Brazil nut (Bertholletia excelsa H.B.K.) and Brazil nut oil: effects on oxidative stress and potential therapeutic health benefits from human, animal, and cell culture models.

Brazil nut (Bertholletia excelsa H.B.K.) is characterized by its high nutritional and energetic value. It contains high levels of l-arginine, antioxidant vitamins, phenolic compounds, and phytosterols. In addition to their biological functions, bioactive compounds and essential fatty acids present therapeutic effects on chronic disease prevention through their antioxidant effects. Thus, this review aims to present the most recent scientific evidence on the effect of Brazil nut on human health. A search for scientific articles was carried out through the MEDLINE/PubMed, Science Direct, and LILACS databases, considering articles published between the years 2010 and 2023. The results showed that Brazil nuts and Brazil nut oil, when consumed regularly and associated with a balanced diet, can improve lipid profile, attenuate inflammatory response, and improve oxidative stress through increased activity and gene expression of antioxidant enzymes. However, further studies are recommended to better understand the mechanisms of action.

Botanical, nutritional, phytochemical characteristics, and potential health benefits of murici (Byrsonima crassifolia) and taperebá (Spondias mombin): insights from animal and cell culture models.

Brazil has great biodiversity, and the Amazon biome stands out for a variety of native fruits with high economic and nutritional potential. Murici (Byrsonima crassifolia) and taperebá (Spondias mombin) are sources of vitamins, minerals, and phytochemicals with potential health benefits. Because of the bioactive potential of these Brazilian fruits, this review aims to gather the most current existing knowledge about their botanical, nutritional, and phytochemical properties, because the presence of several bioactive compounds may bring promising strategies to the prevention and treatment of several diseases. The search was conducted of the LILACS, MEDLINE, PubMed, and Science Direct databases, considering articles published between 2010 and 2023. The compiled results showed that these fruits, their leaves, and seeds have great antioxidant activity and are a good source of phytochemicals, especially phenolic compounds. In vitro and in vivo studies indicate that these bioactive compounds have several health benefits related to the prevention or treatment of diseases, including antioxidant effects; anti-inflammatory effects; and antidiabetic, antidepressant, neuroprotective, antiproliferative, anticancer, hypolipemic, cardioprotective, gastroprotective, hepatoprotective, and nephroprotective effects, and they are particularly related to the reduction of damage from oxidative stress. This review highlights the potential of these fruits as functional foods and for therapeutic purposes. However, it is recommended to conduct more studies on the identification and quantification of phytochemicals present in these fruits and studies in humans to better understand the mechanisms of action related to their effects and to understand the interaction of these compounds with the human body, as well as to prove the safety and efficacy of these compounds on health.

Historical Hg accumulation (∼65 cal kyr BP) in upland lakes of the Southeastern Brazilian Amazonia: New evidence of the extent of geogenic and diagenetic control.

The historical upland lake sediments in the Brazilian Amazon witnessed significant enrichment of total mercury (Hg). However, its spatio-temporal relationships between lakes and the main factors responsible for this enrichment are still poorly constrained. Given this, we geochemically investigated 12 radiometrically dated (extending back to ∼65 cal kyr BP) sediment cores from the Carajás plateau, Brazil. The Hg level in historical sediments presented a large temporal variability (from 1 to 3200 µg/kg), with maximum accumulation peaks observed between 30 and 45 cal kyr BP in core R2, LB3, and R1. However, the lack of the Hg peak in other cores (LV2 and LTI3) during the same period despite being proximity and non-correlation of these Hg peaks with the onset of major volcanic events indicates that this source has little bearing. Hg enrichment is highly dependent on the type of sedimentary facies, with higher values were associated with detritic facies (MI) and detritic+organic facies (P/M). Principal component analysis shows that aluminosilicate minerals and organic matter are essential hosts of Hg in sediments. The positive correlation between Al, Ti, and Hg in detritic facies and their strong coherence with Hg/TOC in R1, R5, LSL, ST02, and LB3 cores indicate that Hg is primarily of lithogenic origin. This can be substantiated by the higher background threshold value of Hg (574 µg/kg) in historical lake sediments compared to those in recent lake sediments (340 µg/kg). However, the most pronounced Hg peak (3200 µg/kg) in R2 around 45 cal kyr BP, which correlates positively with TOC, S, Se, As, and Mo indicates their diagenetic enrichment in organic-rich sediments under anoxic conditions. Thus, in addition to the lithogenic effect, it can be argued that diagenesis can play a significant role in prompting Hg enrichment in the Carajás lake sediments in Amazonia.

Effects of Supplementation of Murici (Byrsonima crassifolia) and Taperebá (Spondias mombin) Pulp Extracts on Food Intake, Body Parameters, and Oxidative Stress Markers in Healthy Rats.

This study evaluates the effects of supplementation of murici (Byrsonima crassifolia) and taperebá (Spondias mombin) pulp extracts on dietary intake, body composition, biochemical parameters, and markers of oxidative stress. Two experiments were conducted with a total of 80 healthy male Wistar rats and a 30-day supplementation. In the first experiment, animals were divided into control (C) group, murici group 50 mg/(kg⸱day) (50Mu), murici group 100 mg/(kg⸱day) (100Mu), and murici group 200 mg/(kg⸱day) (200Mu). In the second experiment, animals were divided into C group, taperebá group 50 mg/(kg⸱day) (50Tap), taperebá group 100 mg/(kg⸱day) (100Tap), and taperebá group 200 mg/(kg⸱day) (200Tap). Results showed lower feed intake in 50Mu, 100Mu, and 100Tap groups (13%, 12%, and 10%, respectively, P < .05) and lower body fat in 200Mu, 100Tap, and 200Tap groups (16.0%, 29.1%, and 27.1%, respectively, P < .05). Only the 100Tap group showed reduced adipose tissue content (30.4%; P < .05). Increased plasma antioxidant capacity was observed at all doses for both fruits. Taperebá supplementation reduced ferrous oxidation-xylenol orange levels (50Tap: 8.4%, 100Tap: 16.1%, 200Tap: 24.3%; P < .05) and increased thiol levels (50Tap: 39%, 100Tap: 31%; P < .05). Serum thiobarbituric acid reactive substances levels were reduced in all groups receiving taperebá (50Tap: 77.7%, 100Tap: 73.1%, 200Tap: 73.8%; P < .05) and murici (50Mu: 44.5%, 100Mu: 34%, 200Mu: 43%; P < .05). Therefore, it is suggested that the inclusion of these fruits in the diet can contribute to health maintenance and disease prevention, through their effects on controlling food intake, improving body composition, and in combating oxidative stress.

Self-medication associated with toothache: a systematic literature review / Automedicação associada à dor de dente: uma revisão sistemática da literatura / Automedicación asociada al dolor de dientes: una revisión sistemática de la literatura

Introduction: Self-medication consists of selecting and using medication without a poprescription or guidance from a healthcare professional. This practice has been widely reported worldwide, which has contributed to a series of adverse health outcomes, such as delayed diagnosis, worsening of clinical conditions, drug interactions, intoxication, and adverse reactions, which tend to compromise patient safety. Objective:To analyze the prevalence of self-medication associated with toothache, the main factors associated with self-medication in dental patients, as well as outline the profile of medications used by these individuals, the preferred route of administration, and the main sources of medication.Methodology:Asystematic review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant articles published in the last ten years, without limitations of language were searched using the following descriptors/MeSHterms and keywords: "self-medication" and (toothache or "dental pain") not Child. Results:The initial search returned 61 manuscripts. Fourteen papers, all cross-sectional studies, were eligible for inclusion in the systematic review.Conclusions:The prevalence of self-medication for toothache ranged from 6.5% to 100.0%. Cultural and economic factors, barriers to access, the high cost of dental treatments, lack of time and money, and the perception that dental problems are not a serious problem are among the main factors associated with the practice. Regarding the drugs used, the most used classes were paracetamol, especially anti-inflammatory drugs, particularly ibuprofen, and analgesics administered orally (AU).

Introdução:A automedicação consiste na escolha e uso de medicamentos sem prescrição ou orientação de um profissional de saúde. Essa prática tem sido amplamente divulgada em todo o mundo, o que tem contribuído para uma série de desfechos adversos à saúde, como atraso no diagnóstico, piora do quadro clínico, interações medicamentosas, intoxicações e reações adversas, que tendem a comprometer a segurança do paciente. Objetivo:Analisar a prevalência da automedicação associada à dor de dente, os principais fatores associados à automedicação em pacientes odontológicos, bem como traçar o perfil dos medicamentos utilizados por esses indivíduos, a via preferencial de administração e as principais fontes de medicação. Metodologia:Uma revisão sistemática foi desenvolvida de acordo com os itens de relatório preferidos para revisões sistemáticas e meta-análises (PRISMA). Foram pesquisados artigos relevantes publicados nos últimos dez anos, sem limitação de linguagem, utilizando os seguintes descritores/MeSHterms e palavras-chave: "self-medication" e (toothache or "dental pain") não Child. Resultados:A busca inicial encontrou61manuscritos. Quatorze artigos, de delineamento transversal,foram considerados elegíveis e incluídos para a revisão.Conclusões:A prevalência de automedicação para dor de dente variou de 6,5% a 100,0%. Fatores culturais e econômicos, barreiras de acesso, alto custo dos tratamentos odontológicos, falta de tempo e dinheiro e a percepção de que os problemas odontológicos não são um problema grave estão entre os principais fatores associados à prática. Em relação aos medicamentos utilizados, as classes mais utilizadas foram o paracetamol, principalmente os anti-inflamatórios, principalmente o ibuprofeno, e os analgésicos por via oral (AU).

Introducción: La automedicación consiste en seleccionar y utilizar medicamentos sin receta ni orientación de un profesional sanitario. Esta práctica ha sido ampliamente reportada a nivel mundial, lo que ha contribuido a una serie de resultados adversos para la salud, como retraso en el diagnóstico, empeoramiento de las condiciones clínicas, interacciones medicamentosas, intoxicaciones y reacciones adversas, que tienden a comprometer la seguridad del paciente.Objetivo: Analizar la prevalencia de automedicación asociada al dolor de muelas, los principales factores asociados a la automedicación en pacientes odontológicos, así como delinear el perfil de medicamentos utilizados por estos individuos, la vía de administración preferida y las principales fuentes de medicación. Metodología: Se desarrolló una revisión sistemática de acuerdo con los Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Se buscaron artículos relevantes publicados en los últimos diez años, sin limitaciones de idioma, utilizando los siguientes descriptores/MeSHterms y palabras clave: "self-medication" y (toothache or "dental pain") not Child. Resultados: La búsqueda inicial arrojó 61 manuscritos. Catorce artículos, todos estudios transversales, fueron elegibles para su inclusión en la revisión sistemática.Conclusiones: La prevalencia de automedicación para el dolor de muelas osciló entre 6,5% y 100,0%. Los factoresculturales y económicos, las barreras de acceso, el alto costo de los tratamientos dentales, la falta de tiempo y dinero, y la percepción de que los problemas dentales no son un problema grave se encuentran entre los principales factores asociados con la práctica. En cuanto a los fármacos utilizados, las clases más utilizadas fueron el paracetamol, especialmente los antiinflamatorios, especialmente el ibuprofeno, y los analgésicos por vía oral (AU).

Psoríase vulgar grave com resposta satisfatória ao uso de anti-interleucina 12/23 (ustequinumabe): relato de caso / Severe psoriasis vulgar with satisfactory response to the use of anti-interleukin 12/23 (ustekinumab): case report

Introdução: A psoríase é uma doença inflamatória crônica imunomediada que acomete a pele e outros órgãos e que está fortemente associada a diversas comorbidades, incluindo doenças cardiovasculares, acidentes vasculares encefálicos, doença renal crônica e distúrbios psiquiátricos. Portanto, é fundamental entender a psoríase não como uma patologia estritamente dermatológica, mas sim multissistêmica. Objetivo: Relatar o caso de uma paciente com psoríase vulgar grave, a fim de auxiliar outros profissionais de saúde no diagnóstico precoce e tratamento eficaz desta doença. Resultado: Paciente feminina, 22 anos, procurou consultório privado referindo apresentar "lesões no corpo todo". Apresentava placas eritematoescamosas em dorso, tronco, membros superiores, membros inferiores. Após inúmeros tratamentos inefetivos, optado por iniciar o tratamento com uma droga anti-interleucina 12 e 23 como Ustequinumabe. Após 30 dias da dose de indução, antes da aplicação da segunda dose de indução, a paciente já apresentava melhora clínica satisfatória. Conclusão: O diagnóstico precoce é fundamental para a administração da terapêutica adequada, que, apesar de não promover a remissão da doença, corrobora para o controle da inflamação sistêmica, cujas implicações aumentam o risco de morbimortalidade dos pacientes

Introduction: Psoriasis is a chronic immune-mediated inflammatory disease that affects the skinand other organs and is strongly associated with several comorbidities, including cardiovascular disease, stroke, chronic kidney disease and psychiatric disorders. Therefore, it is fundamental to understand psoriasis not as a strictly dermatological pathology, but as a multisystemic one. Objective: To report the case of a patient with severe psoriasis vulgaris, in order to help other health professionals in the early diagnosis and effective treatment of this disease. Result: Patient female, 22 years old, looked for a private practice referring to having "injuries all over her body". She had erythematous, scaly plaques on her back, trunk, upper limbs, and lower limbs. After numerousineffective treatments, she opted to start treatment with an anti-interleukin 12 and 23 drug like Ustekinumab. Thirty days after the induction dose, before the application of the second induction dose, the patient already showed satisfactory clinical improvement. Conclusion: Early diagnosis is fundamental for the administration of adequate therapy, which, despite not promoting disease remission, contributes to the control of systemic inflammation, whose implications increase the risk of morbidity and mortality of patients

Introducción: La psoriasis es una enfermedad inflamatoria crónica inmunomediada que afecta la piel y otros órganos y está fuertemente asociada con varias comorbilidades, que incluyen enfermedad cardiovascular, accidente cerebrovascular, enfermedad renal crónica y trastornos psiquiátricos. Por tanto, es fundamental entender la psoriasis no como una patología estrictamente dermatológica, sino como multisistémica. Objetivo: Reportar el caso de un paciente con psoriasis vulgar severa, con el fin de ayudar a otros profesionales de la salud en el diagnóstico precoz y tratamiento efectivo de esta enfermedad. Resultado: Paciente mujer, 22 años, buscó una oficina privada, refiriéndo se a tener "lesiones en todo el cuerpo". Presentaba placas eritematosas, descamativas en espalda, tronco, miembros superiores e inferiores. Después de numerosos tratamientos ineficaces, optó por iniciar un tratamiento con un fármaco antiinterleucina 12 y 23 como Ustekinumab. Treinta días después de la dosis de inducción, antes de la aplicación de la segunda dosis de inducción, el paciente ya mostraba una mejoría clínica satisfactoria. Conclusión: El diagnóstico precoz es fundamental para la administración de una terapia adecuada que, a pesar de no promover la remisión de la enfermedad, apoye el control de la inflamación sistémica, cuyas implicaciones aumentan el riesgo de morbimortalidad de los pacientes

Predicting residual neoplasia after a non-curative gastric ESD: validation and modification of the eCura system in the Western setting: the W-eCura score.

OBJECTIVE: To evaluate the risk factors for lymph node metastasis (LNM) after a non-curative (NC) gastric endoscopic submucosal dissection (ESD) and to validate and eventually refine the eCura scoring system in the Western setting. Also, to assess the rate and risk factors for parietal residual disease. DESIGN: Retrospective multicentre multinational study of prospectively collected registries from 19 Western centres. Patients who had been submitted to surgery or had at least one follow-up endoscopy were included. The eCura system was applied to assess its accuracy in the Western setting, and a modified version was created according to the results (W-eCura score). The discriminative capacities of the eCura and W-eCura scores to predict LNM were assessed and compared. RESULTS: A total of 314 NC gastric ESDs were analysed (72% high-risk resection (HRR); 28% local-risk resection). Among HRR patients submitted to surgery, 25% had parietal disease and 15% had LNM in the surgical specimen. The risk of LNM was significantly different across the eCura groups (areas under the receiver operating characteristic curve (AUC-ROC) of 0.900 (95% CI 0.852 to 0.949)). The AUC-ROC of the W-eCura for LNM (0.916, 95% CI 0.870 to 0.961; p=0.012) was significantly higher compared with the original eCura. Positive vertical margin, lymphatic invasion and younger age were associated with a higher risk of parietal residual lesion in the surgical specimen. CONCLUSION: The eCura scoring system may be applied in Western countries to stratify the risk of LNM after a gastric HRR. A new score is proposed that may further decrease the number of unnecessary surgeries.

Immunonutrients and intestinal microbiota: a gap in the literature.

The human intestinal microbiota is composed of a wide variety of microorganisms that play an important role in intestinal permeability, digestion, and especially, in the maturation of host's immune system. At the same time, effectiveness of immunomodulatory nutrients is known, especially in situations of stress and in strengthening body's defenses. However, the influence of the use of immunonutrients on microbiota's composition and variability is still poorly investigated. Studies indicate that the use of immunomodulators such as omega 3, glutamine, and arginine, can play a role in its modulation, through the immunological enhancement of the hosts. Therefore, this article sought to concentrate the latest evidence on the influence of the use of the main immunonutrients used in clinical practice on human gut microbiota, and their potential benefits.

Endoscopic submucosal dissection of appendicular lesions is feasible and safe: a retrospective multicenter study (with video).

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is challenging for appendicular lesions. We report the outcomes of ESD in this context. METHODS: We collected data of ESD procedures for appendiceal neoplasia in a multicenter prospective registry. Main study endpoints were R0, en-bloc, and curative resection rates and adverse event rate. RESULTS: One hundred twelve patients were included, 47 (42%) with previous appendectomy. Fifty-six (50%) were Toyonaga type 3 lesions (15 [13.4%] postappendectomy). En-bloc and R0 resection rates were 86.6% and 80.4%, respectively, with no significant difference associated with different grades of appendiceal invasion (P = .9 and P = .4, respectively) or previous appendectomy (P = .3 for both). The curative resection rate was 78.6%. Additional surgery was performed in 16 cases (14.3%), including 10 (62.5%) Toyonaga type 3 lesions (P = .04). This included the treatment of 5 cases (4.5%) of delayed perforation and 1 acute appendicitis. CONCLUSIONS: ESD for appendicular lesions is a potentially safer and effective alternative to surgery for a significant proportion of patients.

Progressão infantil de tinea capitis, kerion celsi e infecção secundária bacteriana cutânea com hemocultura positiva para s. Aureus ­ relato de caso / Infant progression of tinea capitis, kerion celsi and secondary bacterial skin infection with positive blood culture s. Aureus - case report

Introdução: A Tinea Capitis (TC) é uma dermatofitose que tem como evolução grave a forma Kerion Celsi (KC). Clinicamente, é caracterizada por manifestações tonsurantes e inflamatórias; diagnosticada por achados clínicos e laboratoriais, como micológico direto com KOH, tricoscopia e cultura fúngica. É utilizado no tratamento de TC antifúngicos sistêmicos por seis a oito semanas. Nesse caso houve associação de infecção secundária por Staphylococcus aureus, caracterizando um quadro atípico, raro. Objetivo: Relatar o caso, pouco descrito na literatura, de criança com Tinea Capitis (TC) com Kerion Celsi (KC) e bacteremia por contaminação secundária local e sistêmica de Staphylococcus aureus. Relato do caso: Paciente feminino, 5 anos, com manchas hiperemiadas, descamativas e pruriginosas de crescimento centrífugo em face, com surgimento de lesões circulares e pelos tonsurados em couro cabeludo que, após uso de antifúngico oral, houve inflamação aguda e saída de secreção. Apesar do tratamento independente domiciliar, com Betametasona e Cetoconazol creme e Cetoconazol 2% xampu, houve involução da lesão de face e ampliação da área de alopecia. Com a procura médica, iniciou tratamento sistêmico com Griseofulvina, seguido de antibioticoterapia oral por quadro bacteriano secundário em couro cabeludo. Houve linfonodomegalia cervical e intensificação do prurido e secreção. Foi internada para análise clínica e laboratorial, com antibioticoterapia endovenosa de amplo espectro: Ceftriaxona e Clindamicina. Colhida cultura da lesão e hemocultura, definiu-se, em ambas, S. aureus. Devido à resistência bacteriana, ocorreu troca para Cefazolina endovenosa. Na alta, a paciente seguiu com apoio dermatológico semanal e Griseofulvina, havendo a troca do antifúngico por Terbinafina. Conclusão: Quadro atípico e raro com progressão para bacteremia. O alerta para o diagnóstico precoce possibilita tratamento oral adequado e menor impacto da doença na qualidade de vida, evitando-se a contaminação secundária bacteriana

Introduction: Tinea Capitis (TC) is a dermatophytosis that has as severe evolution the form Kerion Celsi (KC). Clinically, it is characterized by tonsuring and inflammatory manifestations; diagnosed by clinical and laboratory findings, such as direct mycological with KOH, trichoscopy and fungal culture. It is used in the treatment of systemic antifungal CT for six to eight weeks. In this case there was an association of secondary infection by Staphylococcus aureus, characterizing an atypical, rare condition. Objective: To report the case, little described in the literature, of a child with Tinea Capitis (TC) with Kerion Celsi (KC) and bacteremia due to local and systemic secondary contamination of Staphylococcus aureus. Case report: Female patient, 5 years old, with hyperaemic, scaling and pruritic spots of centrifugal growth on the face, with the appearance of circular lesions and tonsure on the scalp that, after use of oral antifungal, there was acute inflammation and discharge of secretion. Despite the independent home treatment, with Betamethasone and Ketoconazole cream and Ketoconazole 2% shampoo, there was involution of the face injury and enlargement of the area of alopecia. With medical demand, he started systemic treatment with Griseofulvin, followed by oral antibiotic therapy for secondary bacterial condition in the scalp. There was cervical lymph node enlargement and intensification of pruritus and secretion. She was hospitalized for clinical and laboratory analysis, with broad spectrum intravenous antibiotic therapy: Ceftriaxone and Clindamycin. Culture of the lesion and blood culture, was defined in both S. aureus. Due to bacterial resistance, there was exchange for intravenous Cefazolin. At discharge, the patient followed with weekly dermatological support and Griseofulvin, with the exchange of antifungal by Terbinafine. Conclusion: Atypical and rare condition with progression to bacteremia. Early diagnosis provides adequate oral treatment and less impact of the disease on quality of life, avoiding secondary bacterial contamination

Introducción: La Tinea Capitis (TC) es una dermatofitosis cuya evolución severa es la forma Kerion Celsi (KC). Clínicamente se caracteriza por manifestaciones amigdalizantes e inflamatorias; se diagnostica por hallazgos clínicos y de laboratorio, como micología directa con KOH, tricoscopia y cultivo fúngico. Se utiliza en el tratamiento de la TC antifúngica sistémica durante seis a ocho semanas. En este caso se asoció infección secundaria por Staphylococcus aureus, caracterizando una condición atípica y rara. Objetivo: Reportar el caso, poco descrito en la literatura, de un niño con Tinea Capitis (TC) con Kerion Celsi (KC) y bacteriemia por contaminación secundaria local y sistémica de Staphylococcus aureus. Caso clínico: Paciente femenino, de 5 años de edad, con placas hiperémicas, descamativas y pruriginosas de crecimiento centrífugo en la cara, con aparición de lesiones circulares y pelo tonsurado en el cuero cabelludo que, luego de utilizar un antifúngico oral, presentó inflamación aguda y salida de secreciones. A pesar del tratamiento independiente domiciliario, con crema de Betametasona y Ketoconazol y shampoo de Ketoconazol al 2%, se presentó involución de la lesión facial y agrandamiento del área de alopecia. Con la búsqueda médica se inició tratamiento sistémico con Griseofulvina, seguido de antibioticoterapia oral por una afección bacteriana secundaria en el cuero cabelludo. Había agrandamiento de los ganglios linfáticos cervicales y aumento del prurito y la secreción. Ingresa para análisis clínicos y de laboratorio, con antibioticoterapia endovenosa de amplio espectro: Ceftriaxona y Clindamicina. Tras la recogida de cultivo de la lesión y hemocultivo, se definió S. aureus en ambos. Debido a la resistencia bacteriana, hubo un cambio a cefazolina intravenosa. Al alta, la paciente continuó con soporte dermatológico semanal y Griseofulvina, reemplazándose el antifúngico por Terbinafina. Conclusión: Condición atípica y rara con progresión a bacteriemia. La alerta para el diagnóstico precoz permite un adecuado tratamiento oral y menor impacto de la enfermedad en la calidad de vida, evitando contaminaciones bacterianas secundarias

Análise do perfil de intoxicação exógena no estado da bahia entre 2012 a 2021 / Analysis of exogenous poisoning profile in the state of Bahia between 2012 to 2021 / Análisis del perfil de intoxicación exógeno em el estado de Bahia entre 2012 a 2021

Introdução:As intoxicações exógenas têm sido um importante problema de saúde pública, em decorrência da sua elevada frequência, morbidade e complexidade. Objetivo:Analisar o perfil de intoxicação exógena no estado da Bahia durante o período de 2012 a 2021, utilizando como base de informações as notificações disponíveis no Sistema de Informação de Agravo e Notificação. Metodologia:Estudo transversal, descritivo, retrospectivo, de série temporal, com abordagem quantitativa, utilizando dados secundários de natureza pública disponibilizados pelo Ministério da Saúde do Brasil. Foram analisadas informações sobre as intoxicações exógenas no estado da Bahia no período temporal de 2010 a 2021.O total de notificações, total de notificações por ano, sexo, raça, faixa etária e escolaridade foram avaliados. A circunstância da intoxicação, o agente tóxico, os critérios de confirmação dos casos, tipo de exposição e a evolução dos casos também foram investigados. Resultados:No período temporalanalisado,foram notificados um total de 46.187 casos de intoxicação exógena no estado da Bahia, com destaque para região leste do estado (43,26%). 55,21% dos indivíduos eram do sexo feminino, parda (46,52%), com faixa etária de 20 a 39 anos (41,71%), e com ensino médio completo (5,76%). A maioria dos casos aconteceram mediante a tentativas de suicídio (30,68%), tendo como principais agentes tóxicos o uso de medicamentos (36,39%). Grande partedos casos foram confirmados mediante ao estado clínico (53,01%). As intoxicações aguda-única apareceram em maior proporção (53,05%). 1,15% dos pacientes notificados foram a óbito. Conclusões:As intoxicações exógenas consistem em um importante problema desaúde pública para o estado da Bahia, reiterando dessa forma, a importância da adoção de medidas preventivas (AU).

Introduction:Exogenous intoxications have been an important public health problem, due to their high frequency, morbidity and complexity. Objective:To analyze the profile of exogenous intoxication in the state of Bahia during the period from 2012 to 2021, using the notifications available in the Grievance and Notification Information System as a basis for information. Methodology:Cross-sectional, descriptive, retrospective, time-series study, with a quantitative approach, using secondary data of a public nature made available by the Brazilian Ministry of Health. Information on exogenous intoxications in the state of Bahia in the time period from 2010 to 2021 was conducted. The total number of notifications, total number of notifications per year, sex, race, age group and education were evaluated. The circumstance of intoxication, the toxic agent, the criteria for confirming the cases, the type of exposure and the evolution of the cases were also investigated. Results:In the time period analyzed, a total of 46,187 cases of exogenous intoxication were reported in the state of Bahia, with emphasis on the eastern region of the state (43.26%). 55.21% of the individuals were female, brown (46.52%), aged between 20 and 39 years (41.71%), and with complete secondary education (5.76%). Most cases occurred through suicide attempts (30.68%), with the use of medication as the main toxic agents (36.39%). Most cases were confirmed based on the clinical status (53.01%). Acute-single intoxications appeared in a greater proportion (53.05%). 1.15% of the notified patients died. Conclusions:Exogenous intoxications are an important public health problem for the state of Bahia, thus reiterating the importance of adopting preventive measures (AU).

Introducción:Las intoxicaciones exógenas hansido un importante problema de salud pública, por su alta frecuencia, morbilidad y complejidad.Objetivo:Analizar el perfil de las intoxicaciones exógenas en el estado de Bahía durante el período de 2012 a 2021, utilizando como base de información las notificaciones disponibles en el Sistema de Información de Quejas y Notificaciones.Metodología:Estudio transversal, descriptivo, retrospectivo, de serie temporal, con abordaje cuantitativo, utilizando datos secundarios de carácter público puestos a disposición por el Ministerio de Salud de Brasil. Se realizó información sobre intoxicaciones exógenas en el estado de Bahía en el período de 2010 a 2021. Se evaluó el número total de notificaciones, el número total de notificaciones por año, el sexo, la raza, elgrupo de edad y la educación. También se investigó la circunstancia de intoxicación, el agente tóxico, los criterios de confirmación de los casos, el tipo de exposición y la evolución de los casos. Resultados:En el período de tiempo analizado, se notificaron un total de 46.187 casos de intoxicación exógena en el estado de Bahía, con énfasis en la región este del estado (43,26%). El 55,21% de los individuos eran del sexo femenino, morenos (46,52%), con edad entre 20 y 39 años (41,71%) y con enseñanza secundaria completa (5,76%). La mayoría de los casos ocurrieron por intento de suicidio (30,68%), siendo el uso de medicamentos el principal agente tóxico (36,39%). La mayoría de los casos se confirmaron en base al estado clínico (53,01%). Las intoxicaciones agudas-simples se presentaron en mayor proporción (53,05%). Falleció el 1,15% de los pacientes notificados.Conclusiones:Las intoxicaciones exógenas son un importante problema de salud pública para el estado de Bahía, lo que reitera la importancia de adoptar medidas preventivas (AU).

Immunosuppression Protocols in Intestinal and Multivisceral Transplantation-A Literature Review.

BACKGROUND: Intestinal transplantation (IT) and multivisceral transplantation (MVT) are curative therapies for patients with intestinal failure and severe complications associated with total parenteral nutrition. High levels of immunosuppression are required to prevent acute cellular rejection (ACR) from the bowel. Studies regarding pre-treatment, induction, and post-transplant therapy have improved graft acceptance, reducing immunosuppression doses and infectious complications. However, the low rate of IT and MVT and the small number of specialized centers have resulted in a limited number of evidence-based immunosuppression protocols. We reviewed immunosuppression in IT and MVT to draw useful conclusions regarding the best protocol strategies for the induction, maintenance, and management of ACR. METHODS: A review was performed using the PubMed database. Articles on immunosuppression protocols in IT and MVT that addressed graft rejection, infection, or survival, published between 2006 and 2022, were selected. RESULTS: A total of 690 articles were selected. Two researchers applied the inclusion and exclusion criteria and selected 14 articles independently. For induction, thymoglobulin, alemtuzumab, and basiliximab are the most frequently used immunosuppressants for induction. Classic maintenance therapy consists of a combination of corticosteroids and tacrolimus. Methylprednisolone with an increased tacrolimus dose is used most frequently to manage ACR. Depending on the receptor response, such as thymoglobulin, infliximab, adalimumab, or bortezomib, other immunosuppressants should be considered. CONCLUSIONS: There have been great advances in IT and TMV immunosuppression. We conclude that the gold standard immunosuppressive protocol is triple therapy, comprising induction with thymoglobulin, maintenance with steroids for a few months, and tacrolimus and mycophenolate therapy. Innovative approaches for treating intestinal rejection episodes with more appropriate drugs, such as infliximab, adalimumab, or bortezomib, are necessary.

Development of Dipeptide N-acetyl-L-cysteine Loaded Nanostructured Carriers Based on Inorganic Layered Hydroxides.

N-acetyl-L-cysteine (NAC), a derivative of the L-cysteine amino acid, presents antioxidant and mucolytic properties of pharmaceutical interest. This work reports the preparation of organic-inorganic nanophases aiming for the development of drug delivery systems based on NAC intercalation into layered double hydroxides (LDH) of zinc-aluminum (Zn2Al-NAC) and magnesium-aluminum (Mg2Al-NAC) compositions. A detailed characterization of the synthesized hybrid materials was performed, including X-ray diffraction (XRD) and pair distribution function (PDF) analysis, infrared and Raman spectroscopies, solid-state 13carbon and 27aluminum nuclear magnetic resonance (NMR), simultaneous thermogravimetric and differential scanning calorimetry coupled to mass spectrometry (TG/DSC-MS), scanning electron microscopy (SEM), and elemental chemical analysis to assess both chemical composition and structure of the samples. The experimental conditions allowed to isolate Zn2Al-NAC nanomaterial with good crystallinity and a loading capacity of 27.3 (m/m)%. On the other hand, NAC intercalation was not successful into Mg2Al-LDH, being oxidized instead. In vitro drug delivery kinetic studies were performed using cylindrical tablets of Zn2Al-NAC in a simulated physiological solution (extracellular matrix) to investigate the release profile. After 96 h, the tablet was analyzed by micro-Raman spectroscopy. NAC was replaced by anions such as hydrogen phosphate by a slow diffusion-controlled ion exchange process. Zn2Al-NAC fulfil basic requirements to be employed as a drug delivery system with a defined microscopic structure, appreciable loading capacity, and allowing a controlled release of NAC.

Biomaterials Based on Organic Polymers and Layered Double Hydroxides Nanocomposites: Drug Delivery and Tissue Engineering.

The development of biomaterials has a substantial role in pharmaceutical and medical strategies for the enhancement of life quality. This review work focused on versatile biomaterials based on nanocomposites comprising organic polymers and a class of layered inorganic nanoparticles, aiming for drug delivery (oral, transdermal, and ocular delivery) and tissue engineering (skin and bone therapies). Layered double hydroxides (LDHs) are 2D nanomaterials that can intercalate anionic bioactive species between the layers. The layers can hold metal cations that confer intrinsic biological activity to LDHs as well as biocompatibility. The intercalation of bioactive species between the layers allows the formation of drug delivery systems with elevated loading capacity and modified release profiles promoted by ion exchange and/or solubilization. The capacity of tissue integration, antigenicity, and stimulation of collagen formation, among other beneficial characteristics of LDH, have been observed by in vivo assays. The association between the properties of biocompatible polymers and LDH-drug nanohybrids produces multifunctional nanocomposites compatible with living matter. Such nanocomposites are stimuli-responsive, show appropriate mechanical properties, and can be prepared by creative methods that allow a fine-tuning of drug release. They are processed in the end form of films, beads, gels, monoliths etc., to reach orientated therapeutic applications. Several studies attest to the higher performance of polymer/LDH-drug nanocomposite compared to the LDH-drug hybrid or the free drug.

Effects of pre-analytical sample care and analysis methodology on measures of metabolic acidosis in hemodialysis patients.

INTRODUCTION: We evaluated the effects of pre-analytical care on total carbon dioxide (tCO2 ) in hemodialysis patients, as calculated by blood gas analysis (ctCO2 ) or measured by an enzymatic assay (mtCO2 ). METHODS: Blood samples were collected via vascular access before dialysis sessions. For blood gas analysis, eight aliquots were collected, refrigerated or non-refrigerated, and analyzed at 0, 4, 8, and 24 h after collection. A blood sample was then collected for the enzymatic method and distributed into 14 aliquots. Half of the aliquots were refrigerated. The samples analyzed at time point 0 were centrifuged immediately. The remaining aliquots of both the refrigerated and non-refrigerated clusters were centrifuged before storage. Samples were analyzed at 4, 8, and 24 h post-collection. FINDINGS: By blood gas analysis, no significant change was found in bicarbonate values over time, either in the non-refrigerated or refrigerated samples. ctCO2 values during the experiment showed a minor but statistically significant increase of questionable clinical relevance in both non-refrigerated and refrigerated aliquots. In the enzymatic assay, the reduction in mtCO2 levels during the experiment was negligible. The median absolute reductions at the end of the experiment were 1.77, 1.21, 1.04, and 1.12 mmol/L for the non-centrifuged/non-refrigerated, centrifuged/non-refrigerated, non-centrifuged/refrigerated, and centrifuged/refrigerated aliquots, respectively. DISCUSSION: Our results suggest that measured or calculated tCO2 levels of capped and cooled samples are adequate for analyzing the acid-base status of hemodialysis patients, even when such determination is not performed immediately after collection.

Comparison of genotyping methods and toxin gene profiles of Staphylococcus aureus isolates from clinical specimens.

Staphylococcus aureus is a frequent cause of infections worldwide. Methicillin-resistant S. aureus (MRSA) is one of the main causes of Gram-positive infections, and methicillin-susceptible strains (MSSA) primarily colonize and infect community hosts. Multiple virulence factors are involved, with toxins playing a significant role in several diseases. In this study, we assess the prevalence of toxin genes in 89 S. aureus clinical isolates (31 MRSA and 58 MSSA). We evaluated the discriminatory power of the association of internal transcribed spacer-PCR (ITS-PCR) and 3'- end coa gene ( coa-PCR) when compared with other more commonly used and costly techniques. The isolates showed a high level of genetic diversity, and toxins were found in all the isolates. While most toxin classes displayed no statistically significant correlations and were equally distributed in isolates regardless of their resistance status, classic enterotoxins ( sea-see) showed a positive correlation with MSSA isolates. The combination of coa-PCR with ITS-PCR showed a discriminatory index of 0.84, discriminating 22 genotypes that agree with previously determined data by PFGE and MLST. This association between the two PCR-based methods suggests that they can be useful for an initial molecular epidemiological investigation of S. aureus in hospitals, providing significant information while requiring fewer resources.