Sexual violence against children and adolescents in Paraná State: geospatial analysis and main socioeconomic indicators.

OBJECTIVE: Child sexual violence is a multidimensional problem of many contemporary societies, affecting people of all sexes, social stratum and age groups. Offenses involving children and adolescents are more serious, given their total or partial dependence on parents and caregivers. Information on child sexual violence in Brazil is found in raw form and without detail. The objective was to compare the information with social and economic data in the state of Paraná. METHODS: The authors conducted a retrospective study of secondary data from the Notifiable Diseases Information System (SINAN) on cases of sexual violence involving victims aged 0 to 19 years. Results are presented according to notification characteristics. The authors applied exploratory spatial data analysis to assess spatial autocorrelations and investigated relationships by the ordinary least squares regression model. RESULTS: Between 2017 and 2021, there were 13,403 reports of child sexual violence in Paraná State, Brazil. Most victims (82.8%) were female and aged between 10 and 14 years. The majority of sexual violence cases (67.8%) occurred in the home environment. The highest rates on a population basis were observed in the North Central and Greater Curitiba regions, mainly in cities with higher population density and with higher rates of other types of violence. CONCLUSION: The results provide data that can promote a broader understanding of the distribution of sexual violence and the state and associated variations. It is expected to improve the provision of care for victims of child sexual violence and assist in strategic planning to prevent future offenses.

Extraction of Bioactive Compounds From Cannabis sativa L. Flowers and/or Leaves Using Deep Eutectic Solvents.

The increasing demand for medical cannabis urges the development of new and effective methods for the extraction of phytocannabinoids. Deep eutectic solvents (DESs) are an alternative to the use of hazardous organic solvents typically used in the industry. In this study, hydrophilic and hydrophobic DESs were developed based on terpenes, sugars, and natural organic acids as green extraction media for the extraction of cannabis bioactive compounds. The factors influencing the extraction of bioactive components, such as the type of DESs and extraction time, were investigated. Initial screening in hemp showed that the DES composed of Men: Lau (a 2:1-M ratio) had a greater extraction efficiency of cannabidiol (CBD) and cannabidiolic acid (CBDA) (11.07 ± 0.37 mg/g) of all the tested DESs and higher than ethanol. Besides having a higher or equivalent extraction yield as the organic solvents tested, DESs showed to be more selective, extracting fewer impurities, such as chlorophyll and waxes. These results, coupled with the non-toxic, biodegradable, low-cost, and environmentally friendly characteristics of DESs, provide strong evidence that DESs represent a better alternative to organic solvents.

A double edged-sword - The Complement System during SARS-CoV-2 infection.

In the past 20 years, infections caused by coronaviruses SARS-CoV, MERS-CoV and SARS-CoV-2 have posed a threat to public health since they may cause severe acute respiratory syndrome (SARS) in humans. The Complement System is activated during viral infection, being a central protagonist of innate and acquired immunity. Here, we report some interactions between these three coronaviruses and the Complement System, highlighting the central role of C3 with the severity of these infections. Although it can be protective, its role during coronavirus infections seems to be contradictory. For example, during SARS-CoV-2 infection, Complement System can control the viral infection in asymptomatic or mild cases; however, it can also intensify local and systemic damage in some of severe COVID-19 patients, due to its potent proinflammatory effect. In this last condition, the activation of the Complement System also amplifies the cytokine storm and the pathogenicity of coronavirus infection. Experimental treatment with Complement inhibitors has been an enthusiastic field of intense investigation in search of a promising additional therapy in severe COVID-19 patients.

Recurrent arterial thrombosis in a patient with Fabry disease: case report.

Fabry disease is a rare disease, defined as an X-linked lysosomal deposition disease that presents with multisystemic symptoms, including vascular impairment with thrombotic events. A 57-year-old female patient diagnosed with Fabry disease 11 years previously, presented with hyperhidrosis, hypoacusis, and angiokeratoma on the hands. Her previous pathological history included an episode of ischemic stroke before the age of 40 years and chronic acute thrombosis in the right lower limb, 1 year previously, which had been treated with stent angioplasty, with temporary improvement followed by recent relapse of the condition. Thrombotic events fit the typical symptoms of Fabry disease and are caused by deposition of globotriaosylceramide in the vascular endothelium, constituting a prothrombotic state and explaining the recurrence of symptoms and arterial thrombosis in the lower limb.

Quercetin pentaacetate inhibits in vitro human respiratory syncytial virus adhesion.

Human respiratory syncytial virus (hRSV) is one of the main etiological agents of diseases of the lower respiratory tract and is often responsible for the hospitalization of children and the elderly. To date, treatments are only palliative and there is no vaccine available. Natural products show exceptional structural diversity and they have played a vital role in drug research. Several investigations focused on applied structural modification of natural products to improved metabolic stability, solubility and biological actions them. Quercetin is a flavonoid that presents several biological activities, including anti-hRSV role. Some works criticize the pharmacological use of Quercetin because it has low solubility and low specificity. In this sense, we acetylated Quercetin structure and we used in vitro and in silico assays to compare anti-hRSV function between Quercetin (Q0) and its derivative molecule (Q1). Q1 shows lower cytotoxic effect than Q0 on HEp-2 cells. In addition, Q1 was more efficient than Q0 to protect HEp-2 cells infected with different multiplicity of infection (0.1-1 MOI). The virucidal effects of Q0 and Q1 suggest interaction between these molecules and viral particle. Dynamic molecular results suggest that Q0 and Q1 may interact with F-protein on hRSV surface in an important region to adhesion and viral infection. Q1 interaction with F-protein showed ΔG= -14.22 kcal/mol and it was more stable than Q0. Additional, MTT and plate assays confirmed that virucidal Q1 effects occurs during adhesion step of cycle hRSV replication. In conclusion, acetylation improves anti-hRSV Quercetin effects because Quercetin pentaacetate could interact with F-protein with lower binding energy and better stability to block viral adhesion. These results show alternative anti-hRSV strategy and contribute to drug discovery and development.

Trombose arterial recorrente em paciente com doença de Fabry: relato de caso / Recurrent arterial thrombosis in a patient with Fabry disease: case report

Resumo A doença de Fabry é definida como uma doença rara de depósito lisossomal ligada ao cromossomo X que apresenta sintomas multissistêmicos, incluindo comprometimento vascular com eventos trombóticos. Paciente do sexo feminino, 57 anos, com diagnóstico de doença de Fabry há 11 anos, apresentava hiperidrose, hipoacusia e angioqueratoma nas mãos. Na história patológica pregressa, relatou episódio de acidente vascular encefálico isquêmico prévio aos 40 anos de idade e trombose arterial crônica agudizada em membro inferior direito há 1 ano, a qual foi tratada por meio de angioplastia com uso de stent, apresentando melhora temporária e recente recidiva do quadro. Os eventos trombóticos se enquadram nos sintomas típicos da doença de Fabry, e são resultantes do depósito de globotriaosilceramida no endotélio vascular, implicando em um estado pró-trombótico, justificando a reincidência dos sintomas e da trombose arterial em membro inferior.

Abstract Fabry disease is a rare disease, defined as an X-linked lysosomal deposition disease that presents with multisystemic symptoms, including vascular impairment with thrombotic events. A 57-year-old female patient diagnosed with Fabry disease 11 years previously, presented with hyperhidrosis, hypoacusis, and angiokeratoma on the hands. Her previous pathological history included an episode of ischemic stroke before the age of 40 years and chronic acute thrombosis in the right lower limb, 1 year previously, which had been treated with stent angioplasty, with temporary improvement followed by recent relapse of the condition. Thrombotic events fit the typical symptoms of Fabry disease and are caused by deposition of globotriaosylceramide in the vascular endothelium, constituting a prothrombotic state and explaining the recurrence of symptoms and arterial thrombosis in the lower limb.

Transcatheter arterial chemoembolization of hepatocellular carcinoma in a patient with celiac trunk occlusion: a therapeutic challenge.

Transcatheter arterial chemoembolization is a technique for provoking ischemia and cytotoxic activity by selectively injecting microspheres containing chemotherapy drugs into vessels supplying a tumor. An 87-year-old female patient on palliative treatment for hepatocellular carcinoma and with indications for chemoembolization underwent preparatory angiography, which revealed celiac trunk occlusion. The treatment option chosen was selective catheterization of the hepatic artery proper to release the chemotherapy agent via an alternative route through the superior mesenteric artery with communication using the pancreaticoduodenal arcade. Studies have reported evidence showing increased survival after chemoembolization and also reduced tumor growth rate. However, difficulties with accessing and catheterizing the artery feeding the tumor via the alternative access make the procedure a challenge, because of the tortuosity of the pancreaticoduodenal arcade.

Evaluation of thromboprophylaxis in medium-sized general hospital / Avaliação de tromboprofilaxia em hospital geral de médio porte

CONTEXT: Deep vein thrombosis (DVT) is a serious, common disease whose complications include pulmonary thromboembolism (PTE) and postthrombotic syndrome. The importance and benefits of correct and effective pharmacological prophylaxis for DVT are well documented. OBJECTIVES: The aims of this study were to evaluate adequacy of prophylaxis for DVT and PTE at the Santa Casa de Misericórdia de Ponta Grossa (SCMPG), Paraná, Brazil, and determine risk stratification for patients hospitalized in this institution. METHODS: A cohort study was conducted to assess DVT prophylaxis of patients hospitalized on May 15th, 2009. The study population consisted of a sample of 104 patients, subdivided into clinical and surgical groups and stratified into different specialties. Correct use of DVT prophylaxis was evaluated according to recommendations published by The Brazilian Society for Angiology and Vascular Surgery and took into account prophylactic methods specified explicitly in information found in each patient's medical chart. RESULTS: Of the 104 patients interviewed, 51 (49.04%) were clinical patients and 53 (50.96%) surgical. Based on risk stratification, 17 (16.35%) were classified as low risk, 37 (35.58%) as moderate risk, 46 (44.23%) as high risk and 4 (3.85%) as extremely high risk for DVT/PTE. A total of 68 patients (65.38%) received prophylaxis, but of these only 56 (53.85%) received the correct prophylaxis, and 36 (34.62%) did not receive any prophylaxis. CONCLUSION: The rates of prophylaxis use for DVT and PTE in this service are higher than rates published in the literature. .

CONTEXTO: A trombose venosa profunda (TVP) é uma doença frequente e grave, tendo como complicações o tromboembolismo pulmonar (TEP) e a síndrome pós-trombótica. A importância e os benefícios de uma correta e efetiva profilaxia medicamentosa em relação à TVP estão bem documentados. OBJETIVOS: Este trabalho tem por objetivos avaliar a adequação das profilaxias de TVP e TEP na Santa Casa de Misericórdia de Ponta Grossa (SCMPG), Paraná, e estratificar o perfil de risco. MÉTODOS: Realizou-se um estudo de coorte, com a finalidade de avaliar a profilaxia da TVP nos pacientes internados no dia 15 de maio de 2009. Uma amostra de 104 pacientes foi dividida em grupos clínico e cirúrgico, e estratificada em diferentes especialidades. A correta utilização da profilaxia para TVP foi avaliada segundo recomendações da Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV), considerando-se métodos profiláticos presentes nas informações explícitas encontradas na prescrição médica de cada paciente. RESULTADOS: Dos 104 pacientes entrevistados, 51 (49,04%) eram pacientes clínicos e 53 (50,96%) eram cirúrgicos. De acordo com a estratificação do risco, 17 (16,35%) foram classificados como baixo risco, 37 (35,58%) como risco moderado, 46 (44,23%) como alto risco e 4 (3,85%) como altíssimo risco para TVP e TEP. Do total de pacientes, 68 (65,38%) receberam profilaxia, sendo que, deste número, apenas 56 (53,85%) receberam uma profilaxia correta e 36 (34,62%) não receberam nenhuma profilaxia. CONCLUSÕES: As profilaxias de TVP e TEP neste serviço apresentam uma aderência superior aos índices encontrados em trabalhos publicados na literatura. .

Conhecimento dos graduandos de enfermagem relativo à úlcera por pressão: um estudo no cenário privado / Knowledge of nursing students on the pressure ulcer: a study in a private scenario

O objetivo desse estudo foi levantar o conhecimento sobre úlcera por pressão em graduandos de enfermagem de uma universidade privada. Considerando a avaliação de 54 graduandos, o estudo apresentou escores de acertos para estadiamento da úlcera de pressão (61,9%), avaliação da UP (69,7%) e prevenção da úlcera de pressão (59%). Como achados, assinalam-se conhecimentos insuficientes relativos aos produtos utilizados nos curativos, reposicionamento do paciente, aos fatores de risco e escala de Braden. O enfermeiro necessita de formação adequada para aquisição de competências quanto a planejar ações considerando a identificação dos fatores de risco para o desenvolvimento de UP, bem como sua prevenção e tratamento, além da educação dos clientes e seus familiares, a fim de melhorar a qualidade da assistência prestada aos portadores desta condição clínica.

Complicaçöes após aplicaçöes, por via intramuscular, do diclofenaco de sódio: estudo de um caso / Intramuscular site complications after sodium diclofenac injections: case related

O uso da injeçäo intramuscular na terapêutica medicamentosa envolve, na atualidade, uma série de aspectos como: desvantagens quanto ao local, reaçöes adversas e complicaçöes surgidas após as injeçöes. Este estudo tem o objetivo de relatar o caso de uma paciente com complicaçöes pós-aplicaçäo de dezoito injeçöes de Diclofenaco de Sódio. As complicaçöes apresentadas foram dermatológicas e musculares. Ao final, säo discutidos cuidados a serem tomados na aplicaçäo de injeçöes intramusculares, em especial, no uso de Diclofenaco de Sódio, a fim de se evitarem mais casos de complicaçöes, após administraçäo de medicaçöes por via intramuscular.

Tratamento de úlceras de estase venosa com bota de unna e carväo ativado / Treatment of venous stasis ulcers with unna's boot and activated coal

Neste trabalho descreve-se os resultados obtidos no tratamento das úlceras de estase venosa utilizando bota de unna mais curativo de carväo ativado e prata, em 47 pacientes com idade entre 30 e 80 anos. O tempo do tratamento variou de 2 a 16 semanas, a frequência média das trocas dos curativos foi a cada 6 dias. Dos 47 pacientes, 87 por cento tiveram suas feridas cicatrizadas, 8,5 por cento näo obtiveram sucesso e 4,5 por cento abandonaram o tratamento. As principais vantagens observadas foram: reduçäo do número de curativos, economia para o serviço de saúde e pacientes, facilidade da aplicaçäo do tratamento.