Nanoencapsulation and bioaccessibility of polyphenols of aqueous extracts from Bauhinia forficata link

Bauhinia forficata Link is a plant rich in polyphenols that has been used mainly for its hypoglycemic activity, which is related to its antioxidant and anti-inflammatory potential. However, the beneficial effect of these bioactive compounds is directly dependent on their bioaccessibility and bioavailability, requiring processing techniques that can improve and preserve their biological activities. This work aimed to obtain nanocapsulated extracts from the infusion (ESIN) and decoction (ESDC) of B. forficata Link leaves, by spray drying. The encapsulating agents used were maltodextrin and colloidal silicon dioxide. The nanocapsules were characterized by HPLC-PDA-ESI-IT-MSn, evaluated the bioaccessibility of polyphenols after simulated digestion and their antioxidant activity. Additionally, an extensive physicochemical characterization of the nanocapsulated extracts was carried out and their stability and technological parameters were evaluated. The ESIN and ESDC extracts had yields of 57.3 % and 62.7 %, with average nanocapsules sizes of 0.202 μm and 0.179 μm, low humidity and water activity (<0.5), powder density and proper flow properties (Hausner ratio ≤ 1.25; Carr index 18–19 %). Scanning electron microscopy showed a spherical and amorphous morphology and low viscosity, which may have favored the solubility profile. The phenolic compounds of the nanocapsules degraded after 400 °C, showing high thermal stability. The infrared spectra identified the presence of maltodextrin and phenolic compounds and that there were no reactions between them. Chromatography confirmed the presence of phenolic compounds, mainly flavonols and their O-glycosylated derivatives, as well as carbohydrates, probably maltodextrin. Simulated in vitro digestion showed that polyphenols and flavonoids from ESIN and ESDC nanocapsules were bioaccessible after the gastric phase (49.38 % and 64.17 % of polyphenols and 64.08 % and 36.61 % of flavonoids) and duodenal (52.68 % and 79.06 % of polyphenols and 13.24 % and 139.03 % of flavoids), with a variation from 52.27 % to 70.55 % of the antioxidant activity maintained, by the ORAC method, after gastric digestion and still 25 %, after duodenal. Therefore, the nanoencapsulation of extracts of B. forficata is a viable option for the preservation of their bioactive compounds, making them bioaccessible and with antioxidant activity, which make them suitable for incorporation into various nutraceutical formulations, such as capsules, tablets and sachets.info:eu-repo/semantics/publishedVersio

Development of terminological subset for people with covid-19 sequelae

Objectives: to develop a terminological subset of the International Classification for Nursing Practice (ICNP) for people with covid-19 sequelae.® Method: methodological study, which followed the steps: Identification of the relevant terms contained in the literature related to Covid-19 sequelae; Cross-mapping of the terms identified in the review with the terms of the classification; Construction of the statements of diagnoses, outcomes and nursing interventions and mapping of the constructed statements; Content validation of the statements by specialist nurses; and Structuring of the subset based on Roy’s Adaptation Model. For data analysis, the Content Validity Index was used, and the statements with Content Validity Index were validated ≥ 0.80. Content validation was performed by 28 specialist nurses. Results: 178 statements of nursing diagnoses/outcomes were constructed, with 450 nursing intervention statements. After content validation, a quantity of 127 diagnoses/outcomes and 148 nursing interventions were obtained, which comprised the terminological subset proposed in the study. Conclusion: the validated statements that make up the terminological subset with greater predominance were those outlines in the physiological adaptive mode. However, the repercussions on the spiritual, social and personal dimensions are also highlighted.info:eu-repo/semantics/publishedVersio

RECTAL ADENOCARCINOMA: CLINICAL EVALUATION AND TREATMENT THROUGH ROBOTIC SURGERY

Rectal adenocarcinoma is a malignant neoplasm that develops in the glandular cells of the rectum. Its clinical evaluation and treatment have been objects of considerable interest, especially with the advancement of robotic surgery. The introduction of the robot in colorectal surgery has provided significant advantages, such as better visualization, precision and control of movements, resulting in potential benefits for patients. However, the literature on the effectiveness and outcomes of robotic surgery in the treatment of rectal adenocarcinoma is vast and varied. Objective: to examine and synthesize the available evidence on the clinical assessment and treatment of rectal adenocarcinoma using robotic surgery, focusing on the last 10 years. Methodology: The methodology followed the PRISMA checklist guidelines. We used the PubMed, Scielo and Web of Science databases to identify relevant articles published in the last 10 years. The descriptors used were "rectal adenocarcinoma", "robotic surgery", "clinical evaluation", "treatment" and "results". The inclusion criteria were studies that evaluated robotic surgery in the treatment of rectal adenocarcinoma, published in English or Portuguese. The exclusion criteria were studies unrelated to the topic, studies without access to the full text and studies with duplicate data. Results: The results revealed an increasing trend in the use of robotic surgery for the treatment of rectal adenocarcinoma. Key topics covered included oncological outcomes, postoperative complications, post-treatment quality of life, and comparisons with other surgical approaches. Conclusion: The review highlights the growing evidence supporting the efficacy and safety of robotic surgery in the treatment of rectal adenocarcinoma. However, additional studies are needed to further understand its clinical utility and its long-term impact on patient outcomes.Rectal adenocarcinoma is a malignant neoplasm that develops in the glandular cells of the rectum. Its clinical evaluation and treatment have been objects of considerable interest, especially with the advancement of robotic surgery. The introduction of the robot in colorectal surgery has provided significant advantages, such as better visualization, precision and control of movements, resulting in potential benefits for patients. However, the literature on the effectiveness and outcomes of robotic surgery in the treatment of rectal adenocarcinoma is vast and varied. Objective: to examine and synthesize the available evidence on the clinical assessment and treatment of rectal adenocarcinoma using robotic surgery, focusing on the last 10 years. Methodology: The methodology followed the PRISMA checklist guidelines. We used the PubMed, Scielo and Web of Science databases to identify relevant articles published in the last 10 years. The descriptors used were "rectal adenocarcinoma", "robotic surgery", "clinical evaluation", "treatment" and "results". The inclusion criteria were studies that evaluated robotic surgery in the treatment of rectal adenocarcinoma, published in English or Portuguese. The exclusion criteria were studies unrelated to the topic, studies without access to the full text and studies with duplicate data. Results: The results revealed an increasing trend in the use of robotic surgery for the treatment of rectal adenocarcinoma. Key topics covered included oncological outcomes, postoperative complications, post-treatment quality of life, and comparisons with other surgical approaches. Conclusion: The review highlights the growing evidence supporting the efficacy and safety of robotic surgery in the treatment of rectal adenocarcinoma. However, additional studies are needed to further understand its clinical utility and its long-term impact on patient outcomes

UTILIZAÇÃO DO PLASMA RICO EM PLAQUETAS E DA FIBRINA RICA EM PLAQUETAS NA CICATRIZAÇÃO DE FERIDAS CRÔNICAS

Objective: To analyze and evaluate the efficacy and benefits of using platelet-rich plasma and platelet-rich fibrin as therapies to promote the healing of chronic wounds. Methodology: This is a literature review in which the construction of the research is based on the question "What are the efficacy and benefits of using platelet-rich plasma and platelet-rich fibrin to promote the healing of chronic wounds?" The research was conducted in 2023 by consulting the MEDLINE and LILACS databases. Results: Platelet-rich plasma and platelet-rich fibrin have shown efficacy in promoting the healing of chronic wounds. Platelet-rich plasma, with its increased concentration of platelets and growth factors, has shown significant results in closing diabetic and venous ulcers, reducing healing time and decreasing wound dimensions. Similarly, platelet-rich fibrin, a complex fibrin matrix, proved crucial in the healing of diabetic wounds, providing a continuous release of growth factors and improving treatment efficacy. Conclusion: Both therapies have remarkable benefits, offering an optimistic outlook for the effective management of persistent wounds and improving the quality of life of patients with chronic wounds.Objetivo: Analizar y evaluar la eficacia y los beneficios del uso de plasma rico en plaquetas y fibrina rica en plaquetas como terapias para promover la cicatrización de heridas crónicas. Metodología: Se trata de una revisión bibliográfica en la que la investigación se basa en la pregunta "¿Cuál es la eficacia y los beneficios de utilizar plasma rico en plaquetas y fibrina rica en plaquetas para promover la cicatrización de las heridas crónicas?". La investigación se realizó en 2023 consultando las bases de datos MEDLINE y LILACS. Resultados: El plasma rico en plaquetas y la fibrina rica en plaquetas han demostrado eficacia para promover la cicatrización de heridas crónicas. El plasma rico en plaquetas, con su mayor concentración de plaquetas y factores de crecimiento, ha mostrado resultados significativos en el cierre de úlceras diabéticas y venosas, reduciendo el tiempo de cicatrización y disminuyendo las dimensiones de las heridas. Del mismo modo, la fibrina rica en plaquetas, una matriz de fibrina compleja, resultó crucial en la cicatrización de heridas diabéticas, al proporcionar una liberación continua de factores de crecimiento y mejorar la eficacia del tratamiento. Conclusión: Ambas terapias presentan beneficios notables, lo que ofrece una perspectiva optimista para el tratamiento eficaz de las heridas persistentes y la mejora de la calidad de vida de los pacientes con heridas crónicas.Objetivo: Analisar e avaliar a eficácia e os benefícios do uso do plasma rico em plaquetas e da fibrina rica em plaquetas como terapias para promover a cicatrização de feridas crônicas. &nbsp;Metodologia: Trata-se de uma revisão da literatura em que a construção da pesquisa está amparada na questão "Qual é a eficácia e os benefícios do uso do plasma rico em plaquetas e da fibrina rica em plaquetas na promoção da cicatrização de feridas crônicas?" A pesquisa foi conduzida em 2023, por meio da consulta às bases de dados MEDLINE e LILACS. &nbsp;Resultados: O plasma rico em plaquetas e a fibrina rica em plaquetas têm demonstrado eficácia na promoção da cicatrização de feridas crônicas. O plasma rico em plaquetas, com sua concentração aumentada de plaquetas e fatores de crescimento, mostrou resultados significativos no fechamento de úlceras diabéticas e venosas, reduzindo o tempo de cicatrização e diminuindo as dimensões das feridas. Da mesma forma, a fibrina rica em plaquetas, uma matriz de fibrina complexa, revelou-se crucial na cicatrização de feridas diabéticas, proporcionando uma liberação contínua de fatores de crescimento e melhorando a eficácia do tratamento. Conclusão: Ambas as terapias apresentam benefícios notáveis, oferecendo uma perspectiva otimista para a gestão eficaz de feridas persistentes e melhorando a qualidade de vida dos pacientes com feridas crônicas

Construindo hábitos alimentares na infância: um olhar para o futuro

Sabe-se que diversos fatores estão correlacionados no que se refere à promoção de uma melhor qualidade de vida e prevenção de doenças, incluindo a garantia de uma alimentação adequada desde os primeiros anos de vida de um indivíduo. Crianças que, durante seu desenvolvimento, mantêm uma alimentação adequada, baseada em alimentos do tipo in natura e/ou minimamente processados, apresentam maiores chances de se tornarem adultos saudáveis no futuro. Diante disso, este relato de experiência do Projeto de Extensão Universitário “NutriAção - Projeto de Incentivo a Nutrição e Alimentação Saudável nas Comunidades”, cujo propósito é baseado na alimentação saudável infantil, visa ilustrar a ação de práticas de educação alimentar e nutricional como estratégia na construção de hábitos alimentares saudáveis na infância a partir de atividades em instituições filantrópicas na cidade do Rio de Janeiro

Mamoplastia pós-cirurgia bariátrica: Análise das cirurgias realizadas no Sistema Único de Saúde

Post-bariatric surgery mammoplasty is a surgical procedure frequently sought by patients who have experienced significant weight loss after bariatric surgery. This body transformation can result in sagging and ptosis of the breasts, affecting patients' aesthetics and self-esteem. Mammoplasty seeks to remodel and reconstruct the breasts, restoring their shape and firmness. However, although post-bariatric surgery mammoplasty offers significant aesthetic benefits, it also presents risks of complications that can lead to hospital admission. Therefore, the objective of this work was to analyse the incidence of post-bariatric surgery mammoplasty performed in the Unified Health System in Brazil, from 2019 to 2023. This is an ecological time series study, which used data from the Hospital Information System (SIH) of DATASUS. This comprehensive source offers a detailed overview of hospitalizations in the northern region of Brazil. We described a 24% reduction in hospitalizations for mammoplasty post-bariatric surgery in Brazil, with the Southeast accounting for the majority of hospitalizations. Furthermore, the majority of hospitalizations were elective and 100% of hospitalizations were highly complex. The observed decrease not only benefits patients, but also has significant financial implications, reducing hospital costs and optimizing the use of resources in the healthcare system.A mamoplastia pós-cirurgia bariátrica é um procedimento cirúrgico frequentemente procurado por pacientes que passaram por uma significativa perda de peso após a cirurgia bariátrica. Essa transformação corporal pode resultar em flacidez e ptose das mamas, afetando a estética e a autoestima dos pacientes. A mamoplastia busca remodelar e reconstruir as mamas, restaurando sua forma e firmeza. No entanto, embora a mamoplastia pós-cirurgia bariátrica ofereça benefícios estéticos significativos, também apresenta riscos de complicações que podem levar à internação hospitalar. Dessa forma, o objetivo desse trabalho foi analisar a incidência da mamoplastia pós-cirurgia bariátrica realizadas no Sistema Único de Saúde no Brasil, no período de 2019 a 2023. Este é um estudo ecológico de séries temporais, que usou dados do Sistema de Informações Hospitalares (SIH) do DATASUS. Essa fonte abrangente oferece uma visão detalhada das internações na região norte do Brasil. Descrevemos uma redução de 24% nas internações por mamoplastia pós-cirurgia bariátrica no Brasil, com o Sudeste sendo responsável pela maioria das internações. Além disso, a maioria as internações foram eletivas e 100% das internações foram de alta complexidade. A diminuição observada não apenas beneficia os pacientes, mas também tem implicações financeiras significativas, reduzindo os custos hospitalares e otimizando o uso de recursos no sistema de saúde

How can we reduce maternal mortality due to preeclampsia? The 4P rule

Abstract In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management

Zika Brazilian Cohorts (ZBC) Consortium: Protocol for an Individual Participant Data Meta-Analysis of Congenital Zika Syndrome after Maternal Exposure during Pregnancy.

Despite great advances in our knowledge of the consequences of Zika virus to human health, many questions remain unanswered, and results are often inconsistent. The small sample size of individual studies has limited inference about the spectrum of congenital Zika manifestations and the prognosis of affected children. The Brazilian Zika Cohorts Consortium addresses these limitations by bringing together and harmonizing epidemiological data from a series of prospective cohort studies of pregnant women with rash and of children with microcephaly and/or other manifestations of congenital Zika. The objective is to estimate the absolute risk of congenital Zika manifestations and to characterize the full spectrum and natural history of the manifestations of congenital Zika in children with and without microcephaly. This protocol describes the assembly of the Consortium and protocol for the Individual Participant Data Meta-analyses (IPD Meta-analyses). The findings will address knowledge gaps and inform public policies related to Zika virus. The large harmonized dataset and joint analyses will facilitate more precise estimates of the absolute risk of congenital Zika manifestations among Zika virus-infected pregnancies and more complete descriptions of its full spectrum, including rare manifestations. It will enable sensitivity analyses using different definitions of exposure and outcomes, and the investigation of the sources of heterogeneity between studies and regions