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ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

https://doi.org/10.5935/2965-2774.20230136-en

Energy and lipid contents, and polyphenols composition of pequi pulp according to the fruit native area
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Nascimento-Silva, Nara Rúbia Rodrigues do

; Alves-Santos, Aline Medeiros

; Oliveira, Cecília Maria Alves de

; Terezan, Ana Paula

; Silva, Aline Priscilla Gomes da

; Naves, Maria Margareth Veloso

Ciência Rural

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2023, Volume 53 N. 6 elocation e20220063

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

RESUMO: O pequi (Caryocar spp.) é um fruto nativo do cerrado brasileiro e Caryocar brasiliense Camb. é uma das espécies mais prevalentes neste bioma. O consumo da polpa de pequi tem sido associado a benefícios à saúde, como efeitos antioxidantes, anti-inflamatórios, hipolipidêmicos, hepatoprotetores e anticarcinogênicos. Esses benefícios têm sido atribuídos à sua alta densidade em nutrientes e compostos bioativos. No entanto, há evidências de considerável variação no perfil nutricional entre polpas de pequi de diferentes espécies, e entre polpas da mesma espécie, mas de diferentes áreas do cerrado. Além disso, não há informações na literatura sobre o perfil de polifenóis da polpa de C. brasiliense, tampouco sobre a influência da área nativa do fruto na composição desses fitoquímicos. Assim, este estudo analisou a composição de nutrientes e identificou os compostos fenólicos na polpa de frutos de C. brasiliense nativos de quatro diferentes áreas do Cerrado. Houve notável variação nos teores de energia (176,3-387,2 kcal/100 g) e lipídios (13,0-37,5 g/100 g) entre as amostras. Em contrapartida, não foi encontrada diferença na composição em polifenóis, uma vez que ácido gálico, ácido protocatecuico, catequina, epicatequina, ácido p-cumárico e ácido elágico foram identificados em todas as polpas de pequi analisadas. A polpa de C. brasiliense tem potencial para ser utilizada como ingrediente funcional rico em compostos bioativos, porém com diferentes teores de energia e lipídios de acordo com a área nativa do fruto para atender a distintas alegações de saúde do produto.

ABSTRACT: Pequi (Caryocar spp.) is a fruit native to the Brazilian Savannah (Cerrado), and Caryocar brasilienseCamb. is one of the most prevalent species in this biome. The consumption of the pequi pulp has been associated with health benefits, such as antioxidant, anti-inflammatory, hypolipidemic, hepatoprotective, and anticarcinogenic effects. These benefits have been attributed to its high density in nutrients and bioactive compounds. However, there is evidence about considerable variation in the nutritional profile among pequi pulps of different species, and among pulps of the same species, but from different areas of the Cerrado. In addition, there is no information in literature regarding the polyphenols profile of C. brasiliense pulp, neither about the influence of the native area of the fruit on the composition of these phytochemicals. So, this study analyzed the nutrient composition and identified the phenolic compounds in the pulp of C. brasiliense fruits native to four different areas of the Cerrado. There was a remarkable variation in the contents of energy (176.3-387.2 kcal/100 g) and lipids (13.0-37.5 g/100 g) among samples. In contrast, no difference was observed in the polyphenols composition, since gallic acid, protocatechuic acid, catechin, epicatechin, p-coumaric acid, and ellagic acid were identified in all pequi pulps. C. brasiliense pulp shows potential to be used as a functional ingredient rich in bioactive compounds, but with different contents of energy and lipids according to the fruit’s native area to attempt distinct health allegations of the product.

https://doi.org/10.1590/0103-8478cr20220063

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence
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Santos, Lorena Altafin

; Pinheiro, Dyovana Gomes

; Silva, Jéssica Malek da

; Borges, Giovanna Lombardi Bonini

; Silva, Paula Fernanda da

; Ricci-Vitor, Ana Laura

; Vanderlei, Luiz Carlos Marques

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 N. 2 Pages 235 - 243

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. Methods: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. Results: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale “perceived need”, PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The “access” barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. Conclusion: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

https://doi.org/10.21470/1678-9741-2021-0436

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence
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Santos, Lorena Altafin

; Pinheiro, Dyovana Gomes

; Silva, Jéssica Malek da

; Borges, Giovanna Lombardi Bonini

; Silva, Paula Fernanda da

; Ricci-Vitor, Ana Laura

; Vanderlei, Luiz Carlos Marques

Brazilian Journal of Cardiovascular Surgery

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2023, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2021-0436

Pitaya [Hylocereus polyrhizus (F.A.C. Weber) Britton & Rose] effect on glycemia and oxidative stress in aloxan-induced diabetic mice
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LIRA, Sandra Machado

; HOLANDA, Marcelo Oliveira

; SILVA, José Ytalo Gomes da

; MARQUES, Chayane Gomes

; COELHO, Lia Corrêa

; LIMA, Carla Laíne Silva

; COSTA, Joana Talita Galdino

; DANTAS, Juliana Barbosa

; MACIEL, Gladstone Lima

; SILVA, Gisele Silvestre da

; SANTOS, Glauber Batista Moreira

; ZOCOLO, Guilherme Julião

; DIONÍSIO, Ana Paula

; GUEDES, Maria Izabel Florindo

Food Science and Technology

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2023, Volume 43 elocation e56822

Abstract: En | Text: En | PDF: En

Abstract Pitaya is a rich source of bioactive compounds, such as polyphenols and betalains. Moreover, these compounds has been associated with reduced risk of type 2 diabetes mellitus. The aim of this study is to evaluate the effect of this fruit on glycemia and oxidative stress in aloxan-induced diabetic mice. Thus, considering that In the in vivo assays, the mice were divided into 5 groups (n = 6): (a) healthy group treated with water; (b) diabetic mice treated with metformin at 200 mg/kg body weight diluted in water; (c) untreated diabetic mice; (d) diabetic mice treated with pitaya at 200 mg/kg and (e) diabetic mice treated with pitaya at 400 mg/kg of body weight diluted in water. The results shows that pitaya was able significantly to reduce blood glucose (p < 0.05) (200 mg/kg); significantly reduce cholesterol (200 and 400 mg/kg) and significantly increase HDL-c (400 mg/kg) levels. In the oxidative stress experiment, Malondialdehyde levels in the liver were significantly reduced (p < 0.05) in the groups treated with pitaya, when compared to the other groups, suggesting lower lipid peroxidation. The consumption of pitaya reduced the blood glucose and cholesterol and increase the HDL, in addition, the lipid peroxidation - which is common in diabetic patients, was reduced.

https://doi.org/10.1590/fst.56822

Posicionamento Brasileiro sobre Síndrome da Quilomicronemia Familiar – 2023
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Izar, Maria Cristina de Oliveira

; Santos Filho, Raul Dias dos

; Assad, Marcelo Heitor Vieira

; Chagas, Antonio Carlos Palandri

; Toledo Júnior, Alceu de Oliveira

; Nogueira, Ana Cláudia Cavalcante

; Souto, Ana Cristina Carneiro Fernandes

; Lottenberg, Ana Maria

; Chacra, Ana Paula Marte

; Ferreira, Carlos Eduardo dos Santos

; Lourenço, Charles Marques

; Valerio, Cynthia Melissa

; Cintra, Dennys Esper

; Fonseca, Francisco Antonio Helfenstein

; Campana, Gustavo Aguiar

; Bianco, Henrique Tria

; Lima, Josivan Gomes de

; Castelo, Maria Helane Costa Gurgel

; Scartezini, Marileia

; Moretti, Miguel Antonio

; Barreto, Natasha Slhessarenko Fraife

; Maia, Rayana Elias

; Montenegro Junior, Renan Magalhães

; Alves, Renato Jorge

; Figueiredo, Roberta Marcondes Machado

; Fock, Rodrigo Ambrosio

; Martinez, Tânia Leme da Rocha

; Giraldez, Viviane Zorzanelli Rocha

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 4 elocation e20230203

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

https://doi.org/10.36660/abc.20230203

Characterization of uterine involution using B-mode ultrasonography, color Doppler and elastography (acoustic radiation force impulse) for assessing postpartum in Santa Inês ewes
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Mariano, Renata Sitta Gomes

; Santos, Victor José Correia

; Taira, Augusto Ryonosuke

; Silva, Priscila Del Aguila da

; Rodriguez, Mariana Garcia Kako

; Padilha-Nakaghi, Luciana Cristina

; Simões, Ana Paula Rodrigues

; Maronezi, Marjury Cristina

; Avante, Michelle Lopes

; Uscategui, Ricardo Andres Ramirez

; Lima, Bruna Bressianini

; Feliciano, Marcus Antônio Rossi

; Teixeira, Pedro Paulo Maia

; Vicente, Welter Ricardo Russiano

Animal Reproduction

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2023, Volume 20 N. 2 elocation e20220110

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to investigate uterine involution using ultrasonography techniques during postpartum. Postpartum ultrasonography evaluation (B-mode, color Doppler and Acoustic Radiation Force Impulse elastography) of the uterus was performed by transabdominal approach at immediate after birth and sequentially every 48 hours, during 30 days. The uterine echotexture did not present significant variations (P >0.05) being homogeneous in most evaluations; echogenicity of the uterus increased along the evaluation period (P =0.0452). Progressive and remarkable decrease of the total uterine diameter (UD) were observed (P <0.0001), especially during the first days postpartum. The thickness of uterine wall gradually decreased, as well the endometrial, myometrium and lumen diameters (P <0.0001). Uterine blood flow was assessed by Doppler and decreased during postpartum period, being significantly lower (P=0.0225) on the 30th day of postpartum. Uterine parenchyma presented as homogeneous dark areas (not deformable) on qualitative ultrasound elastography and the means shear velocity values of the uterine wall on quantitative elastography did not differ. This is the first study that evaluate the stiffness of uterine wall in healthy ewes, providing baseline data about quantitative and qualitative stiffness of the normal uterus, and it may be a useful tool for early diagnosis of uterine alterations during the postpartum period, using the reference parameter established for the assessment of uterine integrity during postpartum period.

https://doi.org/10.1590/1984-3143-ar2022-0110

Slope position controls prescribed fire effects on soil: a case study in the high-elevation grassland of Itatiaia National Park
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Oliveira, Ana Paula Pessim de

; Silva Neto, Eduardo Carvalho da

; Marcondes, Robson Altiellys Tosta

; Pereira, Marcos Gervasio

; Motta, Marcelo Souza

; Diniz, Yan Vidal de Figueiredo Gomes

; Fagundes, Hugo de Souza

; Delgado, Rafael Coll

; Santos, Otavio Augusto Queiroz dos

; Anjos, Lúcia Helena Cunha dos

Revista Brasileira de Ciência do Solo

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2023, Volume 47 elocation e0230009

Abstract: En | Text: En | PDF: En

ABSTRACT There is a need for greater knowledge about the medium- and long-term effects of prescribed fire management on soil in ecosystems prone to wildfires and more vulnerable to climate change. This study examined the short- and medium-term effects of prescribed fire on soil chemical properties and chemical fractions of soil organic matter (SOM) in two positions of the landscape in a high-elevation grassland environment. The ecosystem is located in the mountain peaks of southeastern Brazil associated with the Atlantic Forest biome. Prescribed fire was conducted in 2017 to reduce understory vegetation and thus prevent potential severe wildfires. Soil samples were collected at the layers of 0.00-0.10, 0.10-0.20, and 0.20-0.40 m, at eight composite sampling. The composite samples were collected on five different occasions: before the prescribed fire, and 10, 30, 90, and 240 days after the prescribed fire. Soil chemical properties, total organic carbon, labile C, and chemical fractionation of SOM were analyzed. All soil properties investigated were affected by the prescribed fire, with variations in landscape position, duration of effect, and soil layer. In the backslope area, the medium-term effect of fire was negative and induced soil degradation and induced soil degradation. In the footslope area, the system showed greater resilience to the effects of fire, as indicated by the recovery of the soil’s chemical properties. These results can help assess the suitability of controlled burning of vegetation for managing risks of fire in mountainous regions, such as high-elevation grasslands.

https://doi.org/10.36783/18069657rbcs20230009

Oral Mucositis in Children with Leukemia Undergoing Chemotherapy: A Case Series
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Santos, Fabio Gomes dos

; Bezerra, Paula Maria Maracajá

; Limão, Nayara Pereira

; Santana, Ynnaiana Navarro de Lima

; Ribeiro, Isabella Lima Arrais

; Bonan, Paulo Rogério Ferreti

; Serpa, Eliane Batista de Medeiros

; Sousa, Simone Alves

; Valença, Ana Maria Gondim

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2023, Volume 23 elocation e220140

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To report nine cases of pediatric patients with Acute Lymphoid Leukemia (ALL) or Acute Myeloid Leukemia who developed severe oral mucositis (SOM) at the first week of chemotherapy. Material and Methods: The cases were selected from a sample of 105 children followed for 10 consecutive weeks. Hematological and personal data were obtained from the patient's medical records. The oral cavity was examined weekly using the modified Oral Assessment Guide. Results: More of the patients were male (55.6%), had black/brown skin (55.6%), with ALL (66.7%), and the mean age was 5.55. Two patients had values below normal for leukocytes, platelets, and creatinine over the follow-up. However, all patients showed changes in the normality of hematological data in most weeks. The most used chemotherapeutic agents were aracytin, etoposide, and methotrexate, known for their high stomatotoxic potential. Patients had 2 to 6 (mean of 4) episodes of SOM and 4 to 7 (mean of 5.5) episodes of OM. One patient at week 7, one patient at week 5, and one patient at weeks 2 and 10 did not have OM. Saliva (84 times) and lips (44 times) were the most affected items. Conclusion: The patients showed oscillations in the severity of oral mucositis and hematological parameters over the follow-up. All patients were exposed to stomatotoxic drugs during the initial phase of cancer treatment.

https://doi.org/10.1590/pboci.2023.067

10.

Diretrizes Brasileiras para o tratamento farmacológico de pacientes hospitalizados com COVID-19: Diretriz conjunta da Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia e Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Stein, Cinara

; Amaral, José Luiz Gomes do

; Azevedo, Luciano Cesar Pontes de

; Belli, Karlyse Claudino

; Colpani, Verônica

; Cunha, Clóvis Arns da

; Dal-Pizzol, Felipe

; Dias, Maria Beatriz Souza

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Monteiro, José Tadeu

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Prado, Clementina Corah Lucas

; Santos, Vania Cristina Canuto

; Silva, Rosemeri Maurici da

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Vidal, Ávila Teixeira

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Machado, Flávia Ribeiro

; Carvalho, Carlos Roberto Ribeiro de

Revista Brasileira de Terapia Intensiva

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mar 2022, Volume 34 N. 1 Pages 1 - 12

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

RESUMO Objetivos: Há diversas terapias sendo utilizadas ou propostas para a COVID-19, muitas carecendo de apropriada avaliação de efetividade e segurança. O propósito deste documento é elaborar recomendações para subsidiar decisões sobre o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: Um grupo de 27 membros, formado por especialistas, representantes do Ministério da Saúde e metodologistas, integra essa diretriz. Foi utilizado o método de elaboração de diretrizes rápidas, tomando por base a adoção e/ou a adaptação de recomendações a partir de diretrizes internacionais existentes (GRADE ADOLOPMENT), apoiadas pela plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Foram geradas 16 recomendações. Entre elas, estão recomendações fortes para o uso de corticosteroides em pacientes em uso de oxigênio suplementar, para o uso de anticoagulantes em doses de profilaxia para tromboembolismo e para não uso de antibacterianos nos pacientes sem suspeita de infecção bacteriana. Não foi possível fazer uma recomendação quanto à utilização do tocilizumabe em pacientes hospitalizados com COVID-19 em uso de oxigênio, pelas incertezas na disponibilidade e de acesso ao medicamento. Foi feita recomendação para não usar azitromicina, casirivimabe + imdevimabe, cloroquina, colchicina, hidroxicloroquina, ivermectina, lopinavir/ ritonavir, plasma convalescente e rendesivir. Conclusão: Até o momento, poucas terapias se provaram efetivas no tratamento do paciente hospitalizado com COVID-19, sendo recomendados apenas corticosteroides e profilaxia para tromboembolismo. Diversos medicamentos foram considerados ineficazes, devendo ser descartados, de forma a oferecer o melhor tratamento pelos princípios da medicina baseada em evidências e promover economia de recursos não eficazes.

ABSTRACT Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.

https://doi.org/10.5935/0103-507x.20220001-pt

11.

Biocompósito biodegradável hidrofóbico a base de amido de banana verde associado à celulose bacteriana
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Oliveira, Rafaela Vargas

; Kumineck Junior, Sandro Rogério

; Garcia, Michele Cristina Formolo

; Apati, Giannini Pasiznick

; Leitzke, Tatiana da Cunha Gomes

; Schneider, Andrea Lima dos Santos

; Pezzin, Ana Paula Testa

Matéria (Rio de Janeiro)

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2022, Volume 27 N. 1 elocation e202149059

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

RESUMO Neste trabalho foi desenvolvido um biocompósito biodegradável a base de amido de banana verde (ABV) associado à celulose bacteriana (CB) e glicerina (GL), visando aplicação em produtos de rápida descartabilidade. Para a extração do amido, bananas verdes foram lavadas, cortadas e submersas em bissulfito de sódio a 1%, armazenadas em geladeira por 24 h, trituradas em liquidificador com água destilada e peneiradas. O amido precipitado foi disposto em placas de Petri e seco em estufa a 37 °C. Para avaliação da melhor composição com características hidrofóbicas e hidrofílicas, foi realizado um planejamento fatorial 23 completo com 3 pontos centrais, totalizando 11 amostras, sendo avaliada a influência da concentração de farelo de CB nos níveis 10 e 30 g/L, GL nas concentrações de 0 e 16 g/L e metiltrietoxisilano (MTES) na etapa de silanização nas concentrações de 0 e 4% em solução alcoólica. A análise de ângulo de contato permitiu identificar a hidrofobicidade das amostras comprovando a eficácia da silanização. Com base nas medidas de ângulo de contato das amostras foram produzidos os corpos de prova para caracterização contendo 20 g/L de CB, 8 g/L de GL e 4% de silano, uma vez que quanto maior concentração de silano, maior foi a hidrofobicidade do material. A análise de espectroscopia no infravermelho com transformada de Fourier (FTIR) apontou as bandas características de silano, comprovando a reação química com MTES, sendo também possível constatar a existência do amido, CB e GL. A análise termogravimétrica (TGA) demonstrou que a temperatura de degradação máxima da amostra ABV/FCB/GLcs silanizada (4%) se apresenta em Tmáx3= 310°C. Com o teste de degrabilidade em solo foi possível identificar que as amostras funcionalizadas demoram mais para degradar em comparação com as não silanizadas devido à sua barreira a umidade, característica que desacelera a degradação por microorganismos.

ABSTRACT In this work, a biodegradable biocomposite was developed, the green banana starch (GBS) associated with bacterial cellulose (BC) and glycerin (GL), aiming for application in rapid disposability products. For starch extraction, green bananas were washed, cut and submerged in 1% sodium bisulfite, stored in the refrigerator for 24 h, crumbled in a blender with distilled and sieved water. The precipitated starch was disposed of on Petri dishes and dried in an oven at 37°C. A complete factorial planning was carried out to evaluate the best composition with hydrophobic and hydrophilic characteristics with 3 central points, totaling 11 samples, the influence of BC bran concentration at levels 10 and 30 g/L, concentrations of 0 and 16 g/L and methyltriethoxisilane (MTES) in the silanization stage in concentrations of 0 and 4% in alcoholic solution. The contact angle analysis allowed identifying samples’ hydrophobicity, proving silanization effectiveness. Based on the contact angle measurements of the samples, the proof bodies for characterization were produced containing 20 g/L of BC, 8 g/L of GL and 4% silane since the higher concentration of silane, the greater material hydrophobicity. The infrared spectroscopy analysis with Fourier transform (FTIR) pointed out the silane characteristics bands, proving the chemical reaction with MTES, and it is also possible to see the existence of starch, BC and GL. Thermogravimetric analysis (TGA) demonstrated that the maximum degradation temperature of the sample GBS /FBC/GLcs silanized (4%) is Tmax3= 310 °C. With the soil degradability test, it was possible to identify that the functionalized samples take longer to degrade than those not silanized because of their barrier moisture, a characteristic that slows down microorganisms’ degradation.

https://doi.org/10.1590/1517-7076-rmat-2021-49059

12.

Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil
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Damascena, Lecidamia Cristina Leite

; Bezerra, Paula Maria Maracajá

; Santos, Fabio Gomes dos

; Lucena, Nyellisonn Nando Nóbrega de

; Vieira, Thiago Isidro

; Viana Filho, José Maria Chagas

; Bonan, Paulo Rogério Ferreti

; Ribeiro, Isabella Lima Arrais

; Serpa, Eliane Batista de Medeiros

; Sousa, Simone Alves de

; Valença, Ana Maria Gondim

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2022, Volume 22 elocation e210211

Abstract: En | Text: En | PDF: En

Abstract Objective: To describe the impact of the COVID-19 pandemic on dental care provided to pediatric cancer patients assisted in a referral hospital. Material and Methods: This is an observational, retrospective study based on secondary data extracted from worksheets of dental procedures for patients aged between 0 and 19 years assisted in the pediatric oncology sector of a hospital in João Pessoa, PB, Brazil. Dental procedures performed by the interdisciplinary team of researchers from August 2018 to February 2020 (19 months prior to the pandemic) and from April 2020 to October 2021 (19 months during the pandemic) were totaled and compared. A descriptive analysis of the data was performed. Results: There was a reduction of 80.2% in dental interventions implemented in the sector during the pandemic, with the number of procedures decreasing from 6,210 (the period before the pandemic) to 1,229 (during the pandemic). Most procedures in both periods were performed for patients assisted in beds, for whom there was a reduction of care provided for 81.2% from 5,275 to 994 procedures. Dental procedures in the outpatient clinic decreased by 74.9%, from 935 to 235. Conclusion: The COVID-19 pandemic negatively impacted dental care provided to pediatric oncology patients by restricting dental procedures to emergency demands, compromising performance prevention and health promotion actions.

https://doi.org/10.1590/pboci.2022.035

13.

Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Morais, Ana Patrícia Pereira

; Santos, Helena Paula Guerra dos

; Yousafzai, Aisha Khizar

; Campelo, Isabella Lima Barbosa

; Guimarães, José Maria Ximenes

Cadernos de Saúde Pública

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2022, Volume 38 N. 12 elocation e00022122

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

Violence is a major social problem in Brazil, with severe repercussions on the health care sector. Primary health care professionals, especially community health workers (CHWs), are at high risk of violence at facilities and in the socially vulnerable area where they work. This study analyzed the relationships between adverse working conditions and dimensions of localized violence on the prevalence of common mental disorders (CMD) among CHWs in Fortaleza, a state capital in Northeastern Brazil. Information was collected with a self-report questionnaire containing items on sociodemographic data, work-related violence, psychoemotional signs and symptoms (Self-Reporting Questionnaire-20), mental health care, and absence from work due to general or mental health issues. Based on the responses of 1,437 CHWs, the prevalence of CMD (32.75%) was associated with perceived, witnessed, or suffered violence in the work area. In the hierarchical analysis, CMD were associated with age, sex, religious identity, years of experience as a CHW with the Family Health Strategy (FHS), work neighborhood, activities in the community, considering the lack of bonding with families as an obstacle, having suffered domestic violence, use of medication for emotional dysregulation, identifying the neighborhood as violent, considering violence a physical or mental health determinant, and identifying impunity as a cause of violence. Thus, the work and mental health of CHWs were significantly affected by violence dimensions. Our findings are relevant to the adoption of strategies to mitigate the effects of violence on the work and mental health of CHWs.

A violência é um grande problema social no Brasil, com graves repercussões no setor de saúde. Profissionais da atenção primária à saúde, principalmente os agentes comunitários de saúde (ACS), apresentam alto risco de violência nas instalações e na área de vulnerabilidade social onde atuam. Este estudo analisou as relações entre condições adversas de trabalho e as dimensões da violência no território na prevalência de transtornos mentais comuns (TMC) entre ACS de Fortaleza, uma capital do Nordeste do Brasil. As informações foram coletadas por meio de um questionário de autorrelato (Self-Reporting Questionnaire-20) com itens sobre dados sociodemográficos, violência relacionada ao trabalho, sinais e sintomas psicoemocionais, cuidados em saúde mental e ausência ao trabalho por problemas gerais ou de saúde mental. Com base nas respostas de 1.437 ACS, a prevalência de TMC (32,75%) foi associada à violência percebida, testemunhada ou sofrida na área de trabalho. Na análise hierárquica, os TMC estavam associados a idade, sexo, identidade religiosa, anos de experiência como ACS na Estratégia Saúde da Família (ESF), bairro onde trabalha, atividades na comunidade, considerando a falta de vínculo com as famílias como obstáculo, ter sofrido violência doméstica, uso de medicação para desregulação emocional, identificar o bairro como violento, considerar violência um determinante da saúde física ou mental e identificar a impunidade como causa de violência. Assim, o trabalho e a saúde mental dos ACS foram significativamente afetados pelas dimensões da violência. Nossos achados são relevantes para a adoção de estratégias para mitigar os efeitos da violência no trabalho e na saúde mental dos ACS.

La violencia es un problema social importante en Brasil, con graves impactos en el sector de la salud. Los profesionales de la atención primaria de salud, en especial los agentes comunitarios de salud (ACS), se encuentran en alto riesgo de violencia en los establecimientos y en el área de vulnerabilidad social donde actúan. Este estudio analizó la relación entre las condiciones laborales adversas y las dimensiones de la violencia localizada en la prevalencia de los trastornos mentales comunes (TMC) entre los ACS de Fortaleza, una capital en la Región Nordeste de Brasil. Para recabar la información, se aplicó un cuestionario de autoinforme (Self-Reporting Questionnaire-20) que constaba de ítems sobre datos sociodemográficos, violencia laboral, signos y síntomas psicoemocionales, cuidados en salud mental y ausencia al trabajo por problemas generales o de salud mental. De las respuestas de 1.437 ACS, se constató que la prevalencia de TMC (32,75%) estuvo asociada con la violencia percibida, que se presenció o sufrió en el lugar de trabajo. En el análisis jerárquico, los TMC se asociaron con la edad, el sexo, la identidad religiosa, los años de experiencia como ACS en la Estrategia de Salud Familiar (ESF), el barrio donde actúan, las actividades en la comunidad, considerando como obstáculo la falta de vínculo con las familias, haber sufrido violencia intrafamiliar, uso de medicamentos para la desregulación emocional, la identificación del barrio como violento, considerar la violencia como determinante de la salud física o mental e identificar la impunidad como causa de la violencia. Por lo tanto, el trabajo y la salud mental de los ACS se vieron significativamente afectados por las dimensiones de la violencia. Estos hallazgos son relevantes para aplicar estrategias de mitigación de los efectos de la violencia en el trabajo y en la salud mental de los ACS.

https://doi.org/10.1590/0102-311xen022122

14.

PROTOCOLOS PARA ATENDIMENTO DE SAÚDE MENTAL NA ATENÇÃO PRIMÁRIA: SUBSÍDIOS PARA TRANSFORMAÇÃO DA ASSISTÊNCIA
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Cordeiro, Gisele Fernandes Tarma

; Santos, Tatiana Marques dos

; Ferreira, Rosa Gomes dos Santos

; Guljor, Ana Paula Freitas

; Peters, Angela Aparecida

; Peres, Maria Angélica de Almeida

Cogitare Enfermagem

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2022, Volume 27 elocation e82680

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

RESUMO Objetivo: analisar as repercussões no atendimento em saúde mental pela implantação de Protocolos de Conduta Assistencial em Unidade Básica de Saúde, em Juiz de Fora - MG - BR. Método: estudo histórico-social, realizado no ano de 2018, tendo por fontes diretas, documentos escritos e depoimentos orais, analisadas pelos pressupostos da Reforma Psiquiátrica. Resultados: apresentam-se as categorias: a) Reorganização da assistência em saúde mental por implantação de Protocolos de Conduta; b) Processo de referência e contrarreferência entre Unidade Básica de Saúde e serviços de atenção especializada em saúde mental; c) Transformação da assistência em saúde mental. Conclusão: protocolos organizaram a rede de atenção em saúde mental, sustentando a capacitação multiprofissional, introduzindo atenção primária à saúde como porta de entrada para acolhimento, tratamento e acompanhamento em saúde mental territorial.

ABSTRACT Objective: to analyze the repercussions on mental health care due to the implementation of Care Conduct Protocols in a Basic Health Unit from Juiz de Fora (Minas Gerais - Brazil). Method: a historical-social study carried out in 2018, having as direct sources written documents and oral testimonies analyzed according to the assumptions of the Psychiatric Reform. Results: the following categories are presented: a) Reorganization of mental health care through the implementation of Conduct Protocols; b) Referral and counter-referral process between Basic Health Units and specialized mental health care services; and c) Transformation of mental health care. Conclusion: the protocols organized the mental health care network, supporting multiprofessional training, introducing Primary Health Care as a gateway to welcoming, treatment and monitoring in territorial mental health.

RESUMEN Objetivo: analizar las repercusiones que tiene sobre la atención en salud mental la implantación de Protocolos de Conducta Asistencial en una Unidad Básica de Salud de Juiz de Fora (Minas Gerais - Brasil). Método: estudio histórico-social, realizado en 2018, cuyas fuentes directas son los documentos escritos y testimonios orales analizados según los presupuestos de la Reforma Psiquiátrica. Resultados: se presentan las categorías: a) Reorganización de la atención en salud mental a través de la implantación de Protocolos de Conducta; b) Proceso de derivación y contraderivación entre la Unidad Básica de Salud y los servicios de atención especializada en salud mental; c) Transformación de la atención en salud mental. Conclusión: los protocolos organizaron la red de atención en salud mental, apoyando la formación multidisciplinaria, instaurando la Atención Primaria de la Salud como puerta de entrada para la recepción, el tratamiento y seguimiento de la salud mental del territorio.

https://doi.org/10.5380/ce.v27i0.82680

15.

Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
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Vieira-Meyer, Anya Pimentel Gomes Fernandes

; Morais, Ana Patrícia Pereira

; Santos, Helena Paula Guerra dos

; Yousafzai, Aisha Khizar

; Campelo, Isabella Lima Barbosa

; Guimarães, José Maria Ximenes

Cadernos de Saúde Pública

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2022, Volume 38 N. 12 elocation e00022122

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

https://doi.org/10.1590/0102-311xen022122

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