The Genus Miconia Ruiz & Pav. (Melastomataceae): Ethnomedicinal Uses, Pharmacology, and Phytochemistry.

Species of the genus Miconia are used in traditional medicine for the treatment of diseases, such as pain, throat infections, fever, and cold, and they used as depuratives, diuretics, and sedatives. This work reviewed studies carried out with Miconia species, highlighting its ethnomedicinal uses and pharmacological and phytochemical potential. This information was collected in the main platforms of scientific research (PubMed, Scopus, and Web of Science). Our findings show that some of the traditional uses of Miconia are corroborated by biological and/or pharmacological assays, which demonstrated, among other properties, anti-inflammatory, analgesic, antimutagenic, antiparasitic, antioxidant, cytotoxic, and antimicrobial activities. A total of 148 chemical compounds were identified in Miconia species, with phenolic compounds being the main constituents found in the species of this genus. Such phytochemical investigations have demonstrated the potential of species belonging to this genus as a source of bioactive substances, thus reinforcing their medicinal and pharmacological importance.

Recognizing dysphagia: implementation of an in-hospital screening protocol.

BACKGROUND: Dysphagia affects up to 30% of hospitalized patients, and it is associated with numerous complications. AIMS: Assess the impact of a 24/7 dysphagia screening protocol in an Internal Medicine Unit regarding respiratory complications (such as aspiration pneumonia) as the primary outcome. Length of stay and discharge destination were secondary outcomes. METHODS: Case-control hospital-based analysis comparing the outcomes before and after the implementation of the screening protocol. We analysed demographic data (such as age and gender) and clinical data (presence of dysphagia, vascular risk factors and other comorbidities, respiratory complications, in hospital length of stay and discharge destination). Patients with at least one of the following risk factors were included: COPD (chronic obstructive pulmonary disease), neurodegenerative disorders including dementia, acute stroke or chronic cerebrovascular disease, head and neck neoplasms/surgery or radiotherapy. Statistical analysis was performed with SPSS®. RESULTS: One hundred twenty-eight consecutive patient files were reviewed as the historical control, while 125 consecutive patients were evaluated after the screening protocol was implemented. Even though the second group had less evidence of dysphagia (33 vs 36), since it was detected earlier, respiratory complications were significantly lower (11.7% before vs 2.4%, p < 0.001), allowing more patients to be discharged home (65.6% vs 84%, p = 0.005) and less mortality (15.6% vs 4%, p = 0.005). CONCLUSIONS: Despite its limitations, this study demonstrates that dysphagia screening produces a significant impact on patients' lives, as well as healthcare professionals and resources. We hope that our results will encourage others to adopt a patient-centred multidisciplinary approach that includes a dysphagia screening protocol.