Urine proteomics as a non-invasive approach to monitor exertional rhabdomyolysis during military training.

Exertional rhabdomyolysis (ERM), a condition often associated with strenuous exercise, a common practice in the military activities, can be defined as the process of injury and rupture of muscle cell membranes, with leakage of its components into the bloodstream. Creatine kinase (CK) has been used for ERM diagnosis, albeit several studies reported the discrepancy between CK levels and clinical signs or symptoms. In this study, we analyzed the biochemical profile of the blood, and the urinary proteome of ten marine soldiers in a special training course. The samples were collected in two periods, M1 and M2, which correspond to the lowest and highest CK levels during training, respectively. Quantitative urinary proteome profile of M1 and M2 showed changes in proteins involved in immune system and cell adhesion-related pathways after strenuous physical exercise. Changes in the abundance of several proteins was observed in individuals carrying genetic polymorphisms related to greater risk for muscle damage. A panel of proteins (CTSH, PIK3IP1, DEFB1, ITGB1, BCAN, and TNFRSF10C) presented high correlation with classical blood biochemical markers of ERM and AGT MET235Thr and ACE I/D polymorphisms. These proteins represent potential urine markers of muscle damage due to intense physical conditions such as military training activities. SIGNIFICANCE: This study analyzed the blood and urine of a cohort of marine soldiers enrolled in a special training program including missions with low and high exposure to strenuous exercise. The biochemical blood profile, polymorphisms mapping and mass spectrometry-based analyses of the urinary proteome was evaluated in such a controlled samples. A total of 226 urinary proteins associated to immune system, cell adhesion and redox homeostasis were significantly changes during ERM shedding lights on the disease pathogenesis. In particular, a panel of six proteins were associated to classical ERM markers and could be used as early non invasive biomarkers.

Risk factors and future directions for preventing and diagnosing exertional rhabdomyolysis.

Exertional rhabdomyolysis may occur when an individual is subjected to strenuous physical exercise. It is occasionally associated with myoglobinuria (i.e. "cola-colored" urine) alongside muscle pain and weakness. The pathophysiology of exertional rhabdomyolysis involves striated muscle damage and the release of cellular components into extracellular fluid and bloodstream. This can cause acute renal failure, electrolyte abnormalities, arrhythmias and potentially death. Exertional rhabdomyolysis is observed in high-performance athletes who are subjected to intense, repetitive and/or prolonged exercise but is also observed in untrained individuals and highly trained or elite groups of military personnel. Several risk factors have been reported to increase the likelihood of the condition in athletes, including: viral infection, drug and alcohol abuse, exercise in intensely hot and humid environments, genetic polymorphisms (e.g. sickle cell trait and McArdle disease) and epigenetic modifications. This article reviews several of these risk factors and proposes screening protocols to identify individual susceptibility to exertional rhabdomyolysis as well as the relevance of proteomics for the evaluation of potential biomarkers of muscle damage.

Repercussão da COVID-19 em crianças e adolescentes: nova inflamação multissistêmica ou desencadeamento da doença de Kawasaki? / COVID-19 repercussion in children and adolescents: a new multisystem inflammation or a Kawasaki disease trigger?

A doença causada pelo novo coronavírus (COVID-19) teve início em dezembro de 2019 na China e rapidamente adquiriu grande importância epidemiológica, com um crescente número de casos e mortes no Brasil e no mundo. Entre os diversos estudos sobre a doença causada pelo SARS-CoV-2, foram relatados casos de crianças infectadas que apresentaram inflamação multissistêmica, mimetizando a doença de Kawasaki, o que instigou a possibilidade de uma associação entre esta e a COVID-19. O presente artigo de revisão visa destacar esta nova possibilidade diagnóstica, discutindo principalmente os sintomas, exames laboratoriais e a epidemiologia que podem diferenciar a síndrome inflamatória multissistêmica em crianças (MIS-C) como decorrente da COVID- 19 ou desencadeante da doença de Kawasaki. O banco de dados eletrônico PubMed foi utilizado para a pesquisa de artigos originais e de revisão de 2020 e 2021, selecionados de acordo com critérios de atualidade e menção a descritores científicos como infecções por coronavírus, síndrome de linfonodos mucocutâneos e inflamação. A revisão dos sintomas da MIS-C e achados de exames laboratoriais relacionados à COVID-19 foi feita por meio de artigos com estudos realizados com mais de 10 pacientes. Entre os principais resultados obtidos tem-se a diferença entre a faixa etária e etnia acometidas, presença de sintomas gastrointestinais, mecanismos de lesão cardíaca envolvidos e alterações de exames laboratoriais na doença de Kawasaki e na MIS-C. Assim, a conclusão é que a MIS-C está relacionada à infecção prévia pelo SARS-CoV-2, compartilhando dos sintomas da doença de Kawasaki, sem atuar como um desencadeante desta doença.

Coronavirus disease 2019 (COVID-19) arose in December 2019 in China and quickly assumed great epidemiological importance, with an increasing number of cases and deaths in Brazil and worldwide. Among the several studies on this disease, cases of children infected with SARS-CoV-2 who had multisystem inflammation, mimicking Kawasaki disease, were reported, which raised the possibility of an association between Kawasaki disease and COVID-19. This review article aims to highlight this new diagnostic possibility and mainly discusses the symptoms, laboratory tests, and epidemiology that may differentiate multisystem inflammatory syndrome in children (MIS-C) as a result of COVID-19 or as a Kawasaki disease trigger. Original and review articles from 2020 and 2021 that were current and mentioned keywords such as coronavirus infections, mucocutaneous lymph node syndrome, and inflammation were selected from the electronic database PubMed. The review of MIS-C symptoms and laboratory findings related to COVID-19 was based on articles of studies that included more than 10 patients. The main results obtained were differences between the affected age group and ethnicity, presence of gastrointestinal tract symptoms, different mechanisms of cardiac injury involved, and changes in laboratory tests in Kawasaki disease and MIS-C. In conclusion, MIS-C is related to previous SARS-CoV-2 infection and leads to the same symptoms of Kawasaki disease, without acting as a trigger for this disease.

Oral Health of Portuguese Children with Type 1 Diabetes: A Multiparametric Evaluation.

OBJECTIVE: To perform a multiparametric evaluation of the oral health of 36 children with type 1 diabetes. STUDY DESIGN: A group of type 1 diabetic children and a sex-age-matched control group were formed. Seven parameters were evaluated: probing depth, bleeding on probing, plaque index (O'Laery index), calculus index (according to Ramfjord), dental caries (using ICDAS), salivary pH and unstimulated salivary flow rate. Statistical analysis was performed and the significance level was set at 5%. RESULTS: Both groups consisted of 36 children with a mean age of 13 years. With regard to bleeding on probing, plaque index and calculus index, higher values were obtained in the diabetic group and the differences between groups were statistically significant for all three parameters. Concerning dental caries and salivary parameters, there were no significant differences between groups. However, a statistically significant correlation between salivary parameters and metabolic control was found. CONCLUSION: This study suggests that type 1 diabetic children are associated with some risk factors related to periodontal disease and dental caries. The proven relationship between diabetes and oral health complications imposes the need for these patients to be integrated into preventive dental programs from a young age.

Chemical composition and antioxidant activity of dried powder formulations of Agaricus blazei and Lentinus edodes.

Several mushroom species have been pointed out as sources of antioxidant compounds, in addition to their important nutritional value. Agaricus blazei and Lentinus edodes are among the most studied species all over the world, but those studies focused on their fruiting bodies instead of other presentations, such as powdered preparations, used as supplements. In the present work the chemical composition (nutrients and bioactive compounds) and antioxidant activity (free radical scavenging activity, reducing power and lipid peroxidation inhibition) of dried powder formulations of the mentioned mushroom species (APF and LPF, respectively) were evaluated. Powder formulations of both species revealed the presence of essential nutrients, such as proteins, carbohydrates and unsaturated fatty acids. Furthermore, they present a low fat content (<2g/100g) and can be used in low-calorie diets, just like the mushrooms fruiting bodies. APF showed higher antioxidant activity and higher content of tocopherols and phenolic compounds (124 and 770 µg/100g, respectively) than LPF (32 and 690 µg/100g). Both formulations could be used as antioxidant sources to prevent diseases related to oxidative stress.

Influence of different substrates on the production of a mutant thermostable glucoamylase in submerged fermentation.

Three mutations, Ser54→Pro, Thr314→Ala, and His415→Tyr, were identified in Aspergillus awamori glucoamylase gene expressed by Saccharomyces cerevisiae. The mutant glucoamylase (GA) was substantially more thermostable than a wild-type GA at 70 °C, with a 3.0 KJ mol(-1) increase in the free energy of thermo-inactivation. The effect of starch from different botanical sources on the production of this GA was measured in liquid fermentation using commercial soluble starch, cassava, potato, and corn as the carbon source. The best substrate for GA production was the potato starch showing an enzymatic activity of 6.6 U/mL. The commercial soluble starch was also a good substrate for the enzyme production with 6.3 U/mL, followed by cassava starch and corn starch with 5.9 and 3.0 U/mL, respectively. These results showed a significant difference on GA production related to the carbon source employed. The mutant GA was purified by acarbose-Sepharose affinity chromatography; the estimated molecular mass was 100 kDa. The mutant GA exhibited optimum activity at pH 4.5 and an optimum temperature of 65 °C.

Estudo higiênico-sanitário de bombas de chocolate com recheio de creme / I study sanitary of bombs of cacao with of cremating

As bombas de chocolate com recheio de creme, podem ser incluídas entre os produtos de confeitaria, que são os obtidos pela adequada cocção de massa elaborada com farinhas, amidos, féculas e outras substâncias alimentícias, doces ou salgados, recheados ou não. Os mesmos poderão ser dispensados de registro em órgão apropriado quando destinados à venda direta ao consumidor, efetuada em balcão do próprio local de produção. Dentre os diversos fatores que podem interferir na qualidade dos produtos alimentícios, podem-se destacar a temperatura, a atmosfera e a umidade relativa, bem como as condições higiênico–sanitárias envolvidas em seu processamento. Principalmente nos produtos de confeitaria, que são perecíveis e possuem uma composição que favorece o desenvolvimento microbiano, as análises microbiológicas ocupam uma posição de destaque, sendo de enorme importância na verificação das condições higiênicas envolvidas na produção, armazenamento, transporte e manuseio. A presença maciça de bolores e leveduras em doces de confeitaria pode geralmente indicar que no decorrer do processo ou armazenamento, ocorreu exposição a esses contaminantes e que condições propícias de inadequada estocagem favoreceram a sua multiplicação. O Staphylococcus aureus, Bacillus cereus e coliformes fecais, dependendo do número encontrado por grama de produto, bem como apenas a presença de Salmonella sp em 25g, poderão indicar impropriedade ao consumo humano, visto que poderão ocasionar toxinfecções alimentares ao consumidor. Considerando os aspectos mencionados, este trabalho teve como objetivo realizar o estudo higiênico – sanitário de bombas de chocolate com recheio de creme, obtidas do comércio varejista do município de São José do Rio Preto – SP, por meio das seguintes análises microbiológicas: contagem de bactérisa aeróbias mesófilas, bolores e leveduras, Staphilococcus aureus, Bacillus cereus, determinação do Número Mais Provável (NMP) de colifomes totais e fecais (termotolerantes), pesquisa de Escherichia coli e de Salmonella sp. Após a obtenção dos resultados, pôde ser verificado que 40 por cento das amostras analisadas estavam em desacordo com os padrões microbiológicos estabelecidos pela legislação vigente para Staphylococcus aureus e Bacillus cereus e 10 por cento não atendiam ao padrão fixado, sendo todos esses exemplares classificados como produtos em condições sanitárias insatisfatórias e portanto, produtos impróprios para o consumo humano.