Pressure Ulcers In Palliative home Care Patients: Prevalence And Characteristics


Pessoas em cuidados paliativos desenvolvem úlceras por pressão (UPP) à medida que a morte se aproxima, contudo, pouco se sabe sobre a dimensão do problema. Realizou-se um estudo descritivo, transversal e quantitativo, cujos objetivos foram: identificar a prevalência de úlceras por pressão em pessoas com câncer em cuidados paliativos domiciliares, comparar o perfil sociodemográfico e clínico dos pacientes com e sem úlceras por pressão e analisar as características das úlceras encontradas nessas pessoas. A amostra foi constituída por 64 pessoas com câncer avançado, em cuidados paliativos domiciliares, a maioria (75,0%) do sexo masculino. Doze (18,8%) apresentaram de uma a três UPP, totalizando 19 lesões, 89,4% desenvolvidas no domicílio e 47,4% de estágio 3. A presença de UPP foi maior entre aqueles que tinham história de lesão anterior. A UPP é um evento de ocorrência expressiva na população estudada, indicando que medidas preventivas devem ser incluídas na atuação das equipes de cuidados paliativos domiciliares.Las personas en cuidados paliativos desarrollan úlceras por presión (UPP) a medida que se acerca la muerte, sin embargo, se desconoce la magnitud del problema. Se realizó un estudio descriptivo, transversal y cuantitativo cuyos objetivos fueron: identificar la prevalencia de las úlceras por presión en pacientes con cáncer en cuidados paliativos domiciliarios, comparar el perfil sociodemográfico y clínico de los pacientes con y sin úlceras por presión y analizar las características de las úlceras encontradas en estas personas. La muestra se constituyó de 64 personas con cáncer avanzado, la mayoría de sexo masculino (75,0%) en cuidados paliativos domiciliarios. Doce participantes (18,8%) tuvieron entre una a tres UPP, con un total de 19 lesiones, de las cuales el 89,4% se desarrolló en el domicilio y el 47,4% estaban en la etapa 3. La prevalencia de UPP fue mayor entre los que tenían antecedentes de lesiones previas. El desarrollo de UPP es un hecho relevante que ocurre en la población estudiada, lo que indica que es primordial incluir medidas preventivas en el trabajo de los equipos de cuidados paliativos domiciliarios.Persons in palliative care develop pressure ulcers (PU) as death approaches, but the extent of the problem is still unknown. The objectives were to identify the prevalence of pressure ulcers in people with cancer in palliative home care, compare the socio-demographic and clinical profile of patients with and without pressure ulcers, and analyze the characteristics of the ulcers. This descriptive, cross-sectional study included 64 people with advanced cancer in palliative home care. Twelve of them (18.8%) had PU, of whom 75.0% were men. The participants had one to three PU, amounting to 19 lesions, 89.4% of those developed at home and 47.4% at stage 3. The presence of PU was higher among those who had a history of previous wound. PU consisted of a significant event occurring in the studied population, indicating that preventive measures should be included in the home palliative care health team.

Atividade residual de herbicidas pré-emergentes aplicados em solos contrastantes

This study investigated the residual activity of different rates of the herbicides alachlor, oxyfluorfen, prometryne and S-metolachlor applied in pre-emergence in soils of contrasting textures. For that, eight simultaneous experiments were conducted with samples of PSAMENT (sandy texture) and RED LATOSOL (clay texture), which received alachlor (0; 2.40 and 3.36 kg ha-1), oxyfluorfen (0; 0.48 and 0.72 kg ha-1), prometryne (0; 0.75 and 1.50 kg ha-1) and S-metolachlor (0; 1.20 and 1.44 kg ha-1) applications. The treatments monitoring was made through sowing of bio-indicator (Brachiaria decumbens or Cucumis sativus). Control was assessed by scores from 0 to 100% at 0, 25, 50, 75, 100 days after application (DAA). Regardeless of rate, alachlor provided control around 80% to 66 DAA, in clay soil and up to 50 DAA in sandy. Oxyfluorfen showed control around 80% to 56 DAA to clay soil and up to 36 DAA to sandy, in both rates. Both rates of prometryne in clay soil provided control over 80% to 28 DAA, with residual activity higher in recommended rate (1.50 kg ha-1). In samples sandy, S-metolachlor provided the same control for both rates, controlling the bio-indicator at 80% up to 52 DAA, and for clay soil in rate at 1.44 kg ha-1, presented 96% control the 80 DAA. Thereby, there was no increase in residual activity in sandy soil, even with the application of the recommended rate for clay soil.O trabalho objetivou estudar a atividade residual de diferentes doses dos herbicidas alachlor, oxyfluorfen, prometryne e S-metolachlor em solos com texturas contrastantes, aplicadas em pré-emergência. Para tanto oito ensaios simultâneos foram realizados, com amostras de NEOSSOLO QUARTZARÊNICO (textura arenosa) e LATOSSOLO VERMELHO (textura argilosa), que receberam aplicações de alachlor (0; 2,40; e 3,36 kg ha-1), oxyfluorfen (0; 0,48; e 0,72 kg ha-1), prometryne (0; 0,75; e 1,50 kg ha-1) e S-metolachlor (0; 1,20; e 1,44 kg ha-1). O monitoramento dos tratamentos foi a partir da semeadura de um bioindicador (Brachiaria decumbens ou Cucumis sativus) aos 0, 25, 50, 75 e 100 dias após a aplicação (DAA) dos herbicidas, avaliando o controle aos 45 dias após a semeadura por meio de notas de 0 à 100%. Independente da dose, o alachlor proporcionou controle acima de 80% até 66 DAA, em solo argiloso, e até 50 DAA, em arenoso. Oxyfluorfen evidenciou controle acima de 80% até 56 DAA para solo argiloso e até 36 DAA para arenoso, em ambas as doses. Ambas as doses de prometryne em solo argiloso proporcionoram controle acima de 80% até 28 DAA, com maior atividade residual na dose recomendada (1,50 kg ha-1). Nas amostras arenosas, S-metolachlor proporcionou o mesmo controle para as duas doses, controlando o bioindicador em 80% até 52 DAA, e para o solo argiloso na dose 1,44 kg ha-1, apresentou 96% de controle até 80 DAA. Desta forma, em solo arenoso não houve aumento da atividade residual, mesmo com a aplicação da dose recomendada para solo argiloso

A filosofia da educação como problematizadora e reflexiva na formação docente

This article aims to analyze the perception of graduates of the course of Letters of the State University of Maranhão, Campus Balsas, about the curricular component "Philosophy of Education" in teacher education. The conception of the relations between the thinking and the pedagogical doing in the Philosophy of Education classes can be a differential in the teacher formation. Methodologically, analytical and explanatory research was used with the aid of questionnaires. The public was selected by the random sample, especially those who worked in basic education. The analysis of quantitative and qualitative content summarized the main categories revealed in the research, namely: 1. Philosophy of Education: problematization and reflection on educational issues; 2. Critical-reflective educational thinking in the philosophical aspect; 3. The constitution of human values in the formation of the citizen. In view of this, it was found that the discipline provided the graduates with subsidies for problematizing, reflexive and critical actions on pedagogical issues in a radical, rigorous and joint manner, according to the precepts proposed by Saviani.Este artículo objetivó analizar la percepción de los egresados del curso de Letras de la Universidad Estatal de Maranhão, Campus Balsas, sobre el componente curricular "Filosofía de la Educación" en la formación docente. La concepción de las relaciones entre el pensar y el hacer pedagógico en las clases de Filosofía de la Educación puede ser un diferencial en la formación docente. Metodológicamente, se utilizó la investigación analítica y explicativa con ayuda de la aplicación de cuestionarios. El público fue seleccionado por la muestra aleatoria, siendo incluidos especialmente aquellos que actuaban en la educación básica. El análisis de contenido cuantitativo y cualitativo sintetizó las principales categorías reveladas en la investigación, a saber: 1. Filosofía de la Educación: problematización y reflexión sobre las cuestiones educativas; 2. Pensamiento crítico-reflexivo educativo en el aspecto filosófico; 3. La constitución de los valores humanos en la formación del ciudadano. En este sentido, se constató que la disciplina proporcionó a los egresados subsidios para las acciones problematizadoras, reflexivas y críticas sobre las cuestiones pedagógicas de modo radical, riguroso y de conjunto, conforme a los preceptos propalados por Saviani.Este artigo objetivou analisar a percepção dos egressos do curso de Letras da Universidade Estadual do Maranhão, Campus Balsas, sobre o componente curricular "Filosofia da Educação" na formação docente. A concepção das relações entre o pensar e o fazer pedagógico nas aulas de Filosofia da Educação pode ser um diferencial na formação docente. Metodologicamente, utilizou-se a pesquisa analítica e explicativa com auxílio da aplicação de questionários. O público foi selecionado pela amostra aleatória, sendo incluídos especialmente aqueles que atuavam na educação básica. A análise de conteúdo quantitativa e qualitativa sintetizou as principais categorias reveladas na pesquisa, a saber: 1. Filosofia da Educação: problematização e reflexão sobre as questões educacionais; 2. Pensamento crítico-reflexivo educacional no aspecto filosófico; 3. A constituição dos valores humanos na formação do cidadão.  Diante disso, constatou-se que a disciplina proporcionou aos egressos subsídios para as ações problematizadoras, reflexivas e críticas sobre as questões pedagógicas de modo radical, rigorosa e de conjunto, conforme os preceitos propalados por Saviani

Seleção de bioindicadores para monitoramento da mobilidade e persistência de herbicidas aplicados no solo

The objective of this work was to select appropriate bioindicators for monitoring the mobility in soil and persistence of amicarbazone, ametryne, diuron and clomazone herbicides. The experiments were conducted in greenhouse conditions, in polyethylene pots of 250 cm3 with dystroferric Red Latosol. In each experiment, it was used one herbicide (amicarbazone, ametryn, diuron or clomazone) and three bioindicators (10 seeds of each specie), distributed in randomized blocks design in a factorial scheme 5 x 3, with three replications. Studied factors were herbicides rates (0; 12.5; 25; 50 and 100% of recommended rate of each herbicide) and species used as bioindicators (Cucumis sativus, Brachiaria decumbens e Sorghum bicolor). Thirty days after sowing, aerial parts of plants were cut and kept in a forced air oven at 40 °C in order to determine dry matter. Among bioindicators species tested, C. sativus was the one that had the highest sensitivity to the concentrations of amicarbazone and ametryne applied in soil. B. decumbens also had an appropriate response for biomonitoring clomazone and diuron, evidencing this idea for further experiments of mobility and persistence in clay soil. S. bicolor specie had the lowest inhibition of biomass among the bioindicators for all herbicides evaluated, therefore not indicated to evaluate the behavior of these herbicides in soil. O objetivo deste trabalho foi selecionar bioindicadores adequados para o monitoramento da mobilidade no solo e persistência dos herbicidas amicarbazone, ametryne, clomazone e diuron. Os experimentos foram conduzidos em casa de vegetação, utilizando vasos de polietileno de 250 cm3,com Latossolo Vermelho distroférrico. Em cada experimento, foi utilizado um herbicida (amicarbazone, ametryne, clomazone ou diuron) e três bioindicadores (10 sementes de cada espécie), distribuídos no delineamento em blocos ao acaso e esquema fatorial 5 x 3, com três repetições. Os fatores estudados foram doses dos herbicidas (0; 12,5; 25; 50 e 100% da dose recomendada de cada herbicida) e espécies utilizadas como bioindicadores (Cucumis sativus, Brachiaria decumbens e Sorghum bicolor). Trinta dias após a semeadura foram cortadas as partes aéreas das plantas que foram mantidas em estufa de ventilação forçada a 40 ºC, visando à determinação da matéria seca. Dentre as espécies de bioindicadores testadas, evidenciou-se que C. sativus foi a que obteve maior sensibilidade às concentrações utilizadas de amicarbazone e ametryne no solo. A B. decumbens também obteve resposta adequada para biomonitoramento do clomazone e diuron, evidenciando essa ideia para futuros experimentos de mobilidade e persistência no solo de textura argilosa. O Sorghum bicolor foi a espécie que apresentou a menor inibição da biomassa, não sendo indicado como bioindicador dos herbicidas estudados

Whole grain bread preserved with lemon juice: a comparative study / Pão integral conservado com suco de limão: um estudo comparativo

The use of natural substances for the replacement of chemicals in food conservation is a global trend. Thus, the aim of this study was to evaluate the effect of lemon juice on wholemeal bread conservation and determine shelf time. This is a quantitative, laboratory and explanatory study in which three formulas of the dough with the same composition of ingredients were tested. One formula had the addition of lemon juice at the concentration of 1.75%; other with industrial antifungal at 1.0%; and the last formula without any addition. Analysis of fibers, humidity, pH and titratable acidity were performed. Shelf life for all formulations was evaluated by the visual method until the formation of mold colonies for 5 days. The samples showed similarity in the variation in humidity level (32.4 to 37.9) in relation to time, having a reduction at the first moment and then in the increase of F1 and F2, and F3 remained constant. The  fiber content of the formulations showed a discrepancy between the contents of the evaluated times. The pH of the three formulas was within the desirable range of 4.0 to 7.0 ensuring good quality for the product according to the technical pattern of baking. The acidity variation between formulas followed a common pattern. Shelf life was similar for formulas containing lemon juice and antifungal solution, however the formula without any addition had the shortest shelf time, confirming the efficiency of lemon in the conservation of wholemeal bread.

Grupo de suporte como estratégia para assistência de enfermagem à família de recém-nascidos hospitalizados

RESUMO Estudo descritivo, exploratório, convergente assistencial. Objetivo: descrever o percurso metodológico do uso da tecnologia de grupo para o cuidado de enfermagem às famílias dos recém-nascidos (RN) internados em Unidade de Terapia Intensiva, oferecendo suporte emocional e informações. A coleta de dados ocorreu de fevereiro a março de 2010 e os sujeitos foram membros das famílias de RN hospitalizados na UTI de um hospital do Estado de Goiás. A condução do grupo incluía: acolhida, apresentação do grupo e contrato grupal; processo grupal; avaliação e encerramento. Conflitos, sentimentos, interações e bloqueios podem surgir durante a sessão grupal, portanto o coordenador deve estar preparado para compreender o movimento do grupo e conduzir os acontecimentos, contribuindo para o crescimento e aprendizagem de todos. O grupo pode ser usado pelo enfermeiro para acolher às famílias dos RN na unidade hospitalar, uma vez que ajuda as pessoas a enfrentarem a crise vivida e atenuar seu sofrimento. Descritores: Acolhimento; Família; Grupos de Apoio; Unidades de Terapia Intensiva Neonatal

Peginterferon still has a place in the treatment of hepatitis C caused by genotype 3 virus

Despite recent advances in therapy for chronic hepatitis C (CHC), the disease caused by genotype 3 virus (GEN3) is still considered a treatment challenge in certain patient subgroups. The aim of this retrospective study was to evaluate the effectiveness and safety of the peginterferon (Peg-IFN) and ribavirin (RBV) combination treatment for GEN3/CHC patients, and to evaluate sustained virological response (SVR) indicators and early treatment interruption due to serious adverse events (SAE). This was a retrospective observational study of GEN3/CHC patients, co-infected or not by HIV and treated with Peg-IFN/RBV in nine Brazilian healthcare centers. The study sample included 184 GEN3/CHC patients; 70 (38%) were co-infected with HIV. The overall SVR rate was 57.1% (95% CI 50-64). Among co-infected and mono-infected patients, the SVR rate was 51.4% (36/70) and 60.5% (69/114), respectively (p=0.241). Thirty-four (18.5%) patients experienced SAE and interrupted treatment. SVR was negatively associated with the use of Peg-IFN alpha 2b (PR 0.75; 95% CI 0.58-0.99; p=0.045) and to early treatment interruption due to SAE (PR 0.36; 95% CI 0.20-0.68; p=0.001). Early treatment interruption due to SAE was associated with age (PR 1.06; 95% CI 1.02-1.10;

Effectiveness and safety of first-generation protease inhibitors in real-world patients with hepatitis C virus genotype 1 infection in Brazil: a multicenter study

OBJECTIVE: To evaluate the effectiveness and safety of first-generation protease inhibitors for the treatment of genotype 1 hepatitis C virus-infected patients at Brazilian reference centers. METHODS: This multicenter cross-sectional study included hepatitis C virus genotype 1 monoinfected patients treated with Peg-interferon, ribavirin, and either boceprevir (n=158) or telaprevir (n=557) between July 2013 and April 2014 at 15 reference centers in Brazil. Demographic, clinical, virological, and adverse events data were collected during treatment and follow-up. RESULTS: Of the 715 patients, 59% had cirrhosis and 67.1% were treatment-experienced. Based on intention-to-treat analysis, the overall sustained viral response was 56.6%, with similar effectiveness in both groups (51.9% for boceprevir and 58% for telaprevir, p=0.190). Serious adverse events occurred in 44.2% of patients, and six deaths (0.8%) were recorded. Cirrhotic patients had lower sustained viral response rates than non-cirrhotic patients (46.9% vs. 70.6%,

The role of spray-drying atmosphere on fridericia chica (bonpl.) L.G. Lohmann standardized extract production for wound healing activity

Fridericia chica (Bonpl.) L.G. Lohmann (synonym Arrabidaea chica Verlot) is widely used in Brazilian folk medicine. Considering overcoming pitfalls of scaling up production of plant extracts, herein the effects of N2 atmosphere for extract spray-drying process is reported. Samples were monitored by in vitro antioxidant activity and microbiological evaluation. The drying atmosphere influenced 3-deoxyanthocyanines content when using air as atomizing gas, decreasing carajurin (37.5%) content with concomitant increase in luteolin yield (24.1%). Both drying processes preserved the pharmacological activity. In the cell migration test with HaCaT cells, the extract dried under air flow (5 μg/mL) promoted wound closure by 78% (12 hours) whereas the extract dried using N2 flow promoted 49% (12 hours), with 98% closure (12 hours) for the positive control. The antimicrobial evaluation for Staphylococcus aureus did not differ within drying atmospheres, with MIC (minimum inhibitory concentration) at 0.39 mg/mL. Therefore, the drying process reported herein did not interfere with the biological activity’s outcome.The authors A.L.T.G.R.and M.A.F thank CNPq for research productivity fellowship. The authors also thank the Chemical, Biological, and Agricultural Pluridisciplinary Research Center (CPQBA/Unicamp) for the laboratory infrastructure. Sao Paulo Research Foundation (FAPESP). This work was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil, Financing Code 001) and the National Council for Scientific and Technological Development (CNPq, Brazil, grant numbers # 132448/2016-5, # 132207/2017-6, # 429463/2018-9).Peer reviewe