Práticas clínicas aplicadas a pacientes com infarto do miocárdio sem obstrução de artéria coronária (minoca) / Clinical Practices Applied To Patients With Myocardial Infarction Non-obstruction Coronary Arteries (Minoca) / Prácticas clínicas aplicadas a pacientes con infarto e miocardio sin obstruccion arteria coronaria (MINOCA)

Objetivo: Identificar práticas clínicas com resultados favoráveis aos pacientes com diagnóstico de infarto agudo do miocárdio sem obstrução de artéria coronária. Método: Revisão integrativa da literatura pela base de dados National Library of Medicine e Biblioteca Virtual de Saúde de estudos publicados entre 2018 e 2022. Resultados:87,5% dos estudos encontrados destacaram estratégias farmacológicas e destes, 62,5% citaram o uso da dupla antiagregaçãoplaquetária como mais utilizada, apesar de nenhum estudo evidenciar benefícios. Os inibidores do sistema renina-angiotensina-aldosterona comprovaram benefícios em três estudos. 75% dos artigos apontaram que esse grupo de pacientes recebem menos medicamentos preventivos comparados aos pacientes com infarto por obstrução coronariana. Outros seis estudos, revelaram condução clínica variável desses pacientes. Conclusão: O uso de inibidores do sistema renina-angiotensina-aldosterona deve ser considerado por ser a única medicação com redução da mortalidade evidenciada. São necessários estudos maiores para orientar com mais segurança à condução do infarto do miocárdio sem obstrução de coronária.(AU)

Objective: To identify clinical practices with favorable results for patients diagnosed with acute myocardial infarction without coronary artery obstruction. Method: Integrative literature review using the National Library of Medicine and Virtual Health Library databases of studies published between 2018 and 2022. Results: 87.5% of the studies found highlighted pharmacological strategies and of these, 62.5% cited the use of dual antiplatelet therapy as the most used, despite no study showing benefits. Inhibitors of the renin-angiotensin-aldosterone system have shown benefits in three studies. 75% of the articles pointed out that this group of patients receive less preventive medication compared to patients with infarction due to coronary obstruction. Another six studies revealed variable clinical management of these patients. Conclusion: The use of renin-angiotensin-aldosterone system inhibitors should be considered as it is the only medication with proven reduction in mortality. Larger studies are needed to guide with more safety the management of myocardial infarction without coronary obstruction.(AU)

Objetivo: Identificar prácticas clínicas con resultados favorables para pacientes con diagnóstico de infarto agudo de miocardio sin obstrucción arterial coronaria. Método: revisión integrativa de la literatura utilizando las bases de datos de la Biblioteca Nacional de Medicina y la Biblioteca Virtual en Salud de estudios publicados entre 2018 y 2022. Resultados: el 87,5% de los estudios encontrados destacaron estrategias farmacológicas y de estos, el 62,5% citó el uso de la terapia antiplaquetaria dual como el más utilizados, a pesar de que ningún estudio muestra beneficios. Los inhibidores del sistema renina-angiotensina-aldosterona han mostrado beneficios en tres estudios. El 75% de los artículos señalaron que este grupo de pacientes recibe menos medicación preventiva en comparación con los pacientes con infarto por obstrucción coronaria. Otros seis estudios revelaron un manejo clínico variable de estos pacientes. Conclusión: Se debe considerar el uso de inhibidores del sistema renina-angiotensina-aldosterona, ya que es el único medicamento con reducción comprobada de la mortalidad. Son necesarios estudios más amplios que orienten con mayor seguridad el manejo del infarto de miocardio sin obstrucción coronaria.(AU)

Perfil alimentar de transplantados cardíacos de um centro transplantador brasileiro - Atuação da enfermagem neste cenário / Perfil alimentario de los trasplantes de corazón en un centro de trasplante brasileño - Desempeño de la enfermería en este escenario / Food profile of heart transplants in a brazilian transplantation center - Nursing performance in this scenario

Objetivo- Descrever o perfil alimentar de pacientes pós transplante cardíaco (TC) tardio de um centro transplantador brasileiro. Método- Estudo observacional transversal com delineamento descritivo. O estudo ocorreu em uma instituição de ensino público de Minas Gerais. A coleta de dados ocorreu no período de 2017 a 2019. Resultados-. A amostra do estudo foi composta por 62 indivíduos transplantados entre os anos de 2006 a 2016. Aproximadamente 63% era do sexo masculino. A média de idade foi de 46,53 anos. O consumo de carboidratos e gorduras foi adequado em 46,77% e 59,68% da amostra, respectivamente. Já o consumo de proteínas foi acima do recomendado em 77,42% e o consumo de fibras abaixo do recomendado em 79,03%. Conclusão- Houve a predominância do sexo masculino. Os indivíduos apresentaram um consumo adequado somente de carboidratos e gorduras. Não houve na literatura estudos descrevendo a atuação do enfermeiro no processo de nutrição neste cenário(AU)

Objective- To describe the dietary profile of patients after late heart transplantation (HT) from a Brazilian transplant center. Method- Cross-sectional observational study with descriptive design. The study took place in a public education institution in Minas Gerais. Data collection took place from 2017 to 2019. Results-. The study sample consisted of 62 individuals transplanted between 2006 and 2016. Approximately 63% were male. The mean age was 46.53 years. The consumption of carbohydrates and fats was adequate in 46.77% and 59.68% of the sample, respectively. The consumption of proteins was above the recommended in 77.42% and the consumption of fibers below the recommended in 79.03%. Conclusion- There was a predominance of males. The individuals presented an adequate consumption of only carbohydrates and fats. There were no studies in the literature describing the role of nurses in the nutrition process in this scenario(AU)

Objetivo- Describir el perfil dietético de pacientes después de un trasplante cardíaco (TC) tardío de un centro de trasplante brasileño. Método- Estudio observacional transversal con diseño descriptivo. El estudio se llevó a cabo en una institución de educación pública en Minas Gerais. La recolección de datos se llevó a cabo de 2017 a 2019. Resultados-. La muestra del estudio estuvo compuesta por 62 individuos trasplantados entre 2006 y 2016. Aproximadamente el 63% eran hombres. La edad media fue de 46,53 años. El consumo de carbohidratos y grasas fue adecuado en el 46,77% y 59,68% de la muestra, respectivamente. El consumo de proteína estuvo por encima del nivel recomendado en un 77,42% y el consumo de fibra por debajo del nivel recomendado en un 79,03%. Conclusión- Hubo predominio del sexo masculino. Los individuos presentaron un consumo adecuado de solo carbohidratos y grasas. No hubo estudios en la literatura que describieran el papel del enfermero en el proceso de nutrición en este escenario.(AU)

Comparison of Quality of Life Between Patients with Advanced Heart Failure and Heart Transplant Recipients

Abstract Introduction: Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). The transplant is expected to increase survival and improve the level of health-related quality of life (HRQoL). The aim of this study was to compare the level of HRQoL, as well as social and clinical variables, between patients with advanced HF and heart transplant (HT) recipients. Methods: This is a cross-sectional study, conducted at a Brazilian university hospital, during outpatient consultations. The level of HRQoL was assessed using the World Health Organization Quality of Life-Bref questionnaire. Descriptive statistics were used to analyze the data, and the comparison of the level of HRQoL was performed using the Mann-Whitney U test. Results: Two hundred sixty-two patients participated in the study. Seventy-nine of them had advanced-stage HF and 183 were HT recipients. Compared to patients with advanced HF, HT recipients had a better level of HRQoL, were less frequently absent from work due to health problems, had higher income, used a higher number of medications, and there was a higher percentage of retirees among them (P-value < 0.001). Conclusion: In every comparison, HT recipients showed a better level of HRQoL than patients with advanced HF, along with less absence from work and higher income. These results suggest that heart transplantation can improve HRQoL and survival of patients with advanced HF.

Comparison of Quality of Life Between Patients with Advanced Heart Failure and Heart Transplant Recipients.

INTRODUCTION: Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). The transplant is expected to increase survival and improve the level of health-related quality of life (HRQoL). The aim of this study was to compare the level of HRQoL, as well as social and clinical variables, between patients with advanced HF and heart transplant (HT) recipients. METHODS: This is a cross-sectional study, conducted at a Brazilian university hospital, during outpatient consultations. The level of HRQoL was assessed using the World Health Organization Quality of Life-Bref questionnaire. Descriptive statistics were used to analyze the data, and the comparison of the level of HRQoL was performed using the Mann-Whitney U test. RESULTS: Two hundred sixty-two patients participated in the study. Seventy-nine of them had advanced-stage HF and 183 were HT recipients. Compared to patients with advanced HF, HT recipients had a better level of HRQoL, were less frequently absent from work due to health problems, had higher income, used a higher number of medications, and there was a higher percentage of retirees among them (P-value < 0.001). CONCLUSION: In every comparison, HT recipients showed a better level of HRQoL than patients with advanced HF, along with less absence from work and higher income. These results suggest that heart transplantation can improve HRQoL and survival of patients with advanced HF.

Ações de enfermagem para a prevenção e controle do delirium em pacientes pós-operatório de cirurgia cardíaca: uma revisão integrativa / Nursing actions for prevention and control of delirium in post-operative patients of heart surgery: an integrative review / Acciones de enfermería para la prevención y control del delirio en pacientes postoperatorios de cirugía cardíaca: una revisión integrativa

Objetivo: Analisar as ações de enfermagem no controle e prevenção do delirium em pacientes pós-operatório de cirurgia cardíaca apresentados na literatura. Método: Estudo de revisão integrativa da literatura. A busca e seleção dos artigos foi realizada através das bases de dados LILACS, MEDLINE, BDENF, IBECS, MEDCARIB, CUMED, Secretaria Estadual de Saúde de São Paulo e coleciona SUS. A amostra foi composta por nove estudos. Resultados: Identificamos entre as ações para o controle e prevenção do delirium a visita familiar estruturada, a comunicação, importância de realizar a orientação verbal sobre o tempo e espaço, reconhecer o delirium precocemente e utilizar escalas para o diagnóstico, sendo a CAM-ICU a mais recomendada e de melhor aplicação. Conclusão: A enfermagem é essencial para realizar ações preventivas e reconhecer o delirium, muitas ações de prevenção são realizadas e, a comunicação e a presença da família é fundamental para se prevenir essa patologia.(AU)

Objective: To analyze nursing actions in the control and prevention of delirium in patients in the postoperative period of cardiac surgery presented in the literature. Method: Study of integrative literature review. The search and selection of articles was carried out through the LILACS, MEDLINE, BDENF, IBECS, MEDCARIB, CUMED, São Paulo State Health Secretariat and SUS collections. The sample consisted of nine studies. Results: We identified among the actions for the control and prevention of delirium the structured family visit, communication, the importance of carrying out verbal orientations in time and space, recognizing the delirium early and using diagnostic scales, CAM-ICU being the most recommended and best application. Conclusion: Nursing is essential to carry out preventive actions and to recognize delirium, many preventive actions are carried out and communication and the presence of the family are essential to prevent this pathology.(AU)

Objetivo: Analizar las acciones de enfermería en el control y prevención del delirio en pacientes en el postoperatorio de cirugía cardíaca presentadas en la literatura. Método: estudio de revisión integradora de la literatura. La búsqueda de los artículos se realizó a través de las bases de datos LILACS, MEDLINE, BDENF, IBECS, MEDCARIB, CUMED, Secretaría de Salud del Estado de São Paulo y recolecta SUS, la muestra estuvo compuesta por nueve estudios. Resultados: Entre las acciones para el control y prevención del delirio, identificamos la visita familiar estructurada, la comunicación, la importancia de realizar una guía verbal en tiempo y espacio, el reconocimiento temprano del delirio y el uso de escalas diagnósticas, siendo Se recomienda CAM-UCI y se aplica mejor. Conclusión: Enfermería es fundamental para realizar acciones preventivas y para reconocer el delirio, se realizan muchas acciones preventivas y la comunicación y la presencia de la familia son fundamentales para prevenir esta patología.(AU)

Assistência de enfermagem a pacientes portadores de insuficiência cardíaca descompensada: uma revisão integrativa / Nursing assistance to patients with discommended heart failure: an integrative review / Asistencia de enfermería para pacientes con insuficiencia cardíaca malestada: una revisión integrativa

O objetivo do estudo foi identificar os cuidados de enfermagem a pacientes portadores de insuficiência cardíaca descompensada descritos em literatura nacional e internacional. Método- Foi realizada uma Revisão Integrativa. A busca foi realizada de forma sistematizada nas bases de dados LILACS, BDENF, IBECS, MEDLINE e Pubmed. Resultados- A amostra constituiu-se de oito artigos, sendo possível identificar intervenções de enfermagem educativas para o controle e prevenção da doença, intervenções durante a internação e após a alta hospitalar. Conclusão- Dentre os estudos selecionados, ficou evidenciado que as intervenções de enfermagem são fundamentais para prevenção e promoção a saúde a pacientes portadores de insuficiência cardíaca descompensada nos diversos cenários de atenção à saúde. O acompanhamento e a educação em saúde ao paciente com insuficiência cardíaca têm grande potencial para atingir mudanças de atitudes e comportamento no enfrentamento a doença.(AU)

The aim of the study was to identify nursing care for patients with decompensated heart failure described in national and international literature. Method- An Integrative Review was carried out. The search was carried out systematically in the databases LILACS, BDENF, IBECS, MEDLINE and Pubmed. Results- The sample consisted of eight articles, it was possible to identify educational nursing interventions for the control and prevention of the disease, interventions during hospitalization and after hospital discharge. Conclusion- Among the selected studies, it was evidenced that nursing interventions are essential for the prevention and promotion of health to patients with decompensated heart failure in the different health care scenarios. Monitoring and health education for heart failure patients has great potential to achieve changes in attitudes and behavior in coping with the disease.(AU)

El objetivo del estudio fue identificar los cuidados de enfermería para pacientes con insuficiencia cardíaca descompensada descritos en la literatura nacional e internacional. Método- Se realizó una Revisión Integrativa. La búsqueda se realizó de forma sistemática en las bases de datos LILACS, BDENF, IBECS, MEDLINE y Pubmed. Resultados- La muestra estuvo formada por ocho artículos, fue posible identificar intervenciones educativas de enfermería para el control y prevención de la enfermedad, intervenciones durante la hospitalización y tras el alta hospitalaria. Conclusión- Entre los estudios seleccionados, se evidenció que las intervenciones de enfermería son fundamentales para la prevención y promoción de la salud de los pacientes con insuficiencia cardíaca descompensada en los diferentes escenarios asistenciales. El seguimiento y la educación sanitaria de los pacientes con insuficiencia cardíaca tiene un gran potencial para lograr cambios en las actitudes y el comportamiento para afrontar la enfermedad.(AU)

Fatores relacionados ao manejo clínico e educacional do paciente em período pré e pós-transplante cardíaco: revisão integrativa / Factors related to clinical and educational management of patients in the pre and post-heart transplant period: an integrative review / Factores relacionados con el manejo clínico y educativo de los pacientes en el período previo y posterior al trasplante cardíaco: una revisión integradora

Objetivo: Analisar as recomendações de condutas terapêuticas e educacionais na assistência ao paciente em período pré e pós-transplante cardíaco. Métodos: Trata-se de revisão integrativa baseada na estratégia PICO, realizada com 12 artigos gerados através de pesquisa nas bases de dados LILACS; MEDLINE; BDENF; IBECS; BINACIS e COLECIONASUS em agosto de 2019. Resultados: É recomendado a atuação da equipe multidisciplinar especializada em transplante e a educação em saúde. Maior grau de instrução, melhor condição cognitiva e altos níveis de satisfação social são preditivos de aumento nos anos de sobrevida pós-transplante. Os principais aspectos a serem trabalhados são: ação da insuficiência cardíaca e seu impacto no organismo, tratamentos disponíveis, período de recuperação, rotinas de exames e acompanhamento. Conclusão: Diante da complexidade do tema faz-se necessário uma equipe assistencial especializada e a reflexão sobre a inclusão do cardiopata e familiares no processo. O apoio psicológico gera melhores resultados e adesão ao tratamento.(AU)

Objective: To analyze the recommendations for therapeutic and educational approaches in patient care in the pre- and post-heart transplant period. Methods: This is an integrative review based on the PICO strategy, carried out with 12 articles generated thrçough research in the LILACS databases; MEDLINE; BDENF; IBECS; BINACIS and COLECIONASUS in August 2019. Results: The work of a multidisciplinary team specialized in transplantation and health education is recommended. A higher level of education, a better cognitive condition and high levels of social satisfaction are predictive of an increase in the years of post-transplant survival. The main aspects to be worked on are: heart failure action and its impact on the organism, available treatments, recovery period, exam routines and follow-up. Conclusion: In view of the complexity of the theme, a specialized assistance team and reflection on the inclusion of cardiopath and family members in the process is necessary. Psychological support generates better results and treatment adherence.(AU)

Objetivo: Analizar las recomendaciones de abordajes terapéuticos y educativos en la atención al paciente en el período pre y postrasplante cardíaco. Métodos: Se trata de una revisión integradora basada en la estrategia PICO, realizada con 12 artículos generados a través de la investigación en las bases de datos LILACS; MEDLINE; BDENF; IBECS; BINACIS y COLECIONASUS en agosto de 2019. Resultados: Se recomienda el trabajo de un equipo multidisciplinario especializado en trasplantes y educación para la salud. Un mayor nivel de educación, una mejor condición cognitiva y altos niveles de satisfacción social son predictores de un aumento en los años de supervivencia postrasplante. Los principales aspectos a trabajar son: acción de la insuficiencia cardíaca y su impacto en el organismo, tratamientos disponibles, período de recuperación, rutinas de exploración y seguimiento. Conclusión: Dada la complejidad del tema, es necesario un equipo asistencial especializado y la reflexión sobre la inclusión del cardiópata y familiares en el proceso. El apoyo psicológico genera mejores resultados y adherencia al tratamiento.(AU)

A methodology to empower citizens towards a low-carbon economy. The potential of schools and sustainability indicators.

Environmental empowering to control resource consumption and environmental impacts is critical to engage citizens to adopt more sustainable habits. This study demonstrates the potential benefits of innovative approaches based on sustainability indicators towards a low-carbon economy. A methodology to measure and promote sustainability in schools has been proposed and evaluated, aiming at showing the environmental performance and informing of potential environmental savings. The methodology, titled ClimACT, has two main purposes: measuring the environmental performance of schools through a school sustainability index based on measurable indicators in the areas of transport, procurement, green spaces, indoor air quality, energy, water and waste; and encouraging students, teachers and families towards an energy-efficient and low-carbon pathway through a structural procedure based on roles, activities and progress evaluation. The approach, applied to 39 pilot schools from Portugal, Spain, France and Gibraltar, achieved promising and encouraging results. All schools deployed the methodology successfully, achieving measurable environmental benefits in 95% of cases, with an average improvement of 10% in the global performance of schools after one year. Moreover, the 5112 surveys applied to school communities, before and after the methodology implementation, highlighted how the sustainable indicators had a significant influence on the daily lives of families, leading to improvements of their behaviour, with an average increase of 20% in indicators regarding good practices in transport, energy, water, waste and citizenship. The environmental empowering through measurable indicators is a step forward a low-carbon economy. This methodology is open and adaptable to all sectors and requirements.

Impacts of social inequalities on the survival of heart transplant recipients in a developing country.

BACKGROUND: Heart transplant (HT) is an alternative for patients with advanced heart failure (HF). Social inequalities may influence survival, but are still not well understood. The aim of this study was to assess the impact of social and clinical inequalities on the survival of HT recipients. METHODS: Retrospective cohort study conducted at a Brazilian hospital from 2006 to 2018. RESULTS: Three hundred and two patients were analyzed. Most HT recipients were male (205, 67.9%), mixed race 146 (48.3%), retired (166, 56.5%), median age 47 (38-57) years, and had studied no more than eight years (191, 65.8%), were younger than 60 years old (256, 84.7%). 149 (51.7%) had per capita monthly income inferior to one Brazilian minimum wage, equivalent to US$250. 123 (95.4%) out of 129 patients had allograft cellular rejection 2R or 3R. Median donor age was 32 (23-39) years. The overall survival was 76.6%, 62.2%, and 58.2%, at 1, 5, and 10 years, respectively. Age <60 years old and higher income were associated with a greater chance of survival (p-values .009 and <.001, respectively). CONCLUSION: Younger age and higher per capita income had positive impact on HT recipient survival. The level of education did not affect survival in this cohort.

Health-Related Quality of Life of Heart Transplant Recipients Living in a Developing Country.

BACKGROUND: Heart transplantation (HT) is the treatment for patients with end-stage heart failure (HF). It is hoped that the procedure increases both survival rates and the level of health-related quality of life (HRQoL), which may, however, be compromised by post-transplant complications. The objective of this study was to analyze the level of HRQoL in HT recipients and considered the influence of variables from social and clinical contexts. MATERIALS AND METHODS: This is a cross-sectional study of HT recipients. The level of HRQoL was assessed by the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire during outpatient consultation. RESULTS: This study analyzed 186 HT recipients from a total of 192 eligible patients. The median level of HRQoL was ≥67.8 points in all domains of the WHOQOL-BREF questionnaire (physical, psychological, social relationships, and environment) and general score of perception of the level of quality of life (QoL) and health. Variables such as age, ethnicity, per capita income, time from last hospitalization, number of current medications, and number of hospitalizations after HT were significantly related to at least 1 domain of the WHOQOL-BREF. CONCLUSION: In this study, HRQoL of HT recipients living in a developing country can be considered satisfactory given the high score obtained in all domains of WHOQOL-BREF and in the perception of the level of QoL and health.

Análise da qualidade de vida de pacientes com insuficiência cardíaca avançada candidatos ou não ao transplante cardíaco / Analysis of the quality of life of patients with advanced heart failure candidates or not for heart transplantation / Análisis de la calidad de vida de los pacientes con insuficiencia cardíaca avanzada, candidatos o no a trasplante de corazón

Introdução: a insuficiência cardíaca (IC) é um grave problema de saúde. Pacientes com IC em estágio avançado apresentam, além de baixa expectativa de vida, alteração no nível de qualidade de vida (QV). Objetivo: analisar o nível de QV de pacientes com IC avançada, candidatos ou não ao transplante cardíaco (TC). Método: estudo transversal realizado em um hospital universitário brasileiro, em que os pacientes foram submetidos à avaliação da QV pelo Minnesota Living With Heart Failure Questionnaire (MLHFQ). Resultados: participaram do estudo 76 pacientes. A principal etiologia da IC foi a chagásica (25 pacientes). As classes funcionais mais frequentes foram NYHA II (26 pacientes) e III (33 pacientes). Pacientes em avaliação para TC e aqueles em fila para TC não apresentaram diferença estatisticamente significativa na avaliação do nível de QV. A pontuação dos pacientes segundo as dimensões avaliadas no MLHFQ foram: dimensão física com mediana 28,5; emocional, 13; outras questões, 21; e, no escore total, 61. O modelo final na análise multivariada demonstrou que a QV está associada a variáveis como classe funcional da IC, número de medicações em uso, número de comorbidades e a ocupação do lar. Discussão e Conclusão: a IC é doença grave, que impacta negativamente na sobrevida e na QV. Neste estudo, o nível de QV dos pacientes esteve associado à classe funcional da IC - NYHA, ao número de medicações em uso e à ocupação do lar. Ações que estimulem e favoreçam a adesão ao tratamento otimizado devem ser incentivadas.(AU)

Introduction: heart Failure (HF) is a serious health problem. Patients with an advanced stage of HF present, besides low life expectancy, a change in the Quality of Life (QoL) level. Objective: to analyze the QoL level of advanced HF patients, candidates or not for Heart Transplantation (HT). Method: a cross-sectional study carried out in a Brazilian university hospital, in which patients were submitted to QoL evaluation by the Minnesota Living With Heart Failure Questionnaire (MLHFQ). Results: 76 patients participated in the study. The main etiology of HF was chagasic (25 patients). The most frequent functional classes were NYHA II (26 patients) and III (33 patients). Patients under evaluation for HT and those in the queue for HT did not show a statistically significant difference in the evaluation of the QoL level. The score of the patients according to the dimensions assessed in the MLHFQ were the following: physical dimension with a median of 28.5; emotional, 13; other questions, 21; and, in the total score, 61. The final model in the multivariate analysis showed that QoL is associated with variables such as HF functional class, number of using medications, number of comorbidities and household occupation. Discussion and Conclusion: HF is a serious disease that ...(AU)

Introducción: la insuficiencia cardíaca (IC) es un problema de salud grave. Los pacientes con IC avanzada tienen, además de baja esperanza de vida, alteraciones en su calidad de vida (CV). Objetivo: analizar la calidad de vida de pacientes con IC avanzada, candidatos o no para trasplante de corazón (TC). Método: estudio transversal realizado en un hospital universitario brasileño, en el que los pacientes se sometieron a una evaluación de calidad de vida mediante el cuestionario Minnesota Living With Heart Failure Questionnaire (MLHFQ). Resultados: 76 pacientes participaron en el estudio. La etiología principal de la insuficiencia cardíaca fue mal de Chagas (25 pacientes). Las clases funcionales más frecuentes fueron NYHA II (26 pacientes) y III (33 pacientes). Los pacientes bajo evaluación para TC y aquellos en fila de espera para TC no mostraron diferencias estadísticamente significativas en la evaluación del nivel de calidad de vida. Las puntuaciones de los pacientes según las dimensiones evaluadas en el MLHFQ fueron: dimensión física con promedio de 28,5; emocional, 13; otros asuntos, 21; y, en el puntaje total, 61. El modelo final en el análisis multivariado demostró que la calidad de vida está asociada con variables como la clase funcional de IC, la cantidad de medicamentos en uso, la cantidad de comorbilidades y la ocupación dueña de casa. Discusión y conclusión: la insuficiencia cardíaca es una enfermedad grave que afecta negativamente la supervivencia y la calidad de vida. En este estudio, el nivel de calidad de vida de los pacientes se asoció con la clase funcional de IC - NYHA, la cantidad de medicamentos en uso y la ocupación dueña de casa. Deben fomentarse acciones que estimulen y favorezcan la adherencia al tratamiento optimizado.(AU)

Profile of Effective Donors for Heart Transplantation: Experience of a Brazilian Center.

BACKGROUND: Brazil's transplant network is a consolidated, worldwide-recognized program, with about 96% of heart transplantations (HTs) financed by its Unified Health System. It is known that the number of HTs has risen in the past few years, but it still does not meet the demand. This study aims to characterize the profile of the heart donors of a Brazilian center and ascertain the factors contributing to the increase in number of HTs. MATERIALS AND METHODS: This is a cross-sectional and analytical study, developed between 2012 and 2018 at a Brazilian transplant center. RESULTS: There were 210 donations for HT in this period. The median age of donors in years (range) was 33 (24-40), and the donors were 15.5 years younger than the recipients (P value < .001). One hundred forty-two donors (67.6%) were male, 98 (46.7%) were mullato, and 115 (54.8%) had cranioencephalic trauma as the cause of brain death. The distance from the transplant center to the organ procurement area was short in 183 (87.1%) cases, enabling a allograft ischemic time with a median of 125 minutes. There was a relevant association between donor age and cause of brain death (P < .001), sex and cause of brain death (P < .001), and organ procurement area and allograft ischemic time (P < .001). Hospitals that provide urgent and emergency care served as sources for a larger number of organ donations. CONCLUSIONS: This study concluded that the profile of most donors for HT include young adult mullato men who were victims of cranioencephalic trauma. In addition, these donors had few comorbidities and a median age of 33 years.

Healthcare waste management in a Brazilian university public hospital.

Some healthcare waste presents hazardousness characteristics and requires specific procedures to ensure the safety management. Waste segregation is an important action to control the risks of each type of waste. Healthcare waste indicators also may improve the waste management system. The aim of this article was to evaluate the healthcare waste management in a Brazilian university hospital, as well as the waste indicators, quantifying and qualifying the waste generation. Weighing of wastes occurred by sampling occurred sampling of seven consecutive days or daily, between 2011 and 2017. General wastes represent more than 55.6% of the total generated, followed by infectious, sharps and chemicals wastes, respectively, 39.1%, 2.9% and 2.4%. The generation rate in 2017 was 4.09 kg bed-1 day-1, including all types of wastes. Non-dangerous wastes represented around 93.3%, including infectious wastes with low potential risks, while dangerous was represented by high infectious risk (1.4%), chemicals (2.4%) and sharps (2.9%). Healthcare waste indicators may favour the risk identification and improve the waste management system, in particular when involving hazardous wastes. Failures in healthcare waste segregation could represent, in addition to the health risks, unnecessary expenses.

Phylogenetic characterization of the first Ungulate tetraparvovirus 2 detected in pigs in Brazil

Abstract Ungulate tetraparvovirus 2 (UTV2) , formerly known as porcine hokovirus due to its discovery in Hong Kong, is closely related to a Primate tetraparvovirus (human PARV-4) and Ungulate tetraparvovirus 1 (bovine hokovirus). Until now, UTV2 was detected in European, Asian and North American countries, but its occurrence in Latin America is still unknown. This study describes the first report of UTV2 in Brazil, as well as its phylogenetic characterization. Tissue samples (lymph node, lung, liver, spleen and kidney) of 240 piglets from eight different herds (30 animals each herd) were processed for DNA extraction. UTV2 DNA was detected by PCR and the entire VP1/VP2 gene was sequenced for phylogenetic analysis. All pigs from this study displayed postweaning multisystemic wasting syndrome (PMWS). UTV2 was detected in 55.3% of the samples distributed in the variety of porcine tissues investigated, as well as detected in almost all herds, with one exception. The phylogenetic analysis demonstrated that Brazilian UTV2 sequences were more closely related to sequences from Europe and United States.

Phylogenetic characterization of the first Ungulate tetraparvovirus 2 detected in pigs in Brazil.

Ungulate tetraparvovirus 2 (UTV2), formerly known as porcine hokovirus due to its discovery in Hong Kong, is closely related to a Primate tetraparvovirus (human PARV-4) and Ungulate tetraparvovirus 1 (bovine hokovirus). Until now, UTV2 was detected in European, Asian and North American countries, but its occurrence in Latin America is still unknown. This study describes the first report of UTV2 in Brazil, as well as its phylogenetic characterization. Tissue samples (lymph node, lung, liver, spleen and kidney) of 240 piglets from eight different herds (30 animals each herd) were processed for DNA extraction. UTV2 DNA was detected by PCR and the entire VP1/VP2 gene was sequenced for phylogenetic analysis. All pigs from this study displayed postweaning multisystemic wasting syndrome (PMWS). UTV2 was detected in 55.3% of the samples distributed in the variety of porcine tissues investigated, as well as detected in almost all herds, with one exception. The phylogenetic analysis demonstrated that Brazilian UTV2 sequences were more closely related to sequences from Europe and United States.

Conformational analysis of 1-chloro- and 1-bromo-2-propanol.

The conformational isomerism of 1-chloro- (1) and 1-bromo-2-propanol (2) was theoretically and spectroscopically (NMR) analyzed. Conformers with the X-C-C-O (X = Cl and Br) fragment in the gauche orientation were found to be strongly prevalent both in the gas phase and solution, as analyzed by means of coupling constants in the diastereotopic methylene hydrogens. The gauche effect was calculated to be due to hyperconjugation rather than intramolecular X···HO hydrogen bond, indicating the rule of the stereochemical control in compounds with motifs (halohydrins) widely found in pharmaceutical and agrochemical products and intermediates.

Quinolines derivatives as novel sunscreening agents.

Currently, the research and development of sunscreens play an important role on the synthesis of actives that are stable in various kinds of formulations-in addition to their efficiency and broad spectrum of protection against ultraviolet radiation. Our objective here was to synthesize new sunscreening chemical agents using quinoline as a base molecule. Twelve quinoline derivatives were synthesized, four of them novel molecules, and their photoprotective activity was determined in vitro using diffuse transmittance spectrophotometry. We determined their SPF, UVAPF, UVA/UVB ratio, critical wavelength and Boots Star Rating. The quinolines derivatives presented a varied profile of photoprotection, their SPF ranging from 2 to 11 and their UVAPF from 2 to 7. In terms of the critical wavelength, all molecules were considered of broad-spectrum by different classifications. Regarding the Boots Star Rating, one compound received no rating, seven of them received a three stars rating, three received a four stars rating and three were given a five stars rating. The molecules showed in the present work have a wide range of possibilities for creating new sunscreen products, once they have good SPF or UVAPF for single molecules, and they also possess other different qualities that can act synergistically.

Biological activities of Solanum sessiliflorum Dunal / Atividades biológicas de Solanum sessiliflorum dunal

This study evaluated the antioxidant, antimicrobial and wound healing activities from the aqueous extract of cubiu (AEC - Solanum sessiliflorum Dunal). The antioxidant activity was evaluated by the scavenging method with 2.2-diphenyl-1.2-picrylhydrazyl radical (DPPH) and, the antimicrobial activity, by the turbidimetric method. The dermal ulcers induced model in rabbits was used in order to study the wound healing activity. Creams containing 5% and 10% AEC and 5% AEC associated with 1% copaiba oil and 1% rosemary oil were tested. The wounds were macroscopically (ulcer aspect and ulcer area contraction) and microscopically examined. The histological study considered the number of inflammatory cells, fibroblasts, blood vessels, collagen and extracellular matrix areas. Analysis of variance (ANOVA) followed by Tukey's post hoc test was performed. The AEC showed IC50=65.12 µg/mL and no antimicrobial activity against all of the strains tested was verified. The formulation containing 5% AEC associated with 1% copaiba oil exhibited the greatest pharmacological potentiality in dermal wound healing due to the increased number of blood vessels (p <0.001) and the largest extracellular matrix area (p <0.001) presented. The results justify further studies about biological activities of cubiu in the search for bioactive compounds.

O presente estudo avaliou as atividades antioxidante, antimicrobiana e cicatrizante do extrato aquoso do cubiu (EAC - Solanum sessiliflorum Dunal). A atividade antioxidante foi avaliada pelo método sequestrante de radicais 2,2-difenil-1,2-picrilhidrazil (DPPH) e, a atividade antimicrobiana, por método turbidimétrico. Para o estudo da atividade cicatrizante foi utilizado o modelo de indução de úlceras dérmicas em coelhos, sendo testados cremes contendo 5% e 10% de EAC e cremes contendo 5% de EAC associado à 1% de óleo de copaíba e à 1% de óleo de alecrim. As lesões foram analisadas macro (aspecto da lesão e contração da área ferida) e microscopicamente. O estudo histológico considerou o número de células inflamatórias, fibroblastos, vasos sanguíneos, e as áreas de colágeno e de matriz extracelular. Foi realizada análise de variância (ANOVA) seguida do teste post hoc de Tukey. O EAC apresentou IC50=65,12 µg/mL e não apresentou atividade antimicrobiana frente a nenhuma das cepas testadas. A formulação contendo 5% de EAC associado a 1% de óleo de copaíba foi a que exibiu maior potencialidade farmacológica na cicatrização de lesões dérmicas, devido ao maior número de vasos sanguíneos (p<0,001) e a maior área de matriz extracelular (p<0,001) apresentados. Os resultados encontrados justificam novos estudos sobre as atividades biológicas do cubiu na busca de compostos bioativos.

Photoprotective activity of resveratrol analogues.

Resveratrol is a promising agent for protecting human skin from UV radiation and to reduce the occurrence of cutaneous malignancies. We describe the photoprotective activity of six resveratrol analogues using the diffuse transmittance technique to determine the SPF and the protection against UVA radiation. The analogues presented a varied profile of photoprotection, the SPF ranging from 2 to 10 and the UVAPF from 0 to 9. Among the six compounds tested, the protection against UVB sunrays provided by compound B was more significant than the protection provided by resveratrol; compounds C, D, E and F show photoprotection similar to resveratrol.

Typing of canine parvovirus strains circulating in Brazil between 2008 and 2010.

Detection and characterisation of the canine parvovirus (CPV-2) strains that are currently circulating are essential for the understanding of viral evolution and the development of measures to control its spread. In the present study, stool samples from 144 dogs were analysed by polymerase chain reaction (PCR) for CPV-2, and 29.2% (42/144) of them were positive. From the 42 positive strains, 71.4% (30) of the dogs had signs of haemorrhagic gastroenteritis. The sequencing of the 583 bp fragment of the VP2 gene from the positive strains identified 78.6% (33/42) of them as type 2c, 19% (8/42) as type 2b and 2.4% (1/42) as type 2a. A phylogenetic analysis of the variants circulating in the canine population of Brazil showed that they are very similar to those found in other countries and type 2c has become the predominant type circulating in Brazil.