho da amostra. Descrevemos nossos planos de análise estatística para os desfechos primários, secundários e terciários. Também descrevemos as análises de subgrupos e sensibilidade. Finalmente, fornecemos detalhes para a apresentação dos resultados, inclusive modelos de tabelas para apresentar as características basais, a evolução das variáveis de hemodinâmica e perfusão, e os efeitos dos tratamentos nos desfechos. Conclusão: Segundo as melhores práticas de pesquisa, relatamos nosso plano de análise estatística e plano de gestão de dados antes do fechamento da base de dados e do início da análise dos dados. Nossa expectativa é que este procedimento previna a ocorrência de vieses na análise e incremente a utilidade dos resultados relatados.


ABSTRACT Background: ANDROMEDA-SHOCK is an international, multicenter, randomized controlled trial comparing peripheral perfusion-targeted resuscitation to lactate-targeted resuscitation in patients with septic shock in order to test the hypothesis that resuscitation targeting peripheral perfusion will be associated with lower morbidity and mortality. Objective: To report the statistical analysis plan for the ANDROMEDA-SHOCK trial. Methods: We describe the trial design, primary and secondary objectives, patients, methods of randomization, interventions, outcomes, and sample size. We describe our planned statistical analysis for the primary, secondary and tertiary outcomes. We also describe the subgroup and sensitivity analyses. Finally, we provide details for presenting our results, including mock tables showing baseline characteristics, the evolution of hemodynamic and perfusion variables, and the effects of treatments on outcomes. Conclusion: According to the best trial practice, we report our statistical analysis plan and data management plan prior to locking the database and initiating the analyses. We anticipate that this procedure will prevent analysis bias and enhance the utility of the reported results.


Subject(s)
Humans , Resuscitation/methods , Shock, Septic/therapy , Data Interpretation, Statistical , Early Goal-Directed Therapy/methods , Research Design , Lactic Acid/blood
18.
Rev. ABENO ; 18(2): 144-155, maio 2018.
Article in Portuguese | LILACS, BBO | ID: biblio-908797

ABSTRACT

O objetivo deste estudo foi compreender as percepções de estudantes de Odontologia de uma instituição pública de ensino superior sobre os estágios supervisionados em serviços públicos de saúde. Trata-se de uma pesquisa com abordagem qualitativa com o recurso de entrevistas semiestruturadas com 18 estudantes, selecionados por conveniência, matriculados do primeiro ao último ano do curso. As entrevistas, audiogravadas e transcritas, foram analisadas a partir da técnica de análise de conteúdo. Foram evidenciadas a aproximação com a população, a experiência profissional humanizada e o conhecimento construído pela vivência nos serviços, produzindo novas estratégias de atuação no Sistema Único de Saúde (SUS). As sugestões relacionaram-se à diversificação dos cenários de prática e a um melhor planejamento de atividades para o desenvolvimento de competências e habilidades. Por meio dos estágios, a formação volta-se para o SUS, que será novamente beneficiado com a inserção desses futuros profissionais na rede de serviços, com consequente melhoria do cuidado em saúde da população (AU).


The aim of this study was to understand the perceptions of Dental students from a public university about the supervised internships in public health services. It is a qualitative research with the use of semi-structured interviews with 18 students, selected for convenience, enrolled from the first to the last year of the course. The interviews, audiotaped and transcribed, were analyzed using the content analysis technique. The proximity with the population, the humanized professional experience and the knowledge built by the experience in the services were highlighted, producing new strategies of action in the Brazilian Health System (SUS). The suggestions were related to the diversification of practice scenarios and better planning of activities for the development of skills and abilities. Through the internships, the training turns to the SUS, which will again benefit from the inclusion of these future professionals in the service network, with consequent improvement in the population´s health care (AU).


Subject(s)
Humans , Male , Female , Education, Dental , Students, Dental , Teaching Care Integration Services , Training Support , Brazil , Interview , Qualitative Research
19.
Rev. CEFAC ; 20(3): 388-399, May-June 2018. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-956499

ABSTRACT

ABSTRACT Purpose: to evaluate the methodological quality of clinical trials published in Brazilian journals. Methods: four trained independent researchers conducted a systematic literature search of all Brazilian speech therapy-related journals over the last ten years, whether the journals were active or inactive. All journal volumes published during that period were selected, and each researcher conducted an individual analysis to identify articles that focused primarily on orofacial motricity. The tools used were the Downs and Black Quality Checklist and the Jadad scale. Results: after the studies were selected and categorized, the final sample comprised six articles, all of which were classified as clinical trials. The observed methodological limitations included a lack of sample planning, randomization and blinding. Mean scores of 16.3 points on the Downs and Black Quality Checklist and 2.3 on the Jadad scale were obtained. Conclusion: the randomized controlled trials in the area of orofacial motricity are scarce in Brazilian literature, suggesting that studies in this area adopting this research design should be expanded and their quality should be improved to promote clinical practice based on scientific evidence.


RESUMO Objetivo: objetivou-se avaliar a qualidade metodológica dos ensaios clínicos publicados em periódicos brasileiros. Métodos: trata-se de uma pesquisa bibliográfica sistemática. Participaram quatro pesquisadores independentes treinados que realizaram um levantamento dos últimos 10 anos em todos os periódicos nacionais da área da Fonoaudiologia, ativos ou inativos. Para tanto, foram selecionados todos os volumes desse período de tempo e cada pesquisador realizou análise individual a fim de identificar estudos que tinham o principal objeto de estudo enquadrado na Motricidade Orofacial. Foram utilizados os seguintes instrumentos Downs and Black Quality Checklist e escala de Jadad. Resultados: após a seleção e categorização dos estudos, a amostra final desta pesquisa foi composta por 6 artigos classificados como ensaios clínicos. Dentre as limitações metodológicas observadas destacam-se a ausência de plano amostral, randomização e cegamento. Identificou-se uma média de 16,3 pontos para o Downs and Black Quality Checklist e 2,3 para escala de Jadad. Conclusão: conclui-se que a literatura brasileira é escassa de ensaios clínicos controlados randomizados na área de motricidade orofacial, sugerindo ampliação e qualificação das investigações que adotam esse delineamento de pesquisa, promovendo, dessa forma, uma prática clínica baseada em evidência científica.

20.
J. appl. oral sci ; 26: e20170222, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-893701

ABSTRACT

Abstract The effect of fluoride agents on the retention of orthodontic brackets to enamel under erosive challenge is little investigated. Objective: The aim of this study was to evaluate the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) agents on the shear bond strength of brackets to enamel and on the enamel microhardness around brackets under erosive challenge. Methods: Brackets were bonded to bovine incisors. Five groups were formed according to fluoride application (n=10): TiF4 varnish, TiF4 solution, NaF varnish, NaF solution and control (without application). The specimens were submitted to erosive challenge (90 s cola drink/2h artificial saliva, 4x per day for 7 days). Solutions were applied before each erosive cycle and varnishes were applied once. Vickers Microhardness (VHN) was obtained before and after all cycles of erosion and the percentage of microhardness loss was calculated. Shear bond strength, adhesive remnant index and polarized light microscopy were conducted after erosion. The data were analyzed by ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: The %VHN had no statistically significant differences among the experimental groups. However, considering the comparisons of all groups with the control group, TiF4 varnish showed the highest protection from enamel demineralization (effect size of 2.94, while the effect size for the other groups was >2.4). The TiF4 varnish group had significantly higher shear bond strength compared to other groups. There was no difference among groups for adhesive remnant index. Polarized light microscopy showed higher demineralization depth for the control group. Conclusions: Application of NaF and TiF4 agents during mild erosive challenge minimized the enamel mineral loss around brackets, however only the experimental TiF4 varnish was able to prevent the reduction of shear bond strength of brackets to enamel.


Subject(s)
Animals , Cattle , Sodium Fluoride/chemistry , Titanium/chemistry , Tooth Erosion/prevention & control , Cariostatic Agents/chemistry , Dental Bonding/methods , Orthodontic Brackets , Dental Enamel/drug effects , Fluorides/chemistry , Reference Values , Saliva, Artificial/chemistry , Surface Properties , Materials Testing , Reproducibility of Results , Analysis of Variance , Tooth Demineralization/prevention & control , Statistics, Nonparametric , Dental Enamel/chemistry , Shear Strength , Hardness Tests , Microscopy, Polarization
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