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Backgrounds: Restrictions in movement and closure of borders imposed by the Sars-Cov- 2 worldwide pandemic have affected the global illicit drug market, including cocaine trafficking. In this scenario, comparing cutting agents added to the cocaine and the drug purity are valuable strategies to understand how the drug trade has been impacted by the pandemic., Methods: In this work, 204 cocaine salt materials seized in the Brazilian Federal District, before (2019) and during COVID-19 pandemics (2020) were analyzed by two analytical techniques: gas chromatography-mass spectrometry (GC-MS) and Fourier-transform infrared spectroscopy (FTIR). Statistical analyses, including Principal Component Analysis (PCA), were applied to evaluate the COVID-19 pandemic impact in the local market. Bibliometric analysis was performed as a forensic intelligence tool., Results: From 2019-2020, cocaine average purity decreased 26 % while the frequency of cutting agents, as caffeine and anesthetics (lidocaine, tetracaine) increased. The high percentage of unknown were increased. Different cocaine profiling seized in 2020 showed new cutting agents, such as Irganox 1076, and Irgafos 168, indicating a trend on new adulterants/diluents introduced in the local market to mitigate the local drug shortage. Also in 2020, there was an increase in the local cocaine seizures, despite of the cocaine drug purity decreased by 26 % compared to 2019., Conclusions: Taken together, these data showed that the covid-19 pandemics has impacted cocaine trafficking in the Brazilian Federal District, an increase in cocaine seizures, which may indicate greater demand for the drug and, specially, changes in the cocaine purity and cutting agents profiling showing how traffickers tried to minimize difficulties in crossing the Brazilian border during COVID-19 restrictions. The information is relevant since Brazil is one of the major departure points for traded cocaine to the world. Bibliometric analysis showed that Irgafos 168 and Irganox 1076 were consistently identified as cocaine cutting agents for the first time., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. All co-authors have seen and agreed with the contents and declare no financial interest or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

The Euterpe genus (mainly Euterpe oleracea Martius, Euterpe precatoria Martius, and Euterpe edulis Martius) has recently gained commercial and scientific notoriety due to the high nutritional value of its fruits, which are rich in polyphenols (phenolic acids and anthocyanins) and have potent antioxidant activity. These characteristics have contributed to the increased number of neuropharmacological evaluations of the three species over the last 10 years, especially açaí of the species Euterpe oleracea Martius. The fruits of the three species exert neuroprotective effects through the modulation of inflammatory and oxidative pathways and other mechanisms, including the inhibition of the mTOR pathway and protection of the blood-brain barrier, all of them intimately involved in several neuropathologies. Thus, a better understanding of the neuropharmacological properties of these three species may open new paths for the development of therapeutic tools aimed at preventing and treating a variety of neurological conditions.

New psychoactive substances (NPS) are an emerging public health issue and deaths are commonly associated with polydrug abuse. Moreover, the number of new substances available is constantly increasing, causing intoxications in low doses, characteristics that impose to toxicology and forensic laboratories to keep routine methods up to date, with high detectability and constantly acquiring new analytical standards. Likewise, NPS metabolites and respective elimination pathways are usually unknown, making it difficult the detection and confirmation of the drug involved in the fatal case in an analytical routine. A literature search was performed on PubMed, Scopus and Web of Science databases for papers related to chromatographic analyses from fatal cases related to NPS use published from 2016 to 2021. A total of 96 papers were retrieved and reviewed in this study. Opioids, synthetic cathinones, phenethylamines/amphetamines and cannabinoids were the NPS classes most found in the fatal cases. In many cases, multiple compounds were detected in the biological samples, including prescription and other illegal drugs. Liquid chromatography-tandem mass spectrometry, an alternative to overcome the gas chromatography-mass spectrometry limitations for some compounds, was the analytical technique most used in the studies, and high resolution mass spectrometry was often applied to NPS metabolite investigation and structural characterization and identification of unknown compounds. Toxicological screening and quantitation methods need to be continuously updated to include new substances that are emerging on the drug market that can be fatal at very low doses., Competing Interests: TV was employed by Brainfarma Pharmaceutical Company. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ferrari Júnior, Leite, Gomes, Vieira, Sepulveda and Caldas.)

Objective: to map the early clinical deterioration technologies used in nurses' professional practice in the care of hospitalized adult patients., Methods: this is a scoping review, according to Joanna Briggs Institute Reviewer's Manual, which seeks to map the main technologies for detecting early clinical deterioration of hospitalized patients available for use by nurses, summarizing them and indicating gaps in knowledge to be investigated., Results: twenty-seven studies were found. The most present variables in the technologies were vital signs, urinary output, awareness and risk scales, clinical examination and nurses' judgment. The main outcomes were activation of rapid response teams, death, cardiac arrest and admission to critical care units., Final Considerations: the study emphasizes the most accurate variables in patient clinical assessment, so that indicative signs of potential severity can be prioritized to guide health conducts aiming to intervene early in the face of ongoing clinical deterioration.

Objective: to know the importance of the spiritual aspects of health care during pregnancy and childbirth, in the light of complexity thinking., Method: qualitative research, based on complexity thinking. Twenty-seven postpartum women with children between one month and six months old participated in the study. The data were collected between August and November 2021, based on individual interviews with guiding questions. Thematic analysis was used for data analysis., Results: three themes were obtained: The inseparability of spiritual care and emotional care; Connection between spirituality and the uterus - sacred temple; Alternative techniques for spiritual health care., Conclusion: the spiritual aspect of health care during pregnancy and childbirth can be considered an essential resource in the support of autonomy, security, and comfort. In addition, it can enable favorable outcomes in childbirth by strengthening the maternal-fetal attachment.

Objective: to develop an ICNP® terminology subset for the care of people with heart failure., Methods: this is a methodological study, which used the theoretical framework of the Mid-Range Nursing Theory for Cardiovascular Rehabilitation, with the steps: Construction of nursing diagnoses/outcomes and interventions statements and Cross-mapping of statements constructed., Results: forty-two diagnosis/outcome statements and 179 nursing intervention statements were constructed, organized based on five theory concepts, with a higher prevalence of statements related to "Rehabilitative care", "Psychosocial support for patients and families" and "Supervised cardiovascular rehabilitation program"., Final Considerations: it was possible to build nursing diagnosis/outcome and intervention statements for developing a terminology subset for the care of people with heart failure, based on the chosen theory.

The use of simulation for nursing education has several advantages. The present study aimed to develop and validate a serious virtual reality game for medication preparation and administration training. This is a methodological study in which a serious virtual reality game named NurseVR was developed and evaluated by teachers and students of a nursing course. In NurseVR, the player presents himself or herself in a simulated hospital environment to prepare and administer a medication. From then on, all the steps to be taken are the player's free choice according to what was learned in the classroom, making the game the closest to reality. High levels of positive agreement to statements concerning the validity of the game were found between students and teachers. The virtual immersion proposal was an innovative tool, and the validation results of the final version of NurseVR allow its use for nursing training., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Emerging contaminants is a topic that has been in evidence, especially in the last decades. These compounds are pesticides, pharmaceuticals, and personal care products that are present in several locations, mainly in large urban centers. The aim of this work was to investigate the fate of seven compounds (atrazine, simazine, ametrine, tebuthiuron, 2,4-D, fipronil, and diclofenac) using leaching column experiments to evaluate accumulation and transfer in 5 different types of urban soils from Porto Alegre, Southern Brazil. Chemical analyses were carried out through liquid chromatography tandem mass spectrometry (LC-MS/MS). The results showed that the soil derived from quaternary sediments, with well-sorted sandy sediments, was the one in which the contaminants had higher mobility. This soil also has a pH above the average of the others in the city, a factor that may also be responsible for less retention of substances. Tebuthiuron is the substance with the greatest leaching potential overall. Column experiments are a relevant tool to understand the behavior of emerging contaminants in soils and implications on the population health.

Objective: To describe the scientific evidence of complications and the need for cardiovascular interventions in people hospitalized by Covid-19., Method: a scoping review carried out according to The Joanna Briggs Institute recommendations, in the MEDLINE, CINAHL, SCOPUS and Web of Science databases., Results: A total of 11 published studies from December of 2019 to April of 2020, presenting low levels of evidence were selected. The evidence described the myocardial injury as the most common cardiac complication reported in Covid-19, reported in approximately 8% to 12% of all severe individuals, with indications for oxygen therapy interventions, thrombotic disorders prevention and treatment, hemodynamic monitoring and assessment tests of cardiac function's performance, along with biochemical markers of myocardial injury, yet not addressing nursing interventions., Conclusion: Cardiovascular complications and interventions have not shown consensus on the found evidence, requiring causal analysis by explanatory studies that support multi-professional clinical protocols in health.

Objective: To identify the knowledge and attitudes about self-care in health among users who received clinical nursing education for hypertension based on the level of knowledge and attitudes of the hypertensive patient through interactive care interventions with patients and relatives in the therapeutic context, with the goal of developing health education., Method: This study represents action research with a qualitative approach on hypertensive patients hospitalized for stroke. Hypertension as a risk factor is most strongly associated with the development of this health problem., Results: Participants were interviewed about their knowledge about the illness before and after the realization of individualized health education activities on the basis of the theory of symbolic interactionism., Conclusion: It was found that the respondents, after participating in the educational process, demonstrated a broader knowledge of hypertension, which motivated them to seek changes in habits that could improve their quality of life. Through the use of symbolic interactionism, health education proved to be a strategy for empowerment and autonomy of the hypertensive subject with respect to their treatment and can be integrated into nursing care.

This study investigates the cardiovascular risk factors in young adults in the interior of northeastern Brazil. This quantitative study conducted with 351 young adults from school 12 public schools in Juazeiro do Norte, Ceará, at random selected and stratified by school and turn. The results were mostly female, mixed, combining study and work, without a partner and living with their parents. There was physical inactivity (57.3%), obesity/ overweight (19.4%), adding salt to food (54.4%), alcohol intake (76.1%), hypertension (1.1%) with 50 % of non-adherence to treatment, diabetes mellitus (0.6%) and family history of cardiovascular disease (86.3%). To characterize the cardiovascular risk in young adults directs health actions and potential partnerships with schools.

In this study we aimed to investigate the risk factors associated with arterial hypertension and diabetes mellitus in young adults assisted in six Family Health Units (UBASF), of Fortaleza, Ceará, Brazil. This is a descriptive and documental study, based on the records of the Care Program to Arterial Hypertension and Diabetes Mellitus (HIPERDIA). The sample was composed of 60 records, including hypertensive, diabetics and patients with the two diagnoses. The results showed prevalence of young female adults (78%). Regarding the risk factors, arterial hypertension (n=45), family history (n=33), overweight (n=33) and sedentary lifestyle (n=27) stood out. Regarding the cardiovascular risk stratification, most presented Medium additional risk for cardiovascular disease. We concluded that the individualized evaluation of risk factors supports an action addressed for possible events, being necessary investments in prevention and also in training and maintenance of the HIPERDIA system.

Background: Considering the immunosuppression of patients with chronic liver disease, their response to vaccination is discussed in literature., Aims: To evaluate the response of hepatitis B vaccine in patients with chronic hepatitis C virus infection., Methods: This is a prospective study in which 85 patients with chronic hepatitis C virus infection (46.8 +/- 9.4 years, 44.7% males) and 46 healthy adults (36.7 +/- 11.1 years; 39.1% males) were evaluated. Confirmation of hepatitis C virus was obtained by the technique of polymerase chain reaction. Viral load was determined by the branched DNA method in 74 patients, and genotype was determined by sequencing in 73 patients. All patients and healthy adults received three doses of Engerix B vaccine IM (at 0, 30 and 180 days). Serological responses to the vaccine were divided into three categories: seroprotection, when anti-HBs was > or =100 mUI/mL; seroconversion, when anti-HBs was 10-99 mUI/mL, and non-reagent, when anti-HBs was <10 mUI/mL., Results: The response of hepatitis B vaccine as determined 1 month following dose 3 was seroprotection in 37.7%, seroconversion in 17.6% and non-reagent in 44.7% among patients and 84.8%, 13.0%, 2.2%, respectively in healthy adults. The number of non-reagent responses was significantly higher among those patients with chronic liver disease. Sixty-five patients with chronic hepatitis were compared to 20 compensated cirrhotic patients in concern to the response to vaccine, but no difference was found. The response to vaccine in patients with genotypes 2 or 3 (n = 40) was better than in those with genotype 1 (n = 33). Response was not related to serum HCV-RNA concentration., Conclusion: The number of non-responders was higher in patients with chronic hepatitis C virus infection, irrespective of histological status and viral load. It is suggested that such patients should receive a double dose of vaccine, particularly the ones with genotype 1.

We present a new local anesthetic technique for ophthalmic surgery that reduces the risks associated with retrobulbar and peribulbar anesthesia. This method uses topical proparacaine plus 1.5 mL of prilocaine (3%) with felypressin injected into the subconjunctival (sub-Tenon's) space. Of 5210 consecutive adult patients in whom the technique was used, all demonstrated adequate analgesia. Sixty-three (1.2%) of the eyes required supplemental analgesia, provided by a single injection of prilocaine (0.5 mL). Ecchymosis and subconjunctival hemorrhage developed in 63 (1.2%) of the eyes. There were no instances of ptosis.