PRÁTICA ESTÉTICA E A AUTOESTIMA DE PACIENTES EM TRATAMENTO ONCOLÓGICO

O câncer constitui um problema de saúde pública no Brasil, bem como mundialmente, agravado nos últimos anos devido ao envelhecimento populacional, principalmente em países em desenvolvimento. Essa é uma doença diferenciada de outras enfermidades crônicas em virtude de sua patologia que pode provocar deformidades, dor e mutilações, provocando, também, grande impacto psicológico, gerando a sentimentos negativos desde o momento do diagnóstico. A autoestima corresponde à valorização intrínseca que o indivíduo faz de si mesmo em diferentes situações e eventos da vida a partir de um determinado conjunto de valores eleitos por ele como positivos ou negativos. Assim, o objetivo do estudo foi avaliar se os procedimentos estéticos podem contribuir para a manutenção e/ ou elevação da autoestima de pacientes em tratamento oncológico. Participaram dessa pesquisa 32 mulheres em tratamentos de quimioterapia e radioterapia. O presente estudo foi de abordagem quantitativa, descritiva, longitudinal, com amostragem aleatória simples e foi desenvolvido na Associação do Voluntariado de Varginha “Vida Viva”. Os resultados obtidos mostraram que os pacientes apresentaram autoestima inicial de 21,84 e final de 21,47. Não foram encontradas diferenças entre a autoestima antes e após a aplicação dos procedimentos estéticos. Conclui-se que as práticas estéticas contribuíram para a manutenção da autoestima dos pacientes

Unripe Musa sapientum peel in the healing of surgical wounds in rats

PURPOSE: To assess the effects of unripe Musa sapientum peel on the healing of surgical wounds in rats. METHODS: One hundred and twenty Wistar rats were divided into two treatment groups of 60 animals each: the control group (gel without the active ingredient) and experimental group (4% Musa sapientum peel gel). A 4 x 4 cm surgical wound was created on the back of each animal. The wound was cleaned daily with 0.9% saline, treated with 4% gel or natrosol gel (control), and covered with gauze. Animals from both groups were sacrificed after seven, 14 and 21 days of treatment; the tissue from the wound site was removed together with a margin of normal skin for histological analysis. RESULTS: No significant differences in wound contraction rates (p=0.982) were found between time points (seven, 14 and 21 days of treatment) in both groups. However, a significantly higher wound contraction rate was observed in the control group on day 21 compared with the experimental group (p=0.029). There were no significant differences in histomorphological features between groups. The experimental group showed an increased number of polymorphonuclear cells on day 7, with a significant reduction on day 21 (p=0.026). CONCLUSION: The use of 4% unripe Musa sapientum peel gel on surgical wounds in rats resulted in an increased number of polymorphonuclear cells on day 7, reduced wound contraction, reduced vascular proliferation and increased concentration of collagen fibers on day 21.Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)UNIFESP Postgraduate Program in Plastic SurgeryUniversidade Federal de São Paulo (UNIFESP) Department of Surgery Division of Plastic SurgeryUNIVAS School of MedicineUNIVAS Department of BiologyUNIFESP, Postgraduate Program in Plastic SurgeryUNIFESP, Department of Surgery Division of Plastic SurgerySciEL

Microbiota de úlceras venosas pós uso de “Bota de Unna”

Modelo do Estudo: Foi realizado um estudo individual, analítico, observacional, longitudinal prospectivo, controlado, estudo de coortes concorrente, realizado no período de abril de 2013 a novembro de 2014. Objetivo: Avaliar a microbiota presente no exudato da úlcera venosa de pacientes com “Bota de Unna” e a sua resistência aos antimicrobianos. Métodos: Foram coletadas amostras do exudato de feridas de pacientes com o uso de “Bota de Unna” e de terapia tópica durante a troca do curativo e após sete dias. Os micro-organismos isolados foram identificados e testados quanto à susceptibilidade a antimicrobianos: Resultado: Os micro-organismos Gram positivos isolados foram: S. aureus, E. faecalis, S. xylosus e S. haemolyticus. Os micro-organismos Gram negativos foram: E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A.baumannii, E. cloacae e Tatumella sp. O percentual de crescimento e a microbiota no exudato da úlcera após sete dias não foi significante entre os dois tipos de curativo. O aumento de resistência dos cocos Gram positivos aos antimicrobianos testados nos pacientes que utilizam a “Bota de Unna” foi maior do que nos pacientes sem bota (p=0,0093). Conclusão: O número de micro-organismos na microbiota do exudato da úlcera venosa após troca do curativo é maior independentemente do tipo do curativo. Os cocos Gram-positivos apresentam aumento de resistência aos antimicrobianos nos pacientes que utilizam a “Bota de Unna”.Model Study: A special analytical observational prospective longitudinal and controlled study of concurrent cohort was conducted from April 2013 to November 2014. Objective: To evaluate the microbiota present in the secretion of venous ulcer patients with “Unna Boot” and their resistance to antimicrobials. Methods: secretion samples were collected from wounds of patients with and without the use of “Unna Boot” and topic therapy during the dressing change and after seven days. The isolated microorganisms were identified and tested for antimicrobial susceptibility: Result: The isolated Gram-positive microorganisms were: S. aureus, E. faecalis, S. haemolyticus and S. xylosus. Gram-negative microorganisms were E. coli, P. aeruginosa, S. plymuthica, P. mirabilis, K. pneumoniae, K. oxytoca, P. stuartii, P. vulgaris, A. hydrophila, S. marcescens, A. baumannii, E. cloacae and Tatumella sp. The growth percentage and the microbiota in the secretion of the ulcer after seven days was not significant between the two types of dressing. The resistance of Gram-positive cocci to antimicrobials in patients using the “Unna Boot” was higher than in patients without boot (p = 0.0093). Conclusion: The number of microorganisms in microbial secretion venous ulcer after dressing change is higher regardless of the type of dressing. The positive cocci increased antimicrobial resistance in patients using the “Unna Boot”

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

The end-of-life and the doctor: the bioethic's implications of the doctor-terminal patient relationship

OBJECTIVE: This research aims at identifying the physician's considerations regarding the terminal patient and evaluating his attitude towards the end of life. METHOD: The method chosen was the qualitative-descriptive type, with methodological frame based upon Collective Subject Discourse. Twenty physicians were interviewed, who were responsible for the terminal patients' treatment at the regional hospital, Pouso Alegre city, in Brazil. Data was reached through a semi-structured questionnaire, with two questions that were recorded and transcribed in full. RESULTS: The discussion of the considerations about terminal patient and the observation of the development of the physician-terminal patient relationship, allows the results to reinforce that the conflict between the professional personality and the medical reality orientates the physician-terminal patient relationship, inducing the physician to judge his embarrassing presence, and even useless, near the patient's bedstead. However, the bioethical principles about the end of life do not limit themselves only to the patient's right of knowing the truth, but also establish the right to the dialogue with his physician and reinforce the necessity of a relationship based on reciprocity. CONCLUSION: Most of the physicians interviewed believe to be their mission to cure. However, according to Hippocrates, the physician's obligation is to treat when that's possible and always take care. This care is defended on the bioethical principles as the physician's presence near the patient, respecting his desire to speak, to be heard, to get answers, at a time when every event, word, thought, purpose, decision and action assume a new meaning.</p