The role of light emitting diode in wound healing: A systematic review of experimental studies.

Wounds represent a growing global issue demanding increased attention. To expedite wound healing, technologies are under development, and light emitting diode (LED) devices of varying wavelengths are being explored for their stimulating influence on the healing process. This article presents a systematic literature review aiming to compile, organize, and analyze the impacts of LED devices on wound healing. This review is registered on the PROSPERO platform [CRD42023403870]. Two blinded authors conducted searches in the Pubmed, Web of Science, Scopus, Embase, and ScienceDirect databases. In vitro and in vivo experimental studies assessing LED utilization in the wound healing process were included. The search yielded 1010 studies, of which 27 were included in the review. It was identified that LED stimulates different healing pathways, promoting enhanced cell proliferation and migration, angiogenesis stimulation, increased collagen deposition, and modulation of the inflammatory response. Thus, it can be concluded that the LED stimulates cellular and molecular processes contingent on the utilized parameters. The effects depend on the standards used. Cell migration and proliferation were better influenced by green and red LED. The extracellular matrix components and angiogenesis were regulated by all wavelengths and the modulation of inflammation was mediated by green, red, and infrared LEDs.

The association of diabetic peripheral neuropathy with cardiac autonomic neuropathy in individuals with diabetes mellitus: A systematic review.

This systematic review aimed to explore the relationship between diabetic peripheral neuropathy (DPN) and cardiac autonomic neuropathy (CAN) in individuals with type 1 and 2 diabetes mellitus (DM). METHODS: The systematic review follow the protocol registered in Prospero (CRD42020182899). Two authors independently searched the PubMed, Scopus, Embase, Cochrane, and Web of Science databases. Discrepancies were resolved by a third author. The review included observational studies investigating the relationship between CAN and DPN in individuals with DM. RESULTS: Initially, out of 1165 studies, only 16 were selected, with 42.8 % involving volunteers with one type of diabetes, 14.3 % with both types of diabetes and 14.3 % not specify the type. The total number of volunteers was 2582, mostly with type 2 DM. It was analyzed that there is a relationship between CAN and DPN. It was observed that more severe levels of DPN are associated with worse outcomes in autonomic tests. Some studies suggested that the techniques for evaluating DPN might serve as risk factors for CAN. CONCLUSION: The review presents a possible relationship between DPN and CAN, such as in their severity.

Coping Styles and Defense Mechanisms Mediate Associations Between Exposure to Adverse Childhood Experiences and CPTSD Symptoms in Faroese Adolescents.

Background: The experience of several adverse childhood experiences (ACEs) has been shown to be associated with Post-Traumatic Stress Disorder (PTSD) and Disturbances in Self-Organization (DSO) symptoms among adolescents. Defense mechanisms and coping styles are psychological processes involved in the association of ACEs with PTSD and DSO symptoms. However, there is a lack of research on the joint association of these variables among Faroese adolescents. Aim: The aim of this study was to analyze the effect of exposure to ACEs on PTSD and DSO symptoms trough the indirect effect of defense mechanisms and coping styles in a sample of Faroese adolescents. Method: Six hundred and eighty-seven Faroese adolescents were recruited from 19 schools. Participants responded to validated self-report questionnaires. A multiple step mediation and a serial mediation methodology were conducted through structural equation modeling. Results: Exposure to ACEs was linked to PTSD and DSO symptoms through the indirect effect of immature defense mechanisms, emotional coping, and detachment coping. Exposure to ACEs was linked to PTSD symptoms through rational coping. Conclusions: The results suggest a mutual relationship between defense mechanisms and coping styles in coping with multiple adversity among adolescents.

Dose-response and efficacy of 904 nm photobiomodulation on diabetic foot ulcers healing: a randomized controlled trial.

PURPOSE: This study aimed to examine the impact of a 904 nm photobiomodulation (PBM) on diabetic ulcers using varying dosages. METHODS: The study was a randomized, double-blind, placebo-controlled clinical trial that compared treatments using PBM (GaAs 904 nm 30w) with three different energy densities (4 J/cm2; 8 J/cm2; 10 J/cm2) in the healing process of non-infected diabetic foot ulcers. Eighty volunteers (48.75% female; 58.5 ± 11.1 years) were randomized into three intervention groups treated with PBM and one control group (PBM placebo). Volunteers performed up 20 interventions with PBM, either placebo or actual, in conjunction with conventional therapy, which involved dressing the wound with Helianthus annuus vegetable oil. The primary variable was the ulcer size reduction rate. RESULTS: GaAs 904 nm PBM yielded a clinically and significant ulcer size rate reduction of diabetic foot ulcers, independently of energy density range (p < 0.05). However, 10 J/cm² had 60% of completely healed ulcers and the highest proportion of patients reaching 50% of ulcer reduction rate after 5 weeks of treatment. In addition, only 10 J/cm² showed a significant difference between control group after a 10-week follow-up (p < 0.05). CONCLUSION: GaAs 904 nm PBM was effective in treating diabetic foot ulcers in this study and a dosage of 10 J/cm², after a 10-week follow-up, proved to be the most effective compared to the other groups. CLINICAL TRIAL REGISTRATION NUMBER: NCT04246814.

Triple tandem trimer immunogens for HIV-1 and influenza nucleic acid-based vaccines.

Recombinant native-like HIV-1 envelope glycoprotein (Env) trimers are used in candidate vaccines aimed at inducing broadly neutralizing antibodies. While state-of-the-art SOSIP or single-chain Env designs can be expressed as native-like trimers, undesired monomers, dimers and malformed trimers that elicit non-neutralizing antibodies are also formed, implying that these designs could benefit from further modifications for gene-based vaccination approaches. Here, we describe the triple tandem trimer (TTT) design, in which three Env protomers are genetically linked in a single open reading frame and express as native-like trimers. Viral vectored Env TTT induced similar neutralization titers but with a higher proportion of trimer-specific responses. The TTT design was also applied to generate influenza hemagglutinin (HA) trimers without the need for trimerization domains. Additionally, we used TTT to generate well-folded chimeric Env and HA trimers that harbor protomers from three different strains. In summary, the TTT design is a useful platform for the design of HIV-1 Env and influenza HA immunogens for a multitude of vaccination strategies.

Viral envelope proteins fused to multiple distinct fluorescent reporters to probe receptor binding.

Enveloped viruses carry one or multiple proteins with receptor-binding functionalities. Functional receptors can be glycans, proteinaceous, or both; therefore, recombinant protein approaches are instrumental in attaining new insights regarding viral envelope protein receptor-binding properties. Visualizing and measuring receptor binding typically entails antibody detection or direct labeling, whereas direct fluorescent fusions are attractive tools in molecular biology. Here, we report a suite of distinct fluorescent fusions, both N- and C-terminal, for influenza A virus hemagglutinins and SARS-CoV-2 spike RBD. The proteins contained three or six fluorescent protein barrels and were applied directly to cells to assess receptor binding properties.

Reliability and validity of the Brazilian version of the world health organization disability assessment schedule (WHODAS 2.0) questionnaire for women with urinary incontinence.

PURPOSE: To analyze the reliability and validity of the WHODAS 2.0 instrument for women with urinary incontinence (UI). METHODS: This is a methodological study with Brazilian women with complaints of urge, stress or mixed UI, over 18 years old, without cognitive disorders. The WHODAS 2.0 (36-item version) and the auxiliary instruments were applied through face-to-face and telephone interviews after 7-14 d. The psychometric properties evaluated were: Cronbach's alpha for internal consistency, intraclass correlation coefficient (ICC) for intra-rater test-retest, Spearman's correlation coefficient (rho) for construct validity of WHODAS 2.0 with auxiliary instruments; and ANOVA for discriminative validity with UI severity. RESULTS: 101 women with UI with a mean age of 50.71 ± 10.39 were included. WHODAS 2.0 showed good reliability in all domains and excellent reliability in the total score (>0.80). The intra-evaluator test-retest showed ICC values between 0.59 and 0.87 (p < 0.001). We observed a positive correlation between the WHODAS 2.0 domains and the instruments recommended by International Continence Society (ICS), with greater emphasis on moderate correlation with the Urinary Impact Questionnaire (IUQ-7) subscale (rho = 0.730 p < 0.001). CONCLUSION: The WHODAS 2.0 instrument is a reliable and valid questionnaire for investigating the functioning and disability of women with UI.

The WHODAS 2.0 is a valid and reliable tool for future functioning research with women with urinary incontinence.The WHODAS 2.0 can be used in clinical practice to assess disabilities in women with urinary incontinence.The validation of WHODAS 2.0 reinforces the need for rehabilitation based on the functioning needs of each patient with urinary incontinence.The WHODAS 2.0 assesses functioning based on the biopsychosocial model, supported by the ICF (International Classification of Functioning, Disability and Health).

Therapeutic Interventions to Improve Static Balance in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

INTRODUCTION: Diabetes mellitus (DM) is a metabolic disorder characterized by an abnormal increase in blood glucose levels, resulting from insulin secretion and/or dysfunctional activity that can lead to several serious complications in addition to decreased postural balance. OBJECTIVE: This study aimed to identify and analyze the main interventions used to improve static balance in patients with DM. METHODS: For the selection of articles, a bibliographic search was performed using PubMed, Scopus, Web of Science, Embase, and Cochrane databases. Only clinical trials that investigated the effect of training on static balance in adults with type 2 DM were selected, and 34 studies were included. RESULTS: The search resulted in the identification of 2681 articles, and of these, 31 were eligible for the study. The identified interventions were proprioceptive, aerobic, resistance training, on platforms, in virtual reality, and Tai Chi. The main results obtained were increase in time in the one-leg stance, Romberg test, and tandem position, a significant increase in the Berg Balance Scale score, balance index, and reduction in the variables of postural sway. CONCLUSION: There are a variety of effective training methods for improving static balance, and the choice of intervention to be applied goes beyond proven effectiveness, depending on reproducibility and/or financial cost.

Increasing sensitivity of antibody-antigen interactions using photo-cross-linking.

Understanding antibody-antigen interactions in a polyclonal immune response in humans and animal models is critical for rational vaccine design. Current approaches typically characterize antibodies that are functionally relevant or highly abundant. Here, we use photo-cross-linking and single-particle electron microscopy to increase antibody detection and unveil epitopes of low-affinity and low-abundance antibodies, leading to a broader structural characterization of polyclonal immune responses. We employed this approach across three different viral glycoproteins and showed increased sensitivity of detection relative to currently used methods. Results were most noticeable in early and late time points of a polyclonal immune response. Additionally, the use of photo-cross-linking revealed intermediate antibody binding states and demonstrated a distinctive way to study antibody binding mechanisms. This technique can be used to structurally characterize the landscape of a polyclonal immune response of patients in vaccination or post-infection studies at early time points, allowing for rapid iterative design of vaccine immunogens.

Competing interests during the key N-glycosylation of 6-chloro-7-deaza-7-iodopurine for the synthesis of 7-deaza-2'-methyladenosine using Vorbrüggen conditions.

A short 3-step synthesis of the antiviral agent 7DMA is described herein. The nature of a major by-product formed during the key N-glycosylation of 6-chloro-7-deaza-7-iodopurine with perbenzoylated 2-methyl-ribose under Vorbrüggen conditions was also investigated. Spectroscopic analyses support that the solvent itself is converted into a nucleophilic species competing with the nucleobase and further reacting with the activated riboside in an unanticipated fashion. These findings call for a revision of reaction conditions when working with weakly reactive nucleobases in the presence of Lewis acids. 7DMA thus obtained was evaluated for its efficacy against an emerging flavivirus in vitro.

Characterization of Systemic Disease Development and Paw Inflammation in a Susceptible Mouse Model of Mayaro Virus Infection and Validation Using X-ray Synchrotron Microtomography.

Mayaro virus (MAYV) is an emerging arthropod-borne virus endemic in Latin America and the causative agent of arthritogenic febrile disease. Mayaro fever is poorly understood; thus, we established an in vivo model of infection in susceptible type-I interferon receptor-deficient mice (IFNAR-/-) to characterize the disease. MAYV inoculations in the hind paws of IFNAR-/- mice result in visible paw inflammation, evolve into a disseminated infection and involve the activation of immune responses and inflammation. The histological analysis of inflamed paws indicated edema at the dermis and between muscle fibers and ligaments. Paw edema affected multiple tissues and was associated with MAYV replication, the local production of CXCL1 and the recruitment of granulocytes and mononuclear leukocytes to muscle. We developed a semi-automated X-ray microtomography method to visualize both soft tissue and bone, allowing for the quantification of MAYV-induced paw edema in 3D with a voxel size of 69 µm3. The results confirmed early edema onset and spreading through multiple tissues in inoculated paws. In conclusion, we detailed features of MAYV-induced systemic disease and the manifestation of paw edema in a mouse model extensively used to study infection with alphaviruses. The participation of lymphocytes and neutrophils and expression of CXCL1 are key features in both systemic and local manifestations of MAYV disease.

Foot wound risk and quality of life of people with type 2 diabetes are related to self-care / O risco de feridas nos pés e a qualidade de vida de pessoas com diabetes tipo 2 estão relacionados a prática do autocuidado

INTRODUCTION: Adherence to self-care has been identified as a means of preventing diabetic foot wounds, positively influencing the clinical outcomes and quality of life of patients. The adherence to this strategy is divergent in different populations. It is essential to determine the self-care practices that are associated with diabetic foot ulcers and the quality of life in adults with diabetes. OBJECTIVE: To understand self-care practices and explore their relationship with the foot wound risk and quality of life of persons with type 2 diabetes in a city in northeastern Brazil. METHODS: A descriptive exploratory study was conducted with a sample of 300 individuals with type 2 diabetes. Data were collected using a sociodemographic questionnaire, classification of foot wound risk, the Summary of Diabetes Self-Care Activities, and SF-36. RESULTS: Adherence to self-care was low for physical exercise, self-monitoring of blood glucose, and foot care. The diet and the use of medication had better adherence by the participants. Foot wound risk was related to no adherence to diet (OR 2.2 95% CI 1.32-3.38), physical activity (OR 0.49 95% CI 0.25-0.95), and blood glucose checking (OR 5.31 95% CI 1.58-17.78). Quality of life was associated with physical activity (OR 0.35 95% CI 0.16-0.74). CONCLUSION: It can be concluded that is a relationship between self-care practices adherence, risk of foot wounds, and quality of life.

INTRODUÇÃO: A adesão ao autocuidado tem sido apontado como meio de prevenção de feridas no pé diabético, influenciando positivamente nos desfechos clínicos e na qualidade de vida dos pacientes. A adesão a esta estratégia é divergente em diferentes populações. É essencial determinar as práticas de autocuidado que estão associadas às feridas do pé diabético e à qualidade de vida em adultos com diabetes. OBJETIVO: Conhecer as prática de autocuidado e explorar sua relação com o risco de feridas nos pés e a qualidade de vida de pessoas com diabetes tipo 2 em uma cidade do nordeste do Brasil. MÉTODOS: Foi realizado um estudo exploratório descritivo com uma amostra de 300 pessoas com diabetes tipo 2. Os dados foram coletados por meio de questionário sociodemográfico, classificação de risco de feridas nos pés, resumo das atividades de autocuidado com a diabetes e sf-36. RESULTADOS: A adesão ao autocuidado foi baixa para exercícios físicos, automonitorização da glicemia e cuidados com os pés. A dieta e o uso de medicamentos apresentaram melhor adesão pelos participantes. O risco de ferimento no pé foi relacionado à não adesão a dieta (OR 2,2 IC 95% 1,32-3,38), atividade física (OR 0,49 IC 95% 0,25-0,95) e verificação da glicemia (OR 5,31 IC 95% 1,58-17,78). A qualidade de vida foi associada à atividade física (OR 0,35 IC 95% 0,16-0,74). CONCLUSÃO: Pode-se concluir que existe relação entre a adesão ao autocuidado, risco de feridas nos pés e qualidade de vida.

Oscilações no equilíbrio estático relacionadas a diabetes mellitus tipo 2 ­ uma revisão sistemática / Oscillations in static balance related to type 2 diabetes mellitus ­ a systematic review

INTRODUÇÃO: A diabetes mellitus tipo 2 (DM2) é uma doença crônica sistêmica ligada às mudanças no estilo de vida, fatores genéticos e ambientais, ocasionando complicações como a neuropatia diabética periférica (NDP). Além disso, pessoas com DM2 apresentam um retardo na condução nervosa das vias motoras e sensoriais, podendo levar a alterações no equilíbrio. OBJETIVO: Descrever as alterações de equilíbrio estático em pacientes com DM2. MATERIAIS E MÉTODOS: A revisão sistemática iniciou em outubro de 2021 ocorrendo a última busca em março de 2023, os artigos foram selecionados por dois autores de forma independente nas bases de dados Pubmed, Scopus e Web of Science. Seguindo o protocolo registrado no PROSPERO e descrito com base nas recomendações do PRISMA, foram selecionados estudos observacionais sem restrição a ano de publicação e idioma, envolvendo equilíbrio de DM em qualquer idade. RESULTADOS: Foram eleitos 20 artigos com indivíduos DM e NPD em um total de 1564 voluntários, demonstrando: DM causa mudança na velocidade e deslocamento do COP alterando o equilíbrio estático, a presença da NPD piora a estabilidade corporal devido as alterações sensitivo motoras. CONCLUSÃO: Indivíduos com DM e NPD demonstram alterações na estabilidade postural como velocidade e deslocamento do centro de pressão (COP) para as direções AP e ML, com ou sem informação visual e na presença da NPD.

INTRODUCTION: Type 2 diabetes mellitus (DM2) is a chronic systemic disease linked to changes in lifestyle, genetic and environmental factors, causing complications such as peripheral diabetic neuropathy (PDN). In addition, people with DM2 have a delay in nerve conduction in motor and sensory pathways, which can lead to changes in balance. OBJECTIVE: To describe static balance changes in patients with DM2. MATERIALS AND METHODS: The systematic review started in October 2021 with the last search occurring in March 2023, the articles were selected by two authors independently from the Pubmed, Scopus and Web of Science databases. Following the protocol registered in PROSPERO and described based on the PRISMA recommendations, observational studies were selected without restriction on year of publication and language, involving DM balance at any age. RESULTS: 20 articles were chosen with DM and NPD individuals in a total of 1564 volunteers, demonstrating that DM causes changes in the speed and displacement of the COP, altering the static balance and the presence of NPD worsens body stability due to sensory-motor changes. CONCLUSION: Individuals with DM and NPD demonstrate changes in postural stability such as velocity and displacement of the center of pressure (COP) for the AP and ML directions, with or without visual information and in the presence of DPN.

Update of Topical Interventions for Healing Diabetic Ulcers-A Systematic Review.

There are a variety of dressings for wound healing. For this reason, research can assist in the choice and proper use of the intervention. This current view of the effectiveness of dressing on diabetic foot ulcers (DFUs) in patients with type 2 diabetes mellitus. This study is a systematic review of clinical trials selected in 4 databases: PubMed, Scopus, Web of Science, and Cochrane. Studies without language restriction, published between 2009 and 2020, were included. The search resulted in the identification of 5651 articles, of which 58 met all inclusion criteria. Among these, 2 biomaterials (D-acellular dermal matrix and keratinocyte) and phenytoin were highlighted for achieving healing rates of 100% and 95.82% ± 2.22%, respectively. The literature presents several alternatives with different actions, cure rates, reduction rates, and varied cost benefits. The growth in the use of biomaterials for the treatment of DFU can be seen in this study.

Morphological and functional changes in skeletal muscle in type 2 diabetes mellitus: A systematic review and meta-analysis.

INTRODUCTION: Changes in the skeletal muscle are common in patients with type 2 diabetes mellitus (T2DM). These changes impair your motor skills. OBJECTIVE: This systematic review aimed to investigate changes in skeletal muscle in patients with T2DM. METHODS: The search was carried out in the PubMed, Scopus, and Web of Science databases until December 1, 2021. Observational studies that evaluated musculoskeletal changes in people with T2DM were included. The review was based on PRISMA recommendations. The primary parameters analyzed were muscle strength, muscle mass, muscle power, and muscle endurance. RESULTS: Forty-eight studies were included, with a total of 26,042 participants. The results revealed that T2DM is associated with a reduction in handgrip [-2.64 (CI 95% = -3.33 to -1.95, Z = -7.50, p < .0001], and knee extension muscle strength [-0.56 (CI 95% = -0.76 to -0.36, Z = -5.64, p < .0001)], a higher percentage of type II fibers [11.74 (CI 95% = 6.24 to 17.25, Z = 4.18, p < .0001)], and a lower percentage of type I fibers [-15.69 (CI 95% = -18.22 to -13.16, Z = -12.16, p < .0001], in addition to a greater thickness of the calcaneus tendon (p < .0001). CONCLUSION: Individuals with T2DM present skeletal muscle impairments, mainly reduced muscle strength, mass, and endurance; increase in the thickness of the calcaneus tendon, and alteration in the proportion of type I and II fibers, even in the initial stage of the disease.

Fatores relacionados ao risco de feridas em pacientes com Diabetes mellitus Tipo 2 / Factors related to wound risk in patients with Type 2 Diabetes mellitus

Poucos estudos abordam as características sociodemográficas e o risco de feridas no nordeste brasileiro. O objetivo do estudo foi determinar a prevalência de risco de feridas e os fatores relacionados em pessoas com diabetes no município de Parnaíba, estado do Piauí, Brasil. Estudo transversal realizado com 300 pessoas com diabetes. Os voluntários foram avaliados por meio de questionário sociodemográfico, monofilamento de 10 g, diapasão de 128 Hz, martelo de reflexo e escala de classificação de risco de feridas. Sexo masculino (OR 2,33; IC 95% 1,22-4,42), idade (OR 1,03; IC 95% 1,01-1,05), inatividade física (OR 2,35; IC 95% 1,26-4,38) e duração maior de diabetes (OR 3,28; IC 95% 1,56-6,91) foram associados ao risco de feridas. Este estudo demonstrou um alto risco de feridas relacionado a idade, sexo feminino, duração da diabetes e inatividade física e alta prevalência de complicações como a neuropatia periférica diabética e amputações.

Few studies have addressed the sociodemographic characteristics and risk of wound development in northeastern Brazil. The objective of the study was to determine the prevalence of wound risk and the related factors in people with diabetes in the municipality of Parnaíba, Piauí State, Brazil. A cross-sectional study was conducted with 300 people with diabetes. The volunteers were assessed using a sociodemographic questionnaire, a 10 g monofilament, a 128 Hz tuning fork, a reflex hammer, and a wound risk rating scale. Male sex (OR 2.33, 95% CI 1.22-4.42), age (OR 1.03, 95% CI 1.01-1.05), physical inactivity (OR 2.35, 95% CI 1.26-4.38), and a longer duration of diabetes (OR 3.28, 95% CI 1.56-6.91) were associated with wound risk. This study demonstrated a high wound risk related to age, male sex, duration of diabetes, and physical inactivity and a high prevalence of complications such as diabetic peripheral neuropathy and amputations.

Mães de recém-nascidos prematuros no contexto da pandemia do COVID-19: uma abordagem qualitativa / Mothers of premature newborns in the context of the COVID-19 pandemic: a qualitative approach / Madres de recién nacidos prematuros en el contexto de la pandemia del COVID-19: un enfoque cualitativo

OBJETIVO: Conhecer as percepções das mães de recém-nascidos prematuros internados na Unidade Neonatal diante da pandemia do COVID-19. MÉTODO: Pesquisa qualitativa realizada entre junho e julho de 2020, envolvendo 12 mães de recém-nascidos prematuros internados nas unidades neonatais de uma maternidade no estado do Ceará durante a pandemia do Coronavírus. As mães foram contactadas via aplicativo WhatsApp. Para a análise textual foi utilizada a classificação hierárquica descendente realizada pelo software IRAMUTEQ. RESULTADOS: A percepção das mães estava centrada nas dificuldades enfrentadas neste período de pandemia. A palavra "não" foi fortemente apresentada no corpus do texto, evidenciando o impacto do impedimento da visita, da permanência das mães nas unidades e o fato de não poder amamentar. CONCLUSÃO: A prestação de uma assistência humanizada nas unidades neonatais não deve se limitar ao recém-nascido, sendo fundamental o apoio emocional às mães por parte da equipe de saúde.

OBJECTIVE: To know the perceptions of mothers of premature newborns hospitalized in the Neonatal Unit in the face of the COVID-19 pandemic. METHOD: Qualitative research carried out in June and July 2020, involving 12 mothers of premature newborns hospitalized in the neonatal units of a maternity hospital in the state of Ceará during the Coronavirus pandemic. Mothers were contacted via WhatsApp application. For the textual analysis, the descending hierarchical classification performed by the IRAMUTEQ software was used. RESULTS: The mothers' perception was centered on the difficulties faced in this pandemic period. The word "no" was strongly presented in the corpus of the text, evidencing the impact of the impediment of the visit, of the mothers' permanence in the units and the fact of not being able to breastfeed. CONCLUSION: The provision of humanized care in neonatal units should not be limited to the newborn, and emotional support for mothers by the health team is essential.

OBJETIVO: Conocer las percepciones de las madres de recién nacidos prematuros internados en unidades neonatales ante la pandemia del COVID-19. MÉTODO: Investigación cualitativa realizada en junio y julio de 2020 con la participación de 12 madres de recién nacidos prematuros internados en las unidades neonatales de una maternidad del estado de Ceará durante la pandemia del Coronavirus. Se contactó a las madres por medio de la aplicación WhatsApp. Para el análisis textual se utilizó la Clasificación Jerárquica Descendente realizada en el programa de software IRAMUTEQ. RESULTADOS: La percepción de las madres se enfocó en las dificultadas que debieron enfrentar en este período de la pandemia. La palabra "no" se hizo presente en gran medida en el corpus del texto, evidenciando así el efecto de la imposibilidad de las visitas y de la permanencia de las madres en las unidades, además del hecho de no poder amamantar. CONCLUSIÓN: La prestación de atención humanizada en las unidades neonatales no debe limitarse al recién nacido, siendo fundamental el apoyo emocional a las madres por parte del equipo de salud.

Implicações dos profissionais da Atenção Primária no atendimento à população em situação de rua / Implications of Primary Care professionals in the assistance to the population in street situation

Objetivo: Analisar as implicações dos profissionais da Atenção Primária com vistas ao atendimento em saúde à população em situação de rua utilizando, para isto, o referencial teórico-metodológico da Análise Institucional (AI), na perspectiva da análise no papel. Método: Trata-se de um estudo descritivo exploratório com abordagem qualitativa. Foram aplicadas entrevistas semiestruturadas a cinco profissionais que atuam em uma Unidade Básica de Saúde, em um município do Piauí. Resultados: Os dados apontam para um entrave ainda presente no imaginário dos profissionais da saúde, que é uma ótica de ações paternalistas e higienistas para a população em situação de rua, embora, indiquem a relevância de um cuidado efetivo, multiprofissional e intersetorial. Identificou-se, ainda, a necessidade de investir em formações permanentes das equipes da Estratégia Saúde da Família, discutindo a relevância do atendimento da Pessoa em Situação de Rua na Atenção Primária à Saúde.

Objective: To analyze the implications of Primary Care professionals focusing on the health care for the street population using the theoretical-methodological framework of Institutional Analysis (AI) from the perspective of the role analysis. Method: This is an exploratory, descriptive study with a qualitative approach. Semi-structured interviews were applied with 05 professionals working in a Basic Health Unit in a municipality of Piauí. Results: The data point to an obstacle still present in the health professionals' imaginary, which is a view of paternalistic and hygienist actions for the street population, although they indicate the relevance of effective, multiprofessional, and intersectoral care. The need to invest in permanent training of the Family Health Strategy teams was also identified, discussing the relevance of the assistance to the Person in Street Situation in Primary Health Care.

Comparing the use of silicone and polyurethane Peripherally Inserted Central Catheters in newborns: A retrospective study.

AIMS AND OBJECTIVES: To compare polyurethane and silicone peripherally inserted central catheters (PICCs) in newborns regarding the success rates of insertion and duration and the reasons for nonelective removal. BACKGROUND: Previous studies have attempted to identify predictors of PICC complications in newborns, such as lower extremity insertion or femoral catheter insertion, procedures that require 60 minutes or more, duration longer than 30 days and non-central position of the catheter tip. However, there is little evidence on which type of PICC material causes less complications, especially in newborns. DESIGN: Retrospective cohort, guided by the STROBE tool. METHODS: We divided the newborns into two groups according to the type of PICC material: polyurethane and silicone. Our sample was composed of 449 PICCs, of which 246 polyurethane PICCs and 203 silicone PICCs, inserted in 294 newborns. Bivariate analysis was performed for data comparison. All statistically significant variables in the bivariate analysis were included in the logistic regression (p ≤ .05). RESULTS: Of the 449 PICCs that we analysed, the central position of the catheter tip predominated for both types of materials, with a higher prevalence of false passage for the polyurethane group. There was no difference between the average duration. The incidence of nonelective PICC removal was 49.27% for the silicone group, and infiltration/extravasation and rupture were among the reasons for nonelective removal. CONCLUSION: The overall success rates in the insertion and duration of the PICC were almost identical for both types of material, despite the high incidence of false passage for polyurethane PICCs. Nonelective removals were higher for silicone PICCs, which also had a higher incidence for infiltration/extravasation and rupture. RELEVANCE TO CLINICAL PRACTICE: Can contribute to the knowledge of the strengths and weaknesses of polyurethane and silicone PICCs, with a view to reduce the incidence of nonelective removals.

Dose-response and efficacy of low-level laser therapy on diabetic foot ulcers healing: Protocol of a randomized controlled trial.

BACKGROUND: Current evidence shows that low-level laser therapy (LLLT) is an effective non-invasive and non-pharmacological strategy to treat diabetic foot ulcers (DFU). However, knowledge of parameterization efficacy remains unclear. METHODS: This randomized, double-blind, controlled trial will be conducted at the Physical Therapy University Clinic. Eighty volunteers will be randomized into four groups. The control group will receive placebo LLLT + conventional treatment. The three active groups will receive 10 (G10), 8 (G8), or 4 J/cm2 (G4) of GaAs 904 nm LLLT plus conventional treatment twice a week for 20 sessions. Conventional treatment involves cleaning and dressing the ulcers. The main outcome will be the area of ulcers and Wagner classification score. Assessments will take place before treatment, after 5 and 10 weeks of treatment, and in the third month after treatment, by a blinded evaluator. IMPLICATIONS: This trial can potentially provide important information and assist in clinical decision-making regarding DFU treatment with LLLT. TRIAL REGISTRATION: NCT04246814, registered 29th January 2020.