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To verify if data obtained in the prehospital evaluation of patients with severe acute respiratory syndrome (SARS) during the initial response to the COVID-19 pandemic is associated with clinical outcomes: mechanical ventilation, hospital discharge, and death. This is a retrospective analysis involving secondary data from the Emergency Medical Service (EMS) records and the Health Surveillance Information System of patients assisted by the EMS in Manaus, from January to June 2020, the period of the first peak of COVID-19 cases. The combination of the two databases yielded a total of 1.190 patients, who received a first EMS response and were later admitted to hospital with SARS and had data on clinical outcomes of interest available. Patients were predominantly male (754, 63.4%), with a median age of 66 (IQR: 54.0-78.0) years. SARS illness before medical assistance was associated to need for invasive mechanical ventilation (IMV, p < 0.001). Lower pre-hospital SpO2 was associated to death (p = 0.025). Death was more common among patients with respiratory support needs, especially in the invasive ventilation group (262/287; 91.3%) (p < 0.001). In addition, IMV was more common among elderly individuals (p < 0.001). Patients admitted to ICU had a greater chance of dying when compared to non-ICU admitted patients (p < 0.001), and closely related to IMV (p < 0.001). Patients in ICU were also older (p = 0.003) and had longer hospital stay (p < 0.001). Mortality was associated with mechanical ventilation (p < 0.001), ICU admission (p < 0.001), and older age (p < 0.001). Patients who died had a shorter length of both ICU and total hospital stay (p < 0.001). Prehospital EMS may provide feasible and early recognition of critical patients with SARS in strained healthcare systems, such as in low-resource settings and pandemics.

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Miconazole-loaded nanoparticles coated with hyaluronic acid (miconazole-loaded nanoparticles/HA) were developed to overcome the limitations of the conventional therapy of the vulvovaginal candidiasis (VVC). They were synthesized by emulsification and solvent evaporation techniques, characterized by diameter, polydispersity index, zeta potential, encapsulation efficiency, atomic force microscopy (AFM), evaluated in terms of efficacy against C. albicans in vitro, and tested in a murine VVC model. Nanoparticles showed 211nm of diameter with a 0.32 polydispersity index, -53mV of zeta potential, and 90% miconazole encapsulation efficiency. AFM evidenced nanoparticles with a spherical shape. They inhibited the proliferation of C. albicans in vitro and in vivo after a single administration. Nanoparticles released the miconazole directly in the site of action at low therapeutic doses, which was enough to eliminate the fungal burden in the murine VVC model. These systems were rationally designed since the existence of the HA induces their adhesion on the vaginal mucus and their internalization via CD44 receptors, inhibiting the C. albicans. Therefore, miconazole-loaded nanoparticles/HA represent an innovative non-conventional pharmaceutical dosage form to treat the VVC and recurrent VVC.

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O estudo buscou conhecer o perfil epidemiológico da sífilis congênita e em gestantes residentes no Estado do Piauí no período de 2007 a 2017. Realizou-se um estudo epidemiológico do tipo ecológico entre os meses de janeiro e fevereiro de 2019 no Sistema de Informação de Agravos de Notificação e Sistema de Informação Sobre Nascidos Vivos. A incidência de sífilis congênita foi crescente durante o período estudado (2007 a 2017) com destaque para a Região de Saúde "Entre Rios". Em relação aos neonatos, são prevalentemente diagnosticados com até 6 dias de vida (94,5%), sexo masculino (49,9%), raça/cor parda (66,4%), sífilis recente (82,8%) e evolução vivos (91,9%). As gestantes têm faixa etária de 20 a 39 anos (69,9%), cor parda (70,5%), baixa escolaridade (28,9%), realizaram pré-natal (85,4%), receberam diagnóstico durante pré-natal (46,6%), não realizaram teste treponêmico (46,2%), o teste não-treponêmico foi reativo (86,8%), apresentaram forma primária da doença (30,5%) e parceiros sem tratamento (60,8%). Faz-se necessário melhorar as ações de vigilância e assistência pré-natal que resultem no planejamento e adoção de intervenções a fim de modificar o quadro epidemiológico.

This study aimed to identify the epidemiological profile of congenital syphilis in pregnant women residing in the State of Piauí from 2007 to 2017. An ecological epidemiological study was carried out between January and February 2019 in the Notifiable Diseases Information System and the Live Births Information System. The incidence of congenital syphilis increased during the period studied (2007 to 2017), with an emphasis in the "Entre Rios" Health Region. Regarding neonates, they were predominantly diagnosed with up to 6 days of life (94.5%), males (49.9%), mixed race/color (66.4%), recent syphilis (82.8%), and evolved to live (91.9%). Pregnant women are aged between 20 and 39 years (69.9%), brown color (70.5%), low schooling (28.9%), underwent prenatal care (85.4%), received diagnosis during prenatal care (46.6%), did not undergo a treponemal test (46.2%), the non-treponemal test was reactive (86.8%), had a primary form of the disease (30.5%), and partners without treatment (60.8%). It is necessary to improve surveillance and prenatal care actions that result in the planning and adoption of interventions in order to change this epidemiological picture.

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Objetivo: descrever os diagnósticos e as intervenções de enfermagem em crianças com transtorno do espectro autista fundamentados em taxonomias de enfermagem e na teoria do autocuidado. Método: estudo exploratório e descritivo, com abordagem qualitativa com 11 crianças e embasado na aplicação do processo de enfermagem. Utilizou-se taxonomia International Nursing Diagnoses: definitions and classification, para definição dos diagnósticos de enfermagem, a teoria do autocuidado e as recomendações da Nursing Interventions Classification para planejamento das intervenções. Resultados: isolamento social, falta de motivação e dependência para execução de atividades constituíram os principais problemas levantados. As afirmativas diagnósticas que possibilitaram a estruturação de 27 intervenções de enfermagem, compreenderam o déficit no autocuidado para alimentação, banho e higiene íntima; o isolamento social; e a disposição para melhora do autocuidado. Considerações finais: a capacidade para o autocuidado esteve comprometida, requerendo estratégias de enfermagem efetivas voltadas para a criança e para os familiares.

Objetivo: describir diagnósticos e intervenciones de enfermería en niños con trastorno del espectro autista basados en taxonomías de enfermería y teoría del autocuidado. Método: estudio exploratorio y descriptivo, con abordaje cualitativo con 11 niños y basado en la aplicación del proceso de enfermería. International Nursing Diagnoses: se utilizó la taxonomía de definitions and classification para definir los diagnósticos de enfermería, la teoría del autocuidado y las recomendaciones de Nursing Interventions Classification para la planificación de la intervención. Resultados: el aislamiento social, la falta de motivación y la dependencia para realizar actividades fueron los principales problemas planteados. Las declaraciones diagnósticas que permitieron la estructuración de 27 intervenciones de enfermería comprendieron el déficit en el autocuidado de la alimentación, el baño y la higiene íntima; aislamiento social; y la voluntad de mejorar el autocuidado. Consideraciones finales: la capacidad de autocuidado se vio comprometida, requiriendo estrategias de enfermería efectivas dirigidas al niño y a los miembros de la familia.

Objective: to describe nursing diagnoses and interventions in children with autism spectrum disorder based on nursing taxonomies and self-care theory. Method: exploratory and descriptive study, with a qualitative approach with 11 children and based on the application of the nursing process. International Nursing Diagnoses: definitions and classification taxonomy was used to define nursing diagnoses, self-care theory and nursing interventions classification recommendations for intervention planning. Results: social isolation, lack of motivation and dependence to perform activities were the main problems raised. The diagnostic statements that allowed the structuring of 27 nursing interventions comprised the deficit in self-care for food, bathing and intimate hygiene; social isolation; and the willingness to improve self-care. Final considerations: the capacity for self-care was compromised, requiring effective nursing strategies aimed at the child and family members.

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OBJECTIVE: To describe, in the mothers' perception, the experiences lived by families in the care of children with autism spectrum disorder. METHOD: Qualitative study, carried out with 20 mothers of children diagnosed with autistic disorder accompanied by an institution in Teresina-Piauí, Brazil. Semi-structured interviews were conducted between February and March 2019 and subjected to content analysis. RESULTS: Five central ideas related to the stages experienced by family members after the diagnosis were identified, ranging from denial to acceptance. Family members and caregivers experience feelings of sadness and mourning for the discovery of the impossibility of curing the syndrome, revealing the need for care for this family. The search for help and adaptations of the routine are constant experiences. CONCLUSION: Caring for children who live with autistic disorder involves learning ranging from structural to emotional aspects, such as dealing with limitations and impossibility of cure, pointing out to the need for family care.

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Amazonian palm berries (açaí, Euterpe oleracea Mart.) are fruits with high nutritional value and antioxidant activity and have aroused the interest of consumers, popularizing fruit pulps enriched with probiotics. Amazonian palm berries (açaí, Euterpe oleracea Mart.) are fruits with high nutritional potential, providing a source of carbohydrates, fibers, proteins, lipids, vitamins, and minerals. Furthermore, açai provides several health benefits, including antioxidant activity. Nutritionally enhanced foods have aroused the interest of consumers, popularizing fruit pulps enriched with probiotics. Probiotics are dietary supplements consisting of live, beneficial microorganisms in the host which improve the intestinal microbiota. The objective of this study was to isolate, identify, and characterize the probiotic potential of an isolated Schleiferilactobacillus harbinensis strain (dubbed Ca12) and provide an optimized bioprocess for its production, using the complete factorial and central rotational compound design to supplement the frozen açai pulp. The isolated strain S. harbinensis Ca12 presented adequate resistance to gastric juice and bile salts, microbial activity against different Candida strains, self-aggregation and coaggregation properties, high adhesion in HT-29 cells, and 35% inhibition of Salmonella in HT-29 cells. When optimized, the cellular biomass production of the S. harbinensis Ca12 strain was approximately 600% higher than the unsupplemented whey, with a production of 3.6 × 1010 CFU mL-1. The S. harbinensis Ca12 strain's viability in the creamy and traditional frozen açai pulp was shown to be stable for up to 6 months at 20 °C. The impact of this study involved for the first time the S. harbinensis Ca12 described in the Brazilian cocoa pulp with activity against Candida albicans of clinical importance, creating the potential of a new functional food with important benefits to human health as prevention for candidiasis.

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Objetivo: detectar a prevalência de depressão pós-parto e fatores sociodemográficos em puérperas atendidas em uma unidade por equipes de Saúde da Família. Método: estudo observacional descritivo, com abordagem quantitativa. Participaram 92 puérperas atendidas pelas Equipes Saúde da Família do município de Teresina, Piauí. A coleta ocorreu de dezembro 2018 a abril 2019. Aplicou-se um questionário envolvendo variáveis socioeconômicas, junto Escala Edimburgo. Os resultados foram analisados por meio de estatística descritiva. Resultados: a prevalência de depressão pós-parto nas puérperas foi 39,13%. Predominaram as puérperas com união estável (36,96%), na faixa etária 18 a 22 anos (44,57%), a maioria declarou cor/raça parda (76,9%) e ocupação do lar (77,17%). Conclusão: a elevada prevalência da Depressão Pós-Parto aponta para a necessidade de provocar mudanças no modelo assistencial destinado à mulher no ciclo gravídico-puerperal, com ênfase na promoção de intervenções que possam minimizar os fatores de risco para este agravo.(AU)

Objective: to detect the prevalence of postpartum depression in puerperal women attended in a unit by Family Health teams. Method: descriptive observational study, with a quantitative approach. The participants were 92 puerperal women attended by the Family Health Strategy Teams of the municipality of Teresina, Piaui. Data was collected from December 2018 to April 2019. A questionnaire socioeconomic was applied, in addition to the Edinburgh Postnatal Depression Scale. The results were analyzed by means of descriptive statistics. Results: the prevalence of postpartum depression was verified in 39.13%. Puerperal women with a stable union predominated (36.96%), aged between 18 and 22 years old (44.57%), the majority declared color / brown race (76.9%) and home occupation (77.17%). Conclusion: the high prevalence of Postpartum Depression points to the need to provoke changes in the model of care for women in the pregnancy-puerperal cycle, with emphasis on the promotion of interventions that can minimize this condition.(AU)

Objetivo: detectar prevalencia de depresión posparto en puérperas atendidas en una unidad por equipos de Salud de la Familia. Método: estudio observacional descriptivo, con abordaje cuantitativo. Los participantes fueron 92 puérperas atendidas por los Equipos de Estrategia de Salud de la Familia en la ciudad de Teresina, Piauí. La recolección de datos se llevó a cabo desde diciembre de 2018 hasta abril de 2019. Se aplicó un cuestionario socioeconómico, además de la Escala de Depresión Posparto de Edimburgo, los resultados se analizaron mediante estadística descriptiva. Resultados: la prevalencia de depresión posparto en 39,13%. Predominaron las mujeres puerperales con unión estable (36,96%), con edades comprendidas entre 18 y 22 años (44,57%), la mayoría declaró color / raza morena (76,9%) y ocupación domiciliaria (77,17%). Conclusión: la alta prevalencia de depresión posparto apunta a la necesidad de generar cambios en el modelo de atención a la mujer en el ciclo embarazo-puerperal, con énfasis en promover intervenciones que minimicen esta condición.(AU)

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Objetivo: verificar as evidências científicas sobre a contribuição da musicoterapia como intervenção no tratamento da criança com Transtorno Espectro Autista. Métodos: Trata-se de uma revisão integrativa da literatura, realizada na base de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde e na Medical Literature Analysis and Retrieval System Online. A busca dos artigos foi realizada de janeiro a março de 2019, utilizando os seguintes descritores controlados: Musicoterapia, Terapêutica e Transtorno autístico que que atenderam aos critérios de inclusão e exclusão do estudo. Resultados: Doze artigos evidenciaram o valor da música e o seu papel como recurso terapêutico em crianças. Conclusão: Analisou doze estudos que enfatizam o uso da musicoterapia como ferramenta de tratamento no TEA, tendo em vista que onze estudos descrevem a forma significativa na melhora do quadro clínico e/psicológico de crianças com Transtorno do Espectro Autista, ao proporcionar melhora na comunicação e na socialização.(AU)

Objective: To analyze the scientific evidence on the contribution of music therapy as an intervention in the treatment of children with autism apectrum disorder. Methods: integrative literature review, carried out in the database: Latin American and Caribbean Literature in Health Sciences and in the Medical Literature Analysis and Retrieval System Online. The search for the articles was carried out from January to March 2019, using the following controlled descriptors: Music Therapy, Treatment, Child, Disorder, Autistic Spectrum that met the inclusion and exclusion criteria of the study. Results: twelve articles showed the value of music and its role as a therapeutic resource in children. Conclusion: Analyzed twelve studies that emphasize the use of music therapy as a treatment tool in autism apectrum disorder, considering that eleven studies describe the significant way in improving the clinical and / psychological condition of children with Autism Spectrum Disorder, by providing improved communication and in socialization.(AU)

Objetivo: analizar la evidencia científica sobre la contribución de la musicoterapia como intervención en el tratamiento de niños con trastorno del espectro autista. Métodos: revisión integradora de la literatura, realizada en la base de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud y en el Sistema de Análisis y Recuperación de Literatura Médica en Línea. La búsqueda de los artículos se realizó de enero a marzo de 2019, utilizando los siguientes descriptores controlados: Musicoterapia, Tratamiento, Niño, Trastorno, Espectro autista que cumplieron con los criterios de inclusión y exclusión del estudio. Resultados: doce artículos mostraron el valor de la música y su papel como recurso terapéutico en los niños. Conclusión: se analizaron doce estudios que enfatizan el uso de la musicoterapia como herramienta de tratamiento en el trastorno del espectro autista, considerando que once estudios describen la forma significativa en la mejora de la condición clínica y / psicológica de los niños con Trastorno del Espectro Autista, al proporcionar una mejor comunicación y socialización.(AU)

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Vancomycin-loaded N,N-dodecyl,methyl-polyethylenimine nanoparticles coated with hyaluronic acid (VCM-DMPEI nanoparticles/HA) were synthesized as an adjuvant for the treatment of bacterial endophthalmitis. The nanoparticles were formulated by experimental statistical design, thoroughly characterized, and evaluated in terms of bactericidal activity and both in vitro and in vivo ocular biocompatibility. The VCM-DMPEI nanoparticles/HA were 154 ± 3 nm in diameter with a 0.197 ± 0.020 polydispersity index; had a + 26.4 ± 3.3 mV zeta potential; exhibited a 93% VCM encapsulation efficiency; and released 58% of the encapsulated VCM over 96 h. VCM and DMPEI exhibited a synergistic bactericidal effect. The VCM-DMPEI nanoparticles/HA were neither toxic to ARPE-19 cells nor irritating to the chorioallantoic membrane. Moreover, the VCM-DMPEI nanoparticles/HA did not induce modifications in retinal functions, as determined by electroretinography, and in the morphology of the ocular tissues. In conclusion, the VCM-DMPEI nanoparticles/HA may be a useful therapeutic adjuvant to treat bacterial endophthalmitis.

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Objetivo identificar, na percepção de enfermeiros, os fatores intervenientes e as estratégias empregadas para a abordagem da violência infantil na Estratégia Saúde da Família. Método estudo qualitativo com 22 enfermeiros de Teresina, Piauí. Os dados foram coletados em outubro de 2019, mediante entrevistas individuais orientadas por um roteiro semiestruturado, submetidas à análise de conteúdo temática. Resultados os enfermeiros revelaram inabilidade para lidar com situações de violência infantil. Eles buscavam abordar esses casos por meio de estratégias pautadas no diálogo, no trabalho interprofissional e na intersetorialidade. Considerações finais foram fatores intervenientes para a abordagem da violência infantil na Estratégia Saúde da Família, o (não)reconhecimento de sinais de abuso infantil, as barreiras para o estabelecimento de vínculo com as famílias e dificuldades de interlocução na rede assistencial. As estratégias para o enfrentamento da violência infantil utilizadas foram trabalho interprofissional, cuidado holístico, articulação com a rede intersetorial e diálogo com a família.

Objetivo identificar, en la percepción de las enfermeras, los factores y estrategias intermedios utilizados para abordar la violencia infantil en la Estrategia de Salud Familiar. Método se trata de un estudio cualitativo con 22 enfermeras de Teresina, Piauí. Los datos fueron recopilados en octubre de 2019, a través de entrevistas individuales guiadas por un guion semiestructurado, sometidos al análisis temático de contenidos. Resultados las enfermeras revelaron incapacidad para lidiar con situaciones de violencia infantil. Trataron de abordar estos casos a través de estrategias basadas en el diálogo, el trabajo interprofesional y la intersectorialidad. Consideraciones finales fueron factores intermedios para el enfoque de la violencia infantil en la Estrategia de Salud Familiar, el (no reconocimiento de signos de abuso infantil), las barreras para establecer vínculos con las familias y las dificultades de interlocución en la red de atención. Las estrategias para hacer frente a la violencia infantil fueron el trabajo interprofesional, el cuidado holístico, la articulación con la red intersectorial y el diálogo con la familia.

Objective identifying, in the perception of nurses, the intervening factors and strategies used to approach child violence in the Family Health Strategy. Method a qualitative study with 22 nurses from Teresina, Piaui. Data were collected in October 2019, through individual interviews guided by a semi-structured script, submitted to Thematic Content Analysis. Results nurses revealed inability to deal with situations of child violence. They sought to approach these cases through strategies based on dialogue, interprofessional work and intersectoriality. Final thoughts there were intervening factors for the approach of child violence in the Family Health Strategy, the (non-recognition of signs of child abuse), the barriers to establishing bonds with families and difficulties in interlocution in the care network. The strategies for coping with child violence were interprofessional work, holistic care, articulation with the intersectoral network and dialogue with the family.

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ABSTRACT Objective: To describe, in the mothers' perception, the experiences lived by families in the care of children with autism spectrum disorder. Method: Qualitative study, carried out with 20 mothers of children diagnosed with autistic disorder accompanied by an institution in Teresina-Piauí, Brazil. Semi-structured interviews were conducted between February and March 2019 and subjected to content analysis. Results: Five central ideas related to the stages experienced by family members after the diagnosis were identified, ranging from denial to acceptance. Family members and caregivers experience feelings of sadness and mourning for the discovery of the impossibility of curing the syndrome, revealing the need for care for this family. The search for help and adaptations of the routine are constant experiences. Conclusion: Caring for children who live with autistic disorder involves learning ranging from structural to emotional aspects, such as dealing with limitations and impossibility of cure, pointing out to the need for family care.

RESUMEN Objetivo: Describir, en la percepción de las madres, las experiencias vividas por las familias en el cuidado de niños con trastorno del espectro autista. Método: Estudio cualitativo, realizado con 20 madres de niños diagnosticados de trastorno autista acompañados de una institución en Teresina-Piauí, Brasil. Las entrevistas semiestructuradas se realizaron entre febrero y marzo de 2019 y se sometieron a análisis de contenido. Resultados: Se identificaron cinco ideas centrales relacionadas con las etapas vividas por los familiares luego del diagnóstico, que van desde la negación hasta la aceptación. Los familiares y cuidadores experimentan sentimientos de tristeza y duelo por el descubrimiento de la imposibilidad de curar el síndrome, revelando la necesidad de cuidar a esta familia. La búsqueda de ayuda y adaptaciones de la rutina son experiencias constantes. Conclusión: Cuidar a los niños que viven con trastorno autista implica aprender que van desde los aspectos estructurales hasta los emocionales, cómo afrontar las limitaciones y la imposibilidad de cura, apuntando a la necesidad del cuidado familiar.

RESUMO Objetivo: Descrever, na percepção das mães, as experiências vivenciadas por famílias no cuidado de crianças com Transtorno do Espectro Autista. Método: Estudo qualitativo, realizado com 20 mães de crianças diagnosticadas com transtorno autístico, acompanhadas por uma instituição em Teresina, Piauí. Entrevistas semiestruturadas foram realizadas entre fevereiro e março de 2019, e submetidas à análise de conteúdo. Resultados: Foram identificadas cinco ideias centrais relacionadas aos estágios vividos pelos familiares após o diagnóstico, desde a negação até a aceitação. Familiares e cuidadores vivenciam sentimentos de tristeza e luto pela descoberta da impossibilidade de cura da síndrome, revelando a necessidade de cuidado para com essa família. A busca por ajuda e as adaptações da rotina são vivências constantes. Conclusão: Cuidar de crianças com transtorno autístico envolve aprendizados que vão dos aspectos estruturais aos emocionais, como lidar com as limitações e impossibilidade de cura, apontando para a necessidade de um cuidado familiar.

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OBJECTIVE: To evaluate the performance of laboratories accredited by the National Health System that perform cytopathology examination of the uterine cervix after 10 years of participation in external quality monitoring (eQM). STUDY DESIGN: Seven laboratories were assessed in this study. To assess the concordance of the representation of epithelia and results, 6,536 examinations (3,433 in 2007 and 3,103 in 2017) were reviewed. Statistical analysis was performed using the κ coefficient as well as the χ2 and the Fisher exact test (p < 0.05). RESULTS: All laboratories showed adequate infrastructure and internal quality monitoring. Regarding the representation of the epithelia, the concordance remained excellent (κ between 0.84 and 0.94). In 2007, 26 false-negative results (FN), 157 false-positive results (FP), and 79 delays in clinical conduct (DCC) were identified (κ = 0.80). In 2017, 24 FN, 42 FP, and 38 DCC were identified (κ = 0.90). Five laboratories showed improvement in concordance from 2007 to 2017. We observed significant improvement in cytomorphological criteria of the results: atypical squamous cells of undetermined significance (p < 0.001), atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (p < 0.016), and low-grade squamous intraepithelial lesion (p < 0.001). We also observed a considerable improvement in the results of cellular abnormalities in glandular epithelium (p < 0.0504). CONCLUSIONS: Ten years after the implementation of eQM, improvements in the concordance of results were observed as well as reductions in FN, FP, and DCC in all laboratories monitored.

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BACKGROUND: Numerous causes of infection in arthroplasties are related to biofilm formation on implant surfaces. In order to circumvent this problem, new alternatives to prevent bacterial adhesion biosurfactants-based are emerging due to low toxicity, biodegradability and antimicrobial activity of several biosurfactants. We revised all patents relating to biosurfactants of applicability in orthopedic implants. METHODS: This work aims to evaluate the capability of a lipopeptide produced by Bacillus subtilis ATCC 19659 isolates acting as inhibitors of the adhesion of Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 29213 onto titanium and stainless steel surfaces and its antimicrobial activity. RESULTS: The adhesion of the strains to the stainless-steel surface was higher than that of titanium. Preconditioning of titanium and stainless-steel surfaces with 10 mg mL-1 lipopeptide reduced the adhesion of E. coli by up to 93% and the adhesion of S. aureus by up to 99.9%, suggesting the strong potential of lipopeptides in the control of orthopedic infections. The minimal inhibitory concentration and minimum bactericidal concentration were 10 and 240 µg mL-1 for E. coli and S. aureus, respectively. CONCLUSION: The lipopeptide produced by Bacillus subtilis ATCC 19659 presented high biotechnological application in human health against orthopedic implants infections.

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Sirtuin 2 is a key enzyme in gene expression regulation that is often associated with tumor proliferation control and therefore is a relevant anticancer drug target. Anilinobenzamide derivatives have been discussed as selective sirtuin 2 inhibitors and can be developed further. In the present study, hologram and three-dimensional quantitative structure-activity relationship (HQSAR and 3D-QSAR) analyses were employed for determining structural contributions of a compound series containing human sirtuin-2-selective inhibitors that were then correlated with structural data from the literature. The final QSAR models were robust and predictive according to statistical validation (q2 and r2pred values higher than 0.85 and 0.75, respectively) and could be employed further to generate fragment contribution and contour maps. 3D-QSAR models together with information about the chemical properties of sirtuin 2 inhibitors can be useful for designing novel bioactive ligands.Communicated by Ramaswamy H. Sarma.

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BACKGROUND: For screening probiotic strains with viability and stability in non-dairy foods for health benefits, we revised all patents relating to probiotics in food. OBJECTIVE: Screening of potential probiotics from Brazilian Minas artisanal cheese and verify their survival in frozen Brazilian cocoa pulp. METHODS: Isolation and identification of the strains. The potential probiotic characterization involved gastric juice and bile resistance, antibiotic and antimicrobial activity, hydrophobicity, autoaggregation, coaggregation and adhesion assay in HT-29 cells. Organoleptic, viability and stability of probiotic strain in frozen cocoa pulp were evaluated. RESULTS: Fourteen strains of Lactobacillus plantarum (9), Weissella paramesenteroides (3), Lactobacillus fermentum (1), and Leuconostoc mesenteroides (1) were obtained. Most of the strains were resistant to simulated gastric acidity and bile salts. Almost all strains were sensitive to the antibiotics tested, except to ciprofloxacin and vancomycin. About 47% of the strains are potential producers of bacteriocins. High hydrophobicity was observed for four strains. Autoaggregation ranged from 8.3-72.6% and the coaggregation capacity from 5.2-60.2%. All of the assessed strains presented more than 90% of adhesion to HT-29 intestinal cells. The percentage of Salmonella inhibition in HT-29 cells ranged from 4.7-31.1%. No changes in color, aroma, and pH were observed in cocoa pulps after storage at -20 °C for 90 days. CONCLUSION: Wild strains of acid lactic bacteria from cheese proved to be viable and stable in frozen Brazilian cocoa pulp. This work showed a promising application of L. plantarum isolated strains to be used with frozen cocoa pulp matrix in probiotics food industry.

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Objetivo: Conhecer o perfil sociodemográfico dos usuários de substâncias psicoativas de um CAPS ad III. Método: Pesquisa descritiva, explorativa, retrospectiva, de abordagem quantitativa. A amostra foi formada por 302 prontuários selecionados entre os 1411 pacientes cadastrados em um município do Maranhão. Resultado: O perfil sociodemográfico dos participantes é na maioria do sexo masculino, com faixa etária mais expressiva de 29 a 39 anos, solteiros, que estudaram até o ensino fundamental incompleto, residem na cidade da pesquisa, moram com os pais, são autônomos ou desempregados. Observou-se que o álcool foi a droga mais utilizada. Conclusão: O consumo diário de drogas também pode ter contribuído para a constituição das características sociodemográficas apresentadas. Todavia, sabe-se do desejo de reabilitação do dependente químico e o vínculo do mesmo com o profissional habilitado de saúde se torna indispensável para o tratamento

Objective: Know the sociodemographic profile of users of psychoactive substances from a CAPS ad III. Method: This is a descriptive, exploratory, retrospective, quantitative. The research involved 302 patient records that made treat on a city of Maranhão. Results: The sociodemographic profile of the participants is male, with a more significant age ranging from 29 to 39 years, unmarried, they studied until incomplete elementary education, live in the city where the research was conducted, live with their parents, are selfemployed and are unemployed. That alcohol was a more used drug followed by crack. Conclusion: It is concluded that daily drug consumption may also have contributed to the constitution of the socio-demographic characteristics presented in this research. However, the desire for rehabilitation of the chemical dependency is known and the link between it same heand the health professional is indispensable for the treatment

Objetivo: Conocer el perfil sociodemográfico de los usuarios de sustancias psicoactivas de un CAPS ad III. Método: Investigación descriptiva, retrospectiva, de abordaje cuantitativo. La muestra fue formada por 302 prontuarios de pacientes catastrados en un municipio del Maranhão. Resultados: El perfil sociodemográfico de los participantes es del sexo masculino, con edad más expresivo de 29 a 39 años, solteros, que estudiaron hasta la enseñanza fundamental incompleta, reside en la ciudad de la investigación, viven con los padres, son autónomos o desempleados. El alcohol fue la droga más utilizada. Conclusion: Se concluye que el consumo diario de drogas también puede haber contribuido a la constitución de las características sociodemográficas presentadas en esa investigación. Sin embargo, se sabe del deseo de rehabilitación del dependiente químico y el vínculo del mismo con el profesional habilitado de salud se vuelve indispensable para el tratamiento

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ABSTRACT Introduction: Although the criteria and recommendations are well defined to improve the quality of cervical cytopathology tests (Pap smear) in Brazil, the quality indicators of several laboratories are below the recommended standards. Objective: To evaluate the quality indicators of cervical cytopathology tests carried out by the Brazilian Unified Health System [Sistema Único de Saúde (SUS)]. Method: Cross-sectional study based on the results of cervical cytopathology tests conducted in the municipality of Cascavel, Paraná, Brazil, from January 2012 to December 2018. The study included 141,191 tests and the following variables were analyzed: sample suitability, cervical cytopathology tests result, and internal quality monitoring indicators recommended by the Brazilian Ministry of Health. Results: The percentage of unsatisfactory tests did not exceed 0.97%. The representation of the squamocolumnar junction ranged from 63% to 67.4%. The percentage of altered exams among the satisfactory samples ranged from 0.46% to 6.44%. The positivity index ranged from 0.46% to 6.44%, while the high-grade squamous intraepithelial lesion/satisfactory indicator ranged from 0.21% to 1.06%, atypical squamous cells of undetermined significance/altered ranged from 22.47% to 49.93%, atypical squamous cells of undetermined significance/satisfactory ranged from 0.1% to 2.57%: and atypical squamous cells of undetermined significance/squamous intraepithelial lesions ranged from 0.31 to 1.02. Conclusion: In 2012 and 2013, the high-grade squamous intraepithelial lesion/satisfactory and the positivity index indicators were below the recommended parameters, and in the remaining years, these indicators were within the parameters recommended. Consequently, a greater number of truly cancer precursor lesions were identified, demonstrating the importance of internal quality control in the prevention of cervical cancer.

RESUMEN Introducción: Aunque criterios y recomendaciones están bien definidos para la mejora de calidad de las pruebas citopatológicas en Brasil, los indicadores de calidad de varios laboratorios se encuentran por debajo de los estándares recomendados. Objetivo: Evaluar los indicadores de calidad de las pruebas citopatológicas de cuello uterino realizadas por el sistema público de salud en Brasil (SUS). Método: Estudio transversal basado en los resultados de pruebas colpocitológicas llevadas a cabo en el municipio de Cascavel, Paraná, Brasil, de enero de 2012 a diciembre de 2018. Se incluyeron 141.191 pruebas; las siguientes variables se analizaron: adecuación de la muestra, resultado de la prueba citopatológica e indicadores de monitoreo interno de calidad recomendados por el Ministerio de Salud. Resultados: El porcentaje de pruebas insatisfactorias no superó 0,97%. La representación de la unión escamo-columnar varió de 63% a 67,4%. El porcentaje de pruebas alteradas entre las muestras satisfactorias varió de 0,46% a 6,44%. El índice de positividad varió de 0,46% a 6,44%, mientras el indicador de lesión intraepitelial de alto grado/satisfactorios, de 0,21% a 1,06%; atipias escamosas de significado indeterminado/alterados, de 22,47% a 49,93%; atipias escamosas de significado indeterminado/satisfactorios, de 0,1% a 2,57%; y razón atipias escamosas de significado indeterminado/lesiones intraepiteliales escamosas, de 0,31 a 1,02. Conclusión: En 2012 y 2013, los indicadores de lesión epitelial de alto grado/satisfactorios e índice de positividad se encontraban por debajo de los parámetros recomendados; en los otros años, esos indicadores estaban dentro de los parámetros recomendados. Por consiguiente, se identificó mayor número de lesiones realmente precursoras del cáncer, demostrando la importancia del control interno de calidad en la prevención del cáncer de cuello uterino.

RESUMO Introdução: Ainda que critérios e recomendações estejam bem definidos para melhoria da qualidade do exame citopatológico no Brasil, os indicadores de qualidade de vários laboratórios apresentam-se abaixo dos padrões recomendados. Objetivo: Avaliar os indicadores de qualidade dos exames citopatológicos do colo do útero realizados pelo Sistema Único de Saúde (SUS). Método: Estudo transversal com base nos resultados dos exames citopatológicos realizados no município de Cascavel, Paraná, Brasil, de janeiro de 2012 a dezembro de 2018. Foram incluídos 141.191 exames; as seguintes variáveis foram analisadas: adequabilidade da amostra, resultado do exame citopatológico e indicadores de monitoramento interno da qualidade recomendados pelo Ministério da Saúde. Resultados: A porcentagem de exames insatisfatórios não ultrapassou 0,97%. A representação da junção escamocolunar variou de 63% a 67,4%. A porcentagem de exames alterados entre as amostras satisfatórias variou de 0,46% a 6,44%. O índice de positividade variou de 0,46% a 6,44%, enquanto o indicador lesão intraepitelial de alto grau/satisfatórios, de 0,21% a 1,06%; atipias escamosas de significado indeterminado/alterados, de 22,47% a 49,93%; atipias escamosas de significado indeterminado/satisfatórios, de 0,1% a 2,57%; e razão atipias escamosas de significado indeterminado/lesões intraepiteliais escamosas, de 0,31 a 1,02. Conclusão: Em 2012 e 2013, os indicadores de lesão intraepitelial de alto grau/satisfatórios e índice de positividade encontravam-se abaixo dos parâmetros recomendados; nos demais anos, esses indicadores estavam dentro dos parâmetros recomendados. Consequentemente, foi identificado um maior número de lesões verdadeiramente precursoras do câncer, demonstrando a importância do controle interno da qualidade na prevenção do câncer do colo do útero.

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Objetivo: Avaliar os conhecimentos de enfermeiros intensivistas sobre a promoção da saúde em Unidade de Terapia Intensiva. Métodos: Estudo descritivo, exploratório, retrospectivo, com abordagem quantitativa, realizado em um Hospital de ensino localizado na cidade de Teresina PI. A coleta de dados ocorreu no período de janeiro a fevereiro de 2015. A análise dos dados ocorreu por meio do software Microsoft Office Excel 2007 para a obtenção de frequência, média e percentual. Resultados: Ainda há muito a avançar para alcançar o desenvolvimento da promoção da saúde no contexto hospitalar, particularmente, no contexto da Unidade de Terapia Intensiva, sobretudo, porque as práticas de saúde instituídas no cuidado ao cliente são centradas hegemonicamente nos aspectos físicos da doença e não é adotada de forma unânime pelos enfermeiros. Conclusão: Os enfermeiros entenderam a importância da promoção da saúde para evitar complicações no estado de saúde dos clientes que assistem

Objective: To evaluate the knowledge of intensive care nurses on health promotion in the Intensive Care Unit. Methods: This is a descriptive, exploratory, retrospective study with a quantitative approach performed at a teaching hospital located in the city of Teresina-PI. The data collection took place from January to February 2015. Data analysis was performed using Microsoft Office Excel 2007 software to obtain frequency, average and percentage. Results: There is still much to be done in order to achieve the development of health promotion in the hospital context, particularly in the context of the Intensive Care Unit, mainly because the health practices instituted in client care are hegemonically focused on the physical aspects of the disease and is not unanimously adopted by nurses. Conclusion: Nurses understood the importance of health promotion to avoid complications in the health status of the clients they attend

Objetivo: Evaluar los conocimientos de enfermeros intensivos en la promoción de la salud en Unidad de Terapia Intensiva. Métodos: Estudio descriptivo, exploratorio, retrospectivo, con abordaje cuantitativo, realizado en un Hospital de enseñanza ubicado en la ciudad de Teresina-PI. La recolección de datos ocurrió en el período de enero a febrero de 2015. El análisis de los datos ocurrió a través del software Microsoft Office Excel 2007 para la obtención de frecuencia, media y porcentual. Resultados: Todavía hay mucho que avanzar para alcanzar el desarrollo de la promoción de la salud en el contexto hospitalario, particularmente, en el contexto de la Unidad de Terapia Intensiva, sobre todo, porque las prácticas de salud instituidas en el cuidado al cliente se centran hegemónicamente en los aspectos físicos de la enfermedad y no es adoptada de forma unánime por los enfermeros. Conclusión: Los enfermeros entendieron la importancia de la promoción de la salud para evitar complicaciones en el estado de salud de los clientes que asisten

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Normal bladder and urethral sphincter development as well as neural/volitional control over bladder-sphincter function are essential steps for regular lower urinary tract function. These maturational sequences are clinically evident by the age of 5 years. However, in 17-22% of children, symptoms persist beyond that age, characterizing lower urinary tract dysfunction (LUTD). The clinical spectrum is wide and includes overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. LUTD may lead to vesicoureteral reflux and recurrent urinary tract infections, increasing the likelihood of renal scarring. LUTD is often associated with constipation and emotional/behavioral disorders such as anxiety, depression, aggressiveness, and social isolation, making diagnosis, and treatment imperative. Diagnosis of LUTD is essentially based on clinical history, investigation of bladder storage, voiding symptoms (urinary frequency, daytime incontinence, enuresis, urgency) and constipation. Dysfunctional Voiding Score System (DVSS) is a helpful tool. Physical examination focuses on the abdomen to investigate a distended bladder or palpable fecal mass, the lumbosacral spine, and reflex testing. Bladder diaries are important for recording urinary frequency and water balance, while uroflowmetry is used to assess voided volume, maximum flow, and curve patterns. Bladder ultrasonography to measure post-void residual urine volume and urodynamics are used as supplemental tests. Current first line treatment is urotherapy, a combination of behavioral measures to avoid postponing micturition, and a restricted diet for at least 2 months. Anticholinergics, ß3 agonists and neuromodulation are alternative therapies to manage refractory overactive bladder. Cure rates, at around 40%, are considered satisfactory, with daytime symptoms improving in 32% of cases. Furthermore, children who are also constipated need treatment, preferentially with polyethylene glycol at doses of 1-1.5 g/kg in the 1st 3 days and 0.25-0.5 g/kg thereafter until the 2-month period of behavioral therapy is complete. If urotherapy fails in cases of dysfunctional voiding, the next step is biofeedback to teach the child how to relax the external urethral sphincter during micturition. Success rate is around 80%. Children with underactive bladder usually need a combination of clean intermittent catheterization, alpha-blockers, biofeedback and neuromodulation; however, cure rates are uncertain.