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OBJECTIVES: The aim of this study is to evaluate pain management adequacy based on the Pain Management Index (PMI), and its association with the Brief Pain Inventory (BPI) in advanced cancer inpatients to a palliative care unit. METHODS: This is a quantitative study concerning advanced cancer inpatients in a specialised palliative care unit between June 2021 and February 2022. The BPI was applied, and analgesia was observed on the first (D1), third (D3) and seventh (D7) day of hospitalisation. Adequate analgesia was considered when PMI≥0. RESULTS: A total of 104 patients were evaluated on D1, 68 on D3 and 45 on D7, with a mean age of 53.6 years (SD±14.1), most of them female (65.4%), with the most frequent primary tumour site located in the gastrointestinal tract (22.1%). The observed analgesia was adequate (PMI≥0) in 52.9% of all patients on D1, 95.6% on D3 and 100% on D7 (p value=0.012). The number of patients with moderate to severe pain interference in general activities (p value 0.012), mood (p value 0.014), walking ability (p value 0.047), normal work (p value 0.038) and pleasure of living (p value 0.025) decreased during hospitalisation. CONCLUSIONS: Pain is a prevalent and impacting symptom in patients undergoing palliative care. Thus, objective analgesic adequacy assessments in specialised services are required. These findings reinforce the importance of effective pain control and corroborate the importance of employing objective tools in evaluating medical services and improving quality of life of patients.
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Objetivo: Relatar a experiência de enfermeiros no cuidado à pessoa idosa na rede de atenção à saúde do estado do Rio Grande do Norte no período de pandemia de COVID-19. Métodos: relato de experiência, desenvolvido em maio de 2020 por um grupo de seis enfermeiros atuantes em todos os níveis de complexidade, no setor público e privado. Resultados: as experiências vivenciadas foram descritas de acordo com o nível de atenção dos serviços de saúde, e suas apresentações se deram em eixos temáticos segundo o local de vivência de cada autor. Salienta-se que as experiências abarcam os cenários da Atenção Primária à Saúde, a Atenção hospitalar na atenção secundária e terciária, além do contexto do serviço particular e público-ensino. Discussões: a atuação do enfermeiro passou por adaptações devido à pandemia, incluindo novos fluxos de atendimento e rotinas que favoreçam a prevenção da transmissão desta doença. Na atenção primária, os profissionais têm oferecido atividades de estimulação cognitiva e física para os idosos domiciliados, com acompanhamento por telefone para evitar busca dispensável dos serviços de saúde. Na atenção hospitalar, a experiência de cuidar de pessoas idosas com COVID-19 revelou que, além de cuidados específicos com a doença, esses pacientes têm requerido maior atenção aos aspectos psicossociais, pois idosos com diagnóstico confirmado precisam permanecer sem acompanhante. Considerações finais: percebemos que nossa formação propicia condições de analisar de forma sensível às situações vividas pelos pacientes idosos que, neste momento de pandemia, demandam cuidados de enfermagem complexos e suporte biopsicossocial e espiritual, dada a gravidade da doença e a necessidade de isolamento destes pacientes.
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INTRODUCTION: Cancer pain is one of the most prevalent manageable symptoms in patients with advanced cancer, and it has a negative impact on quality of life (QoL). OBJECTIVE: The aim of this study is to examine the correlation between cancer pain and QoL in patients with advanced cancer who are hospitalized in a palliative care unit. METHODS: This study is a cross-sectional analysis of patients with advanced cancer who were hospitalized with cancer pain at a specialized palliative care unit between June 2021 and February 2022. Pain intensity and its impact on daily activities were assessed using the Brief Pain Inventory (BPI), while the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 PAL (QLQ-C15-PAL) was used to evaluate QoL. RESULTS: A total of 104 patients with cancer pain were included, with a mean age of 53.6 years (±14.1). Most of the patients were female (65.38%), and the most common primary tumor site was in the gastrointestinal tract (22.11%). The most frequently reported site of cancer pain was the abdomen (32.69%). The mean duration of cancer pain was 52.3 days (±6.2). The domains of QoL most strongly correlated with cancer pain were weakness (coefficient = .52, P < .001), nausea (coefficient = .36, P < .001), and the physical domain (coefficient = -.30, P < .001). CONCLUSION: Cancer pain is strongly correlated with a deterioration in QoL in patients with advanced cancer, and its management should be pursued as a strategy for optimizing QoL.
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The aim of the work was to evaluate antagonistic activity of Lactobacillus spp. and Bifidobacterium spp. in vitro against cariogenic Streptococcus mutans UA 159 and viability in chewing gum, during storage. Antagonistic activity was evaluated in vitro by the "spot on the lawn" test. Two bacteria were chosen and subjected to lyophilization and microencapsulation using the atomization method, containing polyvinylpyrrolidone polymer and lactose as encapsulating agents. For application in food matrices, four treatments were elaborated: chewing gum containing lyophilized B. lactis B94 (BLL), microencapsulated B. lactis B94 (BLE), lyophilized L. brevis (LBL), and microencapsulated L. brevis (LBE). Both microorganisms demonstrated a high capacity for inhibition against S. mutans, when compared to oral antiseptic chlorhexidine 0.2% in vitro, and according to the test of sensitivity profile to proteolytic enzymes, all the bacteria tested are producers of antimicrobial peptides, resulting in the inhibitory activity of the cariogenic bacterium. Furthermore, the viability of B. lactis B94 and L. brevis was maintained after microencapsulation, indicating that the process was efficient, with no significant difference (p < 0.05) between the results. And, in the chewing gum containing the bacteria during the storage period (33 days), it was found that cell immobilization did not significantly influence (p < 0.05) the counts of L. brevis but benefited the viability of B. lactis B94. Therefore, both probiotic bacteria are producers of antimicrobial substances with the ability to inhibit S. mutans, in vitro. The microencapsulation was considered efficient since it influenced the viability of B. lactis B94 (> 8 log CFU/g); however, the microencapsulation did not influence the viability of L. brevis since in both lyophilized and encapsulated form; the concentration of the bacteria remained above 8 log CFU/g during the storage period of the chewing gum.
Subject(s)
Probiotics , Streptococcus mutans , Lactobacillus/physiology , Chewing Gum , Bifidobacterium/physiology , Probiotics/pharmacologyABSTRACT
AimsTo study effects on cellular innate immune responses to novel genes ORF8 and ORF10, and the more conserved Membrane protein (M protein) from the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19, either alone, or in combination with cannabidiol (CBD). Main MethodsHEK293 cells were transfected with a control plasmid, or plasmids expressing ORF8, ORF10, or M protein, and assayed for cell number and markers of apoptosis at 24 h, and expression of interferon and interferon-stimulated genes at 14 h. Key findingsA significant reduction in cell number, and increase in early and late apoptosis, was found after 24 h in cells where expression of viral genes was combined with 1-2 M CBD treatment, but not in control-transfected cells treated with CBD, or in cells expressing viral genes but treated only with vehicle. CBD (2 M) augmented expression of IFN{gamma}, IFN{lambda}1 and IFN{lambda}2/3, as well as the 2-5-oligoadenylate synthetase (OAS) family members OAS1, OAS2, OAS3, and OASL, in cells expressing ORF8, ORF10, and M protein. CBD also augmented expression of these genes in control cells not expressing viral genes, without enhancing apoptosis. SignificanceOur results demonstrate a poor ability of HEK293 cells to respond to SARS-CoV-2 genes alone, but suggest an augmented innate anti-viral response to these genes in the presence of CBD. Furthermore, our results indicate that CBD may prime components of the innate immune system, increasing readiness to respond to viral infection without activating apoptosis, and therefore could be studied for potential in prophylaxis.
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OBJETIVO: Demonstrar se existe relação entre as lesões esportivas com as alterações posturais e a flexibilidade da cadeia posterior. MÉTODOS: Foram avaliados 28 atletas de futebol de campo do sexo masculino, idade entre 17 e 20 anos, divididos em dois grupos: com lesão (G1) e sem lesão (G2). Inicialmente foi verificado peso, idade, tempo de prática e ocorrência de lesões. Em seguida foi realizada avaliação postural para verificar retrações das cadeias musculares e avaliação postural computadorizada. RESULTADOS: Os atletas apresentaram joelhos varo, anteversão pélvica e assimetria no triângulo de Tales. O segmento corpóreo acometido mais frequente foi o tornozelo, seguido de joelhos, virilha e coxas. CONCLUSÕES: Não foi possível estabelecer relação entre as lesões no presente estudo.
PURPOSE: To determine whether a relationship exists between sports injuries with postural changes and flexibility of the posterior chain. METHODS: A total of 28 soccer players in the field of male, aged between 17 and 20 years, divided into two groups: lesion (G1) and without injury (G2). It was initially established weight, age, practice time and occurrence of injuries. Next postural assessment was performed to verify retraction of the muscle and postural assessment computerized. RESULTS: The athletes had knee varus, anterior pelvic tilt and asymmetry in the triangle of Tales. The body segment was the most common ankle, followed by knees, groin and thighs. CONCLUSIONS: Unable to establish the relationship between the lesions in this study.
OBJETIVO: Determinar si existe relación entre las lesiones deportivas con los cambios de postura y la flexibilidad de la cadena posterior. MÉTODOS: Un total de 28 jugadores de fútbol, de edades entre 17 y 20 años, en dos grupos: las lesiones (G1), y sin perjuicio (G2). Se estableció el peso, edad, tiempo de práctica y la aparición de lesiones. Siguiente evaluación postural se realizó para comprobar la retracción de los músculos y la evaluación postural computarizado. RESULTADOS: Los atletas había varo de la rodilla, la inclinación pélvica anterior y la asimetría en el triángulo de cuentos. El segmento del cuerpo era el tobillo más común, seguida por las rodillas, la ingle y los muslos. CONCLUSIONES: No se puede establecer la relación entre las lesiones en este estudio.
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PURPOSE: The purpose of this study was to retrospectively analyze the clinical, demographic, and pathologic properties of oral pyogenic granuloma occurring in a Brazilian population. PATIENTS AND METHODS: We retrieved an archival number of 293 cases that were diagnosed as having oral pyogenic granuloma at the Service of Pathological Anatomy, Discipline of Oral Pathology, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil, during a 38-year period, from 1970 to 2008. The records were reviewed, and information on gender, age, race, lesion site, predisposing factors, clinical features, and clinical diagnosis, treatment, and recurrence was collected. RESULTS: There was a female predilection, and the female-to-male ratio was 2.38:1. The mean age of the patients was 27 years. A high degree of occurrence was observed in the second decade of life. White patients were most commonly affected (44.7%). The most frequently involved site was the gingiva (83%), with a higher prevalence in the maxilla. The majority of cases were symptomatic and showed bleeding; the lesions were described as nodules (71.9%) with a soft consistency (62.3%) and a red surface (73.2%). The base was pedunculated in 61.1% of cases, and the mean size was 1.3 cm. The recurrence rate was 8.2% of cases. CONCLUSION: The clinical, demographic, and pathologic features of oral pyogenic granuloma in the Brazilian population in this study were similar to those in studies of populations from other countries.
Subject(s)
Gingival Diseases/pathology , Granuloma, Pyogenic/pathology , Adult , Aged , Aged, 80 and over , Brazil , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Mouth Mucosa/pathology , Retrospective Studies , Sex Ratio , Young AdultABSTRACT
The epithelioid hemangioendothelioma (EH) is an uncommon angiocentric neoplasm of borderline or intermediatemalignant potential, between the hemangioma and conventional angiosarcoma. It is characterized by the proliferationof endothelial cells with epithelioid or histiocitóide morphology with vacuolated cytoplasm and occasionaleosinophilic spindle cells. Shows potential for local recurrence as well as the ability to metastasize. Rarely affectsthe oral cavity, it have been described from 1975 until 2008 only 27 oral cases. Morphologically the EHs may beconfused with other lesions, from a hemangioma to a squamous cell carcinoma, and thus immunohistochemicalanalysis is required. This paper reports the clinical and immunohistochemical characteristics of a case of EH inthe gingiva of the tooth 35 of a 17 years-old-white-female. We present a review of the clinicopathological and immunohistochemicalcharacteristics of the intraoral epithelioid hemangioendothelioma cases previously reported (AU)
Subject(s)
Humans , Female , Adolescent , Hemangioendothelioma, Epithelioid/pathology , Mouth Neoplasms/pathologyABSTRACT
The epithelioid hemangioendothelioma (EH) is an uncommon angiocentric neoplasm of borderline or intermediate malignant potential, between the hemangioma and conventional angiosarcoma. It is characterized by the proliferation of endothelial cells with epithelioid or histiocitóide morphology with vacuolated cytoplasm and occasional eosinophilic spindle cells. Shows potential for local recurrence as well as the ability to metastasize. Rarely affects the oral cavity, it have been described from 1975 until 2008 only 27 oral cases. Morphologically the EHs may be confused with other lesions, from a hemangioma to a squamous cell carcinoma, and thus immunohistochemical analysis is required. This paper reports the clinical and immunohistochemical characteristics of a case of EH in the gingiva of the tooth 35 of a 17 years-old-white-female. We present a review of the clinicopathological and immunohistochemical characteristics of the intraoral epithelioid hemangioendothelioma cases previously reported.
Subject(s)
Hemangioendothelioma, Epithelioid/pathology , Mouth Neoplasms/pathology , Adolescent , Female , HumansABSTRACT
OBJETIVOS: O objetivo desta pesquisa foi realizar uma análise clínica e morfológica em lesões orais com potencial de malignização. MATERIAL E MÉTODO: Os dados clínicos e morfológicos referentes a tais lesões foram obtidos a partir das fichas clínicas e dos laudos histopatológicos, respectivamente. RESULTADOS: Dos 205 casos analisados, a lesão mais prevalente foi a leucoplasia (70,7 por cento), seguida da queilite actínica (16,1 por cento), eritroplasia (9,8 por cento) e eritroleucoplasia (3,4 por cento). Verificou-se uma associação significativa entre o sexo e as lesões (p < 0,001), sendo o sexo feminino mais prevalente nas leucoplasias e eritroplasias. A raça branca foi mais acometida em todas as lesões. Quanto à localização anatômica, o rebordo alveolar prevaleceu na leucoplasia (21 por cento), na eritroplasia e eritroleucoplasia, o palato foi mais acometido com 47,4 por cento e 57,1 por cento, respectivamente. Com relação à idade, não houve diferença significativa entre as lesões (p > 0,05), sendo mais frequentes nas quinta, sexta e sétima décadas de vida. Observou-se que, na maioria dos casos de eritroplasias e eritroleucoplasias, os diagnósticos clínicos foram incompatíveis com o morfológico. Verificou-se associação significativa entre transformação maligna e lesões (p < 0,001), pois a eritroplasia apresentou uma taxa de malignização de 20 por cento, enquanto na leucoplasia o índice foi de 2,1 por cento. CONCLUSÃO: A prevalência das lesões orais com potencial de malignização foi semelhante ao encontrado na literatura, mas com algumas diferenças em relação ao perfil epidemiológico das mesmas, ressaltando-se que estas entidades merecem uma atenção especial por parte do clínico, especialmente as eritroplasias, que apresentaram um elevado percentual de malignização e o maior índice de equívocos no diagnóstico clínico.
OBJECTIVE: The objective of this study was to perform a clinical and morphological analysis of potentially malignant oral lesions. MATERIAL AND METHOD: The clinical and morphological data related to these lesions were obtained from clinical and histopathological records, respectively. RESULTS: Out of 205 cases, the most prevalent lesion was oral leukoplakia (70.7 percent), followed by actinic cheilitis (16.1 percent), erythroplakia (9.8 percent) and erythroleukoplakia (3.4 percent). There was a significant association between the lesions and gender (p < 0.001). The female gender was the most affected in leukoplakias and erythroplakias. Caucasians were mostly affected in all conditions. As far as anatomical location is concerned, the alveolar ridge was the most prevalent site in oral leukoplakias (21 percent); the palate was the most affected in erythroplakia (47.4 percent) and erythroleukoplakia (57.1 percent). There was no significant difference among the lesions as to age (p > 0.05), although they were more frequent in the 5th, 6th and 7th decades of life. In most cases of erythroplakias and erythroleukoplakias, it was observed that clinical and morphological diagnoses were incompatible. There was a significant association between malignant transformation and lesions (p < 0.001) as the erythroplakia presented a malignization rate of 20 percent, whereas in leukoplakias the rate was 2.1 percent. CONCLUSION: The prevalence of potentially malignant oral lesions was similar to other findings in the medical literature, but with some differences in their epidemiological profile. It is important to highlight that these entities require further medical investigation, mainly erythroplakias, which showed high risk of malignization and the highest rate of clinical misdiagnosis.
