Factors associated with care omission and patient safety climate.

OBJECTIVE: To identify the factors associated with the omission of nursing care and patient safety climate. METHOD: A cross-sectional study developed at a university hospital in the Brazilian Center-West, between September and December 2022. The MISSCARE-Brazil and the Safety Attitudes Questionnaire were applied to a convenience sample of 164 nursing professionals. RESULTS: The most omitted care was walking three times a day or as prescribed (66.5%). The overall score of the Safety Attitudes Questionnaire was 63,8 (SD: 12,6). The level of satisfaction (p<0.018) and the perception of professional adequacy (p<0.018) were associated with the omission of nursing care and the patient safety climate. CONCLUSION: The study showed a high prevalence of omission of care and unfavorable perception of the patient safety climate, mainly associated with professional adequacy for work performance.

Getting knowledge to provide care: prevalence and factors associated with Sexually Transmitted Infections in immigrants from Goiás.

OBJECTIVE: To estimate the prevalence of Sexually Transmitted Infections (STIs) in immigrants and refugees living in the metropolitan region of Goiânia, Goiás. METHOD: This is a cross-sectional and analytical study. Data collection was carried out from July 2019 to January 2020 and 308 immigrants and refugees were included in the sample. All were underwent face-to-face interviews and were tested for HIV, Syphilis, and Hepatitis B, using rapid tests. RESULTS: The general prevalence for any of the STIs investigated was 8.8% (95%CI 6.0% - 12.3%), being 5.8% (95%CI 3.6% - 8.9%) for Hepatitis B, 2.3% for Syphilis (95%CI 1.00% - 4.4%) and 0.7% for HIV (95%CI 0.1% - 2.1%). Multiple analysis, using logistic regression, showed that the variables male gender (OR = 2.7) and length of time living in Brazil (OR = 2.6) were significantly associated with STIs (p < 0.05). CONCLUSION: The results of this study suggest that STIs are a health problem in immigrants/refugees, which appear to be enhanced with the length of migration in the country. Public policies that guarantee health care for this population shall be considered.

Severe esophagitis induced by antituberculosis drugs: a case report.

Tuberculosis stands as one of humanity's oldest afflictions, intrinsically intertwined with social disparities. This formidable disease spares no age group and remains the prevailing cause of infection-induced mortality worldwide, particularly in developing nations. We present a case of a 56-year-old woman with diabetes who was diagnosed with Pulmonary Tuberculosis. After receiving antituberculosis drugs as part of her treatment, she experienced a range of systemic manifestations and suffered from severe ulcerative esophagitis. This adverse reaction led to uncontrollable gastrointestinal intolerance, tragically resulting in her untimely demise. The incident underscores the potential seriousness of adverse reactions that can arise from tuberculosis treatment medications.

Prevenção de quedas na hospitalização: oportunidades educativas na perspectiva dos trabalhadores de Enfermagem* / Preventing falls during hospitalization: educational opportunities from the perspective of Nursing staff / Prevención de caídas durante la hospitalización: oportunidades educativas desde la perspectiva de los trabajadores de Enfermería

Objetivo: descrever as oportunidades educativas identificadas pelos trabalhadores de Enfermagem para prevenir as quedas de pacientes adultos hospitalizados. Método: estudo qualitativo, descritivo, com 21 trabalhadores de Enfermagem de um hospital universitário no sul do Brasil. A coleta de dados ocorreu de março a maio de 2020, com entrevistas semiestruturadas, submetidas à Análise de Conteúdo. Resultados: foram descritas pelos trabalhadores a necessidade de as ações educativas atingirem os envolvidos na prevenção das quedas, emergindo as categorias: Protagonismo do paciente na prevenção das quedas: a educação como estratégia para a percepção do risco; O desafio do envolvimento do familiar/acompanhante como potencializador do cuidado; Dialogicidade na prevenção das quedas: uma reflexão sobre o fazer diário. Conclusão: os trabalhadores identificaram as oportunidades de investimento na educação e na formação, considerando as experiências prévias e o contexto social, criando percursos de aprendizagem, testando novas abordagens para a prevenção de quedas e aprimorando seu papel educativo.

Objective: to describe the educational opportunities identified by Nursing staff to prevent falls in hospitalized adult patients. Method: This is a qualitative, descriptive study with 21 Nursing workers from a university hospital in southern Brazil. Data collection took place from March to May 2020, with semi-structured interviews, submitted to Content Analysis. Results: workers described the need for educational actions to reach those involved in fall prevention, and the following categories emerged: Patient protagonism in fall prevention: education as a strategy for risk perception; The challenge of involving the family member/companion as an enhancer of care; Dialogicity in fall prevention: a reflection on daily practice. Conclusion: workers identified opportunities to invest in education and training, taking into account previous experiences and the social context, creating learning paths, testing new approaches to fall prevention, and improving their educational role.

Objetivo: describir las oportunidades educativas identificadas por los trabajadores de Enfermería para prevenir caídas en pacientes adultos hospitalizados. Método: estudio cualitativo, descriptivo, con 21 trabajadores de Enfermería de un hospital universitario del sur de Brasil. La recolección de datos se realizó de marzo a mayo de 2020, con entrevistas semiestructuradas, sometidas a Análisis de Contenido. Resultados: los trabajadores describieron la necesidad de acciones educativas para llegar a los involucrados en la prevención de caídas, surgiendo las siguientes categorías: Papel del paciente en la prevención de caídas: la educación como estrategia para la percepción del riesgo; El desafío de la participación de la familia/acompañante como potenciador del cuidado; Diálogo en la prevención de caídas: una reflexión sobre la práctica diaria. Conclusión: los trabajadores identificaron oportunidades de inversión en educación y capacitación, considerando experiencias anteriores y el contexto social, creando caminos de aprendizaje, probando nuevos enfoques para prevenir caídas y mejorar su rol educativo.

Severe esophagitis induced by antituberculosis drugs: a case report

ABSTRACT Tuberculosis stands as one of humanity's oldest afflictions, intrinsically intertwined with social disparities. This formidable disease spares no age group and remains the prevailing cause of infection-induced mortality worldwide, particularly in developing nations. We present a case of a 56-year-old woman with diabetes who was diagnosed with Pulmonary Tuberculosis. After receiving antituberculosis drugs as part of her treatment, she experienced a range of systemic manifestations and suffered from severe ulcerative esophagitis. This adverse reaction led to uncontrollable gastrointestinal intolerance, tragically resulting in her untimely demise. The incident underscores the potential seriousness of adverse reactions that can arise from tuberculosis treatment medications.

[Contextual characteristics and demand for health services among Brazilian adolescents: Brazilian National Health Survey, 2019]. / Características contextuais e procura por serviços de saúde entre adolescentes brasileiros: Pesquisa Nacional de Saúde, 2019.

This study aimed to describe the prevalence of demand for health services among Brazilian adolescents and to investigate its association with contextual characteristics of the territory. Study with data from the Brazilian National Health Survey, conducted in 2019, including 43,774 individuals aged from 10 to 19 years. Adolescent's information was obtained through a proxy resident of 18 years or more who answered for all the residents of the household. Poisson regression was used to assess the demand for health services according to geopolitical region, economic status, and type of municipality. The interaction of the health insurance was also evaluated in these associations. Of the total, 11.7% (95%CI: 11.1; 12.3) of the adolescents sought health services in the two weeks prior to the survey. Greater figures of demand were observed in the Southeast (PR = 1.32; 95%CI: 1.15; 1.52) and South regions (PR = 1.31; 95%CI: 1.13; 1.52) compared to the Northern Region of Brazil. Having a health insurance increased the demand for services by adolescents living in rural areas and in capitals and the municipalities of the Metropolitan Areas and/or Integrated Development Regions. The study showed a low prevalence of demand for health services among adolescents and contextual inequalities for the geopolitical region. Having a health insurance was an important marker to understand the disparities in the economic status and in the type of municipality.

Os objetivos foram descrever a prevalência de procura por serviços de saúde entre adolescentes brasileiros e investigar sua associação com características contextuais do território. O estudo utilizou dados da Pesquisa Nacional de Saúde de 2019, realizada com 43.774 indivíduos de 10 a 19 anos. A informação do adolescente foi obtida por meio de um morador proxy de 18 anos ou mais que respondia por si e por todos os moradores da casa. A regressão de Poisson foi utilizada para avaliar a procura por serviços de saúde de acordo com região geopolítica, situação censitária e tipo de município. Também foi avaliada a interação da variável "plano de saúde" nessas associações. Do total, 11,7% (IC95%: 11,1; 12,3) dos adolescentes procuraram serviços de saúde nas duas semanas anteriores à pesquisa. Maiores prevalências de procura foram observadas nas regiões Sudeste (RP = 1,32; IC95%: 1,15; 1,52) e Sul (RP = 1,31; IC95%: 1,13; 1,52) em comparação à Região Norte do país. O acesso a plano de saúde aumentou a busca pelos serviços por adolescentes residentes nas áreas rurais e nas capitais e municípios das Regiões Metropolitanas e/ou Regiões Integradas de Desenvolvimento. O estudo evidenciou baixa prevalência de procura por serviços de saúde entre adolescentes e desigualdades contextuais para a região geopolítica. Ter plano de saúde foi um marcador importante para entender as disparidades na situação censitária e no tipo de município.

El objetivo de este estudio fue estimar la prevalencia de la demanda de servicios de salud entre los adolescentes brasileños e investigar su asociación con las características contextuales del territorio. Estudio con datos de la Encuesta Nacional de Salud, realizada en 2019 con 43.774 individuos de entre 10 y 19 años de edad. La información del adolescente se obtuvo de un residente proxy de 18 años o más que era responsable de sí mismo y de todos los residentes de la casa. La regresión de Poisson se utilizó para evaluar la demanda de servicios de salud según la región geopolítica, la situación en el censo y el tipo de municipio. También se evaluó la interacción de la variable seguro médico en estas asociaciones. Del total, el 11,7% (IC95%: 11,1; 12,3) de los adolescentes buscaron servicios de salud en las dos semanas previas a la encuesta. Se observó mayor prevalencia de demanda en las regiones Sudeste (RP = 1,32; IC95%: 1,15; 1,52) y Sur (RP = 1,31; IC95%: 1,13; 1,52) en comparación con el Norte del país. Tener un seguro médico incrementó la búsqueda de servicios por parte de los adolescentes que viven en áreas rurales y en las capitales y municipios de de las Regiones Metropolitanas y/o Regiones de Desarrollo Integrado. El estudio apuntó a una baja prevalencia de demanda de servicios de salud entre los adolescentes y desigualdades contextuales según la región geopolítica. Tener un seguro médico fue un marcador importante para comprender las disparidades según la situación del censo y el tipo de municipio.

The Brazilian national prospective active surveillance (AS) cohort of patients with low-risk prostate cancer in the public health system: vigiaSUS study protocol.

BACKGROUND: Prostate cancer exhibits a very diverse behaviour, with some patients dying from the disease and others never needing treatment. Active surveillance (AS) consists of periodic PSA assessment (prostate-specific antigen), DRE (digital rectal examination) and periodic prostate biopsies. According to the main guidelines, AS is the preferred strategy for low-risk patients, to avoid or delay definitive treatment. However, concerns remain regarding its applicability in certain patient subgroups, such as African American men, who were underrepresented in the main cohorts. Brazil has a very racially diverse population, with 56.1% self-reporting as brown or black. The aim of this study is to evaluate and validate the AS strategy in low-risk prostate cancer patients following an AS protocol in the Brazilian public health system. METHODS: This is a multicentre AS prospective cohort study that will include 200 patients from all regions of Brazil in the public health system. Patients with prostate adenocarcinoma and low-risk criteria, defined as clinical staging T1-T2a, Gleason score ≤ 6, and PSA < 10 ng/ml, will be enrolled. Archival prostate cancer tissue will be centrally reviewed. Patients enrolled in the study will follow the AS strategy, which involves PSA and physical examination every 6 months as well as multiparametric MRI (mpMRI) every two years and prostate biopsy at month 12 and then every two years. The primary objective is to evaluate the reclassification rate at 12 months, and secondary objectives include determining the treatment-free survival rate, metastasis-free survival, and specific and overall survival. Exploratory objectives include the evaluation of quality of life and anxiety, the impact of PTEN loss and the economic impact of AS on the Brazilian public health system. DISCUSSION: This is the first Brazilian prospective study of patients with low-risk prostate cancer under AS. To our knowledge, this is one of the largest AS study cohort with a majority of nonwhite patients. We believe that this study is an opportunity to better understand the outcomes of AS in populations underrepresented in studies. Based on these data, an AS national clinical guideline will be developed, which may have a beneficial impact on the quality of life of patients and on public health. TRIAL REGISTRATION: Clinicaltrials registration is NCT05343936.

Performance of 'Gala Select' and 'Fuji Suprema' grafted on Geneva series rootstocks under fallow land and replanting conditions in southern Brazil.

Background: Rootstocks less vigorous are among the most crucial management techniques to modernize fruit cultivation. Replanting with fallow land has become necessary due to a lack of land to establish new orchards. Objective: The aim of this study is to determine the effect of various rootstocks of the American Geneva® series on the yield performance of the apple (Malus domestica Borkh) cultivars 'Gala Select' and 'Fuji Suprema' under replanting conditions in southern Brazil. Methods: After two years of fallow land, the experiments were initiated in 2017 and conducted during the 2018, 2019, 2020, and 2021 growing seasons in Painel and Caxias do Sul municipalities at the Santa Catarina and the Rio Grande do Sul State, respectively. The 'Gala Select' and 'Fuji Suprema' were grafted onto the G.202, G.814, G.210, and G.213 Geneva series rootstocks in a tall spindle training system using a randomized complete block design with four replicates. Principal component analysis (PCA) was used to assess the interrelationship among the variable's vigor, productivity, and fruit quality. Results: The PCA result showed significant differences in vigor, productivity, and fruit quality when the G.210 and G.213 and G.814 and G.213 Geneva series rootstocks were used in combination with Gala Select and Fuji Suprema cultivars, respectively. The PCA analysis clustered all cultivar/rootstock combinations into two groups, based on their vigor and productivity and the yield performance and fruit quality data, that differed significantly among combinations and regions. The 'Gala Select'/G.202 and 'Fuji Suprema'/G.213 combinations were less vigorous than the 'Gala Select'/G.210 and 'Fuji Suprema'/G.814 combinations. However, 'Gala Select'/G.210 (semi-dwarfing) and G.213 (dwarfing) are the combinations with high yield performance, productive efficiency and fruit quality, being more reliable to the producer, and less vigorous, resulting in lower labor costs under replating conditions, with two years of fallow land, from 2018 until 2021 growing seasons.

Organização da Atenção Primária à Saúde em Municípios Rurais Remotos do Oeste do Pará / Organization of Primary Health Care in Remote Rural Municipalities in West Pará

RESUMO O artigo objetiva identificar especificidades e estratégias da organização da Atenção Primária à Saúde (APS) em Municípios Rurais Remotos (MRR) do Oeste do Pará frente às singularidades do contexto amazônico. Realizou-se estudo de casos múltiplos em cinco municípios por meio de entrevistas com gestores municipais, enfermeiros e médicos de Equipes de Saúde da Família. As dimensões de análise foram a territorialização, escopo de práticas e organização da agenda, colaboração interprofissional, iniciativas de atração e fixação profissional e uso de tecnologias de informação e comunicação. O trabalho da APS nos MRR, principalmente no interior, organiza-se prioritariamente em atendimentos, procedimentos individuais e imunização. Enfermeiros, técnicos de enfermagem e Agentes Comunitários de Saúde (ACS) do interior possuem escopo de ações ampliado, muitas vezes, por ausência de médicos. Além do impacto positivo do Programa Mais Médicos, destacam-se estratégias locais de atendimentos itinerantes e sobreaviso para urgência. A territorialização, central na discussão de territórios sustentáveis e saudáveis, deve ser dinâmica e exige arranjos diferenciados, com adequação do número de famílias por ACS e por equipes. Estratégias específicas para organizar uma APS integral e integrada à Rede de Atenção à Saúde, financiamento federal suficiente e diferenciado e formação profissional direcionada ao rural são necessárias para garantir acesso e qualidade dos serviços a todos os cidadãos.

ABSTRACT The article aims to identify specificities and strategies for the organization of Primary Health Care (PHC) in Remote Rural Municipalities (MRR) in western Pará in the face of singularities in the Amazonian. Multiple case study in five municipalities, with interviews: municipal managers, nurses and physicians from the Family Health Teams. The analysis dimensions were: territorialization, scope of practices and agenda organization, interprofessional collaboration, professional attraction and retention initiatives and use of information and communication technologies. The work of the PHC in the MRR, mainly in the countryside, is organized primarily around care, individual procedures and immunization. Nurses, nursing technicians and Community Health Agents (CHA) from the countryside have an expanded scope of action, often due to the absence of physicians. In addition to the positive impact of the Mais Médicos Program, local strategies for itinerant care and on-call for emergencies stand out. Territorialization, central to the discussion of sustainable and healthy territories, must be dynamic and require different arrangements, adjusting the number of families per CHA/teams. Specific strategies to organize a comprehensive PHC integrated into the Health Care Network, sufficient and differentiated federal funding and professional training aimed at rural areas, are necessary to guarantee access and quality of services to all citizens.

Selection of Soybean and Cowpea Cultivars with Superior Performance under Drought Using Growth and Biochemical Aspects.

Identifying cultivars of leguminous crops exhibiting drought resistance has become crucial in addressing water scarcity issues. This investigative study aimed to select soybean and cowpea cultivars with enhanced potential to grow under water restriction during the vegetative stage. Two parallel trials were conducted using seven soybean (AS3810IPRO, M8644IPRO, TMG1180RR, NS 8338IPRO, BMX81I81IPRO, M8808IPRO, and BÔNUS8579IPRO) and cowpea cultivars (Aracê, Novaera, Pajeú, Pitiúba, Tumucumaque, TVU, and Xique-xique) under four water levels (75, 60, 45, and 30% field capacity-FC) over 21 days. Growth, water content, membrane damage, photosynthetic pigments, organic compounds, and proline levels were analyzed. Drought stress significantly impacted the growth of both crops, particularly at 45 and 30% FC for soybean and 60 and 45% FC for cowpea plants. The BÔNUS8579IPRO and TMG1180RR soybean cultivars demonstrated the highest performance under drought, a response attributed to increased amino acids and proline contents, which likely help to mitigate membrane damage. For cowpea, the superior performance of the drought-stressed Xique-xique cultivar was associated with the maintenance of water content and elevated photosynthetic pigments, which contributed to the preservation of the photosynthetic efficiency and carbohydrate levels. Our findings clearly indicate promising leguminous cultivars that grow under water restriction, serving as viable alternatives for cultivating in water-limited environments.

Role of ABC Proteins in Secondary Metabolism and Immune (=Defensive) Response in Seaweeds.

Laurencia seaweed species synthesize a broad range of secondary metabolites, mainly terpenes (e.g., elatol), exhibiting diverse ecological roles, such as defense against fouling and herbivores. Recently, an intricate cellular machinery was described concerning terpenes biosynthetic pathways, storage inside corps en cerise (CC), and regulated exocytosis in these species. But for seaweeds in general, the proteins involved in transmembrane transport of secondary metabolites remain unknown. Assays with Rhodamine-123 and cyclosporine A (CSA) revealed the presence of ABC transporters in CC membrane of Laurencia dendroidea. In vivo incubation assays with CSA resulted in CC morphological changes, reduced intracellular elatol concentrations, and increased biofouling cover on the seaweed surface. Cultivation assays in the presence of a marine pathogenic bacteria induced the expression of ABC proteins belonging to the subfamilies ABCB, ABCD, ABCF, and ABCG. The latter subfamily is known to be associated with the transport of plant terpenes. Our results shed new light on the role of ABC proteins in key mechanisms of the defensive system in seaweeds against fouling and herbivory.

COVID-19 in multiple myeloma patients: frequencies and risk factors for hospitalization, ventilatory support, intensive care admission and mortality -cooperative registry from the Grupo Brasileiro de Mieloma Multiplo (GBRAM).

INTRODUCTION: This study evaluated outcomes and risk factors for COVID-19 in 91 Brazilian multiple myeloma (MM) patients between April 2020 and January 2022. RESULTS: Of the 91 MM patients diagnosed with COVID-19, 64% had comorbidities and 66% required hospitalization due to COVID-19, with 44% needing ventilatory support and 37% intensive care. Age (OR 2.02; 95%CI 1.02 - 7.7) and hypertension OR 4.5; 95%CI 1.3 - 15.5) were independently associated with hospitalization and certain MM therapies (corticosteroids and monoclonal drugs) were associated with ventilatory support (OR 4.3; 95%CI 1.3 - 14 and OR 5.7; 95%CI 1.8 - 18, respectively), while corticosteroids and immunomodulatory drugs were linked to ICU admission (OR 5.1; 95% CI 1.4 - 18 and OR 3.4; 95%CI 1.1 - 10, respectively). The overall mortality rate was 30%, with the highest rate observed in the ICU (73%). Additionally, the ECOG performance status was linked to increased mortality (OR 11.5; 95%CI 1.9 - 69). The MM treatment was delayed in 63% of patients who recovered from COVID-19. CONCLUSIONS: The findings highlight the need for preventing COVID-19 and prioritizing vaccination among MM patients, as they have high rates of severe outcomes in the event of COVID-19. It is also essential to monitor the potential clinical impacts of COVID-19 on MM patients in the long-term. Given the limited resources available in treating MM patients in Brazil during the COVID-19 pandemic, outcomes might be worse in this population.

Oligosymptomatic long-term carriers of SARS-CoV-2 display impaired innate resistance but increased high-affinity anti-spike antibodies.

The vast spectrum of clinical features of COVID-19 keeps challenging scientists and clinicians. Low resistance to infection might result in long-term viral persistence, but the underlying mechanisms remain unclear. Here, we studied the immune response of immunocompetent COVID-19 patients with prolonged SARS-CoV-2 infection by immunophenotyping, cytokine and serological analysis. Despite viral loads and symptoms comparable to regular mildly symptomatic patients, long-term carriers displayed weaker systemic IFN-I responses and fewer circulating pDCs and NK cells at disease onset. Type 1 cytokines remained low, while type-3 cytokines were in turn enhanced. Of interest, we observed no defects in antigen-specific cytotoxic T cell responses, and circulating antibodies displayed higher affinity against different variants of SARS-CoV-2 Spike protein in these patients. The identification of distinct immune responses in long-term carriers adds up to our understanding of essential host protective mechanisms to ensure tissue damage control despite prolonged viral infection.

HTLV-1 p12 modulates the levels of prion protein (PrPC) in CD4+ T cells.

Introduction: Infection with human T cell lymphotropic virus type 1 (HTLV-1) is endemic in Brazil and is linked with pro-inflammatory conditions including HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic neuroinflammatory incapacitating disease that culminates in loss of motor functions. The mechanisms underlying the onset and progression of HAM/TSP are incompletely understood. Previous studies have demonstrated that inflammation and infectious agents can affect the expression of cellular prion protein (PrPC) in immune cells. Methods: Here, we investigated whether HTLV-1 infection affected PrPC content in cell lines and primary CD4+cells in vitro using flow cytometry and western blot assays. Results: We found that HTLV-1 infection decreased the expression levels of PrPC and HTLV-1 Orf I encoded p12, an endoplasmic reticulum resident protein also known to affect post-transcriptionally cellular proteins such as MHC-class I and the IL-2 receptor. In addition, we observed a reduced percentage of CD4+ T cells from infected individuals expressing PrPC, which was reflected by IFN type II but not IL-17 expression. Discussion: These results suggested that PrPC downregulation, linked to both HTLV-1 p12 and IFN-γ expression in CD4+ cells, may play a role in the neuropathogenesis of HTLV-1 infection.

Validation of stability-indicating LC method, degradation study, and impact on antioxidant and antifungal activities of Eugenia uniflora leaves extract.

The aim of this study is to demonstrate the stability-indicating capacity of an analytical method for Eugenia uniflora, enhance understanding of the stability of myricitrin, and assess the effect of degradation of spray-dried extract (SDE) on antioxidant and antifungal activities. Validation of the stability-indicating method was carried out through a forced degradation study of SDE and standard myricitrin. The antioxidant and antifungal activities of SDE were evaluated both before and after degradation. The quantification method described was found to be both accurate and precise in measuring myricitrin levels in SDE from E. uniflora, with excellent selectivity that confirmed its stability-indicating capability. The forced degradation study revealed that the marker myricitrin is sensitive to hydrolysis, but generally stable under other stress conditions. By contrast, the standard myricitrin displayed greater susceptibility to degradation under forced degradation conditions. Analysis of the antioxidant activity of SDE before and after degradation showed a negative impact in this activity due to degradation, while no significant effect was observed on antifungal activity. The method described can be a valuable tool in the quality control of E. uniflora, and the findings can assist in determining the optimal conditions and storage of products derived from this species.

Dual-Task Performance, Balance and Aerobic Capacity as Predictors of Falls in Older Adults with Cardiovascular Disease: A Comparative Study.

Cardiovascular diseases (CVD) are highly prevalent and strongly associated with the risk of falls in the elderly. Falls are associated with impairments in cognition and functional or gait performance; however, little is known about these associations in the elderly population with CVD. In this study, we aimed to clarify the possible associations of physical capacity and functional and cognitive outcomes with the incidence of falls in older adults with CVD. In this comparative study, 72 elderly patients were divided into fallers (n = 24 cases) and non-fallers (n = 48 controls) according to the occurrence of falls within one year. Machine learning techniques were adopted to formulate a classification model and identify the most important variables associated with the risk of falls. Participants with the worst cardiac health classification, older age, the worst cognitive and functional performance, balance and aerobic capacity were prevalent in the case group. The variables of most importance for the machine learning model were VO2max, dual-task in seconds and the Berg Scale. There was a significant association between cognitive-motor performance and the incidence of falls. Dual-task performance, balance, and aerobic capacity levels were associated with an increased risk of falls, in older adults with CVD, during a year of observation.

Medicalização da assistência ao parto normal: Perfil de gestantes atendidas em uma maternidade de risco habitual / Medicalización de la asistencia del parto natural: Perfil de las mujeres embarazadas atendidas en una maternidad de bajo riesgo / Medicalization of natural childbirth assistance: Profile of pregnancies women in a low-risk maternity hospital

Introdução: O nascimento tem experimentado mudanças na compreensão do parto como processo natural, tornando-o passível de intervenções, como as relacionadas a abreviação do parto através do uso de medicamentos. Objetivo: Descrever o perfil da assistência às gestantes, verificando a prevalência do uso de medicamentos, instrumentos e protocolos, durante o trabalho de parto e parto, em maternidade pública de saúde, destinada à assistência a gestantes de risco habitual. Método: Estudo transversal, descritivo, exploratório e quantitativo, com população por conveniência (n=26 profissionais de saúde). Foram investigadas as características sociodemográficas dos enfermeiros e médicos que prestavam assistência direta ao parto, além daquelas relativas ao uso de medicamentos, instrumentos e protocolos. Os dados foram tabulados no Epiinfo 7.2.2.2, sendo realizada análise estatística descritiva. Resultados: Observou-se que 53,8% são enfermeiros obstetras e 46,2% médicos obstetras. Dentre os entrevistados: 65,4% asseguraram preencher sempre ou quase sempre o partograma, 61,6% aplicam sempre ou quase sempre o índice de Bishop, 57,7% fazem uso de medicamentos para induzir o parto. A prevalência de profissionais que afirmaram não existir protocolos assistenciais ao parto na instituição somou 80,8%. Conclusão: O presente estudo foi relevante para demonstrar que a maioria dos profissionais não usavam medicamentos aceleradores do trabalho de parto; consideravam a integridade das membranas antes da indução medicamentosa, com maior prevalência de uso da ocitocina em relação ao misoprostol nos casos de necessidade de indução com iguais condições do colo uterino. A maior parte dos profissionais afirmou ainda fazer uso de protocolos de assistência ao parto, embora não fossem os institucionais.

Introducción: El nacimiento ha experimentado cambios en la comprensión del parto como un proceso natural, haciéndolo susceptible de intervenciones, como las relacionadas con la abreviación del parto mediante el uso de medicamentos. Objetivo: Describir el perfil de atención de la gestante, para verificar la prevalencia del uso de medicamentos, instrumentos y protocolos durante el trabajo de parto y parto en una maternidad de la red pública de salud, destinada a la asistencia de gestantes de riesgo habitual. Método: Estudio transversal, descriptivo, exploratorio y cuantitativo con población (n=26 profesionales de la salud). Se investigaron las características sociodemográficas de profesionales de enfermería y profesionales médicos que ofrecían asistencia directa durante el parto, además de las relacionadas con el uso de medicamentos, instrumentos y protocolos. Los datos se tabularon en el programa Epiinfo 7.2.2.2 y se realizó el análisis estadístico descriptivo. Resultados: Se observó que el 53.8 % son personal de enfermería obstetricia y el 46.2 % son obstetras. Entre las entrevistadas, el 65.4 % aseguró que siempre o casi siempre completaba el partograma, el 61.6 % siempre o casi siempre aplicaba el índice de Bishop, el 57.7 % utilizaba medicación para inducir el parto. La prevalencia de profesionales que afirmaron que no existían protocolos de atención del parto en la institución fue de 80.8 %. Conclusión: El presente estudio fue relevante para demostrar que la mayoría de los profesionales no utilizaban fármacos para acelerar el trabajo de parto, consideraron la integridad de las membranas antes de la inducción medicamentosa, con mayor prevalencia de uso de oxitocina, en relación al misoprostol en casos de necesidad de inducción con las mismas condiciones del cuello uterino. La mayoría de los profesionales dijeron que todavía hacen uso de los protocolos de atención al parto, aunque no sean institucionales.

Introduction: Birth has experienced changes in the understanding of childbirth as a natural process, making it amenable to interventions, such as those related to shorten the labor time by medication. Objective: To describe the prevalence of the use of drugs, instruments, and protocols in the labor and delivery profile of assistance in a public maternity hospital that nurses low risk pregnancies. Method: This is a cross-sectional, descriptive, exploratory, and quantitative study with population (n=26 health professionals). The sociodemographic characteristics of nurses and doctors who provide direct assistance during childbirth were analyzed in addition to those related to the use of medications, instruments, and protocols. Data were tabulated in the Epiinfo 7.2.2.2 program; then, a descriptive statistical analysis was performed. Results: It was observed that 53.8% are obstetric nurses and 46.2% are obstetricians. Among the interviewees: 65.4% assured that they always or almost always completed the partograph, 61.6% always or almost always applied the Bishop index, 57.7% used medication to induce labor. The prevalence of professionals who stated that there were no childbirth care protocols in the institution totaled 80.8%. Conclusion: The present study was relevant to demonstrate that most professionals did not use drugs for labor induction; they considered the integrity of the membranes before these drugs; and, when induction was needed, there was a higher prevalence of the use of oxytocin in relation to misoprostol in cases with the same conditions of the uterine cervix. Most professionals said that they still use childbirth care protocols although they are not institutional.

Novel Zn(II)-complex with hybrid chalcone-thiosemicarbazone ligand: Synthesis, characterization, and inhibitory effect on HTLV-1-infected MT-2 leukemia cells.

Chalcone and thiosemicarbazone have attracted attention due to their easy synthetic procedure and high success in the development of antiviral and antitumor, however, there are few biological data on the evaluation of chalcone-thiosemicarbazone hybrids and their complexation with metal ions. In this sense, the present work reports the synthesis and characterization of the hybrid (Z)-2-((E)-3-(4-chlorophenyl)-1-phenylallylidene)hydrazine-1-carbothioamide (CTCl) and its Zn(II)-complex (CTCl-Zn). The compounds were cell-based evaluated in terms of cytotoxicity against human T-cell lymphotropic virus type 1 (HTLV-1) infected leukemia cells (MT-2) and the experimental data were correlated with molecular docking calculations. The ligand and Zn(II)-complex were easily synthesized with a good yield - 57% and 79%, respectively. The dynamic of E/Z isomers with respect to the imine bond configuration of CTCl was evidenced by 1H NMR experiments in DMSO­d6, while the X-ray diffraction of CTCl-Zn showed that Zn(II) ion is tetracoordinated to two ligands in a bidentate mode and the metal ion lies on an intermediate geometry between the see-saw and trigonal pyramid. The ligand and complex exhibited low toxicity and the Zn(II)-complex is more cytotoxic than the ligand, with the corresponding IC50 value of 30.01 and 47.06 µM. Both compounds had a pro-apoptotic effect without the release of reactive oxygen species (ROS) and they can interact with DNA via minor grooves driven by van der Waals forces.

Chromosome diversity in Buthidae and Chactidae scorpions from Brazilian fauna: Diploid number and distribution of repetitive DNA sequences.

In this work, we analyzed cytogenetically eight Chactidae and Buthidae, including the localization of repetitive DNA sequences. The chactids possess monocentric chromosomes and the highest diploid numbers (2n=50 in Brotheas amazonicus, 2n=36 in Chactopsis amazonica, 2n=30 in Neochactas sp.) when compared with buthids (2n=10 in Tityus bahiensis, 2n=14 in Tityus apiacas and Tityus metuendus, 2n=18 in Tityus aba, 2n=26 in Ischnotelson peruassu). The localization of rDNA genes and (TTAGG)n sequences exhibited a conserved pattern of two terminal/subterminal ribosomal cistrons and terminal telomere signals. However, the comparison between the data of C-banding, DAPI after FISH and Cot-DNA fraction indicated a variable quantity and distribution of these regions, as follow: (i) positive heterochromatin and Cot-DNA signals (B. amazonicus and I. peruassu), (ii) small blocks of heterochromatin with large Cot-DNA signals (T. metuendus), (iii) positive heterochromatic regions and absence of Cot-DNA signals (T. aba and T. apiacas), and (iv) negative heterochromatin and Cot-DNA signals (T. bahiensis). Therefore, our results revealed that there still is not a clear relation between quantity of heterochromatin and presence of monocentric or holocentric chromosomes and occurrence of chromosomal rearrangements, indicating that repetitive regions in scorpions must be analyzed using different cytogenetic approaches.