Kounis syndrome. Apropos of a clinical case. / Síndrome de Kounis. A propósito de um caso clínico.

Kounis syndrome, while an acute coronary syndrome, occurs in the context of a hypersensitivity reaction, allergies, or anaphylaxis and is subdivided into three types: coronary spasm in normal arteries, instability of plaques in atherosclerotic coronary arteries, and thrombosis of coronary stents. Herein, the case of a 73-year-old patient who, after administration of amoxicillin/clavulanic acid, went into cardiorespiratory arrest with evidence of ST-T segment elevation on electrocardiogram is reported. Coronarography revealed no obstructive lesions, and spontaneous resolution of electrocardiographic abnormalities was observed. A review of anamnesis with the family revealed a previous allergy to penicillin. The tryptase dosage was strongly positive. Kounis syndrome type 2 was diagnosed, and the clinical outcome was good.

Síndrome de Kounis. A propósito de um caso clínico / Kounis syndrome. Apropos of a clinical case

RESUMO A síndrome de Kounis, enquanto síndrome coronária aguda, ocorre em um contexto de reação de hipersensibilidade, alergia ou anafilaxia, e subdivide-se em três tipos: o espasmo coronário em artérias normais, a instabilidade de placas em artérias coronárias ateroscleróticas e a trombose de stent coronário. Apresenta-se o caso de uma doente de 73 anos que, após administração de amoxicilina/ácido clavulânico, entra em parada cardiorrespiratória, com evidência de supradesnivelamento do segmento ST-T em eletrocardiograma. Realiza coronariografia com ausência de lesões obstrutivas, verificando-se resolução espontânea das alterações eletrocardiográficas. Revisão da anamnese com a família documenta alergia prévia à penicilina. O doseamento de triptase foi fortemente positivo. Foi admitida provável síndrome de Kounis tipo 2, com boa evolução clínica posterior.

ABSTRACT Kounis syndrome, while an acute coronary syndrome, occurs in the context of a hypersensitivity reaction, allergies, or anaphylaxis and is subdivided into three types: coronary spasm in normal arteries, instability of plaques in atherosclerotic coronary arteries, and thrombosis of coronary stents. Herein, the case of a 73-year-old patient who, after administration of amoxicillin/clavulanic acid, went into cardiorespiratory arrest with evidence of ST-T segment elevation on electrocardiogram is reported. Coronarography revealed no obstructive lesions, and spontaneous resolution of electrocardiographic abnormalities was observed. A review of anamnesis with the family revealed a previous allergy to penicillin. The tryptase dosage was strongly positive. Kounis syndrome type 2 was diagnosed, and the clinical outcome was good.

Promoção do aleitamento materno na assistência pré-natal pelo enfermeiro / Promotion of breastfeeding in pre-natal care by the nurse

Objetivo: realizar uma ação educativa sobre o aleitamento materno, para gestantes na sala de espera das consultas de pré-natal, em uma unidade municipal de saúde. Método: trata-se de um estudo descritivo, tipo relato de experiência. Refere-se a um jogo de perguntas aplicado a 15 gestantes, depois, ocorreu a discussão dos temas abordados. Resultados: percebeu-se que as gestantes ainda acreditam em muitos mitos que podem aumentar as chances de desmame precoce, baixo peso e adoecimento da criança, porém, estão cada vez mais informadas sobre a importância da amamentação, mas ainda precisam de orientações e atenção nesse momento da vida delas, pois ainda existem alguns mitos que prevalecem, podendo dificultar a adesão à amamentação exclusiva. Conclusão: tornam-se as ações em saúde relevantes, pois estimulam a troca de saberes entre profissionais e usuários e colaboram positivamente na promoção do aleitamento materno e no empoderamento dessas mulheres para a execução dessa prática. Desperta-se, nos acadêmicos, além disso, por meio de ações educativas em saúde, o lado educador inerente ao profissional enfermeiro.(AU)

Objective: to carry out an educational action on breastfeeding for pregnant women in the waiting room for prenatal consultations in a municipal health unit. Method: it is a descriptive study, type of experience report. Refers to a game of questions applied to 15 pregnant women, after which the discussion of the topics discussed took place. Results: pregnant women still believe in many myths that may increase their chances of early weaning, low weight and illness, but they are increasingly informed about the importance of breastfeeding, but they still need guidance and attention. of their lives, as there are still some myths that prevail, which may make adherence to exclusive breastfeeding difficult. Conclusion: relevant health actions become important, since they stimulate the exchange of knowledge between professionals and users and collaborate positively in the promotion of breastfeeding and in the empowerment of these women to carry out this practice. In the academics, moreover, the educational side inherent to the nurse professional is awakened through educational actions in health.(AU)

Objetivo: realizar una acción educativa sobre lactancia materna, para gestantes en la sala de espera de consultas prenatales, en una unidad municipal de salud. Método: se trata de un estudio descriptivo, tipo relato de experiencia. Se refiere a un juego de preguntas aplicado a 15 gestantes, enseguida, ocurrió una discusión de os temas abordados. Resultados: se percibió que las gestantes todavía creen en muchos mitos que pueden aumentar las chances de destete precoz, bajo peso y enfermedad del niño, sin embargo, están cada vez más informadas sobre la importancia del amamantamiento, pero todavía necesitan de orientaciones y atención en este momento de sus vidas, pues aún existen algunos mitos que prevalecen, pudiendo dificultar la adhesión al amamantamiento exclusivo. Concusión: se convierten las acciones en salud relevantes, pues estimulan el cambio de saberes entre profesionales y usuarios y colaboran positivamente en la promoción de la lactancia materna y en el empoderamiento de esas mujeres para la ejecución de esta práctica. Se despierta, en los académicos, además de eso, por medio de acciones educativas en salud, el lado educador inherente al profesional enfermero. (AU)

Neonatal Cord Blood Oxylipins and Exposure to Particulate Matter in the Early-Life Environment: An ENVIRONAGE Birth Cohort Study.

BACKGROUND: As part of the lipidome, oxylipins are bioactive lipid compounds originating from oxidation of different fatty acids. Oxylipins could provide a new target in the developmental origins model or the ability of early life exposure to change biology. OBJECTIVES: We studied the association between in utero PM2.5 (particulate matter with aerodynamic diameter < 2.5 µm) exposure and oxylipin profiles in newborns. METHODS: Thirty-seven oxylipins reflecting the cyclooxygenase (COX), lipoxygenase (5-LOX and 12/15-LOX), and cytochrome P450 (CYP) pathways were assayed in 197 cord blood plasma samples from the ENVIRONAGE birth cohort. Principal component (PC) analysis and multiple regression models were used to estimate associations of in utero PM2.5 exposure with oxylipin pathways and individual metabolites. RESULTS: A principal component representing the 5-LOX pathway (6 metabolites) was significantly positively associated with PM2.5 exposure during the entire (multiple testing-adjusted q-value = 0.05) and second trimester of pregnancy (q = 0.05). A principal component representing the 12/15-LOX pathway (11 metabolites) was positively associated with PM2.5 exposure during the second trimester of pregnancy (q = 0.05). PM2.5 was not significantly associated with the COX pathway during any time period. There was a positive but nonsignificant association between second-trimester PM2.5 and the CYP pathway (q = 0.16). CONCLUSION: In utero exposure to particulate matter, particularly during the second trimester, was associated with differences in the cord blood levels of metabolites derived from the lipoxygenase pathways. These differences may indicate an effect of air pollution during in utero life on the inflammatory state of the newborn at birth. Oxylipins may be important mediators between early life exposures and health outcomes later in life.

Myrica faya: a new source of antioxidant phytochemicals.

Myrica faya is a fruit tree endemic of the Macaronesia (Azores, Madeira, and Canary Island), and its edible fruits are known as "amorinhos" (little loves), bright red to purple berries, used fresh and in jams and liquors. The phenolic composition and antioxidant capacity of leaves and berries from M. faya are presented here for the first time. The screening of phytochemical compounds was carried out using high-performance liquid chromatography with online UV and electrospray ionization mass spectrometric detection (HPLC-DAD-ESI-MS(n)). There were 55 compounds characterized, mostly galloyl esters of flavonoids and phenolic acids; 26 of the identified compounds (anthocyanins, isoflavonoids, lignans, terpenes, fatty acids, and phenylethanoids) have not been reported in Myrica genus so far. From the data presented here, it can be concluded that faya berries represent a rich source of cyanidin-3-glucoside, flavonoids, and vitamin C. In fact, higher antioxidant activity than that of the well-known Myrica rubra berries (Chinese bayberry) has been observed.

Helichrysum monizii Lowe: phenolic composition and antioxidant potential.

INTRODUCTION: In Madeira Archipelago there are four endemic Helichyrsum species and three of them are used in the traditional medicine. Helichrysum monizii is a rare endemism with very scarce information available concerning its uses in the local traditional medicine. OBJECTIVE: The aim of this work was to study for the first time Helichrysum monizii in terms of its antioxidant capacity and the identification of the phenolic compounds to which that activity is due. METHODOLOGY: Three different methods of extraction were performed and total phenolic and flavonoid contents of extracts were correlated to radical scavenging and antioxidant capacity by DPPH, ABTS, FRAP and ß-carotene assays. An HPLC-DAD-ESI/MS(n) method was employed for the separation and identification of the phenolic and flavonoid components. RESULTS: The results revealed a high antioxidant potential mainly related to the phenolic profile of the plant. Polar components of methanol extracts of Helichrsyum monizii were detected by a high-performance liquid chromatography/electrospray ionisation tandem mass spectrometry (HPLC-DAD-ESI/MS(n) ) method. Thirty-three compounds were identified and 19 of them were identified as quinic acid derivatives. CONCLUSIONS: The high antioxidant potential Helichrysum monizii was for the first time established. Dicaffeoylquinic acids are the main responsible for that activity.

Characterisation of phenolic acid derivatives and flavonoids from different morphological parts of Helichrysum obconicum by a RP-HPLC-DAD-(-)-ESI-MSn method.

The phenolic composition from different morphological parts of Helichrysum obconicum was investigated for the first time and 50 different phenolic compounds were detected. Phenolic acid conjugates, mainly mono- and di-caffeoylquinic acid derivatives, were the major components; some flavonoid derivatives were also detected in small amounts. Their separation and identification was performed by a high-performance liquid chromatography/electron spray ionisation tandem ion trap mass spectrometry method, with special emphasis on MSn fragmentation. The presence of di- and tricaffeoylshikimic acid isomers in Helichrysum species extracts was reported for the first time, the spectra of these compounds were mainly characterised by the presence of a [caffeoylshikimic acid-H]- ion at m/z 335. A lamiridosins-di-O-hexoside, an unusual component in Asteraceae species, was also detected.

Characterization of phenolic compounds in Helichrysum melaleucum by high-performance liquid chromatography with on-line ultraviolet and mass spectrometry detection.

Helicrysum melaleucum is a medicinal plant traditionally used in the islands of the Macaronesia region for the treatment of respiratory diseases. In this work, the phenolic compounds of Helicrysum melaleucum plants collected in different geographical locations of Madeira Island and their morphological parts (total aerial parts, leaves, flowers and stems) were extracted and analyzed separately by high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (HPLC-DAD/ESI-MS(n)). A total of 68 compounds were characterized based mainly on their UV and mass spectra. These included derivatives of O-glycosylated flavonoids (flavonol and flavones type), quinic acid, caffeic acid, lignans and polyphenols. The flowers were found to be the morphological part with higher variety of phenolic compounds. The large differences in the phenolic composition of plants collected from different geographical locations allowed the identification of a few components, such as pinoresinol and methoxylated flavone derivatives, likely to be useful as geographical markers. Also, these results promote further comparison of the bioactivities of the different samples analyzed. This paper marks the first report on the chemical analysis of Helichrysum melaleucum species.

Analysis of phenolic compounds from different morphological parts of Helichrysum devium by liquid chromatography with on-line UV and electrospray ionization mass spectrometric detection.

A simple and rapid method has been used for the screening and identification of the main phenolic compounds from Helichrysum devium using high-performance liquid chromatography with on-line UV and electrospray ionization mass spectrometric detection (LC-DAD/ESI-MS(n)). The total aerial parts and different morphological parts of the plant, namely leaves, flowers and stems, were analyzed separately. A total of 34 compounds present in the methanolic extract from Helichrysum devium were identified or tentatively characterized based on their UV and mass spectra and retention times. Three of these compounds were positively identified by comparison with reference standards. The phenolic compounds included derivatives of quinic acid, O-glycosylated flavonoids, a caffeic acid derivative and a protocatechuic acid derivative. The characteristic loss of 206 Da from malonylcaffeoyl quinic acid was used to confirm the malonyl linkage to the caffeoyl group. This contribution presents one of the first reports on the analysis of phenolic compounds from Helichrysum devium using LC-DAD/ESI-MS(n) and highlights the prominence of quinic acid derivatives as the main group of phenolic compounds present in these extracts. We also provide evidence that the methanolic extract from the flowers was significantly more complex when compared to that of other morphological parts.

Acampamento de férias para jovens com Diabetes Mellitus Tipo I: achados da abordagem psicológica / Vacation camp for children and adolescents with Type 1 Diabetes Mellitus: findings of the psychological approach

Diabetes Mellitus Tipo 1 requer tratamento intensivo no sentido de reduzir o aparecimento e a progressão das suas complicações. Abordagens educacionais são fundamentais para se alcançar o melhor controle metabólico possível. Visando descrever como crianças e adolescentes, participantes de um Acampamento de Férias, percebem sua condição diabética e o tratamento, foram realizadas 98 entrevistas semidirigidas. Os resultados mostraram que o diagnóstico é sempre um fator impactante, difícil de ser aceito pelo jovem e seus familiares. O suporte da família e amigos, quando excessivo, prejudica a qualidade da adaptação. Eles consideram suas vidas sociais restritas e sofrem com o controle imposto pelo tratamento. Consideraram o ambiente do Acampamento de Férias propício para aprender sobre a doença, promover sua independência afetiva e autonomia na auto-monitorização(AU)

Type 1 Diabetes Mellitus requires intensive treatment in order to reduce the incidence and progression of complications. Educational measures are fundamental to reach the best metabolic control possible. This study realized 98 semi-structured interviews aimed to describe how children and adolescents, participants in a Vacation Camp, perceive their diabetic condition and treatment. The results revealed that the diagnosis is always an impacting factor, difficult to be accepted by the young ones and their families. The support from family and friends when excessive impairs their adaptation. They consider their social lives very restricted and suffer with the control imposed by the treatment. They consider the environment of the vacation camp appropriate to learn about their illness and to promote affective independence and autonomy into self-monitoring(AU)

Acampamento de férias para jovens com Diabetes Mellitus Tipo I: achados da abordagem psicológica / Vacation camp for children and adolescents with Type 1 Diabetes Mellitus: findings of the psychological approach

Diabetes Mellitus Tipo 1 requer tratamento intensivo no sentido de reduzir o aparecimento e a progressão das suas complicações. Abordagens educacionais são fundamentais para se alcançar o melhor controle metabólico possível. Visando descrever como crianças e adolescentes, participantes de um Acampamento de Férias, percebem sua condição diabética e o tratamento, foram realizadas 98 entrevistas semidirigidas. Os resultados mostraram que o diagnóstico é sempre um fator impactante, difícil de ser aceito pelo jovem e seus familiares. O suporte da família e amigos, quando excessivo, prejudica a qualidade da adaptação. Eles consideram suas vidas sociais restritas e sofrem com o controle imposto pelo tratamento. Consideraram o ambiente do Acampamento de Férias propício para aprender sobre a doença, promover sua independência afetiva e autonomia na auto-monitorização.

Type 1 Diabetes Mellitus requires intensive treatment in order to reduce the incidence and progression of complications. Educational measures are fundamental to reach the best metabolic control possible. This study realized 98 semi-structured interviews aimed to describe how children and adolescents, participants in a Vacation Camp, perceive their diabetic condition and treatment. The results revealed that the diagnosis is always an impacting factor, difficult to be accepted by the young ones and their families. The support from family and friends when excessive impairs their adaptation. They consider their social lives very restricted and suffer with the control imposed by the treatment. They consider the environment of the vacation camp appropriate to learn about their illness and to promote affective independence and autonomy into self-monitoring.

Quantification of artemisinin in Artemisia annua extracts by 1H-NMR.

Artemisinin is a polycyclic sesquiterpene lactone that is highly effective against multidrug-resistant strains of Plasmodium falciparum, the etiological agent of the most severe form of malaria. Determination of artemisinin in the source plant, Artemisia annua, is a challenging problem since the compound is present in very low concentrations, is thermolabile and unstable, and lacks chromophoric or fluorophoric groups. The ain of this study was to develop a simple protocol for the quantification of artemisinin in a plant extract using an (1)H-NMR method. Samples were prepared by extraction of leaf material with acetone, treatment with activated charcoal to remove chlorophylls and removal of solvent. (1)H-NMR spectra were measured on samples dissolved in deuterochloroform with tert-butanol as internal standard. Quantification was carried out using the using the delta 5.864 signal of artemisinin and the delta 1.276 signal of tert-butanol. The method was optimised and fully validated against a reference standard of artemisinin. The results were compared with those obtained from the same samples quantified using an HPLC-refractive index (RI) method. The (1)H-NMR method gave a linear response for artemisinin within the range 9.85-97.99 mm (r(2) = 0.9968). Using the described method, yields of artemisinin in the range 0.77-1.06% were obtained from leaves of the A. annua hybrid CPQBA x POP, and these values were in agreement with those obtained using an HPLC-RI.