THE IMPACT OF INFORMAL CAREGIVERS DURING CANCER PATIENTS’ TRAJECTORY IN ECONOMIC HEALTH OUTCOMES

In the trajectory of the person with cancer, the presence of uncontrolled symptoms are the main and frequent cause of demand for health services, which increases with the advanced stage of the disease. The modernization of health systems advocates the domiciliation of health care, with proximity assistance, where informal caregivers assume a role of relevance. Persons with cancer prefer this typology of service, as well have positive impact in economic health outcomes. However, it is essential to reflect in the shapes of the professional support, health policies and incentives, which are needed with the finality to prevent burnout of the caregiver. As ensure the resources to certify the self-care and quality of life of the person with cancer and informal caregivers

Prevention and Treatment of Incontinence-Associated Dermatitis (IAD): Contributes of Nursing Intervention

Incontinence-Associated dermatitis (IAD) is a combination of skin changes caused by the presence of confluent moisture, being characterized by prolonged skin exposure to elimination. This is a rather frequent condition, taking into account that there is a significant proportion of people, most of whom are aged 65 years or over and are admitted to acute or long-term care, suffering from urinary and/or fecal incontinence [1]. Typically it is recognized as an inflammation of the skin surface characterized by redness (skin rush), which mainly affects the region of the thighs, buttocks and scrotum, in males and large lips in females [1,2]. This type of injury translates the reaction of the skin to the aggressor agent, immediately compromising its ability to act as a protective barrier [3]. If IAD is not identified and treated in a timely manner, this redness and/or rush may progress rapidly to the local formation of abrasions and vesicular lesions that with prolonged exposure to risk factors may trigger an infectious process with high severity [4]. A cycle begins where a progressive increase of local inflammation and loss of cutaneous integrity is observed [1]

Integrated biocatalytic platform based on aqueous biphasic systems for the sustainable oligomerization of rutin

Rutin is a known antioxidant compound that displays a broad range of biological activities and health-related benefits but presents a low water solubility that can be overcome by its polymerization. In this work, biocompatible aqueous biphasic systems composed of the ionic liquid cholinium dihydrogen phosphate ([CH][DHph]) and the polymer poly(ethylene glycol) 600 (PEG 600) were investigated as an efficient integrated reaction–separation platform for the laccase-catalyzed oligomerization of rutin. Two different approaches were studied to reuse laccase in several oligorutin production cycles, the main difference between them being the use of monophasic or biphasic regimes during the oligomerization reaction. The use of a biphasic regime in the second approach (heterogeneous reaction medium) allowed the successful reuse of the biocatalyst in three consecutive reaction–separation cycles while achieving noteworthy rutin oligomerization yields (95% in the first cycle, 91% in the second cycle, and 89% in the last cycle). These remarkable results were caused by the combination of the increased solubility of rutin in the PEG-rich phase together with the enhanced catalytic performance of laccase in the [Ch][DHph]-rich phase, alongside with the optimization of the pH of the reaction medium straightly linked to enzyme stability. Finally, a life-cycle assessment was performed to compare this integrated reaction–separation platform to three alternative processes, reinforcing its sustainabilityThis research was supported by the Spanish Government (AEI) through the RTI2018-094482-J-I00 project. This work was developed within the scope of the project CICECO-Aveiro Institute of Materials, UIDB/50011/2020 & UIDP/50011/2020, financed by national funds through the Portuguese Foundation for Science and Technology/MCTES. The programme is cofunded by FEDER (UE). A.P.M.T. thanks the FCT for the research contract CEECIND/2020/01867. G.E. thanks the Spanish MICIU for her Ramón y Cajal contract (RYC2018- 024846-I). A.M.-M. thanks the Programa de axudas á etapa predoutoral da Xunta de Galicia (ED481A-2018/023)S

Anais do VI SIMELP – Da união à diversidade

"No VI Simpósio Mundial de Estudos da Língua Portuguesa (SIMELP) “Da união à diversidade”, que teve lugar na Escola Superior de Educação do Instituto Politécnico de Santarém, pretendeu-se proporcionar um espaço aglutinador de discussões entre professores, pesquisadores, estudantes, em áreas como a linguística, a literatura, a cultura, a tradução, a educação, e, ainda, profissionais de outras áreas para quem a língua portuguesa se traduziu num ponto de interesse"info:eu-repo/semantics/publishedVersio

What is the role of apelin regarding cardiovascular risk and progression of renal disease in type 2 diabetic patients with diabetic nephropathy?

Aims. To evaluate the association of different apelin levels with cardiovascular mortality, hospitalization, renal function, and cardiovascular risk factors in type 2 diabetic patients with mild to moderate CKD. Methods. An observational, prospective study involving 150 patients divided into groups according to baseline apelin levels: 1 = 329 pg/mL. Baseline characteristics were analyzed and compared. Multivariate Cox regression was used to find out predictors of cardiovascular mortality, and multivariate logistic regression was used to find out predictors of hospitalization and disease progression. Simple linear regressions and Pearson correlations were used to investigate correlations between apelin and renal disease and cardiovascular risk factors. Results. Patients' survival at 83 months in groups 1, 2, and 3 was 39%, 40%, and 71.2%, respectively (P = 0.046). Apelin, age, and eGFR were independent predictors of mortality, and apelin, creatinine, eGFR, resistin, and visfatin were independent predictors of hospitalization. Apelin levels were negatively correlated with cardiovascular risk factors and positively correlated with eGFR. Patients with lower apelin levels were more likely to start a depurative technique. Conclusions. Apelin levels might have a significant clinical use as a marker/predictor of cardiovascular mortality and hospitalization or even as a therapeutic agent for CKD patients with cardiovascular disease

Tracking the Origin of a Rabbit Haemorrhagic Virus 2 Outbreak in a Wild Rabbit Breeding Centre in Portugal; Epidemiological and Genetic Investigation

As key prey, the wild rabbit downsize constitutes a major drawback on the endangered Iberian lynx (Lynx pardinus) re-introduction in the Iberia. Several captive breeding units mostly located in Alentejo, endeavour the wild rabbit repopulation of depleted areas assigned for the lynx re-introduction. Here we report an RHDV2 outbreak that occurred in early 2016 in a wild rabbit captive breeding unit located in Barrancos municipality. The estimated mortality rate between March and April 2016 was approximately 8.67%. Anatomopathologic examination was carried out for 13 victimized rabbits. Molecular characterization was based on the complete vp60 capsid gene. The 13 rabbit carcasses investigated showed typical macroscopic RHD lesions testing positive to RHDV2- RNA. Comparison of the vp60 nucleotide sequences obtained from two specimens with others publically available disclosed similarities below 98.22% with RHDV2 strains originated in the Iberia and Azores and revealed that the two identical strains from Barrancos-2016 contain six unique single synonymous nucleotide polymorphisms. In the phylogenetic analysis performed, the Barrancos-2016 strains clustered apart from other known strains, meaning they may represent new evolutionary RHDV2 lineages. No clear epidemiological link could be traced for this outbreak where the mortalities were lower compared with previous years. Yet, network analysis suggested a possible connection between the missing intermediates from which the strains from Barrancos 2013, 2014 and 2016 have derived. It is therefore possible that RHDV2 has circulated endemically in the region since 2012, with periodic epizootic occurrences. Still, six years after its emergence in wild rabbits, RHDV2 continues to pose difficulties to the establishment of natural wild rabbit populations that are crucial for the self-sustainability of the local ecosystems

Nutritional Interventions In The Treatment Of Acne Vulgaris: A Systematic Review Of Clinical Trials / Intervenções Nutricionais No Tratamento Da Acne Vulgaris: Uma Revisão Sistemática Dos Ensaios Clínicos

The aim of this study is to review the literature about dietary interventions on acne vulgaris in order to support the development of more effective treatments in clinical practice. A systematic review of the literature, from clinical trials over the last five years, available in Pub Med and SciELO. The selected articles were analyzed according to the Jadad scale, CONSORT and risk of bias using the Cochrane protocol. CONSORT indicated that most of the evidence score was attributed in the titles, abstracts and some of the methods. In particular, the methods of the studies evaluated, when lacking detail, received lower scores, among the evidence, expressed as a percentage. The results, after using the Jadad scale, indicated a similar profile to that obtained with the CONSORT protocol. However, this tool is limited with regard to randomization and blinding. Using the Cochrane method, the risk of bias was evaluated. Results corroborated the evaluations by CONSORT and Jadad scale. Supplementation with n-3 fatty acids, Camellia sinensis, Berberis vulgaris, chromium, selenium and probiotics were significant, but results were limited for the treatment of acne vulgaris. Consumption of foods with increased glycemic load and chocolate indicated a correlation with an increase in acneiform lesions. Changes in nutritional status of alfa-tocopherol, cobalamin and folic acid were associated with the use of isotretinoin. There is a need to increase the quantity and quality of scientific evidence on the nutritional treatment of acne vulgaris in order to more effectively and safely guide the nutritional actions of clinical practice today

ALIMENTAÇÃO ESCOLAR E A ACEITABILIDADE DOS ALUNOS DE UMA ESCOLA PÚBLICA MUNICIPAL

Fundado em 1955, O Programa Nacional de Alimentação Escolar (PNAE), objetivou atender as crianças pré-escolares e escolares da rede pública, escolas indígenas e quilombolas, combatendo grande parte das carências nutricionais durante o período escolar. Analisar a aceitabilidade que os alunos têm das refeições escolares, bem como a percepção dos pais e professores sobre a alimentação escolar na Zona Urbana da cidade de Barbalha-Ce. Estudo descritivo de abordagem qualitativa. Foi realizado com alunos, pais e professores da rede municipal de ensino. O instrumento utilizado foi um roteiro semiestruturado e para a análise dos dados qualitativos, utilizou-se a técnica segundo o agrupamento de estratégias para a análise do conteúdo de acordo com Bardin, a partir da qual foram formados os discursos-sínteses. Foram entrevistados (vinte) sujeitos, cinco professores, dez alunos e cinco pais, todos pertencentes ao município de Barbalha-CE, em estabelecimento de ensino público. Os professores têm entre 29 a 58 anos de idade, com renda de mais de um salário mínimo, sendo 80% do sexo feminino e 20% do sexo masculino, todos com ensino superior completo. Os alunos têm entre 7 a 12 anos, 70% do sexo feminino e 30% do sexo masculino, cursando o ensino fundamental. Já os pais têm entre 38 a 58 anos, com escolaridade máxima de ensino fundamental incompleto. Com base nos resultados obtidos, os participantes da pesquisa mostraram que percebem a importância da merenda escolar na vida dos alunos, afirmando que ela contribui para uma melhor qualidade de vida, inclusive favorecendo em um melhor aprendizado escolar

Prospective cohort studies to evaluate the safety and immunogenicity of the 2013, 2014, and 2015 seasonal influenza vaccines produced by Instituto Butantan

Annual vaccination is the most effective way to prevent seasonal influenza illness. Instituto Butantan (IB) performed clinical studies with its 2013, 2014 and 2015 seasonal trivalent influenza vaccines (inactivated split-virion). Prospective cohort studies were carried out to describe the safety and immunogenicity of Instituto Butantan influenza vaccines, in healthy adults and elderly, from 2013 to 2015. Immediately after the informed consent was signed, participants underwent blood collection followed by vaccination. On study days 1, 2 and 3 post-vaccination participants were contacted by the staff to evaluate the occurrence of solicited (local and systemic) and non-solicited adverse reactions. On study day 21 (+7) subjects returned to the clinical site for final safety assessments and blood collection to evaluate post-vaccination immunogenicity. The immunogenicity analyses were performed by means of hemagglutination inhibition (HI) assay. The immunogenicity endpoints were: seroprotection (SPR) and seroconversion (SCR) rates and the geometric mean HI antibody titer ratio (GMTR). The 2013 study was conducted at the Centro de Referência para Imunobiológicos Especiais (CRIE) and at the Centro de Pesquisa Clínica do Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo while the 2014 and 2015 studies were conducted at CRIE. The vaccine composition followed the WHO recommendation for the Southern hemisphere seasonal influenza vaccine. Fortyseven healthy adults and 13 elderly participated in the 2013 study, 60 healthy adults and 60 elderly in the 2014 study, and 62 healthy adults and 57 elderly in the 2015 study. In the 2013, 2014 and 2015 studies, pain was the most frequent local adverse reaction and headache the most frequent systemic adverse reaction. All observed adverse reactions were classified as mild or moderate and none as severe. SPR >70% and SPR >60% were observed in adults and elderly, respectively, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. SCR >40% was observed in adults, for the three vaccine viruses, only in the 2014 study and SCR >30% was observed in the elderly, for the three vaccine viruses, only in the 2013 and 2014 studies. GMTR >2.5 among adults, for the three vaccine viruses was only observed in the 2013 study and GMTR >2.0 was observed among elderly, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. The 2013, 2014 and 2015 seasonal influenza vaccines produced by Instituto Butantan were safe and immunogenic according to the immunogenicity criteria defined by the European Medicines Agency (EMA)