Physiological response of Conilon coffee clone sensitive to drought grafted onto tolerant rootstock

O objetivo deste trabalho foi determinar alterações fisiológicas e de tolerância à seca em clones de café Conilon (Coffea canephora) contrastantes quanto à sensibilidade ao deficit hídrico. Foram avaliadas as enxertias recíprocas entre os clones 109A, sensível ao deficit hídrico, e 120, tolerante – 120/109A, 120/120, 109A/120, 109A/109A –, além de seus respectivos pés-francos. As plantas foram cultivadas em vasos de 12 L em casa de vegetação. Após seis meses, metade das plantas foi submetida ao deficit hídrico por meio da suspensão da irrigação, até que as folhas atingissem o potencial hídrico de antemanhã de -3,0 MPa. Quando o clone 120 foi usado como porta-enxerto, as plantas apresentaram sistema radicular mais profundo, mas com menor massa, retardaram por mais tempo a desidratação celular das folhas e apresentaram maior eficiência no uso da água. Sob seca severa, os teores de amido e sacarose decresceram em todos os tratamentos, enquanto os teores de glicose, frutose, aminoácidos totais e prolina aumentaram, particularmente nos tratamentos 109A pé-franco, 109A/109A e 120/109A. Essas plantas apresentaram menor eficiência no uso da água. O acúmulo de solutos não foi associado à tolerância à seca. O uso de porta-enxertos tolerantes à seca contribui para a maior tolerância das plantas ao deficit hídrico.The objective of this work was to determine alterations in physiology and those due to drought tolerance on Conilon coffee (Coffea canephora) contrasting clones regarding the sensitivity to hydric stress. The reciprocal grafting between clones 109A, drought sensitive, and 120, drought tolerant, – 120/109A, 120/120, 109A/120, 109A/109A – along with their ungrafted control plants (109A and 120) were evaluated. Plants were cultivated in 12-L vases in greenhouse. Six months after grafting, half of the plants was subjected to water deficit, by suspending irrigation until leaves reached the hydric potential of -3,0 MPa. When clone 120 was used as rootstock, plants presented deeper roots, although with lower root-biomass, higher ability to postpone leaf dehydration and higher instantaneous water-use efficiency (WUE). Under severe drought, starch and sucrose contents decreased similarly, regardless of the treatment, whereas leaf concentrations of glucose, fructose, total amino acids and proline were higher in non-grafted 109A, 109A/109A, and 120/109A plants. These plants showed the lowest WUE values. Solute accumulation was not primarily related to drought tolerance. The use of drought tolerant rootstocks improves to drought tolerance in coffee

APLICABILIDADE DAS PRÁTICAS INTEGRATIVAS NO SISTEMA ÚNICO DE SAÚDE.

Objective: To discuss the applicability of integrative practices in the single health system through the existing literature. Methods: This is a qualitative integrative literature review. The search for works involved in the research was carried out in the following databases: SCIELO, LILACS, BDENF and MEDLINE, using the descriptors in health sciences: "Comprehensive health care", "Complementary therapies" and "Single health system". The inclusion criteria were: articles published between 2013 and 2023, with free access to full texts, articles in Portuguese, English and Spanish and related to the theme. Exclusion criteria were: duplicate articles, incomplete articles, abstracts, reviews, debates, articles published in event proceedings and unavailable in full. Results: The therapeutic resources that make up ICPs are diverse, and in public health services they are more frequent because they favor lower costs. Conclusion: It can be concluded that integrative practices integrated into PHC have a very satisfactory effect on users' quality of life, and should minimize medication that is often unnecessary.Objetivo: Discutir por meio da literatura existente acerca da aplicabilidade das práticas integrativas no sistema único de saúde. Métodos: Trata-se de uma revisão integrativa da literatura de caráter qualitativo. A busca dos trabalhos envolvidos na pesquisa foi realizada nas seguintes bases de dados: SCIELO, LILACS, BDENF e MEDLINE, a partir dos descritores em ciências da saúde: “Assistência integral à saúde”, “Terapias complementares” e “Sistema único de saúde”. Os critérios de inclusão foram: publicados no período entre 2013 e 2023, cujo acesso ao periódico era livre aos textos completos, artigos em idioma português, inglês e espanhol e relacionados a temática. Critérios de exclusão foram: artigos duplicados, incompletos, resumos, resenhas, debates, artigos publicados em anais de eventos e indisponíveis na íntegra. Resultados: Os recursos terapêuticos que compõe as PICs são diversas, sendo que nos serviços públicos de saúde eles são mais frequentes por favorecerem a diminuição de custos. Conclusão: Conclui-se que as práticas integrativas integradas na APS têm um efeito muito satisfatório no que diz respeito a qualidade de vida dos usuários, devendo minimizar ações medicamentosas que muitas das vezes não são necessárias

ENFRENTAMENTO DAS DOENÇAS CRÔNICAS NÃO TRANSMISSÍVEIS NA ATENÇÃO PRIMÁRIA À SAÚDE

Objective: To discuss the existing literature on coping with chronic non-communicable diseases in primary care. Methods: This is a qualitative integrative literature review. The search for works involved in the research was carried out in the following databases: SCIELO, LILACS, BDENF and MEDLINE, using the descriptors in health sciences: "Primary health care", "Chronic non-communicable diseases" and "Health promotion". The inclusion criteria were: published between 2013 and 2023, with free access to full texts, articles in Portuguese, English and Spanish and related to the theme. Exclusion criteria were: duplicate articles, incomplete articles, abstracts, reviews, debates, articles published in event proceedings and unavailable in full. Results: It is worth highlighting the promotion and prevention of NCDs to be tackled in primary care, in conjunction with the urgent and emergency care networks, in order to expand approaches to these diseases at all levels of care. Conclusion: This study concluded that educational activities are one of the most effective means of combating chronic non-communicable diseases, and that these activities need to begin in primary care.Objetivo: Discutir por meio da literatura existente acerca do enfrentamento das doenças crônicas não transmissíveis na atenção primária. Métodos: Trata-se de uma revisão integrativa da literatura de caráter qualitativo. A busca dos trabalhos envolvidos na pesquisa foi realizada nas seguintes bases de dados: SCIELO, LILACS, BDENF e MEDLINE, a partir dos descritores em ciências da saúde: “Atenção primária á saúde”, “Doenças crônicas não transmissíveis” e “Promoção da saúde”. Os critérios de inclusão foram: publicados no período entre 2013 e 2023, cujo acesso ao periódico era livre aos textos completos, artigos em idioma português, inglês e espanhol e relacionados a temática. Critérios de exclusão foram: artigos duplicados, incompletos, resumos, resenhas, debates, artigos publicados em anais de eventos e indisponíveis na íntegra. Resultados: Vale destacar as ações de promoção e prevenção das DCNTs para seu enfrentamento na atenção primária, juntamente em articulação com as redes de urgência e emergência de modo a aumentar a ampliação das abordagens dessas doenças em todos os níveis de atenção. Conclusão: O presente estudo concluiu que as atividades educativas é um dos meios mais eficazes para combater as doenças crônicas não transmissíveis, sendo que essas atividades precisam iniciar-se na atenção primária

FISIOTERAPIA ASSOCIADA À TOXINA BOTULÍNICA NA DIPLEGIA ESPÁSTICA: um relato de caso

Crianças com diplegia espástica apresentam um padrão de marcha caracterizado pela posição do tornozelo em flexão plantar, flexão excessiva do joelho associado ao valgismo e aumento da adução e rotação interna do quadril. A postura em flexão plantar do tornozelo, secundária à espasticidade, é um dos principais fatores que interferem na função da marcha. Foi realizado um relato de caso para descrever e avaliar a atuação fisioterapêutica associada à aplicação da toxina botulínica tipo A (Dysport) nos flexores plantares de uma criança com diplegia espástica. A criança foi avaliada pré-aplicação da toxina botulínica, 30 e 60 dias após a sua aplicação pelo Sistema de Classificação da Função Motora Grossa (GMFCS), da Medida da Função Motora Grossa (GMFM), da goniometria do tornozelo e do Vídeo Gait Analysis (VGA). O programa de fisioterapia iniciou-se no dia seguinte à aplicação. Foi verificada mudança de um nível no GMFCS com melhora de 9,4% na área de meta do GMFM. Na amplitude de movimento do tornozelo direito houve uma melhora de 15º com o joelho fletido e 17º com joelho estendido e no tornozelo esquerdo uma melhora de 3º e 10º, respectivamente. No VGA ocorreu alteração de um grau no tornozelo esquerdo. Isso demonstra que um programa de fisioterapia associado à aplicação da toxina botulínica interferiu positivamente no desempenho da funcionalidade de uma criança com diplegia espástica e encurtamento dos flexores plantares

Serum levels of vancomycin: is there a prediction using doses in mg/kg/day or m2/day for neonates?

Coagulase-negative Staphylococcus has been identified as the main nosocomial agent of neonatal late-onset sepsis. However, based on the pharmacokinetics and erratic distribution of vancomycin, recommended empirical dose is not ideal, due to the inappropriate serum levels that have been measured in neonates. The aim of this study was to evaluate serum levels of vancomycin used in newborns and compare the prediction of adequate serum levels based on doses calculated according to mg/kg/day and m2/day. This is an observational reprospective cohort at a referral neonatal unit, from 2011 to 2013. Newborns treated with vancomycin for the first episode of late-onset sepsis were included. Total dose in mg/kg/day, dose/m2/day, age, weight, body surface and gestational age were identified as independent variables. For predictive analysis of adequate serum levels, multiple linear regressions were performed. The Receiver Operating Characteristic curve for proper serum vancomycin levels was also obtained. A total of 98 patients received 169 serum dosages of the drug, 41 (24.3%) of the doses had serum levels that were defined as appropriate. Doses prescribed in mg/kg/day and dose/m2/day predicted serum levels in only 9% and 4% of cases, respectively. Statistical significance was observed with higher doses when the serum levels were considered as appropriate (p < 0.001). A dose of 27 mg/kg/day had a sensitivity of 82.9% to achieve correct serum levels of vancomycin. Although vancomycin has erratic serum levels and empirical doses cannot properly predict the target levels, highest doses in mg/kg/day were associated with adequate serum levels. Keywords: Vancomycin, Drug dosage calculations, Pharmacokinetics, Infant, Newborn, Sepsi

Reciprocal grafting between clones with contrasting drought tolerance suggests a key role of abscisic acid in coffee acclimation to drought stress

The role of abscisic acid (ABA) in drought tolerance of Coffea canephora is unknown. To determine whether ABA is associated with drought tolerance and if the use of tolerant rootstocks could increase ABA and drought tolerance, we performed reciprocal grafting experiments between clones with contrasting tolerance to drought (clone 109, sensitive; and clone 120, tolerant). Plants were grown in large (120 L) pots in a greenhouse and subjected to drought stress by withholding irrigation. The non-grafted 120 plants and graft treatments with 120 as a rootstock showed a slower reduction of predawn leaf water potential (Ψpd) and a lower negative carbon isotopic composition ratio compared with the other grafting combinations in response to drought. The same 120 graft treatments also showed higher leaf ABA concentrations, lower levels of electrolyte leakage, and lower activities of ascorbate peroxidase and catalase under moderate (Ψpd = − 1.0 or − 1.5 MPa) and severe (Ψpd = − 3.0 MPa) drought. Root ABA concentrations were higher in plants with the 120 rootstocks regardless of watering regime. The 120 shoots could also contribute to drought tolerance because treatment with 120/109 rootstock/scion combination showed postponed dehydration, higher leaf ABA concentration, and lower leaf electrolyte leakage compared with the sensitive clone. We conclude that both the shoot and root systems of the tolerant clone can increase the concentrations of ABA in leaves in response to drought. This further suggests that ABA is associated with a delayed onset of severe water deficit and decreased oxidative damage in C. canephora

Scale up of implementation of a multidimensional intervention to enhance hypertension and diabetes care at the primary care setting: A protocol for a cluster-randomized study in Brazil

Background: Hypertension and diabetes mellitus (DM) are highly prevalent in low and middle-income countries (LMICs), and the proportion of patients with uncontrolled diseases is higher than in high-income countries. Innovative strategies are required to surpass barriers of low sources, distance and quality of health care. Our aim is to assess the uptake and effectiveness of the implementation of an integrated multidimensional strategy in the primary care setting, for the management of people with hypertension and diabetes mellitus in Brazil.Methods: This scale up implementation study called Control of Hypertension and diAbetes in MINas Gerais (CHArMING) Project has mixed-methods, and comprehends 4 steps: (1) needs assessment, including a standardized structured questionnaire and focus groups with health care practitioners; (2) baseline period, 3 months before the implementation of the intervention; (3) cluster randomized controlled trial (RCT) with a 12-months follow-up period; and (4) a qualitative study after the end of follow-up. The cluster RCT will randomize 35 centers to intervention (n = 18) or usual care (n = 17). Patients ≥18 years old, with diagnosis of hypertension and/or DM, of 5 Brazilian cities in a resource-constrained area will be enrolled. The intervention consists of a multifaceted strategy, with a multidisciplinary approach, including telehealth tools (decision support systems, short message service, telediagnosis), continued education with an approach to issues related to the care of people with hypertension and diabetes in primary care, including pharmacological and non-pharmacological treatment and behavioral change. The project has actions focused on professionals and patients.Conclusions: This study consists of a multidimensional strategy with multidisciplinary approach using digital health to improve the control of hypertension and/or DM in the primary health care setting. We expect to provide the basis for implementing an innovative management program for hypertension and DM in Brazil, aiming to reduce the present and future burden of these diseases in Brazil and other LMICs.Clinical Trial Identifier: This study was registered in ClinicalTrials.gov. (NCT05660928).</p