Exploring the Potential of Myrcia Genus Essential Oils: A Review of Biological Activities and Recent Advances.

The present study provides a comprehensive analysis of the chemical composition of essential oils from species of the Myrcia genus and their applications. The compiled results highlight the chemical diversity and biological activities of these oils, emphasizing their potential importance for various therapeutic and industrial applications. The findings reveal that Myrcia essential oils present a variety of bioactive compounds, such as monoterpenes and sesquiterpenes, which demonstrate antimicrobial activities against a range of microorganisms, including Gram-positive and Gram-negative bacteria, as well as yeasts. Furthermore, this study highlights the phytotoxic activity of these oils, indicating their potential for weed control. The results also point to the insecticidal potential of Myrcia essential oils against a range of pests, showing their viability as an alternative to synthetic pesticides. Additionally, species of the genus Myrcia have demonstrated promising hypoglycemic effects, suggesting their potential in diabetes treatment. This comprehensive synthesis represents a significant advancement in understanding Myrcia essential oils, highlighting their chemical diversity and wide range of biological activities. However, the need for further research is emphasized to fully explore the therapeutic and industrial potential of these oils, including the identification of new compounds, understanding of their mechanisms of action, and evaluation of safety and efficacy in different contexts.

High-frequency Ultrasound in the Assessment before and after Applying HArmonyCa™.

AIM: To describe a clinical case of ultrasound (US) used to evaluate, before, post-immediately, and after 4 months, the facial application of a volumizing and biostimulating substance. BACKGROUND: Detecting the behavior of injected filler materials with high-frequency US-guided application is the future of natural facial rejuvenation with more predictable and satisfactory results. TECHNIQUE: A patient indicated for orofacial harmonization (OFH) procedures through volumizing and biostimulating material application was invited to participate. The technique was performed by applying HArmonyCa™ (Allergan Aesthetics, Irvine, CA, USA) in the gonial, preauricular, and bilateral lateral zygomatic angle regions. The first evaluations used the US images before and after product application with a Logiq e® high-frequency US device (GE Healthcare, Chicago, IL, USA) with a probe/linear transducer of 18 MHz. About 4 months after the procedure, a new assessment with the same initial acquisition pattern was performed. The first evaluation showed normal-looking anatomical structures without the esthetic material. Immediately after the procedure and 4 months later, the assessments presented semi-permanent esthetic fillers as dispersed lobulated hyperechogenic areas with a cloud aspect. CONCLUSION: High-frequency US was efficient in the static evaluation of HArmonyCa™ behavior on the facial skin. CLINICAL SIGNIFICANCE: The US-guided application of injectable products in specific areas has minimal side effects and contributes to more predictable and satisfactory results. How to cite this article: Gouveia RSA, Tostes LLL, Bezerra FV, et al. High-frequency Ultrasound in the Assessment before and after Applying HArmonyCa™. J Contemp Dent Pract 2024;25(1):10-14.

Sustainable Applications of Nanopropolis to Combat Foodborne Illnesses.

Propolis has numerous biological properties and technological potential, but its low solubility in water makes its use quite difficult. With the advent of nanotechnology, better formulations with propolis, such as nanopropolis, can be achieved to improve its properties. Nanopropolis is a natural nanomaterial with several applications, including in the maintenance of food quality. Food safety is a global public health concern since food matrices are highly susceptible to contamination of various natures, leading to food loss and transmission of harmful foodborne illness. Due to their smaller size, propolis nanoparticles are more readily absorbed by the body and have higher antibacterial and antifungal activities than common propolis. This review aims to understand whether using propolis with nanotechnology can help preserve food and prevent foodborne illness. Nanotechnology applied to propolis formulations proved to be effective against pathogenic microorganisms of industrial interest, making it possible to solve problems of outbreaks that can occur through food.

Candida species causing fungal keratitis: molecular identification, antifungal susceptibility, biofilm formation, and clinical aspects.

The study aimed to evaluate the clinical aspects, molecular identification, biofilm formation, and antifungal susceptibility profile of Candida species isolated from fungal keratitis. Thirteen Candida isolates from 13 patients diagnosed with Candida keratitis were retrieved and grown in pure culture. Species identification was performed by micromorphology analysis and ITS-rDNA sequencing. The broth microdilution method tested the minimum inhibitory concentration (MIC) of four antifungal drugs (fluconazole, amphotericin B, voriconazole, and anidulafungin). The biofilms were cultured and incubated with antifungal drugs for 24 h. The XTT reduction assay measured the biofilm activity. Biofilm MICs were calculated based on a 50% reduction in metabolic activity compared with the activity of the drug-free control. Among isolates, two were C. albicans, 10 were C. parapsilosis (sensu stricto), and one was C. orthopsilosis. All isolates were classified as susceptible or intermediate to all four antifungal drugs. Four isolates were very low biofilm producers (30%). Nine isolates were biofilm producers, and all biofilm samples were unsusceptible to all drugs tested. Previous ocular surgery was the most common underlying condition for fungal keratitis (84.6%), and C. parapsilosis was the most frequent Candida species (76.9%). Four patients (30.7%) needed keratoplasty, whereas two (15.3%) required evisceration. The biofilm formation ability of Candida isolates decreased antifungal susceptibility compared with planktonic cells. Despite in vitro antifungal susceptibility, almost half of the patients were unresponsive to clinical treatment and needed surgery.

Metabolomic analysis and ecofriendly enrichment of sunflower meal extract.

BACKGROUND: The presence of phenolic compounds in sunflower is well reported in the literature; however, knowledge is scarce when it comes to the composition of other secondary metabolites in this species and their by-products. This work evaluated, for the first time, the phytochemical composition of sunflower meal produced in Brazil. A combination of mixture design and central composite rotatable design 23 models was then applied to maximize the recovery of bioactive compounds using ecologically friendly solvents and concentrating by applying activated carbon, a sustainable adsorbent. The product of this extraction-concentration was also evaluated by an untargeted metabolomic approach using ultra-performance liquid chromatography coupled to mass spectrometry. RESULTS: A diverse and abundant profile of phenolic compounds was obtained from Brazilian sunflower meal: in total, 51 natural products were tentatively identified, 35 of which for the first time in sunflower. The sorption capacity of the activated charcoal, in the optimized process conditions, was effective in the separation and concentration of minority secondary metabolites. The ecofriendly extract proved to be enriched in plumberoside, p-coumaric acid, and alkaloids. CONCLUSIONS: Investigation of the phytochemical profile of sunflower meal produced in Brazil pointed to several secondary metabolites reported for the first time in sunflower samples, including phenolic compounds, alkaloids, and terpenes. The use of activated charcoal in an alkaline medium as an adsorbent for the concentration of these phytochemicals, from an aqueous extract, generated a potentially cost-effective, ecofriendly extract, enriched in minor metabolites, indicating a possible innovative way to selectively obtain these compounds from sunflower meal. © 2022 Society of Chemical Industry.

KeraKlear Artificial Cornea Implantation Assisted by Femtosecond Laser in Eyes With Aniridia.

PURPOSE: The purpose of this study was to evaluate the feasibility of treating aniridia-associated keratopathy with a nonpenetrating artificial cornea in 2 patients with corneal blindness secondary to aniridia. METHODS: This was a prospective, nonrandomized, interventional study of 2 consecutive patients with corneal blindness caused by aniridia. Ophthalmological examination was performed before the nonpenetrating keratoprosthesis surgery and then repeated 1, 7, 15, 30, 90, and 180 days and subsequently every 90 days thereafter. Optical coherence tomography was performed 90 days postsurgery to assess the position of the implant. RESULTS: Visual acuity improved significantly after the KeraKlear surgery. Postoperative findings included periprosthetic corneal thinning, neovascularization, and retroprosthetic opacity. CONCLUSIONS: KeraKlear nonpenetrating artificial corneas represent a promising alternative to keratolimbal allografts and Boston keratoprosthesis for the treatment of aniridia-associated keratopathy.

Fungal keratitis management in a referral cornea center in Brazil / Manejo de ceratites fúngicas em centro de referência no Brasil

Abstract Purpose: To report etiological diagnosis, predisposing risk factors, therapeutic strategies and visual outcome of patients treated at the Department of Ophthalmology of Federal University of São Paulo. Methods: This is a retrospective, descriptive, and observational study from medical and laboratory records of the Department of Ophthalmology of Federal University of São Paulo, including all patients with culture proven fungal keratitis in 5 years, from October 2012 through October 2017. Results: There were 2260 fungi microbiologic test requests. Of these, 140 samples had positive cultures for fungi and sixty-six patients were followed at our clinic. Forty-five patients (68.2%) were men, and the mean age was 48.06 (±17.39) years. Fusarium spp. was the most frequently isolated fungus (32 cases; 48.5%), followed by Candida parapsilosis (12 cases; 18.2%). Thirty-four patients (51.5%) underwent intracameral injection of amphotericin B (5 µg per 0.1 ml). In 11 patients (32.3%), infection was eradicated after intracameral amphotericin B associated to topical antifungal treatment and, in 23 patients (67.7%), therapeutic keratoplasty was needed. No complication related to intracameral amphotericin B injection was observed in this series. Forty-three patients (65.1%) ended up with therapeutic keratoplasty. Three patients (4.5%) evolved to evisceration or enucleation. At the last follow-up visit, 53 patients (80.3%) had visual acuity worse than 20/200. Conclusion: Despite current antifungals drugs and distinct administration strategies, fungal keratitis remains challenging. Delayed antifungal therapy may explain poor clinical outcomes. Intracameral amphotericin B associated to topical antfungal treatment seems to be a safe and helpful alternative for non-responsive fungal keratitis. But it is important to formulate other treatment strategies, hence to improve patients' outcomes, since most patients ended-up with significant visual impairment even after current treatment.

Resumo Objetivo: Descrever diagnósticos etiológicos, fatores de risco, estratégias terapêuticas e resultados visuais de pacientes com ceratite fúngica tratados no Departamento de Oftalmologia da Universidade Federal de São Paulo. Métodos: Trata-se de um estudo retrospectivo, descritivo e observacional, a partir da análise de prontuários médicos e laboratoriais do Departamento de Oftalmologia da Universidade Federal de São Paulo, incluindo todos os pacientes com ceratite fúngica comprovada por cultura no período de outubro de 2012 a outubro de 2017. Resultados: Foram realizadas 2260 solicitações de testes microbiológicos. Destas, 140 amostras apresentaram culturas positivas para fungos, e 66 pacientes foram acompanhados em nosso serviço. Quarenta e cinco pacientes (68,2%) eram do sexo masculino, e a média de idade foi de 48,06 (± 17,39) anos. Fusarium spp. foi o fungo mais freqüentemente isolado (32 casos; 48,5%), seguido por Candida parapsilosis (12 casos; 18,2%). Trinta e quatro pacientes (51,5%) foram submetidos à injeção intracameral de anfotericina B (5 µg por 0,1 ml). Destes, 11 pacientes (32,3%) tiveram a infecção erradicada. Nos outros 23 pacientes (67,7%), o transplante terapêutico foi necessário. Nenhuma complicação relacionada à injeção intracameral de anfotericina B foi observada neste estudo. No total, 43 pacientes (65,1%) evoluíram para transplante terapêutico, e 3 pacientes (4,5%) foram submetidos à evisceração ou enucleação. Cinquenta e três pacientes (80,3%) apresentaram acuidade visual final pior que 20/200. Conclusões: Apesar dos diversos medicamentos antifúngicos atuais e vias de administração, o tratamento das ceratites fúngicas permanece desafiador. O atraso no início do tratamento adequado pode justificar o desfecho clínico desfavorável de grande parte dos pacientes. A injeção intracameral de anfotericina B mostrou-se uma alternativa terapêutica segura para ceratites fúngicas refratárias. Mas outras estratégias de tratamento devem ser formuladas, visando melhorar os resultados visuais dos pacientes.

Effect of Contextual Interference in the Practicing of a Computer Task in Individuals Poststroke.

OBJECTIVES: Sensory and motor alterations resulting from stroke often impair the performance and learning of motor skills. The present study is aimed at investigating whether and how poststroke individuals and age- and sex-matched healthy controls benefit from a contextual interference effect on the practice of a maze task (i.e., constant vs. random practice) performed on the computer. METHODS: Participants included 21 poststroke individuals and 21 healthy controls, matched by sex and age (30 to 80 years). Both groups were divided according to the type of the practice (constant or random) presented in the acquisition phase of the learning protocol. For comparison between the groups, types of practice, and blocks of attempts, the analysis of variance with Tukey's post hoc test (p < 0.05) was used. RESULTS: Poststroke individuals presented longer movement times as compared with the control group. In addition, only poststroke individuals who performed the task with random practice showed improved performance at the transfer phase. Moreover, randomized practice enabled poststroke individuals to perform the transfer task similarly to individuals without any neurological impairment. CONCLUSION: The present findings indicated a significant effect of contextual interference of practice in poststroke individuals, suggesting that applying randomized training must be considered when designing rehabilitation protocols for this population.

Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline / Alterações da superfície ocular no tratamento da Rosácea: comparação entre isotretinoína oral em baixa dosagem e doxiciclina

ABSTRACT Purpose: To compare the impact of ocular changes between systemic treatment with doxycycline and low-dose oral isotretinoin in patients with moderate-to-severe papulopustular rosacea. Methods: Patients were randomized to receive either isotretinoin 0.3-0.4 mg/kg (group A) or doxycycline 100 mg/day (group B) for 16 weeks. Ocular symptoms were searched and evaluated, including best-corrected visual acuity (BCVA), Schirmer test, breakup time, rose bengal staining score, and meibomian gland dysfunction grading. The patients were retested at the end of treatment. Results: The present study included 39 patients (30 females and 9 males). Best-corrected visual acuity was > 20/30 in >90% of patients in both groups and did not change after treatment. After treatment, improvement in ocular symptoms and meibomian gland dysfunction was more pronounced in group B (p<0.05); the other parameters did not reach statistical significance. Conclusion: Doxycycline improved meibomian gland dysfunction, ocular symptoms, and ocular surface in patients with rosacea. Even though some patients experienced worsening meibomian gland dysfunction and symptoms, no subject experienced any serious complications after administration of low-dose isotretinoin.

RESUMO Objetivos: Comparar o impacto das alterações oculares entre o tratamento sistêmico de doxiciclina e isotretinoína em baixa dosagem em pacientes com rosácea papulopustulosa moderada a grave. Métodos: Os pacientes form randomizados para receber isotretinoína 0,3 a 0,4 mg/kg (grupo A) ou doxiciclina 100mg/dia (grupo B) por 16 semanas. Os sintomas oculares foram pesquisados e avaliados, incluindo melhor acuidade visual corrigida, teste de Schirmer, tempo de ruptura do filme lacrimal, coloração de rosa bengala e graduação da disfunção de glândula de Meibomius. Os pacientes foram novamente testados no final do tratamento. Resultados: O presente estudo incluiu 39 pacientes (30 mulheres e 9 homens). A melhor acuidade visual corrigida foi >20/30 em >90% dos pacientes em ambos os grupos e não se alterou após o tratamento. A melhora dos sintomas oculares e da disfunção de glândula de Meibomius foi mais pronunciada no grupo B (p<0,05) após o tratamento; as demais variáveis não atingiram significância estatística. Conclusão: A doxiciclina melhorou a disfunção de glândula de Meibomius, os sintomas oculares e a superfície ocular de pa cientes com rosácea. Mesmo que alguns pacientes tenham piorado a disfunção e os sintomas da glândula de Meibomius, nenhum indivíduo apresentou complicações graves após a admi nistração de baixas doses de isotretinoína.

Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline.

PURPOSE: To compare the impact of ocular changes between systemic treatment with doxycycline and low-dose oral isotretinoin in patients with moderate-to-severe papulopustular rosacea. METHODS: Patients were randomized to receive either isotretinoin 0.3-0.4 mg/kg (group A) or doxycycline 100 mg/day (group B) for 16 weeks. Ocular symptoms were searched and evaluated, including best-corrected visual acuity (BCVA), Schirmer test, breakup time, rose bengal staining score, and meibomian gland dysfunction grading. The patients were retested at the end of treatment. RESULTS: The present study included 39 patients (30 females and 9 males). Best-corrected visual acuity was > 20/30 in >90% of patients in both groups and did not change after treatment. After treatment, improvement in ocular symptoms and meibomian gland dysfunction was more pronounced in group B (p<0.05); the other parameters did not reach statistical significance. CONCLUSION: Doxycycline improved meibomian gland dysfunction, ocular symptoms, and ocular surface in patients with rosacea. Even though some patients experienced worsening meibomian gland dysfunction and symptoms, no subject experienced any serious complications after administration of low-dose isotretinoin.

Clinical profile and ophthalmologic manifestations of Herpes Zoster Ophthalmicus / Perfil clínico e achados oftalmológicos no Herpes Zoster Oftálmico

ABSTRACT Objective: Herpes Zoster Ophthalmicus (HZO) is caused by varicella-zoster virus (VZV) and commonly affects elderly or immunocompromised patients. It has the potential to generate severe complications such as corneal ulcers, uveitis, retinal necrosis and post herpetic neuralgia. This study aimed to evaluate patients at the acute onset of the disease and describe their clinical profile and ophthalmologic findings. Methods: A cross-sectional study was performed from March 2014 to October 2015. All consecutive patients with the diagnosis of acute HZO (at a vesicle, pustule or crust stage) were enrolled and submitted to an ophthalmologic exam that included ectoscopy, best corrected visual acuity, corneal sensitivity test, slit-lamp examination, Goldmann applanation tonometry and funduscopic examination. Results: Nineteen patients were included. The mean age was 71 years old, ranging from 52 to 88. Ten patients had high blood pressure (52.6%) and nine (47.3%) had diabetes. Visual acuity lowered in comparison to the fellow eye in eleven patients (57%), ranging from one to six lines of vision, due mostly to epithelial keratitis and ocular discharge. Intraocular pressure (IOP) did not varied in most cases compared to the fellow eye. Hutchinson's sign (HS) was present in seven (36%) patients. The correlation between HS and anterior chamber reaction as well as decreased corneal sensitivity was statistically significant with Fisher's test of 0.009 and 0.029 respectively (p<0.05). Conclusion: The clinical profile of our patients was elderly patients with a higher rate of diabetes. Correlation between Hutchinson's sign and anterior chamber reaction as well as decrease in corneal sensitivity was significant. High intraocular pressure or posterior segment complications were not found in any cases.

RESUMO Objetivos: Herpes Zoster Oftálmico (HZO) é uma doença causada pelo vírus varicella-zoster que comumente afeta idosos ou doentes imunossuprimidos, com potencial para gerar graves comorbidades oculares, incluindo úlceras corneanas, uveíte, necrose retiniana e neuralgia pós-herpética. O objetivo deste estudo foi avaliar estes pacientes na forma aguda da doença e descrever seu perfil clínico e achados oftalmológicos. Métodos: Um estudo transversal foi realizado entre março de 2014 e outubro de 2015. Todos os pacientes consecutivos com o diagnóstico de HZO (na forma vesicular, pustulosa ou crostosa) foram incluídos e submetidos ao exame oftalmológico que incluiu ectoscopia, melhor acuidade visual corrigida, teste de sensibilidade corneana, biomicroscopia, tonometria de aplanação de Goldmann e fundoscopia. Resultados: Dezenove pacientes foram incluídos. A idade média foi de 71 anos. Dez (52,6%) pacientes relataram hipertensão arterial sistêmica e nove (47,3%) diabetes mellitus. A acuidade visual do olho acometido se encontrou abaixo do olho contra lateral em 57% dos casos, variando entre uma a seis linhas de visão. A pressão intraocular não variou na maioria dos casos em comparação com o olho contralateral. O sinal de Hutchinson estava presente em sete (36%) pacientes. A correlação entre este sinal e a presença tanto de reação de câmara anterior quanto de hipoestesia corneana foi positiva estatisticamente, com teste exato de Fisher de 0,009 e 0,029 respectivamente (p<0,05). Conclusão: Idosos com uma prevalência elevada de diabetes mellitus representaram o perfil clínico dos pacientes deste estudo. A correlação entre o sinal de Hutchinson e reação de câmara anterior, bem como daquele com hipoestesia corneana foi estatisticamente significativa. Não foi identificado nenhum caso de hipertensão ocular ou complicações de segmento posterior.

Autonomic dysfunction in patients with central serous chorioretinopathy / Disfunção autonômica em pacientes com coriorretinopatia serosa central

Abstract Objetive: To evaluate the association between sympathetic nervous system activity and blood pressure variability with central serous chorioretinopathy (CSC). Methods: We performed an individual, observational, and cross-sectional study involving 11 patients with CSC and 16 healthy individuals in similar age range. Participants underwent spectral power analysis of heart rate variability (HRV) at the Hypertension Department of Heart Institute at the University of São Paulo. Results: We demonstrated sympathetic activity predominance in CSC group and found that the LF (low frequency) of heart rate variability was significantly higher in this group (p = 0.04). when compared to control group. The CSC group's mean LF / HF (high frequency) ratio was higher than the control group but was not statistically significant (p = 0.2). Blood pressure variability was higher in CSC patients than in normal patients (p = 0.055), whereas heart rate variability was lower in these patients when compared to normal patients, although no statistical significance was found (p = 0.2). Spontaneous baroreflex function was significantly reduced in patients with CSC when compared to healthy individuals (p = 0.04). Conclusion: Autonomic dysfunction and a predominance of sympathetic modulation were observed in CSC patients.

Resumo Objetivo: Avaliar a associação entre a atividade do sistema nervoso simpático e a variabilidade da pressão arterial com a coriorretinopatia serosa central (CSC). Métodos: Estudo individuado, observacional e transversal envolvendo 11 pacientes com CSC e 16 indivíduos saudáveis de idade semelhante. Os participantes foram submetidos à análise de poder espectral da variabilidade da freqüência cardíaca no Departamento de Hipertensão do Instituto do Coração da Universidade de São Paulo. Resultados: Observamos o predomínio da atividade simpática no grupo com CSC, evidenciado pelo LF da variabilidade da freqüência cardíaca significativamente maior neste grupo (P = 0.04) quando comparado ao grupo controle. A média da relação LF / HF e a variabilidade da pressão arterial foram maiores nos pacientes com CSC do que nos pacientes normais (P = 0,2 e P = 0,055, respectivamente), enquanto a variabilidade da freqüência cardíaca foi menor nesses pacientes quando comparados aos pacientes normais (P = 0,2), embora não tenha sido encontrada significância estatística. A função barorreflexa espontânea também foi significativamente reduzida nos pacientes com CSC quando comparados aos indivíduos saudáveis (P= 0,04). Conclusão: Concluímos que há sinais de disfunção autonômica e predomínio da modulação simpática nos pacientes com CSC.

Projeto SACI (Sonhar, Acordar, Contribuir e Integrar): formação para o trabalho de Educação em Saúde / THE SACI PROJECT: training for work in Health Education / EL PROYECTO SACI: formación para el trabajo de Educación en Salud

Este estudo retrata a história de uma intervenção no cotidiano dos serviços de saúde implicada com a reflexão crítica da realidade e com a emancipação de sujeitos: o Projeto SACI (Sonhar, Acordar, Contribuir e Integrar). Este projeto, que se enquadra como Promoção da Saúde e Educação em Saúde inclui questões ambientais às ações desenvolvidas pela Estratégia de Saúde da Familia sob a orientação do PAVS ­ Programa Ambientes Verdes e Saudáveis. Anualmente, estudantes de disciplinas de estágios supervisionados dos cursos de Fonoaudiologia e Psicologia da PUC-SP integrados ao Pró-saúde II, realizado em parceria com a Supervisão Técnica de Saúde da Freguesia do Ó / Brasilândia participam do Projeto SACI, compartilhando informações com os profissionais e com a população, agenciando encontros e atividades, para debater questões relacionadas com o tema saúde e educação ambiental.O resgate de sua história foi feito por meio de oficinas de escrita que reuniu Agentes Comunitários e Profissionais do NASF sob a coordenação de dois tutores educacionais, que em conjunto com professores e estudantes sistematizaram a presente narrativa. O projeto foi implementado por Agentes Comunitários de Saúde (ACS) de uma Unidade Básica de Saúde com o objetivo de promover Educação em Saúde com crianças e adolescentes da região, que apresenta altos índices de vulnerabilidade social. O resgate de sua história mostra a potência transformadora de um coletivo mobilizado, consciente das contradições que enfrentam cotidianamente, e participante de uma rede de relações do território de saúde.

This study presents the story of an intervention in the daily practice of health services involved with the critical reflection of reality and with the development of the subjects: the SACI Project (Dream, Waking up, Contribute and Integrate). This project is characterized as Health Promotion and Health Education and includes environmental issues in the actions developed by the Family Health Strategy under the guidance of Green and Healthy Environments Project - Building Integrated Public Policies (PAVS). Each year, students from disciplines of supervised stages of speech therapy and psychology courses of PUC-SP, integrated with the Pro-Health II and in partnership with the Health Technical Supervision of Freguesia do Ó / Brasilândia participate in the SACI Project, sharing information with professionals and with the population, touting meetings and activities, to discuss issues related to the theme of health and environmental education. The rescue of its history was done through writing workshops attended by Community Agents and professionals of NASF under the coordination of two educational tutors. Together with teachers and students, they systematized this narrative. The project was implemented by Community Health Agents (CHA) of a Basic Health Unit in order to promote health education to children and adolescents in the region, which has high social vulnerability indices. In addition, the rescue of its history shows the transforming power of a mobilized public, aware of the contradictions they face daily and participant of a network of health territory relations.

Este estudio presenta la historia de una intervención en la práctica diaria de los servicios de salud que participan en la reflexión crítica de la realidad y con el desarrollo de temas: el proyecto SACI (Sueño, Despertar, Contribuir e Integrar). Este proyecto se inscribe como Promoción de la Salud y Educación para la Salud incluye cuestiones ambientales a las acciones desarrolladas por la Estrategia de Salud de la Familia bajo la dirección del Proyecto Ambientes Verde y Saludable - Construyendo políticas públicas integradas (PAVS). Cada año, los estudiantes de disciplinas supervisados etapas de cursos de terapia del habla y la psicología de la PUC-SP, participan en el Proyecto SACI, el intercambio de información con los profesionales y con la población, haciendo alarde de actividades para examinar cuestiones relacionadas con el tema del rescate de la salud y la educación ambiental.O rescate de su historia se hace a través de talleres de escritura asistido por Agentes comunitarios y profesionales de lo NASF bajo la coordinación de dos tutores educativos, que en conjunto de los profesores y estudiantes sistematizan esta narrativa. El proyecto fue implementado por Agentes Comunitarios de Salud (ACS) con el fin de promover la educación para la salud de los niños y adolescentes de la región, que tiene altos índices de vulnerabilidad social . Y el rescate de su historia muestra el poder transformador de un público movilizado, consciente de las contradicciones que se enfrentan todos los días y participante de una red de relaciones territoriales de salud.

Capability of CBCT to identify patients with low bone mineral density: a systematic review.

The aim of this study was to systematically review the literature about the capability of CBCT images to identify individuals with low bone mineral density (BMD). As the literature is scarce regarding this topic, the purpose of this systematic review is also to guide future research in this area. A detailed search was performed in five databases without restrictions of time or languages. Additionally, a grey literature search was conducted. The Quality Assessment Tool for Diagnostic Accuracy Studies-2 was applied to evaluate the methodological design of selected studies. With the inclusion of only six studies, the evidence is limited to endorse the use of CBCT assertively as a diagnostic tool for low BMD. All of the three studies that analyzed radiomorphometric indices found that the linear measurements of the mandibular inferior cortex were lower in osteoporotic individuals. CBCT-derived radiographic density vertebral and mandibular measurements were also capable for differentiating individuals with osteoporosis from individuals with normal BMD. The analysis of the cervical vertebrae showed high accuracy measurements. This systematic review indicates a scarcity of studies regarding the potential of CBCT for screening individuals with low BMD. However, the studies indicate that radiomorphometric indices and CBCT-derived radiographic density should be promising tools for differentiating individuals with osteoporosis from individuals with normal BMD.

Discursos práticos sobre ocorrências, processos decisórios e decorrências de Conferências Municipais de Saúde / Practical discourses about events, decisions processes and effects of Health municipal conferences in Brazil / Discursos prácticos sobre hechos, procesos decisorios y consecuencias de las Conferencias Municipales de Salud en Brasil

Que significados podem ser evidenciados em discursos de participantes de Conferências Municipais de Saúde acerca de tais eventos, seus processos decisórios e decorrências? Para analisar tais discursos práticos, referidos a eventos ocorridos em seis municípios do Ceará em 2007, realizou-se estudo de casos múltiplos, a partir de análise documental, entrevistas e grupos focais, com análise hermenêutica e dialética. Sobre as ocorrências dos eventos, evidenciam-se as oportunidades de expressão e mobilização de alguns grupos de interesses por demandas específicas, em cenários de interlocução competitiva e busca de mediações políticas visando eficácia simbólica eventual. Dentre as decorrências a partir das decisões deliberadas, destacam-se discursos sobre a negligência de governos municipais na incorporação dessas demandas em suas agendas políticas e na implantação de estratégias institucionais correspondentes. Como, também, a ausência de monitoramento a fim por parte dos respectivos Conselhos Municipais de Saúde.

What can be elicited from the discourse analysis of Municipal Health Conferences attendees regarding these meetings, its decision-making processes and results? This is a multiple case study of events that took place in six towns in the State of Ceará (Northeast of Brazil) in 2007, based on documental review, interviews and focus groups, with a hermeneutics and dialectic analysis. Throughout these meetings, there are evidences of the voice and the advocacy of groups with specific requests, under a landscape of competitive dialogue and the search of political mediations pursuing symbolical effectiveness. From the decision-making process point of view, the more relevant elements are the statements concerning the negligence of municipal governments on incorporating these resolutions on their political agenda and its corresponding institutional implantation strategies, as well as the absence of supervision by the Municipal Health Councils.

¿Qué significados pueden destacarse en los discursos de participantes de las Conferencias Municipales de Salud? Se analizaron conferencias realizadas en el Noreste de Brasil durante el año 2007. Este fue un estudio de múltiples casos, de fundamentación teórica hermenéutica y dialéctica, basado en técnicas de análisis documental, entrevistas y grupos focales. En las conferencias se destacaron la posibilidad de expresión y movilización de algunos grupos de intereses por demandas específicas, escenarios de interlocución competitiva y búsqueda de mediaciones políticas orientadas para la obtención de cierta eficacia simbólica eventual. Sobre las consecuencias de las decisiones deliberadas, se destacaron ciertos discursos sobre la negligencia de los gobiernos municipales en la incorporación de estas demandas en sus agendas políticas, así como en el despliegue de estrategias institucionales correspondientes. También se reveló la ausencia de monitoreo por parte de los respectivos Consejos Municipales de Salud.

Sensibilizando a criança com diabetes para o cuidado de si: contribuição à prática educativa / Sensitizing children with diabetes to self-care: contributions to educational practice / Sensibilizando al niño con diabetes para el cuidado de sí: contribuciones a la práctica educativa

Objetivo: Analisar a aplicabilidade da dinâmica Corpo Saber na sensibilização da criança para o cuidado de si por meio de suas experiências. Métodos: Estudo descritivo e analítico desenvolvido em maio e junho de 2013, com seis crianças diabéticas em idade escolar, atendidas no ambulatório de um hospital de referência em Fortaleza/CE. Resultados: A dinâmica promoveu um ambiente de descontração favorável à expressão de sentimentos e demonstração dos cuidados básicos ao conviver com o diabetes. A sensibilização foi permeada de reflexões sobre o início da doença e o momento atual vivido. Assim, compartilharam com os pares as necessidades de cuidados e aprendizagens no controle metabólico. Conclusão: A aplicação da dinâmica Corpo Saber favoreceu o desenvolvimento de atividades educativas com a participação das crianças em momentos de aprendizagem sobre o cuidado de si.

Objective: To analyze the applicability of Body Knowledge dynamics in sensitizing children, through the expression of theirexperiences, to the practice of self-care. Methods: This descriptive and analytical study was conducted in May and June 2013with six diabetic school-aged children attending the outpatient clinic of a referral hospital in Fortaleza, CE, Brazil. Results: Thedynamics promoted a relaxed environment conducive to the expression of feelings and the reporting of basic care providedfor diabetes. Sensitization was permeated with reflections upon the onset of the disease and current time. Thus, the childrenshared with their peers the need for care actions and learning concerning metabolic control. Conclusion: The application ofBody Knowledge dynamics favored the development of educational activities with the participation of children, which promotedlearning regarding self-care.

Objetivo: Analizar la aplicabilidad de la dinámica Cuerpo Saber en la sensibilización del niño para el cuidado de sí mediantesus experiencias. Métodos: Estudio descriptivo y analítico desarrollado en mayor y junio del 2013, con seis niños diabéticosen edad escolar, atendidas en el ambulatorio de un hospital de referencia en Fortaleza-CE. Resultados: La dinámica promovióun ambiente de relajamiento favorable a la expresión de sentimientos y demostración de los cuidados básicos al convivir conla diabetes. La sensibilización fue permeada de reflexiones sobre el inicio de la enfermedad y el momento actual vivido. Así,compartieron con las parejas las necesidades de cuidados y aprendizajes en el control metabólico. Conclusión: La aplicaciónde la dinámica Cuerpo Saber favoreció el desarrollo de actividades educativas con la participación de los niños en momentosde aprendizaje sobre el cuidado de sí.

Fibrose cística e glomeruloesclerose segmentar e focal: relato de caso / Cystic fibrosis and focal and segmental glomerulosclerosis: case report

JUSTIFICATIVA E OBJETIVOS: Com o aumento significativo da expectativa de vida de pacientes com fibrose cística (FC), maior número de complicações tem sido relatado em adultos. Há poucos relatos de envolvimento renal na FC. O objetivo deste estudo foi apresentar um caso de paciente portador desta doença que desenvolveu complicação renal. RELATO DO CASO: Paciente do sexo masculino, 29 anos, há seis anos diagnosticado com FC. Apresentava episódios recorrentes de infecções respiratórias desde a infância. Evoluiu com proteinúria, sendo submetido à biópsia renal. CONCLUSÃO: Há necessidade de conhecer melhor o envolvimento renal em pacientes com FC e monitorar a função renal.

BACKGROUND AND OBJECTIVES: With the significant growth in the life expectancy of cystic fibrosis (CF) patients, a higher number of complications in adults has been reported. There are few reports of renal involvement in CF. The aim of this study is to present the case of a patient with this pathology who developed renal complication. CASE REPORT: male patient, 29 years old, diagnosed with CF six years ago. He had presented recurrent respiratory infections since childhood. He developed proteinuria and underwent a renal biopsy. CONCLUSION: It is necessary to better understand renal involvement in CF patients and consider further monitoring of the renal function.

Estudos sobre envelhecimento no Brasil: revisão bibliográfica / Studies on aging in Brazil: literature review

O objetivo do presente trabalho foi realizar uma revisão bibliográfica dos estudos sobre envelhecimento no âmbito das ciências da saúde, a fim de apresentar um panorama do que tem sido pesquisado sobre o assunto na América Latina e no Brasil no período de 1982 a 2010. Utilizou-se a bases de dados LILACS disponível on line na Biblioteca Virtual em Saúde (BVS). Constatou-se um aumento expressivo do número de publicações a partir de 2006, principalmente nas categorias: estado de saúde (51%, n=318), avaliação cognitiva (12,72%, n=66), estudos sociodemográficos (6,16% n=32), medicamentos (3,27% n=17) e avaliação funcional (3,08% n=16). Na categoria estado de saúde, houve maior número de publicações relativas a atividade física (17,9% n=57), doenças cardiovasculares (11,95% n=38), dieta (7,6% n=24), saúde bucal (6,6% n=21), menopausa/andropausa (6,3% n=20), quedas (5,97% n=19), atividade sexual (5,03% n=16) e depressão (4,1% n=13). Concluiu-se que é importante estudar estes temas relacionados à senescência, para contribuir com a qualidade de vida nesta faixa etária.

Percepções de puérperas adolescentes frente à assistência de enfermagem no alojamento conjunto / Adolescent puerpera perceptions concerning nursing care in rooming-in facility / Percepciones de puérperas adolescentes acerca de la asistencia de enfermería en el alojamiento conjunto

O presente estudo objetivou conhecer percepções de puérperas adolescentes sobre a assistência da enfermagem no Alojamento Conjunto (AC). Pesquisa exploratória, qualitativa, realizada em uma maternidade filantrópica em Mossoró-RN, mediante entrevistas semi-estruturadas efetuadas com 10 puérperas adolescentes, em julho de 2009. Os dados encontrados sobre a assistência de enfermagem no AC foram organizados em categorias que, ora se referem a concepções positivas sobre atividades da enfermagem, sobretudo, à administração de medicamentos, e ora expressam a ausência do acompanhamento profissional e o desejo de um lugar exclusivo para mães adolescentes. Conclui-se que há sentimentos de ambigüidade entre as puérperas, o que pode estar associado à necessidade de uma assistência sistematizada da enfermagem no AC, à pouca experiência das adolescentes e às incertezas surgidas com a vivência do período puerperal.

The present study intended to know perceptions of puerpera adolescent about nursing care in Rooming-in facility (RI). This exploratory research, of a qualitative approach, was done at a philanthropic maternity hospital in Mossoró, RN, through semi-structured interviews with 10 parity adolescents in July, 2009. The found data about nursing care in RI were organized by categories that are sometimes relative to positive conceptions about nursing care, mainly to the drug administration, and sometimes they express the absence of professional monitoring and the wish of a private place to the adolescent mothers. It follows that there are ambiguity feelings among the puerpera adolescents that can be associated to the necessity of a systemized nursing care in RI, to the little experience of the adolescents and to the uncertainties of puerperal period.

El presente estudio planteó como objetivo conocer percepciones de puérperas adolescentes sobre la asistencia de enfermería en el Alojamiento Conjunto (AC). Investigación que utiliza abordaje exploratorio, cualitativo, realizada en una maternidad filantrópica en Mossoró-RN, a través de entrevistas semiestructuradas, efectuadas con 10 puérperas adolescentes en el mes de julio del 2009. Los datos encontrados sobre la asistencia de enfermería en el AC fueron organizados en categorías que, en algunas ocasiones se refieren a concepciones positivas sobre actividades de la enfermería, sobre todo, a la administración de medicinas y, en otras ocasiones expresan la ausencia del acompañamiento profesional y el deseo de un sitio exclusivo para madres adolescentes. Llegamos a la conclusión de que hay sentimientos de ambigüedad entre las puérperas, que pueden estar relacionados a la necesidad de una asistencia sistematizada de la enfermería en el AC, a la limitada experiencia de las adolescentes y a la incertidumbre surgida con la vivencia del periodo puerperal.

Cateter central de inserção periférica: protocolo para recém-nascidos / Peripheral insertion of central venous catheter (PICC): a protocol to newborns

Os avanços tecnológicos ocorridos na área neonatal têm contribuído para o aumento da sobrevida de recém-nascidos (RN) com idade gestacional cada vez menor. Um acesso vascular no recém-nascido é essencial para a infusão de fluídos e eletrólitos. O cateter venoso central de inserção periférica (PICC) é um dispositivo que permite permanência prolongada, associado a um menor risco de complicações mecânicas e infecciosas O presente trabalho tem por objetivo apresentar um protocolo para unificar condutas à inserção, manuseio e atuação nas complicações do PICC. Foi desenvolvido a partir da vivência participativa e conjunta da equipe multiprofissional, que refletiu na melhoria da assistência prestada aos recém-nascidos.