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The objective of this work was to determine whether the addition of phytogenic compounds based on essential oils (carvacrol, eugenol, cinnamaldehyde) and resinous pepper oil (capsaicin) to the diet of Jersey cows at the beginning of lactation affects anti-inflammatory, antioxidant and immunomodulatory responses, as well as whether there are effects of EO on blood metabolites, ruminal fermentation, digestibility and milk production and composition. Six primiparous cows (370.00 ± 17 kg body weight (BW); 13.02 kg dry matter intake (DMI); 21 days of lactation and average milk production of 20 ± 2 L per day) were allocated to crossed experimental design (2 × 2) with two experimental periods of 28 days and two treatments. Blood, milk and rumen fluid were collected and, at the end of each period, feed and feces samples were collected to evaluate the apparent digestibility of nutrients. The groups were control (CLT) without supplementation and treated (BEO) with the addition of 150 mg/kg of dry matter of the phytogenic to the concentrated portion of the diet. Cows in the BEO group had lower numbers of leukocytes (P ≤ 0.05) and lymphocytes (P ≤ 0.02), but total protein and globulin levels were higher on days 21 and 28 (P ≤ 0.01). In the BEO group, the levels of immunoglobulin A, immunoglobulin heavy chain and transferrin were higher (P ≤ 0.05). The levels of ceruloplasmin, haptoglobin and C-reactive protein were lower in the BEO group (P ≤ 0.05). Lipid peroxidation levels and protein carbonyl content were lower in the BEO group. The total antioxidant capacity (P ≤ 0.09) and the activity of glutathione S-transferase (P ≤ 0.03) and glutathione peroxidase (P ≤ 0.05) were higher in the BEO group. Cows in the BEO group had lower pH (P ≤ 0.05), acetic acid concentrations (P ≤ 0.01) and higher protozoa counts (P ≤ 0.01). Our results suggest that phytogenic supplementation has positive effects on the health of Jersey cows in early lactation, characterized by immunostimulant, antioxidant and anti-inflammatory effects.
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Alimentación Animal , Antioxidantes , Capsaicina , Dieta , Lactancia , Aceites Volátiles , Animales , Bovinos , Femenino , Lactancia/efectos de los fármacos , Dieta/veterinaria , Aceites Volátiles/administración & dosificación , Aceites Volátiles/farmacología , Alimentación Animal/análisis , Capsaicina/administración & dosificación , Capsaicina/farmacología , Leche/química , Antiinflamatorios/administración & dosificación , Antiinflamatorios/farmacología , Suplementos Dietéticos/análisis , Rumen/metabolismoRESUMEN
INTRODUCTION: Peripheral nerve injury (PNI) is increasingly prevalent and challenging to treat despite advances in microsurgical techniques. In this context, adipose tissue derivatives, such as adipose-derived stem cells, nanofat, and stromal vascular fraction have been gaining attention as potential allies in peripheral nerve regeneration. OBJECTIVES: This study aims to explore the use of adipose tissue derivatives in nerve regeneration following peripheral nerve transection in murine models. Thus, we assess and synthesize the key techniques and methods used for evaluating the obtained nerve regeneration to guide future experimental research and clinical interventions. METHODOLOGY: A systematic review was conducted in February 2024, adhering to the Cochrane and PRISMA 2020 guidelines, using the PubMed, SciELO, and LILACS databases. The focus was on experimental studies involving adipose tissue derivatives in nerve regeneration in animal models post-transection. Only experimental trials reporting nerve regeneration outcomes were included; studies lacking a comparator group or evaluation methods were excluded. RESULTS: Out of 273 studies initially identified from MEDLINE, 19 were selected for detailed analysis. The average study included 32.5 subjects, with about 10.2 subjects per intervention subgroup. The predominant model was the sciatic nerve injury with a 10 mm gap. The most common intervention involved unprocessed adipose-derived stem cells, utilized in 14 articles. CONCLUSIONS: This review underscores the significant potential of current methodologies in peripheral nerve regeneration, particularly highlighting the use of murine models and thorough evaluation techniques.
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Cancer is a leading cause of mortality globally and is projected to be the primary cause of death in Brazil by 2030. Yet, for high school students, information and understanding about cancer are primarily offered through standard biology lessons. This study aimed to assess the feasibility of a brief educational intervention related to cancer among high school students in a Brazilian private school. Participants attended a 1-h online session regarding different aspects of cancer. A self-reported questionnaire about the main topics addressed in the session was filled out before [pre] and after [post] the educational intervention and the results were compared by McNemar's chi-square test. From 900 parents invited, 44 (4.9%) responded to the invitation and agreed with their children's participation, and 24 students attended the activity. The questionnaire was easy to fill out for the students and allowed us to measure differences after the educational intervention. The high school students considered the most interesting topics cancer myths and protective/risk factors. The project was feasible and showed easy application and better knowledge after the educational intervention. The main challenge is related to the access to parents to authorize their children's participation. Designing interventions that focus on cancer education might be a viable way to increase prevention and early diagnosis with implications for students, their families, and the community.
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Estudios de Factibilidad , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Neoplasias , Instituciones Académicas , Estudiantes , Humanos , Femenino , Adolescente , Masculino , Brasil , Proyectos Piloto , Neoplasias/prevención & control , Estudiantes/psicología , Encuestas y CuestionariosRESUMEN
Pectin is widely used in several products in the industry. Conventionally, strong and harmful acids are used for its extraction. This study optimized the extraction of orange peel's pectin using citric acid, considering yield and degree of esterification (DE) as response variables. Proximal analyses were performed, and the samples were subjected to a Box-Behnken design on three central points, considering as variables the temperature, time, and pH. The results of proximate analyses of the orange peels revealed 11.76 % moisture content, 87.26 % volatiles, 0.09 % ash, 50.45 % soluble carbohydrates, 70.60 % total carbohydrates, 0.89 % fixed carbon, 5.35 % lipids, and 36.75 mg GAE/g of phenolic compounds. The resulting second-order polynomial model described the relation of the input and output variables related to each other. The best performance to obtain a higher yield (18.18 %) of high methoxyl pectin (DE 50 %) was set at 100 °C/30 min/pH 2.48. Pectin showed antioxidant properties by ABTS and DPPH assays and similar thermal properties to the commercial polymer. Its equivalent weight was 1219.51 mol/g, and the methoxyl and anhydrouronic acid were 2.23 and 67.10 %, respectively. Hence, pectin extraction with citric acid results in a high-quality polymer and could be used as a gelling agent, stabilizer, or texturizer in food products.
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Citrus sinensis , Pectinas , Pectinas/química , Citrus sinensis/química , Ácido Cítrico/química , Temperatura , Antioxidantes/farmacología , ExcipientesRESUMEN
The Amazon rainforests have been undergoing unprecedented levels of human-induced disturbances. In addition to local impacts, such changes are likely to cascade following the eastern-western atmospheric flow generated by trade winds. We propose a model of spatial and temporal interactions created by this flow to estimate the spread of effects from local disturbances to downwind locations along atmospheric trajectories. The spatial component captures cascading effects propagated by neighboring regions, while the temporal component captures the persistence of local disturbances. Importantly, all these network effects can be described by a single matrix, acting as a spatial multiplier that amplifies local forest disturbances. This matrix holds practical implications for policymakers as they can use it to easily map where the damage of an initial forest disturbance is amplified and propagated to. We identify regions that are likely to cause the largest impact throughout the basin and those that are the most vulnerable to shocks caused by remote deforestation. On average, the presence of cascading effects mediated by winds in the Amazon doubles the impact of an initial damage. However, there is heterogeneity in this impact. While damage in some regions does not propagate, in others, amplification can reach 250%. Since we only account for spillovers mediated by winds, our multiplier of 2 should be seen as a lower bound.
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Conservación de los Recursos Naturales , Bosques , Humanos , Bosque Lluvioso , VientoRESUMEN
Introduction: Breast engorgement (BE) is a problem that affects many women, especially in the first days of breastfeeding, producing inflammatory symptoms. Nonpharmacological therapies are inexpensive, safe, and can produce symptom relief. Objective: This study aims to analyze the safety of therapeutic ultrasound regarding possible risks of overheating and the effects of its use alone and associated with lymphatic drainage (LD) in women. Material and Methods: Effectiveness is measured through thermography, visual analog scale, and six-point scale of BE. This is a nonrandomized clinical trial with a sample of 34 in the ultrasound group (G1), 28 in the ultrasound and LD group (G2), and 37 in the control group (G3). Results: The mean reduction for engorgement was 1.3 ± 0.8 to G1, 1.4 ± 1.0 to G2, and 1.2 ± 0.9 to G3 according to the six-point scale. The mean reduction for pain level was 3.6 ± 2.1 to G1, 4.0 ± 3.1 to G2, and 4.0 ± 2.2 to G3 according to the visual analogue scale. Conclusion: It was observed that all therapies were effective in reducing the level of engorgement, according to the six-point scale. However, combined ultrasound and LD therapy has been shown to be more effective in reducing the level of pain. Brazilian Registry of Clinical Trials (RBR-6btb6zz).
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Trastornos de la Lactancia , Terapia por Ultrasonido , Femenino , Humanos , Lactancia Materna , Trastornos de la Lactancia/terapia , Dolor , DrenajeRESUMEN
Berries are highly perishable and susceptible to spoilage, resulting in significant food and economic losses. The use of chemicals in traditional postharvest protection techniques can harm both human health and the environment. Consequently, there is an increasing interest in creating environmentally friendly solutions for postharvest protection. This article discusses various approaches, including the use of "green" chemical compounds such as ozone and peracetic acid, biocontrol agents, physical treatments, and modern technologies such as the use of nanostructures and molecular tools. The potential of these alternatives is evaluated in terms of their effect on microbial growth, nutritional value, and physicochemical and sensorial properties of the berries. Moreover, the development of nanotechnology, molecular biology, and artificial intelligence offers a wide range of opportunities to develop formulations using nanostructures, improving the functionality of the coatings by enhancing their physicochemical and antimicrobial properties and providing protection to bioactive compounds. Some challenges remain for their implementation into the food industry such as scale-up and regulatory policies. However, the use of sustainable postharvest protection methods can help to reduce the negative impacts of chemical treatments and improve the availability of safe and quality berries.
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Brown macroalgae represent one of the most proliferative groups of living organisms in aquatic environments. Due to their abundance, they often cause problems in aquatic and terrestrial ecosystems, resulting in health problems in humans and the death of various aquatic species. To resolve this, the application of Sargassum has been sought in different research areas, such as food, pharmaceuticals, and cosmetics, since Sargassum is an easy target for study and simple to obtain. In addition, its high content of biocompounds, such as polysaccharides, phenols, and amino acids, among others, has attracted attention. One of the valuable components of brown macroalgae is their polysaccharides, which present interesting bioactivities, such as antiviral, antimicrobial, and antitumoral, among others. There is a wide variety of methods of extraction currently used to obtain these polysaccharides, such as supercritical fluid extraction (SFE), pressurized liquid extraction (PLE), subcritical water extraction (SCWE), ultrasound-assisted extraction (UAE), enzyme-assisted extraction (EAE), and microwave-assisted extraction (MAE). Therefore, this work covers the most current information on the methods of extraction, as well as the purification used to obtain a polysaccharide from Sargassum that is able to be utilized as alginates, fucoidans, and laminarins. In addition, a compilation of bioactivities involving brown algae polysaccharides in in vivo and in vitro studies is also presented, along with challenges in the research and marketing of Sargassum-based products that are commercially available.
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The encapsulation of gallic acid (GA) through several methods has enhanced its shelf life and facilitated industrial applications. Polymeric matrices made of alginate and pectin were evaluated to encapsulate GA via spray drying. The pH-responsive release mechanism was monitored to validate the matrices' performances as wall materials and extend the bioactive compound stability. The microcapsules produced were characterized via scanning electron microscopy (SEM), dynamic light scattering (DLS), Fourier-transform infrared spectroscopy (FTIR), and cyclic voltammetry (CV). The retention and encapsulation efficiency ranges were 45-82% and 79-90%, respectively. The higher values were reached at 3 and 0.75% (w/v) pectin and sodium alginate, respectively. The scanning electron microscopy showed smooth spherical capsules and the average particle size ranged from 1327 to 1591 nm. Their performance and stability were evaluated with optimal results at a pH value of 7 throughout the investigation period. Therefore, this work demonstrated the suitability of gallic acid encapsulation via spray drying using pectin and alginate, which are biopolymers that can be obtained from circular economy processes starting from agro-industrial biomass. The developed formulations provide an alternative to protecting and controlling the release of GA, promoting its application in the food, pharmaceutical, and cosmetic industries and allowing for the release of compounds with high bioactive potential.
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OBJECTIVE: To validate a set of indicators for monitoring the quality of surgical procedures in the Brazilian Unified Health System (SUS). METHODS: Validation study developed in 5 stages: 1) literature review; 2) prioritization of indicators; 3) content validation of indicators by RAND/UCLA consensus method; 4) pilot study for reliability analysis; and 5) development of instruction for tabulation of outcome indicators for monitoring via official information systems. RESULTS: From the literature review, 217 indicators of surgical quality were identified. The excluded indicators were: those based on scientific evidence lower than 1A, similar, specific, which corresponded to sentinel events; and those that did not apply to the SUS context. Twenty-six indicators with a high level of scientific evidence were submitted to expert consensus. Twenty-two indicators were validated, of which 14 process indicators and 8 outcome indicators with content validation index ≥80%. Of the validated process indicators, 6 were considered substantially reliable (Kappa coefficient between 0.6 and 0.8; p < 0.05) and 2 had almost perfect reliability (Kappa coefficient > 0.8, p < 0.05), when the inter-rater agreement was analyzed. One could measure and establish tabulation mechanism for TabWin for 7 outcome indicators. CONCLUSION: The study contributes to the development of a set of potentially effective surgical indicators for monitoring the quality of care and patient safety in SUS hospital services.
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Indicadores de Calidad de la Atención de Salud , Calidad de la Atención de Salud , Humanos , Brasil , Proyectos Piloto , Reproducibilidad de los ResultadosRESUMEN
Coral reefs are habitats with high animal and mineral diversity and are subject to both climate change and anthropogenic impacts. This article presents novel and relevant data on the Seixas coral reef environment's geological, sedimentological, mineralogical, and biotic aspects in Paraíba State, northeastern Brazil. The aim of this study is to evaluate the processes of reef formation and the diversity of coral reef species in urban coastal environments in northeastern Brazil using a multi-proxy approach. Materials and methods employed to analyze the formation and diversity of biotic and abiotic species include (a) bathymetric survey, (b) collection of sedimentological, mineralogical, and granulometric data, (c) geological and stratigraphic determination, and (d) identification of biotic and abiotic species. Mineralogical slide results reveal that the Seixas Reef is a recent biogenic coral-algal carbonate formation associated with coastline evolution, high coastal sedimentation, and changes that occurred alongside sea-level rise (Holocene-Quaternary period). The diversity results indicate that benthic organism settlement occurred on a consolidated arenite base, with the fauna undergoing continuous succession processes. It can be concluded that this coral reef is highly vulnerable due to the material of its formation and comprises subsectors with high diversity (fore reef) and others with low diversity (reef top), which are affected by both anthropogenic and natural factors. Studies of this nature can contribute to understanding the evolution of coastal reefs, as their proximity to the continent makes them more vulnerable, and they experience direct physical impacts from fishing and tourist activities.
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Antozoos , Arrecifes de Coral , Animales , Ecosistema , Brasil , Cambio ClimáticoRESUMEN
Emerging pollutants (EPs) are a group of different contaminants, such as hormones, pesticides, heavy metals, and drugs, usually found in concentrations between the order of ng and µg per liter. The global population's daily city and agro-industrial activities release EPs into the environment. Due to the chemical nature of EPs and deficient wastewater treatment and management, they are transported to superficial and groundwater through the natural water cycle, where they can potentially cause harmful effects on living organisms. Recent efforts have focused on developing technology that allows EPs quantification and monitoring in real-time and in situ. The newly developed technology aims to provide accessible groundwater management that detects and treats EPs while avoiding their contact with living beings and their toxic effects. This review presents some of the recently reported techniques that have been applied to advance the detection of EPs in groundwater and potential technologies that can be used for EP removal.
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The COVID-19 pandemic has brought increments in market sales and prescription of medicines commonly used to treat mental health disorders, such as depression, anxiety, stress, and related problems. The increasing use of these drugs, named psychiatric drugs, has led to their persistence in aquatic systems (bioaccumulation), since they are recalcitrant to conventional physical and chemical treatments typically used in wastewater treatment plants. An emerging environmental concern caused by the bioaccumulation of psychiatric drugs has been attributed to the potential ecological and toxicological risk that these medicines might have over human health, animals, and plants. Thus, by the application of biocatalysis-assisted techniques, it is possible to efficiently remove psychiatric drugs from water. Biocatalysis, is a widely employed and highly efficient process implemented in the biotransformation of a wide range of contaminants, since it has important differences in terms of catalytic behavior, compared to common treatment techniques, including photodegradation, Fenton, and thermal treatments, among others. Moreover, it is noticed the importance to monitor transformation products of degradation and biodegradation, since according to the applied removal technique, different toxic transformation products have been reported to appear after the application of physical and chemical procedures. In addition, this work deals with the discussion of differences existing between high- and low-income countries, according to their environmental regulations regarding waste management policies, especially waste of the drug industry.
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COVID-19 , Contaminantes Químicos del Agua , Animales , Humanos , Biocatálisis , Bioacumulación , Pandemias , Agua , Contaminantes Químicos del Agua/análisis , Biodegradación AmbientalRESUMEN
In this work, we present 5 cases of Kennedy Class I patients with atrophic posterior mandible treated with the placement of 01 short WS Neodent® implant and a healing screw to support the removable prosthesis, transforming them into Kennedy Class III patients. To quickly evaluate and verify the benefit of this treatment, masticatory performance was evaluated with maximum bite force and chewing ability. A VAS questionnaire was also applied for a practical preoperative and postoperative evaluation of overall quality of life-changing for the patient after this treatment. This treatment plan was planned in order to reduce drastically the treatment costs and morbidity, and to enhance oral function and the quality of life for these patients. Also, this treatment lead to residual bone preservation, enhanced masticatory function and patient satisfaction. Especially in countries with a large number of patients with missing teeth and socio-economic difficulties to be fully rehabilitated with dental implants and fixed prosthesis treatment options with reduced costs are important to be in our armamentary os possibilities. Key words:Dental implants, masticatory performance, chewing, oral function, mixing ability.
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Due to the constant growth of the human population and anthropological activity, it has become necessary to use sustainable and affordable technologies that satisfy the current and future demand for agricultural products. Since the nutrients available to plants in the soil are limited and the need to increase the yields of the crops is desirable, the use of chemical (inorganic or NPK) fertilizers has been widespread over the last decades, causing a nutrient shortage due to their misuse and exploitation, and because of the uncontrolled use of these products, there has been a latent environmental and health problem globally. For this reason, green biotechnology based on the use of microalgae biomass is proposed as a sustainable alternative for development and use as soil improvers for crop cultivation and phytoremediation. This review explores the long-term risks of using chemical fertilizers for both human health (cancer and hypoxia) and the environment (eutrophication and erosion), as well as the potential of microalgae biomass to substitute current fertilizer using different treatments on the biomass and their application methods for the implementation on the soil; additionally, the biomass can be a source of carbon mitigation and wastewater treatment in agro-industrial processes.
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Microalgas , Suelo , Humanos , Fertilizantes/análisis , Huella de Carbono , Carbono , Biotecnología , BiomasaRESUMEN
The aim of this study was to examine the chronic toxicity of imidacloprid (IMI), clothianidin (CLO) and fipronil (FIP) as a single exposure, as well as binary mixtures of IMI with CLO or FIP toward collembolans Folsomia candida, which are fauna present in the soil. Chronic toxicity assays were performed following an ISO guideline in a Tropical Artificial Soil (TAS), and the influence on the number and growth of the juveniles produced were determined. The range of nominal concentrations used in the tests with the individual compounds was 0.08-1.28 mg/kg (IMI), 0.079-1.264 mg/kg (FIP) and 0.007-0.112 mg/kg (CLO), whereas the mixture assays were performed with half the value used in the tests with individual compounds. Based upon single exposures, IMI produced a similar impact of reducing reproduction by 50% (EC50 ranging from 0.74 to 0.85 mg/kg) compared to FIP (EC50 = 0.78 mg/kg), whereas CLO was the most toxic to F. candida (EC50 = 0.08 mg/kg). Their mixtures generally resulted in a diminished effect on reproduction, as evidenced by the higher EC50 values. In contrast, in the case of the IMI+FIP combination at high concentrations at the EC50 level, a synergistic effect on toxicity was observed. The single exposure to the three insecticides and the mixture of IMI-FIP also decreased the size of generated juveniles, which was evidenced by the reduction in the proportion of large juveniles and increased proportion of small juveniles. However, both binary mixtures (IMI-FIP and IMI-CLO) presented antagonistic effects as evidenced by less than expected reductions in growth. Data on the toxic effects of IMI in a mixture with other seed dressing insecticides to collembolans provides useful information to environmental risk assessors by diminishing the uncertainties on the ecological risk of exposure to pesticides, enabling soil management degradation by utilizing multiple insecticides.
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Artrópodos , Insecticidas , Animales , Insecticidas/toxicidad , Neonicotinoides/toxicidad , SueloRESUMEN
Introduction: Introduction: food type represents higher odds of having obesity (OB), especially in overweight (OW) subjects. Minimally and ultra-processed foods can be associated with the odds of having OB in OW subjects. Objective: to investigate the association of minimally and ultra-processed food consumption with OB in OW adults. Methods: we included 15,024 participants (9,618 OW [25.0-29.9 kg/m2], 5,406 OB [≥ 30 kg/m2]) with ages ranging from 18 to 59 years from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL, Brazil). Minimally and ultra-processed food daily consumption scores and confounding variables (age, sex, scholarly, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the association of minimally and ultra-processed food consumption scores with OB (odds ratio [OR]). Results: minimally processed food consumption score quartiles (1st = 1[food-score/day]; 2nd = 6[food-score/day]; 3rd = 7[food-score/day]; 4th = 8[food-score/day]) presented higher values compared to ultra-processed food (1st = 1[food-score/day]; 2nd = 1[food-score/day]; 3rd = 2[food-score/day]; 4th = 4[food-score/day]). For each score of minimally processed food consumed, there was a -5.9 % odds of OB. Thus, the higher quartile (4th) of minimally processed food consumption score represents less odds of OB (OR: -47.2 %; p < 0.001). Each ultra-processed food score consumed presented odds of 3.7 % of OB. Therefore, higher consumption of ultra-processed food (4th quartile) shows higher odds of OB (OR: +14.8 %; p < 0.001). All associations remained significatively even after being adjusted by the confounders. Conclusion: the consumption scores of minimally processed and ultra-processed foods presented a magnitude capable of impacting OW adults' odds of OB, even when controlled by sociodemographic factors, physical activity, hypertension, and diabetes.
Introducción: Introducción: el tipo de alimentación representa una mayor probabilidad de tener obesidad (OB), especialmente en sujetos con sobrepeso (SO). Los alimentos mínimamente procesados y ultraprocesados se pueden asociar con las probabilidades de tener OB en sujetos con SO. Objetivo: investigar la asociación del consumo de alimentos mínimamente procesados y ultraprocesados con la OB en adultos con SO. Métodos: se incluyeron 15.024 participantes (9.618 SO [25,0-29,9 kg/m2], 5.406 OB [≥ 30 kg/m2]) con edades entre 18 y 59 años de la encuesta basal 2019 de la Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas mediante una Encuesta Telefónica (VIGITEL, Brasil). Se midió el puntaje de consumo diario de alimentos mínimamente procesados y ultraprocesados y variables de confusión (edad, sexo, escolaridad, actividad física, hipertensión y diabetes). Mediante una regresión logística binaria se analizóla asociación de las puntuaciones de consumo de alimentos mínimamente procesados y ultraprocesados con la OB (odds ratio [OR]). Resultados: los cuartiles de puntuación de consumo de alimentos mínimamente procesados (1.º = 1[alimento-puntuación/día]; 2.º = 6[alimento-puntuación/día]; 3.º = 7[alimento-puntuación/día]; 4.º = 8[alimento-puntuación/día]) presentaron valores superiores en comparación con los alimentos ultraprocesados (1.º = 1[alimento-puntuación/día]; 2.º = 1[alimento-puntuación/día]; 3.º = 2[alimento-puntuación/día]; 4.º = 4[alimento-puntuación/día]). Por cada punto de alimentos mínimamente procesados consumidos, hubo una probabilidad de OB del -5,9 %. Por lo tanto, el cuartil más alto (4.º) de puntuación de consumo de alimentos mínimamente procesados representa menos probabilidades de OB (OR: -47,2 %; p < 0,001). Cada puntaje de alimentos ultraprocesados consumidos presentó probabilidades de 3.7 % de OB. Por lo tanto, un mayor consumo de alimentos ultraprocesados (cuartil 4.º) muestra mayores probabilidades de OB (OR: +14,8 %; p < 0,001). Todas las asociaciones se mantuvieron significativamente incluso después de ajustarlas por los factores de confusión. Conclusión:las puntuaciones de consumo de alimentos mínimamente procesados y ultraprocesados impactaron en la probabilidad de desarrollar OB en adultos con SB, incluso cuando se controló por factores sociodemográficos, actividad física, hipertensión y diabetes.
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Hipertensión , Sobrepeso , Adulto , Humanos , Sobrepeso/epidemiología , Estudios Transversales , Alimentos Procesados , Comida Rápida/efectos adversos , Obesidad/epidemiología , Brasil/epidemiología , Dieta , Manipulación de AlimentosRESUMEN
ABSTRACT OBJECTIVE To validate a set of indicators for monitoring the quality of surgical procedures in the Brazilian Unified Health System (SUS). METHODS Validation study developed in 5 stages: 1) literature review; 2) prioritization of indicators; 3) content validation of indicators by RAND/UCLA consensus method; 4) pilot study for reliability analysis; and 5) development of instruction for tabulation of outcome indicators for monitoring via official information systems. RESULTS From the literature review, 217 indicators of surgical quality were identified. The excluded indicators were: those based on scientific evidence lower than 1A, similar, specific, which corresponded to sentinel events; and those that did not apply to the SUS context. Twenty-six indicators with a high level of scientific evidence were submitted to expert consensus. Twenty-two indicators were validated, of which 14 process indicators and 8 outcome indicators with content validation index ≥80%. Of the validated process indicators, 6 were considered substantially reliable (Kappa coefficient between 0.6 and 0.8; p < 0.05) and 2 had almost perfect reliability (Kappa coefficient > 0.8, p < 0.05), when the inter-rater agreement was analyzed. One could measure and establish tabulation mechanism for TabWin for 7 outcome indicators. CONCLUSION The study contributes to the development of a set of potentially effective surgical indicators for monitoring the quality of care and patient safety in SUS hospital services.
RESUMO OBJETIVO Validar um conjunto de indicadores para monitoramento da qualidade dos procedimentos cirúrgicos no Sistema Único de Saúde (SUS). MÉTODOS Estudo de validação desenvolvido em 5 etapas: 1) revisão de literatura; 2) priorização de indicadores; 3) validação de conteúdo dos indicadores por método de consenso RAND/UCLA; 4) estudo piloto para análise da confiabilidade; e 5) desenvolvimento de instrutivo para tabulação dos indicadores de resultado para monitoramento via sistemas de informações oficiais. RESULTADOS A partir da revisão de literatura, foram identificados 217 indicadores de qualidade cirúrgica. Os indicadores excluídos foram: indicadores baseados em evidências científicas inferiores a 1A, similares, específicos, que correspondiam a eventos sentinelas; e aqueles que não se aplicavam ao contexto do SUS. Foram submetidos ao consenso de especialistas 26 indicadores com alto nível de evidência científica. Foram validados 22 indicadores, dos quais 14 indicadores de processo e 8 indicadores de resultado com índice de validação de conteúdo ≥80%. Dos indicadores de processo validados, 6 foram considerados confiáveis substancialmente (Coeficiente de Kappa entre 0,6 e 0,8; p < 0,05) e 2 tiveram confiabilidade quase perfeita (coeficiente de Kappa > 0,8, p < 0,05), quando analisada a concordância interavaliador. Foi possível mensurar e estabelecer mecanismo de tabulação para TabWin para 7 indicadores de resultado. CONCLUSÃO O estudo contribui com o desenvolvimento de um conjunto de indicadores cirúrgicos potencialmente eficazes para o monitoramento da qualidade do cuidado e segurança do paciente nos serviços hospitalares do SUS.
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Calidad de la Atención de Salud , Procedimientos Quirúrgicos Operativos , Sistema Único de Salud , Indicadores de Calidad de la Atención de Salud , Seguridad del PacienteRESUMEN
Objetivo: Avaliar os indicadores antropométricos e o consumo alimentar de pessoas com diabetes mellitus tipo 2 atendidas em uma unidade básica de saúde na cidade de São Luís, Maranhão.Métodos:Trata-se de um estudo do tipo transversal, descritivo, com abordagem quantitativa realizado com 46 pacientes portadores de diabetes mellitus tipo 2,atendidos em uma unidade básica de saúde da capital maranhense. Foram utilizados formulários semiestruturados para a coleta de dados sociodemográficos, antropométricos e relacionados aos hábitos alimentares. As análises foram realizadas por meio de estatística descritiva, com dados sendo representados através de média, frequência e seus respectivos desvios padrões além do teste de correlação de Pearson entre as variáveis quantitativas. Resultados:A amostra foi representada em maioria por mulheres(54,4%), idosos (59,6%), sedentários (63,1%), que apresentavam alta obesidade abdominal (80,4%),ingeriam baixa quantidade de fibras (93,5%) e consumiam em grande quantidade proteínas (67,4%), gorduras saturadas (69,6%) esacarose (57,5%).Conclusão: Fatores como peso inadequado e alimentação desregulada podem representar risco para o controle glicêmico e contribuir para o agravamento do diabetes mellitus. Descritores: Diabetes mellitus. Estado nutricional. Ingestão de alimentos.
Objective: To evaluate the anthropometric indicators and food consumption of people with Type2 Diabetes Mellitustreated at a Basic Health Unit in the city of São Luís, Maranhão. Methods: This is a cross-sectional and descriptive study with a quantitative approach conducted with 36patients who have Type2 Diabetes Mellitus, treated at a BasicHealth Unit in the capital city of Maranhão. Semi-structured forms were used to collect sociodemographic and anthropometric data, as well as related to eating habits. The analyses were performed using descriptive statistics, with data represented as mean,frequency and their respective standard deviations, in addition to Pearson's correlation test between the quantitative variables. Results: The sample was mostly representedby women (54.4%), older adults(59.6%), sedentary people (63.1%), who had high abdominal obesity (80.4%), ingested a low amount of fiber (93.5%) and consumed a large amount ofprotein (67.4%), saturated fat(69.6%) and sucrose (57.5%). Conclusion: Factors such as inadequate weight and unregulated eating habits can represent risks for glycemic control and contribute to worsening of Diabetes Mellitus. Descriptors:Diabetes mellitus. Nutritional status. Eating.
Asunto(s)
Estado Nutricional , Diabetes Mellitus , Ingestión de AlimentosRESUMEN
Abstract Objective: Olfaction influences nutrition, safety, and the cognitive development of children. Presently there are few olfactory tests for children, and normative reference values are generally lacking. In this study, we validate the Pediatric Smell WheelTM (PSW) to evaluate olfactory function in Brazilian children. Methods: We modified and validated the PSW, a test developed in the United States, for administration in Brazil, and established normative data for Brazilian children. The validation process consisted of five phases. First, we identified odorants familiar to Brazilian children. Second, we established the test-retest reliability of the Brazilian PSW test that employed these odorants. Third, we compared the test scores of healthy children to those microsmic from adenoid hypertrophy. Fourth, we examined the test's ability to detect improvement in olfactory function before and after adenoidectomy. Finally, we determined a normative 10th percentile cut point for defining microsmia in a sample of 169 healthy Brazilian children between 5 and 12 years of age. Results: Eleven odors were identified for inclusion in the test. The test-retest reliability was modest (r = 0.54, p < 0.001), although likely attenuated based on the inclusion of only data from children with normal function. The test clearly differentiated the olfactory function of children with adenoid hypertrophy from that of healthy children and demonstrated the return of function after adenoidectomy. An overall score <7 was found useful in defining hyposmia, although additional age-related cut-points were also defined. Conclusion: A Brazilian version of the PSW was developed and validated and found to be efficacious in detecting smell dysfunction in children ranging in age from 5 to 12 years. Level of evidence: 1b (Diagnosis).