Ninety-Day Oral Toxicity Assessment of an Alternative Biopolymer for Controlled Release Drug Delivery Systems Obtained from Cassava Starch Acetate

The large consumption of biodegradable films from cassava starch acetate (FCSA) as ingredients in food and pharmaceutical products requires the assessment of the possible toxicity of these products. The aim of this study was to investigate the toxicity of biodegradable film from cassava starch acetate after oral exposure of Wistar rats for 90 days. The amount of food consumed and the body weight were weekly monitored. Blood and urine samples were obtained for the assessment of serum parameters and renal function. Histopathological analyses in target organs were also performed. No evidence of clinical toxicity in hematological, biochemical, or renal parameters in the FCSA-treated animals was found. In addition, relative organ weight and histopathological evaluations did not differ between groups treated with FCSA and control. Data obtained suggest that the subchronic exposure to FCSA does not cause obvious signs of toxicity in Wistar rats, indicating possible safety of this biofilm

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Entendimento sobre o autoconhecimento e sua relação com a detecção precoce do câncer de mama

Trabalho de Conclusão de Curso, apresentado para obtenção do grau de Bacharel, no Curso de Enfermagem, da Universidade do Extremo Sul Catarinense, UNESC.Câncer é o nome dado ao conjunto de mais de 100 doenças, as quais possuem em comum o desordenado crescimento de células que propendem a invadir tecidos e órgão vizinhos. No Brasil, este é um grande problema de saúde pública devido ao grande índice de morbidade e mortalidade de tal doença. O câncer de mama é o mais frequente em mulheres e a segunda causa de morte nesse grupo populacional em todo o mundo, tornando-se ainda mais temido por acometer uma parte culturalmente valorizada do corpo feminino. Desta forma, o autoconhecimento tem papel importante na detecção precoce da doença, possibilitando um tratamento em estágios iniciais, o que contribui para um melhor prognóstico da doença. Este estudo descritivo, exploratório e de campo, de amostra por conveniência, foi realizado em uma Estratégia Saúde da Família do bairro Santa Luzia, no município de Criciúma/SC e teve por objetivo identificar o entendimento de mulheres sobre o autoconhecimento e sua relação com a detecção precoce do câncer de mama em uma ESF de Criciúma/SC. A coleta de dados qualitativos aconteceu entre os dias 14 e 23 de agosto de 2019, através de entrevista estruturada, a qual contou com a participação de dez mulheres. Os critérios de inclusão para este estudo foram mulheres com idades entre 18 e 69 anos e os de exclusão, gestantes e mulheres que não assinaram o Termo de Consentimento Livre e Esclarecido. A análise qualitativa se deu por meio da análise de conteúdo, a qual, segundo Minayo (2008) tem o objetivo de descrever, interpretar e explicar os dados coletados, a fim de que as questões formuladas no estudo possam ser respondidas. Os aspectos éticos foram respeitados segundo as resoluções 466/12 e 510/2016 e os principais resultados foram a falta de orientações em relação aos métodos de prevenção e detecção precoce do câncer de mama; percepção da importância do autoconhecimento quando relacionado com a detecção precoce do câncer de mama e; orientações quanto a realização do autoexame das mamas como fator fortalecedor do autoconhecimento. Diante deste estudo, notou-se uma evolução nas diretrizes para detecção precoce do câncer de mama, a qual visa fortalecer o conhecimento da mulher sobre o próprio corpo, porém estas orientações pouco são repassadas, o que dificulta o processo. Sugere-se então, educações permanentes com profissionais de saúde, assim como fortalecimento das educações em saúde com mulheres, principalmente durante as consultas de enfermagem

Controlling factors on the abundance, diversity and size of living benthic foraminiferal assemblages in the NE sector of Guanabara Bay (Brazil)

The disposal of waste and sewage by anthropic activities in Guanabara Bay (GB), Rio de Janeiro State (Brazil) is negatively affected this coastal ecosystem over the last few decades. This research intends to document how organic matter and metal enrichment affect the benthic organisms. Physicochemical, textural, geochemical and microfaunal data (foraminifera) are analyzed in nine stations in the NE sector of Guanabara Bay. The size and structure of the living foraminiferal assemblages are analyzed on each sedimentary fractions (63-150 mu m, 150-250 mu m, 250-500 mu m and >500 mu m) of every station. In the fraction >500 mu m no foraminifera were found. Results suggest that organic matter contents are high everywhere whereas metals concentrations increase in Sao Goncalo region. The dimension, diversity and equitability of the living foraminiferal assemblages were reduced in the study area. Ammonia tepida was the dominant taxon in all samples. Living specimens identified in the 63-150 mu m sedimentary fraction were found at all stations except in front of Sao Goncalo city (stations GB9 and GB8). Most of species were not found in the 250-500 mu m sediment fraction in most sites except for instance Ammonia tepida. This species dominate in eutrophic areas but where organic matter is in an oxide stage and regardless of whether there is or not gas seep. Foraminiferal density and diversity increased in areas with a prevalence of organic matter from oceanic biological production and declined in areas where organic matter and metals are retained in disoxic/anoxic phases of the sediments

Resumos concluídos - Saúde Coletiva

Resumos concluídos - Saúde Coletiv

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt