Abstract Introduction: accidental dislodgement of enteral feeding tubes has been considered as an important quality indicator of the efficacy of enteral nutrition therapy. However, in clinical practice, the use of feeding tube attachment devices (FTADs), as an alternative to the traditional method of adhesive tape alone, has not yet been evaluated for its effectiveness in reducing inadvertent tube dislodgement. Objective: to evaluate the impact of using a dedicated FTAD compared with the traditional securing method with adhesive tape on the occurrence of accidental enteral feeding tube removal. Methods: a randomized clinical trial comparing two strategies for enteral feeding tube securement: use of traditional adhesive tape vs FTAD. The primary endpoint was the percentage of accidental enteral feeding tube dislodgement after randomization. Results: a total of 104 inpatients (mean age: 61.4 ± 17.5 years) were included (52 patients per group). Most were women with cerebrovascular disease (35.6%), diabetes (28.8%) and neoplasia (27.9%). There were 39 (37.5%) cases of accidental tube removal, 30.8% in the FTAD group and 44.2% in the adhesive tape group (p = 0.22). During follow-up, patients in the FTAD group received a mean of 60.0% of the volume of enteral nutrition prescribed, while patients in the adhesive tape group received 57.0% (p = 0.61). There was no difference in skin lesions between the groups. Conclusion: the strategy of using a dedicated FTAD as the method for securing enteral feeding tubes did not reduce the risk of accidental tube dislodgement compared with the traditional securing method with adhesive tape.

Resumen Introducción: la expulsión accidental de sondas de alimentación enteral se ha considerado un indicador importante de la calidad de la eficacia de la terapia de nutrición enteral. Sin embargo, en la práctica clínica, el uso de dispositivos de fijación de tubos de alimentación (FTAD, por sus siglas en inglés), como una alternativa al método tradicional de cinta adhesiva exclusivamente, aún no se ha evaluado por su eficacia para reducir el desprendimiento accidental de sondas. Objetivo: evaluar el impacto de usar un FTAD dedicado en comparación con el método tradicional de aseguramiento con cinta adhesiva en caso de que se produzca una extracción accidental de la sonda de alimentación enteral. Métodos: se realizó un ensayo clínico aleatorizado que comparó dos estrategias para asegurar la sonda de alimentación enteral: el uso de cinta adhesiva tradicional frente a FTAD. El punto final primario fue el porcentaje de desplazamiento accidental del tubo de alimentación enteral después de la aleatorización. Resultados: se incluyó un total de 104 pacientes hospitalizados (edad media 61,4 ± 17,5 años) (52 pacientes por grupo). La mayoría eran mujeres con enfermedad cerebrovascular (35,6%), diabetes (28,8%) y neoplasia (27,9%). Hubo 39 casos (37.5%) de extracción accidental de tubos, 30,8% en el grupo FTAD y 44,2% en el grupo de cinta adhesiva (p = 0,22). Durante el seguimiento, los pacientes del grupo FTAD recibieron una media del 60,0% del volumen de nutrición enteral prescrito, mientras que los pacientes del grupo de cinta adhesiva recibieron el 57,0% (p = 0,61). No hubo diferencia en las lesiones de la piel entre los grupos. Conclusión: la estrategia de utilizar un FTAD dedicado como método para asegurar las sondas de alimentación enteral no redujo el riesgo de retiradas accidentales en comparación con el método tradicional de sujeción con cinta adhesiva.

Três novos neo-clerodanos, antiscorbuticano A, antiscorbuticano B, e antiscorbuticano C e os compostos conhecidos glutinol, friedelina, 5,7-di-hidroxiflavanona (pinocembrina), 5-hidroxi-3,6,7,4'-tetrametoxiflavona, 5-hidroxi-3,6,7,3',4'-pentametoxiflavona (artemetina), 5,4'-di-hidroxi-3,6,7,3'-tetrametoxiflavona (penduletina) e 5,3',4'-tri-hidroxi-3,6,7-trimetoxiflavona (crisosplenol D) foram isolados do extrato de metanol de Tinnea antiscorbutica. O composto antiscorbuticano B não apresentou atividade mutagênica para doses até 250 µg por caixa (teste de Ames) e não induziu micronúcleos na linha celular V79 em doses até 100 µg mL-1.

Three new neo-clerodanes, antiscorbuticane A, antiscorbuticane B and antiscorbuticane C, and known compounds glutinol, friedelin, 5,7-dihydroxyflavanone (pinocembrin), 5-hydroxy-3,6,7,4'-tetramethoxyflavone, 5-hydroxy-3,6,7,3',4'-pentamethoxyflavone (artemetin), 5,4'-dihydroxy-3,6,7,3'-tetramethoxyflavone (penduletin) and 5,3',4'-trihydroxy-3,6,7-trimethoxyflavone (chrysosplenol D), were isolated from the methanol extract of Tinnea antiscorbutica. Antiscorbuticane B exhibited no mutagenic activity at doses of up to 250 µg per plate (Ames test) and did not induce micronucleus formation in the V79 cell line at doses of up to 100 µg mL-1.

O latex de Euphorbia conspicua foi fracionado nas frações triterpênica e irritantes I e II. Da fração triterpênica foram isolados 15 compostos já conhecidos e um novo triterpeno denominado 3β-(E)-cinamoileuforbol. A fração irritante II forneceu o 20-O-acetil-3-O-angeloil-ingenol. A atividade moluscicida dos compostos eufol, 3b-acetoxieufa-8,24-dieno, 3β-(E)-cinamoileuforbol e 20-O-acetil-3-O-angeloil-ingenol foi avaliada. O 20-O-acetil-3-O-angeloil-ingenol apresentou uma LC100 de 1 mg mL-1, a qual foi equivalente ao moluscicida padrão niclosamida. Os compostos eufol, 3b-acetoxieufa-8,24-dieno e 3β-(E)-cinamoileuforbol apresentaram uma fraca atividade moluscicida. O 3β-(E)-cinamoileuforbol foi submetido a testes de mutagenicidade (teste de Ames com TA 98, 100 e 102) na presença e ausência de ativação metabólica (mistura S9). Foram também realizados os ensaios de citotoxicidade (teste MTT) e genotoxicidade (teste dos micronúcleos, CBMN) com e sem mistura S9, em células V79 de Hamster chinês. O 3β-(E)-cinamoileuforbol revelou-se fracamente citotóxico e sem atividade mutagênica ou genotóxica.

Euphorbia conspicua latex was fractionated into triterpenic and irritant fractions I and II. The triterpenic fraction afforded 15 known compounds and a new triterpene, 3β-(E)-cinnamoyleuphorbol. 20-O-Acetyl-3-O-angeloylingenol was isolated from irritant fraction II. The compounds euphol, 3β-acetoxyeupha-8,24-diene, 3β-(E)-cinnamoyleuphorbol and 20-O-Acetyl-3-O-angeloylingenol were evaluated for molluscicidal activity. 20-O-Acetyl-3-O-angeloylingenol presented LC100 value of 1 mg mL-1, equivalent to that of the standard molluscicide niclosamide. Compounds euphol, 3β-acetoxyeupha-8,24-diene and 3β-(E)-cinnamoyleuphorbol showed low molluscicidal activity. Mutagenic assays (Ames test with strains TA 98, 100 and 102) were performed with 3β-(E)-cinnamoyleuphorbol in the presence and absence of metabolic activation (S9 mix). In V79 cells, the cytotoxicity of 3β-(E)-cinnamoyleuphorbol was evaluated using the MTT assay and the genotoxicity was assessed using the cytokinesis-block micronucleus assay (CBMN) with or without S9 mix. Mutagenic or genotoxic activity was not detected, and no significant cytotoxicity was observed for 3β-(E)-cinnamoyleuphorbol at lower doses.