Produção de soluções aquosas a partir de plantas medicinais com atividade antiparasitária

The therapeutic use of medicinal plants is an ancient practice that has evolved with advances in science, making it possible to monitor their effects and promote the use of phytotherapics, even as a complementary therapy against parasitosis. In Brazil, national policies guarantee safe access to and the rational use of medicinal plants and phytotherapics, due to their effectiveness in primary health care. The aim of this study was to produce aqueous solutions with medicinal plants that are already part of people's daily lives to combat parasitic activity: Eucalyptus globulus, Mentha crispa, Petroselinum crispum, Coriandrum sativum and Punica granatum. To this end, dried hydroalcoholic crude extracts were produced using the maceration method and subsequent rotaevaporation for drying. Aqueous solutions were prepared at concentrations of 5mg/ml, 2.5mg/ml, 1.25mg/ml and 0.625mg/ml of all the extracts, after which the antiparasitic activity against Giardia sp and Entamoeba sp cysts was determined. To observe the toxicity of the solutions, the Artemia salina technique was used. The aqueous solutions of Eucalyptus globulus and Punica granatum showed activity against the microorganisms tested, the toxicity was significant for the Petroselinum crispum solutions and non-toxic for Punica granatum and Coriandrum sativum. All the aqueous solutions showed good stability. This highlights the potential and importance of research for therapeutic validation and improvement, allowing further studies to be carried out.El uso terapéutico de las plantas medicinales es una práctica milenaria que ha evolucionado con los avances de la ciencia, lo que permite controlar sus efectos y promover el uso de fitoterápicos, incluso como terapia complementaria contra las parasitosis. En Brasil, las políticas nacionales garantizan el acceso seguro y el uso racional de plantas medicinales y fitoterápicos, debido a su eficacia en la atención primaria de salud. El objetivo de este estudio fue producir soluciones acuosas con plantas medicinales que ya forman parte de la vida cotidiana de las personas para combatir la actividad parasitaria: Eucalyptus globulus, Mentha crispa, Petroselinum crispum, Coriandrum sativum y Punica granatum. Para ello, se elaboraron extractos crudos hidroalcohólicos desecados mediante el método de maceración y posterior rotaevaporación para su secado. Se prepararon soluciones acuosas a concentraciones de 5mg/ml, 2,5mg/ml, 1,25mg/ml y 0,625mg/ml de todos los extractos, tras lo cual se determinó la actividad antiparasitaria frente a quistes de Giardia sp y Entamoeba sp. Para observar la toxicidad de las soluciones se utilizó la técnica de Artemia salina. Las soluciones acuosas de Eucalyptus globulus y Punica granatum mostraron actividad contra los microorganismos ensayados, la toxicidad fue significativa para las soluciones de Petroselinum crispum y no tóxica para Punica granatum y Coriandrum sativum. Todas las soluciones acuosas mostraron una buena estabilidad.Esto pone de relieve el potencial y la importancia de la investigación para validar y mejorar las terapias, lo que permite realizar nuevos estudiosO uso terapêutico das plantas medicinais é uma prática ancestral que tem evoluído com os avanços na área científica, sendo possível acompanhar os seus efeitos e promover a utilização dos fitoterápicos, até mesmo como terapia complementar contra parasitoses. No Brasil, as políticas nacionais garantem o acesso seguro e o uso racional de plantas medicinais e fitoterápicos, devido à sua eficácia no atendimento primário à saúde. Esse trabalho visou produzir soluções aquosas com plantas medicinais já inseridas no cotidiano populacional para combater a atividade parasitária, sendo elas: Eucalyptus globulus, Mentha crispa, Petroselinum crispum, Coriandrum sativum e Punica granatum. Para tanto, extratos brutos secos hidroalcoólicos foram produzidos, utilizando o método de maceração e posterior rotaevaporação para secagem. Foram preparadas soluções aquosas nas concentrações de 5mg/ml, 2,5mg/ml, 1,25mg/ml e 0,625mg/ml de todos os extratos, posteriormente, foram determinadas a atividade antiparasitária frente aos cistos de Giardia sp e de Entamoeba sp. Para a observação da toxicidade das soluções, foi utilizada a técnica de Artemia salina. As soluções aquosas de Eucalyptus globulus e Punica granatum, apresentaram resultados de atividade frente aos microrganismos testados, a toxicidade foi expressiva para as soluções de Petroselinum crispum e atóxica para Punica granatum e Coriandrum sativum. Todas as soluções aquosas expressaram boa estabilidade. Desta feita destaca-se o potencial e a importância da pesquisa para validação e aprimoramento terapêutico, permitindo que estudos posteriores sejam realizados

Translation, adaptation and validation the contents of the Diabetes Medical Management Plan for the Brazilian context

Objetivo: traduzir, adaptar e validar o conteúdo do Diabetes Medical Management Plan para o contexto brasileiro, protocolo elaborado pela Associação Americana de Diabetes, que orienta a conduta dos educadores para o cuidado das crianças e adolescentes com diabetes mellitus nas escolas. Método: trata-se de estudo metodológico, realizado em quatro etapas: tradução inicial, síntese da tradução inicial, retrotradução e validação de conteúdo por um Comitê de Juízes, composto por 94 especialistas (29 linguistas aplicados e 65 profissionais da área da Saúde), para avaliação da versão traduzida por meio de um questionário online. O nível de concordância dos juízes foi calculado com base no Índice de Validade de Conteúdo. Os dados coletados foram exportados para análise estatística no ambiente R. Resultados: a avaliação do instrumento apresentou boa concordância entre os juízes das áreas da Saúde e Linguística Aplicada, com Índice de Validade de Conteúdo médio de 0,9 e 0,89, respectivamente, e pequena variabilidade do índice entre grupos (diferença inferior a 0,01). Os itens da versão traduzida, avaliados como insatisfatórios pelos juízes, foram reformulados com base nas ponderações dos profissionais de cada grupo. Conclusão: construiu-se uma versão brasileira do Diabetes Medical Management Plan, denominado Plano de Manejo do Diabetes na Escola.Objective: to translate, adapt and validate the contents of the Diabetes Medical Management Plan for the Brazilian context. This protocol was developed by the American Diabetes Association and guides the procedure of educators for the care of children and adolescents with diabetes in schools. Method: this methodological study was conducted in four stages: initial translation, synthesis of initial translation, back translation and content validation by an expert committee, composed of 94 specialists (29 applied linguists and 65 health professionals), for evaluation of the translated version through an online questionnaire. The concordance level of the judges was calculated based on the Content Validity Index. Data were exported into the R program for statistical analysis: Results: the evaluation of the instrument showed good concordance between the judges of the Health and Applied Linguistics areas, with a mean content validity index of 0.9 and 0.89, respectively, and slight variability of the index between groups (difference of less than 0.01). The items in the translated version, evaluated as unsatisfactory by the judges, were reformulated based on the considerations of the professionals of each group. Conclusion: a Brazilian version of Diabetes Medical Management Plan was constructed, called the Plano de Manejo do Diabetes na Escola.Objetivo: traducir, adaptar y validar el contenido del Diabetes Medical Management Plan para el contexto brasileño, protocolo elaborado por la Asociación de Diabetes Americana, que orienta la conducta de los educadores para el cuidado de niños y adolescentes con diabetes mellitus en las escuelas. Método: se trata de estudio metodológico, realizado en cuatro etapas: traducción inicial, síntesis de la traducción inicial, retrotraducción y validación de contenido por un Comité de Jueces, compuesto por 94 especialistas (29 lingüistas aplicados y 65 profesionales del área de la Salud), para evaluación de la versión traducida por medio de un cuestionario online. El nivel de concordancia de los jueces fue calculado con base en el Índice de Validez de Contenido. Los datos recolectados fueron exportados para ser analizados estadísticamente en el ambiente R. Resultados: la evaluación del instrumento presentó buena concordancia entre los jueces de las áreas de Salud y Lingüística Aplicada, con Índice de Validez de Contenido promedio de 0,9 y 0,89, respectivamente, y pequeña variabilidad del índice entre grupos (diferencia inferior a 0,01). Los ítems de la versión traducida, evaluados como insatisfactorios por los jueces, fueron reformulados con base en las sugestiones de los profesionales de cada grupo. Conclusión: se construyó una versión brasileña del Diabetes Medical Management Plan, denominado Plan de Administración de la Diabetes en la Escuela

A INFLUÊNCIA DO AMBIENTE FAMILIAR NA MANIFESTAÇÃO DO TRANSTORNO DE PERSONALIDADE NARCISISTA

The manifestation of Narcissistic Personality Disorder (NPD) is often influenced by various factors, with the family environment being an important component. Family dynamics play a crucial role in the development of this disorder, impacting the formation of the individual's self-image and patterns of interpersonal relationships. In this context, understanding the influence of the family environment on the expression of NPD is fundamental to effectively address this complex psychological condition. Objectives: To investigate and understand the specific influence of the family environment on the manifestation of narcissistic personality disorder, exploring interaction patterns, parental styles, and family dynamics that may contribute to the development of this disorder. Methodology: Articles found were read, and inclusion and exclusion criteria were applied. Within the inclusion criteria, original articles addressing the investigated topic and allowing full access to the study's content were considered, published between 2016 and 2023, in Portuguese and English. The research was conducted through online access to the databases of the National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Health Sciences Literature (LILACS) in February 2024. Results and Discussions: The complexity of treating narcissistic personality disorder (NPD) is highlighted. Psychopharmacological treatments have shown limited efficacy, being more useful in comorbidities with other conditions. Several psychotherapeutic approaches were explored, with Dialectical Behavioral Therapy and Schema-Focused Therapy standing out, as well as psychoanalytic approaches such as Transfer-Centered Psychotherapy and Mentalization-Based Therapy. However, regardless of the approach, narcissistic patients are challenging to treat due to difficulty in accepting the diagnosis and lack of empathy. Motivation for change often arises from external crises, making therapeutic commitment fragile. Therapists' countertransference is also a challenge, with difficult-to-manage negative feelings that, when understood, can provide valuable information about the patient's internal world. In summary, the results highlight the need for therapeutic strategies adapted to the complexity of NPD, considering the specific characteristics of narcissistic patients and the inherent challenges in the therapeutic process. Conclusion: In conclusion, addressing Narcissistic Personality Disorder (NPD) demands a deep understanding of therapeutic nuances. The results underscore the complexity in the effectiveness of psychopharmacological treatments and the importance of specific psychotherapeutic approaches. Difficulty in accepting the diagnosis, lack of empathy, and challenges in countertransference emphasize the need for adapted therapeutic strategies. Amidst these challenges, the pursuit of realistic treatment goals and the creation of therapeutic contracts are crucial. These findings underline the importance of continuing research and refining therapeutic approaches to effectively manage NPD.The manifestation of Narcissistic Personality Disorder (NPD) is often influenced by various factors, with the family environment being an important component. Family dynamics play a crucial role in the development of this disorder, impacting the formation of the individual's self-image and patterns of interpersonal relationships. In this context, understanding the influence of the family environment on the expression of NPD is fundamental to effectively address this complex psychological condition. Objectives: To investigate and understand the specific influence of the family environment on the manifestation of narcissistic personality disorder, exploring interaction patterns, parental styles, and family dynamics that may contribute to the development of this disorder. Methodology: Articles found were read, and inclusion and exclusion criteria were applied. Within the inclusion criteria, original articles addressing the investigated topic and allowing full access to the study's content were considered, published between 2016 and 2023, in Portuguese and English. The research was conducted through online access to the databases of the National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Health Sciences Literature (LILACS) in February 2024. Results and Discussions: The complexity of treating narcissistic personality disorder (NPD) is highlighted. Psychopharmacological treatments have shown limited efficacy, being more useful in comorbidities with other conditions. Several psychotherapeutic approaches were explored, with Dialectical Behavioral Therapy and Schema-Focused Therapy standing out, as well as psychoanalytic approaches such as Transfer-Centered Psychotherapy and Mentalization-Based Therapy. However, regardless of the approach, narcissistic patients are challenging to treat due to difficulty in accepting the diagnosis and lack of empathy. Motivation for change often arises from external crises, making therapeutic commitment fragile. Therapists' countertransference is also a challenge, with difficult-to-manage negative feelings that, when understood, can provide valuable information about the patient's internal world. In summary, the results highlight the need for therapeutic strategies adapted to the complexity of NPD, considering the specific characteristics of narcissistic patients and the inherent challenges in the therapeutic process. Conclusion: In conclusion, addressing Narcissistic Personality Disorder (NPD) demands a deep understanding of therapeutic nuances. The results underscore the complexity in the effectiveness of psychopharmacological treatments and the importance of specific psychotherapeutic approaches. Difficulty in accepting the diagnosis, lack of empathy, and challenges in countertransference emphasize the need for adapted therapeutic strategies. Amidst these challenges, the pursuit of realistic treatment goals and the creation of therapeutic contracts are crucial. These findings underline the importance of continuing research and refining therapeutic approaches to effectively manage NPD

Alterações cognitivas na infecção pelo HIV: uma revisão sistemática: Cognitive changes in HIV infection: a systematic review

Provocada pelo vírus da imunodeficiência humana, com a síndrome da imunodeficiência adquirida, numa pessoa tem o seu sistema imunológico prejudicado, tornando-se suscetível a outras doenças e infecção. Tem-se a estimativa de que 50% dos infectados com o referido vírus podem sofrer alterações cognitivas. Diante disso, este estudo tem como objetivo refletir sobre mudanças estruturais cerebrais e comprometimento cognitivo em pacientes com HIV. Portanto, trata-se de uma revisão sistemática de literatura, desenvolvida a partir da seleção de estudos nas bases de dados Scielo, Pubmed e BVS/Medline a partir do uso de descritores DeCS/MeSH e aplicação de critérios de inclusão e exclusão. Após a análise e interpretação dos dados, concluiu-se que há uma significativa prevalência de HAND em adultos infectados por HIV, no que se refere a alterações cognitivas, especialmente entre pacientes do sexo feminino, de baixa escolaridade e renda, com diagnóstico tardio e baixa quantidade de linfócitos CD4 no início do tratamento. Entre essas pessoas, revelam-se comprometimentos quanto à memória, atenção, controle de impulsos, velocidade de processamento e motora, dentre outros

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Influence of the shading caused by the maize plants on the anatomy of the bean leaf of different growth habits. II. Mesophyll

Foram estudadas a organização e a espessura do mesofilo e a área do folíolo em cultivares de feijão (Phaseolus vulgaris L.) de hábito de crescimento determinado (cv. Canário 101) e indeterminado (cvs. Rio Tibagi e Costa Rica 1031), sob influência do sombreamento pelo milho, de acordo com os sistemas de cultivo: feijoeiro com milho seco cortado a 10 cm do solo, dobrado à altura da primeira espiga e mantido em pé. Foram feitas avaliações no folíolo central da terceira folha trifoliolada, e, em seções transversais da região mediana da lâmina foliar. Medidas da radiação fotossinteticamente ativa (RFA) foram tomadas, semanalmente, em diferentes níveis de altura das plantas. Os sistemas de cultivo com milho seco dobrado e em pé, juntamente com o sombreamento intra e entre plantas de feijoeiro, reduziram a disponibilidade total de radiação. A disposição dos tecidos constituintes do mesofilo, parênquimas paliçádico e lacunoso não foi influenciada pela radiação disponível resultante dos sistemas de cultivo utilizados, que influenciou, no entanto, a espessura desses tecidos e da lâmina foliar, promovendo a sua expansão celular. O parênquima lacunoso foi mais afetado pelas quantidades de radiação do que o parênquima paliçádico. O sombreamento induziu aumento da área do folíolo. The arrangement and thickness of the leaf mesophyll and leaflet area were studied in bean (Phaseolus vulgaris L.) cultivars with determinate (Canário 101) and indeterminate (Rio Tibagi and Costa Rica 1031) growth habit, grown under different light intensities determined by shading by maize plants. The cropping systems were: dried plants of maize cut at 10 cm from the soil surface, plants doubled over below the first ear and upright plants. The evaluations were made on the central leaflet of the third trifoliolate leaf at the median region. Measurements of photosynthetically active radiation (PAR) were taken weekly at different plant heights. The cropping systems with doubled over and upright maize plants, allied to intra and inter shading among bean plants caused a decrease in the total radiation. The arrangement of the palisade and spongy parenchyma in the leaf mesophyll was not influenced by the available radiation, but the thickness of those tissues and the leaf blade were influenced, leading to cell expansion of the structures. The spongy parenchyma was more influenced by the amount of radiation than the palisade parenchyma. The shading induced an increase in area of the leaflet