HIPPOCRATES IS CARE: HISTORY AND SOME BIOLOGICAL PATHWAYS ON CAREGIVER

AbstractHippocrates is the mainstay of care. Plato and Aristotle state humoralism as the way that Hippocrates understands human health disorders. He closely observed patients to restore humoral equilibrium, relying on healing power of nature to recover health, rejecting drugs or any kind of procedure that could harm the individual. The development of a common ground of understanding is desirable as a process of negotiating treatment goals and methods which may create an atmosphere of support and solidarity. The concept of supportive care was formalized in Belgium in 1992 with attention to multicultural aspect of our population. The biological basis on care are backed on cortical circuitries, association of pathways, existence of several neurotransmitters, which mediates integrative process promoting behavior, emotion and cognitive. Care may influence favorably all these biological systems and help to improve quality of live or even cure the patient. Descriptors: Hippocrates is Care, Biological Basis on Care, Pathways of Care

HIPPOCRATES IS CARE: HISTORY AND SOME BIOLOGICAL PATHWAYS ON CAREGIVER

Abstract Hippocrates is the mainstay of care. Plato and Aristotle state humoralism as the way that Hippocrates understands human health disorders. He closely observed patients to restore humoral equilibrium, relying on healing power of nature to recover health, rejecting drugs or any kind of procedure that could harm the individual. The development of a common ground of understanding is desirable as a process of negotiating treatment goals and methods which may create an atmosphere of support and solidarity. The concept of supportive care was formalized in Belgium in 1992 with attention to multicultural aspect of our population. The biological basis on care are backed on cortical circuitries, association of pathways, existence of several neurotransmitters, which mediates integrative process promoting behavior, emotion and cognitive. Care may influence favorably all these biological systems and help to improve quality of live or even cure the patient. Descriptors: Hippocrates is Care, Biological Basis on Care, Pathways of Care

Estimation of Ascorbic Acid in Intact Acerola (Malpighia emarginata DC) Fruit by NIRS and Chemometric Analysis

Acerola fruit is one of the richest natural sources of ascorbic acid ever known. As a consequence, acerola fruit and its products are demanded worldwide for the production of health supplements and the development of functional products. However, the analytical determination of ascorbic acid is time-consuming and costly. In this study, we show a non-destructive, reliable, and fast method to measure the ascorbic acid content in intact acerola, using near-infrared spectroscopy (NIRS) associated with multivariate calibration methods. Models using variable selection by means of interval partial least squares (iPLS) and a genetic algorithm (GA) were tested. The best model for ascorbic acid content, based on the prediction performance, was the GA-PLS method with second derivative spectral pretreatment, with a root mean square error of cross-validation equal to 22.9 mg/100 g, root mean square error of prediction equal to 46.3 mg/100 g, ratio of prediction to deviation equal to 8.0, determination coefficient for calibration equal to 0.98 and determination coefficient for prediction equal to 0.96. The current methodology, using NIR spectroscopy and chemometrics, is a promising and rapid tool to determine the ascorbic acid content of intact acerola fruit

Evaluation of the effects of the recommended oral dose of diflubenzuron on bovine sperm and oocyte quality using CASA and OPU-IVEP

IntroductionThe aim of this study was to evaluate potential effects of diflubenzuron on the production and quality of gametes, and on in vitro embryo production (IVEP) outcomes, in cattle.MethodsTwo experiments were performed, the first to evaluate effects on semen, and the second on cumulus-oocyte complexes (COC) and on IVEP. Nelore (Bos taurus indicus) bulls (n = 14) or heifers (n = 16) were allocated into control (CG) or treatment (DIF) groups. All groups received a mineral mix supplement added (DIF) or not (CG) with diflubenzuron (30 mg/head/day), during 8 weeks. Animals were weighed and blood samples were collected throughout the experimental period. Every other week, bulls were subjected to semen collection and heifers to transvaginal ultrasound-guided follicle aspiration sessions. Semen underwent physical and morphological evaluation, and samples were stored for further computer-assisted sperm analysis. The COC recovered were evaluated according to morphology and those classified as viable were sent to an IVEP laboratory.ResultsDiflubenzuron had no effect (P > 0.05) on average body weight or in any blood hematological or biochemical endpoints, regardless of gender. In experiment 1, there was no difference (P > 0.05) between DIF and CG groups for sperm concentration, morphology, or kinetics. In experiment 2, there was also no effect of diflubenzuron on the number of total, viable, or grade I oocytes, as well as on cleavage or blastocyst rates (P > 0.05).DiscussionIn summary, the oral administration of diflubenzuron, within the recommended dose, has no short-term negative effects on sperm production and quality or on oocyte yield and developmental potential in vitro, in cattle

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