Objective to understand the influence of communication as a basic nursing instrument in the promotion of dignity in Palliative Care. Method theoretical reflection through literature review and using Chochinov’s Dignity Model. The research of scientific articles was carried out on the online knowledge library, on the Elsevier publications database and on the database-aggregating platform EBSCO Host Web, published during the period 2010-2016. Results interventions associated with nurses’ communication skills that promote the dignity of clients in palliative care were identified. The communication interventions that most promote dignity are those that transmit to the palliative client respect for their individuality and appreciation of their personal history. Conclusion nurses should adopt a posture of empathic understanding, active listening, availability, attention to emotional needs, nonverbal components (such as physical presence and visual contact), management of expectations and encouragement of self-care.

Objetivo entender la influencia de la comunicación como instrumento básico de enfermería en la promoción de la dignidad en los Cuidados Paliativos. Método reflexión teórica a través de la revisión de la literatura y el uso del Modelo de Dignidad de Chochinov. La investigación de artículos científicos se llevó a cabo en la biblioteca de conocimientos en línea, en la base de datos de publicaciones Elsevier y en la plataforma agregadora de bases de datos EBSCO Host Web, publicados durante el período 2010-2016. Resultados se identificaron intervenciones asociadas a las habilidades de comunicación de las enfermeras que promueven la dignidad de los clientes en los cuidados paliativos. Las intervenciones de comunicación que más promueven la dignidad son las que transmiten al cliente paliativo el respeto por su individualidad y apreciación de su historia personal. Conclusión las enfermeras deben adoptar una postura empática de comprensión, escucha activa, disponibilidad, atención a las necesidades emocionales, componentes no verbales (como la presencia física y el contacto visual), gestión de expectativas y fomento del autocuidado.

Objetivo compreender a influência da comunicação enquanto instrumento básico de Enfermagem na promoção da dignidade em Cuidados Paliativos. Método reflexão teórica mediante revisão da literatura e com recurso ao Modelo da Dignidade de Chochinov. A pesquisa de artigos científicos foi realizada na biblioteca do conhecimento online, na base de dados das publicações Elsevier e na plataforma agregadora de bases de dados EBSCO Host Web, publicados durante o período 2010-2016. Resultados identificou-se intervenções associadas às competências comunicacionais dos enfermeiros que promovem a dignidade dos clientes em cuidados paliativos. As intervenções comunicacionais que mais promovem a dignidade são as que transmitem ao cliente paliativo o respeito pela sua individualidade e valorização da sua história pessoal. Conclusão o enfermeiro deve adotar uma postura de compreensão empática, escuta ativa, disponibilidade, atenção às necessidades emocionais, aos componentes não verbais (como a presença física e o contacto visual), à gestão de expectativas e o incentivo do autocuidado.

Resumo Objetivo Realizar a adaptação transcultural do Routine Task Inventory-Expanded para uso com idosos com demência no Brasil. Método Estudo de adaptação transcultural de instrumento de avaliação, seguindo diretrizes reconhecidas para tradução, retrotradução e comitê de especialistas. Pré-teste realizado com 10 sujeitos idosos sem prejuízos cognitivos. Estudo de confiabilidade (concordância entre avaliadores e análise de consistência interna) realizado com sujeitos idosos com e sem demência (n=26). Resultados A tradução inicial foi revista para não alterar o construto do instrumento. A partir da revisão por especialistas e do pré-teste identificou-se necessidade de ajustes nos itens C.Banho, G.Uso de telefone e H.Uso de equipamentos adaptativos para conferir maior clareza à compreensão dos itens. O instrumento apresentou consistência interna α= 0,813 ABVD/autorrelato a α=0,966, AVD/cuidador e confiabilidade entre avaliadores ICC (IC95%) de 0,987 em AIVD a 1,000 em comunicação. Conclusão Alcançou-se a adaptação transcultural do Routine Task Inventory- Expanded mantendo sua equivalência em relação ao instrumento original.

Abstract Objective Cross-cultural adaptation of the Routine Task Inventory-Expanded assessment for use in Brazil. Method This cross-cultural adaptation study of the Routine Task Inventory-Expanded followed translation, back-translation, and expert committee review guidelines. The pre-test was performed with 10 elderly subjects with no cognitive impairment. The reliability study (agreement between evaluators and internal consistency) was executed with elderly subjects with and without dementia (n=26). Results The initial translation was revised to preserve the instrument’s construct. Adjustments were made to task C. Bathing, task G. Use of the telephone, and task H. Use adaptive equipment to clarify the meaning of items. The instrument showed internal consistency α= 0.813 ADL/self-report to α=0.966, ADL/caregiver, and reliability between ICC evaluators (95%IC) from 0.987 in IADL to 1.000 in communication. Conclusion The cross-cultural adaptation of the Routine Task Inventory-Expanded was achieved, maintaining equivalency to the original instrument and providing a new instrument to assess cognitive functional abilities of elderly individuals living with dementia in routine daily living activities for use in Brazil.

Abstract Background With the growth of the elderly population in Brazil and the increasing impact of depression and anxiety, the importance of preventing these disorders has been highlighted. Studies have shown an inverse relationship between rates of depression/anxiety and physical activity, pointing out its role as a possible protective factor. Objectives To conduct a randomized study with elderly adults in the community, who present with subsyndromal depression and anxiety, that will evaluate the effectiveness of physical activity with a collaborative stepped-care strategy; and to compare the effectiveness of physical activity in preventing subsyndromal depression and anxiety, with regard to the usual care group. Methods The article contains the methodological description of an arm of a large study entitled “Prevention and Treatment of Depression in Elderly”, in which 2,566 Brazilian older adults were screened to identify clinically significant depressive and anxiety symptoms. Those with clinically significant depressive or anxiety symptoms, not meeting criteria for depressive or anxiety disorder, will be invited to participate in a randomized clinical trial with 2 intervention groups: a step-by-step preventive care programme using physical activity, and usual care. The effectiveness of physical activity in the prevention of depressive and anxiety disorders will be evaluated. Discussion New health policies could be implemented, aiming to reduce the number of elderly people with depression and anxiety in primary care. In addition, training may be implemented for family health teams so that screening tools could be used to make an early identification of individuals with (or at risk of developing) mental disorders.

BACKGROUND In a screen of extracts from plants and fungi to detect antileishmanial activity, we found that the ethyl acetate extract of the fungus Nectria pseudotrichia, isolated from the tree Caesalpinia echinata (Brazilwood), is a promising source of bioactive compounds. OBJECTIVES The aims of this study were to isolate and determine the chemical structures of the compounds responsible for the antileishmanial activity of the organic extract from N. pseudotrichia. METHODS Compounds were isolated by chromatographic fractionation using semi-preparative high-performance liquid chromatography, and their chemical structures were determined by analytical and spectral data and by comparison with published data. The antileishmanial activity of the isolated compounds was evaluated in intracellular amastigote forms of Leishmania (Viannia) braziliensis expressing firefly luciferase as reporter gene, and cytotoxicity was determined in Vero and THP-1 mammalian cell lines by MTT assay. FINDINGS Fractionation of the extract yielded seven compounds: 10-acetyl trichoderonic acid A (1), 6′-acetoxy-piliformic acid (2), 5′,6′-dehydropiliformic acid (3), piliformic acid (4), hydroheptelidic acid (5), xylaric acid D (6), and cytochalasin D (7). Compounds 1, 2 and 3 are reported here for the first time. Compounds 1, 2, and 5 were more active, with IC50 values of 21.4, 28.3, and 24.8 µM, respectively, and showed low toxicity to Vero and THP-1 cells. MAIN CONCLUSIONS N. pseudotrichia produces secondary metabolites that are more toxic to intracellular amastigote forms of L. (V.) braziliensis than to mammalian cells.

ABSTRACT In spite of advances in colorectal cancer treatments, approximately 1.4 million new global cases are estimated for 2015. In this sense, Brazilian plant diversity offers a multiplicity of essential oils as prospective novel anticancer compounds. This study aimed to evaluate the antiproliferative effect of the essential oils from four Lippia species in CT26.WT colon tumor cells, as a measurement of cell cycle phase distribution and microRNA expression. CT26.WT showed cell cycle arrest at G2/M phase after treatment with 100 µg/ml of Lippia alba (Mill.) N.E.Br. ex Britton & P. Wilson, Lippia sidoides Cham., and Lippia lacunosa Mart. & Schauer, Verbenaceae, essential oils and, at the same concentration, Lippia rotundifolia Cham. essential oil caused an augment of G0/G1 phase. The miRNA expression profiling shows change of expression in key oncogenic miRNAs genes after treatment. Our findings suggest growth inhibition mechanisms for all four essential oils on CT26.WT cells involving direct or indirect interference on cell cycle arrest and/or oncogenic miRNAs expression.

Aiming to identify new sources of bioactive secondary metabolites, we isolated 82 endophytic fungi from stems and barks of the native Brazilian tree Caesalpinia echinata Lam. (Fabaceae). We tested their ethyl acetate extracts in several in vitro assays. The organic extracts from three isolates showed antibacterial activity against Staphylococcus aureus and Escherichia coli [minimal inhibitory concentration (MIC) 32-64 μg/mL]. One isolate inhibited the growth of Salmonella typhimurium (MIC 64 μg/mL) and two isolates inhibited the growth of Klebsiella oxytoca (MIC 64 μg/mL), Candida albicans and Candida tropicalis (MIC 64-128 μg/mL). Fourteen extracts at a concentration of 20 μg/mL showed antitumour activities against human breast cancer and human renal cancer cells, while two isolates showed anti-tumour activities against human melanoma cancer cells. Six extracts were able to reduce the proliferation of human peripheral blood mononuclear cells, indicating some degree of selective toxicity. Four isolates were able to inhibit Leishmania (Leishmania) amazonensis and one isolate inhibited Trypanosoma cruzi by at least 40% at 20 μg/mL. The trypanocidal extract obtained from Fusarium sp. [KF611679] culture was subjected to bioguided fractionation, which revealed beauvericin as the compound responsible for the observed toxicity of Fusarium sp. to T. cruzi. This depsipeptide showed a half maximal inhibitory concentration of 1.9 μg/mL (2.43 μM) in a T. cruzi cellular culture assay.

Annona cornifolia A. St. -Hil. é uma pequena árvore anual perene encontrada no cerrado brasileiro; seu fruto verde é usado popularmente no tratamento de úlceras. As acetogeninas isoladas a partir das sementes de Annona cornifolia anteriormente apresentaram atividade antioxidante. Continuando as nossas investigações sobre as atividades biológicas das acetogeninas, quatro misturas binárias e dez acetogeninas bis-tetra-hidrofurânicas adjacentes puras foram avaliadas quanto às atividades: citotóxica (sobre três linhagens de células tumorais humanas), antifúngica (sobre Paracoccidioides brasiliensis), tripanocida (sobre Trypanosoma cruzi) e leishmanicida (sobre Leishmania amazonensis). As acetogeninas apresentaram atividade citotóxica, confirmando seu uso potencial na terapia anticâncer. Quanto às atividades leishmanicida e tripanocida, foi observada uma inibição de 87% das formas amastigotas de L. amazonensis e 100% de formas amastigotas e tripomastigotas de T. cruzi, quando testadas a uma concentração de 20 µg mL–1. Além disso, seis acetogeninas mostraram maior atividade sobre todas as três cepas testadas de P. brasiliensis que o trimetoprim-sulfametoxazol, um medicamento usado no tratamento da paracoccidioidomicose. Assim, as acetogeninas podem ser uma alternativa no tratamento de uma série de doenças que têm um enorme impacto em milhões de pessoas no mundo. Este trabalho relata pela primeira as atividades antifúngica, leishmanicida e tripanocida para estas acetogeninas.

Annona cornifolia A. St. -Hil. is a small annual perennial tree found in the Brazilian savannah; their green fruit is popularly used in the treatment of ulcers. The acetogenins isolated from the seeds of Annona cornifolia previously showed to possess antioxidant activity. In continuation of our investigations on the biological activities of acetogenins, four binary mixtures and ten pure adjacent bis-tetrahydrofuran annonaceous acetogenins were evaluated: the cytotoxic (against three human tumor cell lines), antifungal (against Paracoccidioides brasiliensis), trypanocidal (against Trypanosoma cruzi) and leishmanicidal (against Leishmania amazonensis) activities. Acetogenins presented cytotoxic activity confirming their potential use in anti-cancer therapy. Regarding leishmanicidal and trypanocidal activities, an inhibition of 87% of L. amazonensis amastigotes and 100% of T. cruzi amastigotes and trypomastigotes was observed, when tested at the concentration of 20 µg mL–1. Moreover, six acetogenins showed more activity against all the three tested isolates of P. brasiliensis than trimethoprim-sulfamethoxazole, a drug used for treating paracoccidioidomycosis. Thus, acetogenins may be an alternative in treating a number of diseases that have a huge impact on millions of people worldwide. This paper reports for the first time the antifungal, leishmanicidal and trypanocidal activities for these acetogenins.

Several Lippia species have been used in folk medicine mainly for gastrointestinal and respiratory diseases. Their biological properties have been partially associated to the terpenoids found in their essential oils. According to the World Health Organization, cancer is the leading cause of death worldwide and is described as a complex group of diseases with several hallmarks. One of its acceptable defining features is the cell proliferation beyond their boundaries forming the tumors. Importantly, some drugs currently available were discovered by the investigation of plant secondary metabolites. Thus, this study aimed to evaluate in vitro cytotoxic effect of the essential oils extracted from five Lippia species against tumor cell lines. The results indicated that mouse colon carcinoma CT26.WT cell line viability was significantly reduced showing an IC50 of 19.05, 30.20 and 36.30 µg/ml when treated with the essential oils of L. sidoides, L. salviifolia and L. rotundifolia, respectively. Human lung carcinoma A549 cell line also had a compromised viability to the action of L. alba carvone chemotype essential oil. The tested essential oils did not compromise viability of the normal cell line CHO. These finds suggest that the studied Lippia essential oils might be good candidates for further in-depth studies.

Many phenolic compounds such as xanthones, quinones and coumarins have been isolated from Kielmeyera species; however the presence of flavonoids have been showed in other genera in the Calophylleae tribe as Caraipa, Mesua and Calophyllum. Six known glycosidic flavonoids: quercetin 3-β-O-galactopyranoside (1), quercetin 3-β-O-glucopyranoside (2), quercetin 3-O-α-rhamnoside (3), luteolin 6-C-β-glucopyranoside (4), isovitexin (5), kaempferol 3-O-α-rhamnoside (6) and one triterpene, lupenone (7) were isolated, for the first time, from organic crude extract of Kielmeyera variabilis Mart. & Zucc., Calophyllaceae, leaves. The crude organic extract from K. variabilis leaves exhibited 95% of leishmanidal activity at 20 µg/mL on amastigote-like form of Leishmania (Leishmania) amazonensis in vitro model and only compound 3 showed 40-45% of growth inhibition at concentration ranging from 0.78 to 20 µg/mL. In addition, quercetin 3-O-α-rhamnoside (quercitrin) was found to be the major metabolite. Our results and previous reports suggest that synergistic effects of flavonoid glycosides are the cause of significant leishmanidal activity of the crude organic extract from K. variabilis leaves.

Em nosso trabalho anterior (Fabri et al. 2009), mostramos que diferentes extratos de Mitracarpus frigidus apresentaram atividades antibacteriana, antifúngica e leishmanicida significativas. Com o objetivo de aprofundar o conhecimento sobre essa espécie, esse trabalho objetiva identificar os constituintes químicos e avaliar as atividades biológicas in vitro de seu óleo essencial. Dessa forma, o óleo essencial das partes aéreas de M.frigidus foi obtido por hidrodestilação e analisado por CG/EM. Entre os compostos detectados, 11 foram identificados, sendo linalol e o acetato de eugenol os componentes majoritários. O óleo essencial de M. frigidus exibiu moderada atividade antibacteriana contra Staphyloccocus aureus, Bacillus cereus, Pseudomonas aeruginosa e Enterobacter cloacae (CIM 250 µg/mL). Por outro lado, apresentou forte efeito antifúngico contra Cryptoccocus neoformans (CIM 8 µg/mL) e Candida albicans (CIM 63 µg/mL). Expressiva atividade contra as formas promastigostas de Leishmania major e Leishmania amazonensis com valores CI50 de 47, 2 e 89, 7 µg/mL, respectivamente, também foi observada. Além disso, a atividade antioxidante foi investigada através do ensaio com o radical DPPH e este apresentou uma significativa atividade com CI50 de 38 µg/mL. A citotoxidade contra Artemia salina foi moderada com CL50 de 88 µg/mL. Os resultados aqui apresentados são o primeiro relato sobre a composição química e propriedades biológicas do óleo essencial M. frigidus.

In our previous work (Fabri et al. 2009), we showed that different extracts of Mitracarpus frigidus had significant antibacterial, antifungal and leishmanicidal activities. In order to increase our knowledge about this species, this work assesses the chemical composition and the in vitro biological activity of its essential oil. Thus, the essential oil obtained by hydrodistillation of the aerial parts of M. frigidus was analyzed by GC/MS. Among several compounds detected, 11 were identified, being linalool and eugenol acetate the major components. The essential oil exhibited a moderate antibacterial effect against Staphyloccocus aureus, Bacillus cereus, Pseudomonas aeruginosa and Enterobacter cloacae (MIC 250 µg/mL). On the other hand, it showed a strong antifungal effect against Cryptoccocus neoformans (MIC 8 µg/mL) and Candida albicans (MIC 63 µg/mL). Expressive activity against L. major and L. amazonensis promastigote forms with IC50 values of 47.2 and 89.7 µg/mL, respectively, were also observed. In addition, the antioxidant activity was investigated through DPPH radical-scavenging and showed a significative activity with IC50 of 38 µg/mL. The cytotoxicity against Artemia salina was moderate with LC50 of 88 µg/mL. The results presented here are the first report on the chemical composition and biological properties of M. frigidus essential oil.

Blepharocalyx salicifolius (Kunth) O. Berg, Myrtaceae, is an endemic species that occurs at Southern America. This species was studied to intend to isolation of the active compounds that could be used in vitro model against leishmaniosis, tumoral cell and paracoccidioidomycosis. After Gel Permeation Chromatography, the ethanolic extract from leaves yielded sixteen fractions. Five compounds were isolated and assayed, showing activity against tumoral cells, from 3.33 to 12.83 µg.mL-1; Leishmania (Leishmania) amazonensis from 2.19 to 20.80 µg.mL-1 and Paracoccidioides brasiliensis from 3.10 to 12.5 µg.mL-1.

Organic extracts from leaves and stems of Stillingia oppositifolia Baill. ex Müll. Arg., Euphorbiaceae, were screened for antifungal and cytotoxic properties. The extracts presented Minimum Inhibitory Concentration values around 250 µg.mL-1 against Candida krusei and Candida tropicalis, and around 63 µg.mL-1 for Paracoccidioides brasiliensis. They were tested on three human cell lines (UACC-62, MCF-7, and TK-10), disclosing GI50 values, (concentration able to inhibit 50% of the cell growth) ranging from 50 to 100 µg.mL-1. Organic extract from stems furnished hexanic, dichloromethanic and aqueous phases after partition. Chromatographic fractionation of the hexanic soluble phase of the stems yielded aleuritolic acid 3-acetate, β-sitosterol, 3-epi-β-amyrin, β-amyrone and palmitic acid. These compounds showed antifungal and cytotoxic activities in the same range as the organic crude extract and low toxic effect against mononuclear cells obtained from human peripheral blood. This is the first report on chemical and biological potential of S. oppositifolia.

OBJECTIVES: To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION: Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS: We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE) inventory. RESULTS: ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION: Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS: We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.