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Background: Colorectal cancers (CRCs) from people with biallelic germline likely pathogenic/pathogenic variants in MUTYH or NTHL1 exhibit specific single base substitution (SBS) mutational signatures, namely combined SBS18 and SBS36 (SBS18+SBS36), and SBS30, respectively. The aim was to determine if adenomas from biallelic cases demonstrated these mutational signatures at diagnostic levels. Methods: Whole-exome sequencing of FFPE tissue and matched blood-derived DNA was performed on 9 adenomas and 15 CRCs from 13 biallelic MUTYH cases, on 7 adenomas and 2 CRCs from 5 biallelic NTHL1 cases and on 27 adenomas and 26 CRCs from 46 non-hereditary (sporadic) participants. All samples were assessed for COSMIC v3.2 SBS mutational signatures. Results: In biallelic MUTYH cases, SBS18+SBS36 signature proportions in adenomas (mean±standard deviation, 65.6%±29.6%) were not significantly different to those observed in CRCs (76.2%±20.5%, p-value=0.37), but were significantly higher compared with non-hereditary adenomas (7.6%±7.0%, p-value=3.4×10-4). Similarly, in biallelic NTHL1 cases, SBS30 signature proportions in adenomas (74.5%±9.4%) were similar to those in CRCs (78.8%±2.4%) but significantly higher compared with non-hereditary adenomas (2.8%±3.6%, p-value=5.1×10-7). Additionally, a compound heterozygote with the c.1187G>A p.(Gly396Asp) pathogenic variant and the c.533G>C p.(Gly178Ala) variant of unknown significance (VUS) in MUTYH demonstrated high levels of SBS18+SBS36 in four adenomas and one CRC, providing evidence for reclassification of the VUS to pathogenic. Conclusions: SBS18+SBS36 and SBS30 were enriched in adenomas at comparable proportions observed in CRCs from biallelic MUTYH and biallelic NTHL1 cases, respectively. Therefore, testing adenomas may improve the identification of biallelic cases and facilitate variant classification, ultimately enabling opportunities for CRC prevention.
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This study aims to analyze the protective and destructive critical processes of 34 water women in the municipalities of Cabo de Santo de Agostinho and Ipojuca, Pernambuco, Brazil, from February/21 to August/22. The work process stages were systematized by the work flowchart, and we employed Breilh's critical processes matrix to organize the data. The destructive processes identified in the general domain were injustice and socio-environmental vulnerability, such as the economic development model, the Suape Industrial Port Complex, the 2019 oil spill crime disaster, the COVID-19 pandemic, and the difficult access to public policies; in the particular domain: overloads and extended working hours, use of rudimentary equipment and tools, and unequal gender, class, and race relationships; in the singular domain: physical and mental illnesses and deaths. The protective processes identified in the general domain were sustainable development objectives, public health, and social assistance policies; in the particular domain, group work and processing, consumption for subsistence; in the singular domain, fishing as a therapeutic, pleasurable, and sharing process. The study highlighted the central issues of the water women and the need to establish public policies targeting their care.
Objetivou-se analisar os processos críticos, protetores e destrutivos do trabalho de 34 mulheres das águas nos municípios de Cabo de Santo de Agostinho e Ipojuca (PE), de fevereiro de 2021 a agosto de 2022. As etapas do processo de trabalho foram sistematizadas pelo fluxograma do trabalho e organizadas na matriz de processos críticos de Breilh. Os processos destrutivos, no domínio geral, foram: injustiça e vulnerabilização socioambiental como modelo de desenvolvimento econômico, o Complexo Industrial Portuário de Suape, o desastre-crime de petróleo ocorrido em 2019, a pandemia de COVID-19 e dificuldade de acesso às políticas públicas; no particular: jornadas e sobrecargas de trabalho, uso de equipamentos e ferramentas rudimentares e relações desiguais de gênero, classe e raça; no singular: adoecimentos físicos, mentais e mortes. Os processos protetores, no domínio geral: os objetivos de desenvolvimento sustentável, políticas públicas de saúde e assistência social; no particular: trabalho e beneficiamento em grupo, consumo para subsistência; no singular: a pesca como processo terapêutico, prazeroso e de partilha. O estudo destacou os problemas centrais das mulheres das águas e a necessidade do estabelecimento de políticas públicas voltadas ao seu cuidado.
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COVID-19 , Brasil , Feminino , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pesqueiros , Adulto , Política Pública , Saúde Pública , Pessoa de Meia-Idade , Desenvolvimento SustentávelRESUMO
Sourdough production is a complex fermentation process. Natural sourdough fermentation without standardization causes great variability in microbial communities and derived products. Starter cultures have emerged as alternatives to natural fermentation processes, which could improve bakery quality and produce bioactive compounds. This study aimed to evaluate the impacts of freeze-drying on the production and viability of sourdoughs with Lactiplantibacillus pentosus 129 (Lp) and Limosilactobacillus fermentum 139 (Lf), as well as their effects on the quality of long-fermentation bread. These strains were selected based on their better performance considering acidification and exopolysaccharide production capacity. Sourdough with Lp and Lf were propagated until the 10th day, when physicochemical and microbiological parameters were determined. The produced sourdoughs were freeze-dried, and bread samples were produced. The freeze-drying process resulted in high survival rates and few impacts on the metabolic activity of Lp and Lf until 60 days of storage. Incorporating Lp and Lf improved the microbiological and physicochemical properties of sourdough and long-fermentation breads. Tested freeze-dried sourdoughs led to reduced bread aging (higher specific volume and decreased starch retrogradation) and increased digestibility. The results show the potential of the freeze-dried sourdoughs produced with Lp and Lf as innovative strategies for standardizing production protocols for the bakery industry, especially for producing long-term fermentation bread.
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As pescadoras artesanais do litoral de Pernambuco enfrentam os impactos das indústrias, do derramamento de petróleo e da pandemia de covid-19, conformando uma sindemia que agrava as vulnerabilidades socioe-conômicas, ambientais e sanitárias. Objetivou-se demonstrar que estratégias de comunicação e divulgação científica, como a cartilha "Saúde das mulheres das águas" e o documentário O mar que habita em mim, são importantes por promoverem a democratização do conhecimento. Trata-se de pesquisa-ação do tipo etnográfica para identificar aspectos do trabalho e da vida. Participaram 34 pescadoras, mediante grupos focais, oficina de fluxograma laboral, vivência do trabalho da pesca, análise e produção de estratégias. Esses materiais demonstram a relação saúde doença no trabalho da pesca enfatizando narrativas sobre deter-minação social da saúde. As estratégias comunicativas provocaram interesse da sociedade, promoveram debate e contribuíram para a consciência de profissionais/gestores de saúde sobre os povos das águas e as situações nos territórios.
Artisanal fisherwomen of Pernambuco face the impacts of the industries, of an oil spill and of the covid-19 pandemic, forming a syndemic that aggravates socioeconomic, environmental and health vulnerabilities. The objective was to demonstrate that scientific communication and dissemination strategies, such as the booklet "Saúde das mulheres das águas" and the documentary O mar que habita em mim, promote knowledge. This is an ethnographic type of action research to identify aspects of work and life. A total of 34 artisanal fisherwomen participated, in focus groups, labor flowchart workshop, experience of fishing work, analysis and production of strategies. These materials demonstrate the health disease relationship in fishing work, emphasizing the narratives of the fisherwomen about the social determination of their health. The communicative strategies provoked society's interests, promoted the debate and contributed to the awareness of professionals and health managers about the health of water's people and situations in the territories.
Pescadoras artesanales de pernambucano enfrentan impactos de industrias, derrame de petróleo y la pandemia de covid-19, formando una sindemia que agrava vulnerabilidades socioeconómicas, ambientales y de salud. El objetivo fue demostrar que las estrategias de comunicación y divulgación científica, como el folleto "'Salud das mujeres das aguas" y el documentario El mar que habita en mí, democratizan el conocimiento. Tiene abordaje de investigación-acción, etnográfica, para identificar aspectos del trabajo y la vida. Participaron 34 pescadoras en grupos focales, taller del flujo de trabajo, vivencia del trabajo en la pesca, análisis y elaboración de estrategias. Estos materiales demuestran la relación salud enfermedad en el trabajo pesquero, enfatizando narrativas sobre la determinación social de la salud. Las estrategias comu-nicativas despertaron el interés de la sociedad, promovieron el debate y contribuyeron a la sensibilización de los profesionales/gestores de la salud sobre los pueblos de las aguas y las situaciones de los territorios.
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Mulheres , Comunicação , Risco à Saúde Humana , Meio Ambiente , Comunicação e Divulgação Científica , Comunicação em Saúde , Pesqueiros , Equidade de Gênero , Vulnerabilidade Social , Fatores Socioeconômicos , Trabalho , Impactos da Poluição na Saúde , Indústria de Petróleo e Gás , COVID-19RESUMO
BACKGROUND AND PURPOSE: Chronic neuropathic pain (NP) is commonly associated with cognitive and emotional impairments. Cannabidiol (CBD) presents a broad spectrum of action with a potential analgesic effect. This work investigates the CBD effect on comorbidity between chronic NP, depression, and memory impairment. EXPERIMENTAL APPROACH: The connection between the neocortex and the hippocampus was investigated with biotinylated dextran amine (BDA) deposits in the prelimbic cortex (PrL). Wistar rats were submitted to chronic constriction injury (CCI) of the sciatic nerve and CA1 treatment with CBD (15, 30, 60 nmol). KEY RESULTS: BDA-labeled perikarya and terminal buttons were found in CA1 and dentate gyrus. CCI-induced mechanical and cold allodynia increased c-Fos protein expression in the PrL and CA1. The number of astrocytes in PrL and CA1 increased, and the number of neuroblasts decreased in CA1. Animals submitted to CCI procedure showed increasing depressive-like behaviors, such as memory impairment. CBD (60 nmol) treatment decreased mechanical and cold allodynia, attenuated depressive-associated behaviors, and improved memory performance. Cobalt chloride (CoCl2: 1 nM), WAY-100635 (0.37 nmol), and AM251 (100 nmol) intra-PrL reversed the effect of CA1 treatment with CBD (60 nmol) on nociceptive, cognitive, and depressive behaviors. CONCLUSION: CBD represents a promising therapeutic perspective in the pharmacological treatment of chronic NP and associated comorbidities such as depression and memory impairments. The CBD effects possibly recruit the CA1-PrL pathway, inducing neuroplasticity. CBD acute treatment into the CA1 produces functional and molecular morphological improvements.
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Canabidiol , Disfunção Cognitiva , Hipocampo , Neocórtex , Neuralgia , Ratos Wistar , Animais , Canabidiol/farmacologia , Canabidiol/uso terapêutico , Masculino , Neuralgia/tratamento farmacológico , Ratos , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Disfunção Cognitiva/tratamento farmacológico , Neocórtex/efeitos dos fármacos , Hiperalgesia/tratamento farmacológico , Vias Neurais/efeitos dos fármacos , Sintomas Afetivos/tratamento farmacológico , Sintomas Afetivos/etiologiaRESUMO
The Caatinga biome occurs only in Brazil and offers epidemiological conditions that should be assessed differently from other regions of Brazil and the world. Thus, the aim of this survey was to identify antimicrobial resistance, enterotoxin and biofilm production genes in Staphylococcus spp. isolated from facilities and fomites in a veterinary hospital in Caatinga biome. Samples were collected from surfaces of small animal clinical care tables (n =8), cages in the dog and cat hospitalisation sector and animals with infectious diseases (n = 21), small animal surgical centre (n =8), sterilisation sector (n =7) and stethoscopes (n = 32) by using sterile swabs. Bacterial isolation and identification, antimicrobial resistance phenotypic test and molecular detection of antimicrobial resistance, biofilm formation and enterotoxin genes were carried out. Ninety-five bacterial isolates were obtained, and 29 (30.5%) were identified as Staphylococcus spp. Overall, 13 isolates (44.8%) of six species of Staphylococcus spp. showed antimicrobial resistance profile, as well as S. haemolyticus expressed phenotypic profile of multidrug resistance. The antimicrobials with the highest resistance rates were penicillin and tetracycline. The most frequent resistance genes were blaZ and tetM, both detected in 10 (76.9%) isolates. The mecA, tetL and tetK genes had frequencies of 38.5% (5/13), 23.1% (3/13) and 15.4% (2/13), respectively. The biofilm production marker, icaD gene, was detected in one S. sciuri strain. SEE gene, which encodes enterotoxins, was detected in 15.4% (2/13) of the strains (S. pseudintermedius and S. intermedius). The occurrence of Staphylococcus spp. carrying resistance genes to diferent classes of antimicrobials, presenting MDR phenotypic pattern and carrying enterotoxins and biofim encoding genes recovered from veterinary hospital facilities and fomites in the Caatinga biome reinforce the need to implement prevention cares in veterinary practices to avoid One Health-concerning conditions.
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INTRODUÇÃO: A osteorradionecrose (ORN) é uma complicação associada ao tratamento radioterápico em região de cabeça e pescoço, caracteriza-se como a formação de osso necrótico e desvitalizado. Possui sinais e sintomas como dor, formação de fístula intra ou extraoral, exposição óssea, trismo, fratura patológica e sequestro ósseo. A proposta terapêutica mais eficaz é o debridamento ósseo e dos tecidos moles afetados associado a antibioticoterapia. A radioterapia reduz a vascularização do tecido, causando hipóxia e reduzindo sua capacidade de regeneração tecidual. Diante de um caso de trauma, a reparação não será efetiva e o tecido pode progredir para um tecido necrótico e desvitalizado. RELATO DE CASO: Paciente gênero feminino, 59 anos com diagnóstico de Insuficiência Mitral grave estágio D de provável etiologia reumática, fibrilação atrial em uso de anticoagulante antagonista de vitamina K, histórico de tratamento radioterápico de neoplasia de língua há oito anos e extração dentária recente. Como queixa principal, dor de difícil controle medicamentoso. Ao exame físico extraoral apresentava edema, hiperemia em região submandibular direita efístula com drenagem de exsudato purulento.No exame físico intraoral desdentada total superior e inferior sem uso de prótese dentáriacom presença de exposição óssea em rebordo alveolar de aproximadamente 5cm na região inferior anterior e posterior do lado direito. A hipótese diagnóstica foi de ORN. Conduta realizada em conjunto com equipe de cirurgia bucomaxilofacial de serviço externofoi debridamento de tecido ósseo necrótico em região de rebordo alveolar até região de parassínfise esquerda para remoção de tecido ósseo desvitalizado, antibioticoterapia e acompanhamento odontológico semanal com sessões de laserterapia de baixa potência e terapia fotodinâmica. Após a realização de cirurgia cardíaca para troca da valva paciente evoluiu com fratura patológica em mandíbula e foiencaminhada para ressecção parcial de mandíbulasob anestesia geral. No pós-operatório apresentoudiscreta assimetria facial, ausência de exposição óssea e regressão total da sintomatologia dolorosa. CONSIDERAÇÕESFINAIS: O manejo da ORN é considerado desafiador em pacientes tratados com radioterapia de cabeça e pescoço. O caso evidencia a importânciado diagnóstico e tratamento correto para evitar complicações tardias que reduzam a qualidade de vida. O cirurgião-dentista deve estar atento à prevenção dessa condição.
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Insuficiência da Valva MitralRESUMO
INTRODUÇÃO: Os anticoagulantes orais são administrados principalmente para prevenção de eventos tromboembólicos, o antagonista da Vitamina K (AVK) mais utilizado é a Varfarina, pertencente ao grupo dos cumarínicos. As diversas interações medicamentosas e alimentares podem aumentar sua biodisponibilidade sanguínea de forma a potencializar o seu efeito. O controle da anticoagulação deve ser realizado com a monitorização terapêuticado tempo de protrombina (TP) e aRazão Normalizada Internacional (RNI), cuja dose varia para cada indivíduo. A hemorragia é o efeito adverso mais comum do anticoagulante. Valores de RNI > 5 estão associados a risco de sangramento e a reversão do efeito do AVK pode ser conseguido com várias medidas, desde a simples suspensão da droga, a administração de vitamina K ou a administração de plasma fresco congelado (PFC) ou complexo protrombínico, de acordo com a urgência da situação. O sinal clínico mais frequente é o sangramento muco-cutâneo e, em casos de eventos traumáticos favorece a formação de equimose e hematomas. RELATO DE CASO: Paciente gênero masculino, 77 anos com diagnóstico de Miocardiopatia Chagásica com Insuficiência Cardíaca fração de ejeção reduzida (30%), em uso de anticoagulante antagonista de vitamina K, com histórico de queda da própria altura. Foi solicitada a interconsulta da equipe de odontologia, por sangramento ativo em cavidade oral e queixa de trauma por mordida. Ao exame físico extraoral paciente contactuante verbal, deambulante com auxílio, dieta via oral assistida e abertura mandibular preservada. No exame físico intraoral paciente desdentado superior em uso de prótese total e dentado parcial inferior em uso de prótese parcial removível, com presença de lesões arroxeadas em região de ventre lingual e assoalho bucal do lado direito e em região de dorso de língua com laceração característica de trauma por mordida do lado direito de aproximadamente 1 centímetro de diâmetro com relato de sintomatologia dolorosa. Solicitado o exame laboratorial com resultado de RNI 10.0. O diagnóstico foi hematoma como manifestação bucal de intoxicação cumarínica. Foi realizada laserterapia para analgesia e cicatrização do local traumatizado, e discussão com equipe médica que prescreveu três doses de vitamina K e duas bolsas de plasma para reversão do quadro. CONSIDERAÇÕES FINAIS: O caso apresenta a importância da avaliação odontológica para diagnóstico e tratamento imediato no contexto hospitalar e na atividade multiprofissional, além de reduzir possíveis complicações sistêmicas durante a internação.
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CumarínicosRESUMO
INTRODUÇÃO: A COVID-19, infecção respiratória causada pelo vírus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), é capaz de provocar complicações graves devido ao mecanismo de resposta inflamatória exacerbada pelo aumento de biomarcadores inflamatórios (tempestade de citocinas). O SARS-CoV-2 tem acesso àscélulas por meio do acoplamento da proteína Spike (proteína-S) ao receptor localizado na enzima conversora de angiotensina-2 (ECA2). Pacientes hipertensos apresentam maior expressão de ECA2 devido à ação de medicamentos anti-hipertensivos, tornando-os mais vulneráveis ao contágio e complicações da COVID-19. Além dos agravos no sistema estomatognático relacionados à saúde debilitada do paciente e às intercorrências da internação, sabe-se que piores condições de saúde oral aumentam a produção de citocinas inflamatórias por ação, por exemplo, de patógenos periodontais, podendo agravar consideravelmente quadros da COVID-19. OBJETIVO: Avaliar a influência da higiene oral no desfecho clínico de pacientes hipertensos com COVID-19 em um hospital terciário de cardiologia, além de descrever as variáveis demográficas. MÉTODO: Estudo quantitativo e descritivo de prontuários odontológicos de pacientes hipertensos adultos com COVID-19 em Enfermaria e Unidade de Terapia Intensiva de um hospital cardiológico no período de março de 2021 a março de 2022. A análise das variáveis foi realizada com auxílio do software R versão 4.1.2 e testes de hipótese baseados no teste-Z para comparações entre proporções. RESULTADOS: Dentre os 79 prontuários eletrônicos avaliados, 78% apresentava diagnóstico de hipertensão arterial sistêmica. Entre os hipertensos, o gênero masculino foi o mais prevalente (75%) e a idade média foi de 64,2 anos. Cerca de 53% dos hipertensos apresentavam higiene oral insatisfatória diagnosticada pelo Índice de Higiene Oral do Paciente Crítico (IHOPC). Ao comparar a proporção de óbitos entre pacientes com higiene oral insatisfatória e a presença ou não de hipertensão arterial sistêmica, identificou-se correlação significativa entre hipertensos com higiene oral insatisfatória e piores desfechos (óbito). Conclusão: Dentro das limitações do estudo, conclui-se que hipertensos infectados por Sars- -Cov-2 e com higiene oral insatisfatória apresentam piores prognósticos. A precariedade na condiçaÌo oral de doentes crônicos associada aos agravos da COVID-19 e pela própria doença de base ressalta a necessidade do reforço nos cuidados orais a doentes críticos, além de realçar a importância da presença do cirurgião-dentista em ambiente hospitalar
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The pathogenic nature of infections caused by Candida spp. underscores the necessity for novel therapeutic agents. Extracts of Schinopsis brasilienses Engl are \ a promising source of agents with antifungal effects. This study aimed to assess the antifungal potential of the leaf extract of S. brasilienses. The antifungal activity was evaluated by determining the minimum inhibitory concentrations and fungicide concentrations (MIC and MFC). The antibiofilm potential was assessed by counting colony-forming units/mL. The study examined the inhibition kinetics of fungal growth and potential synergism between gallic acid or the extract and nystatin using the Checkerboard method. Cytotoxicity was evaluated through the MTT assay. The extract exhibited antifungal effect against all tested strains, with MIC and MFC ranging from 31.25-250 µg/mL. Gallic acid, the main isolated compound, displayed a MIC of 2000 µg/mL. The extract of S. brasilienses at 31.25 µg/mL inhibited the formation of biofilm by C. albicans and significantly reduced the mass of mature biofilm after 24 and 48 h (p < 0. 05). At a concentration of 125 µg/mL, the extract demonstrated significant inhibition of fungal growth after 6 hours. The combination of gallic acid or extract with nystatin did not exhibit synergistic or antagonistic effect. Furthermore, the extract did not induce cytotoxicity to a human cell line. The extract of S. brasiliensis demonstrates antifungal activity against Candida, generally exhibiting fungicidal action and capacity to inhibit biofilm formation as well as reduce mature biofilms. Additionally, the extract showed low cytotoxicity to human cells.
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Anacardiaceae , Candida , Humanos , Antifúngicos , Nistatina , Candida albicans , Biofilmes , Ácido Gálico , Extratos VegetaisRESUMO
We evaluated the diagnostic clinical performance characteristics (DCPC) of cerebrospinal fluid (CSF) total protein (TP), white blood cell count (WBC), and lactate (LA) with different cutoff points as adjunct biomarkers of confirmed or presumptive symptomatic neurosyphilis (NS) and the impact of HIV infection. From 5,640 participants who underwent lumbar punctures, 236 participants were included, and classified as either people with HIV (PWH) or people without HIV (PWoH) according to the CDC criteria for confirmed NS (n = 42), presumptive NS (n = 74), systemic syphilis (SS) (n = 38), serological diagnosis of syphilis (n = 18), PWH without SS and NS (n = 10), and negative control (n = 72). In PWoH, for presumptive NS, the combination of CSF TP > 45 mg/dL and/or WBC > 5.0 cells/mm3 is valuable for screening, whereas in PWH, it is not recommended for either screening or case-finding NS, however the DCPC were better in the suppressed group. In PWoH, the value of CSF TP > 45 mg/dL is adequate for both screening and confirmation of presumptive NS, subject to prevalence. For WBC count > 20 cell/mm3, the positive predictive value (PPV) of the test is almost perfect, suggesting a confirmatory test. In PWH, CSF TP is an inadequate marker of NS. The WBC count, with cutoffs of > 10 or > 20 cells/mm3, was moderately applicable for screening.As conclusions: CSF WBC count and TP showed distinct DCPC in confirmed or presumptive NS, better in the former. These biomarkers could be included for presumptive NS diagnosis. DCPC of these biomarkers for the diagnosis of NS is greatly affected by HIV co-infection.
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Com o surgimento da pandemia causada pelo vírus da severe acute respiratory syndrome (SARS-CoV-2), necessitou-se implementar medidas de controle hospitalar, a fim de evitar a propagação e reinfecção dos pacientes acometidos. Assim, objetivou-se identificar as estratégias adotadas pela enfermagem no enfrentamento da covid-19, mediante revisão integrativa da literatura nas bases de dados: SciELO, LILACS e BVS, de 2019 a 2022. Selecionou-se palavras-chave seguindo os Descritores de Ciências da Saúde (DeCS) e operadores booleanos. A transmissão do novo coronavírus ocorre de pessoa para pessoa, por inalação ou contato com gotículas respiratórias do indivíduo infectado com incubação de dois a 14 dias. Os sintomas variam entre febre, tosse, dor de garganta, dificuldade respiratória, e outros. A alta transmissibilidade do vírus alastrou-se de forma rápida e frequente, sendo necessário se atentar à segurança dos profissionais de saúde e dos pacientes, por meio da correta utilização dos equipamentos de proteção individual (EPI) e da sistematização da assistência de enfermagem, na qual o enfermeiro direciona e coordena, de forma individualizada, a prestação da assistência ao paciente na unidade de saúde, observando os sinais e sintomas para determinar a gravidade do quadro clínico e prestar todos os cuidados necessários. Este trabalho proporcionou uma visão ampla das estratégias adotadas pelos profissionais de enfermagem, destacando a atuação corajosa, ativa e contínua deles na linha de frente do enfrentamento da pandemia, com prestação da assistência integral de qualidade aos pacientes.
The emergence of the pandemic caused by the severe acute respiratory syndrome virus (SARS-CoV-2) required implementing hospital control measures to prevent the spread and reinfection of affected patients. Thus, this study analyzes practices used by nurses to combat COVID-19 by means of an integrative literature review. Bibliographic search was conducted in the SciELO, LILACS and BVS databases from 2019 to 2022 using DeCS descriptors and Boolean operators. COVID-19 transmission occurs from person to person through inhalation or contact with respiratory droplets from infected individuals with incubation of 2 to 14 days. Symptoms range from fever, cough, sore throat, difficulty breathing to more severe reactions. Its high transmissibility lead to a quick and frequent spread, demanding better attention to professional and patient safety through the correct use of PPEs and the systematization of nursing care, in which nurses direct and coordinate the provision of individualized care to patients the health unit, observing signs and symptoms to determine clinical severity and provide all necessary care. The present work gave a broad view of the strategies adopted by nursing professionals, highlighting their courageous, active and continuous actions on the front line to combat the pandemic, providing comprehensive quality care to patients.
La pandemia provocada por el virus del síndrome respiratorio agudo severo (SARS-CoV-2) requirió la implementación de medidas de control hospitalario para evitar la propagación y reinfección de los pacientes afectados. En este contexto, se pretende identificar las estrategias de afrontamiento de la covid-19 utilizadas por la enfermería; para ello, se realizó una revisión integradora de la literatura en las bases de datos SciELO, LILACS y BVS en el período de 2019 a 2022. Las palabras clave se seleccionaron siguiendo los Descriptores de las Ciencias de la Salud (DeSC) y los operadores booleanos. El nuevo coronavirus se propaga de persona a persona mediante la inhalación o contacto con gotículas respiratorias de la persona infectada en un período de incubación de 2 días a 14 días. Los síntomas van desde fiebre, tos, dolor de garganta, dificultad para respirar, entre otros. La propagación del virus se dio de manera rápida y frecuente, por lo que se requirió prestar atención a la seguridad de los profesionales de la salud y de los pacientes, mediante el uso correcto de los equipos de protección individual (EPI) y la sistematización de los cuidados de enfermería, en que el enfermero dirige y coordina, de manera individualizada, la atención al paciente en la unidad de salud, observando sus signos y síntomas para determinar la gravedad del cuadro clínico y brindarle los cuidados necesarios. Este trabajo proporciona una visión amplia de las estrategias adoptadas por los profesionales de enfermería, con su acción valiente, activa y continua en primera línea en el afrontamiento a la pandemia, brindando una atención integral de calidad a los pacientes.
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The aim of the study was to evaluate the efficacy of anthropometric, metabolic, and endocrine abnormalities as predictors of estimated average glucose and other biomarkers of dysglycemia in women with different phenotypes of polycystic ovary syndrome (PCOS). This cross-sectional study included 648 women with PCOS and 330 controls. A single protocol of investigation was applied for all subjects. PCOS women were divided by phenotypes according to the Rotterdam criteria. Biomarkers of dysglycemia were considered dependent variables and anthropometric, lipid, and hormone alterations as independent variables using univariate and multivariate logistic regressions. Univariate logistic regression analysis, controlled for age and BMI, showed that many biomarkers of dysglycemia could be predicted by anthropometric, lipid, and endocrine variables. Multivariate logistic models showed that in non-PCOS women estimated average glucose (eAG) was predicted by lower TSH levels (OR=0.39; p=0.045); fasting glucose was predicted by increased T (OR=2.3). For PCOS, phenotype A, eAG was predicted by decreased HDL-C (OR=0.17, p=0.023) and high levels of free estradiol (OR=7.1, p<0.001). Otherwise, in PCOS, phenotype D, eAG was predicted by higher levels of HDL-C. The current study demonstrated that eAG was poorly predicted by anthropometric, lipid, and hormone parameters. Nevertheless, without adding significant benefits, it was comparable with other established markers of dysglycemia in women with different PCOS phenotypes.
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Abstract The pathogenic nature of infections caused by Candida spp. underscores the necessity for novel therapeutic agents. Extracts of Schinopsis brasilienses Engl are / a promising source of agents with antifungal effects. This study aimed to assess the antifungal potential of the leaf extract of S. brasilienses. The antifungal activity was evaluated by determining the minimum inhibitory concentrations and fungicide concentrations (MIC and MFC). The antibiofilm potential was assessed by counting colony-forming units/mL. The study examined the inhibition kinetics of fungal growth and potential synergism between gallic acid or the extract and nystatin using the Checkerboard method. Cytotoxicity was evaluated through the MTT assay. The extract exhibited antifungal effect against all tested strains, with MIC and MFC ranging from 31.25-250 μg/mL. Gallic acid, the main isolated compound, displayed a MIC of 2000 μg/mL. The extract of S. brasilienses at 31.25 μg/mL inhibited the formation of biofilm by C. albicans and significantly reduced the mass of mature biofilm after 24 and 48 h (p < 0. 05). At a concentration of 125 μg/mL, the extract demonstrated significant inhibition of fungal growth after 6 hours. The combination of gallic acid or extract with nystatin did not exhibit synergistic or antagonistic effect. Furthermore, the extract did not induce cytotoxicity to a human cell line. The extract of S. brasiliensis demonstrates antifungal activity against Candida, generally exhibiting fungicidal action and capacity to inhibit biofilm formation as well as reduce mature biofilms. Additionally, the extract showed low cytotoxicity to human cells.
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RESUMO Objetivo construir e validar conteúdo de instrumento para avaliação socioestrutural e comportamental associado à infecção pelo HIV em jovens. Método estudo metodológico, desenvolvido em duas etapas: elaboração do instrumento; e validação de conteúdo. Os itens que compuseram o instrumento foram selecionados através de revisão literária, tendo como referencial os domínios multiníveis do Modelo Social Ecológico Modificado, categorizados em componentes socioestruturais e comportamentais. O conteúdo foi avaliado por especialistas em duas rodadas conduzidas pela técnica Delphi, admitindo-se um índice de concordância de, no mínimo, 80%. Resultados a primeira versão do instrumento continha 52 itens, distribuídos em três domínios. Na primeira rodada, 19 itens (36,5%) obtiveram Índice de Validade de Conteúdo inferior a 0,80, dois itens foram excluídos e os demais foram reformulados. Na segunda rodada, 2 itens foram excluídos e 3 foram incorporados como subitem, totalizando 45 itens. O Índice de Validade de Conteúdo do Instrumento foi de 95%. Conclusão e implicações para a prática as recomendações dos especialistas contribuíram para a qualificação do instrumento Avaliação Socioestrutural e Comportamental-HIV, possibilitando a reorganização do conteúdo. O instrumento é válido para a identificação de fatores socioestruturais e comportamentais associados à infecção pelo HIV em jovens, com potencial para constituir planejamento de cuidados preventivos.
RESUMEN Objetivo construir y validar el contenido de un instrumento de evaluación socioestructural y conductual asociada a la infección por VIH en jóvenes. Método estudio metodológico, desarrollado en dos etapas: elaboración del instrumento; y validación de contenido. Los ítems que conformaron el instrumento fueron seleccionados a través de una revisión literaria, tomando como referencia los dominios multinivel del Modelo Ecológico Social Modificado, categorizados en componentes socioestructurales y conductuales. El contenido fue evaluado por expertos en dos rondas realizadas mediante la técnica Delphi, suponiendo una tasa de acuerdo de al menos el 80%. Resultados la primera versión del instrumento contuvo 52 ítems, distribuidos en tres dominios. En la primera ronda, 19 ítems (36,5%) tuvieron un Índice de Validez de Contenido inferior a 0,80, dos ítems fueron excluidos y el resto fueron reformulados. En la segunda ronda, se excluyeron 2 ítems y se incorporaron 3 como subítems, totalizando 45 ítems. El Índice de Validez de Contenido del Instrumento fue del 95%. Conclusión e implicaciones para la práctica las recomendaciones de los expertos contribuyeron para la calificación del instrumento Evaluación Socioestructural y del Comportamiento-VIH, permitiendo la reorganización del contenido. El instrumento es válido para identificar factores socioestructurales y conductuales asociados a la infección por VIH en jóvenes, con potencial para constituir una planificación de atención preventiva.
ABSTRACT Objective to construct and validate the content of an instrument for sociostructural and behavioral assessment associated with HIV infection in young people. Method a methodological study developed in two steps: instrument elaboration; and content validity. The items that made up the instrument were selected through a literary review using the Modified Social Ecological Model multilevel domains as a reference, categorized into sociostructural and behavioral components. Content was assessed by experts in two rounds conducted using the Delphi technique, assuming an agreement rate of at least 80%. Results the first version of the instrument contained 52 items, distributed across three domains. In the first round, 19 items (36.5%) had a Content Validity Index lower than 0.80, two items were excluded and the rest were reformulated. In the second round, 2 items were excluded and 3 were incorporated as subitems, totaling 45 items. The Instrument Content Validity Index was 95%. Conclusion and implications for practice experts' recommendations contributed qualifying the Sociostructural and Behavioral Assessment-HIV instrument, enabling content reorganization. The instrument is valid for identifying socio-structural and behavioral factors associated with HIV infection in young people, with the potential to constitute preventive care planning.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Infecções por HIV/epidemiologia , HIV , Saúde do Adolescente , Populações Vulneráveis , Determinantes Sociais da Saúde , Análise MultinívelRESUMO
Familial hypercholesterolemia (FH) is a common genetic disorder of lipid metabolism caused by pathogenic/likely pathogenic variants in LDLR, APOB, and PCSK9 genes. Variants in FH-phenocopy genes (LDLRAP1, APOE, LIPA, ABCG5, and ABCG8), polygenic hypercholesterolemia, and hyperlipoprotein (a) [Lp(a)] can also mimic a clinical FH phenotype. We aim to present a new diagnostic tool to unravel the genetic background of clinical FH phenotype. Biochemical and genetic study was performed in 1,005 individuals with clinical diagnosis of FH, referred to the Portuguese FH Study. A next-generation sequencing panel, covering eight genes and eight SNPs to determine LDL-C polygenic risk score and LPA genetic score, was validated, and used in this study. FH was genetically confirmed in 417 index cases: 408 heterozygotes and 9 homozygotes. Cascade screening increased the identification to 1,000 FH individuals, including 11 homozygotes. FH-negative individuals (phenotype positive and genotype negative) have Lp(a) >50 mg/dl (30%), high polygenic risk score (16%), other monogenic lipid metabolism disorders (1%), and heterozygous pathogenic variants in FH-phenocopy genes (2%). Heterozygous variants of uncertain significance were identified in primary genes (12%) and phenocopy genes (7%). Overall, 42% of our cohort was genetically confirmed with FH. In the remaining individuals, other causes for high LDL-C were identified in 68%. Hyper-Lp(a) or polygenic hypercholesterolemia may be the cause of the clinical FH phenotype in almost half of FH-negative individuals. A small part has pathogenic variants in ABCG5/ABCG8 in heterozygosity that can cause hypercholesterolemia and should be further investigated. This extended next-generation sequencing panel identifies individuals with FH and FH-phenocopies, allowing to personalize each person's treatment according to the affected pathway.
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Hipercolesterolemia , Hiperlipoproteinemia Tipo II , Humanos , Pró-Proteína Convertase 9/genética , Hipercolesterolemia/genética , LDL-Colesterol/genética , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/diagnóstico , Fenótipo , Patrimônio Genético , Receptores de LDL/genética , MutaçãoRESUMO
Resumo Objetivou-se analisar os processos críticos, protetores e destrutivos do trabalho de 34 mulheres das águas nos municípios de Cabo de Santo de Agostinho e Ipojuca (PE), de fevereiro de 2021 a agosto de 2022. As etapas do processo de trabalho foram sistematizadas pelo fluxograma do trabalho e organizadas na matriz de processos críticos de Breilh. Os processos destrutivos, no domínio geral, foram: injustiça e vulnerabilização socioambiental como modelo de desenvolvimento econômico, o Complexo Industrial Portuário de Suape, o desastre-crime de petróleo ocorrido em 2019, a pandemia de COVID-19 e dificuldade de acesso às políticas públicas; no particular: jornadas e sobrecargas de trabalho, uso de equipamentos e ferramentas rudimentares e relações desiguais de gênero, classe e raça; no singular: adoecimentos físicos, mentais e mortes. Os processos protetores, no domínio geral: os objetivos de desenvolvimento sustentável, políticas públicas de saúde e assistência social; no particular: trabalho e beneficiamento em grupo, consumo para subsistência; no singular: a pesca como processo terapêutico, prazeroso e de partilha. O estudo destacou os problemas centrais das mulheres das águas e a necessidade do estabelecimento de políticas públicas voltadas ao seu cuidado.
Abstract This study aims to analyze the protective and destructive critical processes of 34 water women in the municipalities of Cabo de Santo de Agostinho and Ipojuca, Pernambuco, Brazil, from February/21 to August/22. The work process stages were systematized by the work flowchart, and we employed Breilh's critical processes matrix to organize the data. The destructive processes identified in the general domain were injustice and socio-environmental vulnerability, such as the economic development model, the Suape Industrial Port Complex, the 2019 oil spill crime disaster, the COVID-19 pandemic, and the difficult access to public policies; in the particular domain: overloads and extended working hours, use of rudimentary equipment and tools, and unequal gender, class, and race relationships; in the singular domain: physical and mental illnesses and deaths. The protective processes identified in the general domain were sustainable development objectives, public health, and social assistance policies; in the particular domain, group work and processing, consumption for subsistence; in the singular domain, fishing as a therapeutic, pleasurable, and sharing process. The study highlighted the central issues of the water women and the need to establish public policies targeting their care.
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Resumo Objetivo Identificar a percepção de pessoas idosas que cuidam de outras pessoas idosas sobre o cuidado oferecido, assim como as estratégias de enfrentamento de dificuldades nesse processo sob a ótica da Teoria de Coping no contexto da covid-19. Método Trata-se de um estudo fenomenológico, com pessoas idosas e participantes do Programa Universidade Aberta à Maturidade da Universidade Estadual da Paraíba, que também são cuidadoras de pessoas idosas. Os instrumentos de coleta de dados foram: questionário sociodemográfico e roteiro semiestruturado. Foram realizadas entrevistas por meio de videochamada e os dados foram avaliados pela Análise do Conteúd Resultados Participaram 17 idosos cuidadores com idades entre 60 e 79 anos. Foram elencadas três categorias temáticas: 1) Dificuldades enfrentadas no período da pandemia; 2) Estratégias de enfrentamento utilizadas na época da pandemia; 3) Necessidades de melhoria na execução da função de cuidador. Conclusão Houve evidência de aumento do estresse, presença de ansiedade e risco de sobrecarga. Nessas circunstâncias, desenvolveram estratégias de enfrentamento através da educação, uso de redes sociais e de busca por apoio.
Abstract Objective To identify the perception of older adults who are caregivers for other older adults about the care offered, as well as the strategies for coping with difficulties in this process from the perspective of Coping Theory in the context of COVID-19. Method This is a henomenological study, with elderly people and participants in the Universidade Aberta à Maturidade, Program of the State University of Paraíba. Data collection instruments were a sociodemographic questionnaire, and semi-structured script. Interviews were carried out via video call and the data was evaluated by Content Analysis. Results 17 elderly caregivers aged between 60 and 79 years participated. Three thematic categories were listed: 1) Difficulties faced during the pandemic period; 2) Coping strategies used during the pandemic; 3) Needs for improvement in the performance of the caregiver role. Conclusion we found evidence of increased stress, presence of anxiety and risk of overload. In these circumstances, the participants developed coping strategies through education, use of social networks and seeking support.
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Objective:To analyze the effect of methylene blue and 10% curcumin in fungi and bacteria through an in vitrostudy using photodynamic therapy (PDT). Methods:Curcumin and methylene blue were photosensitized by a Photon Lase III laser applied for 90 s in a dark environment within a laminar flow chamber. Enterococcus faecalisand Candida albicans strains were cultured and standardized.Then, a minimum inhibitoryconcentration (MIC) assay was conducted for these photosensitizers, with concentration variations and incubation to evaluate their antimicrobial activity. Results:With PDT, Curcumin had significant antibacterial activity against E. faecalis (MIC = 250 µg/mL).In contrast, methylene blue had antibacterial activity against E. faecalis (MIC < 12.5 µg/mL with PDT) and antifungal activity against C. albicans (MIC <12.5 µg/mL with or without PDT).Both agents showed greater efficacy in the presence of the laser.The results suggest that curcumin and methylene blue associated with laser may effectively treat microbial infections. Conclusion:Further research is needed to evaluate the efficacy and safety of using these agents in animal and human models and theireffectiveness against different bacterial and fungal strains.
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INTRODUCTION: The uniqueness of the way of life of rural riverside populations is of interest because they are the largest traditional Amazonian population. Their eating habits reveal their life conditions and relationship with the urban environment and is a poorly investigated subject. This research aimed to describe and analyze the food consumption of Amazonian riverside populations based on the food types consumed and reported by the families. METHODS: A cross-sectional study was carried out on the rural riverside population occupying part of the riverbank of Rio Negro, in Manaus County, North Brazil. This population can only be accessed by river. Random, systematic, stratified sampling was conducted on 287 households. A questionnaire about consumed food, socioeconomic conditions and food obtainment was applied. The analysis was performed in R software. Descriptive statistical analysis and log-binomial regression were carried out. RESULTS: It was observed that eating habits were mainly based on in natura (unprocessed) or minimally processed foods, according to the food classification system NOVA. Food diversity was low and the most consumed food types were coffee, flour and rice. The influence of small local markets, income and traditional practices on food intake based on food processing level was also observed. Thus, the chances of eating fish in locations with a small grocery shop were lower (p=0.009) and of eating chicken were higher (p≤0.001). The chances of consuming in natura or minimally processed foods among the literate population (p=0.041) with higher income (p≤0.001) were higher. The chances of eating processed foods were lower where fishing (p=0.007) and farming (p=0.009) were practiced. CONCLUSION: Based on these unexpected results, the present research highlights the food consumption of a riverside population and reduces the shortage of information about the largest traditional Amazonian population.