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Nurse-Led Programs Focusing on Social Support for People with Type 2 Diabetes Mellitus: A Scoping Review
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Rodrigues dos Santos, Isabela Mendonça

; Palmeira Tavares Rolim, Isaura Letícia

; D’Eça Júnior, Aurean

; Bulcão Loureiro, Maria Almira

; Barros da Silva, Diogo Matheus

; Góis Lopes, Geysa Santos

Aquichan

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mar 2024, Volume 24 N. 1 elocation e2412

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

Resumo Introdução: os programas liderados por enfermeiros desempenham um papel fundamental no engajamento do individuo na autogestao do diabetes mellitus tipo 2 (DM2), pois impactam na melhoria da qualidade de vida. A autogestao apoiada pelo suporte social torna-se crucial, sobretudo por descrever a importancia do enfermeiro na promocao da saude da pessoa com DM2, tendo em vista que essa intervencao pode contribuir para reduzir as consequencias e os agravamentos da doenca. Objetivo: mapear os programas com foco no suporte social para pessoas com DM2 liderados por enfermeiros. Materiais e método: revisado de escopo que seguiu as diretrizes metodologicas do Joanna Briggs Institute. Utilizou-se como descritores de busca “autocuidado”, “intervencao liderada por enfermeiro”, “diabetes mellitus tipo 2”, com busca nos bancos de dados Web of Science, Medline, CINAHL, Catalogo de Teses e Dissertacoes da Capes, Scopus, JBI Evidence Synthesis, PsycINFO e Repositorios Cientificos de Acesso Aberto de Portugal, entre fevereiro e marco de 2022. Os criterios de elegibilidade foram estudos publicados nos ultimos 10 anos, em ingles, espanhol e portugues, abrangendo a experiencia do individuo em programas com foco na autogestao por meio do suporte social liderados por enfermeiros. Resultados: 12 estudos incluidos, publicados nos Estados Unidos, na Inglaterra e no Ira, com foco no suporte social de apoio a autogestao de pessoas com DM2 e com concentracao em locais de atendimento as pessoas com doencas cronicas. Observou-se que a maioria dos programas liderados por enfermeiros e implementada em paises desenvolvidos e apresenta como caracteristica principal enfase na teoria social cognitiva. O publico se caracterizou por ser maioria mulheres, faixa etaria de adultos maiores de 22 anos, com baixa escolaridade. Conclusões: o estudo respondeu ao objetivo proposto ao demonstrar que, apesar do baixo custo para a implementacao com alta devolutiva social e economica, ainda e considerado escasso o desenvolvimento desses programas. Reitera-se a necessidade de estudos posteriores com enfase nos niveis emocionais, como depressao e ansiedade.

Resumen Introducción: los programas dirigidos por enfermeras desempeñan un papel fundamental a la hora de implicar a las personas en el autocontrol de la diabetes mellitus tipo 2 (DM2), ya que repercuten en la mejora de la calidad de vida. El autocontrol respaldado por el apoyo social es crucial, especialmente porque describe la importancia de los profesionales de enfermeria en la promocion de la salud de las personas con diabetes mellitus tipo 2 (DM2), dado que esta intervencion puede ayudar a reducir las consecuencias y el empeoramiento de la enfermedad. Objetivo: mapear los programas centrados en el apoyo social para personas con DM2 dirigidos por enfermeros. Materiales y método: una revision de alcance que siguio las directrices metodologicas del Instituto Joanna Briggs. Los descriptores de busqueda utilizados fueron “autocuidado”, “intervencion dirigida por enfermeros”, “diabetes mellitus tipo 2”, con busqueda en la Web of Science, Medline, CINAHL, Catalogo de Tesis y Disertaciones de la Capes [Coordinacion de Perfeccionamiento de Personal de Nivel Superior], Scopus, JBI Evidence Synthesis, PsycINFO y Repositorios Cientificos de Acceso Abierto de Portugal, entre febrero y marzo de 2022. Los criterios de elegibilidad fueron estudios publicados en los ultimos 10 anos, en ingles, espanol y portugues, que cubrieran la experiencia individual de programas dirigidos por profesionales de enfermeria centrados en la autogestion a traves del apoyo social. Resultados: se incluyeron 12 estudios, publicados en Estados Unidos, Inglaterra e Iran, centrados en el apoyo social para la autogestion de personas con DM2 y en entornos de atencion a personas con enfermedades cronicas. Se observo que la mayoria de los programas dirigidos por enfermeros se aplican en paises desarrollados y tienen como caracteristica principal el enfasis en la teoria cognitiva social. El publico se caracterizo por ser mayoritariamente femenino, mayor de 22 anos y con bajo nivel de estudios. Conclusiones: el estudio respondio al objetivo propuesto demostrando que, a pesar del bajo costo de implementacion con alto retorno social y economico, el desarrollo de estos programas aun es considerado escaso. Se reitera la necesidad de nuevos estudios que enfaticen niveles emocionales como la depresion y la ansiedad.

Abstract Introduction: Nurse-led programs have a determinant role in the engagement of individuals in the self-management of type 2 diabetes mellitus (T2DM), as they contribute to improving quality of life. Self-management assisted by social support is vital, especially as it describes the importance of nurses in promoting health for people with T2DM, as this intervention can help reduce the consequences and progression of the disease. Objective: To map programs focused on nurse-led social support for people with T2DM. Materials and Methods: This is a scoping review in line with the methodological guidelines of the Joanna Briggs Institute. The search descriptors used were “autocuidado” (self-care), “intervenção liderada por enfermeiro” (nurse-led intervention), and “diabetes mellitus tipo 2” (type 2 diabetes mellitus), with searches in the Web of Science, Medline, CINAHL, Capes Theses and Dissertations Catalog, Scopus, JBI Evidence Synthesis, PsycINFO, and the Portuguese Open Access Scientific Repositories databases conducted between February and March 2022. The eligibility criteria were studies published within the last 10 years, in English, Spanish, and Portuguese, covering the individual’s experience in programs focused on self-management through nurse-led social support. Results: A total of 12 studies were included, all of which were published in the United States, England, and Iran, focusing on social support for self-management in people with T2DM, and centered on care facilities for people with chronic diseases. It was found that most nurse-led programs have been implemented in developed countries and that their main characteristic is their emphasis on social cognitive theory. The population was characterized by being mostly women, aged over 22, with a low level of education. Conclusions: The study met the proposed objective by demonstrating that, despite the low implementation cost with high social and economic returns, the development of these programs is still scarce. The need for further studies focusing on emotional levels, such as depression and anxiety, is highlighted.

https://doi.org/10.5294/aqui.2024.24.1.2

Microsilages elephant grass BRS Capiaçu added with commercial microbial consortium on different days of regrowth
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Santos, Allan Stênio da Silva

; Araújo, Daniel Louçana da Costa

; Silva, Ivone Rodrigues da

; Araújo, Matheus Sousa

; Alves, Arnaud Azevêdo

; Parente, Henrique Nunes

; Oliveira, Maria Elizabete de

; Lopes, João Batista

Revista mexicana de ciencias pecuarias

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mar 2024, Volume 15 N. 1 Pages 32 - 48

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract This study aimed to evaluate whether bacterial inoculation improves the fermentative, microbiological, and chemical characteristics of silages of the elephant grass cv. BRS Capiaçu on different regrowth days. The experimental design was completely randomized and set up in a 3x2 factorial arrangement (three regrowth days, with and without inoculant), with four replications. There was a significant interaction between the regrowth days and inoculant on the pH, ammoniacal nitrogen (N-NH3), and effluent losses (EL) of the silages. Inoculation decreased the EL with the advance of regrowth days and increased the dry matter recovery index compared to the silages without inoculant. The population of molds and yeasts decreased when inoculation was adopted to the forage harvested after 85 d. There was a significant interaction between the dry matter (DM), crude protein (CP) and neutral detergent fiber corrected for ash and protein (NDFap) contents of the silages. Inoculation in the grass harvested after 85 d increased the DM contents of the silage. The highest CP contents were observed in the silages after 85 d. The NDFap contents of the grasses harvested after 110 and 135 d were higher than those of the grass harvested after 85 d. The NDFap contents of the silages without inoculant increased with the harvest age. The BRS Capiaçu forage silage harvested at 110 d demonstrated favorable performance for silage production. However, the influence of inoculant use was low for the characteristics evaluated.

Resumen Este estudio tuvo como objetivo evaluar si la inoculación bacteriana mejora las características fermentativas, microbiológicas y químicas de los ensilados del pasto elefante cv. BRS Capiaçu en diferentes días de rebrote. El diseño experimental fue completamente al azar y se estableció en un arreglo factorial 3x2 (tres días de rebrote, con y sin inoculante), con cuatro repeticiones. Hubo una interacción significativa entre los días de rebrote y el inoculante sobre el pH, el nitrógeno amoniacal (N-NH3) y las pérdidas por efluentes (PE) de los ensilados. La inoculación disminuyó la PE con el avance de los días de rebrote y aumentó la tasa de recuperación de materia seca en comparación con los ensilados sin inoculante. La población de mohos y levaduras disminuyó cuando se adoptó la inoculación al forraje cosechado después de 85 d. Hubo una interacción significativa entre la materia seca (MS), la proteína cruda (PC) y la fibra detergente neutro corregida por los contenidos de cenizas y proteína (FDNcp) de los ensilados. La inoculación en el pasto cosechado después de 85 días aumentó el contenido de MS del ensilado. Los mayores contenidos de PC se observaron en los ensilados después de 85 días. Los contenidos de FDNcp de los pastos cosechados después de 110 y 135 días fueron mayores que el del pasto cosechado después de 85 días. El contenido de FDNcp de los ensilados sin inoculante aumentó con la edad de cosecha. El ensilado de forraje de BRS Capiaçu cosechado a los 110 días demostró un desempeño favorable para la producción de ensilado. Sin embargo, la influencia del uso de inoculantes fue baja para las características evaluadas.

https://doi.org/10.22319/rmcp.v15i1.6379

Lower expression of NOTCH components in peripheral blood mononuclear cells of allogeneic hematopoietic cell transplant patients
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Colella, Marcos Paulo

; Morini, Beatriz Corey

; Niemann, Fernanda

; Lopes, Matheus Rodrigues

; Saad, Sara Olalla

; Favaro, Patricia

Hematology, Transfusion and Cell Therapy

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sep 2023, Volume 45 N. 3 Pages 324 - 329

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Chronic graft-versus-host disease (cGvHD) not only remains the main cause of late mortality after allogeneic hematopoietic cell transplant, but also has the capacity of causing severe organ impairment in those who survive. The Notch, a highly conserved ligand-receptor pathway, is involved in many immunological processes, including inflammatory and regulatory responses. Recently, mouse models have shown that the blockage of canonical Notch signaling prevents GvHD. Objective and Method: Due to the lack of data on the Notch pathway in human chronic GvHD, we sought to study the expression of NOTCH components in primary samples of patients who received allo-HCT and presented active cGvHD or a long-term clinical tolerance to cGvHD. Results: Our results showed a significantly lower expression of NOTCH components in both groups that received allo-HCT, independently of their cGvHD status, when compared to healthy controls. Conclusion: Moreover, there were no differences in gene expression levels between the active cGvHD and clinically tolerant groups. To our knowledge, this is one of the first studies performed in human primary samples and our data indicate that much remains to be learned regarding NOTCH signaling as a new regulator of GvHD. Introduction graftversushost graft versus host (cGvHD transplant survive ligandreceptor ligand receptor processes responses Recently GvHD Method alloHCT allo HCT longterm long term Results alloHCT, HCT, status controls Conclusion Moreover knowledge

https://doi.org/10.1016/j.htct.2022.05.005

Ischemic Stroke and Acute Myocardial Infarction: Trends in in-Hospital Mortality in Brazil from 1998 to 2018 Infarction inHospital Hospital 199 201 19 20 1 2
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Santos, Júlio Martinez

; Martinez, Alessandra Barboza Resende

; Silva, Emerson de Jesus

; Santana, Gustavo Roberto

; Barbosa, Romero Henrique de Almeida

; Lima, David Fernandes

; Lopes, Matheus Rodrigues

; Lopes, Johnnatas Mikael

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220217

Abstract: En | Text: En | PDF: En

Abstract Background Ischemic stroke and acute myocardial infarction (AMI) are cardiovascular diseases with high morbidity and mortality rates in Brazil and worldwide. Their outcomes are influenced by public policies aimed at mitigating risk factors and by investments in infrastructure of emergency support and quality of hospital care. Objective To analyze the trend in the proportion of in-hospital deaths from ischemic stroke and AMI in Brazil as a way of evaluating the effectiveness of urgency and emergency services. Methods Ecological time series study using data from the Hospital Information System. The outcome was the proportion of in-hospital deaths from ischemic stroke and AMI with stratification by sex and state. Prais-Winsten regression was used to analyze the trend between 1998-2018 with α≤0,05. Results The proportion of deaths from AMI and ischemic stroke declined in the time series (p<0.001), decreasing annually by 0.17% and 0.25%, respectively. In 20 years, it reduced 43.76% (ischemic stroke) and 32.39% (AMI) in both sexes. However, the decline was more evident in the South and Southeast regions. Conclusion The reduction in hospital deaths from AMI and ischemic stroke was heterogeneous among Brazilian regions, which may be related to inequality in emergency services and hospital support. (AMI worldwide care inhospital System state PraisWinsten Prais Winsten 19982018 1998 2018 1998-201 α005 α 0 05 α≤0,05 p<0.001, p0001 p p<0.001 , 001 (p<0.001) 017 17 0.17 025 25 0.25% respectively 2 years 4376 43 76 43.76 3239 32 39 32.39 sexes However regions 1998201 199 201 1998-20 α00 α≤0,0 p000 p<0.00 00 (p<0.001 01 1 0.1 02 0.25 437 4 7 43.7 323 3 32.3 199820 19 1998-2 α0 α≤0, p00 p<0.0 (p<0.00 0. 0.2 43. 32. 19982 1998- α≤0 p0 p<0. (p<0.0 α≤ p<0 (p<0. p< (p<0 (p< (p

https://doi.org/10.36660/ijcs.20220217

A 14-Year Follow-Up Study of Sequelae in Primary Teeth and Permanent Successors After Dental Trauma 14Year Year 14 FollowUp Follow Up 1
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Costa, Mariana Pires da

; Jural, Lucas Alves

; Silva, Leticia Lopes de Almeida da

; Parada, Matheus Cesar da Silva

; Leão, Anna Thereza Thome

; Luiz, Ronir Raggio

; Lenzi, Michele Machado

; Magno, Marcela Baraúna

; Soares, Thais Rodrigues Campos

; Maia, Lucianne Cople

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2023, Volume 23 elocation e220084

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate the presence of sequelae in primary teeth and their permanent successors, as well as associations between TDI and the presence of sequelae in both teeth. Material and Methods: In this 14-year retrospective study, 2.290 records were reviewed, 192 patients who suffered dental trauma in primary teeth were followed until the eruption of successor teeth were included. Descriptive, chi-square, and regression logistic with generalized estimating equations tests were performed (p<0.05). Results: 362 primary and successor teeth were followed. Sequelae were present in 71.8% of primary teeth and 25.7% of their successors. Teeth with complicated fracture (100%), extrusion (100%) and avulsion (100%) resulted in the largest amounts of sequelae in primary teeth and intrusion (61%) on their successors. Age was associated with sequelae in permanent teeth (p<0.01). Extrusion (OR 10.06; CI 2.12-47.63) and intrusion (OR 7.51; CI 2.73-20.70) had a higher risk to cause sequelae in primary and permanent teeth, respectively. Conclusion: The type of injury involved influenced the sequelae in traumatized teeth and their successors, and the age of the child influenced the presence of sequelae in permanent teeth. Objective successors Methods 14year year 14 study 2290 2 290 2.29 reviewed 19 included Descriptive chisquare, chisquare chi square, square chi-square p<0.05. p005 p p<0.05 . 0 05 (p<0.05) Results 36 718 71 8 71.8 257 25 7 25.7 100%, 100 100% , (100% 61% 61 (61% p<0.01. p001 p<0.01 01 (p<0.01) OR 10.06 1006 10 06 2.1247.63 2124763 2.12 47.63 12 47 63 2.12-47.63 7.51 751 51 2.7320.70 2732070 2.73 20.70 73 20 70 2.73-20.70 respectively Conclusion 1 229 29 2.2 p00 p<0.0 (p<0.05 3 71. 25. (100 6 (61 (p<0.01 10.0 1247 2.1247.6 212476 212 2.1 4763 47.6 4 2.12-47.6 7.5 75 5 7320 2.7320.7 273207 273 2.7 2070 20.7 2.73-20.7 22 2. p0 p<0. (p<0.0 (10 (6 10. 124 2.1247. 21247 21 476 47. 2.12-47. 7. 732 2.7320. 27320 27 207 20. 2.73-20. p<0 (p<0. (1 ( 2.1247 2124 2.12-47 2.7320 2732 2.73-20 p< (p<0 2.124 2.12-4 2.732 2.73-2 (p< 2.12- 2.73- (p

https://doi.org/10.1590/pboci.2023.035

Physical Training Improves Cardiac Structure and Function of Rats After Doxorubicin-Induced Cardiomyopathy DoxorubicinInduced Doxorubicin Induced
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Souza, Fernanda Rodrigues

; Campos, Érica Carolina

; Lopes, Leandro Teixeira Paranhos

; Rodrigues, Clesnan Mendes

; Gonçalves, Danilo Lemes Naves

; Beletti, Marcelo Emílio

; Mantovani, Matheus Matioli

; Duarte, Poliana Rodrigues Alves

; Gonçalves, Alexandre

; Resende, Elmiro Santos

International Journal of Cardiovascular Sciences

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dec 2022, Volume 35 N. 6 Pages 718 - 726

Abstract: En | Text: En | PDF: En

Abstract Background: The use of doxorubicin in chemotherapy has been associated with cardiotoxicity and heart failure. Physical exercise produces favorable morphofunctional adaptations in the cardiovascular system and may reverse cardiac dysfunction in patients undergoing chemotherapy. Objective: To assess the effects of physical training on myocardial structure, cardiac function, and exercise tolerance in Wistar rats initiated after the onset of cardiotoxicity-induced cardiotoxicity. Methods: This study investigated 30 adult male Wistar rats randomly divided into four groups: control (C), exercise (EX), doxorubicin (DX), and doxorubicin and exercise (DXEX). The DX and DXEX groups received six doses of doxorubincin from 1.25 mg/kg body weight up to a cumulative dose of 7.5 mg/kg. Injections were administered intraperitoneally three times a week for two weeks; after this stage, the EX and DXEX groups started physical training (swimming) sessions three times a week with a load of 5% of their body weight. Echocardiography and exercise tolerance tests were performed. Generalized linear models were used in statistical analysis, and a p<0.05 was set as statistically significant. Results: Left ventricular shortening fraction and ejection fraction were reduced in the DX group compared to C, EX, and DXEX. The DXEX group showed greater tolerance to effort when compared to the DX and C groups. Conclusion: Physical training, initiated after the onset of doxorubicin-induced cardiotoxicity, improved cardiac function and exercise tolerance in rats. Background failure Objective structure cardiotoxicityinduced induced Methods 3 , (C) (EX) DX, (DX) . (DXEX) 125 1 25 1.2 mgkg mg kg 75 7 5 7. weeks stage swimming (swimming performed analysis p005 p 0 05 p<0.0 significant Results Conclusion doxorubicininduced (C (EX (DX (DXEX 12 2 1. p00 p<0. p0 p<0 p<

https://doi.org/10.36660/ijcs.20210095

Atherosclerosis Complications in the Brazilian Population: An Ecological Time Series Study
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Silva, Emerson de Jesus

; Gomes Junior, Francieudo da Silva

; Firmiano, João Vitor Bezerra

; Silva, Nilson Roberto da

; Carlini, Wendel Aguiar

; Guedes, Marcello Barbosa Otoni Gonçalves

; Lopes, Matheus Rodrigues

; Lopes, Johnnatas Mikael

International Journal of Cardiovascular Sciences

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mar 2022, Volume 35 N. 2 Pages 243 - 252

Abstract: En | Text: En | PDF: En

Abstract Background: Atherosclerosis is a serious health problem, and several factors contribute to its occurrence. Longitudinal and qualified monitoring of primary health care (PHC) may contribute to the management of atherosclerosis and reduction of avoidable hospital admissions. Objectives: To estimate the trend in hospitalizations for atherosclerosis and the impact of PHC coverage on its evolution from 2008 to 2018 in Brazil. Methods: An ecological time series analytical study based on the outcomes of hospital admissions for atherosclerosis in Brazil. Time in years, PHC coverage, and Family Health Strategy (FHS) services were considered independent variables. A Prais–Winsten model was used to estimate the outcome trend, and α < 0.05 was adopted. Results: We observed a mean increase of 1.81 hospitalizations for atherosclerosis per 100 000 inhabitants annually (p = 0.002) in Brazil. This growth was evidenced in the Northeast (p < 0.001), Southeast (p = 0.003), and South (p < 0.001) regions, being stable in the North (p = 0.057) and Midwest (p = 0.62) regions. Men presented twice the growth in hospitalizations from the fifth decade of life on (p < 0.01). An inversely proportional relationship was observed for PHC coverage (B = -0.71; p < 0.001) and the proportion of FHS services (B = -0.59; p < 0.001) with the rate of admissions due to atherosclerosis in Brazil. Conclusions: Although hospitalizations for atherosclerotic complications are increasing in Brazil, they present regional and individual gender and age discrepancies, as well as a mitigating effect exerted by PHC coverage.

https://doi.org/10.36660/ijcs.20210117

Avaliação do autocuidado com os pés entre pacientes portadores de diabetes melito
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Lima, Lorrany Junia Lopes de

; Lopes, Matheus Rodrigues

; Botelho Filho, Carlos Alberto de Lima

; Cecon, Roberta Stofeles

Jornal Vascular Brasileiro

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2022, Volume 21 elocation e20210011

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Contexto O pé diabético é uma complicação do diabetes melito (DM), sendo a maior causa de amputação dos membros inferiores. Objetivos Avaliar a prática de medidas de autocuidado com os pés, segundo sexo e escolaridade, em pacientes portadores de DM na região nordeste no estado da Bahia. Métodos Estudo quantitativo, observacional, analítico, transversal, realizado com 88 pacientes portadores de DM, em consulta de rotina, de fevereiro a março de 2020. A coleta de dados foi executada através da aplicação de questionários socioeconômico e do autocuidado com os pés (conhecimento sobre pé diabético, hábitos de cuidado/inspeção dos pés e procura pela Unidade de Saúde na presença de alterações com a saúde dos pés). Resultados Do total, 58% dos indivíduos desconhecia o termo “pé diabético”, porém possuíam cuidados mínimos adequados com os pés, como inspecioná-los (60,2%), hidratá-los (65,9%), não andar descalço (81,8%) e cortar as unhas (92%), apesar de 90,9% não utilizar sapatos considerados adequados. Houve relação entre menor nível de escolaridade e pior desempenho nas questões referentes a andar descalço, hidratar os pés, cortar as unhas, usar calçados adequados e identificar micoses (p < 0,05), porém não houve associação da realização das medidas de autocuidado e sexo. Conclusão Os portadores de DM entrevistados não realizaram todas as medidas de autocuidado com os pés e desconheciam o termo “pé diabético”. Houve associação entre menor escolaridade e menor capacidade de realização dessas medidas, o que sugere que o letramento em saúde seria importante para melhoria desse autocuidado, contribuindo para diminuição de complicações e amputações dos pés.

Abstract Background The diabetic foot is a complication of diabetes mellitus (DM) and is the most common cause of lower limb amputation. Objectives To assess foot self-care practices by sex and educational level in DM patients from the Northeast of Brazil, state of Bahia. Methods This was a quantitative, cross-sectional, observational, analytical study with 88 DM patients seen at routine consultations from February to March of 2020. Data were collected using questionnaires on socioeconomic data and self-care of feet (knowledge about the diabetic foot, habits related to care/inspection of feet, and visits to the Healthcare Center when changes to foot health are detected). Results 58% of the sample did not know the term “diabetic foot”, but a majority did perform minimum adequate foot care practices, such as inspecting feet (60.2%), moisturizing feet (65.9%), avoiding walking barefoot (81.8%), and trimming toenails (92%), although 90.9% did not wear footwear considered appropriate. There was a relationship between lower educational level and worse performance in questions relating to walking barefoot, moisturizing feet, trimming toenails, wearing appropriate footwear, and identifying mycoses (p < 0.05), but there was no association between performing self-care activities and sex. Conclusions Interviewed patientswith DM did not perform all foot self-care activities and did not know what the term “diabetic foot” means. There was an association between lower educational level and reduced capacity to perform these activities, which suggests that health literacy is important to improve self-care of feet, contributing to reduce complications and foot amputations.

https://doi.org/10.1590/1677-5449.210011

Adipose tissue-derived stromal/stem cells + cholecalciferol: a pilot study in recent-onset type 1 diabetes patients
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Dantas, Joana Rodrigues

; Araújo, Débora Batista

; Silva, Karina Ribeiro

; Souto, Débora Lopes

; Pereira, Maria de Fátima Carvalho

; Luiz, Ronir Raggio

; Mantuano, Matheus dos Santos

; Claudio-da-Silva, Cesar

; Gabbay, Monica Andrade Lima

; Dib, Sérgio Atala

; Couri, Carlos Eduardo Barra

; Maiolino, Angelo

; Rebelatto, Carmen Lúcia Kuniyoshi

; Daga, Débora Regina

; Senegaglia, Alexandra Cristina

; Brofman, Paulo Roberto Slud

; Baptista, Leandra S.

; Oliveira, José Egídio Paulo de

; Zajdenverg, Lenita

; Rodacki, Melanie

Archives of Endocrinology and Metabolism

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jun 2021, Volume 65 N. 3 Pages 342 - 351

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: Adipose tissue-derived stromal/stem cells (ASCs) and vitamin D have immunomodulatory actions that could be useful for type 1 diabetes (T1D). We aimed in this study to investigate the safety and efficacy of ASCs + daily cholecalciferol (VIT D) for 6 months in patients with recent-onset T1D. Materials and methods: In this prospective, dual-center, open trial, patients with recent onset T1D received one dose of allogenic ASC (1 x 106 cells/kg) and cholecalciferol 2,000 UI/day for 6 months (group 1). They were compared to patients who received chol-ecalciferol (group 2) and standard treatment (group 3). Adverse events were recorded; C-peptide (CP), insulin dose and HbA1c were measured at baseline (T0), after 3 (T3) and 6 months (T6). Results: In group 1 (n = 7), adverse events included transient headache (all), mild local reactions (all), tachycardia (n = 4), abdominal cramps (n = 1), thrombophlebitis (n = 4), scotomas (n = 2), and central retinal vein occlusion at T3 (n = 1, resolution at T6). Group 1 had an increase in basal CP (p = 0.018; mean: 40.41+/-40.79 %), without changes in stimulated CP after mixed meal (p = 0.62), from T0 to T6. Basal CP remained stable in groups 2 and 3 (p = 0.58 and p = 0.116, respectively). Group 1 had small insulin requirements (0.31+/- 0.26 UI/kg) without changes at T6 (p = 0.44) and HbA1c decline (p = 0.01). At T6, all patients (100%; n = 7) in group 1 were in honeymoon vs 75% (n = 3/4) and 50% (n = 3/6) in groups 2 and 3, p = 0.01. Conclusions: Allogenic ASC + VIT D without immunosuppression was safe and might have a role in the preservation of β-cells in patients with recent-onset T1D. ClinicalTrials.gov: NCT03920397.

https://doi.org/10.20945/2359-3997000000368 236 downloads

10.

Cannabinoids in Neurology - Position paper from Scientific Departments from Brazilian Academy of Neurology
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BRUCKI, Sonia Maria Dozzi

; ADONI, Tarso

; ALMEIDA, Carlos Mauricio Oliveira

; ANDRADE, Daniel Ciampi de

; ANGHINAH, Renato

; BARBOSA, Luciana Mendonça

; BAZAN, Rodrigo

; CARVALHO, Alzira Alves de Siqueira

; CARVALHO, William

; CHRISTO, Paulo Pereira

; COLETTA, Marcus Della

; CONFORTO, Adriana Bastos

; CORREA-NETO, Ylmar

; ENGELHARDT, Eliasz

; FRANÇA JUNIOR, Marcondes Cavalcante

; FRANCO, Clelia

; VON GLEHN, Felipe

; GOMES, Helio Rodrigues

; HOULY, Caroline Gomes de Barros

; KAUP, Alexandre Ottoni

; KOWACS, Fernando

; KANASHIRO, Aline

; LOPES, Victor Gonçalves

; MAIA, Débora

; MANREZA, Maria

; MARTINEZ, Alberto Rolim Muro

; MARTINEZ, Sandra Cristina Gonçalves

; NADER, Saulo Nardy

; NEVES, Luciana de Oliveira

; OKAMOTO, Ivan Hideyo

; OLIVEIRA, Rogério Adas Ayres de

; PEIXOTO, Fabiano de Melo

; PEREIRA, Cristiana Borges

; SABA, Roberta Arb

; SAMPAIO, Leticia Pereira de Brito

; SCHILLING, Lucas Porcello

; SILVA, Marcus Tulius Teixeira

; SILVA, Emanuelle Roberta

; SMID, Jerusa

; SOARES, Cristiane Nascimento

; SOBREIRA-NETO, Manoel

; SOUSA, Nise Alessandra de Carvalho

; SOUZA, Leonardo Cruz de

; TEIVE, Hélio Afonso Ghizoni

; TERRA, Vera Cristina

; VALE, Matheus

; VIEIRA, Vitor Mendes Grise

; ZANOTELI, Edmar

; PRADO, Gilmar

Arquivos de Neuro-Psiquiatria

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apr 2021, Volume 79 N. 4 Pages 354 - 369

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Os canabinoides compreendem os endocanabinoides, fitocanabinoides e os canabinoides sintéticos e desempenham ações no sistema nervoso central e periférico. Uma quantidade enorme de publicações tem sido lançada nos últimos anos, embora a cannabis seja conhecida por milênios. Os Departamentos Científicos da Academia Brasileira de Neurologia descreveram as evidências do uso médico em suas áreas. A literatura está em constantes mudanças e possíveis novas evidências podem surgir nos próximos dias ou meses. A prescrição dessas substâncias deve ser discutida com os pacientes e suas famílias, com conhecimento sobre eventos adversos e sua eficácia.

ABSTRACT Cannabinoids comprehend endocannabinoids, phytocannabinoids, and synthetic cannabinoids, with actions both in the central and peripherical nervous systems. A considerable amount of publications have been made in recent years, although cannabis has been known for over a thousand years. Scientific Departments from the Brazilian Academy of Neurology described evidence for medical use in their areas. Literature is constantly changing, and possible new evidence can emerge in the next days or months. Prescription of these substances must be discussed with patients and their families, with knowledge about adverse events and their efficacy.

https://doi.org/10.1590/0004-282x-anp-2020-0432 1049 downloads

11.

Nuances between sedentary behavior and physical inactivity: cardiometabolic effects and cardiovascular risk
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Melo, Erika Andressa Simões de

; Ferreira, Laryssa Elza de Santana

; Cavalcanti, Rodolfo José Ferreira

; Botelho Filho, Carlos Alberto de Lima

; Lopes, Matheus Rodrigues

; Barbosa, Romero Henrique de Almeida

Revista da Associação Médica Brasileira

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feb 2021, Volume 67 N. 2 Pages 335 - 343

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: The aim of this study was to highlight the differences between the cardiometabolic effects and the cardiovascular risk of physical inactivity and sedentary behavior. METHODS: A narrative bibliographic review was conducted. In the research, national and international articles were selected from the PubMed, SciELO, and LILACS databases using the descriptors “sedentary lifestyle, cardiovascular risk, physical inactivity, sedentary behavior, and cardiovascular risks.” DISCUSSION: Both physical inactivity and sedentary behavior are related to metabolic and organic changes, promoting a chronic proinflammatory state, cardiac remodeling, increased body adiposity, and skeletal muscle dysfunction. It is possibly stated that both of them result in a higher risk of developing chronic diseases, resulting in higher global and cardiovascular morbidity and mortality, with nuances in their intrinsic effects. CONCLUSIONS: It is inferred that both physical inactivity and sedentary behavior are cardiovascular risk factors that can be modified with the correct clinical approach. It is necessary to differentiate physically inactive individuals from those with a high number of sedentary behaviors. These concepts need better clinical applicability to improve the prevention of primary and secondary cardiovascular risks.

https://doi.org/10.1590/1806-9282.67.02.20200746 164 downloads

12.

Concordância entre dois instrumentos para avaliação do letramento em saúde
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Cangussú, Luana Resende

; Alho, Eduardo Antonio Sartori

; Cardoso, Felipe Esdras Lucas

; Tenório, Adirlene Pontes de Oliveira

; Barbosa, Romero Henrique de Almeida

; Lopes, Johnnatas Mikael

; Lopes, Matheus Rodrigues

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. 2 elocation e2020490

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Objetivo Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA, respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); e a concordância de acertos encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e desenvolvimento de instrumentos específicos às condições de saúde que permitam obter resultado próximo ao real contexto dos indivíduos.

Abstract Objetivo To determine agreement between the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) measurement instruments as a strategy for estimating concurrent validity. Methods This was a cross-sectional study conducted with users of the Brazilian National Health System. An agreement approach using a weighted Kappa test for qualitative data was applied in order to test for concurrent validity. Results 372 individuals participated. It was found that 66% and 62% of them did not have an adequate level of literacy according to SAHLPA-18 and S-TOFHLA, respectively. There was strong correlation between the instruments (p<0.001; r=0.60), although the 65.3% agreement of correct answers found was considered weak (Kappa=0.35; p<0.001). Conclusion The SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. Use of different instruments is indicated in research intended to measure level of literacy, as is the development of instruments specific to health conditions that allow results close to the real context of individuals to be obtained.

Resumen Objetivo Determinar la concordancia entre instrumentos de medición psicométrica short test of functional health literacy in adults (S-TOFHLA) y short assessment of health literacy for portuguese-speaking adults (SAHLPA-18) como estrategia para estimar la validez concurrente. Métodos estudio transversal realizado con usuarios del Sistema Único de Salud. Para testear la validez concurrente se aplicó un enfoque de concordancia con una prueba ponderada de Kappa para datos cualitativos. Resultados participaron 372 individuos. Se encontró que 66% y 62% de estos no tenía un nivel adecuado de letramiento según SAHLPA-18 y S-TOFHLA, respectivamente. Hubo una fuerte correlación entre los instrumentos (p<0.001; r=0.60), sin embargo 65.3% de concordancia, se consideró débil (Kappa=0.35; p<0.001). Conclusión Los instrumentos SAHLPA-18 y S-TOFHLA tienen diferentes construcciones y escasa concordancia. En la investigación se indica el uso de diferentes instrumentos para medir el nivel de letramiento y el desarrollo de instrumentos específicos a las condiciones de salud que permitan obtener resultados cercanos al contexto real de los individuos.

https://doi.org/10.1590/s1679-49742021000200004 277 downloads

13.

Concordância entre dois instrumentos para avaliação do letramento em saúde
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Cangussú, Luana Resende

; Alho, Eduardo Antonio Sartori

; Cardoso, Felipe Esdras Lucas

; Tenório, Adirlene Pontes de Oliveira

; Barbosa, Romero Henrique de Almeida

; Lopes, Johnnatas Mikael

; Lopes, Matheus Rodrigues

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. 2 elocation e2020490

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/s1679-49742021000200004

14.

Relationship between vitamin D deficiency and psychophysiological variables: a systematic review of the literature
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Silva, Mariluce Rodrigues Marques

; Barros, Waleska Maria Almeida

; Silva, Mayara Luclécia da

; Silva, José Maurício Lucas da

; Souza, Ana Patrícia da Silva

; Silva, Ana Beatriz Januário da

; Fernandes, Matheus Santos de Sousa

; Souza, Sandra Lopes de

; Souza, Viviane de Oliveira Nogueira

Clinics

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2021, Volume 76 elocation e3155

Abstract: En | Text: En | PDF: En

Vitamin D is a fat-soluble vitamin that plays a role not only in calcium homeostasis, but also in several other functions, including cell growth and immune functions, and is considered a neurosteroid. Vitamin D deficiency is highly prevalent worldwide and has been suggested to be associated with an increased risk of emotional disorders. Therefore, the association between vitamin D levels and psychophysiological disorders, such as depression, anxiety, and mood, has been investigated. To list these variables, a bibliographical literature research was conducted in the MEDLINE/PubMed, Web of Science, Scopus, Science Direct and PsycINFO databases, between November and December 2020, with no year limits of publication. The studies involved humans aged between 18 and 59 years without associated diseases. This review presents evidence of the main variables involved in this association, main tools used to verify these variables, and methods used to verify circulating vitamin D levels in populations. Most studies have indicated that the main psychophysiological variables involved with vitamin D levels are depression and anxiety followed by mood, and an association has been observed between increased serum vitamin D levels and reduction in symptoms of depression, anxiety, and mood, and there is a heterogeneity of methods for assessing vitamin D. More studies are clearly needed to improve our understanding of their role in modulating the psychophysiological aspects of vitamin D levels.

https://doi.org/10.6061/clinics/2021/e3155 52 downloads

15.

Effect of Metabolic Syndrome on Parkinson's Disease: A Systematic Review
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Souza, Ana Patrícia da Silva

; Barros, Waleska Maria Almeida

; Silva, José Maurício Lucas

; Silva, Mariluce Rodrigues Marques

; Silva, Ana Beatriz Januário

; Fernandes, Matheus Santos de Sousa

; Santos, Maria Eduarda Rodrigues Alves dos

; Silva, Mayara Luclécia da

; Carmo, Taciane Silva do

; Silva, Roberta Karlize Pereira

; Silva, Karollainy Gomes da

; Souza, Sandra Lopes de

; Souza, Viviane de Oliveira Nogueira

Clinics

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2021, Volume 76 elocation e3379

Abstract: En | Text: En | PDF: En

Evidence shows that metabolic syndrome (MS) is associated with a greater risk of developing Parkinson's disease (PD) because of the increase in oxidative stress levels along with other factors such as neuroinflammation and mitochondrial dysfunction. However, because some studies have reported that MS is associated with a lower risk of PD, the relationship between MS and PD should be investigated. This study aimed to investigate the effect of MS on PD. Two authors searched five electronic databases, namely, MEDLINE, PubMed, Scopus, PsycINFO, Web of Science, and Science Direct, for relevant articles between September and October 2020. After screening the title and abstract of all articles, 34 articles were selected for full-text review. Finally, 11 articles meeting the eligibility criteria were included in the study. The quality of articles was critically evaluated using the Joanna Briggs Institute. Overall, we evaluated data from 23,586,349 individuals (including healthy individuals, with MS and PD) aged 30 years or more. In cohort studies, the follow-up period varied between 2 and 30 years. MS contributed considerably to the increase in the incidence of PD. In addition, obesity, a component of MS, alone can increase the probability of developing neurodegenerative diseases. However, despite few studies on MS and PD, changes in cognitive function and more rapid progression of PD disease has been documented in patients with MS using methods commonly used in research.

https://doi.org/10.6061/clinics/2021/e3379

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