Nanoemulsified Essential Oil of Melaleuca leucadendron Leaves for Topical Application: In Vitro Photoprotective, Antioxidant and Anti-Melanoma Activities.

Melanoma, primarily caused by solar ultraviolet (UV) radiation, can be prevented by the use of sunscreens. However, the use of synthetic sunscreens raises environmental concerns. Natural compounds with antioxidant photoprotective properties and cytotoxic effects against cancer cells can be promising for the prevention and treatment of melanoma with less environmental effect. This study focuses on Melaleuca leucadendron essential oil (EO) for photoprotection and antitumor applications. EO was hydrodistilled from M. leucadendron leaves with a 0.59% yield. Gas chromatography-mass spectrometry detected monoterpenes and sesquiterpenes. Nanoemulsions were prepared with (NE-EO) and without EO (NE-B) using the phase inversion method, showing good stability, spherical or oval morphology, and a pseudoplastic profile. Photoprotective activity assessed spectrophotometrically showed that the NE-EO was more effective than NE-B and free EO. Antioxidant activity evaluated by DPPH and ABTS methods indicated that pure and nanoemulsified EO mainly inhibited the ABTS radical, showing IC50 40.72 and 5.30 µg/mL, respectively. Cytotoxicity tests on L-929 mouse fibroblasts, NGM human melanocyte, B16-F10 melanoma, and MeWo human melanoma revealed that EO and NE-EO were more cytotoxic to melanoma cells than to non-tumor cells. The stable NE-EO demonstrates potential for melanoma prevention and treatment. Further research is required to gain a better understanding of these activities.

Benznidazole-Loaded Polymeric Nanoparticles for Oral Chemotherapeutic Treatment of Chagas Disease.

Chagas disease (CD) is a worldwide public health problem. Benznidazole (BZ) is the drug used to treat it. However, in its commercial formulation, it has significant side effects and is less effective in the chronic phase of the infection. The development of particulate systems containing BZ is therefore being promoted. The objective of this investigation was to develop polymeric nanoparticles loaded with BZ and examine their trypanocidal impact in vitro. Two formulas (BNP1 and BNP2) were produced through double emulsification and freeze drying. Subsequent to physicochemical and morphological assessment, both formulations exhibited adequate yield, average particle diameter, and zeta potential for oral administration. Cell viability was assessed in H9C2 and RAW 264.7 cells in vitro, revealing no cytotoxicity in cardiomyocytes or detrimental effects in macrophages at specific concentrations. BNP1 and BNP2 enhanced the effect of BZ within 48 h using a treatment of 3.90 µg/mL. The formulations notably improved NO reduction, particularly BNP2. The findings imply that the compositions are suitable for preclinical research, underscoring their potential as substitutes for treating CD. This study aids the quest for new BZ formulations, which are essential in light of the disregard for the treatment of CD and the unfavorable effects associated with its commercial product.

A Descriptive Study of Corneal Graft Failure in Retransplant Patients.

OBJECTIVE: To identify the main predictors for corneal graft failure in patients who underwent retransplantation. METHOD: This is a cross-sectional research with a quantitative and analytical approach, conducted based on data from secondary sources of a Human Eye Tissue Bank (HETB) in Northeast Brazil. Data were collected from the medical charts of all patients transplanted between January 2010 and December 2014. Descriptive statistics were used for the univariate analysis by means of absolute and relative frequencies and means. For the inferential analysis, the chi-square (X²) and the Fisher's Exact tests were used. RESULTS: A total of 241 records were reviewed, representing 258 keratoplasties, of which 27 (10.46%) were retransplantations due to corneal graft failure. Of the total, 55.56% of the individuals were female, with a mean age of 58.56 years, 55.56% of the population was brown, and the highest relative frequency of housing found was in the Central Mesoregion. Of the corneal graft failure cases, 88.89% were due to late failure, 30.77% of cases were classified as pseudophakic and 11.57% as aphakic. Through inferential analysis, a statistical association was obtained among the variable "corneal graft failure" and mesoregion of the state, presence of glaucoma, vascularization, and classification of the eye. CONCLUSION: The prognosis of keratoplasty is of multifactorial nature. Factors such as mesoregion of the State (place of residence), glaucoma, corneal vascularization, and aphakic eyes represent predictors for graft failure in the analyzed sample.

Novel Fe3O4 Nanoparticles with Bioactive Glass-Naproxen Coating: Synthesis, Characterization, and In Vitro Evaluation of Bioactivity.

Immune response to biomaterials, which is intimately related to their surface properties, can produce chronic inflammation and fibrosis, leading to implant failure. This study investigated the development of magnetic nanoparticles coated with silica and incorporating the anti-inflammatory drug naproxen, aimed at multifunctional biomedical applications. The synthesized nanoparticles were characterized using various techniques that confirmed the presence of magnetite and the formation of a silica-rich bioactive glass (BG) layer. In vitro studies demonstrated that the nanoparticles exhibited bioactive properties, forming an apatite surface layer when immersed in simulated body fluid, and biocompatibility with bone cells, with good viability and alkaline phosphatase activity. Naproxen, either free or encapsulated, reduced nitric oxide production, an inflammatory marker, while the BG coating alone did not show anti-inflammatory effects in this study. Overall, the magnetic nanoparticles coated with BG and naproxen showed promise for biomedical applications, especially anti-inflammatory activity in macrophages and in the bone field, due to their biocompatibility, bioactivity, and osteogenic potential.

Folk medicine, biological activity, and chemical profiles of Brazilian Acanthaceae (Lamiales) - A review.

INTRODUCTION: The botanical family Acanthaceae (order Lamiales) potentially comprises 4900 species in 191 genera with extensive morphological, habit and habitat diversity. The family is widely distributed throughout the world but is especially rich in tropical and subtropical regions. Many of its species have great ornamental importance and are broadly used for medicinal purposes in several countries of Asia and Africa. Brazil is a main center of diversity of the family, where they are distributed across all its biomes, mainly in the herbaceous-shrub stratum. Medicinal investigations about Brazilian species are scarce, the exception being a single native species, Justicia pectoralis Jacq., that is widely used and studied chemically. AIM OF THE REVIEW: This work compiled studies that indicated folk medicinal use, investigated biological activity, or evaluated the chemical composition of Brazilian species of Acanthaceae. MATERIAL AND METHODS: Medicinal uses, investigations of biological activities and chemical data were collected and summarized through bibliographic surveys. Tables were compiled to standardize the information and the appropriate references were gathered for each species. Registration of chemical components used in the treatment of ailments and in preserving health were emphasized with the aim of stimulating future investigations. RESULTS: The breadths of habitats and morphologies of the family are directly related to its chemical diversity, as confirmed here for Brazilian species. Although the investigated species represent less than 9% of the total richness of the family in Brazil, they encompass a great diversity of chemical substances. The data indicated folk medicinal uses for 26 species and biological tests for 23, while 30 species were investigated chemically. Ruellia and Justicia were the most researched genera with 12 and 11 species, representing approximately 14% and 7% of Brazilian species of each genus, respectively. Two species are native to other countries but become naturalized in Brazil. Studies of native species were carried out in different countries around the world, with many reports of medicinal uses and biological tests. Examples of uses include anticancer and antidepressant actions, as well as activities against respiratory problems and other diseases. CONCLUSIONS: This work highlights the chemical and biological diversity of the studied Brazilian species of Acanthaceae, which emphasizes the need to expand studies with native Brazilian species.

Depressive symptoms and associated factors in pregnant women attended in primary healthcare / Síntomas depresivos y factores asociados en gestantes atendidas en atención primaria de salud / Sintomas depressivos e fatores associados em gestantes assistidas na atenção primária à saúde

ABSTRACT Objective: to analyze the prevalence and factors associated with depressive symptoms in pregnant women attended in primary healthcare. Method: this is an epidemiological, cross-sectional and analytical study conducted in Montes Claros, in the north of the state of Minas Gerais, Brazil. The dependent variable (depressive symptoms) and independent variables (sociodemographic characteristics, social support, obstetric characteristics, sexuality and health conditions) were collected through a questionnaire and validated scales. The collection took place between October 2018 and November 2019. Descriptive, bivariate and multiple analyzes were performed through multinomial logistics regression. Results: a sample of 1,279 pregnant women was evaluated. The estimated prevalence of moderate and serious depressive symptoms was 16.2% and 25.2%, respectively. Low social support (p<0.001), low sexual performance (p = 0.002) and a high level of perceived stress (p<0.001) were factors associated with moderate depressive symptoms. First gestational trimester (p = 0.006), low social support (p<0.001), low sexual performance (p<0.001) and a high level of perceived stress (p<0.001) were factors associated with serious depressive symptoms. Conclusion: the prevalence of moderate and serious depressive symptoms in pregnant women attended in primary healthcare was considerable. Factors related to social support, gestational quarter (first quarter), sexuality and perceived stress showed association with these symptoms. Caution and the promotion of mental health is necessary for pregnant women in this scenario.

RESUMEN Objetivo: analizar la prevalencia y factores asociados a síntomas depresivos en gestantes atendidas en Atención Primaria de Salud. Método: se trata de un estudio epidemiológico, transversal y analítico, realizado en Montes Claros, norte del estado de Minas Gerais - Brasil. La variable dependiente (síntomas depresivos) y las variables independientes (características sociodemográficas, apoyo social, características obstétricas, sexualidad y condiciones de salud) se recogieron mediante un cuestionario y escalas validadas. La recolección se realizó entre octubre de 2018 y noviembre de 2019. Se realizaron análisis descriptivos, bivariados y múltiples mediante Regresión Logística Multinomial. Resultados: se evaluó una muestra de 1279 gestantes. Las prevalencias estimadas de síntomas depresivos moderados y graves fueron del 16,2% y el 25,2%, respectivamente. El bajo apoyo social (p<0,001), el bajo rendimiento sexual (p=0,002) y el alto nivel de estrés percibido (p<0,001) fueron factores asociados con síntomas depresivos moderados. El primer trimestre del embarazo (p=0,006), el bajo apoyo social (p<0,001), el bajo rendimiento sexual (p<0,001) y el alto nivel de estrés percibido (p<0,001) fueron factores asociados con síntomas depresivos severos. Conclusión: la prevalencia de síntomas depresivos moderados y graves en gestantes atendidas en Atención Primaria de Salud fue considerable. Factores relacionados con el apoyo social, el trimestre gestacional (primer trimestre), la sexualidad y el estrés percibido se asociaron con estos síntomas. En este escenario, es necesaria una mayor atención a las mujeres embarazadas y la promoción de la salud mental.

RESUMO Objetivo: analisar a prevalência e os fatores associados aos sintomas depressivos em gestantes assistidas na Atenção Primária à Saúde. Método: trata-se de um estudo epidemiológico, transversal e analítico, realizado em Montes Claros, norte do estado de Minas Gerais - Brasil. A variável dependente (sintomas depressivos) e as variáveis independentes (características sociodemográficas, apoio social, características obstétricas, sexualidade e condições de saúde) foram coletadas por meio de questionário e escalas validadas. A coleta ocorreu entre outubro de 2018 e novembro de 2019. Realizaram-se análises descritivas, bivariada e múltipla mediante Regressão Logística Multinomial. Resultados: avaliou-se amostra de 1279 gestantes. As prevalências estimadas de sintomas depressivos moderados e graves foram de 16,2% e 25,2%, respectivamente. Baixo apoio social (p<0,001), baixo desempenho sexual (p=0,002) e elevado nível de estresse percebido (p<0,001) foram fatores associados aos sintomas depressivos moderados. Primeiro trimestre gestacional (p=0,006), baixo apoio social (p<0,001), baixo desempenho sexual (p<0,001) e elevado nível de estresse percebido (p<0,001) foram fatores associados aos sintomas depressivos graves. Conclusão: as prevalências de sintomas depressivos moderados e graves em gestantes assistidas na Atenção Primária à Saúde foram consideráveis. Fatores relativos ao apoio social, ao trimestre gestacional (primeiro trimestre), à sexualidade e ao estresse percebido apresentaram associação a esses sintomas. Nesse cenário, fazem-se necessários o cuidado ampliado às gestantes e a promoção da saúde mental.

Protocolo gráfico de validação para avaliação da assistência de enfermagem segura em hemodiálise / Protocolo gráfico de validación para evaluación de asistencia de enfermería segura en hemodiálisis / Validation graphic protocol for assessing safe nursing care in hemodialysis

Resumo Objetivo Validar o conteúdo e a aparência de um protocolo gráfico para avaliação do cuidado seguro de enfermagem a pacientes em hemodiálise. Método Estudo metodológico com abordagem quantitativa, organizado em três procedimentos: teóricos, a partir de uma scoping review; empíricos, na qual ocorreu processo de construção do protocolo gráfico e checklist para avaliação do cuidado seguro; por fim, os analíticos, para a validação propriamente dita com uso da técnica Delphi e participação de nove juízes especialistas em duas rodadas para o alcance da concordância. Resultados Elaboraram-se o checklist e o protocolo gráfico. Quanto à validade de conteúdo, em Delphi I, três critérios obtiveram Coeficiente de Validade de Conteúdo =0,77 no checklist. No que corresponde ao Delphi II, foram alcançados 80% em todos os itens referentes ao Coeficiente de Validade de Conteúdo, e todos os índices ficaram acima de 0,80. A validação de aparência ocorreu utilizando critérios de Suitability Assessment of Materials no Delphi I. Foi possível atingir um Coeficiente de Validade de Conteúdo total maior que 0,80 em todos, enquanto que, no Delphi II, os protocolos alcançaram concordância maior que 80% e Coeficiente de Validade de Conteúdo maior que 0,88, já que o checklist apresentou maior Coeficiente de Validade de Conteúdo com 0,91. Conclusão Apresentam-se o protocolo gráfico e o checklist para avaliação do cuidado seguro aos pacientes em hemodiálise válidos em seu conteúdo e aparência.

Resumen Objetivo Validar el contenido y la apariencia de un protocolo gráfico para la evaluación del cuidado seguro de enfermería a pacientes en hemodiálisis. Métodos Estudio metodológico con enfoque cuantitativo, organizado en tres procedimientos: teórico, a partir de una scoping review; empírico, donde se realizó el proceso de elaboración del protocolo gráfico y checklist para la evaluación del cuidado seguro; y por último, analítico, para la validación propiamente dicha mediante el uso del método Delphi y la participación de nueve jueces especialistas en dos rondas para alcanzar la concordancia. Resultados Se elaboró la checklist y el protocolo gráfico. Respecto a la validez del contenido, en Delphi I tres criterios obtuvieron Coeficiente de Validez de Contenido = 0,77 en la checklist. En lo referente al Delphi II, se alcanzó el 80 % en todos los ítems relacionados con el Coeficiente de Validez de Contenido, y todos los índices fueron superiores a 0,80. La validación de la apariencia se realizó con los criterios de la Suitability Assessment of Materials en Delphi I. Se logró alcanzar un Coeficiente de Validez de Contenido total mayor a 0,80 en todos, mientras que en Delphi II, los protocolos lograron una concordancia mayor a 80 % y Coeficiente de Validez de Contenido mayor a 0,88, ya que la checklist presentó mayor Coeficiente de Validez de Contenido con 0,91. Conclusión El protocolo gráfico y la checklist para la evaluación del cuidado seguro a pacientes en hemodiálisis demostraron ser válidos en su contenido y apariencia.

Abstract Objective To validate the content and appearance of a graphic protocol for evaluating safe nursing care for hemodialysis patients. Methods Methodological study with a quantitative approach, organized into three procedures: theoretical from a Scoping Review; empirical in which the process of constructing the graphic protocol and checklist for the evaluation of safe care took place; finally, the analytics for the validation itself using the Delphi technique and the participation of nine expert judges in two rounds to reach agreement. Results The checklist and the graphic protocol were elaborated. As for content validity in Delphi I, three criteria obtained Content Validity Coefficient =0.77 in the checklist. In what corresponds to Delphi II, 80% was achieved in all items regarding the Content Validity Coefficient, all indices were above 0.80. Appearance validation took place using criteria of the Suitability Assessment of Materials in Delphi I, it was possible to achieve a total Content Validity Coefficient greater than 0.80 in all, while in Delphi II the protocols reached agreement greater than 80% and Content Validity Coefficient greater than 0.88, since the checklist showed a higher Content Validity Coefficient with 0.91. Conclusion The graphic protocol and checklist for evaluating safe care for hemodialysis patients are presented, valid in their content and appearance.

Common mental disorders in hematopoietic stem cell transplant patients: a scoping review / Trastornos mentales comunes en pacientes con trasplante de células madre hematopoyéticas: revisión del alcance / Transtornos mentais comuns em pacientes transplantados com células-tronco hematopoéticas: revisão de escopo

ABSTRACT Objective: to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. Methods: this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. Results: the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. Conclusions: the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.

RESUMEN Objetivo: mapear los trastornos mentales recurrentes comunes en pacientes sometidos a trasplante de células madre hematopoyéticas. Métodos: se trata de una revisión de alcance realizada en enero de 2022 en bases de datos electrónicas y repositorios de disertaciones y tesis. Se incluyeron publicaciones que respondieron a la pregunta de investigación, cumplieron con el objetivo del estudio y estaban disponibles en su totalidad en formato electrónico, en cualquier idioma. Resultados: la muestra estuvo compuesta por 28 estudios, 14 de los cuales fueron publicados en los Estados Unidos de América. Los trastornos mentales comunes encontrados fueron depresión, ansiedad, estrés postraumático y trastornos del estado de ánimo. Se mencionaron 20 síntomas, entre los más prevalentes se encuentran fatiga y trastornos del sueño/insomnio. Conclusiones: se destacó la dificultad e importancia de realizar el diagnóstico diferencial de estos trastornos, ya que sus síntomas pueden confundirse con otros problemas de salud y tienen un fuerte potencial de interferir en la evolución del paciente.

RESUMO Objetivo: mapear os transtornos mentais comuns recorrentes em pacientes submetidos ao transplante de células-tronco hematopoéticas. Métodos: trata-se de revisão de escopo realizada em janeiro de 2022 em bases de dados eletrônicas e repositórios de dissertações e tese. Foram incluídas publicações que respondessem à questão de pesquisa, atendessem ao objetivo do estudo e que estivessem disponíveis na íntegra em meio eletrônico, em qualquer idioma. Resultados: a amostra foi composta por 28 estudos, dos quais 14 foram publicados nos Estados Unidos da América. Os transtornos mentais comuns encontrados foram os transtornos depressivos, de ansiedade, estresse pós-traumático e de humor. Foram citados 20 sintomas, entre os mais prevalentes estão a fadiga e distúrbios do sono/insônia. Conclusões: evidenciaram-se a dificuldade e a importância de realizar o diagnóstico diferencial desses transtornos, uma vez que seus sintomas podem ser confundidos com outros problemas de saúde e têm forte potencial para interferir na evolução do paciente.

Common mental disorders in hematopoietic stem cell transplant patients: a scoping review.

OBJECTIVE: to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. METHODS: this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. RESULTS: the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. CONCLUSIONS: the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.

Anti-Trypanosoma cruzi Potential of Vestitol Isolated from Lyophilized Red Propolis.

Chagas disease (CD) is a worldwide public health problem, and the drugs available for its treatment have severe limitations. Red propolis is a natural extract known for its high content of phenolic compounds and for having activity against T. cruzi. The aim of this study was to investigate the trypanocidal potential of red propolis to isolate, identify, and indicate the mode of action of the bioactive compounds. The results revealed that the total phenolic content was 15.4 mg GAE/g, and flavonoids were 7.2 mg QE/g. The extract was fractionated through liquid-liquid partitioning, and the trypanocidal potential of the samples was evaluated using the epimastigote forms of the Y strain of T. cruzi. In this process, one compound was characterized by MS, 1H, and 13C NMR and identified as vestitol. Cytotoxicity was evaluated employing MRC-5 fibroblasts and H9C2 cardiomyocytes, showing cytotoxic concentrations above 15.62 µg/mL and 31.25 µg/mL, respectively. In silico analyses were applied, and the data suggested that the substance had a membrane-permeation-enhancing effect, which was confirmed through an in vitro assay. Finally, a molecular docking analysis revealed a higher affinity of vestitol with farnesyl diphosphate synthase (FPPS). The identified isoflavan appears to be a promising lead compound for further development to treat Chagas disease.

Transition of Care for Individuals with Mental Disorders in Brazil: A Contextual Analysis.

OBJECTIVE: To describe the contexts of care transition for individuals with mental disorders in the Brazilian setting. METHODS: A contextual analysis was conducted through a scoping review. The search for studies was conducted in databases and thesis and dissertation portals, and the analysis was based on immediate, specific, general, and meta-contexts. RESULTS: The sample, consisting of eight studies, indicated that the following factors are present in the contexts where care transition occurs: Peculiarities of care transition for individuals with mental disorders; Perspectives that can strengthen or weaken this transition; Approaches proposed in the past for the development of care transition; and Elements related to Brazilian legislation. FINAL CONSIDERATIONS: It is observed that the transition of care for individuals with mental disorders in Brazil takes place in various contexts of care levels. These variations present significant potentials and barriers in the care scenarios.

Music and Tactile Stimuli during Daily Milking Affect the Welfare and Productivity of Dairy Cows.

The objective of this study was to evaluate the effects of tactile stimuli and music during daily milking on the productive, physiological, well-being, and health parameters of dairy cows. The experiment, which lasted 39 days, was conducted on a commercial farm with forty crossbred cows (age: 36 to 42 months; weight: 350 to 400 kg) distributed in a completely randomized design (2 × 2) via the following treatments: (Con)-cows not exposed to stimuli, (Tac)-cows exposed to tactile stimuli before milking, (Mus)-cows exposed to music during milking, (Tac+Mus)-cows exposed to both stimuli. In this study, classical music with a slow (75 to 107 BPM) and moderate tempo (90 to 100 BPM) was played, and tactile stimuli was provided manually using a flexible stick in the posterior region and udders of the cows. Cows not exposed to any of the stimuli had up to 41% higher residual milk quantity compared to those exposed to one of or both of the stimuli. The sound stimulus promoted an increase in milk letdown before the start of milking. Cows exposed to stimuli showed higher serotonin levels, indicating a beneficial effect on animal well-being. However, cows exposed to pre-milking tactile stimuli showed an increase in somatic cell count. Combining both techniques may have positive effects on milk productivity and well-being. However, using music alone may be more recommendable as it does not pose health risks.

Implementação da Prática Avançada de Enfermagem no enfrentamento do atraso vacinal: um relato de experiência / Implementation of Advanced Practice Nursing in coping with vaccine delay: an experience report

OBJETIVO: Descrever a implementação de práticas avançadas de enfermagem para abordar o atraso na imunização em crianças menores de dois anos de idade. MÉTODO: Trata-se de um relato de experiência que monitorou a situação vacinal de crianças menores de dois anos e descreveu práticas avançadas de enfermagem para melhorar a adesão à vacinação. RESULTADOS: Foi monitorado o estado vacinal das crianças e realizadas ações e intervenções individuais e coletivas, como consultas individuais, buscas ativas, ligações telefônicas e mensagens via aplicativo de celular, educação continuada e produção de materiais educativos para conscientização entre a comunidade, pais/responsáveis e profissionais de saúde sobre a importância de manter o calendário vacinal atualizado, conforme proposto pelo Programa Nacional de Imunizações. CONCLUSÃO: As intervenções neste relatório demonstraram implicações importantes para a saúde pública e podem sugerir que as práticas avançadas de enfermagem têm um impacto positivo na melhoria da cobertura vacinal.

OBJECTIVE: To describe the implementation of advanced practice nursing to address delayed immunization in children under two years of age. METHOD: This experience report monitored the immunization status of children under two years of age and described advanced practice nursing to improve immunization compliance. RESULTS: The immunization status of children was monitored, and individual and collective actions and interventions were carried out, such as individual consultations, active searches, telephone calls and messages via a mobile phone application, ongoing education, and the production of educational materials to raise awareness among the community, parents/guardians and health professionals about the importance of keeping the immunization schedule up to date, as proposed by the Brazilian National Immunization Program. CONCLUSION: The interventions in this report have demonstrated important public health implications and may suggest that advanced nursing practices positively impact improving immunization coverage.

Changes in the skin characteristics of Nellore steers during the rearing phase in hot climate pasture supplemented with protein sources.

We hypothesized that the protein source in supplements and the insolation and ambient temperature changes in different seasons could cause changes in the skin of Nellore steers during the rearing phase on warm-climate pasture. The objective of this study was to evaluate the effects of replacing true protein (soybean meal) with NPN (extruded urea) in the supplement on the skin characteristics of steers grazing on Marandu grass pastures. Thirty-six Nellore steers with an average initial weight of 250.0 kg and 15 months of age were used. Skin biopsies were performed at three different times: summer, autumn, and winter. The protein source has effects on the length of the glandular portion, number of follicles, and gland area in steers during the rearing phase at different seasons of the year. In the summer, the skin presented a higher compact structure, while in the autumn and winter, the skin presented a sparser arrangement. Skin from steers that received soybean meal in supplement had a more significant number of follicles in the summer and a smaller area and length of sweat glands. The dermis thickness of steers supplemented with soybean meal was greater than that of urea supplemented. The epidermis thickness and dermis of the steers' skin were greater at the autumn (April). Sweat gland depth was greater in autumn (April) and winter (July) than in summer (December). The protein source in the supplement alters the skin characteristics by increasing of dermis thickness of Nellore steers during the growth phase. The insolation and ambient temperature changes in different seasons alter the skin structure by increasing the epidermis and dermis thickness, sweat glands depth, and glands area of the skin of steers during the growth phase.

Transition of care in post-hospitalization patients due to covid-19 in a hospital in northeastern Brazil.

OBJECTIVE: To analyze the transition of care for post-hospitalization patients due to covid-19 in a hospital in northeastern Brazil. METHODS: Quantitative, cross-sectional, descriptive, and analytical study carried out between 2020 and 2021. The sample had 78 patients. Data collection took place by telephone with the support of a sociodemographic questionnaire and the care transition assessment instrument (Care Transitions Measure). RESULTS: The average length of stay was 24.04 days. The average score for care transition was 71.68 (±11.71). "Self-management training" and "Understanding of medications" had higher averages, 75.15 (±13.76) and 74.10 (±16.20). CONCLUSIONS: The average length of stay was 24.04 days. The average score for care transition was 71.68 (±11.71). "Self-management training" and "Understanding of medications" had higher averages, 75.15 (±13.76) and 74.10 (±16.20).

Olfactory Stimulation as Environmental Enrichment for Domestic Horses-A Review.

Horses constantly face several challenges inherent to the domestic environment, and it is common for the expression of their natural behavior to be drastically limited. Environmental enrichment has been suggested as an alternative to improve the captive situation of domestic horses. Among the recently proposed enrichment strategies, olfactory stimulation has emerged as a method for improving several aspects related to animal behavior. Olfaction is a sensory modality that plays a significant role in the expression of equine behavior, and in recent years, studies have shown that olfactory stimulation can influence the physiological and behavioral parameters of horses. This review provides current information on the anatomical particularities of the equine olfactory system, presents the physiological mechanisms involved in the odor detection process, and demonstrates how stress can interfere with this process. Finally, the use of olfactory stimulation as an environmental enrichment for domestic horses (Equus ferus caballus) is explored. The need for new studies that answer pertinent questions related to this topic is discussed throughout the manuscript.

Structure-based discovery of novel cruzain inhibitors with distinct trypanocidal activity profiles.

Over 110 years after the first formal description of Chagas disease, the trypanocidal drugs thus far available have limited efficacy and several side effects. This encourages the search for novel treatments that inhibit T. cruzi targets. One of the most studied anti-T. cruzi targets is the cysteine protease cruzain; it is associated with metacyclogenesis, replication, and invasion of the host cells. We used computational techniques to identify novel molecular scaffolds that act as cruzain inhibitors. First, with a docking-based virtual screening, we identified compound 8, a competitive cruzain inhibitor with a Ki of 4.6 µM. Then, aided by molecular dynamics simulations, cheminformatics, and docking, we identified the analog compound 22 with a Ki of 27 µM. Surprisingly, despite sharing the same isoquinoline scaffold, compound 8 presented higher trypanocidal activity against the epimastigote forms, while compound 22, against the trypomastigotes and amastigotes. Taken together, compounds 8 and 22 represent a promising scaffold for further development of trypanocidal compounds as drug candidates for treating Chagas disease.

Controlled Release and Cell Viability of Ketoconazole Incorporated in PEG 4000 Derivatives.

In recent years, polymeric materials have been gaining prominence in studies of controlled release systems to obtain improvements in drug administration. These systems present several advantages compared with conventional release systems, such as constant maintenance in the blood concentration of a given drug, greater bioavailability, reduction of adverse effects, and fewer dosages required, thus providing a higher patient compliance to treatment. Given the above, the present work aimed to synthesize polymeric matrices derived from polyethylene glycol (PEG) capable of promoting the controlled release of the drug ketoconazole in order to minimize its adverse effects. PEG 4000 is a widely used polymer due to its excellent properties such as hydrophilicity, biocompatibility, and non-toxic effects. In this work, PEG 4000 and derivatives were incorporated with ketoconazole. The morphology of polymeric films was observed by AFM and showed changes on the film organization after drug incorporation. In SEM, it was possible to notice spheres that formed in some incorporated polymers. The zeta potential of PEG 4000 and its derivatives was determined and suggested that the microparticle surfaces showed a low electrostatic charge. Regarding the controlled release, all the incorporated polymers obtained a controlled release profile at pH 7.3. The release kinetics of ketoconazole in the samples of PEG 4000 and its derivatives followed first order for PEG 4000 HYDR INCORP and Higuchi for the other samples. Cytotoxicity was determined and PEG 4000 and its derivatives were not cytotoxic.

Oral and oropharyngeal cancer: time from first symptoms to treatment initiation and associated factors.

The aim of this study was to evaluate the time elapsed from first symptoms to the treatment of oral and oropharyngeal cancer (OOC) and to identify variables associated with treatment delay. This is an observational study with retrospective and prospective data collection. Patients with a diagnosis of OOC seen at the Head and Neck Surgery outpatient clinic of a Brazilian public hospital were included and followed up to treatment initiation. Participants answered a questionnaire for the collection of socioeconomic, demographic, cultural, and clinical information, as well as information about the time elapsed from first symptoms to the first appointment with a head and neck surgeon. Time to treatment was classified into four intervals: 1- first symptoms to first medical appointment; 2- first medical appointment to specialized medical care; 3- specialized medical care to preparation for treatment; and 4- preparation for treatment to treatment initiation. Bivariate statistics were computed. Out of 100 participants, nine died before treatment. Mean time to treatment was 217 days. Highest mean time was observed for interval 2 (94 days), followed by interval 1 (63 days), interval 4 (39 days), and interval 3 (21 days). At interval 1, a longer time was associated with severe alcohol consumption, severe smoking, and family history of cancer. At interval 2, the delay was associated with appointment with a general practitioner, clinical diagnosis of disease other than cancer, and antibiotic prescription. At interval 4, delay in treatment was associated with surgical treatment. Patients with OOC experience delays from symptom onset to treatment initiation. The longest interval was associated with professional delay, followed by patient delay in help-seeking.

Voice Disorders and Mental health of Basic Education Teachers in a Brazilian Municipality.

OBJECTIVE: To identify associations with voice disorders in elementary school teachers of a Brazilian municipality STUDY DESIGN: This was a quantitative cross-sectional and analytical study with probability sampling carried out in the 2016 school year METHOD: Self-report of vocal complaints was used for the dependent variable vocal disorder. The independent variables were sociodemographic and occupational characteristics, working conditions that generate discomfort, habits and behaviors, mental health and self-perception of health. For the evaluation of the Burnout Syndrome (BS), the questionnaire Cuestionário para la Evaluación del Syndrome de Quemarse por el Trabajo (CESQT) was used and, for depression, the Beck Depression Inventory (BDI) scale instrument. Multiple fit models were used applying the Binary Logistic Regression RESULTS: A total of 634 teachers participated in this study. There was a predominance of women (85.3%) with mean age 40.6 years (SD ±9.5); 62.1% were married, 70.2% had children and a mean teaching time of 12.9 years (SD ±8.4); 19.3% had voice disorders; 14.5% experienced BS and 24.0% depression. Voice disorders were associated with women (OR=2.30) working longer weekly hours (OR=1.75), with psycho-emotional problems, with burnout (OR=1.95) and depressive symptoms (OR=1.70), and were also associated with women who reported negative self-perception of health (OR= 1.97) CONCLUSION: Voice disorders appear to be strongly associated with mental health problems, mainly in women, in those with a longer working week and those who reported a negative perception of health. Public policies are required to prevent psycho-emotional problems and for vocal health promotion of the teaching category.