Effectiveness of epidural morphine for the treatment of cancer pain in patients with gastrointestinal neoplasm-a systematic review.

One-third of cancer pain patients do not experience adequate pain relief using analgesic ladder by the World Health Organization. Interventional procedures, such as epidural morphine, have been considered. This study aimed to review the literature comparing the effects of epidural administration of morphine with the oral route. This systematic review included randomized controlled trials (RCTs) conducted with patients with gastrointestinal neoplasm. A search was conducted on PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and CINAHL databases to identify studies published up to May 2023. The retrieved study was evaluated using the Risk of Bias 2 (RoB 2) tool and qualitatively synthesized. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach (Prospero: CRD42021264728). Only one RCT, a crossover trial, was included in this systematic review. The study was conducted with ten participants (one withdrawal) and reported a statistically significant difference between both subcutaneous and epidural morphine solutions and oral morphine. The adverse events were not described. The included study presents some concerns of bias and low certainty of evidence on the effectiveness and security of epidural morphine administration. The available literature does not suffice to elucidate whether morphine administration via the epidural route is more effective than other routes. Further RCTs are necessary to improve the level of evidence on the effectiveness and risk-benefit of epidural morphine in the management of cancer pain in gastrointestinal neoplasm patients.

Symbiotic microparticles produced through spray-drying-induced in situ alginate crosslinking for the preservation of Pediococcus pentosaceus viability.

Probiotic microorganisms are a promising alternative to antibiotics in preventing and treating bacterial infections. Within the probiotic group, the lactic acid bacteria (LAB)stand out for their health benefits and for being recognized as safe by regulatory agencies. However, these microorganisms are sensitive to various environmental conditions, including the acidic environment of the stomach. Faced with these obstacles, this work aimed to promote the symbiotic microencapsulation of LAB in a composite matrix of alginate and prebiotics to enhance their survival and improve their probiotic activity during gastrointestinal transit. We evaluated the effect of inulin, fructo-oligosaccharides (FOS) and mannan-oligosaccharides (MOS) as prebiotic sources on the growth of Pediococcus pentosaceus LBM34 strain, finding that MOS favored LAB growth and maintenance of microencapsulated cell viability. The symbiotic microparticles were produced using the spray-drying technique with an average size of 10 µm, a smooth surface, and a composition that favored the stabilization of live cells according to the FTIR and the thermal analysis of the material. The best formulation was composed of 1 % of alginate, 10 % MOS and 1 % M10 (% w/v), which presented notable increases in the survival rates of the probiotic strain in both alkaline and acidic conditions. Therefore, this industrially scalable approach to symbiotic LAB microencapsulation can facilitate their growth and colonization within the host. This effort aims to contribute to reducing antibiotic reliance and mitigating the emergence of new zoonotic diseases, which pose significant challenges to public health.

Advances in ophthalmic preparation: the role of drug nanocrystals and lipid-based nanosystems.

Nanocrystals and lipid-based nanosystems have the potential to play a crucial role in a significant shift in the treatment of ophthalmic diseases. These drug delivery systems allow overcoming the barriers imposed by anatomy and physiology of the organ of vision. This review aims to present new perspectives for these innovative preparations, emphasising the applications of the nanocrystal and lipid-based nanosystem while outlining their advantages and the drawbacks. The in vivo performance of the lipid-based nanosystems was highlighted. Lipid-based nanosystems and nanocrystals showed a prolonged effect, improved ocular bioavailability, upper therapeutic efficacy, higher permeation, prolonged residence time, and sustained drug release, compared to the current applications. Well-established and innovative developments updates of these systems are highlighted herein.

The effect of ozone gas sterilization on the properties and cell compatibility of electrospun polycaprolactone scaffolds.

The growing area of tissue engineering has the potential to alleviate the shortage of tissues and organs for transplantation, and electrospun biomaterial scaffolds are extremely promising devices for translating engineered tissues into a clinical setting. However, to be utilized in this capacity, these medical devices need to be sterile. Traditional methods of sterilization are not always suitable for biomaterials, especially as many commonly used biomedical polymers are sensitive to chemical-, thermal- or radiation-induced damage. Therefore, the objective of this study was to evaluate the suitability of ozone gas for sterilizing electrospun scaffolds of polycaprolactone (PCL), a polymer widely utilized in tissue engineering and regenerative medicine applications, by evaluating if scaffolds composed of either nanofibres or microfibres were differently affected by the sterilization method. The sterility, morphology, mechanical properties, physicochemical properties, and response of cells to nanofibrous and microfibrous PCL scaffolds were assessed after ozone gas sterilization. The sterilization process successfully sterilized the scaffolds and preserved most of their initial attributes, except for mechanical properties. However, although the scaffolds became weaker after sterilization, they were still robust enough to use as tissue engineering scaffolds and this treatment increased the proliferation of L929 fibroblasts while maintaining cell viability, suggesting that ozone gas treatment may be a suitable technique for the sterilization of polymer scaffolds which are significantly damaged by other methods.

Antifungal effect of electrospun nanofibers containing cetylpyridinium chloride against Candida albicans.

It is known that cetylpyridinium chloride (CPC) has in vitro and in vivo antifungal action against Candida albicans, with advantages over other common antiseptics. A CPC delivery-controlled system, transported in polymer nanofibers (PVP/PMMA), was developed to increase the bioavailability of the drug in contact with the oral mucosa. The objectives of this study were to determine if CPC in nanofiber has antifungal action against C. albicans, and in what concentration it must be incorporated, so that the fraction released can yield an inhibitory concentration. The nanofiber was prepared by electrospinning, and sterilized with gamma irradiation. Nanofiber disks with 0.05%, 1.25%, 2.5% and 5% CPC, with 5% miconazole (MCZ) and with no drug, as well as filter paper disks with 5% CPC, with 5% MCZ and with no drug were used in this study. A Candida albicans suspension (ATCC 90028) was inoculated in Mueller-Hinton Agar plates. The disks were placed on the plates and the inhibition zone diameters were measured 48h later. The nanopolymeric disks contracted in contact with the agar. All the concentrations of CPC incorporated in the nanofiber presented inhibitory action against C. albicans. Concentrations of 2.5% and 5% CPC presented a significant advantage over the nanofiber with no drug, proving the antifungal action of CPC. Under these experimental conditions, 5% CPC has greater inhibitory action against C. albicans than 5% MCZ, both in nanofiber and in filter paper. A modification made in the polymer to decrease the contraction rate may allow a larger inhibition zone to be maintained, thereby increasing the clinical usefulness of the polymer.

Empreendimentos econômicos de catadores de resíduos e legislações vigentes: avanços e limites / Economic enterprises of waste pickers and current legislation: progress and limits

Este artigo tem como objetivo apontar alguns avanços, limites e desafios dos empreendimentos econômicos solidários (EES) de catadores para a promoção da melhoria das condições de trabalho e para o avanço na cadeia produtiva da reciclagem. A partir da sistematização de informações disponíveis no Sistema Nacional de Informações em Economia Solidária foi elaborado um panorama geral de EES de catadores no Brasil considerando suas formas de organização e as dificuldades enfrentadas na comercialização dos produtos, entre outros aspectos. Neste artigo, também foram abordados alguns avanços nas legislações para o setor da reciclagem dos resíduos e para esse tipo de empreendimento. Espera-se que os resultados e reflexões apresentados possam contribuir com informações relevantes para direcionar políticas públicas, fomentar investimentos, colaborar em processos de assessorias e para o desenvolvimento de novos trabalhos a serem realizados para e com os catadores(AU)

This article aims to point some advances, limitations and challenges of the Solidarity Economic Enterprises (SEE) of waste pickers to promote the improvement in their work conditions and the advance in the chain of production of recycling. With the systematization of the information available on the National System of Solidarity Economy (SIES) we elaborated an overview of ESS pickers in Brazil considering its forms of organization, the difficulties experienced in the commercialization of the products, among others. We also discussed some legislation advances for the waste recycling sector and for these enterprises. It is expected that the results and reflections presented here can contribute with relevant information to guide public policies, to encourage investment, to collaborate with consulting processes and to develop new works to be done for and with waste pickers(AU)

Empreendimentos econômicos de catadores de resíduos e legislações vigentes: avanços e limites / Economic enterprises of waste pickers and current legislation: progress and limits

Este artigo tem como objetivo apontar alguns avanços, limites e desafios dos empreendimentos econômicos solidários (EES) de catadores para a promoção da melhoria das condições de trabalho e para o avanço na cadeia produtiva da reciclagem. A partir da sistematização de informações disponíveis no Sistema Nacional de Informações em Economia Solidária foi elaborado um panorama geral de EES de catadores no Brasil considerando suas formas de organização e as dificuldades enfrentadas na comercialização dos produtos, entre outros aspectos. Neste artigo, também foram abordados alguns avanços nas legislações para o setor da reciclagem dos resíduos e para esse tipo de empreendimento. Espera-se que os resultados e reflexões apresentados possam contribuir com informações relevantes para direcionar políticas públicas, fomentar investimentos, colaborar em processos de assessorias e para o desenvolvimento de novos trabalhos a serem realizados para e com os catadores.

This article aims to point some advances, limitations and challenges of the Solidarity Economic Enterprises (SEE) of waste pickers to promote the improvement in their work conditions and the advance in the chain of production of recycling. With the systematization of the information available on the National System of Solidarity Economy (SIES) we elaborated an overview of ESS pickers in Brazil considering its forms of organization, the difficulties experienced in the commercialization of the products, among others. We also discussed some legislation advances for the waste recycling sector and for these enterprises. It is expected that the results and reflections presented here can contribute with relevant information to guide public policies, to encourage investment, to collaborate with consulting processes and to develop new works to be done for and with waste pickers

Influência de fármacos na movimentação dentária induzida / The influence of drugs on orthodontic tooth movement

A Ortodontia está fundamentada na habilidade do profissional em produzir umacontrolada movimentação dos dentes através do osso alveolar, a partir da aplicação da forçaortodôntica. Entretanto, a movimentação ortodôntica pode ser influenciada por vários fatores,dentre eles, o uso de medicamentos. Em vista do exposto, o objetivo deste trabalho foirealizar uma revisão narrativa da literatura sobre a influência de fármacos ou suplementos namovimentação dentária induzida. Como a maior parte dos trabalhos foi realizada com animaise não com humanos e há grande variabilidade entre as metodologias, não se pode afirmarcategoricamente sobre qualquer modificação na movimentação ortodôntica causada poralgum tipo de fármaco que o paciente utilize durante o tratamento ortodôntico. Vislumbra-se,futuramente, atuar na taxa da movimentação ortodôntica com o auxílio de medicamentos.

Orthodontics is based on the professional's ability to produce a controlledteeth movement in alveolar bone through the application of orthodontic force. However, theorthodontic movement may be influenced by several factors, including the use of medicines.Due to it, the aim of this study was to perform a narra tive literature review on the effectsof drugs on experimental tooth movement. As most experimental studies were done withanimais instead of humans and there is a great variability among the methodologies, stetementscannot yet be done about any change in tooth movement caused by some kind ofmedication took by patients during orthodontic treatment. We envision in the future actingon orthodontic tooth movement with the aid of drugs.

Release properties of chemical and enzymatic crosslinked gelatin-gum Arabic microparticles containing a fluorescent probe plus vetiver essential oil.

Oil-containing gelatin-gum Arabic microparticles were prepared by complex coacervation followed by crosslinking with glutaraldehyde or transglutaminase. A fluorescent mixture, khusimyl dansylate (KD) as the fluorescent compound mixed to the vetiver essential oil, was used as oil model. The effect of the type of crosslinking of the coacervated gelatin-gum Arabic membrane, the physical state of microparticles, wet or freeze-dried and the type of release media, aqueous with surfactants, Sodium Dodecyl Sulphate (sds) or Tween 80 (tw) and anhydrous ethanol as organic media on the release rate of the KD from the microparticles, was experimentally investigated. It was shown that the oil was dispersed uniformly throughout the microparticles and the chemical crosslinked microparticles were more resistant to swelling, presenting smaller sizes after hydration. Also the crosslinking effect, transglutaminase or glutaraldehyde, could be confirmed by the integrity of the crosslinked gelatin-gum Arabic microparticles after incubation in the aqueous sds media, compared to complete dissolution of the uncrosslinked microparticles in this media. The cumulative fluorescent KD release from the gelatin-gum Arabic microparticles decreased in the following order of dissolution media: anhydrous ethanol>tw>sds and the wet microparticles have shown a faster KD release than freeze-dried ones. A mathematical model was used to estimate the diffusion coefficient (D). The chemically crosslinked gelatin-gum Arabic microparticles ensured a pronounced retard effect in the KD diffusion, presenting a D varying from 0.02 to 0.6 x 10(-11)cm(2)/s, mainly in an aqueous media, against D varying from 1.05 to 13.9 x 10(-11)cm(2)/s from the enzymatic crosslinked microparticles.

Proporção divina em maloclusão classe II / Divine proportion in malocclusion class II

O tratamento ortodôntico deve considerar a função e a estética, com harmonia e equilíbrio proporcional da face. Este estudo mediu seis fatores na cefalometria traçada da telerradiografia. Incluindo indivíduos caucasianos, vinte do gênero feminino e vinte do masculino, com todos os dentes permanentes na boca e com classe II esquelética e dentária nos três tipos da faces, utilizando as proporções divinas proposta por Ricketts em 1982. os resultados permitiram analisar cada grandeza separadamente mostrando exatamente qual região não apresentava as divinas proporções e se era possível as tratamento ortodôntico e/ ou cirúrgico conseguir estas proporções. Considerando o estudo, indivíduos com classe II, devem ser avaliados individualmente, pois observou-se muita variação nestas proporções para pacientes com este tipo de maloclusão.

The orthodontic treatment must consider both function and esthetic, with harmony and balance proportions of the face. This study measured six factors in lateral cephalometric radiography on the head side. Including Caucasian individuals, twenty was from feminine genus and twenty from the masculine genus, with all permanent teeth, dental and skeleton Class II in three face types using the divine proportion sample proposed by Ricketts in 1982. The results allowed value the greatness separately showing exactly which region there wasn’t divine proportions and if it was possible by orthodontic treatment and/ or surgery to approach for divine proportions. Considering the study individuals how has Class II malocclusion, must be valued individually, because there are too many variations in this proportions in patients with this kind of malocclusion.

Quem é o aluno PROFAE? / Who's the PROFAE student?

Este estudo teve como objetivo principal verificar o perfil do aluno técnico de enfermagem do curso do Projeto de Profissionalização dos Trabalhadores da Área de Enfermagem, PROFAE desenvolvido no Hospital Ipiranga vinculado ao Centro Formador de Recursos Humanos (CEFOR) da Secretaria de Estado da Saúde de São Paulo...