Study Design of a Brazilian Observational Study of Edoxaban in Patients with Atrial Fibrillation (EdoBRA). / Desenho de Estudo de um Estudo Observacional Brasileiro sobre o uso de Edoxabana em Pacientes com Fibrilação Atrial (EdoBRA).

BACKGROUND: Clinical trials showed the safety of Edoxaban, a non-vitamin K-dependent oral anticoagulant (NOAC), and its efficacy to prevent stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients and also to prevent and treat venous thromboembolism. However, additional research is needed to evaluate the safety and effectiveness of Edoxaban in a real-world scenario in the Brazilian population. OBJECTIVE: In order to understand the risks and benefits of Edoxaban use in routine clinical settings, the EdoBRA study is being conducted to gain insight into the safety and effectiveness of Edoxaban use in non-preselected patients with NVAF in Brazil. METHODS: The EdoBRA study is a multicenter, prospective, observational study conducted in 36 sites in Brazil. NVAF patients ≥ 18 years treated with commercially available Edoxaban who initiated treatment for at least 14 days and no longer than 90 days prior to enrollment, and who are not simultaneously participating in any interventional study are eligible for this study. Seven hundred patients are planned to be enrolled and one-year of follow up, with data collections expected at baseline and 3, 6, and 12 months after the study enrollment. The primary safety objective is ISTH Clinically Relevant Bleeding, and the secondary effectiveness objective focuses on relevant cardiovascular outcomes related to NVAF. CONCLUSION: EdoBRA observational study will generate relevant additional information about NOAC Edoxaban on various aspects of patient management in routine care, such as its safety and effectiveness profile in patients with NVAF in Brazil.

FUNDAMENTO: Os ensaios clínicos demonstraram a segurança da Edoxabana, um anticoagulante oral não dependente de vitamina K (NOAC), e a sua eficácia na prevenção de acidente vascular cerebral e embolia sistémica em pacientes com fibrilação atrial não valvar (FANV) e também na prevenção e tratamento de tromboembolismo venoso. No entanto, pesquisas adicionais são necessárias para avaliar a segurança e a eficácia da Edoxabana em um cenário real na população brasileira. OBJETIVO: A fim de compreender os riscos e benefícios do uso da Edoxabana em cenários clínicos de rotina, o estudo EdoBRA está sendo conduzido para obter informações sobre a segurança e eficácia do uso da Edoxabana em pacientes não pré-selecionados com FANV no Brasil. MÉTODOS: O estudo EdoBRA é um estudo multicêntrico, prospectivo e observacional, realizado em 36 centros no Brasil. São elegíveis para este estudo pacientes com FANV, ≥ 18 anos de idade, tratados com Edoxabana disponível comercialmente, que iniciaram o tratamento por pelo menos 14 dias e não mais do que 90 dias antes da data de inclusão no estudo, e que não estão participando de nenhum outro estudo de intervenção. Ao todo, 700 pacientes devem ser inscritos e acompanhados por um ano, com coletas de dados programadas para o período basal e 3, 6 e 12 meses após a inscrição no estudo. O objetivo primário de segurança é o sangramento clinicamente relevante (de acordo com critérios da Sociedade Internacional de Trombose e Hemostasia - ISTH), e o objetivo secundário de eficácia são desfechos cardiovasculares relevantes relacionados à FANV. CONCLUSÃO: O estudo observacional EdoBRA gerará informações adicionais relevantes sobre a Edoxabana enquanto NOAC em diversos aspectos do manejo de pacientes no atendimento clínico de rotina, como perfil de segurança e efetividade em pacientes com FANV no Brasil.

Desenho de Estudo de um Estudo Observacional Brasileiro sobre o uso de Edoxabana em Pacientes com Fibrilação Atrial (EdoBRA) / Study Design of a Brazilian Observational Study of Edoxaban in Patients with Atrial Fibrillation (EdoBRA)

Resumo Fundamento: Os ensaios clínicos demonstraram a segurança da Edoxabana, um anticoagulante oral não dependente de vitamina K (NOAC), e a sua eficácia na prevenção de acidente vascular cerebral e embolia sistémica em pacientes com fibrilação atrial não valvar (FANV) e também na prevenção e tratamento de tromboembolismo venoso. No entanto, pesquisas adicionais são necessárias para avaliar a segurança e a eficácia da Edoxabana em um cenário real na população brasileira. Objetivo: A fim de compreender os riscos e benefícios do uso da Edoxabana em cenários clínicos de rotina, o estudo EdoBRA está sendo conduzido para obter informações sobre a segurança e eficácia do uso da Edoxabana em pacientes não pré-selecionados com FANV no Brasil. Métodos: O estudo EdoBRA é um estudo multicêntrico, prospectivo e observacional, realizado em 36 centros no Brasil. São elegíveis para este estudo pacientes com FANV, ≥ 18 anos de idade, tratados com Edoxabana disponível comercialmente, que iniciaram o tratamento por pelo menos 14 dias e não mais do que 90 dias antes da data de inclusão no estudo, e que não estão participando de nenhum outro estudo de intervenção. Ao todo, 700 pacientes devem ser inscritos e acompanhados por um ano, com coletas de dados programadas para o período basal e 3, 6 e 12 meses após a inscrição no estudo. O objetivo primário de segurança é o sangramento clinicamente relevante (de acordo com critérios da Sociedade Internacional de Trombose e Hemostasia - ISTH), e o objetivo secundário de eficácia são desfechos cardiovasculares relevantes relacionados à FANV. Conclusão: O estudo observacional EdoBRA gerará informações adicionais relevantes sobre a Edoxabana enquanto NOAC em diversos aspectos do manejo de pacientes no atendimento clínico de rotina, como perfil de segurança e efetividade em pacientes com FANV no Brasil.

Abstract Background: Clinical trials showed the safety of Edoxaban, a non-vitamin K-dependent oral anticoagulant (NOAC), and its efficacy to prevent stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients and also to prevent and treat venous thromboembolism. However, additional research is needed to evaluate the safety and effectiveness of Edoxaban in a real-world scenario in the Brazilian population. Objective: In order to understand the risks and benefits of Edoxaban use in routine clinical settings, the EdoBRA study is being conducted to gain insight into the safety and effectiveness of Edoxaban use in non-preselected patients with NVAF in Brazil. Methods: The EdoBRA study is a multicenter, prospective, observational study conducted in 36 sites in Brazil. NVAF patients ≥ 18 years treated with commercially available Edoxaban who initiated treatment for at least 14 days and no longer than 90 days prior to enrollment, and who are not simultaneously participating in any interventional study are eligible for this study. Seven hundred patients are planned to be enrolled and one-year of follow up, with data collections expected at baseline and 3, 6, and 12 months after the study enrollment. The primary safety objective is ISTH Clinically Relevant Bleeding, and the secondary effectiveness objective focuses on relevant cardiovascular outcomes related to NVAF. Conclusion: EdoBRA observational study will generate relevant additional information about NOAC Edoxaban on various aspects of patient management in routine care, such as its safety and effectiveness profile in patients with NVAF in Brazil.

Fisheries monitoring in Brazil: How can the 2030 agenda be met without fisheries statistics? / Monitoramento da pesca no Brasil: como cumprir a agenda 2030 sem estatísticas da pesca?

Every activity that involves exploitation of natural resources, such as fishing, needs to be organized and conducted based on information from monitoring programs to allow continuous evaluation. With the increasing fishing pressure in Brazil, the understanding of the importance of fisheries monitoring programs and how they can inform and assist in conservation decision-making remains limited. Based on the literature on fisheries and participatory conservation, we call attention to the need to generate information on the national fisheries sector in order to improve fisheries in the country. Given the context of the need to generate information on fishing stocks under exploitation, as well as to identify potential alternative fisheries and carry out various sectoral analyses in compliance with the 2030 Agenda for Sustainable Development, we present and discuss in the present paper the lack of a system of continuous fishing monitoring in Brazil and its effects on the fisheries sustainability in the country.

Toda atividade que atua envolvendo a exploração de recursos naturais, como a pesca, precisa ser organizada e conduzida com base nas informações dos programas de monitoramento para permitir uma avaliação contínua. Com o aumento da pressão pesqueira no Brasil, o entendimento da importância dos programas de monitoramento da pesca e como eles podem informar e auxiliar na tomada de decisões de conservação permanece limitado. Com base na literatura sobre pesca e conservação participativa, chamamos a atenção para a necessidade de gerar informações sobre o setor pesqueiro nacional para melhorar a pesca no país. Dado o contexto da necessidade de gerar informações sobre os estoques pesqueiros em exploração, bem como identificar potenciais alternativas de pesca e realizar diversas análises setoriais em conformidade com a Agenda 2030 para o Desenvolvimento Sustentável, é apresentada e discutida no presente trabalho a falta de um sistema de monitoramento contínuo da pesca no Brasil e seus efeitos na sustentabilidade da pesca no país.

α-Tubulin detyrosination links the suppression of MCAK activity with taxol cytotoxicity.

α/ß-Tubulin posttranslational modifications (PTMs) generate microtubule diversity, but whether they account for cancer cell resistance to microtubule-targeting drugs remains unknown. Here, we performed a pilot dissection of the "cancer tubulin code" using the NCI-60 cancer cell panel. We found that acetylated, detyrosinated, and ∆2-α-tubulin that typically accumulate on stable microtubules were uncoupled in many cancer cells. Acetylated α-tubulin did not affect microtubule dynamics, whereas its levels correlated with, but were not required for, taxol-induced cytotoxicity. In contrast, experimental increase of α-tubulin detyrosination, and/or depletion of the detyrosination-sensitive microtubule-depolymerizing enzyme MCAK, enhanced taxol-induced cytotoxicity by promoting cell death in mitosis and the subsequent interphase, without causing a cumulative effect. Interestingly, only increased detyrosinated α-tubulin aggravated taxol-induced spindle multipolarity. Overall, we identified high α-tubulin acetylation as a potential biomarker for cancer cell response to taxol and uncovered a mechanistic link between α-tubulin detyrosination and the suppression of MCAK activity in taxol-induced cytotoxicity, likely by promoting chromosome missegregation, regardless of spindle defects.

Impact of different scan strategies and implant angulation on impression accuracy of full arch multiple implant: an in vitro study / Impacto de diferentes estratégias de escaneamento e angulação dos implantes na acurácia da moldagem de implantes múltiplos em arco completo: um estudo in vitro

Objective: to evaluate the impact of three different scan strategies and implant angulation on impression accuracy of an intraoral scanner for full-arch multiple implant scan. Material and Method: A maxillary edentulous model with six implant analogs served as a reference model. The four anterior analogs were positioned parallel to each other, the distal right and the distal left was placed with an angulation of 15o and 20o, respectively. Thirty impression were performed using an intraoral scanner (CEREC Primescan). The master cast was digitalized with an industrial reference scanner (ATOS Core 80). All scans were converted to standard tessellation language (STL), superimposed on the reference scan with a 3d inspection software (GOM Inspect Professional 2019) and then analyzed. Results: All linear distances presented equivalence [p<0.01] to those found on the reference scan for all scan strategies. All scan strategies presented a tendency of negative means for linear distances except for d4 in strategy C. All angular distances did not present equivalence [p=0.05] to those found on the reference scan. Significant 3D deviations [p<0.05] were found between strategy B (0.02 ± 0.01) and C (0.05 ± 0.04) for d1. In all others linear and angular distances no statistically significant difference was found between strategies A, B and C. Conclusions: There was no statistically significant difference between strategies A, B and C except for d1 in strategy B and C; Implant angulation did not affect the accuracy of the CEREC Primescan IOS (AU)

Objetivo: avaliar o impacto de três diferentes estratégias de escaneamento e angulação do implante na acurácia da moldagem de um scanner intraoral na moldagem de múltiplos implantes em arco completo. Material e Métodos: Um modelo edêntulo de maxila contendo seis análogos de implante serviu como modelo de referência. Os quatro análogos anteriores foram posicionados paralelos entre si, o distal direito e o distal esquerdo foram posicionados com angulação de 15o e 20o, respectivamente. Trinta moldagens foram realizadas usando um scanner intraoral (CEREC Primescan). O modelo mestre foi digitalizado com um scanner de referência industrial (ATOS Core 80). Todas as escaneamentos foram convertidas para a linguagem de mosaico padrão (STL), sobrepostas ao escaneamento de referência com um software de inspeção 3D (GOM Inspect Professional 2019) e, em seguida, analisadas. Resultados: Todas as distâncias lineares apresentaram equivalência [p <0,01] àquelas encontradas na escaneamento de referência para todas as estratégias. Todas as estratégias de escaneamento apresentaram tendência de médias negativas para distâncias lineares, exceto para d4 na estratégia C. Todas as distâncias angulares não apresentaram equivalência [p = 0,05] às encontradas no escaneamento de referência. Desvios 3D significativos [p <0,05] foram encontrados entre a estratégia B (0,02 ± 0,01) e C (0,05 ± 0,04) para d1. Em todas as outras distâncias lineares e angulares, nenhuma diferença estatisticamente significativa foi encontrada entre as estratégias A, B e C. Conclusões: Não houve diferença estatisticamente significante entre as estratégias A, B e C, exceto para d1 na estratégia B e C; A angulação do implante não afetou a precisão do CEREC Primescan. (AU)

O papel da(o) psicóloga(o) na saúde indígena / The role of the psychologist in indigenous health / El papel del psicólogo en la salud indígena

Este trabalho apresenta contribuições ao papel dos profissionais em Psicologia na Atenção Diferenciada à Saúde Indígena, destacando o entre-lugar teórico-prático ocupado junto aos povos Guarani, Kaiowá e Terena, e demonstrando a relação entre a Política Pública de Saúde, com suas exigências normativas e disciplinares, e a ordem cósmica, refletidas nos saberes em Saúde das diferentes figurações sociais e grupos-sujeitos com que trabalhamos. A partir dos diferentes ethos e estilos dos grupos indígenas e não indígenas e suas acepções de saúde, nos deparamos com a complexidade desse cenário-contexto, representada pela multiculturalidade/interculturalidade e pelas relações de poder e saber no cuidado em saúde. Assim, a Psicologia e demais profissões de saúde se veem desafiadas a produzirem uma Atenção à Saúde que cumpra sua função e tenha a eficácia simbólico-material necessária aos povos indígenas. Nesse sentido, a Cartografia como recurso metodológico nos permite acompanhar o processo, adentrar os textos e contextos de produção de Atenção à Saúde Indígena e compreender a emergência do pensamento limiar com a participação dos conhecimentos e saberes indígenas no cuidado em Saúde. A Psicologia Decolonial surge como alternativa, não como uma nova receita de atuação, mas provendo uma orientação teórico-prática que viabiliza a coexistência dos saberes indígenas e não indígenas no cuidado em Saúde. A supervisão das lideranças tradicionais e a entrada na cosmologia e nas epistemologias indígenas se tornam imprescindíveis para a atuação da Psicologia, possibilitando novos enlaces afetivo-intelectuais e políticos no cuidado em Saúde.(AU)

This work presents contributions to the role of professionals in Psychology in Differentiated Indigenous Healthcare, highlighting the theoretical-practical in-between occupied by indigenous people Guarani, Kaiowá, and Terena and demonstrating the relationship between the Public Health Politics, with its normative and disciplinary requirements, and the cosmic order, reflected in the knowledge of Health of the different social representations and subject-groups we work with. From the different ethos and styles of indigenous and non-indigenous groups and their meanings of health, we faced the complexity of this scenario-context, represented by multiculturalism/interculturalism and the relations of power and knowledge in healthcare. With this, the Psychology and other health professions are challenged to produce a Healthcare that fulfills its function and has the symbolic-material effectiveness necessary to the indigenous peoples. In this sense, the Cartography, as a methodological resource, allows us to follow the process, get into the texts and contexts of production in Indigenous Healthcare and understand the emergence of the threshold thought with the participation of indigenous knowledge and wisdom in the Healthcare. The Decolonial Psychology is an alternative, not as a new performance recipe, but as a theoretical-practical guideline that enables the coexistence of indigenous and non-indigenous knowledge in Healthcare. The supervision of traditional leaderships and the entry in the indigenous cosmology and epistemology became indispensable to the performance of Psychology, enabling new affective-intellectual and political links in Healthcare.(AU)

Este trabajo presenta contribuciones al papel de los profesionales en Psicología en la Atención Diferenciada a la Salud Indígena, destacando el entre-lugar teórico-práctico ocupado junto a los pueblos Guaraní, Kaiowá y Terena, y demostrando el tránsito entre la Política Pública de Salud, con sus requisitos normativas y disciplinarias, y el orden cósmico, reflejadas en los saberes en Salud de las diferentes figuraciones sociales y grupos-sujetos con los que trabajamos. Desde los diferentes ethos y estilos de los grupos indígenas y no indígenas y sus acepciones de Salud, nos encontramos con la complejidad de este escenario-contexto representada por la multiculturalidad / interculturalidad y por las relaciones de poder y conocer en el cuidado en Salud. Así, la Psicología y demás profesiones de salud se ven desafiadas a producir una Atención a la Salud que cumpla su función y tenga eficacia simbólico-material necesaria para los pueblos indígenas. En ese sentido, la Cartografía, como recurso metodológico, nos permite acompañar el proceso, adentrar a los textos y contextos de producción de Atención a la Salud Indígena y comprender la emergencia del pensamiento umbral con la participación de los conocimientos y saberes indígenas en el cuidado en Salud. La Psicología Decolonial surge como alternativa, no como una nueva receta de actuación, sino como orientadora teórico-práctica que viabiliza la coexistencia de los saberes indígenas y no indígenas en el cuidado en Salud.(AU)

Gender-related differences in the modulation of anthropometric, biochemical, and immune markers by physical activity in hypertensive and diabetic individuals.

Systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM) compose the two major noncommunicable chronic inflammatory diseases. Physical activity has been shown as a promising complementary approach to control the systemic inflammation. However, it is still unclear whether this modulation is gender-dependent. The objective of this study was evaluate the gender-related influence of physical activity on the inflammatory response and biochemical profile of individuals with SAH and T2DM. An international physical activity questionnaire was applied to 376 individuals diagnosed with SAH and T2DM in order to access their exercises routine and was evaluated the influence of physical activity in biochemical, anthropometrical, and immunological markers involved in these disorders in men and women. Even though active individuals have exhibited lower serum levels of IL-1ß, IFN-γ, TNF-α, and IL-17A, the ratios between IL-10 and all inflammatory cytokines were higher in men than in women. Physically active individuals also demonstrated increased HDL/LDL and HDL/VLDL ratios. Moreover, multiple correlations revealed that in active women both IL-10 and TNF-α serum levels positively correlate with fasting glucose levels, and were negatively associated with HDL levels. Our findings suggest that gender-related differences dictate a distinct crosstalk between inflammatory and biochemical markers in physically active individuals.

Regular physical activity reduces the proinflammatory response in older women with diabetes and hypertension in the postmenopausal phase.

Aging in women is characterized by extreme hormonal changes leading them to develop a chronic low-grade inflammation that is linked to the development of systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM). In this scenario, physical activity emerges as an interesting methodology, since it seems to be connected to a decrease in serum levels of some pro-inflammatory cytokines. Nevertheless, most studies evaluate these cytokines in an isolated manner not considering the influence of comorbidities on the responsiveness of participants to the benefits of physical activity. So, this study aimed to assess the influence of physical activity on body composition, anthropometric parameters, lipid profile, and inflammatory markers of diabetic and hypertensive older postmenopausal women. We evaluated 163 women aged from 60 to 80 years, diagnosed with T2DM and SAH that were assisted by the Family Health Units in Vitória da Conquista, Bahia, Brazil. The pratice of physical activity was measured by the International Physical Activity Questionnaire with the participants being classified as active or sedentary individuals. Active older women presented better body composition, lipid profile and inflammatory balance. This was connected to a better correlation profile between these factors in active older women, characteristics that were not noticed in sedentary older women. Moreover, IL-17A and the relationship between IL-10 and the other pro-inflammatory cytokines examined was greatly influenced by physical activity. Consequently, physical activity is linked to a global improvement in T2DM and SAH risk factors and with a positive inflammatory modulation in diabetic and hypertensive older women.

The Tubulin Code in Mitosis and Cancer.

The "tubulin code" combines different α/ß-tubulin isotypes with several post-translational modifications (PTMs) to generate microtubule diversity in cells. During cell division, specific microtubule populations in the mitotic spindle are differentially modified, but only recently, the functional significance of the tubulin code, with particular emphasis on the role specified by tubulin PTMs, started to be elucidated. This is the case of α-tubulin detyrosination, which was shown to guide chromosomes during congression to the metaphase plate and allow the discrimination of mitotic errors, whose correction is required to prevent chromosomal instability-a hallmark of human cancers implicated in tumor evolution and metastasis. Although alterations in the expression of certain tubulin isotypes and associated PTMs have been reported in human cancers, it remains unclear whether and how the tubulin code has any functional implications for cancer cell properties. Here, we review the role of the tubulin code in chromosome segregation during mitosis and how it impacts cancer cell properties. In this context, we discuss the existence of an emerging "cancer tubulin code" and the respective implications for diagnostic, prognostic and therapeutic purposes.

Effects of transcranial direct current stimulation on heart rate variability: a systematic review protocol.

OBJECTIVE: This systematic review aims to synthesize the available evidence on the effects of transcranial direct current stimulation on heart rate modulation, indexed by heart rate variability parameters in healthy individuals and those with clinical disorders. INTRODUCTION: There is some evidence that altered heart rate variability parameters are associated with different clinical disorders. For example, diminished parasympathetic activity has been explored as a potential biomarker for some chronic pain conditions. Considering the dynamic interaction between brain and heart, neuromodulatory strategies targeting this relationship could exert a positive influence on the cardiac autonomic system. Transcranial direct current stimulation is a non-invasive neuromodulation technique that has been presenting recent advances in the treatment of various clinical disorders. However, the evidence concerning transcranial direct current stimulation application focusing on brain-heart interaction is still controversial. INCLUSION CRITERIA: This review will consider studies that investigate the effects of transcranial direct current stimulation on heart rate variability in healthy participants or those with clinical disorders. METHODS: This review will follow JBI systematic review methodology recommendations. PubMed, Embase, CINAHL, Web of Science, PsycNET, Cochrane Controlled Register of Trials (CENTRAL) and Physiotherapy Evidence Database (PEDro) will be searched, along with several sources of gray literature. Retrieval of full-text studies, and assessment of methodological quality and data extraction, will be performed independently by two reviewers. Data will be pooled in statistical meta-analysis, where possible. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018114105.

Cost-effectiveness of edoxaban vs low-molecular-weight heparin and warfarin for cancer-associated thrombosis in Brazil.

BACKGROUND: Venous thromboembolism (VTE) is the second leading cause of death in cancer patients. In Brazil, even though low-molecular-weight heparin (LMWH) is the gold standard of care for the management of cancer-associated thrombosis (CAT), its cost limits its use and therefore warfarin is commonly prescribed. Direct oral anticoagulants (DOACs), such as edoxaban, have been introduced as an alternative in this setting. OBJECTIVE: The aim of this study was to compare the cost-effectiveness of edoxaban with LMWH (Model 1) and warfarin (Model 2) to support clinicians and hospitals when choosing an anticoagulant to manage CAT. MATERIALS AND METHODS: Cost-effectiveness analyses were performed using Markov state-transition models over a timeframe of 5 years, in a hypothetical, 64 years-old patients cancer population with an index VTE event. Transition probabilities, costs, quality-adjusted life years (QALYs) and risk reductions were either derived from the literature, estimated or calculated. A willingness-to-pay limit of 3 Gross Domestic Product (GDP) per head was used. Deterministic and probabilistic sensitivity analyses were performed for robustness. The main outcome of this study was the incremental cost-effectiveness ratio (ICER), expressed as cost per QALY gained. RESULTS: Model 1 base case analysis demonstrated dominance of edoxaban compared to LMWH, with an ICER of $5204.46, representing cost saved per QALY lost. In Model 2, edoxaban was associated with a $736.90 cost increase vs. warfarin, with an ICER of $2541.03. Sensitivity analyses confirmed base-case results. CONCLUSION: Edoxaban represents a cost-saving alternative to LMWH for the management of CAT and is cost-effective vs. warfarin.

Association between body composition and inflammation: A central role of IL-17 and IL-10 in diabetic and hypertensive elderly women.

In women, aging is evidenced by physiological hormonal alterations that trigger changes in body composition, emergence of chronic low-grade inflammation, which is an important pre-disposition to the development of chronic diseases such as Systemic Arterial Hypertension (SAH) and Type 2 Diabetes Mellitus (T2DM). Although it is a strong pro-inflammatory nature disorder, little is known about how body composition interferes with inflammatory markers in diabetic and hypertensive elderly women. Therefore, this study's objective was to evaluate the inflammation in diabetic and hypertensive elderly women, and their association with fat mass. It comprised the evaluation of 144 women aged between 60 and 80 years old, diagnosed with SAH and T2DM, assisted by Family Health Units in Vitória da Conquista, Bahia, Brazil. According to body mass index (BMI), these women were classified as either eutrophic or overweight. In the eutrophic females, the IL-10 / IL-17A ratio was increased when compared to those overweight. In addition, IL-17 correlated negatively with HDL and positively with total cholesterol, LDL, triglycerides, VLDL, and glucose in the eutrophic ones, but not in the overweight individuals. IL-10 also showed differences in the correlation pattern observed between the groups, since for this eutrophic cytokine, it presented positive correlation with the waist circumference, waist/height ratio, and negative association with IL-17, while in overweight elderly women, it was not observed such pattern. Hence, this work demonstrates how the amount of fat mass interferes with the balance of cytokines, especially IL-10 and IL-17, and how it may exert an effect on biochemical parameters and risk factors associated with T2DM and SAH.

Efficacy and safety of loxoprofen sodium topical patch for the treatment of pain in patients with minor acute traumatic limb injuries in Brazil: a randomized, double-blind, noninferiority trial.

Posttraumatic injury pain is commonly treated with oral nonsteroidal anti-inflammatory drugs. However, oral nonsteroidal anti-inflammatory drugs cause several adverse events, with topical formulations arising as an important alternative. Therefore, we aimed at evaluating the efficacy and safety of loxoprofen patch (LX-P) in the treatment of patients with posttraumatic pain. This phase III, randomized, double-blind, noninferiority study enrolled Brazilian patients aged 18 to 65 years diagnosed with lower and upper limb posttraumatic injury who were experiencing moderate or severe pain. Patients were assigned to active LX-P or to loxoprofen tablet (LX-T), and pain intensity was measured based on a visual analog scale score variation after 7 days of treatment. Data on clinical symptoms, rescue medication use, and adverse events were also collected. Visual analog scale score variation was compared using a 10% noninferiority margin. Two hundred forty-two patients were randomly assigned to LX-P (n = 123) or to LX-T (n = 119). The results showed a reduction in pain after 7 days of treatment: -49.96 (n = 118; SE 1.7) in the LX-P and -47.71 (n = 117; SE 1.6) in the LX-T groups (difference of -2.25; 95% CI: -5.97 to 1.47; P = 0.23). On the safety analysis, the LX-T group presented twice as many patients with treatment-emergent adverse events as the LX-P group (30.8% and 14.2%, respectively). A sensitivity analysis demonstrated that rescue medication use has not affected the primary end point. This study showed that LX-P has a comparable efficacy to LX-T, but with a better safety profile, being a therapeutic option for the treatment of posttraumatic injury pain.

Brain acetylcholinesterase of three perciformes: From the characterization to the in vitro effect of metal ions and pesticides.

Estuarine environments gather pollution from large regions including urban and industrial zones. The monitoring of environmental quality in these areas constitutes a real requirement for global sustainable development. Therefore, the aim of this study was to characterize the physicochemical and kinetic parameters of brain acetylcholinesterase (AChE) in the species Centropomus undecimalis, Diapterus auratus and Diapterus rhombeus and to assess the effects (in vitro) of pesticides and metal ions on their respective activities in order to investigate them as potential biomarkers. Physicochemical properties such as thermostability, optimal pH and temperature, as well as kinetic parameters were investigated. AChE was pointed as the predominant cholinesterase (ChE) in the brains of the species under study. The highest optimum pH value was observed for C. undecimalis (8.0), and the lowest for D. rhombeus and D. auratus, with 7.2 and 7.0, respectively. The optimal temperature was 35 °C for the three species. The AChEs of the three species presented moderate thermostability, since they retained 61%, 72% and 67% of the activity up to 45 °C (C. undecimalis, D. auratus and D. rhombeus, respectively). The carbamate carbofuran showed to be the strongest inhibitor even at very low concentrations (IC50: 0.182, 0.174 and 0.203 µmol/L - C. undecimalis, D. auratus and D. rhombeus, respectively), followed by dichlorvos and carbaryl. According to the findings, the AChE of these species may be proposed as in vitro biomarker of exposure to carbofuran and dichlorvos (all three species) and carbaryl (D. auratus and D. Rhombeus), as well as for exceeding limit concentrations of Hg2+ (D. rhombeus) and As3+ (D. auratus) in biomonitoring programs located or not at estuarine environments.

Transtornos mentais comuns entre trabalhadores de enfermagem de um hospital psiquiátrico / Trastornos mentales comunes entre trabajadores de enfermería de un hospital psiquiátrico / Common mental disorders among nursing workers in a psychiatric hospital

Resumo Objetivo: Verificar as associações entre as variáveis sociodemográficas, laborais e condições de saúde e hábitos de vida e os transtornos mentais comuns entre os trabalhadores de enfermagem de um hospital psiquiátrico. Métodos: Estudo transversal, quantitativo, realizado em um hospital psiquiátrico. Participaram 74 trabalhadores de enfermagem. A coleta dos dados ocorreu por meio de questionário para caracterização sociodemográfica, laboral e de condições de saúde e hábitos de vida, da subescala Número de Doenças Diagnosticadas pelo Médico, extraída do Índice de Capacidade para o Trabalho, do Questionário de Insônia de Ohayon e do Self Reporting Questionnaire - 20. A análise estatística foi realizada utilizando os testes qui-quadrado, exato de Fisher, t de Student e U de Mann Whitney. Resultados: A prevalência de transtornos mentais comuns foi de 25,7%. As variáveis associadas aos transtornos mentais comuns foram: categoria profissional (p=0,015), tempo para lazer (p<0,001), problemas de saúde (p=0,003) e satisfação com o sono (p=0,003). Conclusão: Os achados das associações permitem inferir que existe uma relação entre os hábitos de vida do trabalhador, sua atividade laborativa e o desfecho evidenciado pelo maior percentual de transtornos mentais comuns. Este estudo contribui com subsídios para propostas de intervenções e ações preventivas para o adoecimento.

Resumen Objetivo: Verificar las asociaciones entre las variables sociodemográficas, laborales y condiciones de salud y hábitos de vida y los trastornos mentales comunes entre los trabajadores de enfermería de un hospital psiquiátrico. Métodos: Estudio transversal, cuantitativo, realizado en un hospital psiquiátrico. Han participado 74 trabajadores de enfermería. La recolección de los datos ocurrió a través de cuestionario para la caracterización sociodemográfica, laboral y de condiciones de salud y hábitos de vida, de la subescala Número de Enfermedades Diagnosticadas por el Médico, extraída del Índice de Capacidad para el Trabajo, del Cuestionario de Insomnio de Ohayon y del Self Reporting Questionnaire - 20. El análisis estadístico ha sido realizado utilizando las pruebas Chi-cuadrado, exacto de Fisher, t de Student y U de Mann Whitney. Resultados: La prevalencia de trastornos mentales comunes ha sido de un 25,7%. Las variables asociadas con los trastornos mentales comunes han sido: categoría profesional (p=0,015), tiempo para el ocio (p<0,001), problemas de salud (p=0,003) y satisfacción con el sueño (p=0,003). Conclusión: Los hallazgos de las asociaciones permiten inferir que existe una relación entre los hábitos de vida del trabajador, su actividad laboral y el desfecho evidenciado por el mayor perceptual de trastornos mentales comunes. Este estudio contribuye con subsidios para propuestas de intervenciones y acciones preventivas para la enfermedad.

Abstract Objective: To check the associations between sociodemographic and occupational variables, health conditions, and life habits and common mental disorders among nursing workers of a psychiatric hospital. Methods: This is a cross-sectional, quantitative study performed in a psychiatric hospital. Seventy-four nursing workers participated. Data were collected through a questionnaire for sociodemographic, occupational, and health and life habits characterization of the subscale Number of current diseases diagnosed by a physician, extracted from the Work Ability Index, the Ohayon Insomnia Questionnaire, and the Self-Reporting Questionnaire - 20. Statistical analysis was performed using chi-square, Fisher's exact, Student's t, and Mann-Whitney U tests. Results: The prevalence of common mental disorders was 25.7%. The variables associated with common mental disorders were: professional category (p = 0.015), leisure time (p <0.001), health problems (p = 0.003), and sleep satisfaction (p = 0.003). Conclusion: The findings of these associations allow us to infer that there is a relationship between workers' life habits, their work activity, and the outcome evidenced by the higher percentage of common mental disorders. This study contributes with subsidies for proposing interventions and actions to prevent workers from becoming ill.

Dissecting the role of the tubulin code in mitosis.

Mitosis is an essential process that takes place in all eukaryotes and involves the equal division of genetic material from a parental cell into two identical daughter cells. During mitosis, chromosome movement and segregation are orchestrated by a specialized structure known as the mitotic spindle, composed of a bipolar array of microtubules. The fundamental structure of microtubules comprises of α/ß-tubulin heterodimers that associate head-to-tail and laterally to form hollow filaments. In vivo, microtubules are modified by abundant and evolutionarily conserved tubulin posttranslational modifications (PTMs), giving these filaments the potential for a wide chemical diversity. In recent years, the concept of a "tubulin code" has emerged as an extralayer of regulation governing microtubule function. A range of tubulin isoforms, each with a diverse set of PTMs, provides a readable code for microtubule motors and other microtubule-associated proteins. This chapter focuses on the complexity of tubulin PTMs with an emphasis on detyrosination and summarizes the methods currently used in our laboratory to experimentally manipulate these modifications and study their impact in mitosis.

Combined effect of bacteriocin produced by Lactobacillus plantarum ST8SH and vancomycin, propolis or EDTA for controlling biofilm development by Listeria monocytogenes / Efecto combinado de la bacteriocina producida por Lactobacillus plantarum ST8SH y la vancomicina, el própolis o el EDTA para controlar el desarrollo del biofilm producido por Listeria monocytogenes

The Listeria monocytogenes strains selected in the present study exhibited similar behavior in biofilm formation, independently of the tested conditions (bacteriocin from L. plantarum ST8SH, vancomycin, propolis (a natural antimicrobial product) and EDTA (chelating agent)), individual or in associations. The individual application of vancomycin had better inhibitory activity than that of propolis and EDTA; however, the association of the previously mentioned antimicrobial agents with bacteriocins resulted in better performance. However, when we compared the effects of vancomycin, propolis and EDTA, we could clearly observe that the combined application of bacteriocin and vancomycin was more effective than the combination of bacteriocin and propolis, and bacteriocin and EDTA. Considering the current need to reduce the use of antimicrobials and chemical substances in food processing, propolis can represent an alternative to improve the inhibitory effect of bacteriocins against L. monocytogenes biofilm formation, based on the obtained results. In general, high concentrations of bacteriocin produced by L. plantarum ST8SH were more effective in biofilm inhibition, and similar results were observed for vancomycin and propolis; however, all tested EDTA concentrations had similar effect on biofilm formation.

Las cepas de Listeria monocytogenes seleccionadas en el presente estudio presentaron comportamientos similares en la formación de biofilms, independientemente de los tratamientos a las que fueron sometidas (bacteriocina de Lactobacillus plantarum ST8SH, vancomicina, própolis (produto natural antimicrobiano) y EDTA (agentes quelante)), individual o en combinaciones. La aplicación individual de vancomicina presentó una mejor actividad inhibitoria frente a las aplicaciones individuales de própolis y de EDTA; sin embargo, la combinación de estos agentes antimicrobianos con las bacteriocinas resultó en un mejor desempeño. Se observó claramente que la aplicación combinada de bacteriocina y vancomicina fue más efectiva para controlar el desarrollo de biofilm en comparación con la combinación de la bacteriocina y el própolis o de la combinación de la bacteriocina y el EDTA. Considerando la necesidad actual de reducir el uso de sustancias antimicrobianas y químicas en el procesamiento de alimentos y sobre la base de los resultados obtenidos, se puede afirmar que el própolis representa una alternativa para mejorar el efecto inhibitorio de bacteriocinas contra la formación de biofilm de L. monocytogenes. En general, altas concentraciones de la bacteriocina producida por L. plantarum ST8SH fueron más eficaces en la inhibición del biofilm, y se observaron resultados similares para la vancomicina y el própolis; sin embargo, todas las concentraciones de EDTA evaluadas tuvieron un efecto similar en la formación de biofilm.

Combined effect of bacteriocin produced by Lactobacillus plantarum ST8SH and vancomycin, propolis or EDTA for controlling biofilm development by Listeria monocytogenes.

The Listeria monocytogenes strains selected in the present study exhibited similar behavior in biofilm formation, independently of the tested conditions (bacteriocin from L. plantarum ST8SH, vancomycin, propolis (a natural antimicrobial product) and EDTA (chelating agent)), individual or in associations. The individual application of vancomycin had better inhibitory activity than that of propolis and EDTA; however, the association of the previously mentioned antimicrobial agents with bacteriocins resulted in better performance. However, when we compared the effects of vancomycin, propolis and EDTA, we could clearly observe that the combined application of bacteriocin and vancomycin was more effective than the combination of bacteriocin and propolis, and bacteriocin and EDTA. Considering the current need to reduce the use of antimicrobials and chemical substances in food processing, propolis can represent an alternative to improve the inhibitory effect of bacteriocins against L. monocytogenes biofilm formation, based on the obtained results. In general, high concentrations of bacteriocin produced by L. plantarum ST8SH were more effective in biofilm inhibition, and similar results were observed for vancomycin and propolis; however, all tested EDTA concentrations had similar effect on biofilm formation.

Risco de adoecimento e custo humano no trabalho em um hospital psiquiátrico / Risk of illness and human cost at work in a psychiatric hospital

Objective: To investigate the risk of illness and to the human cost at work from the point of view of the nursing team of a psychiatric hospital. Method: A cross-sectional study performed in a psychiatric hospital with 74 nursing workers. The Human Cost of Labor Scale was applied. Results: In the evaluation of the human cost at work, the cognitive cost factor was evaluated as a critical risk for the sickness of the nursing worker, while the factors affective cost and physical cost demonstrated a satisfactory evaluation. The items considered critical for illness referred to: having control of emotions, dealing with the aggressiveness of others, use of vision and memory, and repeated and repeated use of the legs and hands. Conclusion: The evaluated items reveal conditions critical to the health of the nursing worker in mental health, revealing risk of illness.

Objetivo: Investigar los riesgo de enfermedad y el costo humano en el trabajo desde el punto de vista del equipo de enfermería de un hospital psiquiátrico. Método: Estúdio transversal, realizado en un hospital psiquiátrico, con 74 trabajadores de enfermería. Se aplicó la Escala de Costo Humano en el Trabajo. Resultados: En la evaluación del costo humano en el trabajo, el factor costo cognitivo fue evaluado como riesgo crítico para la enfermedad del trabajador de enfermería, mientras que los factores costo afectivo y costo físico demostraron una evaluación satisfactoria. Los elementos considerados críticos para la enfermedad se refirieron a: tener control de las emociones, tratar con la agresividad de los demás, el uso de la visión y la memoria y el uso continuo y repetido de las piernas y las manos. Conclusión: Los ítems evaluados revelan condiciones críticas para la salud del trabajador de enfermería en salud mental, revelando riesgo de enfermedad.

Objetivo: Investigar o risco de adoecimento e o custo humano no trabalho sob o ponto de vista da equipe de enfermagem de um hospital psiquiátrico. Método: Estudo transversal, realizado em um hospital psiquiátrico, com 74 trabalhadores de enfermagem. Foi aplicada a Escala de Custo Humano no Trabalho. Resultados: Na avaliação do custo humano no trabalho, o fator custo cognitivo foi avaliado como risco crítico para adoecimento do trabalhador de enfermagem, enquanto os fatores custo afetivo e custo físico demonstraram avaliação satisfatória. Os itens considerados críticos para adoecimento referiram-se a: ter controle das emoções, lidar com a agressividade dos outros, uso da visão e memória, uso contínuo e repetido das pernas e mãos. Conclusão: Os itens avaliados indicaram condições críticas para a saúde mental do trabalhador de enfermagem, revelando risco de adoecimento.

Intervenção prevencionista para acidentes de trabalho com agentes biológicos em enfermagem / Preventive intervention for occupational accidents with biological agents in nursing

O estudo teve como objeto os acidentes de trabalho com agentes biológicos entre profissionais de enfermagem em um hospital geral público. Objetivos: descrever o conhecimento, atitude e prática dos profissionais de enfermagem sobre os riscos ocupacionais biológicos; discutir com os trabalhadores de enfermagem uma proposta de práticas prevencionistas para acidentes de trabalho com agentes biológicos; implementar práticas prevencionistas para acidentes com agentes biológicos na perspectiva de uma cultura de prevenção de acidentes no trabalho. O percurso metodológico fez uso da pesquisa descritiva, exploratória e de intervenção, de natureza quantitativa e qualitativa, com abordagem do conhecimento, atitude e práticas em saúde e do método da pesquisa convergente assistencial. O espaço físico foi um hospital geral público, localizado em uma cidade do interior do estado de Minas Gerais. Os participantes foram 36 trabalhadores de enfermagem que notificaram acidentes de trabalho com agentes biológicos no período entre 2013 e 2015. Os instrumentos para coleta de dados utilizados foram: questionário sociodemográfico e laboral dos participantes, descrição dos acidentes de trabalho e dos riscos ocupacionais biológicos; questionário de conhecimento, atitude e práticas em saúde diante dos riscos ocupacionais biológicos; roteiro para discussões individuais e em grupo; e, observação participante. Os dados quantitativos foram tratados através de análise estatística descritiva com utilização do programa SPSS, enquanto os dados qualitativos foram submetidos a análise temática. Posteriormente, as propostas de intervenção preventivas sugeridas pelos participantes foram aplicadas nos ambientes de trabalho. O projeto foi aprovado em Comitê de Ética em Pesquisa e seguiu as exigências da Resolução 466/2012. Os resultados evidenciaram que os acidentes de trabalho com agentes biológicos caracterizam-se, predominantemente, por lesões percutâneas causadas por instrumentos perfurocortantes que atingiram os dedos das mãos de técnicos de enfermagem do sexo feminino. O modelo de análise identificou divergências entre o conhecimento, atitude e práticas em saúde, tais como, deficiência no conhecimento acerca de normas de prevenção, atitudes inadequadas sobre higienização das mãos e comportamentos inseguros, como baixa adesão a práticas de precaução padrão, ao uso de EPI e a aplicação da NR 32. Da análise de conteúdo emergiram as seguintes categorias temáticas que posteriormente balizaram as intervenções: situações e causas dos acidentes de trabalho com agentes biológicos; fatores intervenientes na prevenção de acidentes de trabalho com agentes biológicos; EPI como forma de proteção dos trabalhadores de enfermagem; e, responsabilidades das instituições hospitalares para promoção da saúde e segurança dos trabalhadores de enfermagem. Posteriormente, as ações preventivas para acidentes de trabalho com agentes biológicos incluíram a realização de diálogos de segurança, sinalização para precaução padrão, folder, pôster, criação do jornal "Cultura de Segurança", campanha prevencionista pela Intranet, vigilância do trabalho seguro e participação em seminário.(AU)