Orofacial myofunctional and polysomnographic characteristics of children with Down syndrome and obstructive sleep apnea: a pilot study. / Características miofuncionais orofaciais e polissonográficas de crianças com Síndrome de Down e apneia obstrutiva do sono: estudo piloto.

PURPOSE: To investigate oropharyngeal structures and functions in a pediatric population with Down Syndrome (DS) and obstructive sleep apnea (OSA) and to correlate with the apnea/hypopnea index (AHI) and sleep questionnaires. METHODS: 12 Children with DS and OSA, between the age of 4 and 12 years old, underwent polysomnography (PSG); sleep questionnaires, Pediatric Sleep Questionnaire (PSQ) and Obstructive Sleep Apnea-18 (OSA-18); and speech-language evaluation using the Short Evaluation of Orofacial Myofunctional Protocol (ShOM). RESULTS: There was a positive correlation between ShoM higher scores and the apnea-hypopnea index (AHI) and between ShoM and the number of hypopneas. The orofacial myofunctional alterations observed in the studied group were: oral breathing, alteration in lip tonus and competence, tongue posture at rest and in swallowing, and occlusal alteration. There was also an increased risk for OSA according to the sleep questionnaires, as well as the presence of obesity and overweight, but without correlation with the severity of OSA. CONCLUSION: All DS children show alterations in orofacial characteristics, higher scores being associated to severe OSA. Orofacial myofunctional evaluation may help to identify different phenotypes in Down syndrome children with Obstructive sleep Apnea, enhancing the need for a multidisciplinary approach.

OBJETIVO: Investigar as estruturas e funções orofaríngeas de uma população pediátrica com Síndrome de Down (SD) e apneia obstrutiva do sono (AOS) e correlacionar com o índice de apneia/hipopneia (IAH) e questionários do sono. MÉTODO: 12 Crianças com SD e AOS, entre 4 e 12 anos, foram submetidas à polissonografia (PSG); questionários do sono, Pediatric Sleep Questionnaire (PSQ) e Obstructive Sleep Apnea-18 (OSA-18); e triagem fonoaudiológica por meio do Short Evaluation of Orofacial Myofunctional Protocol (ShOM). RESULTADOS: Verificou-se uma correlação positiva entre pontuações mais elevadas no ShOM e o índice de apneia hipopneia (IAH) e entre o ShOM e número de hipopneias. As alterações miofuncionais orofaciais observadas no grupo estudado foram: respiração oral, alteração no tônus e competência labial, na postura de língua em repouso e na deglutição e alteração oclusal. Verificou-se também, um risco aumentado para AOS conforme os questionários do sono, bem como presença de obesidade e sobrepeso, mas sem correlação com a gravidade da AOS. CONCLUSÃO: Todas as crianças apresentaram alterações miofuncionais orofaciais, sendo que escores mais altos no ShOM, ou seja, um maior comprometimento miofuncional orofacial, estavam associados à maior gravidade de AOS, sugerindo que a avaliação miofuncional orofacial dentro de uma abordagem multidisciplinar pode auxiliar na identificação de fatores de risco para AOS em crianças com SD.

Características miofuncionais orofaciais e polissonográficas de crianças com Síndrome de Down e apneia obstrutiva do sono: estudo piloto / Orofacial myofunctional and polysomnographic characteristics of children with Down syndrome and obstructive sleep apnea: a pilot study

RESUMO Objetivo Investigar as estruturas e funções orofaríngeas de uma população pediátrica com Síndrome de Down (SD) e apneia obstrutiva do sono (AOS) e correlacionar com o índice de apneia/hipopneia (IAH) e questionários do sono. Método 12 Crianças com SD e AOS, entre 4 e 12 anos, foram submetidas à polissonografia (PSG); questionários do sono, Pediatric Sleep Questionnaire (PSQ) e Obstructive Sleep Apnea-18 (OSA-18); e triagem fonoaudiológica por meio do Short Evaluation of Orofacial Myofunctional Protocol (ShOM). Resultados Verificou-se uma correlação positiva entre pontuações mais elevadas no ShOM e o índice de apneia hipopneia (IAH) e entre o ShOM e número de hipopneias. As alterações miofuncionais orofaciais observadas no grupo estudado foram: respiração oral, alteração no tônus e competência labial, na postura de língua em repouso e na deglutição e alteração oclusal. Verificou-se também, um risco aumentado para AOS conforme os questionários do sono, bem como presença de obesidade e sobrepeso, mas sem correlação com a gravidade da AOS. Conclusão Todas as crianças apresentaram alterações miofuncionais orofaciais, sendo que escores mais altos no ShOM, ou seja, um maior comprometimento miofuncional orofacial, estavam associados à maior gravidade de AOS, sugerindo que a avaliação miofuncional orofacial dentro de uma abordagem multidisciplinar pode auxiliar na identificação de fatores de risco para AOS em crianças com SD.

ABSTRACT Purpose To investigate oropharyngeal structures and functions in a pediatric population with Down Syndrome (DS) and obstructive sleep apnea (OSA) and to correlate with the apnea/hypopnea index (AHI) and sleep questionnaires. Methods 12 Children with DS and OSA, between the age of 4 and 12 years old, underwent polysomnography (PSG); sleep questionnaires, Pediatric Sleep Questionnaire (PSQ) and Obstructive Sleep Apnea-18 (OSA-18); and speech-language evaluation using the Short Evaluation of Orofacial Myofunctional Protocol (ShOM). Results There was a positive correlation between ShoM higher scores and the apnea-hypopnea index (AHI) and between ShoM and the number of hypopneas. The orofacial myofunctional alterations observed in the studied group were: oral breathing, alteration in lip tonus and competence, tongue posture at rest and in swallowing, and occlusal alteration. There was also an increased risk for OSA according to the sleep questionnaires, as well as the presence of obesity and overweight, but without correlation with the severity of OSA. Conclusion All DS children show alterations in orofacial characteristics, higher scores being associated to severe OSA. Orofacial myofunctional evaluation may help to identify different phenotypes in Down syndrome children with Obstructive sleep Apnea, enhancing the need for a multidisciplinary approach.

Breastfeeding lifespan control of growth, maintenance, and metabolism of small intestinal epithelium.

Gastrointestinal epithelial cells respond to milk-born molecules throughout breastfeeding, influencing growth, and development. The rapid renewal of the small intestine depends on the proliferation in the crypt that drives cell fates. We used early weaning model to investigate immediate and late effects of breastfeeding on proliferation, differentiation of jejunal epithelial cells. Wistar rats were either allowed to suckle (S) until 21 postnatal days or submitted to early weaning (EW) at 15 days. By comparing ages (18, 60, and 120 days), we found that EW decreased Ki67 indices and villi height at 18 and 60 days (p < 0.05), and at 120 days they were similar between diets. Proliferative reduction and augmented expression of Cdkn1b (p27 gene) were parallel. In the stem cell niche, EW increased the number and activity (Defa24) of Paneth cells at 18 and 60 days (p < 0.05), and Lgr5 and Ascl2 genes showed inverted responses between ages. Among target cells, EW decreased goblet cell number at 18 and 60 days (p < 0.05) and increased it at 120 days (p < 0.05), whereas enteroendocrine marker genes were differentially altered. EW reduced enterocytes density at 18 days (p < 0.05), and at 120 days this population was decreased (vs. 60 days). Among cell fate crypt-controlling genes, Notch and Atoh1 were the main targets of EW. Metabolically, intraperitoneal glucose tolerance was immediately reduced (18 days), being reverted until 120 days (p < 0.05). Currently, we showed that breastfeeding has a lifespan influence on intestinal mucosa and on its stem cell compartment. We suggest that, although jejunum absorptive function is granted after early weaning, the long lasting changes in gene expression might prime the mucosa with a different sensitivity to gut disorders that still have to be further explored.

Avaliação do risco de suicídio entre alunos no início, meio e fim do curso de medicina de uma universidade no Rio de Janeiro / Suicide risk assessment among students at the beginning, in the middle and at the end of the medicine course of a university in the city of Rio de Janeiro ­ Brazil

Objetivo: Avaliar o risco de suicídio e a existência de comportamento suicida entre acadêmicos nos estágios inicial, intermediário e final do curso de Medicina de uma universidade particular e analisar os fatores de risco possivelmente associados à ideação suicida nessa população. Materiais e métodos: Foram analisados, em estudo transversal, 376 estudantes. Todos os participantes responderam questionário autopreenchível, por meio da plataforma eletrônica Google Forms, composto por 3 seções: perguntas sobre questões pessoais, perguntas do Questionário de Comportamento Suicida Revisado (Suicide Behavior Questionnaire Revised: SBQ-R) e do Inventário de Ideação Suicida Positiva e Negativa (Positive and Negative Suicide Ideation: PANSI). Resultados: 34% dos alunos eram do 1º ano, outros 34% do 3º ano e 32%, do 6º ano. 71,8% da população do estudo é composta pelo sexo feminino e 39,6% possui idade entre 21 e 24 anos. Na classificação de risco de suicídio segundo o PANSI, 31,7% dos estudantes apresentaram médio risco e 5,3%, alto risco. Na análise por etapa do curso, o 3º ano apresentou-se com maior porcentagem em alto risco (70,0%). De acordo com o SBQ-R, 37,2% dos estudantes da população total apresentaram comportamento suicida. Dentre as variáveis analisadas, orientação sexual, história de bullying na infância, conflito com responsáveis, história familiar de transtorno mental, uso de drogas ilícitas, história de violência sexual e ansiedade autorreferida foram consideradas como fatores de risco para suicídio na população total e na subanálise feita por ano de faculdade. Conclusão: A população do estudo apresenta aumento das taxas de ideação e comportamento suicida em relação a população geral. Assim, é necessária a implantação de medidas dentro das universidades para promover a saúde mental e diminuir aspectos estressantes sobre os acadêmicos. [au]

Objective : The purpose of this study is to assess the risk of suicide and the existence of suicidal behavior among academics in the early, intermediate and final stages of a private medical school, and also to analyze risk factors possibly associated with suicidal ideation in this population. Methods: This is a cross-sectional study with 376 medical students. All the participants answered a self-fillable questionnaire through the electronic platform Google Forms composed of 3 sections: questions about personal issues; questions of the Suicide Behavior Questionnaire Revised (SBQ-R); and of the Positive and Negative Suicide Ideation (PANSI) Inventory. Results: 34% of the students were in the 1st year of graduation, 34% in the 3rd year, and 32%, in the 6thyear. 71.8% of the population is female and 39.6% are between 21 and 24 years old. In the suicide risk classification according to PANSI, 31.7% of the students were in the medium risk group and 5.3% in high risk group. In the analysis per year, the 3rd year showed a greater percentage of high risk (70.0%). According to the SBQ-R classification of suicide risk, 37.2% of students out of the total population revealed suicidal behavior. Among the analyzed variables, sexual orientation, history of childhood bullying, domestic conflict, presence of mental disorders in family, use of illicit drugs, history of sexual violence and self-reported anxiety were considered as risk factors for suicide. The highlighted results revealed the same pattern when analyzed per year of college. Conclusion: The survey population has increased rates of suicidal negative ideation and behavior compared to the general population. Therefore, it is necessary to implement programs in colleges to promote a greater state of well-being and reduce stressful aspects in academics. [au]

Paneth cells and their multiple functions.

The small intestine mucosa is lined by specialized cells that form the crypt-villus axis, which expands its surface. Among the six intestinal epithelial cell types, the Paneth cell is located at the base of the crypt, and it contains numerous granules in its cytoplasm, composed of antimicrobial peptides, such as defensins and lysozyme, and growth factors, such as epidermal growth factor, transforming growth factor-α, and Wnt ligands. Together, these elements act in the defense against microorganisms, regulation of intestinal microbiota, maintenance, and regulation of stem cell identity. Pathologies that target Paneth cells can disturb such defense activity, but they also affect the maintenance of the stem cell niche. In that way, Crohn's disease, necrotizing enterocolitis, and graft-versus-host disease promote a reduction of Paneth cell population, and, consequently, secretion of their products into the lumen of the crypts, making the affected organism predisposed to infections and dysbiosis. Additionally, the emergence of new intestinal cells is also decreased. This review aims to address the main characteristics of Paneth cells, highlighting their multiple functions and the importance of their preservation to ensure bowel homeostasis.

Silicon as an attenuator of drought stress in plants of Oryza sativa L. treated with dietholate / Silício como atenuador de estresse hídrico em plantas de Oryza sativa L. tratadas com dietholate

Abstract Silicon (Si) is an element that can improve the growth and development of rice plants in water-deficient environments because it is an enzymatic stimulant, signaling for production of antioxidant compounds. Therefore, the aim of this study was to examine the relationship between water deficiency and the effect of Si on two rice cultivars whose seeds were treated with dietholate. The experimental design was fully randomized with three replicates, and treatments were organized in a 3x2x2x4 factorial arrangement: three water soil conditions (50% and 100% of soil water retention capacity (WRC) and complete submergence in a water blade of 5.0 cm); two cultivars (IRGA 424 RI and Guri INTA CL); two sources of Si (sodium metasilicate and potassium metasilicate); and four rates of Si (0; 4.0; 8.0 and 16 g L-1). Chlorophyll a and b, leaf area and shoot and root dry weight increased at higher rates of Si under the three soil water regimes. There was an increase in superoxide dismutase and guaiacol peroxidase enzyme activity in the cultivars at higher rates of Si, reducing lipid peroxidation caused by water deficiency. Therefore, Si did indeed attenuate water deficiency stress in rice plants emerging from seeds treated with dietholate.

Resumo O silício (Si) é um elemento que pode proporcionar melhor crescimento e desenvolvimento às plantas de arroz cultivadas em ambientes com deficiência hídrica, por ser um estimulador enzimático, promovendo sinalização para produção de compostos antioxidantes. Assim, o objetivo deste trabalho foi estudar a relação entre deficiência hídrica e o efeito do Si em duas cultivares de arroz tratadas com dietholate. O delineamento experimental utilizado foi inteiramente casualizado, com três repetições e os tratamentos arranjados em esquema fatorial 3x2x2x4, sendo os fatores: três condições hídricas do solo (50%, 100% da capacidade de retenção de água no solo (CRA) e lâmina d'água de 5,0 cm), duas cultivares (IRGA 424 RI e Guri INTA CL), duas fontes de Si (metassilicato de sódio e metassilicato de potássio) e quatro doses de Si (0; 4,0; 8,0 e 16 g L-1). O índice de clorofila a e b, a área foliar e o teor de massa seca da parte aérea e raiz aumentaram com o aumento das doses de Si nas três condições hídricas do solo. Houve um aumento na atividade das enzimas superóxido dismutase e guaiacol peroxidase nas cultivares estudadas à medida que as doses de Si aumentaram, diminuindo a peroxidação de lipídios, causada pela restrição hídrica. Portanto, o Si atenua o estresse por déficit hídrico em plantas de arroz emergentes de sementes tratadas com dietholate.

Educação Física e sexualidade: desafios educacionais / Review of the book: Physical Education and sexuality: educational challenges / Reseña del libro:Educação Física e sexualidade: desafios educacionais

O presente texto apresenta uma resenha do livro "Educação Física e sexualidade: desafios educacionais", organizado por Priscila Gomes Dornelles, Ileana Wenetz e Maria Simone Vione Schwengber, publicado pela Editora Unijuí em 2017. A obra é composta por seis capítulos, com pesquisas de renomados(as) pesquisadores(as) que se propuseram a investigar as possíveis relações entre as questões de gênero e sexualidade no âmbito da Educação Física, evidenciando as contribuições desse campo de conhecimento nos processos de fortalecimento de perspectivas de gênero e sexualidade determinadas a partir das características anatômicas e fisiológicas de cada sujeito. Em síntese, as pesquisas apresentadas servem como um indicativo de que a Educação Física escolar se caracteriza como uma disciplina que, seja a partir dos seus discursos, seja pelas práticas pedagógicas ou silenciamentos, potencializa a normalização de comportamentos fundamentados pela conexão e dependência entre as categorias sexo-gênero-sexualidade.

This text presents a review of the book "Physical Education and sexuality: educational challenges", organized by Priscila Gomes Dornelles, Ileana Wenetz and Maria Simone Vione Schwengber, published by Editora Unijuí in 2017. The work comprises six chapters, with research conducted by renowned researchers who proposed to investigate the possible relationships between issues of gender and sexuality in the context of Physical Education, highlighting the contributions of this field of knowledge in the processes of strengthening perspectives of gender and sexuality determined from the anatomical and physiological characteristics of each individual. In summary, the researches presented serve as an indication that school Physical Education is characterized as a subject that, whether based on its discourse, whether through its pedagogical practices or its silencing, potentializes the normalization of behaviors based on the connection and dependence between the sex-gender-sexuality categories.

Este texto presenta una reseña del libro "Educação Física e sexualidade: desafios educacionais", organizado por Priscila Gomes Dornelles, Ileana Wenetz y Maria Simone Vione Schwengber, publicado por la Editora Unijuí en 2017. El trabajo consta de seis capítulos, con investigaciones de reconocidos/as investigadores/as, quienes se propusieron indagar las posibles relaciones entre temas de género y sexualidad en el contexto de la Educación Física, destacando los aportes de este campo del conocimiento en los procesos de fortalecimiento de perspectivas de género y sexualidad determinadas a partir de las características anatómicas y fisiológicas de cada sujeto. En resumen, las investigaciones presentadas sirven como indicio de que la Educación Física escolar se caracteriza por ser una disciplina que, ya sea a partir de sus discursos, ya sea a través de prácticas pedagógicas o silenciamientos, potencia la normalización de conductas fundamentadas a partir de la conexión y dependencia entre las categorías sexo-género-sexualidad.

Lipid droplet biogenesis and COX-2 pathway activation are triggered by Barrett's esophagus and adenocarcinoma, but not esophageal squamous cell carcinoma risk factors.

Esophageal cancer (EC) is an aggressive disease, presenting two main histological subtypes: adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). The two EC subtypes widely differ concerning virtually all factors. ESCC development is mainly associated with tobacco and alcohol abuse, whereas obesity and chronic gastroesophageal reflux disease (GERD) are important risk factors not only for EAC, but also for for Barrett's esophagus (BE), an intestinal metaplasia that precedes EAC. Obesity triggers ectopic lipid droplets (LD) accumulation in non-adipose tissues. LD are organelles involved in cell metabolism, signaling, proliferation and production of inflammatory mediators. Therefore, the aim of this work was to investigate LD occurrence and role in EC. This study shows progressive LD levels increase along EAC development, in esophageal samples from non-obese through obese individuals, as well as BE, and EAC patients, whereas no significant changes were observed in ESCC samples, when compared to non-tumor samples. Additionally, in order to mimic BE and EAC risk factors exposure, a non-tumor esophageal cell line was incubated with oleic acid (OA) and acidified medium and/or deoxycholic acid (DCA), revealing a significant increment in LD amount as well as in COX-2 and CXCL-8 expression, and in IL-8 secretion. Further, COX-2 expression and LD amount presented a significant positive correlation and were detected co-localized in EAC, but not in ESCC, suggesting that LD may be the site for eicosanoid production in EAC. In conclusion, this study shows that obesity, and BE- and EAC-associated inflammatory stimuli result in a gradual increase of LD, that may be responsible for orchestrating inflammatory mediators' production and/or action, thus contributing to BE and EAC genesis and progression.

Silicon as an attenuator of drought stress in plants of Oryza sativa L. treated with dietholate.

Silicon (Si) is an element that can improve the growth and development of rice plants in water-deficient environments because it is an enzymatic stimulant, signaling for production of antioxidant compounds. Therefore, the aim of this study was to examine the relationship between water deficiency and the effect of Si on two rice cultivars whose seeds were treated with dietholate. The experimental design was fully randomized with three replicates, and treatments were organized in a 3x2x2x4 factorial arrangement: three water soil conditions (50% and 100% of soil water retention capacity (WRC) and complete submergence in a water blade of 5.0 cm); two cultivars (IRGA 424 RI and Guri INTA CL); two sources of Si (sodium metasilicate and potassium metasilicate); and four rates of Si (0; 4.0; 8.0 and 16 g L-1). Chlorophyll a and b, leaf area and shoot and root dry weight increased at higher rates of Si under the three soil water regimes. There was an increase in superoxide dismutase and guaiacol peroxidase enzyme activity in the cultivars at higher rates of Si, reducing lipid peroxidation caused by water deficiency. Therefore, Si did indeed attenuate water deficiency stress in rice plants emerging from seeds treated with dietholate.

Fonoaudiologia, gerontologia e a apneia obstrutiva do sono: relato de caso / Speech-language pathology, gerontology and obstructive sleep apnea: case report

RESUMO A eficácia da terapia fonoaudiológica está comprovada para a apneia obstrutiva do sono (AOS), principalmente para a população adulta. Entretanto, estudos com população acima de 65 anos são escassos. Assim, o objetivo do presente estudo foi analisar a evolução clínica longitudinal de um sujeito idoso com AOS submetido à terapia miofuncional orofacial (TMO). Caso clínico, sexo masculino, 72 anos, com AOS, submetido à TMO após ter realizado avaliação clínica, exames de polissonografia (PSG) e avaliação clínica otorrinolaringológica, bem como a aplicação da escala de sonolência de Epworth, a classificação de Mallampati e a avaliação fonoaudiológica miofuncional orofacial em três momentos distintos: antes da TMO, após a TMO e após 22 meses da TMO. A TMO se configurou na realização de exercícios isométricos e isotônicos para região orofacial e faríngea, treino funcional em sessões semanais de 30 minutos, durante cinco meses, quando, então, as sessões foram espaçadas. Após os 22 meses de TMO, observaram-se evoluções nos parâmetros objetivos e subjetivos relativos ao sono, que foram analisados e identificados por meio de uma nova polissonografia (PSG), com os seguintes dados: exame basal, 24,5 eventos/hora e último exame de 4,63 eventos/hora. Verificou-se acentuada melhora da sonolência diurna excessiva e, ainda, melhora dos parâmetros miofuncionais orofaciais. Deste modo, pôde-se constatar que a TMO demonstrou resultados eficientes e eficazes na intervenção e no tratamento terapêutico fonoaudiológico, tendo como base a AOS do paciente idoso. Ressalta-se que tais resultados foram acompanhados e controlados por meio de avaliação multidisciplinar de modo longitudinal.

ABSTRACT The effectiveness of speech-language therapy is proven for obstructive sleep apnea (OSA), especially for the adult population. However, studies with a population over 65 years are scarce. Thus, the aim of the present study was to analyze the longitudinal clinical evolution of an OSA elderly subject undergoing Orofacial Myofunctional Therapy (OMT). Male clinical case, 72 years old, with OSA submitted to OMT, polysomnography (PSG) exams, otorhinolaryngological clinical evaluation, Epworth sleepiness scale application, Mallampati classification and orofacial myofunctional speech evaluation in 3 different moments in time (before OMT, after OMT and after 22 months of OMT). OMT was configured to perform isometric and isotonic exercises for the orofacial and pharyngeal regions and functional training in weekly sessions of 30 minutes for 5 months. After that period, the sessions were spaced for biweekly, monthly and quarterly. After 22 months of OMT, an evolution was observed in the objective and subjective parameters related to sleep, identified by polysomnography (baseline test: 24.5 events / hour and last test of 4.63 events per hour), improvement in excessive daytime sleepiness and improvement of myofunctional orofacial parameters. Thus, it was observed that OMT demonstrated efficient and effective results of speech therapy intervention and therapeutic treatment based on OSA in this case report of an elderly person. It is noteworthy that such results were monitored and controlled through multidisciplinary evaluation in a longitudinal way.

[Barriers to implementing guideline recommendations to improve childbirth care: rapid review of evidenceObstáculos a la aplicación de las recomendaciones para la atención del parto normal: revisión rápida de evidencia]. / Barreiras à implementação de recomendações para assistência ao parto normal: revisão rápida de evidências.

OBJECTIVE: To identify potential barriers to the implementation of the National Childbirth Guidelines in Brazil based on the best available global evidence. METHOD: A rapid review of evidence was performed in six databases in March/April 2019. Secondary studies published in English, Spanish, or Portuguese with a focus on barriers of any nature relating to the implementation of the Guidelines were retrieved. RESULTS: Twenty-three documents (21 reviews and two practice guides) were included in the review. The barriers identified were grouped into 52 meaning categories and then reorganized into nine thematic clusters: delivery and childbirth care model, human resource management, knowledge and beliefs, gender relations, health care service management, attitudes and behaviors, communication, socioeconomic conditions, and political interests. CONCLUSIONS: The results show that combined approaches may be required to address different barriers to the implementation of the Guidelines. For successful implementation, it is essential to engage health care leaders, professionals, and users in the effort to change the delivery and childbirth care model. Also necessary is the development of intersectoral initiatives to improve the socioeconomic conditions of women and families and to curtail gender inequalities.

OBJETIVO: Identificar los posibles obstáculos a la aplicación de las recomendaciones formuladas en las Directrices Nacionales para la Atención del Parto Normal en Brasil a partir de la mejor evidencia disponible a nivel mundial. MÉTODOS: En marzo/abril de 2019 se llevó a cabo una revisión rápida de seis bases de datos. Se seleccionaron estudios secundarios publicados en español, inglés o portugués sobre los obstáculos de cualquier tipo que pudieran estar relacionados con la aplicación de las recomendaciones contenidas en las Directrices. RESULTADOS: Se incluyeron 23 documentos (21 revisiones sistemáticas y 2 guías de práctica clínica). Los obstáculos identificados se agruparon en 52 categorías con base en su semejanza de significado y luego se reorganizaron en nueve grupos temáticos: modelo de atención del parto, gestión de recursos humanos, creencias y conocimientos, relaciones de género, gestión de servicios de salud, actitudes y comportamientos, comunicación, condiciones socioeconómicas e intereses políticos. CONCLUSIONES: La aplicación de las Directrices puede requerir enfoques combinados para hacer frente a diferentes obstáculos. La participación de los administradores y los trabajadores de la salud en el proceso de cambio del modelo de atención del parto, así como la participación de los usuarios, son fundamentales para que la aplicación de las Directrices sea satisfactoria. Además, se necesitan medidas intersectoriales para mejorar las condiciones socioeconómicas de las mujeres y las familias y para combatir las desigualdades entre los géneros.

Fractions of Selaginella convoluta (Arn) Spring (Selaginellaceae) attenuate the nociceptive behavior events in mice / Frações de Selaginella convoluta (Ar) Spring (Selaginellaceae) atenuam a resposta nociceptiva em camundongos

Abstract Selaginella convoluta (Arn.) Spring is a species popularly known as "jericó", and used in folk medicine as analgesic and anti-inflammatory. This study aimed to investigate in mice the antinociceptive and anti-inflammatory activities of the hexane (Sc-Hex) and chloroform (Sc-CHCl3) fractions (100, 200 and 400 mg/kg) obtained by partition of crude ethanol extract from S. convoluta. The preliminary phytochemical analysis of the fractions was performed. Antinociceptive activity was evaluated by writhing, formalin and hot-plate tests. Anti-inflammatory activity was evaluated using carrageenan-induced pleurisy. The rota-rod test was used to evaluate motor coordination. Preliminary phytochemical screening showed that the Sc-Hex and the Sc-CHCl3 were positive for the presence of flavonoids, anthracene derivatives, quinones, triterpenes and steroids. Inhibition of writhing was observed for fractions tested. The Sc-Hex at all doses tested was effective in reducing the nociceptive behavior produced by formalin only in the second phase. However, the Sc-CHCl3 decreased the paw licking time in the first and second phases. In the hot plate no significant effect was observed for any fraction. In the rota-rod test, treated mice did not demonstrate any significant motor performance changes. In the carrageenan-induced pleurisy, Sc-CHCl3 (200 mg/kg) reduced cell migration to the pleural cavity. These results reveal the antinociceptive properties of S. convoluta , which support, in part, its traditional use, since the fractions did not presented significant activity in the inflammatory response profile. We further verify that this antinociceptive effect could be by activation of nociceptive peripheral pathway.

Resumo Selaginella convoluta é uma espécie popularmente conhecida como "jericó", e usada na medicina popular como analgésica e anti-inflamatória. Este estudo teve como objetivo investigar em camundongos as atividades antinociceptiva e anti-inflamatória das frações hexânica (Sc-Hex) e clorofórmica (Sc-CHCl3) (100, 200 e 400 mg/kg) obtidas por partição do extrato etanólico bruto de S. convoluta . A análise fitoquímica preliminar das frações foi realizada. A atividade antinociceptiva foi avaliada pelos testes de contorções abdominais, formalina e placa quente. A atividade anti-inflamatória foi avaliada usando pleurisia induzida por carragenina. O teste do rota-rod foi utilizado para avaliar a coordenação motora. A triagem fitoquímica preliminar mostrou que Sc-Hex e Sc-CHCl3 apresentaram reação positiva para a presença de flavonoides, derivados antracênicos, quinonas, triterpenos e esteroides. A inibição das contorções foi observada para as frações testadas. Sc-Hex em todas as doses testadas foi efetivo na redução do comportamento nociceptivo produzido pela formalina somente na segunda fase. No entanto, Sc-CHCl3 diminuiu o tempo de lambida da pata na primeira e segunda fases. Na placa quente, nenhum efeito significativo foi observado para qualquer fração. No teste do rota-rod os camundongos tratados não demonstraram mudanças significativas na coordenação motora. Na pleurisia induzida por carragenina, Sc-CHCl3 (200 mg/kg) reduziu a migração celular para a cavidade pleural. Estes resultados revelam a propriedade antinociceptiva de S. convoluta, justificando, em parte, seu uso tradicional, uma vez que os extratos não apresentaram atividade significativa no perfil de resposta inflamatória. Verificamos ainda que esse efeito antinociceptivo mostrou-se ligado à ativação da via periférica nociceptiva.

Fractions of Selaginella convoluta (Arn.) Spring (Selaginellaceae) attenuate the nociceptive behavior events in mice.

Selaginella convoluta (Arn.) Spring is a species popularly known as "jericó", and used in folk medicine as analgesic and anti-inflammatory. This study aimed to investigate in mice the antinociceptive and anti-inflammatory activities of the hexane (Sc-Hex) and chloroform (Sc-CHCl3) fractions (100, 200 and 400 mg/kg) obtained by partition of crude ethanol extract from S. convoluta. The preliminary phytochemical analysis of the fractions was performed. Antinociceptive activity was evaluated by writhing, formalin and hot-plate tests. Anti-inflammatory activity was evaluated using carrageenan-induced pleurisy. The rota-rod test was used to evaluate motor coordination. Preliminary phytochemical screening showed that the Sc-Hex and the Sc-CHCl3 were positive for the presence of flavonoids, anthracene derivatives, quinones, triterpenes and steroids. Inhibition of writhing was observed for fractions tested. The Sc-Hex at all doses tested was effective in reducing the nociceptive behavior produced by formalin only in the second phase. However, the Sc-CHCl3 decreased the paw licking time in the first and second phases. In the hot plate no significant effect was observed for any fraction. In the rota-rod test, treated mice did not demonstrate any significant motor performance changes. In the carrageenan-induced pleurisy, Sc-CHCl3 (200 mg/kg) reduced cell migration to the pleural cavity. These results reveal the antinociceptive properties of S. convoluta , which support, in part, its traditional use, since the fractions did not presented significant activity in the inflammatory response profile. We further verify that this antinociceptive effect could be by activation of nociceptive peripheral pathway.

Plants utilized as medicines by residents of Quilombo da Fazenda, Núcleo Picinguaba, Ubatuba, São Paulo, Brazil: A participatory survey.

ETHNOPHARMACOLOGICAL RELEVANCE: Participatory research can help to broaden the understanding of medical systems and beliefs of traditional communities. An ethnopharmacological survey in collaboration with local people focused on plants used in quilombos located in Southeast Region in Brazil identified cultural factors that influence plant and recipe choice. AIM OF THE STUDY: To investigate the factors related to the therapeutic efficiency of medicinal plants from the perspective of Quilombo da Fazenda residents. MATERIALS AND METHODS: University researchers collaborated with community residents for both aims and methods of the study. The local partners were trained in the gathering of ethnopharmacological data and then selected and interviewed the residents considered experts on the use of medicinal plants. Data on the use of each species were supported by voucher specimens collected by the local partners and university researchers. Participant observations and field diaries by the university researchers supplemented the data. RESULTS: Eight interviewees mentioned 92 medicinal species with 60 therapeutic uses, applied in 208 recipes or remedies. Asteraceae (13 species), Lamiaceae (5) and Urticaceae (5) contributed most medicinal plant species. Of the 12 etic categories of use, the circulatory system category had the highest number of plants mentioned. Decoction was the most commonly used preparation method (66.8%), and most remedies were administered orally (76.4%). Eighty-six recipes included more than one plant species and/or the addition of other components, such as sugar, salt or animal products. Several cultural factors influence medicinal plant use. Popular beliefs on the quality of blood or the humoral properties of plants and illnesses, characteristics of the plants and other factors determine which plant is used and why. CONCLUSIONS: The participatory method identified a large number of factors that influence medicinal plant use: the patient's blood type; the condition of the plant and the disease (hot-cold system); the route of administration and dosage; the preventive uses of the plants; and the influence of other factors, such as the sun, the moon and dew. The participatory approach is useful for gaining insight on the decision processes of medicinal plant use in traditional societies, and also for those communities wanting to document their knowledge with or without the participation of the academy.

Fractions of Selaginella convoluta (Arn.) Spring (Selaginellaceae) attenuate the nociceptive behavior events in mice

Abstract Selaginella convoluta (Arn.) Spring is a species popularly known as jericó, and used in folk medicine as analgesic and anti-inflammatory. This study aimed to investigate in mice the antinociceptive and anti-inflammatory activities of the hexane (Sc-Hex) and chloroform (Sc-CHCl3) fractions (100, 200 and 400 mg/kg) obtained by partition of crude ethanol extract from S. convoluta. The preliminary phytochemical analysis of the fractions was performed. Antinociceptive activity was evaluated by writhing, formalin and hot-plate tests. Anti-inflammatory activity was evaluated using carrageenan-induced pleurisy. The rota-rod test was used to evaluate motor coordination. Preliminary phytochemical screening showed that the Sc-Hex and the Sc-CHCl3 were positive for the presence of flavonoids, anthracene derivatives, quinones, triterpenes and steroids. Inhibition of writhing was observed for fractions tested. The Sc-Hex at all doses tested was effective in reducing the nociceptive behavior produced by formalin only in the second phase. However, the Sc-CHCl3 decreased the paw licking time in the first and second phases. In the hot plate no significant effect was observed for any fraction. In the rota-rod test, treated mice did not demonstrate any significant motor performance changes. In the carrageenan-induced pleurisy, Sc-CHCl3 (200 mg/kg) reduced cell migration to the pleural cavity. These results reveal the antinociceptive properties of S. convoluta , which support, in part, its traditional use, since the fractions did not presented significant activity in the inflammatory response profile. We further verify that this antinociceptive effect could be by activation of nociceptive peripheral pathway.

Resumo Selaginella convoluta é uma espécie popularmente conhecida como jericó, e usada na medicina popular como analgésica e anti-inflamatória. Este estudo teve como objetivo investigar em camundongos as atividades antinociceptiva e anti-inflamatória das frações hexânica (Sc-Hex) e clorofórmica (Sc-CHCl3) (100, 200 e 400 mg/kg) obtidas por partição do extrato etanólico bruto de S. convoluta . A análise fitoquímica preliminar das frações foi realizada. A atividade antinociceptiva foi avaliada pelos testes de contorções abdominais, formalina e placa quente. A atividade anti-inflamatória foi avaliada usando pleurisia induzida por carragenina. O teste do rota-rod foi utilizado para avaliar a coordenação motora. A triagem fitoquímica preliminar mostrou que Sc-Hex e Sc-CHCl3 apresentaram reação positiva para a presença de flavonoides, derivados antracênicos, quinonas, triterpenos e esteroides. A inibição das contorções foi observada para as frações testadas. Sc-Hex em todas as doses testadas foi efetivo na redução do comportamento nociceptivo produzido pela formalina somente na segunda fase. No entanto, Sc-CHCl3 diminuiu o tempo de lambida da pata na primeira e segunda fases. Na placa quente, nenhum efeito significativo foi observado para qualquer fração. No teste do rota-rod os camundongos tratados não demonstraram mudanças significativas na coordenação motora. Na pleurisia induzida por carragenina, Sc-CHCl3 (200 mg/kg) reduziu a migração celular para a cavidade pleural. Estes resultados revelam a propriedade antinociceptiva de S. convoluta, justificando, em parte, seu uso tradicional, uma vez que os extratos não apresentaram atividade significativa no perfil de resposta inflamatória. Verificamos ainda que esse efeito antinociceptivo mostrou-se ligado à ativação da via periférica nociceptiva.

Silicon as an attenuator of drought stress in plants of Oryza sativa L. treated with dietholate

Abstract Silicon (Si) is an element that can improve the growth and development of rice plants in water-deficient environments because it is an enzymatic stimulant, signaling for production of antioxidant compounds. Therefore, the aim of this study was to examine the relationship between water deficiency and the effect of Si on two rice cultivars whose seeds were treated with dietholate. The experimental design was fully randomized with three replicates, and treatments were organized in a 3x2x2x4 factorial arrangement: three water soil conditions (50% and 100% of soil water retention capacity (WRC) and complete submergence in a water blade of 5.0 cm); two cultivars (IRGA 424 RI and Guri INTA CL); two sources of Si (sodium metasilicate and potassium metasilicate); and four rates of Si (0; 4.0; 8.0 and 16 g L-1). Chlorophyll a and b, leaf area and shoot and root dry weight increased at higher rates of Si under the three soil water regimes. There was an increase in superoxide dismutase and guaiacol peroxidase enzyme activity in the cultivars at higher rates of Si, reducing lipid peroxidation caused by water deficiency. Therefore, Si did indeed attenuate water deficiency stress in rice plants emerging from seeds treated with dietholate.

Resumo O silício (Si) é um elemento que pode proporcionar melhor crescimento e desenvolvimento às plantas de arroz cultivadas em ambientes com deficiência hídrica, por ser um estimulador enzimático, promovendo sinalização para produção de compostos antioxidantes. Assim, o objetivo deste trabalho foi estudar a relação entre deficiência hídrica e o efeito do Si em duas cultivares de arroz tratadas com dietholate. O delineamento experimental utilizado foi inteiramente casualizado, com três repetições e os tratamentos arranjados em esquema fatorial 3x2x2x4, sendo os fatores: três condições hídricas do solo (50%, 100% da capacidade de retenção de água no solo (CRA) e lâmina dágua de 5,0 cm), duas cultivares (IRGA 424 RI e Guri INTA CL), duas fontes de Si (metassilicato de sódio e metassilicato de potássio) e quatro doses de Si (0; 4,0; 8,0 e 16 g L-1). O índice de clorofila a e b, a área foliar e o teor de massa seca da parte aérea e raiz aumentaram com o aumento das doses de Si nas três condições hídricas do solo. Houve um aumento na atividade das enzimas superóxido dismutase e guaiacol peroxidase nas cultivares estudadas à medida que as doses de Si aumentaram, diminuindo a peroxidação de lipídios, causada pela restrição hídrica. Portanto, o Si atenua o estresse por déficit hídrico em plantas de arroz emergentes de sementes tratadas com dietholate.

Design, synthesis, molecular docking and biological evaluation of thiophen-2-iminothiazolidine derivatives for use against Trypanosoma cruzi.

In this study, we designed and synthesized a series of thiophen-2-iminothiazolidine derivatives from thiophen-2-thioureic with good anti-Trypanosoma cruzi activity. Several of the final compounds displayed remarkable trypanocidal activity. The ability of the new compounds to inhibit the activity of the enzyme cruzain, the major cysteine protease of T. cruzi, was also explored. The compounds 3b, 4b, 8b and 8c were the most active derivatives against amastigote form, with significant IC50 values between 9.7 and 6.03µM. The 8c derivative showed the highest potency against cruzain (IC50=2.4µM). Molecular docking study showed that this compound can interact with subsites S1 and S2 simultaneously, and the negative values for the theoretical energy binding (Eb=-7.39kcal·mol(-1)) indicates interaction (via dipole-dipole) between the hybridized sulfur sp(3) atom at the thiazolidine ring and Gly66. Finally, the results suggest that the thiophen-2-iminothiazolidines synthesized are important lead compounds for the continuing battle against Chagas disease.

Diseño del kit de tinción Ziehl Neelsen del Instituto nacional de Higiene "Rafael Rangel" / Design Kit Ziehl Neelsen the Instituto Nacional de Higiene "Rafael Rangel"

La tinción de Ziehl Neelsen (ZN), es una técnica de coloración de microorganismos para la identificación de patógenos, como Mycobacterium tuberculosis causante de la tuberculosis, que requiere de tres (03) soluciones: Carbol Fucsina Fenicada (Fucsina Básica), Azul de Metileno al 1% y Solución Decolorante, que se elaboran en la Sección de Reactivos y Colorantes del Instituto Nacional de Higiene "Rafael Rangel" y se emplean en el diagnóstico de tuberculosis. Esta investigación surgió con el propósito de comprobar el tiempo de caducidad y condiciones de almacenamiento de dichos productos y presentarlos en un estuche tipo kit para su distribución, en apoyo a la Red Nacional de Laboratorios de Salud Pública y comercialización con otros entes. Se realizó el ensayo de tres (3) lotes del kit de Ziehl Neelsen; con su respectiva contramuestra que fue evaluada en el análisis final. Se registraron los parámetros físicos de temperatura y humedad relativa bajo condiciones normales de almacenamiento en el laboratorio, con las muestras protegidas de la luz. Se evaluó la funcionalidad por medio de la tinción ZN observada bajo microscopio, de tres (03) muestras con ATCC 700686: M. peregrinum y ATCC 29213: S. aureus por lote; tomando en cuenta el exceso de colorante, y la definición de las coloraciones. Estas evaluaciones se realizaron durante dos (02) años encontrándose como resultado que física y funcionalmente los productos contentivos en el kit se mantenían estables, fijándose un tiempo de caducidad de dos (02) años.

Ziehl Neelsen (ZN) is a staining technique of microorganisms for the identification of pathogens as Mycobacterium tuberculosis, causative of tuberculosis, which requires three (03) solutions: Carbol Fuchsin combined with Phenol (Basic Fuchsin), Methylene Blue 1% and Bleaching solution, which are prepared in Section of Reagents and Coloring of the Instituto Nacional de Higiene "Rafael Rangel" and are used in the diagnosis of tuberculosis. This investigation was made with the purpose of checking the shelf life and storage conditions of these products and present them in a kit type container for distribution in support of the National Network of Public Health Laboratories and marketing with other entities. The analysis was performed in three (3) batches of the Ziehl Neelsen kit; with their respective counter sample that was evaluated in the final analysis. The physical parameters of temperature and relative humidity were recorded in the laboratory under normal storage conditions with samples protected from light. The functionality was evaluated through ZN staining being observed under a microscope three (03) samples with ATCC 700686: M. peregrinum and ATCC 29213: S. aureus by Batch; taking into consideration the excess dye, and the definition of the colors. These evaluations were conducted for two (02) years found as main result that physically and functionally the products in the kit were stable, and can set an expiration time of two years.