Identification of third stage larvae of strongyles and molecular diagnosis of Strongylus vulgaris in the feces of Thoroughbred horses kept in training centers in Rio de Janeiro, Brazil.

The aims of the present study were to identify strongyles in the feces of Thoroughbred horses based on larval morphology; to detect Strongylus vulgaris using molecular diagnosis and compare results to those of feces culture; and to determine the association between the presence of S. vulgaris with corresponding animal information (age range, gender, and anthelmintic use). Feces of horses kept in six Training Centers in Rio de Janeiro State, that showed the presence of ≥500 eggs per gram of feces (EPG) were subjected to strongyle identification. Of the 520 fecal samples collected, 35 had an EPG ≥ 500. After fecal culture for L3 larvae identification, DNA was extracted, subjected to PCR to amplify the ITS2 region DNA fragment of S. vulgaris, and sequenced. A total of 3500 larvae were analyzed. Most were classified as small strong (99.7%), with an emphasis on the type A subfamily of Cyathostominae. Forms of S. vulgaris only corresponded to 0.2%. In all, 25 samples showed amplified S. vulgaris DNA products and 11 showed nucleotide sequences with high sequence identity. Fecal culture and PCR results showed poor agreement (kappa = 0.105) for S. vulgaris diagnosis. Age, gender, anthelmintic use, and anthelmintic administration interval were not statistically significant. The present study showed the presence of S. vulgaris in the feces of horses kept in Rio de Janeiro Training Centers, mainly seen via PCR, which has emerged as the most effective tool for diagnosis. This study made it possible to identify strongyles that infect horses in the region, emphasizing upon the necessity for constant monitoring of the animals.

Effects of training Community Health Agents on dementia: a quasi-experimental study.

OBJECTIVES: to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. METHODS: a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer's Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student's t-test for related samples was used, and the effect size was calculated. RESULTS: while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. CONCLUSIONS: it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.

Tapirira guianensis is Selectively Cytotoxic, Induces Apoptosis to the Glioblastoma and Decreases Tumor Growth and Angiogenesis in vivo.

Glioblastoma is the most frequent primary malignant brain tumor without effective treatment, which makes this work extremely relevant. The study of the bioactive compounds from medicinal plants plays an important role in the discovery of new drugs.This research investigated the constituents of Tapirira guianensis and its antitumor potential (in vitro and in vivo) in glioblastoma. The T. guianensis extracts were characterized by mass spectrometry. The ethyl acetate partition (01ID) and its fractions 01ID-F2 and 01ID-F4 from T. guianensis showed potential antitumor treatment evidenced by selective cytotoxicity for GAMG with IC50 14.1 µg/mL, 83.07 µg/mL, 59.27 µg/mL and U251 with IC50 25.92 µg/mL, 37.3 µg/mL and 18.84 µg/mL. Fractions 01ID-F2 and 01ID-F4 were 10 times more selective when compared to TMZ and 01ID for the two evaluated cell lines. T. guianensis also reduced matrix metalloproteinases 2 - 01ID-F2 (21.84%), 01ID-F4 (29.6%) and 9 - 01ID-F4 (73.42%), ID-F4 (53.84%) activities, and induced apoptosis mainly through the extrinsic pathway. Furthermore, all treatments significantly reduced tumor size (01ID p < 0,01, 01ID-F2 p < 0,01 and 01ID-F4 p < 0,0001) and caused blood vessels to shrink in vivo. The present findings highlight that T. guianensis exhibits considerable antitumor potential in preclinical studies of glioblastoma. This ability may be related to the phenolic compounds and sesquiterpene derivatives identified in the extracts. This study deserves further in vivo research, followed by clinical investigation.

Effects of training Community Health Agents on dementia: a quasi-experimental study / Efectos de la capacitación de Agentes Comunitarios de Salud en la demencia: un estudio cuasi experimental / Efeitos da capacitação de Agentes Comunitários de Saúde na demência: um estudo quase experimental

ABSTRACT Objectives: to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. Methods: a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer's Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student's t-test for related samples was used, and the effect size was calculated. Results: while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. Conclusions: it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.

RESUMEN Objetivos: evaluar el conocimiento de los Agentes Comunitarios de Salud sobre la demencia antes y después de un taller de capacitación para la detección de signos de la enfermedad. Métodos: estudio cuasi experimental con 33 agentes comunitarios, en el que se recopilaron datos sociodemográficos y conocimiento sobre la demencia, evaluados mediante la Escala de Conocimiento de la Enfermedad de Alzheimer, antes y después del taller. Hubo 10 sesiones semanales en línea y sincrónicas. Se utilizó la prueba t de Student para muestras relacionadas y se calculó el tamaño del efecto. Resultados: mientras que la puntuación promedio en la evaluación inicial a través del instrumento de medición fue de 16,3, en la evaluación final fue de 21,24. Se observó un aumento en la puntuación de instrumento después de participar en el taller, con un valor de 4,94. Conclusiones: es urgente invertir en la educación continua de estos profesionales para aumentar la conciencia en la detección oportuna de casos de demencia en atención primaria y la concienciación sobre factores potencialmente modificables.

RESUMO Objetivos: avaliar o conhecimento dos Agentes Comunitários de Saúde sobre demência antes e após a oficina de capacitação para detecção de sinais da doença. Métodos: estudo quase-experimental com 33 agentes comunitários, no qual foram coletadas informações sociodemográficas e de conhecimento sobre demência, avaliadas pela Alzheimer's Disease Knowledge Scale, no pré e pós-oficina. Houve 10 encontros semanais, online e síncronos. Utilizou-se o teste t de Student para amostras relacionadas e calculou-se o tamanho do efeito. Resultados: enquanto a média de pontos na avaliação inicial, por meio do instrumento de medida, foi de 16,3, na avaliação final foi de 21,24. Observou-se aumento na pontuação na escala após a participação na oficina, com um valor de 4,94. Conclusões: é urgente investir na educação permanente desses profissionais para maior conscientização na detecção oportuna de casos de demência ainda na atenção básica e conscientização de fatores potencialmente modificáveis.

No Association of Angiotensin-Converting Enzyme Insertion/Deletion (ACE I/D) Gene Polymorphism in the Susceptibility to Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients: An Updated Meta-Analysis.

Diabetic retinopathy (DR) is a complex and multifactorial pathology encompassing environmental, metabolic, and polygenic influences. Among the genes possibly involved in the development and progression of DR, the Angiotensin I-converting enzyme (ACE) gene stands out, which presents an insertion (I) or deletion (D) polymorphism of a 287 bp Alu repetitive sequence in intron 16. Thus, this study aimed to perform a systematic review with meta-analysis to elucidate the relationship between the ACE gene (I/D) polymorphism (rs1799752) and the development and progression of DR in type 2 diabetic patients. PubMed/MEDLINE, Embase, Web of Science, and Scopus databases were systematically searched to retrieve articles that investigated the association between ACE gene (I/D) polymorphism in DR patients. Sixteen articles were included in the systematic review. The results describe no significant association between the polymorphism and DR risk (OR = 1.12; CI = 0.96-1.31; and p = 0.1359) for genotypic analysis by the dominant model (II vs. ID+DD). Moreover, we also observed no significant association between the D allele on the allele frequency analysis (I vs. D) and the DR risk (OR = 1.10; CI = 0.98-1.23; and p = 0.1182). Forest plot analysis revealed that the discrepancy between previous studies most likely arose from variations in their sample sizes. In conclusion, I/D polymorphism appears to be not involved in the susceptibility to and progression of the DR in type 2 diabetic patients.

First microscopic and molecular parasitological survey of Strongylus vulgaris in Brazilian ponies.

The frequency of gastrointestinal parasites with an emphasis on Strongylus vulgaris was investigated among the Brazilian Pony breed kept on farms in the municipality of Teresópolis, state of Rio de Janeiro. Fecal samples were collected in three stud farms: A (n= 22 animals), B (n= 3), and C (n= 2). Fecal samples were subjected to the quantitative Mini-FLOTAC technique, using three different solutions, and to qualitative techniques. The parasite prevalence was found to be 81.4%. Eggs from strongylids were identified in 74% of the ponies. Eggs of Parascaris spp. were detected in 22.7% of the animals, which were all females of farm A. At this locality, mares were kept with their foals in fenced paddocks all the time. The NaCl solution of d = 1.200 g/ml was generally the one that presented the highest frequency of diagnosis of nematode eggs and the highest mean of fecal eggs per gram. The fecal samples were also subjected to the polymerase chain reaction for amplification of DNA from the ITS2 region for Strongylus vulgaris. Twelve samples presented nucleotide sequences for S. vulgaris. In the end, this study revealed the high frequency (96.3%) of S. vulgaris among ponies on farms in Teresópolis, Rio de Janeiro, Brazil.

Temporal analysis of paracetamol-induced hepatotoxicity.

Paracetamol-induced hepatotoxicity (APAP) causes severe damage that may be irreversible. Understanding the evolution of liver injury caused by overdose of the drug is important to assist in the treatment. In the present study, we evaluated the acute intoxication by APAP (500 mg/kg) in periods of 3 and 12 hours in C57BL/6 mice through biochemical, histological, inflammatory parameters, and the redox status. The results showed that in the 3-hour period there was an increase in creatinine dosage and lipid peroxidation (TBARS) compared to the control group. In the period of 12 hours after APAP intoxication all parameters evaluated were altered; there was an increase of ALT, AST, and necrosis, besides the increase of redox status biomarkers as carbonylated protein, TBARS, and MMP-9. We also observed activation of the inflammasome pathway as well as a reduction in the regenerative capacity of hepatocytes with a decrease in binucleated liver cells. In cytochrome gene expression, the mRNA level increased in CYP2E1 isoenzyme and reduced CYP1A2 expression. This study indicated that early treatment is necessary to mitigate APAP-induced acute liver injury, and alternative therapies capable of controlling the progression of intoxication in the liver are needed.

Piperine as Therapeutic Agent in Paracetamol-Induced Hepatotoxicity in Mice.

High doses of paracetamol (APAP) can cause irreversible liver damage. Piperine (P) inhibits cytochrome P450, which is involved in the metabolism of various xenobiotics, including paracetamol. We evaluated the hepatoprotective effects of piperine with or without N-acetylcysteine (NAC) in APAP-induced hepatotoxicity. The mice were treated with two doses of piperine (P20 or P40) and/or NAC at 2 h after administration of APAP. The NAC+P20 and NAC+P40 groups showed a reduced area of necrosis, MMP-9 activity, and Casp-1 expression. Furthermore, the NAC+P20 group was the only treatment that reduced alanine aminotransferase (ALT) and increased the levels of sulfhydryl groups (-SH). In the NAC+P40 group, NLRP-3 expression was reduced. Aspartate aminotransferase (AST), thiobarbituric acid-reactive substances (TBARS), and IL-1ß expression decreased in the NAC, NAC+P20, and NAC+P40 groups compared to the APAP group. The liver necrosis area, TNF levels, carbonylated protein, and IL-18 expression decreased in the P40, NAC, NAC+P20, and NAC+P40 groups compared to the APAP group. The cytokine IL-6 was reduced in all treatments. Piperine can be used in combination with NAC to treat APAP-induced hepatotoxicity.

Piroplasm Infection in Domestic Cats in the Mountainous Region of Rio de Janeiro, Brazil.

Piroplasm infections in domestic cats have been reported with increasing frequency in numerous countries. However, in some states of Brazil, little information is available about the occurrence of these parasites. Blood samples were collected from 250 cats treated at a private clinic in the mountainous region of Rio de Janeiro. The samples were each subjected to a blood count, microscopic examination, and molecular research on piroplasms. The animals' clinical histories and epidemiological information were analyzed to identify the risk factors associated with infection. Ticks were recovered during the clinical care and were identified and subjected to molecular analyses to determine the presence of piroplasm DNA. Piroplasms were detected in 2.7% (7/250) of the cats. Nucleotide sequences of Babesia vogeli were identified in six cats, while the Cytauxzoon sp. was identified in one cat. Cats displaying apathy/weakness/prostration and hemorrhage/bleeding were more likely to be infected. In addition, Amblyomma aureolatum was recovered from a cat PCR-negative for piroplasms. This is the first study in Rio de Janeiro that has detected Babesia vogeli in cats. The results obtained here underscore the need for further studies in Rio de Janeiro to investigate the dynamics of such infections and the vectors involved.

3D-printed microchip electrophoresis device containing spiral electrodes for integrated capacitively coupled contactless conductivity detection.

In this work, we demonstrate for the first time the design and fabrication of microchip electrophoresis devices containing cross-shaped channels and spiral electrodes around the separation channel for microchip electrophoresis and capacitively coupled contactless conductivity detection. The whole device was prepared in a digital light processing-based 3D printer in poly(ethylene glycol) diacrylate resin. Outstanding X-Y resolution of the customized 3D printer ensured the fabrication of 40-µm cross section channels. The spiral channels were filled with melted gallium to form conductive electrodes around the separation channel. We demonstrate the applicability of the device on the separation of sodium, potassium, and lithium cations by microchip electrophoresis. Graphical abstract.

Caracterização do modelo assistencial ao parto e nascimento realizado por residentes de enfermagem obstétrica / Characterization of the assistance model for parturition and birth performed by obstetric nursing residentes / Caracterización del modelo de atención al parto y al nacimiento realizado por residentes de enfermería obstétrica

Objetivo: caracterizar o modelo assistencial ao parto e nascimento realizado por residentes de um programa estadual de residência na região central do Brasil e verificar o impacto desse modelo assistencial na repercussão clínica materna e neonatal. Método: trata-se de um estudo transversal, retrospectivo, com abordagem quantitativa, composto por 356 mulheres e seus neonatos que tiveram seu parto assistido pelas residentes em enfermagem obstétrica (REO) em uma maternidade de risco habitual pública estadual, em Goiás, no período de 2017 a 2019. Para a análise estatística os dados quantitativos foram analisados através de distribuição de frequências, porcentagens, média e desvio padrão. Resultados: verificou-se a realização de boas práticas ao parto e nascimento: alimentação livre durante o TP (76,97%), escolha do acompanhante (58,43%), amniotomia (28,93%), baixa taxa de episiotomia (4,78%), contato pele a pele (91,29%), clampeamento oportuno do cordão umbilical (56,18%), amamentação na 1ª hora de vida (62,64).Considerações finais: a qualidade da assistência prestada por REO foi intimamente expressada pela proporção de parturientes que não foram submetidas a intervenções desnecessárias, bem como apontou desfechos neonatais satisfatórios somados às boas práticas proporcionadas. (AU)

Objective: Characterize the assistance model of childbirth and birth carried out by obstetric nursing residents on a state program in the central region of Brazil and verify the impact of this assistance model on maternal and neonatal clinical repercussion. Methods: This is a cross sectional, descriptive, and retrospective study, with a quantitative approach, composed of 356 women and their newborns who had their birth assisted by obstetric nursing residents in a usual risk state hospital, in Goiás, from 2017 to 2019. For statistical analysis, quantitative data were covered by the distribution of frequencies, percentages, means, and standard deviation. Results: Good practices were observed in parturition and birth: free feed during labor (76,97%), choice of companion (58,43%), amniotomy (28,93%), low episiotomy rate (4,78%), skin to skin contact (91,29%), timely clamping of the umbilical cord (56,18%), breastfeeding in the first hour of life (62,64). Conclusion: The quality of assistance provided by obstetric nursing residents was intimately expressed by the proportion of parturients who were not submitted to unnecessary interventions, as well as indicated satisfactory neonatal outcomes added to the good practices provided. (AU)

Objetivo: Caracterizar el modelo de parto y atención al nacimiento que realizan los residentes de un programa estatal de residencia en el centro de Brasil y verificar el impacto de este modelo asistencial en las repercusiones clínicas maternas y neonatales. Métodos: Se trata de un estudio transversal y retrospectivo con un enfoque cuantitativo, compuesto por 356 mujeres y sus recién nacidos que tuvieron su parto asistidos por residentes en enfermería obstétrica en una maternidad de riesgo habitual del Estado, en Goiás, en el período de 2017 a 2019. Para el análisis estadístico, los datos cuantitativos se analizaron utilizando la distribución de frecuencias, porcentajes, media y desviación estándar. Resultados: Se verificaron buenas prácticas se realizaron en el parto y el nacimiento: alimentación gratuita durante trabajo de parto (76,97%), elección de compañero (58,43%), amniotomía (28,93%), baja tasa de episiotomía (4,78%), contacto piel con piel (91,29%), sujeción oportuna del cordón umbilical (56,18%), lactancia materna en la primera hora de vida (62,64). Conclusión: La calidad de la atención prestada por residentes en enfermería obstétrica se expresó estrechamente por la proporción de parturientes que no fueron sometidos a intervenciones innecesarias, así como señaló resultados neonatales satisfactorios añadidos a las buenas prácticas proporcionadas. (AU)

Árvore da vida: projeto de impressão placentária em maternidades públicas estaduais do Centro-Oeste / Tree of life: placenta printing project in public maternities in the midwest state

Objetivo: relatar a experiência de residentes e enfermeiros obstétricos na implantação do projeto de impressão placentária em maternidades públicas do Estado de Goiás. Métodos: Trata-se de um relato de experiência acerca da realização de impressão placentária. A iniciativa ocorreu em Hospitais-Maternidades de Goiânia-GO. O projeto se iniciou em janeiro de 2019 e ficou vigente até março de 2020, devido à pandemia da Covid-19. O público-alvo consistiu em mulheres assistidas pela equipe de enfermagem obstétrica, sem exclusão de qualquer natureza. Resultados: As parturientes que receberam o carimbo da placenta expressaram face de surpresa e transmitiram sentimentos de gratidão, felicidade, empatia e sensibilidade. O momento do parto e nascimento é resgatado por meio de uma memória positiva, expressa, muitas vezes, pelo olhar direcionado ao recém-nascido. Ocorre o estreitamento do vínculo com a equipe de saúde, favorecendo uma comunicação facilitada, satisfação e confiança, além do estímulo profissional, aperfeiçoamento da técnica e promoção da humanização. Conclusão: O Carimbo da Placenta é um método de registro e de resgate do parto e nascimento que, somado às boas práticas, garantem não só a humanização na assistência, mas um vínculo afetivo e de segurança da paciente com a equipe de saúde. (AU)

Objective: To report the experience of residents and obstetric nurses in implementing the placenta printing project in public maternity hospitals in Goias State. Methods: This is an experience report about placenta printing. The initiative took place in Maternity Hospitals in Goiânia-GO. The project started in January 2019 and went on until March 2020, due to the Covid-19 pandemic. The target audience consisted of women assisted by the obstetric nursing team, without exclusion of any kind. Results: The parturients who received the placenta stamp were surprised and expressed feelings of gratitude, happiness, empathy and sensitivity. The childbirth moment is recovered through a positive memory, often expressed by looking at the newborn. Bonds are established with the health team, favoring open communication, satisfaction and trust, in addition to professional stimulation, technique improvement and promoting humanization. Conclusion: The Placenta Stamp is a method of registering and recovering labor and birth that, added to good practices, guarantee not only the humanization of assistance, but also the affective bond and safety feelings of the patient toward the health team. (AU)

Objetivo: Informar sobre la experiencia de residentes y enfermeras obstétricas en la implementación del proyecto de impresión placentaria en maternidades públicas en el Estado de Goiás. Métodos: Este es un informe de experiencia sobre la realización de la impresión de placenta. La iniciativa se pasó en los hospitales-maternidades de Goiânia-GO. El proyecto comenzó en enero de 2019 y siguió hasta marzo de 2020, debido a la pandemia de Covid-19. El público objetivo consistió en mujeres asistidas por el equipo de enfermería obstétrica, sin exclusión de ninguna naturaleza. Resultados: Las parturientas que recibieron el sello de placenta expresaron sorpresa y transmitieron sentimientos de gratitud, felicidad, empatía y sensibilidad. El momento del parto y el nacimiento se rescata a través de una memoria positiva, expresada, muchas veces, mirándose al recién nacido. Existe un estrechamiento del vínculo con el equipo de salud, lo que favorece a la comunicación, satisfacción y confianza, además de la estimulación profesional, la mejora de la técnica y la promoción de la humanización. Conclusión: El Sello de la Placenta es un método de registro y rescate del parto y del nacimiento que, sumado a las buenas prácticas, garantizan no solo la humanización de la asistencia, sino también el vínculo afectivo y de seguridad del paciente con el equipo de salud. (AU)

Ecological mechanisms explaining interactions within plant-hummingbird networks: morphological matching increases towards lower latitudes.

Interactions between species are influenced by different ecological mechanisms, such as morphological matching, phenological overlap and species abundances. How these mechanisms explain interaction frequencies across environmental gradients remains poorly understood. Consequently, we also know little about the mechanisms that drive the geographical patterns in network structure, such as complementary specialization and modularity. Here, we use data on morphologies, phenologies and abundances to explain interaction frequencies between hummingbirds and plants at a large geographical scale. For 24 quantitative networks sampled throughout the Americas, we found that the tendency of species to interact with morphologically matching partners contributed to specialized and modular network structures. Morphological matching best explained interaction frequencies in networks found closer to the equator and in areas with low-temperature seasonality. When comparing the three ecological mechanisms within networks, we found that both morphological matching and phenological overlap generally outperformed abundances in the explanation of interaction frequencies. Together, these findings provide insights into the ecological mechanisms that underlie geographical patterns in resource specialization. Notably, our results highlight morphological constraints on interactions as a potential explanation for increasing resource specialization towards lower latitudes.

The Brazilian TP53 mutation (R337H) and sarcomas.

Sarcomas represent less than 1% of all solid neoplasms in adults and over 20% in children. Their etiology is unclear, but genetic susceptibility plays an important role in this scenario. Sarcoma is central in Li-Fraumeni Syndrome (LFS), a familial predisposition cancer syndrome. In Brazil, the high prevalence of p.Arg337His mutations in the TP53 gene brings about a unique condition: a cluster of LFS. In the present work, we studied 502 sarcoma patients not selected by age or family history in an attempt to assess the impact of the so-called "Brazilian germline TP53 mutation" (p.Arg337His) on this tumor type. We found that 8% of patients are carriers, with leiomyosarcoma being the main histologic type of sarcoma, corresponding to 52.5% of the patients with the mutated TP53 gene. These findings emphasize the importance of genetic counseling and can better guide the management of sarcoma patients.

Juvenile Sjögren's Syndrome: Clinical Characteristics With Focus on Salivary Gland Ultrasonography.

OBJECTIVE: Juvenile Sjögren's syndrome (SS) is a rare, poorly defined, and possibly underdiagnosed condition affecting children and adolescents. The aim of this study was to characterize symptoms and clinical findings of juvenile SS and to explore the clinical application of major salivary gland ultrasonography (SGUS) in patients with juvenile SS. METHODS: A cross-sectional multicenter study recruited patients with disease onset until age 18 years (n = 67). Disease characteristics were recorded, and unstimulated whole sialometry and SGUS examination of the parotid and submandibular salivary glands were performed. RESULTS: The female:male ratio was 58:9. The mean age at first symptom was 10.2 years and 12.1 years at diagnosis. Ocular and oral symptoms were noted in 42 of 67 patients (63%) and 53 of 66 patients (80%), respectively. The American-European Consensus Group or American College of Rheumatology/European League Against Rheumatism classification criteria for primary SS were fulfilled by 42 of 67 patients (63%). Pathologic SGUS findings were observed in 41 of 67 patients (61%); 26 of 41 SGUS+ patients (63%) fulfilled primary SS criteria. Salivary gland enlargements/parotitis were noted in 37 of 58 patients and were nonsignificantly associated with SGUS+ status (P = 0.066). The mean levels of saliva were 5.6 ml/15 minutes in SGUS- patients compared to 3.3 ml/15 minutes in the SGUS+ patients (P = 0.049). A total of 36 of 41 SGUS+ patients (88%) were anti-Ro/La+ compared to 14 of 26 SGUS- patients (54%) (P = 0.001). In addition, 24 of 39 SGUS+ patients (62%) were positive for rheumatoid factor (RF), whereas only 5 of 25 SGUS- patients (20%) were RF+ (P = 0.001). CONCLUSION: Juvenile SS is characterized by a large spectrum of clinical symptoms and findings. Several glandular and extraglandular parameters such as hyposalivation, swollen salivary glands, and autoantibodies are associated with pathologic SGUS findings.

Sm16, A Schistosoma mansoni Immunomodulatory Protein, Fails to Elicit a Protective Immune Response and Does Not Have an Essential Role in Parasite Survival in the Definitive Host.

Sm16 is an immunomodulatory protein that seems to play a key role in the suppression of the cutaneous inflammatory response during Schistosoma mansoni penetration of the skin of definitive hosts. Therefore, Sm16 represents a potential target for protective immune responses induced by vaccination. In this work, we generated the recombinant protein rSm16 and produced polyclonal antibodies against this protein to evaluate its expression during different parasite life-cycle stages and its location on the surface of the parasite. In addition, we analyzed the immune responses elicited by immunization with rSm16 using two different vaccine formulations, as well as its ability to induce protection in Balb/c mice. In order to explore the biological function of Sm16 during the course of experimental infection, RNA interference was also employed. Our results demonstrated that Sm16 is expressed in cercaria and schistosomula and is located in the schistosomula surface. Despite humoral and cellular immune responses triggered by vaccination using rSm16 associated with either Freund's or alum adjuvants, immunized mice presented no reduction in either parasite burden or parasite egg laying. Knockdown of Sm16 gene expression in schistosomula resulted in decreased parasite size in vitro but had no effect on parasite survival or egg production in vivo. Thus, our findings demonstrate that although the vaccine formulations used in this study succeeded in activating immune responses, these failed to promote parasite elimination. Finally, we have shown that Sm16 is not vital for parasite survival in the definitive host and hence may not represent a suitable target for vaccine development.

Carcinoma ductal infiltrante na gestação, desafio diagnóstico e terapêutico: relato de caso / Infiltrating ductal carcinoma during pregnancy, diagnostic and therapeutic challenge: a case report

Introdução: O câncer de mama é a neoplasia mais frequentemente diagnosticada no mundo, sendo a segunda que mais afeta a mulher no ciclo gravídico-puerperal e a principal causa de morte por câncer em mulheres. O câncer de mama associado à gravidez refere-se àquele diagnosticado durante a gravidez ou no primeiro ano pós-parto. A incidência está aumentando à medida que as mulheres atrasam a primeira gestação. Descrição: O artigo traz o relato do caso de uma gestante com câncer de mama na cidade de Juiz de Fora, MG. Discussão: A gestação deve ser considerada como agravante do câncer de mama, sendo o tratamento semelhante ao da população geral. Prematuridade e baixo peso ao nascer são os eventos indesejáveis mais comuns. Conclusão: A abordagem multidisciplinar é fundamental para estabelecer um plano de tratamento individualizado e a paciente ser acolhida, orientada e participar de todo o processo de decisão terapêutica.(AU)

Introduction: Breast cancer is the most frequently diagnosed cancer in the world, being the second that most affects women in the pregnancy-puerperal cycle and the leading cause of cancer death in women. Pregnancy-associated breast cancer refers to cancer diagnosed during pregnancy or in the first year postpartum. The incidence is increasing as women delay first pregnancy. Description: The article reports the case of a pregnant woman with breast cancer in the city of Juiz de Fora, MG. Discussion: Pregnancy should be considered as aggravating breast cancer, being the treatment similar to the general population. Prematurity and low birth weight are the most common undesirable events. Conclusion: The multidisciplinary approach is fundamental to establish an individualized treatment plan and the patient to be welcomed, guided and to participate in the whole therapeutic decision process.(AU)

Differential Profile of BRCA1 vs. BRCA2 Mutated Families: A Characterization of the Main Differences and Similarities in Patients.

The identification of families at-risk for hereditary breast cancer (BC) is important because affected individuals present a much higher cancer risk than the general population. The aim of this study was to identify the most important factors associated with the presence of a pathogenic BRCA1/BRCA2 mutation. Family history (FH), histopathological and immunohistochemical characteristics were compared among BC women with pathogenic BRCA1/BRCA2 variants; VUSs in BRCA1/BRCA2; BRCA1/BRCA2 WT and sporadic BC. The most significative differences observed concerned the molecular subtype of the tumors, age at cancer diagnosis and FH of cancer. The presence of bilateral breast cancer (BBC), number of BC cases and the presence of ovarian cancer (OC) increased (respectively) 5.797, 5.033 and 4.412 times the risk of being a BRCA1/BRCA2 mutation carrier. Besides, women with BRCA1 or BRCA2 mutations presented different tumor and FH profiles. The main characteristics associated with a BRCA1 mutation were triple negativity (OR: 17.31), BBC history (OR: 4.96) and occurrence of OC (OR: 4.32). There were no major discerning components associated with BRCA2 mutations. Thus, we conclude that tumor pathology and FH of cancer might be considered together at the time of genetic testing mainly in countries where access to genetic testing is still restricted.