Online scientific research on placentophagy: a bibliometric analysis.

Objective: To classify the bibliometric indicators of online scientific research on placentophagy. Methods: A bibliometric study was conducted to quantify the scientific production of authors and institutions with the aim of highlighting the growth and impact of these publications nationally and internationally. The Bradford Law, network maps, and textual statistics were used, with searches conducted in libraries and databases in October 2021. Results: The sample consisted of 64 articles, whose primary authors were associated with 49 institutions, and mostly with degrees in anthropology. The United States of America was the country that published the most papers on the theme, and most studies were reviews with individual production. Through the term analysis, it was found that the predominant themes regarding placentophagy were the following: Alternative therapy for women's health, methodologies used for research in this area, period of placenta ingestion (postpartum period), and its benefits. Conclusion: The bibliometric indicators found are essential for the development of future research.

Online scientific research on placentophagy: a bibliometric analysis

Abstract Objective: To classify the bibliometric indicators of online scientific research on placentophagy. Methods: A bibliometric study was conducted to quantify the scientific production of authors and institutions with the aim of highlighting the growth and impact of these publications nationally and internationally. The Bradford Law, network maps, and textual statistics were used, with searches conducted in libraries and databases in October 2021. Results: The sample consisted of 64 articles, whose primary authors were associated with 49 institutions, and mostly with degrees in anthropology. The United States of America was the country that published the most papers on the theme, and most studies were reviews with individual production. Through the term analysis, it was found that the predominant themes regarding placentophagy were the following: Alternative therapy for women's health, methodologies used for research in this area, period of placenta ingestion (postpartum period), and its benefits. Conclusion: The bibliometric indicators found are essential for the development of future research.

Lesão facial grave em um gambá-de-orelha-branca (Didelphis albiventris) - tratamento com ozonioterapia / Severe facial wound in a white-eared opossum (Didelphis albiventris) - treatment with ozone therapy

Background: Ozone therapy (OT) is a type of treatment that uses ozone gas, which has high oxidizing power. OT has been utilized for various diseases and to accelerate the wound healing process and reduce inflammation. Additionally, OT is a low-cost treatment recommended for patients that can be easily restrained. There are several methods of ozone administration, including topical use through bagging, cupping, or rectal insufflation, in addition to ozonated autohemotherapy. Based on the benefits of OT and the scarcity of reports describing its effects on white-eared opossums (Didelphis albiventris), we report on the use of ozone in the treatment of a severe facial wound in a white-eared opossum. Case: An adult female white-eared opossum weighing 1.6 kg was rescued from a fire. The patient was pregnant, dehydrated, hypothermic and had an extensive burn wound in the facial region. Due to the stress of captivity and its aggressive behavior, the animal needed to be chemically restrained with dexmedetomidine and butorphanol. Following sedation, the cephalic vein was catheterized and intravenous fluid therapy with ringer lactate was started to treat dehydration. Next, enrofloxacin, meloxicam, and tramadol hydrochloride were administered. Body rewarming was performed with thermal bags. The microbial load of the wound was reduced with chlorhexidine degerming solution followed by washing with saline solution. A thin layer of silver sulfadiazine cream was applied to the wound area. Over the following days the patient was treated with OT using the cupping technique combined with ozonated sunflower oil. After the first applications there was an improvement in the appearance of the wound, which initially had a purulent aspect. After 20 days of treatment the wound showed good granulation and there were no signs of infection, and at 45 days of treatment it was completely healed. The patient was then released with her baby. Discussion: Ozone therapy was included in the patient's treatment plan to enhance the tissue repair process in order to reintroduce the animal to the wild in the shortest possible time. The strategy was successful in improving healing and reducing tissue inflammation and infection. Ozone is known to cause the inactivation of microorganisms as a result of the oxidation of phospholipids and lipoproteins present in the cell membrane of bacteria and to interrupt viral replication. Ozone helps in the perfusion of injured tissues, contributing to the entry of humoral components, which control inflammation. Moreover, ozone contributes to increase supply of oxygen and nutrients to tissues and to stimulate increased production of fibrinogen and formation of granulation tissue. Ozone increases the enzymatic antioxidant response, while also playing a role in immunoregulation. Ozone can be used in several ways and via various methods with potential routes including intravenous, urethral, intramuscular, subcutaneous, or intra-articular, in addition to rectal and intramammary insufflation. Immunomodulatory, anti-inflammatory, analgesic, and antiseptic effects can be achieved with different doses and concentrations, which enables its application in different types of pathologies. Because of the aggressive behavior of the animal, in the current case we opted for the cupping technique combined with ozonated oil, both techniques which can be administered easily with only physical restraint of the patient. Cupping allows for the provision of a higher concentration of ozone gas locally whereas the ozonated oil maintains the effect of the gas for slightly longer, enhancing its effect and promoting tissue repair. The present report showed that OT is an effective alternative for the treatment of burn wounds in opossums, without causing adverse effects to the patient or her baby.

The use of herbal treatments as alternatives to control uterine diseases in dairy cows.

Uterine diseases are a common gynecological issue that affects dairy cows during the postpartum period. The treatment of uterine diseases is mainly managed through antimicrobials; however, the problem of antibiotic residues, increased antimicrobial resistance of pathogens, and the abuse of antibiotics causes serious problems in the dairy chain around the world, which can affect the efficiency of conventional medicines. In these regards, alternative treatment strategies are needed to reduce the use of antibiotics in dairy production. This review primarily provides an overview that focuses on various alternative sources and methodologies, including plants extracts and essential oils, for the control of bovine uterine diseases, and it presents the advantages and limitations related to the use of these herbal therapies.

Review of Therapies using TiO2 Nanomaterials for Increased Anticancer Capability.

Recently, Titanium dioxide (TiO2) has been studied as an alternative to treat cancer diseases under different activation therapies. The aim of this review was to describe the effect of TiO2 nanoparticles (NPs) on some cancer cell lines and their interaction with phototherapies such as photodynamic therapy (PDT), photothermal therapy (PTT), sonodynamic therapy (SDT), and ultraviolet therapy (UV) for anticancer treatment. The use of TiO2 combined with PDT, PTT, SDT, or UV has shown a remarkable capacity to enhance the killing of cancer cells through reactive oxygen species formation. Thus, the combination of TiO2 and activation therapies exhibited great potential and could be a viable anticancer treatment strategy. However, more studies on phototherapies in combination with TiO2 and their effects under different experimental conditions (TiO2 concentration, type of cancer cells, and intensity and frequency of therapies) are necessary to guarantee the safe use of this kind of therapy.

Da contracultura à somaterapia: a criação e o desenvolvimento inicial de uma terapia anarquista / From counterculture to somatherapy: the creation and early development of an anarchist therapy

Resumo Este trabalho faz parte de uma pesquisa maior, na qual se procura compreender como a somaterapia de Roberto Freire surgiu e se desenvolveu a partir da contracultura dos anos 1970. Abordam-se a criação e o desenvolvimento inicial da somaterapia, partindo do que se compreende ser um "mito de criação": uma narrativa ordenada e coerente que explica o surgimento da terapia e que aparece, de forma recorrente, com poucas alterações. Analisam-se, ainda, narrativas posteriores a esse período que remetem ao processo de nomeação da somaterapia. Nesta análise, são encontrados conflitos de dados e incongruências que indicam a complexidade desses processos e o esforço dos autores no sentido de ordenação e legitimação da técnica terapêutica.

Abstract This work is part of a larger survey on how Roberto Freire's somatherapy emerged and developed from the counterculture of the 1970s, addressing the creation and initial development of somatherapy, starting from what is understood to be a "creation myth," an orderly and coherent narrative explaining the emergence of this therapy that is frequently repeated with few changes. Later narratives referring to the process of naming somatherapy are also examined, revealing inconsistencies and conflicts in the data that indicate the complexity of these processes and the authors' efforts to add order and legitimacy to this therapeutic technique.

Genotoxicity and mutagenicity assessment of a standardized extract (P2Et) obtained from Caesalpinia spinosa.

The standardized P2Et extract obtained from Caesalpinia spinosa has shown antioxidant, and direct antitumor activity, but also activation of specific immune response through the induction of tumor immunogenic cell death in breast and melanoma cancer models. The present work evaluated the mutagenicity and genotoxicity profile of P2Et to continue the development of the P2Et. Genotoxicity was evaluated by OECD 1997 a guideline and mutagenicity by OECD 2016. At P2Et's doses of 500, 1000, and 2000 mg/kg body weight in mice (Mus musculus), the difference between the number of micronuclei in PCE of the groups were not statistically significant (17 (negative control), 15 (500 mg/kg), 15 (1000 mg/kg), 19 (2000 mg/kg) and 271 (positive control). Similarly, P2Et did not induce gene mutations by base pair changes or frameshifts in the genome of Salmonella Typhimurium strains TA98, TA100, TA102, TA1535 and TA1537 at the tested range of concentrations up to 5000 µg/plate in the absence and presence of metabolic activation. Therefore, the P2Et was considered as non- mutagenic and non-genotoxic at the conditions of the tests.

Anti-Ehrlichia properties of the dichloromethane fraction of Ageratum conyzoides associated with doxycycline: In vitro study / Propriedades anti-Ehrlichia da fração diclorometânica de Ageratum conyzoides associada com doxiciclina: estudo in vitro

The increasing number of cases of canine ehrlichiosis caused by Ehrlichia canis in hospitals and veterinary clinics has demonstrated the need for a new drug protocol for this disease. Doxycycline is used to treat ehrlichiosis, but the resistance of the microorganism to this treatment protocol, as well as the various side effects to the animals, has become a concern. Several studies have shown a positive interaction with extracts of plants and drugs, which allow for the reduction of the concentration necessary to produce the desired effect, minimizing adverse effects. This study determined the efficiency of the combination of the dichloromethane (DCM) fraction of Ageratum conyzoides L. with anti-Ehrlichia activity and doxycycline by using the checkerboard assay. Plant material was collected in São Luís, northeastern Brazil, followed by extraction in MeOH: H2O (8:2) and partitioning of the DCM fraction. After determining the Minimum Inhibitory Concentration (MIC) of the fraction under study against DH82 cells infected with Ehrlichia canis, it was combined with doxycycline to derive the Fractional Inhibitory Concentration Index (CIF Index). A reduction of 5.83 times the doxycycline minimum inhibitory concentration was observed, showing that this fraction of A. conyzoides composed predominantly by the class of lignans, identified by mass spectrometry notably intensified the activity of doxycycline against E. canis, resulting in a synergistic effect.(AU)

O crescente número de casos de erliquiose canina por Ehrlichia canis em hospitais e clínicas veterinárias tem demonstrado a necessidade de um novo protocolo de medicamentos para essa doença. A doxiciclina é usada para tratar a erliquiose, mas a resistência do microrganismo a esse protocolo de tratamento, bem como os diversos efeitos colaterais para os animais, tornou-se uma preocupação. Vários estudos têm demonstrado interação positiva com extratos de plantas e fármacos, que permitem a redução da concentração necessária para produzir o efeito desejado, minimizando os efeitos adversos. Este estudo determinou a eficiência da combinação da fração diclorometânica (DCM) de Ageratum conyzoides L. com atividade anti-Ehrlichia canis associada com doxiciclina por meio do ensaio de Checkerboard. O material vegetal foi coletado em São Luís, Maranhão, nordeste do Brasil, seguido pela extração em MeOH:H2O (8:2) e partição da fração diclorometânica. Após a determinação da Concentração Inibitória Mínima (CIM) da fração em estudo frente às células DH82 infectadas com Ehrlichia canis, a mesma foi combinada com a doxiciclina para derivação do Índice de Concentração Inibitória da Fração (Índice CIF). Observou-se uma redução de 5,83 vezes a concentração inibitória mínima da doxiciclina mostrando que esta fração de A. conyzoides, composta predominantemente por lignanas identificadas por espectrometria de massas, notavelmente intensificou a atividade desse fármaco contra E. canis, resultando em um efeito sinérgico.(AU)

Anti-Ehrlichia properties of the dichloromethane fraction of Ageratum conyzoides associated with doxycycline: In vitro study / Propriedades anti-Ehrlichia da fração diclorometânica de Ageratum conyzoides associada com doxiciclina: estudo in vitro

The increasing number of cases of canine ehrlichiosis caused by Ehrlichia canis in hospitals and veterinary clinics has demonstrated the need for a new drug protocol for this disease. Doxycycline is used to treat ehrlichiosis, but the resistance of the microorganism to this treatment protocol, as well as the various side effects to the animals, has become a concern. Several studies have shown a positive interaction with extracts of plants and drugs, which allow for the reduction of the concentration necessary to produce the desired effect, minimizing adverse effects. This study determined the efficiency of the combination of the dichloromethane (DCM) fraction of Ageratum conyzoides L. with anti-Ehrlichia activity and doxycycline by using the checkerboard assay. Plant material was collected in São Luís, northeastern Brazil, followed by extraction in MeOH: H2O (8:2) and partitioning of the DCM fraction. After determining the Minimum Inhibitory Concentration (MIC) of the fraction under study against DH82 cells infected with Ehrlichia canis, it was combined with doxycycline to derive the Fractional Inhibitory Concentration Index (CIF Index). A reduction of 5.83 times the doxycycline minimum inhibitory concentration was observed, showing that this fraction of A. conyzoides composed predominantly by the class of lignans, identified by mass spectrometry notably intensified the activity of doxycycline against E. canis, resulting in a synergistic effect.

O crescente número de casos de erliquiose canina por Ehrlichia canis em hospitais e clínicas veterinárias tem demonstrado a necessidade de um novo protocolo de medicamentos para essa doença. A doxiciclina é usada para tratar a erliquiose, mas a resistência do microrganismo a esse protocolo de tratamento, bem como os diversos efeitos colaterais para os animais, tornou-se uma preocupação. Vários estudos têm demonstrado interação positiva com extratos de plantas e fármacos, que permitem a redução da concentração necessária para produzir o efeito desejado, minimizando os efeitos adversos. Este estudo determinou a eficiência da combinação da fração diclorometânica (DCM) de Ageratum conyzoides L. com atividade anti-Ehrlichia canis associada com doxiciclina por meio do ensaio de Checkerboard. O material vegetal foi coletado em São Luís, Maranhão, nordeste do Brasil, seguido pela extração em MeOH:H2O (8:2) e partição da fração diclorometânica. Após a determinação da Concentração Inibitória Mínima (CIM) da fração em estudo frente às células DH82 infectadas com Ehrlichia canis, a mesma foi combinada com a doxiciclina para derivação do Índice de Concentração Inibitória da Fração (Índice CIF). Observou-se uma redução de 5,83 vezes a concentração inibitória mínima da doxiciclina mostrando que esta fração de A. conyzoides, composta predominantemente por lignanas identificadas por espectrometria de massas, notavelmente intensificou a atividade desse fármaco contra E. canis, resultando em um efeito sinérgico.

Anti-Ehrlichia properties of the dichloromethane fraction of Ageratum conyzoides associated with doxycycline: In vitro study / Propriedades anti-Ehrlichia da fração diclorometânica de Ageratum conyzoides associada com doxiciclina: estudo in vitro

ABSTRACT: The increasing number of cases of canine ehrlichiosis caused by Ehrlichia canis in hospitals and veterinary clinics has demonstrated the need for a new drug protocol for this disease. Doxycycline is used to treat ehrlichiosis, but the resistance of the microorganism to this treatment protocol, as well as the various side effects to the animals, has become a concern. Several studies have shown a positive interaction with extracts of plants and drugs, which allow for the reduction of the concentration necessary to produce the desired effect, minimizing adverse effects. This study determined the efficiency of the combination of the dichloromethane (DCM) fraction of Ageratum conyzoides L. with anti-Ehrlichia activity and doxycycline by using the checkerboard assay. Plant material was collected in São Luís, northeastern Brazil, followed by extraction in MeOH: H2O (8:2) and partitioning of the DCM fraction. After determining the Minimum Inhibitory Concentration (MIC) of the fraction under study against DH82 cells infected with Ehrlichia canis, it was combined with doxycycline to derive the Fractional Inhibitory Concentration Index (CIF Index). A reduction of 5.83 times the doxycycline minimum inhibitory concentration was observed, showing that this fraction of A. conyzoides composed predominantly by the class of lignans, identified by mass spectrometry notably intensified the activity of doxycycline against E. canis, resulting in a synergistic effect.

RESUMO: O crescente número de casos de erliquiose canina por Ehrlichia canis em hospitais e clínicas veterinárias tem demonstrado a necessidade de um novo protocolo de medicamentos para essa doença. A doxiciclina é usada para tratar a erliquiose, mas a resistência do microrganismo a esse protocolo de tratamento, bem como os diversos efeitos colaterais para os animais, tornou-se uma preocupação. Vários estudos têm demonstrado interação positiva com extratos de plantas e fármacos, que permitem a redução da concentração necessária para produzir o efeito desejado, minimizando os efeitos adversos. Este estudo determinou a eficiência da combinação da fração diclorometânica (DCM) de Ageratum conyzoides L. com atividade anti-Ehrlichia canis associada com doxiciclina por meio do ensaio de Checkerboard. O material vegetal foi coletado em São Luís, Maranhão, nordeste do Brasil, seguido pela extração em MeOH:H2O (8:2) e partição da fração diclorometânica. Após a determinação da Concentração Inibitória Mínima (CIM) da fração em estudo frente às células DH82 infectadas com Ehrlichia canis, a mesma foi combinada com a doxiciclina para derivação do Índice de Concentração Inibitória da Fração (Índice CIF). Observou-se uma redução de 5,83 vezes a concentração inibitória mínima da doxiciclina mostrando que esta fração de A. conyzoides, composta predominantemente por lignanas identificadas por espectrometria de massas, notavelmente intensificou a atividade desse fármaco contra E. canis, resultando em um efeito sinérgico.

Recent advances and future directions for uterine diseases diagnosis, pathogenesis, and management in dairy cows.

Researchers, veterinarians, and farmers' pursuit of a consistent diagnosis, treatment, and prevention of uterine diseases remains challenging. The diagnosis and treatment of metritis is inconsistent, a concerning situation when considered the global threat of antimicrobial resistance dissemination. Endometritis is an insidious disease absent on routine health programs in many dairy farms and from pharmaceutical therapeutics arsenal in places like the US market. Conversely, a multitude of studies advanced the understanding of how uterine diseases compromise oocyte, follicle, and embryo development, and the uterine environment having long-lasting effects on fertility. The field of uterine disease microbiome also experienced tremendous progress and created opportunities for the development of novel preventives to improve the management of uterine diseases. Activity monitors, biomarkers, genomic selection, and machine learning predictive models are other innovative developments that have been explored in recent years to help mitigate the negative impacts of uterine diseases. Albeit novel tools such as vaccines for metritis, immune modulators, probiotics, genomic selection, and selective antimicrobial therapy are promising, further research is warranted to implement these technologies in a systematic and cost-effective manner.

Antimicrobial activity of polypyrrole nanoparticles and aqueous extract of Moringa oleifera against Staphylococcus spp. carriers of multi-drug efflux system genes isolated from dairy farms.

Our objectives were to identify genes of the multi-drug efflux system and to evaluate the antimicrobial activities of polypyrrole nanoparticles (PPy-NPs) and aqueous extract of Moringa oleifera against Staphylococcus spp. isolated from dairy farms in Northeast Brazil. Initially, 162 Staphylococcus spp. isolates were subjected to in vitro antimicrobial sensitivity tests. Of these, 35 presented antimicrobial multi-drug resistance phenotypes. These 35 isolates were then referred for the detection of norA, norB, norC, msrA, mgrA, tet-38, and lmrS genes, all of which feature in multi-drug efflux systems. In the isolates carrying the genes, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of PPy-NPs and Moringa oleifera aqueous extract were determined. In the molecular analysis of the 35 isolates norA, norC, tet-38, and msrA genes were detected and for the other genes norB, lmrS and mgrA there was no amplification. Antimicrobial activity was verified of PPy-NPs and aqueous extract of Moringa oleifera in Staphylococcus spp. carrying multi-drug efflux system genes. We concluded that there are multi-drug efflux system genes present in the Staphylococcus spp. from the agricultural environment in Northeast Brazil, and that aqueous extract of Moringa oleifera and PPy-NPs show bactericidal activity against these isolates.

The brief psychotherapeutic intervention relaxation, mental images and spirituality: a systematic review

ABSTRACT BACKGROUND: The brief psychotherapeutic intervention "relaxation, mental images and spirituality" (relaxamento, imagens mentais e espiritualidade, RIME) is a form of complementary and alternative health-related therapy. It is a pioneer in the matter of relating the elements of spirituality to relaxation and to visualization of mental images. OBJECTIVE: To ascertain the history, use and benefits of RIME that have been reported in the scientific literature, within different health/disease contexts. The questions that guided this study were: In what contexts has the brief RIME psychotherapeutic intervention been used? What were its benefits? DESIGN AND SETTING: Systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, in a public university. METHODS: The BVSPsi, CINAHL, MEDLINE, SciELO, SCOPUS and Web of Science databases were searched in September and October 2018. RESULTS: The findings showed that RIME promoted resignification of the symbolic pain of the death of patients without the possibility of cure; improved quality of life within the process of dying; contributed to the quality of life of breast cancer patients with cure possibilities; contributed to the emotional wellbeing of ostomized patients; brought quality-of-life benefits for patients with head-and-neck cancer; promoted empowerment for women with breast cancer and strengthened their libido; and promoted resignification of the spiritual pain of bereaved youths, offering a satisfactory return from mourning preparation. CONCLUSIONS: It was found that RIME has a construct history based on rigorous scientific methodology, covering quality of life and spiritual, emotional and subjective wellbeing. RIME has not been used internationally and new studies within this field, with different cases, should be encouraged. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ID 164211.

Protective Effects of Pomegranate in Endothelial Dysfunction.

BACKGROUND: Punica granatum L. is an infructescence native of occidental Asia and Mediterranean Europe, popularly referred to as pomegranate. It has been used in ethnomedicine for several applications, including the treatment of obesity, inflammation, diabetes, and the regulation of blood lipid parameters. Thus, pomegranate has been linked to the treatment of cardiovascular diseases that have endothelial dysfunction as a common factor acting mainly against oxidative stress due to its high polyphenol content. Its biocomponents have antihypertensive, antiatherogenic, antihyperglycemic, and anti-inflammatory properties, which promote cardiovascular protection through the improvement of endothelial function. METHODS: Different electronic databases were searched in a non-systematic way to uncover the literature of interest. CONCLUSION: This review article presents updated information on the role of pomegranate in the context of endothelial dysfunction and cardiovascular diseases. We have shown that pomegranate, or rather its components (e.g., tannins, flavonoids, phytoestrogens, anthocyanins, alkaloids, etc.), have beneficial effects on the cardiovascular system, improving parameters such as oxidative stress and the enzymatic antioxidant system, reducing reactive oxygen species formation and acting in an anti-inflammatory way. Thus, this review may contribute to a better understanding of pomegranate's beneficial actions on endothelial function and possibly to the development of strategies associated with conventional treatments of cardiovascular diseases.

Recent advances and future directions for uterine diseases diagnosis, pathogenesis, and management in dairy cows

Researchers, veterinarians, and farmers' pursuit of a consistent diagnosis, treatment, and prevention of uterine diseases remains challenging. The diagnosis and treatment of metritis is inconsistent, a concerning situation when considered the global threat of antimicrobial resistance dissemination. Endometritis is an insidious disease absent on routine health programs in many dairy farms and from pharmaceutical therapeutics arsenal in places like the US market. Conversely, a multitude of studies advanced the understanding of how uterine diseases compromise oocyte, follicle, and embryo development, and the uterine environment having long-lasting effects on fertility. The field of uterine disease microbiome also experienced tremendous progress and created opportunities for the development of novel preventives to improve the management of uterine diseases. Activity monitors, biomarkers, genomic selection, and machine learning predictive models are other innovative developments that have been explored in recent years to help mitigate the negative impacts of uterine diseases. Albeit novel tools such as vaccines for metritis, immune modulators, probiotics, genomic selection, and selective antimicrobial therapy are promising, further research is warranted to implement these technologies in a systematic and cost-effective manner.(AU)

Recent advances and future directions for uterine diseases diagnosis, pathogenesis, and management in dairy cows

Researchers, veterinarians, and farmers' pursuit of a consistent diagnosis, treatment, and prevention of uterine diseases remains challenging. The diagnosis and treatment of metritis is inconsistent, a concerning situation when considered the global threat of antimicrobial resistance dissemination. Endometritis is an insidious disease absent on routine health programs in many dairy farms and from pharmaceutical therapeutics arsenal in places like the US market. Conversely, a multitude of studies advanced the understanding of how uterine diseases compromise oocyte, follicle, and embryo development, and the uterine environment having long-lasting effects on fertility. The field of uterine disease microbiome also experienced tremendous progress and created opportunities for the development of novel preventives to improve the management of uterine diseases. Activity monitors, biomarkers, genomic selection, and machine learning predictive models are other innovative developments that have been explored in recent years to help mitigate the negative impacts of uterine diseases. Albeit novel tools such as vaccines for metritis, immune modulators, probiotics, genomic selection, and selective antimicrobial therapy are promising, further research is warranted to implement these technologies in a systematic and cost-effective manner.

Multidrug-Resistant Bacteria and Alternative Methods to Control Them: An Overview.

Antibiotic resistance is one of the greatest challenges in the health system nowadays, representing a serious problem for public health. Initially, antibiotic-resistant strains were restricted to the hospital environment, but now they can be found everywhere. Globalization, excessive use of antibiotics in animal husbandry and aquaculture, use of multiple broad-spectrum agents, and lack of good antimicrobial stewardship can be listed as the factors most responsible for the spread of antibiotic resistance. The increase in the prevalence of antibiotic-resistant pathogens implies having fewer antimicrobial agents to treat infections. The estimate is that by 2050, there will be no effective antibiotic available, if no new drug is developed or discovered. This raises the need to search for alternative methods of controlling antibiotic-resistant pathogens. Considering this problem, the objective of this review is to outline the most frequent antibiotic-resistant bacteria and describe the advantageous and limitations of alternative methods that have been proposed to control them.

Estrategias no farmacológicas para el manejo de los síntomas vasomotores en la menopausia

Los síntomas vasomotores afectan a gran número de mujeres en la peri y posmenopausia, impactando notablemente en la calidad de vida; por otro lado, su duración en el tiempo es incierta y muchas veces prolongada. Si bien la terapia hormonal de la menopausia (THM) constituye el tratamiento más efectivo para los síntomas climatéricos en su conjunto, en algunos casos existen contraindicaciones para su uso. Por lo tanto, ofrecer estrategias de tratamiento en las mujeres con contraindicación al tratamiento hormonal resulta mandatorio. Contamos con una amplia gama de opciones no hormonales, tanto farmacológicas como no farmacológicas. Dentro de estas últimas se incluyen las terapias alternativas o naturales (isoflavonas y cimicifuga racemosa), las modificaciones sobre el estilo de vida y las terapias complementarias. Las terapias alternativas presentaron resultados controvertidos en cuanto a la efectividad sobre los síntomas climatéricos y, por otro lado, debido a que su mecanismo de acción involucra a los receptores estrogénicos, están contraindicadas en las pacientes con antecedentes personales de cánceres hormonodependientes. Las modificaciones del estilo de vida impactan positivamente la salud general de la mujer, más allá de los síntomas climatéricos. En cuanto a las terapias complementarias, las únicas recomendadas son la terapia cognitiva conductual y la hipnosis. Se debe individualizar en cada caso la mejor opción terapéutica, teniendo en cuenta los antecedentes, interacciones medicamentosas, estado cognitivo, entre otros, ya que el objetivo final es mejorar la calidad de vida de nuestras pacientes.

Vasomotor symptoms affect a large number of women in the peri and post menopause with significant impact on quality of life; the duration of these symptoms is uncertain and often prolonged. Although menopausal hormone therapy is the most effective treatment for climacteric symptoms, there are some contraindications for its use. Therefore, it is mandatory to offer other treatment strategies for women with contraindication to hormonal treatment. We have a wide range of non-hormonal options available, both pharmacological and non-pharmacological. Among the latter, we include alternative or natural therapies (isoflavones and cimicifuga racemosa), lifestyle changes, and complementary therapies. Alternative therapies show controversial results regarding effectiveness on climacteric symptoms, and their mechanism of action involves estrogen receptors; they are contraindicated in patients with a personal history of hormone-dependent cancers. Lifestyle modifications have a positive impact on women's general health, beyond the climacteric symptoms. The only complementary therapies recommended are cognitive behavioral therapy and hypnosis. In each case, the best therapeutic option should be individualized, taking into account the patient's clinical history, drug interactions and cognitive status, since the ultimate goal is to improve quality of life.

Oncologia integrativa: das práticas complementares aos seus resultados / Integrative oncology: from complementary practices to its results

Introdução: A Medicina Integrativa é um campo de estudo relativamente novo, muito procurado por pacientes oncológicos, que busca trazer abordagens alternativas, de maneira segura e baseada em evidências, aos tratamentos oncológicos convencionais. Desta forma, objetivamos com este estudo construir um panorama do que se sabe de mais recente sobre práticas complementares e seus resultados no manejo dos pacientes em tratamento de câncer. Métodos: Através da plataforma Omnis, selecionamos nove artigos de acordo com os critérios: abordagem ao assunto proposto, disponibilidade online do artigo e não especificidade quanto ao tipo de câncer, excluindo um total de 42 artigos. Para a descrição dos resultados, separamos as terapias complementares abordadas nos estudos e analisamos os desfechos encontrados. Resultados: Entre as terapias de mind-body, ressaltamos uma melhora significativa do estresse, depressão e ansiedade, fadiga e qualidade de vida. A massagem oncológica, individualizada para cada paciente, mostrou melhora principalmente para dor e fadiga, e bem-estar geral. Sobre os fitoterápicos e suplementos, existem poucos estudos com boas evidências; porém, há relato de diminuição da dor, náusea e vômitos, principalmente após uso de cannabidiol. Podemos ressaltar também a importância da dieta e exercício físico na melhora da microbiota intestinal, intimamente relacionada ao sistema imune, e alívio de fadiga, problemas no sono, ansiedade e bem-estar geral. Por último, citamos a prática integrativa mais estudada, a acupuntura, e a melhora da dor relatada por 74% dos pacientes de um estudo após apenas uma sessão. Conclusão: Apesar dos resultados positivos encontrados, muitas são as limitações citadas nos estudos, como a falta de padronização e amostras pequenas. Isso reflete na prática médica como a comunicação ineficaz entre médicos e pacientes ou orientações defasadas. Por fim, são necessários novos estudos controlados randomizados para estabelecer resultados mais consistentes.

Introduction: Integrative medicine is a relatively new field of study trying to bring alternative, safe and evidence-based approaches to conventional oncology treatments. Thus, we aim with this study to build a panorama of what is known of the most recent on complementary practices and their results in the management of patients in cancer treatment. Methods: Through the Omnis platform, we selected nine articles according to the criteria of approach to the proposed subject, online availability of the article and inespecificity regarding the type of cancer, excluding a total of 42 articles. For the description of the results, we separated all complementary therapies included in the studies and analyzed the outcomes. Results: Among the mind-body therapies, we emphasize a significant improvement of stress, emotional disturbances (depression and anxiety), fatigue and quality of life. Oncological massage, individualized for each patient, showed improvement mainly for pain and fatigue, as well as improvement of general well-being. On herbs and supplements, there are few studies with good evidence; however, there is a decrease in pain, nausea and vomiting, especially after the use of cannabidiol. We also emphasized the importance of diet and physical exercise in improving the intestinal microbiota, closely related to the immune system, and to relieving fatigue, sleep problems, anxiety and general well-being. Finally, we cited the most studied integrative medicine practice, acupuncture, and the improvement of pain reported by 74% of the patients, in a trial, after only one session. Conclusion: Despite the positive results found, there are many limitations cited in each study, such as lack of standardization and small samples. This reflects in medical practice as an ineffective communication between doctors and patients or outdated guidance. Finally, further randomized controlled trials are needed to establish results that are more consistent.

A "miracle" cancer drug in the era of social media: A survey of Brazilian oncologists' opinions and experience with phosphoethanolamine / Uma "milagrosa" droga contra o câncer na era da mídia social: uma pesquisa sobre a opinião e a experiência dos oncologistas brasileiros com a fosfoetanolamina

Summary Introduction: Patients who are treating cancer have often used alternative therapies. In the internet era, information can be broadcasted widely, and this happened with phosphoethanolamine in Brazil, where this substance was claimed by the population to be the "cure for cancer." Method: This is a cross-sectional study developed by the Brazilian Society of Clinical Oncology (SBOC). An objectively structured questionnaire was sent by e-mail and SMS to active MDs members of the SBOC. Descriptive statistics was used to evaluate the data. Statistical significance between the variables was tested by Pearson's Chi-squared test (p<0.05 was considered significance). Results: The survey was sent to 1,072 oncologists, and 398 (37.1%) answered at least part of it. One hundred and fifteen (28.9%) had followed patients who had used phosphoethanolamine. Among these, 14 (12.2%) observed adverse events and four (3.5%) attributed clinical benefit to the substance. Most of the oncologists (n=331; 83.2%) believe that it should only be used as part of a clinical trial protocol. Most physicians did not recommend this drug to their patients (n=311; 78.1%). Oncologists in Southeast, South and Midwest Brazil were more likely to have patients taking the drug compared to the Northern and Northeastern regions. Conclusion: This is the first survey to assess the opinion and experience of oncologists about this alternative therapy. Most oncologists in Brazil do not believe that synthetic phosphoethanolamine is active in cancer treatment, do not recommend its use without proper evaluation, and state that it should only be available to patients in the context of clinical trials.

Resumo Introdução: Alguns pacientes com diagnóstico de câncer utilizam terapias alternativas. Na era da internet, as informações podem se dissipar de forma rápida e abrangente, como foi o caso da fosfoetanolamina no Brasil, onde foi aclamada pela população como sendo a "cura para o câncer". Método: Trata-se de um estudo transversal desenvolvido pela Sociedade Brasileira de Oncologia Clínica (SBOC). Através de e-mail e SMS, enviou-se um questionário com perguntas objetivas para oncologistas membros ativos da SBOC. Os dados foram avaliados por meio de estatística descritiva. A significância estatística entre as variáveis ​​foi testada pelo teste Qui-quadrado de Pearson (p<0,05 foi considerado significativo). Resultados: O questionário foi enviado para 1.072 oncologistas, tendo 398 (37,1%) respondido pelo menos parte dele. Cento e quinze (28,9%) tinham pacientes que fizeram uso da fosfoetanolamina. Desses, 14 (12,2%) observaram eventos adversos e quatro (3,5%) atribuíram benefício clínico para a substância. A maioria (n=331; 83,2%) acreditava que ela só deveria ser utilizada dentro de um ensaio clínico. A principal recomendação dada aos pacientes foi contra o seu uso (n=311; 78,1%). Oncologistas das regiões Sudeste, Sul e Centro-Oeste tiveram mais pacientes que tomaram a substância quando comparados com as regiões Norte e Nordeste. Conclusão: Este é o primeiro estudo que avalia a opinião dos oncologistas sobre essa terapia alternativa e sua experiência. A maioria dos oncologistas brasileiros não acredita que a fosfoetanolamina sintética seja ativa no tratamento do câncer, não recomendando seu uso sem avaliação adequada, e afirmam que a substância só deve estar disponível no contexto de ensaios clínicos.