Integralidade do cuidado de enfermagem do pré-natal ao puerpério / Completeness of nursing care from prenatal to puerperium

Objetivo: compreender a integralidade do cuidado de enfermagem do pré-natal ao puerpério. Método: pesquisa de campo, com abordagem qualitativa, realizada na unidade hospitalar, localizada na região metropolitana de Fortaleza/CE. A coleta de dados ocorreu no período de abril a maio de 2021, com a participação de 26 puérperas. Resultados: a mulher, no tocante à sua integralidade durante o ciclo do pré-natal ao puerpério, obteve um cuidado com o foco biológico, surgindo a família como um apoio para os aspectos emocionais. O enfermeiro é o profissional responsável pela criação da confiabilidade da gestante e família, durante o momento do pré-natal até o puerpério. Conclusão: a integralidade do cuidado desenvolvido pelo enfermeiro encontra desafios relacionados à necessidade de uma visão que contemple o processo saúde-doença que rodeia essa mulher.

Objective: To understand the comprehensiveness of nursing care from prenatal care to puerperium. Method: Field research, with a qualitative approach, carried out in a hospital located in the metropolitan region of Fortaleza/CE. Data collection took place from April to May 2021 with the participation of 26 postpartum women. Results: The woman, regarding her completeness during the cycle from prenatal to postpartum obtained a care with the biological focus, emerging the family as a support for the emotional aspects. The nurse is the professional responsible for creating the reliability of the pregnant woman and her family, from the prenatal period to postpartum. Conclusion: The integrality of care provided by nurses faces challenges related to the need for a vision that contemplates the health-disease process that surrounds this woman.

Asistencia telefónica en la adherencia a la práctica de una dieta saludable de los pacientes con diabetes mellitus tipo 2 / Suporte telefônico na adesão á alimentação saudável de pacientes com diabetes mellitus tipo 2 / Telephone support for adherence to healthy eating practices among people with type 2 diabetes mellitus

Objetivo: Investigar los efectos de la asistencia telefónica en la adhesión a la práctica de una dieta saludable de los pacientes con diabetes mellitus tipo 2. Métodos: Se realizó un ensayo clínico que involucró a 63 pacientes con diabetes mellitus tipo 2, 36 pacientes asignados al grupo de intervención (G1) y 27 en el grupo control (G2). Para el G1 se llevó a cabo una intervención de asistencia telefónica que correspondía a cuatro llamadas telefónicas que abordan: la planificación de comidas, tipos y porciones de comida y la comida sana. Para G2, se llevó a cabo la atención habitual en sus unidades. Los efectos de la asistencia telefónica en la dieta sana se midieron al inicio del estudio (T1) y después de la intervención (T2) en cuatro meses. Resultados: En G1, 16 (44,44%) pacientes se unieron en T1, disminuyendo para 14 (38.88%) en T2. En el G2, 08 (29,62%) pacientes se unieron en T1 y aumentó a 09 (33,33%) en T2. Hubo un aumento del consumo de frutas y verduras, reducción el consumo de alimentos ricos en grasas y alta en la tasa de azúcar, así como un aumento en el fraccionamiento de las comidas después de la intervención en G1. Hubo una diferencia significativa en la reducción de los niveles de glucosa en ayuno en los pacientes no adherentes y em la reducción de Hb1Ac entre los pacientes adherente G1. Conclusión: Los efectos de la asistencia telefónica después de la intervención de cuatro meses resultó insuficiente para aumentar la adherencia a una alimentación sana, pero observó un aumento del consumo de frutas y verduras y la disminución del consumo de alimentos ricos en grasas y alto contenido de azúcar y refrescos

Objetivo: Verificar os efeitos do suporte telefônico na adesão á prática de uma alimentação saudável de pacientes com diabetes mellitus tipo 2. Métodos: Tratou-se de um ensaio clínico do qual participaram 63 pacientes com diabetes mellitus tipo 2, sendo 36 pacientes alocados para o grupo intervenção (G1) e 27 para o grupo controle (G2). Para o G1, foi conduzida uma intervenção de suporte telefônico que correspondeu a quatro ligações telefônicas abordando: planejamento alimentar, tipos e porções de alimentos e alimentos saudáveis. Para o G2, foi conduzido o cuidado usual em sua unidade de saúde. Os efeitos do suporte telefônico na alimentação saudável foram medidos no início (T1) e após a intervenção (T2) em quatro meses. Resultados: No G1, 16 (44,44%) pacientes aderiram no T1, diminuindo para 14 (38,88%) no T2. No G2, 08 (29,62%) pacientes aderiram no T1 e aumentou para 09 (33,33%) no T2. Houve aumento do consumo de frutas, verduras e legumes, redução do consumo de alimentos gordurosos e ricos em açúcar além de aumento no fracionamento das refeições após a intervenção no G1. Observou-se diferença significativa na redução da glicemia de jejum entre os pacientes não aderentes e na redução da Hb1Ac entre os pacientes aderentes do G1. Conclusão: Os efeitos do suporte telefônico após a intervenção de quatro meses mostrou-se insuficiente para aumentar a adesão à alimentação saudável, porém observamos o aumento de consumo de frutas, verduras e legumes e diminuição do consumo de alimentos gordurosos e ricos em açúcar e refrigerantes

Objective: To verify the effects of telephone support on adherence to healthy eating practices among patients with type 2 diabetes mellitus. Methods: This was a clinical trial with 63 patients with type 2 diabetes mellitus; 36 patients were allocated to the intervention group (G1) and 27 patients to the control group (G2). For G1, telephone support was provided, consisting of four telephone calls addressing food planning, types and portions of food, and healthy foods. For G2, normal care was given in their health facility. The effects of telephone support on healthy eating were measured at baseline (T1) and at four months after the intervention (T2). Results: In G1, 16 (44.44%) patients joined at T1, which dropped to 14 (38.88%) by T2. In G2, 8 (29.62%) patients started at T1 and the number rose to 9 (33.33%) by T2. After the G1 intervention, there was an increase in the consumption of fruits and vegetables, a reduction in the consumption of fatty foods and foods high in sugar, and an increase in meal frequency. A significant difference was noted in reduced fasting blood glucose among non-adherent patients and reduced Hb1Ac among adherent patients from G1. Conclusion: The four-month intervention using telephone support proved insufficient to increase adherence to healthy eating. However, there was an increase in consumption of fruits and vegetables and a decrease in the consumption of fatty foods, foods high in sugar, and soft drinks

[Adherence to nutritional recommendations and sociodemographic variables in patients with diabetes mellitus]. / Adesão às recomendações nutricionais e variáveissociodemográficas em pacientes com diabetes mellitus.

OBJECTIVE: To determine if there is a relationship between adherence to nutritional recommendations and sociodemographic variables in Brazilian patients with type 2 diabetes mellitus. METHODS: Cross-sectional observational study using a stratified random sample of 423 individuals. The Food Frequency Questionnaire (FFQ) was used, and the Fisher's exact test was applied with 95% confidence interval (p<0.05). RESULTS: Of the 423 subjects, 66.7% were women, mean age of 62.4 years (SD = 11.8), 4.3 years of schooling on average (SD = 3.6) and family income of less than two minimum wages. There was association between the female gender and adherence to diet with adequate cholesterol content (OR: 2.03; CI: 1.23; 3.34), between four and more years of education and adherence to fractionation of meals (OR: 1 92 CI: 1.19; 3.10), and income of less than two minimum wages and adherence to diet with adequate cholesterol content (OR: 1.74; CI: 1.03, 2.95). CONCLUSION: Adherence to nutritional recommendations was associated with the female gender, more than four years of education and family income of less than two minimum wages.

Adherence to nutritional recommendations and sociodemographic variables in patients with diabetes mellitus / Adhesión a las recomendaciones de nutrición y variables sociodemográficas en pacientes con diabetes mellitus / Adesão às recomendações nutricionais e variáveis sociodemográficas em pacientes com diabetes mellitus

OBJECTIVETo determine if there is a relationship between adherence to nutritional recommendations and sociodemographic variables in Brazilian patients with type 2 diabetes mellitus.METHODSCross-sectional observational study using a stratified random sample of 423 individuals. The Food Frequency Questionnaire (FFQ) was used, and the Fisher's exact test was applied with 95% confidence interval (p<0.05).RESULTSOf the 423 subjects, 66.7% were women, mean age of 62.4 years (SD = 11.8), 4.3 years of schooling on average (SD = 3.6) and family income of less than two minimum wages. There was association between the female gender and adherence to diet with adequate cholesterol content (OR: 2.03; CI: 1.23; 3.34), between four and more years of education and adherence to fractionation of meals (OR: 1 92 CI: 1.19; 3.10), and income of less than two minimum wages and adherence to diet with adequate cholesterol content (OR: 1.74; CI: 1.03, 2.95).CONCLUSIONAdherence to nutritional recommendations was associated with the female gender, more than four years of education and family income of less than two minimum wages.

OBJETIVOVerificar si hay relación entre la adhesión a las recomendaciones de nutrición y las variables sociodemográficas de pacientes brasileños con diabetes mellitus tipo 2.MÉTODOSEstudio observacional seccional, con muestra aleatoria estratificada constituida de 423 individuos. Se utilizó el Cuestionario de Frecuencia de Consumo Alimentario. Se aplicó el Test Exacto de Fisher con intervalo de confianza del 95% (p-valor<0,05).RESULTADOSDe los 423 sujetos, el 66,7% eran mujeres, promedio de edad de 62,4 (DP=11,8) años, promedio de años de estudio de 4,3 (DP=3,6) y renta familiar inferior a dos sueldos mínimos. Se encontró asociación entre sexo femenino y adhesión a la dieta con adecuado contenido de colesterol (OR:2,03; IC:1,23;3,34), entre cuatro años y más de estudio y adhesión al fraccionamiento de las comidas (OR:1,92; IC:1,19;3,10), renta inferior a dos sueldos mínimos y adhesión a la dieta con adecuado contenido de colesterol (OR:1,74; IC:1,03;2,95).CONCLUSIÓNLa adhesión a las recomendaciones de nutrición estuvo asociada con el sexo femenino, escolaridad superior a cuatro años y renta familiar inferior a dos sueldos mínimos.

OBJETIVOVerificar se há relação entre a adesão às recomendações nutricionais e variáveis sociodemográficas de pacientes brasileiros com diabetes mellitus tipo 2.MÉTODOSEstudo observacional seccional, com amostra aleatória estratificada constituída por 423 indivíduos. Utilizou-se o Questionário de Frequência de Consumo Alimentar. Aplicou-se o Teste Exato de Fisher com intervalo de confiança de 95% (p-valor<0,05).RESULTADOSDos 423 sujeitos, 66,7% eram mulheres, média de idade 62,4 (DP=11,8) anos, média de anos de estudo de 4,3 (DP=3,6) e renda familiar inferior a dois salários mínimos. Foi encontrada associação entre sexo feminino e adesão à dieta com adequado teor de colesterol (OR:2,03; IC:1,23;3,34), entre quatro anos e mais de estudo e adesão ao fracionamento das refeições (OR:1,92; IC:1,19;3,10), renda inferior a dois salários mínimos e adesão à dieta com adequado teor de colesterol (OR:1,74; IC:1,03;2,95).CONCLUSÃOA adesão às recomendações nutricionais foi associada ao sexo feminino, escolaridade superior a quatro anos e renda familiar inferior a dois salários mínimos.

Metabolite profiling, antioxidant and antibacterial activities of Brazilian propolis: Use of correlation and multivariate analyses to identify potential bioactive compounds.

The production of propolis by honeybees results from a selective collection of exudates from various plant species and present many potentialities in the pharmaceutical industry. The objective of this study was to investigate the chemical profile of Brazilian propolis, as well as their in vitro antioxidant and antibacterial activities. Gas chromatography-mass spectrometry was applied for chemical profiling of propolis extracts. Total phenolic compounds were quantified by Folin-Ciocalteu and antioxidant properties were assessed by 2,2-diphenyl-1-picrylhydrazyl radical scavenging assay. Antibacterial activity was assessed against Staphylococcus aureus, Bacillus subtilis, and Micrococcus luteus. Correlation and multivariate statistical analysis were used to identify potential bioactive compounds in the extracts. Twenty-nine metabolites were identified along with 34 other metabolites that were classified into the following classes: triterpenoids (12), acetyltriterpenoids (3), sesquiterpenes (6), steroids (4), and hydrocarbons (9). The antioxidant capacity (IC50) ranged from 21.50 to 78.77µg/mL, whereas the content of total phenolic compounds ranged from 31.88 to 204.30mg GAE/g of dry weight. Total phenolic compounds and methyl retinoate showed a positive correlation with the antioxidant capacity, whereas tetradecanal, γ-palmitolactone and ethyl hydrocinnamate showed a negative correlation. Different sets of metabolites are shown to correlate with the antibacterial activity of the extracts, which is largely dependent on the type of microorganism. This innovative approach allowed us to identify likely bioactive compounds in the extracts, although the mechanism(s) underlying antibacterial activity encompass a complex trait, which might involve synergistic effects.

Age is not associated with hospital admission or uncontrolled symptoms of asthma if proper treatment is offered.

BACKGROUND: Aging modifies immune response and respiratory physiology. Few studies evaluate the effect of age on asthma. The aim of our study was to evaluate whether age is associated with uncontrolled symptoms and hospital admissions due to asthma in a setting where patients were receiving proper treatment. METHODS: We enrolled 401 patients with uncontrolled asthma who were inhaled corticosteroid-naive. The follow-up period was 1 year. They received medications for asthma, performed spirometry, a symptoms questionnaire, and all emergency room visits and hospital admissions due to asthma were reported. The primary end point was hospital admission during the follow-up period. RESULTS: Baseline data demonstrated that subjects >55 years of age had a later onset of asthma and a longer duration of symptoms. Adjusted logistic regression models demonstrated that older age at enrollment did not predict asthma control in the follow-up: hospital admission due to asthma [odds ratio (OR) 1.7 and 95% confidence interval (CI) 0.6-4.7], symptoms score (OR 0.6 and 95% CI 0.3-1.1) and emergency room visits due to asthma (OR 0.9 and 95% CI 0.6-1.3). Older age was associated with worse lung function (OR 1.8 and 95% CI 1.1-3.3). CONCLUSION: This study allows us to conclude that older age is associated with a later onset of asthma and a longer duration of symptoms. Age does not predict hospital admissions or poor control of asthma symptoms if proper treatment is offered. It does, however, predict worse lung function.

Alcohol consumption and emotional problems related to diabetes mellitus / Consumo de álcool e problemas emocionais relacionados ao diabetes mellitus / Consumo de alcohol y problemas emocionales relacionados a la diabetes mellitus

This study aimed to analyze the use of alcohol and emotional problems in patients with diabetes. The convenience sample consisted of 82 patients with type 2 diabetes in two centers of university extension in 2010. For data collection we used the Alcohol Use Disorders Identification Test and the Problem Areas in Diabetes. The results showed that 93.9% of patients had low risk for alcohol and 21.9% rated their emotional problems as relevant. We conclude that alcohol use and emotional problems are important variables for planning a diabetes education program...

Este estudo teve como objetivo analisar o uso de álcool e os problemas emocionais de pacientes com diabetes. A amostra de conveniência foi constituída por 82 pacientes com diabetes tipo 2, em dois centros de extensão universitária, em 2010. Para coleta de dados, foram utilizados os instrumentos Alcohol Use Disorder Identification Test e o Problem Areas in Diabetes. Os resultados mostraram que 93,9% dos pacientes apresentaram baixo risco para uso de álcool e 21,9% classificaram os problemas emocionais enfrentados como relevantes. Conclui-se que o uso de álcool e os problemas emocionais constituem variáveis importantes para o planejamento de programa educativo em diabetes...

Este estudio tuvo como objetivo analizar el uso de alcohol y los problemas emocionales de pacientes con diabetes. La muestra de conveniencia fue constituida por 82 pacientes con diabetes tipo 2 en dos centros de extensión universitaria, en 2010. Para recogida de datos fueron utilizados los instrumentos Alcohol Use Disorder Identification Test y el Problem Areas in Diabetes. Los resultados mostraron que 93,9% de los pacientes presentaron bajo riesgo para uso de alcohol y 21,9% clasificaron los problemas emocionales enfrentados como relevantes. Se concluye que el uso de alcohol y los problemas emocionales constituyen variables importantes para la planificación de programa educativo en diabetes...

Alcohol consumption and emotional problems related to diabetes mellitus / Consumo de álcool e problemas emocionais relacionados ao diabetes mellitus / Consumo de alcohol y problemas emocionales relacionados a la diabetes mellitus

This study aimed to analyze the use of alcohol and emotional problems in patients with diabetes. The convenience sample consisted of 82 patients with type 2 diabetes in two centers of university extension in 2010. For data collection we used the Alcohol Use Disorders Identification Test and the Problem Areas in Diabetes. The results showed that 93.9% of patients had low risk for alcohol and 21.9% rated their emotional problems as relevant. We conclude that alcohol use and emotional problems are important variables for planning a diabetes education program.(AU)

Este estudo teve como objetivo analisar o uso de álcool e os problemas emocionais de pacientes com diabetes. A amostra de conveniência foi constituída por 82 pacientes com diabetes tipo 2, em dois centros de extensão universitária, em 2010. Para coleta de dados, foram utilizados os instrumentos Alcohol Use Disorder Identification Test e o Problem Areas in Diabetes. Os resultados mostraram que 93,9% dos pacientes apresentaram baixo risco para uso de álcool e 21,9% classificaram os problemas emocionais enfrentados como relevantes. Conclui-se que o uso de álcool e os problemas emocionais constituem variáveis importantes para o planejamento de programa educativo em diabetes.(AU)

Este estudio tuvo como objetivo analizar el uso de alcohol y los problemas emocionales de pacientes con diabetes. La muestra de conveniencia fue constituida por 82 pacientes con diabetes tipo 2 en dos centros de extensión universitaria, en 2010. Para recogida de datos fueron utilizados los instrumentos Alcohol Use Disorder Identification Test y el Problem Areas in Diabetes. Los resultados mostraron que 93,9% de los pacientes presentaron bajo riesgo para uso de alcohol y 21,9% clasificaron los problemas emocionales enfrentados como relevantes. Se concluye que el uso de alcohol y los problemas emocionales constituyen variables importantes para la planificación de programa educativo en diabetes.(AU)

Análise dos níveis pressóricos em gestantes no diagnóstico precoce da síndrome hipertensiva gestacional / Blood pressure analysis among pregnant women for an early diagnosis of gestational hypertensive syndrome / Análisis de los niveles presóricos en gestantes en el diagnóstico precoz del síndrome hipertensivo gestacional

O objetivo foi comparar os níveis pressóricos em gestantes aferidos na sala de preparo de um Centro de Saúde da Família com as medidas verificadas no consultório seguindo as Diretrizes Brasileiras de Hipertensão. Estudo comparativo e quantitativo tendo como amostra 94 gestantes. A coleta de dados ocorreu no período de setembro a novembro de 2011 em duas etapas: a primeira se consistiu da coleta dos valores da PA aferidos rotineiramente pelos funcionários da sala de preparo, nesta foi realizada observação da técnica de aferição da PA. A segunda etapa ocorreu no consultório no qual foi realizada aferição da PA seguindo a VI Diretrizes Brasileiras de Hipertensão. Foram encontradas disparidades em 87% das aferições variando de -38 a 28mmHg para pressão sistólica e -26 a 20mmHg para pressão diastólica. Conclui-se que existe diferença significativa entre as medidas de pressões arteriais verificadas rotineiramente na sala de preparo e as medidas realizadas no consultório.

The objective was to compare the blood pressure (BP) levels of pregnant women, measured in a preparation room of a Family Health Center and verified in the consultation room following the Brazilian Guidelines for Hypertension. This comparative and quantitative study was performed with 94 pregnant women. Data collection was conducted between September and November of 2011 in two phases: the first consisted of collecting BP measurements by the preparation room staff, and observing the technique used for the measurement. The second phase occurred in the consultation room, when the BP was measured once again, following the 6th Brazilian Guidelines for Hypertension. Differences were observed in 87% of the measurements, ranging from - 38 to 28mmHg for systolic BP and - from 26 to 20mmHg for diastolic BP. It is concluded that a significant difference exists between the BP measurements taken in the preparation room and those taken in the consultation room.

Se objetivó comparar niveles presóricos en gestantes medidas en sala de preparto de un Centro de Salud de la Familia con las medidas verificadas en consultorio, siguiendo las Directivas Brasileñas de Hipertensión. Estudio comparativo y cuantitativo, con muestra de 94 gestantes. Datos recolectados de setiembre a noviembre de 2011 en dos etapas: la primera consistió en recolección de valores de PA medidos rutinariamente por los empleados de la sala de preparto, en ésta se realizó observación de la técnica de medición de PA. La segunda etapa aconteció en el consultorio donde fue efectuada medición de PA siguiendo las VI Directivas Brasileñas de Hipertensión. Fueron encontradas disparidades en 87% de las mediciones, variando de -38 a 28mmHg para presión sistólica y -26 a 20mmHg para diastólica. Se concluye en que existe diferencia significativa entre las medidas de presiones arteriales verificadas rutinariamente en sala de preparto y las realizadas en consultorio.

Acceptance of digital cervicography complementary to Papanicolaou cytology: a descriptive-exploratory study / Aceptación de la cervicografía digital complementar la citología de papanicolaou: estudio descriptivo exploratorio / Aceitação da cervicografia digital complementar a citologia de papanicolaou: estudo descritivo-exploratório

Aim: Analyze the acceptability of digital cervicography as a complementary method to Papanicolaou cytology for diagnosing cervical cancer. Method: An exploratory-descriptive study, quantitative approach. The survey had 63 participants and data was collected between June and August 2012. For data evaluation we used the results of cytologic collection and digital cervicography. Result: 100% of acceptance verified within participants. Regarding the Papanicolaou cytology, 96.8% of glandular, 8% of metaplastic, and 100% of squamous epithelium were found. Inflammation was found in 58.6% of the sample and malignant cell alterations in 1.6%. Discussion: The low sensitivity level of Papanicolaou cytology and the good acceptability rates of digital cervicography suggest the complementarity of these for cancer diagnosis. Conclusion: The implementation of digital cervicography as an exam complementary to Papanicolaou cytology is of great importance in order to increase the sensitivity level at cervical cancer detection.

Objetivo: evaluar la aceptación de la Cervicografia Digital como método complementar a la citología de Papanicolaou para diagnóstico del cáncer de cuello uterino. Método: estudio descriptivo exploratorio, enfoque cuantitativo. La investigación conto con 63 participantes, los datos fueron recolectados entre junio y agosto de 2012. Para evaluación de los datos se tuvo el resultado de recolección citológica, y la cervicografia digital. Resultado: Se verifico 100% de aceptabilidad de la cervicografia digital entre las participantes. Cuanto al examen de Papanicolaou, se verifico 100% de epitelio escamoso, 96,8%, glandular e 8%, metaplásico. La inflamación estuvo presente en 58,6% de la muestra y las alteraciones celulares malignas en 1,6%. Discusión: La baja sensibilidad de la citología de Papanicolau y la buena aceptabilidad y eficacia de la cervicografia digital sugiren a complementariedad de estos en el diagnóstico del cáncer. Conclusión: La implementación de la cervicografia digital como examen complementar a citología de Papanicolaou es de grande valia para aumentar la sensibilidad en el rastreo del cáncer de cuello uterino.

Objetivo: avaliar a aceitação da Cervicografia Digital como método complementar a citologia de Papanicolaou para diagnóstico do câncer de colo uterino. Método: estudo descritivo-exploratório, abordagem quantitativa. A pesquisa contou com 63 participantes, os dados foram coletados entre junho e agosto de 2012. Para avaliação dos dados teve-se o resultado da coleta citológica, e a cervicografia digital. Resultado: Verificou-se 100% de aceitabilidade da cervicografia digital entre as participantes. Quanto ao exame de Papanicolaou, verificou-se 100% de epitélio escamoso, 96,8%, glandular e 8%, metaplásico. A inflamação esteve presente em 58,6% da amostra e as alterações celulares malignas em 1,6%. Discussão: A baixa sensibilidade da citologia de Papanicolau e a boa aceitabilidade e eficácia da cervicografia digital sugerem a complementariedade destes no diagnóstico do câncer. Conclusão: A implementação da cervicografia digital como exame complementar a citologia de Papanicolaou é de grande valia para aumentar a sensibilidade no rastreamento do câncer de colo uterino.

Modulation of the oscillatory mechanics of lung tissue and the oxidative stress response induced by arginase inhibition in a chronic allergic inflammation model.

BACKGROUND: The importance of the lung parenchyma in the pathophysiology of asthma has previously been demonstrated. Considering that nitric oxide synthases (NOS) and arginases compete for the same substrate, it is worthwhile to elucidate the effects of complex NOS-arginase dysfunction in the pathophysiology of asthma, particularly, related to distal lung tissue. We evaluated the effects of arginase and iNOS inhibition on distal lung mechanics and oxidative stress pathway activation in a model of chronic pulmonary allergic inflammation in guinea pigs. METHODS: Guinea pigs were exposed to repeated ovalbumin inhalations (twice a week for 4 weeks). The animals received 1400 W (an iNOS-specific inhibitor) for 4 days beginning at the last inhalation. Afterwards, the animals were anesthetized and exsanguinated; then, a slice of the distal lung was evaluated by oscillatory mechanics, and an arginase inhibitor (nor-NOHA) or vehicle was infused in a Krebs solution bath. Tissue resistance (Rt) and elastance (Et) were assessed before and after ovalbumin challenge (0.1%), and lung strips were submitted to histopathological studies. RESULTS: Ovalbumin-exposed animals presented an increase in the maximal Rt and Et responses after antigen challenge (p<0.001), in the number of iNOS positive cells (p<0.001) and in the expression of arginase 2, 8-isoprostane and NF-kB (p<0.001) in distal lung tissue. The 1400 W administration reduced all these responses (p<0.001) in alveolar septa. Ovalbumin-exposed animals that received nor-NOHA had a reduction of Rt, Et after antigen challenge, iNOS positive cells and 8-isoprostane and NF-kB (p<0.001) in lung tissue. The activity of arginase 2 was reduced only in the groups treated with nor-NOHA (p <0.05). There was a reduction of 8-isoprostane expression in OVA-NOR-W compared to OVA-NOR (p<0.001). CONCLUSIONS: In this experimental model, increased arginase content and iNOS-positive cells were associated with the constriction of distal lung parenchyma. This functional alteration may be due to a high expression of 8-isoprostane, which had a procontractile effect. The mechanism involved in this response is likely related to the modulation of NF-kB expression, which contributed to the activation of the arginase and iNOS pathways. The association of both inhibitors potentiated the reduction of 8-isoprostane expression in this animal model.

Práticas e saberes dos enfermeiros da atenção básica acerca da colpocitologia oncótica e inspeção visual / Practices and knowledge of basic attention nurses about papanicolaou test and visual inspection

As elevadas taxas de morbimortalidade por Câncer de Colo Uterino (CCU) no Brasil podem dever-se à baixa cobertura populacional da Colpocitologia Oncótica (CO), além de condutas terapêuticas e diagnósticas insuficientes e/ou inadequadas. Objetivou-se avaliar as práticas e saberes dos enfermeiros da atenção básica acerca da CO e inspeção visual. Estudo descritivo-correlacional transversal, realizado em uma Instituição de Ensino Superior de Juazeiro do Norte-CE. A amostra foi não probabilística obtida por conveniência, totalizando 144 enfermeiros. Foi aplicado um questionário com informações acerca de conhecimentos dos enfermeiros sobre a Inspeção Visual com Ácido Acético, o teste de Schiller, reconhecimento e capacidade de descrever tecnicamente estruturas que são observadas na prática diária das consultas ginecológicas de enfermagem e a eficácia e segurança do profissional em indicar o aprofundamento diagnóstico quando se depara com uma alteração do colo uterino sugestiva de infecção pelo HPV, independentemente do resultado da CO. A análise exploratória dos dados valeu-se de frequências absolutas e relativas, médias e desvios-padrão, e a análise das variáveis categóricas. Verificou-se que a maioria dos entrevistados possuía idade entre 26 e 30 anos (N=78; 54,2%), com um ano ou menos (N=48; 33,3%) de atuação profissional, e que exerciam suas atividades no PSF (N=100; 69,4%), sobretudo em Juazeiro do Norte (N=49; 34%). Foi ainda verificado que 96,5% acreditavam que ainda existiam muitas informações desconhecidas ou novas sobre propedêutica do CCU e 97,2% reconheciam a necessidade de receberem atualizações, 68,1% afirmaram que a participação em treinamentos não interfere nas demais atividades profissionais. Percebeu-se que a experiência anterior dos enfermeiros na visualização do achado clínico apresentado variou de 14,6% a 48,6%. Na avaliação de práticas e saberes dos enfermeiros acerca do Teste de Schiller, o percentual de acerto maior dos enfermeiros foi de apenas 9,7% no que diz respeito à conservação dessa solução. Acerca da descrição das estruturas apontadas nas imagens clínicas, a estrutura que apresentou maior percentual de acerto (5,5%) entre os enfermeiros foi a identificação do canal cervical e junção escamo-colunar. Verificou-se que a linha de base de conhecimentos sobre a morfologia da cérvice uterina e a capacidade de reconhecer as estruturas anormais era insuficiente para a maior parte dos enfermeiros realizar com segurança a IV e o teste de Schiller. Diante desse resultado é importante a realização de treinamentos com estes profissionais, fato que é corroborado pelo interesse e motivação dos mesmos em relação a estas estratégias.

Atopy is not associated with poor control of asthma.

INTRODUCTION: Atopy is part of the immunopathology of allergic diseases; however, the effect of atopy on the prognosis of asthma in adult patients is not established yet. The aim of this study is to investigate whether there is an association between lack of control of asthma and sensitization to aeroallergens. The relation between rhinitis severity and atopy was also investigated. METHODS: Six hundred and thirty-nine patients aged ≥ 20 years with uncontrolled and untreated asthma were enrolled. They were followed for 1 year, received inhaled corticosteroids combined with long-acting beta-2 agonists, performed spirometry, skin prick test to aeroallergens, and reported emergency room visits due to asthma. Questionnaires (Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ)) were applied to evaluate asthma symptoms and quality of life. Rhinitis diagnosis and severity were evaluated. RESULTS: Baseline data demonstrated that atopic patients were younger and had earlier onset of asthma. Gender, body mass index, and lung function were similar between atopic and nonatopic patients. Low schooling had a borderline association with nonatopic asthma. Follow-up data demonstrated that there was no significant difference between atopic and nonatopic patients in asthma symptoms, quality of life, frequency of patients with uncontrolled asthma, emergency room visit, hospital admission, airway obstruction, nor response to treatment. Rhinitis severity was also similar between atopic and nonatopic individuals. CONCLUSIONS: In conclusion, positive skin prick test to common aeroallergens was not found to be predictor of asthma control among adults.

Clinical characteristics and prognosis in near-fatal asthma patients in Salvador, Brazil.

OBJECTIVE: To determine the frequency of near-fatal asthma in a group of severe asthma patients, as well as the clinical characteristics and prognosis of these patients within a one-year follow-up period. METHODS: A prospective study involving 731 low-income patients with severe asthma treated at a referral outpatient clinic located in the city of Salvador, Brazil. The patients were submitted to spirometry at admission, received medications for asthma, and were monitored regarding the frequency of asthma exacerbations during the follow-up period. A subsample of 511 patients also completed questionnaires regarding asthma symptoms and asthma-related quality of life. RESULTS: Of the 731 patients studied, 563 (77%) were female. The median age was 47 years, and 12% were illiterate. Most of the patients had rhinitis, and 70 patients (10%) reported near-fatal asthma prior to admission. Of these 70 patients, 41 (59%) reported having been intubated previously. The patients reporting a history of near-fatal asthma at admission were more likely to have asthma exacerbations during the follow-up period and to respond poorly to therapy than were those not reporting such a history. At the end of the follow-up period, the scores on the two questionnaires were similar between the two groups of patients. CONCLUSIONS: The frequency of near-fatal asthma was high in this group of low-income patients with severe asthma. The patients with a history of near-fatal asthma had a worse prognosis than did those without such a history, although both groups had received the same kind of treatment. Curiously, the intensity of symptoms and the quality of life at the end of the study were similar between the two groups.

Características clínicas e prognóstico em pacientes com asma quase fatal em Salvador, Bahia / Clinical characteristics and prognosis in near-fatal asthma patients in Salvador, Brazil

OBJETIVO: Determinar a frequência de asma quase fatal em um grupo de pacientes com asma grave, assim como as características clínicas e o prognóstico desses pacientes em um ano de seguimento. MÉTODOS: Estudo prospectivo envolvendo 731 pacientes de baixa renda com asma grave tratados em um ambulatório de referência para asma na cidade de Salvador (BA). Os pacientes realizaram espirometria na admissão do estudo, receberam medicações para asma e foram monitorizados quanto à frequência de exacerbações durante o seguimento. Uma subamostra de 511 pacientes também respondeu questionários de sintomas e de qualidade de vida relacionada a asma. RESULTADOS: Dos 731 pacientes estudados, 563 (77 por cento) eram do sexo feminino, com mediana de idade de 47 anos, e 12 por cento não eram alfabetizados. A maioria dos pacientes apresentava rinite, e 70 (10 por cento) relataram asma quase fatal antes da admissão. Desses 70 pacientes, 41 (59 por cento) relataram terem sido intubados previamente. Os pacientes com asma quase fatal na admissão eram mais propensos a exacerbações de asma durante o acompanhamento e tiveram menor resposta ao tratamento do que aqueles sem asma quase fatal. Os resultados dos questionários no final do acompanhamento foram semelhantes nos dois grupos de pacientes. CONCLUSÕES: A frequência de asma quase fatal foi alta nesta população de pacientes com asma grave e de baixa renda. Os pacientes com histórico de asma quase fatal tiveram um pior prognóstico que aqueles sem esse histórico, embora tenham recebido o mesmo tratamento. Curiosamente, a intensidade dos sintomas e a qualidade de vida no final do estudo foram semelhantes entre os dois grupos de pacientes.

OBJECTIVE: To determine the frequency of near-fatal asthma in a group of severe asthma patients, as well as the clinical characteristics and prognosis of these patients within a one-year follow-up period. METHODS: A prospective study involving 731 low-income patients with severe asthma treated at a referral outpatient clinic located in the city of Salvador, Brazil. The patients were submitted to spirometry at admission, received medications for asthma, and were monitored regarding the frequency of asthma exacerbations during the follow-up period. A subsample of 511 patients also completed questionnaires regarding asthma symptoms and asthma-related quality of life. RESULTS: Of the 731 patients studied, 563 (77 percent) were female. The median age was 47 years, and 12 percent were illiterate. Most of the patients had rhinitis, and 70 patients (10 percent) reported near-fatal asthma prior to admission. Of these 70 patients, 41 (59 percent) reported having been intubated previously. The patients reporting a history of near-fatal asthma at admission were more likely to have asthma exacerbations during the follow-up period and to respond poorly to therapy than were those not reporting such a history. At the end of the follow-up period, the scores on the two questionnaires were similar between the two groups of patients. CONCLUSIONS: The frequency of near-fatal asthma was high in this group of low-income patients with severe asthma. The patients with a history of near-fatal asthma had a worse prognosis than did those without such a history, although both groups had received the same kind of treatment. Curiously, the intensity of symptoms and the quality of life at the end of the study were similar between the two groups.

Estimativa do fluxo dos resíduos de equipamentos elétricos e eletrônicos no município de Belo Horizonte, Minas Gerais, Brasil / Flow of e-waste at the city of Belo Horizonte, Minas Gerais, Brazil

O objetivo deste trabalho foi determinar o fluxo dos resíduos de equipamentos elétricos e eletrônicos (REEE) no município de Belo Horizonte - Minas Gerais, Brasil. Para atingir o objetivo, pesquisaram-se a estimativa de geração, a quantidade e o peso dos materiais recicláveis e de substâncias tóxicas presentes. Os resultados mostraram que o potencial de geração é de 153 mil toneladas de resíduos para o período de 2008 a 2023, e a principal destinação dada pelos consumidores particulares para o descarte desses resíduos é a doação. Concluiu-se que as iniciativas de gerenciamento ambientalmente adequadas são oriundas de iniciativas privadas e aplicadas somente em equipamentos de informática e telefonia móvel, e que os demais resíduos estão sendo manipulados sem as devidas precauções de saúde e segurança do trabalhador, bem como dispostos de forma irregular.

The aim of this study was to obtain an understanding of the flow of e-waste at the city of Belo Horizonte - Minas Gerais, Brazil. An estimative of the amount of e-waste generated and the domestic and second hand flow were investigated to achieve this goal. The results estimated approximately 153,000 tones of e-waste generated for the period of 2008 to 2023, and the main domestic disposal given by the consumers is donation. We concluded that the environmental management initiatives usually comes from the private sector and are applied to computers and mobile phones only. Other e-wastes are handled using improper tools, creating health and safety hazards for the workers, as well as those e-wastes have been arranged in an irregular way.

The impact of a program for control of asthma in a low-income setting.

The prevalence of asthma is increasing in developing countries and the burden of uncontrolled asthma affects patients, families, and the health system. This is to summarize, evaluate, and discuss previous reports on the impact of a targeted and comprehensive approach to the most severe cases of asthma in a low-income setting. A Program for Control of Asthma (ProAR) was developed in Salvador, Bahia, Brazil, prioritizing the control of severe asthma. By facilitating referrals from the public health system and providing proper multidisciplinary but simple management including education and medication, for free, the Program enrolled 2385 patients in 4 reference clinics. They are offered regular follow up and discharged back to primary health care only when asthma control can be maintained without requirement of a combination of an inhaled corticosteroid and a long-acting ß2 agonist. ProAR has markedly reduced health resource utilization and decreased the rate of hospital admissions because of asthma in the entire City (2.8 million inhabitants) by 74%. Moderate to severe rhinitis was associated with lack of control of asthma. The average income of the families in the ProAR was US$2955 a year, and they spent 29% of all their income attempting to control the severe asthma of one member, a unbearable expenditure for a low-income family. The ProAR was shown to be cost-effective, reducing costs to the public health system (US$387 patient/year) and the families (US$789 patient/year). In a low-income setting of Brazil, an intervention prioritizing the control of severe asthma was feasible, effective, and reduced costs.

Automonitorização da glicemia capilar no domicílio: revisão integrativa da literatura / Self-monitoring blood glucose at home: integrative literature review / Automonitorización de la glucemia capilar en el domicilio: revisión integradora de la literatura

A presente investigação é uma revisão integrativa que teve como objetivo buscar e avaliar as evidências científicas disponíveis sobre automonitorização da glicemia capilar no domicílio para o alcance do bom controle metabólico das pessoas com diabetes mellitus, no período de 1990 a 2009. Para tanto, a seleção dos estudos foi realizada por meio de quatro bases de dados: PUBMED (National Library of Medicine), MEDLINE/BVS (Medical Literature Analysis and Retrieval System Online/Biblioteca Virtual em Saúde), LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde) e CINAHL (Cumulative Index to Nursing and Allied Heath Literature), resultando em 28 artigos científicos. A apresentação dos artigos incluídos nessa revisão integrativa foi distribuída em quatro quadros, considerando os seguintes pontos: periódico, ano/país, título, autoria, tipo de estudo, objetivo, resultados e conclusão. Os resultados foram discutidos de forma descritiva e em consonância com o objetivo proposto. Destaca-se a importância da automonitorização da glicemia capilar no domicílio, devendo-se, portanto, ser estimulada entre pessoas com diabetes mellitus. Contudo, torna-se necessário que o profissional de saúde esteja embasado cientificamente, para programar intervenções eficazes e atender às necessidades reais da pessoa com diabetes mellitus.

This integrative review aimed to search and to evaluate the available scientific evidence about blood glucose self-monitoring at home with a view to good metabolic control in the people with diabetes mellitus, in the period between 1990 and 2009. To develop this, the selection of the studies was carried through four databases: PUBMED (National Library of Medicine), MEDLINE/BVS (Medical Literature Analysis and Retrieval System Online/Virtual Health Library), LILACS (Latin American and Caribbean Center on Health Sciences Information) and CINAHL (Cumulative Index to Nursing and Allied Heath Literature), resulting in twenty-eight scientific articles. The presentation of the articles included in this integrative review was distributed in four pictures, having considered the following points: periodic, year/country, title, authors, type of study, purpose, results and conclusion. The results were discussed of descriptive form and in accord with considered purpose. We highlight the importance of blood-glucose self-monitoring at home, having itself, therefore, to be stimulated between people with diabetes mellitus. However, itïs necessary that the health professionals are scientific foundations, to program effective interventions and attend to the real needs of the people with diabetes mellitus.

La finalidad de esta revisión integradora es buscar y evaluar la evidencia científica disponible sobre automonitorización de la glucemia capilar en el domicilio con objeto de buen control metabólico en personas con diabetes mellitus, en el período entre 1990 y 2009. Para realizar esto, la selección de los estudios fue ejecutada en cuatro bases de dados: PUBMED (Biblioteca Nacional de la Medicina), MEDLINE/BVS (Análisis de la Literatura Médica y Sistema de Recuperación en Línea/Biblioteca Virtual de la Salud), LILACS (Centro Latinoamericano y del Caribe en la Información de Ciencias de la Salud) y CINAHL (Índice Cumulativo al Oficio de Enfermera y a la Literatura Aliada del Brezo), resultando en veinte y ocho artículos científicos. La presentación de los artículos incluidos en esta revisión integradora fue distribuida en cuatro cuadros, considerando los puntos siguientes: periódico, año/país, título, autores, tipo de estudio, finalidad, metodología, resultados y conclusión. Los resultados fueron discutidos de forma descriptiva y de acuerdo con la finalidad considerada. Destacamos la importancia de la automonitorización de la glucemia capilar en el domicilio, debiendo, por lo tanto, ser estimulado entre las personas con diabetes mellitus. Sin embargo, torna-se necesario que el profesional de salud esté embasada científicamente para programar intervenciones eficaces y atender a las necesidades verdaderas de la persona con diabetes mellitus.

[Digital cervicography criteria: improving sensitivity in uterine cervical cancer diagnosis]. / Critérios de positividade para cervicografia digital: melhorando a sensibilidade do diagnóstico do câncer cervical.

This study aimed to validate the scoring criteria for digital cervicography. The study enrolled 300 women submitted to a clinical protocol using cytological examination alone, digital cervicography without image magnification (Evaluation 1), and digital cervicography plus additional image magnification and considering the positive criteria (Evaluation 2). Women's mean age was 27.6 years. Positive criteria for digital cervicography were identified in 111 positive cases with pre-cancerous cervical lesions (100%) and in 8 cases classified as false positives (2.6%). Evaluations 1 and 2 classified the tests as positive (163; 54.3%) and suspected (146; 48.6%), respectively. According to the findings, digital cervicography was more sensitive (99.1%) and cytology more specific (100%). Digital cervicography sensitivity increased by 4.5 times when the positive criteria were applied as compared to cytology alone, besides involving low cost, thus suggesting that it is a viable technique.

Critérios de positividade para cervicografia digital: melhorando a sensibilidade do diagnóstico do câncer cervical / Digital cervicography criteria: improving sensitivity in uterine cervical cancer diagnosis

O objetivo deste trabalho foi validar critérios de positividade para cervicografia digital. Estudo realizado com 300 mulheres submetidas a protocolo clínico composto por exame citológico, uma avaliação por meio de cervicografia digital sem ampliação de imagem (Avaliação 1), e outra avaliação também usando cervicografia digital mas com ampliação adicional de imagem e os critérios de positividade propostos neste estudo (Avaliação 2). A idade média das mulheres foi de 27,6 anos. Os critérios de positividade para cervicografia digital foram identificados em 111 casos (100 por cento) dos testes positivos para lesões precursoras do câncer do colo uterino e em 8 casos (2,6 por cento) considerados falso-positivos. As avaliações 1 e 2 classificaram os exames como positivos (163; 54,3 por cento) e suspeitos (146; 48,6 por cento), respectivamente. Os resultados revelam que a cervicografia digital foi mais sensível (99,1 por cento) e a citologia mais específica (100 por cento). O desempenho alcançado pela cervicografia digital, quando aplicado os critérios de positividade, alcançou sensibilidade 4,5 vezes superior ao desempenho da citologia oncológica, além do baixo custo, sugerindo ser uma técnica factível.

This study aimed to validate the scoring criteria for digital cervicography. The study enrolled 300 women submitted to a clinical protocol using cytological examination alone, digital cervicography without image magnification (Evaluation 1), and digital cervicography plus additional image magnification and considering the positive criteria (Evaluation 2). Women's mean age was 27.6 years. Positive criteria for digital cervicography were identified in 111 positive cases with pre-cancerous cervical lesions (100 percent) and in 8 cases classified as false positives (2.6 percent). Evaluations 1 and 2 classified the tests as positive (163; 54.3 percent) and suspected (146; 48.6 percent), respectively. According to the findings, digital cervicography was more sensitive (99.1 percent) and cytology more specific (100 percent). Digital cervicography sensitivity increased by 4.5 times when the positive criteria were applied as compared to cytology alone, besides involving low cost, thus suggesting that it is a viable technique.