Competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica / Competencias de enfermería en el cuidado de personas con accidente cerebrovascular elegibles para terapia trombolítica / Nursing competencies in the care of patients with stroke who are eligible for thrombolytic therapy

Resumo Introdução: O acidente vascular cerebral isquêmico tem como tratamento a terapia trombolítica, aplicada ainda na fase aguda, promovendo melhora importante nas sequelas acarretadas por este agravo. Considerando a complexidade da terapia trombolítica, torna-se necessário que os enfermeiros compreendam suas competências para auxiliar no cuidado. Objetivo: Identificar evidências científicas acerca das competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica. Metodologia: Revisão integrativa composta por seis etapas em seis etapas (elaboração da questão, busca na literatura, coleta de dados, análise, discussão e apresentação da revisão), realizada nas bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase e CINAHL. A busca foi realizada entre agosto e setembro de 2022 adotando como critérios de inclusão estudos primários; gratuitos, disponíveis eletronicamente na íntegra; nos idiomas inglês, português e espanhol. Foram obtidos inicialmente 2.830 estudos, os quais passaram por uma seleção, onde foram incluídos aqueles que atendiam os critérios previamente estabelecidos. Resultados: Com base nos doze estudos incluídos nesta revisão identificaram-se competências voltadas à três atividades do cuidado: gestão do cuidado como trabalho em equipe, códigos, fluxos e protocolos, assistência ao paciente antes, durante e após a utilização da terapia trombolítica e educação em saúde para equipe, pacientes e familiares. Conclusão: Os achados desta revisão puderam evidenciar as competências do enfermeiro no cuidado aos pacientes elegíveis a terapia trombolítica, as quais perpassam diferentes áreas de atuação do enfermeiro. Para este estudo prevaleceram as competências assistências, seguida por competências gerenciais.

Resumen Introducción: El accidente cerebrovascular isquémico se trata con terapia trombolítica, aplicada incluso en la fase aguda, que promueve una mejoría significativa de las secuelas provocadas por este padecimiento. Considerando la complejidad de la terapia trombolítica, es necesario que las personas profesionales de enfermería comprendan sus competencias para ayudar en el cuidado. Objetivo: Identificar evidencias científicas sobre las competencias del personal de enfermería en el cuidado de pacientes con accidente cerebrovascular elegibles para terapia trombolítica. Metodología: Revisión integradora que consta de seis etapas (elaboración de la pregunta, búsqueda bibliográfica, recolección de datos, análisis, discusión y presentación de la revisión), realizada en las bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase y CINAHL. La búsqueda se realizó entre agosto y septiembre de 2022. Los criterio de inclusión fueron: estudios primarios, gratuito, disponible electrónicamente en su totalidad, en inglés, portugués y español. Inicialmente se obtuvieron 2830 estudios, los cuales fueron sometidos a un proceso de selección, que incluyó aquellos que cumplían con los criterios previamente establecidos. Resultados: A partir de los doce estudios incluidos en esta revisión, se identificaron competencias centradas en tres actividades asistenciales: gestión del cuidado como trabajo en equipo, códigos, flujos y protocolos, atención a pacientes antes, durante y después del uso de la terapia trombolítica y educación en salud para personal, pacientes y familias. Conclusión: Los hallazgos de esta revisión pudieron resaltar las competencias de las personas profesionales en enfermería en el cuidado de personas elegibles para terapia trombolítica, que abarcan diferentes áreas de actuación del personal de enfermería. Para este estudio, prevalecieron las habilidades asistenciales, seguidas de las competencias gerenciales.

ABSTRACT Introduction: Ischemic stroke is treated with thrombolytic therapy, applied even in the acute phase, promoting a significant improvement in the after-effects caused by this condition. Considering the complexity of thrombolytic therapy, it is necessary for nurses to understand the skills required to assist in care. Objective: To identify scientific evidence about the competencies of nurses in the care of patients with stroke who are eligible for thrombolytic therapy. Methodology: An integrative review consisting of six stages (elaboration of the question, literature review, data collection, analysis, discussion, and presentation), conducted in MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase, and CINAHL databases. The search was carried out between August and September 2022 using primary studies as the inclusion criteria: free of charge, fully available electronically, published in English, Portuguese, or Spanish. Initially, 2.830 studies were obtained, which underwent a selection process that included only those studies that met the previously established criteria. Results: Based on the twelve studies included in this review, competencies focused on three care activities were identified: care management such as teamwork; codes; flows and protocols; patient care before, during, and after the use of thrombolytic therapy; and education health education for staff, patients, and families. Conclusion: The findings of this review highlighted the nurses' competencies in the care of patients eligible for thrombolytic therapy, which encompass different areas of the nurse's work. For this study, assistance competencies prevailed, followed by management competencies.

Effects of liquid extract from Plinia cauliflora fruits residues on Chinese hamsters biochemical parameters / Efeitos do extrato líquido de resíduos de frutos de Plinia cauliflora sobre os parâmetros bioquímicos de hamsters chineses

Plinia cauliflora (Mart.) Kausel, popularly known as jabuticaba, is rich in polyphenols. Phenolic compounds exhibit several biological properties, which reflect on biomarkers such as biochemical parameters. In the present study, we evaluated the plasmatic levels of glucose, total cholesterol, HDL-cholesterol, triglycerides, and uric acid of Chinese hamsters fed for 45 days with a regular diet or cholesterol-enriched diet supplemented with a liquid extract obtained from P. cauliflora fruits residues standardized in ellagic acid and total phenolic compounds. The results showed that the concentrated extract obtained from jabuticaba residues increased the glycemia of animals fed with a regular diet and reduced the plasmatic uric acid levels of animals fed with a cholesterol-enriched diet. Since hyperuricemia is considered to be a significant risk factor of metabolic disorders and the principal pathological basis of gout, the liquid extract from P. cauliflora fruits residues would be a promising candidate as a novel hypouricaemic agent for further investigation.

Plinia cauliflora (Mart.) Kausel, popularmente conhecida como jabuticaba, é rica em polifenois. Os compostos fenólicos apresentam diversas propriedades biológicas, que refletem em biomarcadores, como os parâmetros bioquímicos. No presente estudo, avaliamos os níveis plasmáticos de glicose, colesterol total, HDL-colesterol, triglicerídeos e ácido úrico em hamsters chineses alimentados por 45 dias com dieta regular ou dieta enriquecida com colesterol suplementada com extrato líquido obtido de resíduos de frutos de P. cauliflora padronizado em ácido elágico e compostos fenólicos totais. Os resultados mostraram que o extrato concentrado obtido dos resíduos de jabuticaba aumentou a glicemia dos animais alimentados com dieta regular e reduziu os níveis plasmáticos de ácido úrico dos animais alimentados com dieta rica em colesterol. Uma vez que a hiperuricemia é considerada um fator de risco significativo de distúrbios metabólicos e a principal base patológica da gota, o extrato líquido dos resíduos de frutas de P. cauliflora seria um candidato promissor como um novo agente hipouricêmico para investigação posterior.

Effects of liquid extract from Plinia cauliflora fruits residues on Chinese hamsters biochemical parameters

Abstract Plinia cauliflora (Mart.) Kausel, popularly known as jabuticaba, is rich in polyphenols. Phenolic compounds exhibit several biological properties, which reflect on biomarkers such as biochemical parameters. In the present study, we evaluated the plasmatic levels of glucose, total cholesterol, HDL-cholesterol, triglycerides, and uric acid of Chinese hamsters fed for 45 days with a regular diet or cholesterol-enriched diet supplemented with a liquid extract obtained from P. cauliflora fruits residues standardized in ellagic acid and total phenolic compounds. The results showed that the concentrated extract obtained from jabuticaba residues increased the glycemia of animals fed with a regular diet and reduced the plasmatic uric acid levels of animals fed with a cholesterol-enriched diet. Since hyperuricemia is considered to be a significant risk factor of metabolic disorders and the principal pathological basis of gout, the liquid extract from P. cauliflora fruits residues would be a promising candidate as a novel hypouricaemic agent for further investigation.

Resumo Plinia cauliflora (Mart.) Kausel, popularmente conhecida como jabuticaba, é rica em polifenois. Os compostos fenólicos apresentam diversas propriedades biológicas, que refletem em biomarcadores, como os parâmetros bioquímicos. No presente estudo, avaliamos os níveis plasmáticos de glicose, colesterol total, HDL-colesterol, triglicerídeos e ácido úrico em hamsters chineses alimentados por 45 dias com dieta regular ou dieta enriquecida com colesterol suplementada com extrato líquido obtido de resíduos de frutos de P. cauliflora padronizado em ácido elágico e compostos fenólicos totais. Os resultados mostraram que o extrato concentrado obtido dos resíduos de jabuticaba aumentou a glicemia dos animais alimentados com dieta regular e reduziu os níveis plasmáticos de ácido úrico dos animais alimentados com dieta rica em colesterol. Uma vez que a hiperuricemia é considerada um fator de risco significativo de distúrbios metabólicos e a principal base patológica da gota, o extrato líquido dos resíduos de frutas de P. cauliflora seria um candidato promissor como um novo agente hipouricêmico para investigação posterior.

Evaluation of the effects of SPONDIAS MOMBIN extract as an alternative antimicrobial drug

The extract of Spondias mombin has constituents which may improve psychiatric disorders, in addition to having antiviral, antifungal, and antimicrobial activity. But despite having several benefits, it is necessary to assess whether the extract may interfere with cell metabolism so furthermore its microbicide potential can be explored. Fifteen Wistar rats were used, divided into four groups (control group; control with extract; hyperlipidemic diet; hyperlipidemic diet and extract). For 12 weeks, the animals were weighed and their blood glucose was assessed. Afterwards, they were euthanized, and the biological material was collected. The evaluation confirmed the efficacy of the extract of S. mombin against cell metabolism of rats, without negatively altering cell viability; the group of rats with an hyperlipidemic diet showed an increase in body weight; however, in the individual assessment of the organs, there were no significant changes. The glycemic index, liver parameters, lipids, and mineral ions did not show changes. Furthermore, the antimicrobial potential of S. mombin extract was observed against Staphylococcus aureus ATCC 29213 and Staphylococcus aureus BLACC. The results suggest that S. mombin extract did not interfere with cell viability, did not show cytotoxicity to cells that were exposed to it, nor did it interfere with the metabolism, organs, and biochemical indices of rats with a standard or hyperlipidemic diet. Considering such characteristics and the potential activities observed in this present study, additional evaluation should be conducted to further assess the role of S. mombin extract as a source of new alternative antimicrobial drug as well as its possible beneficial activity to the cardiovascular system.

Stroke Is Associated with Refractory Hypertension among Resistant and Refractory Patients in a Cross-Sectional Study

Abstract Background Refractory hypertension (RfH) is a severe phenotype of resistant hypertension (RH) linked to higher risk of stroke and other adverse cardiovascular events, but knowledge about it is still lacking. Objectives To evaluate the association between RfH and stroke. Methods We conducted a cross-sectional study in a referral clinic for patients with severe hypertension in the period from 2018 to 2020. RH was defined as uncontrolled blood pressure (BP) despite the use of 3 antihypertensive agents, including a diuretic, or the use of ≥ 4 agents regardless of BP control. RfH was defined as lack of BP control despite use of ≥ 5 antihypertensive agents. Individuals were classified as RfH or RH, and multivariate logistic regression models were constructed to examine the association between RfH and stroke. Results We evaluated a total of 137 patients; 81% were female, and 93,3% were Black or multiracial. The mean age was 64.4 years. Stroke was more prevalent in the RfH group (35.7%), in comparison to the RH group (12.8%) (p value = 0.01). Unadjusted odds ratio (OR) and 95% confidence interval (CI) for factors associated with stroke were RfH (OR 3.77; 95% CI 1.45 to 9.80), systolic BP (OR 1.02; 95% CI 1.002 to 1.04) and diastolic BP (OR 1.03; 95% CI 1.001 to 1.06). Adjusted OR for factors associated with stroke were RfH (OR 3.55; 95% CI 1.02 to 12.42), systolic BP (OR 1.02; 95% CI 0.99 to 1.05) and diastolic BP (OR 1.01; 95% CI 0.96 to 1.06). Conclusion RfH was associated with higher prevalence of stroke. Efforts are required to better understand this association to prevent adverse cardiovascular outcomes in these patients.

Process optimization of physicochemical properties of spray-dried Hydrocotyle umbellata L. extract

Abstract Hydrocotyle umbellata L., Araliaceae, is a species that is recommended in Ayurvedic medicine for its effects on the central nervous system, such as anxiolytic and memory-stimulant effects. Despite the medicinal potential of this species, its phytopharmaceutical and technological potential to produce standardized extracts has not been investigated. This study analyzes the influence of spray drying parameters on the contents of the chemical markers (total phenolic, total flavonoid, and hibalactone) and the functional properties of H. umbellata extract. The optimization of drying conditions was performed using a central composite design combined with response surface methodology and desirability function approach. The mathematical models fitted to experimental data indicated that all the evaluated drying parameters significantly influenced the chemical contents. The optimal conditions were: inlet temperature of 120 °C, feed flow rate of 4 mL min-1, and colloidal silicon dioxide:maltodextrin ratio of 16%:4%. Under these conditions, the powder samples had spherical particles and desirable physicochemical and functional properties, such as low water activity and moisture content, good product recovery, reconstitution, and flowability. Thus, spray drying might be a promising technique for processing standardized H. umbellata extracts.

Prevalence of obesity in patients with breast cancer followed-up at an oncology service in Goiania

To verify the prevalence of obesity in patients undergoing cancer follow-up at Hospital das Clínicas in Universidade Federal de Goiás, analyzing the epidemiological and laboratory profile. Methods: Retrospective, analytical and observational study. The final sample consisted of 498 medical records of patients under regular follow-up with indication for chemotherapy between June 2018 and 2020. Anthropometric data, gestational history, personal and family history, menopausal status, comorbidities, staging, and laboratory tests were observed. Results: A mean body mass index of 28.3 kg/m² was found among the patients, and 26.51% were obese. Mean age at diagnosis was 52.79 years, and 51.81% were in menopause. Also, 26.23% had a personal history of breast cancer, and 44.76% had family history. Regarding comorbidities, 51.15% had them, being the most frequent one systemic arterial hypertension, more prevalent in the obese group compared to the normal body mass index. Also, 11.96% of the patients were nulliparous. Regarding staging, most were in T2N0M0 at diagnosis. In laboratory tests, it was found that among patients with breast cancer who had information on lipid profile, low-density lipoprotein and total cholesterol were above the reference limit. Conclusion: 57.63% were obese or overweight, demonstrating body mass index as a risk factor for breast cancer. It was observed that the group of patients with obesity had a statistically significant relationship with the presence of concomitant comorbidities; however, no statistically significant results were found regarding the relationship between body mass index and menopausal status.

Perfil epidemiológico da sífilis adquirida em pacientes de um laboratório clínico universitário em Goiânia-GO, no período de 2017 a 2019 / Epidemiological profile of syphilis acquired in patients of a university clinical laboratory in Goiânia-GO from 2017 to 2019

Objetivo: A sífilis é uma doença infectocontagiosa, transmitida pela via sexual e verticalmente durante a gestação. Quando não tratada adequadamente, a doença pode permanecer no organismo por grandes períodos sem sintomas clínicos, pode evoluir atingindo múltiplos sistemas do organismo. O objetivo deste estudo foi determinar o perfil epidemiológico de usuários do Laboratório Clínico da PUC Goiás, com casos confirmados de sífilis adquirida, no período de 2017 a 2019. Métodos: Trata-se de uma pesquisa retrospectiva, a partir da análise dos resultados dos exames de VDRL e FTA-Abs no banco de dados eletrônico do laboratório. Resultados: Um total de 8.884 exames de rastreamento para sífilis adquirida foi solicitado neste período. Deste total, 11,1%, 17,2% e 10,9% apresentaram resultados reagentes no VDRL, respectivamente, nos anos de 2017, 2018 e 2019. Um percentual de 78,7% dos exames positivos para sífilis (VDRL) foi confirmado pelo teste treponêmico FTA-Abs (IgG). Em 2017, 32,45% dos exames foram reagentes para FTA-abs; 7,95% em 2018, e 9,3% em 2019. Os resultados desta pesquisa evidenciam uma maior prevalência de casos de sífilis adquirida em adultos jovens do sexo masculino (47,9%/2017; 72,9%/2018; 63,0%/2019) com baixa escolaridade. Conclusão: Nos últimos anos, a sífilis tem se tornado um grande problema de saúde pública, visto o seu aumento a cada ano, mesmo com tratamento simples e diagnóstico rápido. Medidas de controle, principalmente voltadas para o tratamento adequado do paciente e parceiro, uso de preservativo, informação à população devem ser fortalecidas pelos programas de saúde para controle da sífilis na população estudada.

Objective: Syphilis is an infectious disease, transmitted sexually and vertically during pregnancy. When not treated properly, the disease can remain in the organism for long periods without clinical symptoms, it can evolve reaching multiple systems. The objective of this study was to determine the epidemiological profile of users of the Clinical Laboratory of PUC Goiás, with confirmed cases of acquired syphilis, in the period from 2017 to 2019. Methods: This is a retrospective research, based on the analysis of the results of the VDRL exams and FTA-Abs in the laboratory's electronic database. Results: A total of 8,884 screening tests for acquired syphilis were ordered during this period. Of this total, 11.1%, 17.2% and 10.9% had positive results in the VDRL, respectively, in the years 2017, 2018 and 2019. A percentage of 78.7% of the positive tests for syphilis (VDRL) were confirmed by the FTA-Abs (IgG) treponemic test. In 2017, 32.45% of the tests were reactive for FTA-abs; 7.95% in 2018, and 9.3% in 2019. The results of this research show a higher prevalence of cases of acquired syphilis in young male adults (47.9% / 2017; 72.9% / 2018; 63,0% / 2019) with low education. Conclusion: In recent years, syphilis has become a major public health problem, as it increases every year, even with simple treatment and rapid diagnosis. Control measures, mainly aimed at the adequate treatment of the patient and partner, use of condoms, information to the population must be strengthened by health programs for syphilis control in the studied population.

Evaluation of breastfeeding self-effectiveness and its associated factors in puerperal women assisted at a public health system in Brazil / Avaliação da autoeficácia para amamentação e seus fatores associados em puérperas assistidas no sistema público de saúde no Brasil

Abstract Objectives: evaluate breastfeeding self-efficacy and its associated factors in puerperal women assisted at a public health system in Brazil. Methods: it is a cross-sectional analytical study, with convenience sampling and two instruments: sociodemographic, personal and clinical, and Breastfeeding Self-Efficacy Scale (BSES-SF), applied to puerperal women in a puerperal outpatient clinic at two public maternity hospitals in Goiânia/GO, from September to November 2019. Inclusion criteria: mothers in puerperal period, age above 18 years, children born at term and on exclusive breastfeeding. Exclusion criteria: report depression and premature wean. Results: 128puerperal women were interviewed. The average age was 26.7 (± 5.9) years old. The levels of self-efficacy were high (95.3%) and no puerperal had a low level. The variables with statistical significance were: experience in breastfeeding (p= 0.0312), not having received information on breastfeeding during pregnancy (p=0.0292), did not receive other milk at the maternity (p=0.0380), did not feel pain while breastfeeding (p=0.0242), being able to breastfeed on demand (p=0.0124), presence of breast engorgement (p=0.0207), presenting protruding nipples (p=0.0427). Conclusions: clinical and personal aspects were identified as risk factors for early weaning. This can provide information for the training ofprofessionals and structuring the interventions in health services, with a view in preventing these risks.

Resumo Objetivos: avaliar a autoeficácia da amamentação e seus fatores associados em puérperas atendidas no sistema público de saúde. Métodos: estudo transversal analítico, com amostragem por conveniência e dois instrumentos: sociodemográfico, pessoal e clínico, e Escala de Autoeficácia em Amamentação, aplicada a puérperas em um ambulatório de acompanhamento puerperal de duas maternidades públicas de Goiânia/GO, de setembro a novembro de 2019. Critérios de inclusão: mães no período puerperal, idade acima de 18 anos, filhos nascidos a termo e em aleitamento materno exclusivo. Critérios de exclusão: autorrelato de depressão e desmame prematuro. Resultados: foram entrevistadas 128 puérperas. A média de idade foi de 26,7 (± 5,9). Os níveis de autoeficácia foram altos (95,3%) e nenhuma puérpera obteve nível baixo. As variáveis com significância estatística foram: experiência em amamentar (p = 0,0312), não ter recebido informações sobre aleitamento materno durante a gravidez (p = 0,0292), não ter recebido outro leite na maternidade (p = 0,0380), não sentindo dor durante a amamentação (p = 0,0242), sendo amamentada sob demanda (p = 0,0124), presença de ingurgitamento mamário (p = 0,0207), apresentando mamilos salientes (p = 0,0427). Conclusões: foram identificados aspectos clínicos e pessoais como fatores de risco para o desmame precoce. Isso pode fornecer informações para a formação de profissionais e a estruturação de intervenções nos serviços de saúde, visando a prevenção desses riscos.

Associação entre Vaginose Bacteriana e Anormalidades Citológicas nos Exames Citopatológicos Analisados em um Laboratório Escola de Goiânia-GO / Association Between Bacterial Vaginosis and Cytological Abnormalities in Cytopathological Exams Analyzed in a Laboratory School of Goiânia-GO / Asociación entre Vaginosis Bacteriana y Anormalidades Citológicas en Exámenes Citopatológicos Analizados en una Escuela de Laboratorio de Goiânia-GO

Introdução: A Gardnerella vaginalis facilita a infecção pelo papilomavírus humano (HPV). Objetivo: Verificar a associação entre anormalidades citológicas e presença de Gardnerella vaginalis nos esfregaços cervicovaginais encaminhados ao Laboratório Clínico da Pontifícia Universidade Católica de Goiás (LAC/PUC Goiás) estratificadas por faixa etária. Método: Estudo transversal realizado no LAC/PUC Goiás entre janeiro de 2013 a dezembro de 2015. Para análises estatísticas, a variável idade foi categorizada em ≤39 anos e >40 anos, utilizando o programa IBM SPSS Statistics (Version 2.0, 2011®) para o teste de qui-quadrado (X²), com intervalo de confiança de 95% e valor p<0,05. Resultados: Foram analisados 4.558 exames citopatológicos, a maioria com presença de Lactobacillus spp. (46,97%). A prevalência dos agentes patogênicos foi a Gardnerella vaginalis (79,6%), seguida de Candida spp. (16,8%), Trichomonas vaginalis (2,2%), Herpes simplex (0,4 %) e Chlamydia trachomatis (0,1%). As anormalidades citológicas foram observadas em 9,1%, sendo atypical squamous cells of undetermined significance (ASC-US) 2,57%, low grade squamous intraepithelial lesion (LSIL) 1,78%, atypical squamous cells of undetermined significance cannot exclude high grade squamous intraepithelial lesion (ASC-H) 3,52%, high grade squamous intraepithelial lesion (HSIL) 1,08%, atypical endocervical cells, favor neoplastic (AGC-NEO) 0,22% e carcinoma 0,02%. Houve uma associação significante entre anormalidades citológicas graves e mulheres ≥40 anos, OR 3,01 (IC 95% 2,0-4,58) (p<0,0001). Mulheres ≤40 anos mostraram significância à presença de Gardnerella vaginalis (p<0,0004). Conclusão: Uma elevada prevalência de Gardnerella vaginalis foi encontrada associada com as anormalidades citológicas, principalmente em mulheres sexualmente ativas.

Introduction:Gardnerella vaginalis facilitates human papillomavirus (HPV) infection. Objective: To verify the association between cytological abnormalities and the presence of Gardnerella vaginalis in cervicovaginal smears sent to the Clinical Laboratory of the Pontifical Catholic University of Goiás (LAC/PUC Goiás) stratified by age range. Method: Cross-sectional study carried out at LAC/PUC Goiás from January 2013 to December 2015. For statistical analysis, the variable age was categorized as ≤39 years and >40 years, using the IBM SPSS Statistics program (Version 2.0, 2011®) for the chi-square test (X²), with a 95% confidence interval and p<0.05. Results:4,558 cytopathological exams were analyzed, most of them with the presence of Lactobacillus spp (46.97%). The prevalence of pathogens was Gardnerella vaginalis (79.6%), followed by Candida spp. (16.8%), Trichomonas vaginalis (2.2%), Herpes simplex (0.4%) and Chlamydia trachomatis (0.1%). Cytological abnormalities were observed in 9.1%, being atypical squamous cells of undetermined significance (ASC-US) 2.57%, low grade squamous intraepithelial lesion (LSIL) 1.78%, atypical squamous cells of undetermined significance cannot exclude high intraepithelial lesion (ASC-H) 3.52%, high grade squamous intraepithelial lesion (HSIL) 1.08%, atypical endocervical cells, neoplastic favor (AGC-NEO) 0.22% and carcinoma 0.02%. There was a significant association between severe cytological abnormalities and women >40 years old OR 3.01 (95% CI 2.0-4.58) (p<0.0001). Women ≤40 years old showed the presence of Gardnerella vaginalis (p<0.0004). Conclusion:A high prevalence of Gardnerella vaginalis was found and its association with cytological abnormalities, especially in sexually active women.

Introducción:Gardnerella vaginalis facilita la infección por el virus del papiloma humano (VPH). Objetivo: Verificar la asociación entre anormalidades citológicas y la presencia de Gardnerella vaginalis en frotis cervicovaginales enviadas al Laboratorio Clínico de la Pontificia Universidad Católica de Goiás (LAC/PUC Goiás) estratificadas por grupo de edad. Método: Estudio transversal realizado en LAC/PUC Goiás desde enero de 2013 hasta diciembre de 2015. Para el análisis estadístico, la edad variable se clasificó como ≤39 años y >40 años, utilizando el programa IBM SPSS Statistics (Versión 2.0, 2011®) para la prueba de chi-cuadrado (X²), con un intervalo de confianza del 95% y p <0,05. Resultados: Se analizaron 4.558 exámenes citopatológicos. La prevalencia de Lactobacillusspp. con 46,97%. Los patógenos como Gardnerella vaginalis fueron 79,6%, Candidaspp. 16,8%, Trichomonas vaginalis 2,2%, Herpes simplex 0,4%, y Chlamydia trachomatis 0,1%. Se observaron anormalidades citológicas en 9,1%, con células escamosas atípicas de significado indeterminado (ASC-US) 2,57%, lesión intraepitelial escamosa de bajo grado (LSIL) 1,78%, células escamosas atípicas de significación indeterminada no pueden excluir lesión intraepitelial (ASC-H) 3,52%, lesión intraepitelial escamosa de alto grado (HSIL) 1,08%, células endocervicales atípicas, favor neoplásico (AGC-NEO) 0,22% y carcinoma 0,02%. Hubo una asociación significativa entre anormalidades citológicas severas y mujeres >40 años OR 3,01 (IC 95% 2,0-4,58) (p<0,0001). Las mujeres ≤40 años mostraron la presencia de Gardnerella vaginalis (p<0,0004). Conclusión: Se encontró una alta prevalencia de Gardnerella vaginalis y su asociación con anomalías citológicas, especialmente en mujeres sexualmente activas.

Avaliação da qualidade de vida em pacientes idosos antes e após a cirurgia de catarata / Quality of life assessment in elderly patients before and after cataract surgery

RESUMO Objetivo: Avaliar a qualidade de vida de pacientes idosos antes e após de se submeterem à cirurgia de catarata. Métodos: Estudo longitudinal analítico com abordagem quantitativa. A coleta de dados se deu em duas etapas (antes da cirurgia de catarata e 2 meses após o procedimento), tendo sido aplicados dois questionários, sendo um sociodemográfico e o outro o World Health Organization Quality of Life OLD. Recorreu-se à estatística descritiva e aos testes estatísticos t de Student, análise de variância, de Mann-Whitney e de Kruskal-Wallis. Resultados: Participaram da pesquisa 34 idosos, sendo 15 (44,1%) até 69 anos de idade e 19 (55,9%) com mais de 69 anos. Identificou-se decréscimo nos escores do Funcionamento do Sensório nos idosos que não tinham atividade de lazer (p=0,0006), não praticavam atividade física (p=0,0023) e não utilizavam a internet (p=0,0010). No domínio Atividades Passadas, Presentes e Futuras, identificou-se aumento do escore nos idosos que não tinham atividade de lazer (p=0,0258), não praticavam atividade física (p=0,0303), afirmaram ter outros problemas de saúde (p=0,0372) e referiram ter boa saúde (p=0,0298). Já no domínio Participação Social, houve aumento do escore nos idosos que não tinham atividade de lazer (p=0,0068), não praticavam atividade física (p=0,0033) e afirmaram ter saúde regular (p=0,0102). Conclusão: Evidenciaram-se decréscimo no Funcionamento do Sensório e aumento nas Atividades Passadas, Presentes e Futuras e na Participação Social.

ABSTRACT Objective: To evaluate quality of life of elderly patients before and after cataract surgery. Methods: A longitudinal analytical study with quantitative approach. Data collection was performed in two stages (before cataract surgery and 2 months after the procedure), when two questionnaires were used - a sociodemographic and the World Health Organization Quality of Life (WHOQLD). Descriptive statistics and Student's t test, analysis of variance, Mann-Whitney and Kruskal-Wallis tests were employed. Results: A total of 34 elderly individuals participated in the research, 15 (44.1%) aged up to 69 years and 19 (55.9%) over 69 years. A decrease in the Sensory Functioning scores was identified in those who had no leisure activity (p=0.0006), did not exercise (p=0.0023) and did not use the internet (p=0.0010). In the domain Past, Present and Future Activities, an increase in the score was observed in the elderly who had no leisure activity (p=0.0258), did not exercise (p=0.0303), reported having other health problems (p=0.0372), and in those who reported having good health status (p=0.0298). In the Social Participation domain, there was an increase in the score of the elderly who had no leisure activity (p=0.0068), did not exercise (p=0.0033), and of those who reported having regular health status (p=0.0102). Conclusion: There was a decrease in Sensory Functioning scores and an increase in the domains Past, Present and Future Activities, as well as Social Participation.

The Mitigating Effect of Jatropha curcas L. Latex against Genotoxicity Induced by Doxorubicin

Jatropha curcas (Euphorbiaceae) is a multiple purpose lacticiferous plant with potential for biodiesel production and medicinal uses. There is in the literature different analyses about the toxic and cytogenotoxic effects of J. curcas extracts, but few information about latex toxicity. In addition, few models were employed to evaluate the toxicity response to J. curcas latex, and the toxicity in in vivo mammal’s model has not been tested yet. The cytotoxic, mutagenic and antimutagenic potential of J. curcas latex were investigated using mouse bone marrow erythrocytes. The results indicated a cytotoxic and mutagenic potential of this latex to mammalian cells. But, when J. curcas latex was co-administrated with doxorubicin (DXR – chemotherapy medication), a reduction in the number of micronuclei was observed, indicating an interaction between J. curcas latex and DXR. The interaction of latex with DXR can cause a reduction in the activity of this drug and impair the treatment of its users. Moreover, there is a lack of data on herb–drug interactions, what should be more investigated to safeguard the wellbeing of patients.

Avaliação da prevalência de dermatites de contato ocupacionais em profissionais de beleza atuantes em Goiânia, Goiás, Brasil

Objetivos ­ Avaliar a prevalência das dermatites de contato (DC) ocupacionais, destacando os principais tipos de cosméticos indutores, o conhecimento dos participantes sobre a doença, o seu diagnóstico e tratamento em uma amostra de 378 profissionais da beleza atuantes em Goiânia, Goiás. Métodos ­ Estudo transversal descritivo, prospectivo, com abordagem quantitativa. Resultados ­ Um total de 43,9% dos participantes deste estudo declararam apresentar DC após exposição a produtos cosméticos no trabalho. Cerca de 64,0% dos participantes desta pesquisa não demonstraram conhecimento satisfatório relacionado aos principais agentes causadores diretos das DC ocupacionais. As tinturas e descolorantes capilares, produtos para alisamentos capilares e produtos para maquilagem foram os cosméticos mais relacionados com o desenvolvimento das DC ocupacionais nestes profissionais. As regiões corporais dos profissionais mais afetadas pelas lesões das DC ocupacionais foram as mãos, o couro cabeludo e a face. A partir do diagnóstico da DC 25,8% dos profissionais tiveram que mudar de atividade laboral dentro do seu segmento de trabalho. Cerca de 28,8% dos profissionais apresentaram conhecimento insatisfatório sobre as principais medidas de prevenção das DC ocupacionais. Conclusão ­ A implementação ou aprimoramento de programas preventivos primários eficazes, pelos estabelecimentos e instituições formadoras destes profissionais é primordial para a redução da prevalência das dermatites ocupacionais. O conhecimento e a conscientização sobre fatores de risco individuais pela categoria é extremamente importante, especialmente nos aprendizes, que constituem um grupo-alvo para a execução de medidas de prevenção primária

Objectives ­ To evaluate the prevalence of occupational contact dermatites (CD), highlighting the main types of inductive cosmetics, the participants' knowledge about the disease, its diagnosis and treatment in a sample of 378 beauty professionals working in Goiania, Goias. Methods ­ Descriptive, prospective cross-sectional study with a quantitative approach. Results ­ A total of 43.9% of the participants in this study reported having CD after exposure to cosmetic products at work. About 64.0% of the participants of this research did not demonstrate satisfactory knowledge related to the main direct causative agents of occupational CD. Hairdye and bleaching agents for hair, hair straighteners and make-up products were the cosmetics most associated with occupational CD in these professionals. The body regions of the professionals most affected by occupational DC injuries were the hands, scalp and face. From the diagnosis of CD 25.8% of the professionals had to change their work activity within their work segment. About 28.8% of the professionals presented unsatisfactory knowledge about the main measures of prevention of occupational DC. Conclusion ­ The implementation or improvement of effective primary prevention programs by the institutions and training institutions of these professionals is necessary to reduce the prevalence of occupational dermatitis. Knowledge and awareness of individual risk factors by category is extremely important, especially for apprentices, who are a target group for the implementation of primary prevention measures

HPLC-PDA method validated for the determination of hibalactone in Hydrocotyle umbellata subterraneous parts and its ultrasound-assisted extraction optimization

ABSTRACT In this work, we developed and validated a HPLC-PDA method for the quantification of hibalactone in Hydrocotyle umbellata L., Araliaceae, subterraneous parts extracts and optimized its ultrasound-assisted extraction. Chromatographic separations were carried out with an isocratic mobile phase of acetonitrile/methanol/water (10:65:25), a flow of 0.8 ml min−1, detection at 290 nm and C18 column (250 × 4.6 mm, 5 µm). The method validation parameters were determined according to Brazilian legislation. The optimization of the hibalactone ultrasound-assisted extraction was performed using Box-Behnken design and response surface methodology. The HPLC method for hibalactone quantification proved to be selective, linear, precise, accurate and robust, being useful for the analysis of hibalactone in H. umbellata subterraneous parts extracts. The optimal ultrasound-assisted extraction conditions were obtained with solid-to-liquid ratio of 1:5 g ml−1, ethanolic strength of 70% (v/v) and temperature of 65 °C. The results can provide support of the quality control and standardization of raw materials from H. umbellata.

Antiangiogenic potential of Jatropha curcas latex in the chick chorioallantoic membrane model / Potencial antiangiogênico do látex de Jatropha curcas em modelo de membrana corioalantoica de embrião de galinha

AIMS: To perform a physicochemical and phytochemical characterization of Jatropha curcas latex and to investigate its antiangiogenic potential. METHODS: We performed an initial physicochemical characterization of J. curcas latex using thermal gravimetric analyses and Fourier Transform Infrared spectroscopy. After that, phenols, tannins and flavonoids were quantified. Finally, the potential of J. curcas latex to inhibit angiogenesis was evaluated using the chick chorioallantoic membrane model. Five groups of 20 fertilized chicken eggs each had the chorioallantoic membrane exposed to the following solutions: (1) water, negative control; (2) dexamethasone, angiogenesis inhibitor; (3) Regederm®, positive control; (4) 25% J. curcas latex diluted in water; (5) 50% J. curcas latex diluted in water; and (6) J. curcas crude latex. Analysis of the newly-formed vascular net was made through captured images and quantification of the number of pixels. Histological analyses were performed to evaluate the inflammation, neovascularization, and hyperemia parameters. The results were statically analyzed with a significance level set at p<0.05. RESULTS: Physicochemical characterization showed that J. curcas latex presented a low amount of cis-1.4-polyisoprene, which reduced its elasticity and thermal stability. Phytochemical analyses of J. curcas latex identified a substantial amount of phenols, tannins, and flavonoids (51.9%, 11.8%, and 0.07% respectively). Using a chick chorioallantoic membrane assay, we demonstrated the antiangiogenic potential of J. curcas latex. The latex induced a decrease in the vascularization of the membranes when compared with neutral and positive controls (water and Regederm®). However, when compared with the negative control (dexamethasone), higher J. curcas latex concentrations showed no significant differences. CONCLUSIONS: J. curcas latex showed low thermal stability, and consisted of phenols, tannins, and flavonoids, but little or no rubber. Moreover, this latex demonstrated a significant antiangiogenic activity on a chick chorioallantoic membrane model. The combination of antimutagenic, cytotoxic, antioxidant and antiangiogenic properties makes J. curcas latex a potential target for the development of new drugs.

OBJETIVOS: Realizar uma caracterização físico-química e fitoquímica do látex de Jatropha curcas e investigar o seu potencial antiangiogênico. MÉTODOS: foi realizada uma caracterização físico-química inicial do látex de J. curcas utilizando as análises termogravimétricas e a espectroscopia com a Transformada de Fourier. Depois disso, fenóis, taninos e flavonoides foram quantificados. Finalmente, o potencial do látex de J. curcas em inibir a angiogênese foi avaliado através do uso de modelo de membrana corioalantoica de embrião de galinha. Cinco grupos, cada um com 20 ovos de galinha fertilizados, tiveram a membrana corioalantoica exposta às seguintes soluções: (1) água, controle negativo; (2) dexametasona, inibidor da angiogênese; (3) Regederm®, controle positivo; (4) 25% de látex de J. curcas diluído em água; (5) 50% de látex de J. curcas diluído em água; e (6) látex bruto de J. curcas. A análise da rede vascular recém-formada foi feita por meio de imagens capturadas e quantificação do número de pixels. Análises histológicas foram realizadas para avaliar os parâmetros de inflamação, neovascularização e hiperemia. Os resultados foram analisados estaticamente com nível de significância estabelecido em p<0,05. RESULTADOS: A caracterização físico-química mostrou que o látex de J. curcas apresenta uma baixa quantidade de cis-1,4-poliisopreno, o que reduz sua elasticidade e estabilidade térmica. Análises fitoquímicas do látex de J. curcas identificaram uma quantidade significativa de fenóis, taninos e flavonoides (51,9%, 11,8% e 0,07% respectivamente). Usando o modelo de membrana corioalantoica de ovo de galinha embrionado, demonstrou-se o potencial antiangiogênico do látex de J. curcas. O látex induziu a diminuição da vascularização das membranas, em comparação aos grupos controle neutro e positivo (água e Regederm®). CONCLUSÕES: O látex de J. curcas apresentou baixa estabilidade térmica, ausência ou pouca quantidade de borracha e presença de fenóis, taninos e flavonoides em sua composição. Além disso, apresentou alta atividade antiangiogênica no modelo de membrana corioalantoica de embrião de galinha. A combinação de propriedades antimutagênicas, citotóxicas, anti-inflamatórias, antioxidantes e antiangiogênicas faz com que o látex de J. curcas seja um alvo potencial para o desenvolvimento de novos medicamentos.

Evaluation of the chemical composition and variability of the volatile oils from Trembleya parviflora leaves

Abstract Trembleya parviflora (D. Don) Cogn., Melastomataceae, also known as "quaresmeira-branca", is a subshrub that is commonly used to treat verminosis, scabies, dermatoses, rheumatism, vaginal infections, ulcerations and wounds. The aim of this work was to perform a morphological study of T. parviflora, evaluate the composition and chemical variability of the volatile oils from the leaves, perform phytochemical screening of the powder from the leaves and to define parameters for quality control of the plant material. Macroscopic characterization of T. parviflora was carried out by naked eye in Serra dos Pireneus, Pirenópolis, Goiás for 12 months. Volatile oils were subjected to hydrodistillation with Clevenger apparatus and analyzed by gas chromatography-mass spectrometry. Phytochemical screening and ash and volatile compound content determination were performed by conventional techniques. T. parviflora has simple, oppositely crossed and petiolate leaves. The inflorescence of this plant is a cyme. The presence of coumarins, steroids, triterpenes, flavonoids and tannins was observed. The total ash content was 4.05 ± 0.02%; the insoluble ash content was 0.10 ± 0.03%; and the volatile compound content was 9.53 ± 0.02%. The major compounds present in the volatile oils were α-terpineol (2.7-16.5%), α-pinene (0.6-25.4%), β-pinene (2.7-23.1%), sabinene (1.2-14.1%), acetoxyeudesman-4-α-ol (0.6-6.3%) and 2,4a-8,8-tetramethyldecahydrocyclopropanaphtalene (2.4-24.4). Two clusters were identified: Cluster I represented the period with low levels of rainfall, and Cluster II represented the period with high levels of rainfall. This study provides data that can be applied for the quality control of powdered leaves and is the first description of the chemical composition and variability of the volatile oils from the leaves of T. parviflora.

Ureteroileal bypass: a new technic to treat ureteroenteric strictures in urinary diversion

ABSTRACT Objective: To present our technique of ureteroileal bypass to treat uretero-enteric stric- tures in urinary diversion. Materials and Methods: One hundred and forty-one medical records were reviewed from patients submitted to radical cystectomy to treat muscle-invasive bladder cancer between 2013 and 2015. Twelve (8.5%) patients developed uretero-enteric anastomotic stricture during follow-up. Five patients were treated with endoscopic dilatation and double J placement. Four were treated surgically with standard terminal-lateral im- plantation. Three patients with uretero-enteric anastomotic stricture were treated at our institution by "ureteroileal bypass", one of them was treated with robotic surgery. Results: All patients had the diagnosis of uretero-enteric anastomotic stricture via computerized tomography and DTPA renal scan. Time between cystectomy and diag- nosis of uretero-enteric anastomotic stricture varied from five months to three years. Mean operative time was 120±17.9 minutes (98 to 142 min) and hospital stay was 3.3±0.62 days (3 to 4 days). Mean follow-up was 24±39.5 months (6 to 72 months). During follow-up, all patients were asymptomatic and presented improvement in ure-terohydronephrosis. Serum creatinine of all patients had been stable. Conclusions: Latero-lateral ureter re-implantation is feasible by open or even robotic surgery with positive results, reasonable operation time, and without complications.

Phytochemistry and antimicrobial activity of Campomanesia adamantium

ABSTRACT Campomanesia adamantium (Cambess.) O. Berg., Myrtaceae, is a plant popularly used for its anti-inflammatory, anti-diarrhoeal and urinary antiseptic activities. The aims of this study were to obtain the crude ethanolic extract and the hexane, dichloromethane, ethyl acetate, aqueous and concentrated aqueous tannin fractions from C. adamantium leaves, perform biomonitored fractionation to isolate and identify chemical compounds, study the chemical composition of the volatile oils of the leaves and flowers and test the antimicrobial activity of the ethanolic extract, fractions, isolated substances and volatile oils. Phytochemical screening and chromatographic and spectrometric techniques were used. Volatile oils were isolated by hydrodistillation in a Clevenger apparatus and analyzed by gas chromatography/mass spectrometry. The antimicrobial activity was tested by a broth microdilution test. The component stictane-3,22-diol was isolated and identified from the hexane fraction, while valoneic and gallic acid were isolated and identified from the concentrated aqueous tannin fraction. The major constituents of the volatile oils of the leaves were verbenene (13.91%), β-funebrene (12.05%) and limonene (10.32%), while those of the volatile oils of the flowers were sabinene (20.45%), limonene (19.33%), α-thujene (8.86%) and methyl salicylate (8.66%). Antibacterial activity was verified for the hexane fraction, while antifungal activity was observed for the aqueous fraction and concentrated aqueous tannin fraction and for vanoleic acid. These results may justify the popular use of C. adamantium.

Validation of a photostability indicating method for quantification of furanocoumarins from Brosimum gaudichaudii soft extract

ABSTRACT A validation study of a reverse-phase high-performance liquid chromatographic assay for the quantification of two furanocoumarins (psoralen and bergapten) in soft extract obtained from Brosimum gaudichaudii Trécul, Moraceae, roots was conducted. The developed method was sensitive, rapid, reproducible, easy and precise, and showed linearity (r > 0.99) in the range of 10-64 µg/ml for psoralen, and 9-56 µg/ml for bergapten. It also showed a good efficiency for the photodegradation analysis of psoralen and bergapten in the soft extract. The photostability results showed that the Higuchi model presented the best fitting to the obtained data. Both chemical markers showed stability over 2.6 days, suggesting potential applications of the extract in obtaining intermediate products from this plant material. Furanocoumarins take around 30 min to be activated by UV light, reaching the maximum biological potential. Thus, the results obtained to the Higuchi model, corresponding to 2.6 days of stability, shows feasibility with future applications of these chemical markers.

Chemical composition and seasonality variability of the Spiranthera odoratissima volatile oils leaves

ABSTRACT Spiranthera odoratissima A. St.-Hil., Rutaceae, known as "manacá" is a shrub native of the Brazilian Cerrado. Their leaves and roots are popularly used to treat rheumatism, infection and abdominal pain. This study analyzed the chemical composition of volatile oils from leaves of S. odoratissima and verified the seasonal variability of its chemical composition. The volatile oils were obtained by hydrodistillation using a Clevenger type apparatus and analyzed by gas chromatography coupled to mass spectrometry. The main chemical components found in samples of volatile oils were β-caryophyllene, bicyclogermacrene, δ-cadinene, amorphous-4,7(11)-diene, α-epi-muurolol, α-cadinol, α-muurolol and γ-cadinene. The hierarchical clustering identified three groups: the first was characterized by α-epi-muurolol, the second by amorphous-4,7(11)-diene and the third group was characterized by α-muurolol. The discriminant canonical analysis was used to differentiate between clusters on the basis of oil composition. The results suggest that the rainfall presented a relationship with the chemical composition of the volatile oil. This is the first study conducted on the seasonal behavior of the chemical constituents in volatile oil from leaves of S. odoratissima.