Which Components of The International Classification of Functioning, Disability and Health (ICF) are Covered by Cardiac Rehabilitation Assessment Tools among Individuals with Heart Failure?

BACKGROUND: The therapeutic assessment of functioning in cardiac rehabilitation from the perspective of the International Classification of Functioning, Disability and Health (ICF) can provide a biopsychosocial approach to health care. However, it is unclear which components are reflected in the instruments used for cardiac rehabilitation in individuals with heart failure (HF). OBJECTIVES: To investigate which ICF components (body function, structures, activities, participation, environmental factors, and personal factors) are represented in the assessment instruments used in individuals with HF and to identify the most appropriate instrument to use based on the inclusion of these factors. METHODS: Forty-four clinical trials included in an updated Cochrane systematic review that investigated the effects of exercise-based cardiac rehabilitation in patients with HF were reviewed. The instruments were analyzed to extract significant concepts linked to the ICF codes. RESULTS: A total of 12 outcomes and 40 instruments were identified. The concepts were linked to 2466 codes in the following ICF components: body functions (41.8%), activities (29.7%), participation (8.4%), environmental factors (3.8%), personal factors (1.3%), and body structures (1.0%); other concepts (13.9%) were classified as not covered by ICF. None of the instruments presented concepts linked to all ICF components. The Minnesota Living with Heart Failure Questionnaire (MLHFQ), however, demonstrated comprehensive coverage of the ICF components, with the exception of body structure. CONCLUSIONS: Body function was the most frequently detected ICF component. Individual instruments did not provide a comprehensive perspective on the functioning level of individuals with HF. The MLHFQ provided the greatest coverage of ICF components.

Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study.

Melatonin (MLT), the main product of the pineal gland, is involved in muscle tissue repair and regeneration, besides several other important physiologic functions. In COPD, MLT administration can improve lung oxidative stress and sleep quality, but its potential effects on the outcomes of pulmonary rehabilitation (PR) have not been previously investigated. A randomized controlled trial was undertaken to test the hypothesis that a combined approach of rehabilitative exercise training and MLT supplementation could maximize functional performance, health status and quality of life in patients with COPD. Thirty-nine individuals with COPD referred to a supervised PR program at the Federal University of Ceara, Brazil, were randomized to receive MLT (3 mg/day; n = 18) or placebo (n = 21). Exercise capacity (6-min walk test - 6MWT), health status (COPD assessment test), and quality of life (airways questionnaire 20) were investigated as primary outcomes. No differences were observed at baseline in demographic, anthropometric and clinical characteristics between MLT and placebo groups. At the end of PR, superiority of the MLT group was demonstrated in improvement in the distance covered in the 6MWT (71 ± 26 vs. 25 ± 36 m; p < 0.01), health status (-11 ± 6 vs. -3 ± 5; p < 0.01), and quality of life (-6.9 ± 3.0 vs. -1.9 ± 2.4; p < 0.01), compared to the placebo group. In conclusion, MLT supplementation during the course of 12 weeks of PR can improve functional capacity, health status and quality of life in patients with COPD. These findings may have significant implications for the management of this condition.

Cultural Adaptation and Validation of the Barriers to HIV Testing Scale-Karolinska Version for Brazilian Men Who Have Sex With Men.

ABSTRACT: The aim of this study was to perform the cultural adaptation and validation of the Barriers to HIV testing scale-Karolinska version for Brazilian men who have sex with men. A methodological study was conducted for cultural adaptation and validation of the scale. Reliability analyses, exploratory factor analysis, confirmatory factor analysis, and convergent and discriminant validity tests were performed. Four factors were extracted: F1, personal consequences; F2, structural barriers; F3, confidentiality; F4, economic consequences and individual concerns. Good fit indexes were obtained: (χ 2 )/GL (2.71); goodness of fit index (0.94); root-mean-square error of approximation (0.052; 90% CI [0.045-0.059]); Tucker-Lewis index (0.94); normed fit index (0.93); IFI (0.95); comparative fit index (0.95). Convergent validity results were greater than 0.7 for the four factors. The adapted version of the scale showed satisfactory reliability and validity for assessing barriers to HIV testing among men who have sex with men.

Validity, Reproducibility, and Minimal Detectable Difference of the Functional Upper Extremity Function Test - Simplified Version - for Adults With Moderate to Severe Asthma and COPD.

BACKGROUND: Upper-limbs (ULs) functional tests which are valid and reliable for individuals with chronic respiratory disease (CRD) are scarce. The aim of this study was to investigate the intra-rater reproducibility, validity, minimal detectable difference (MDD), and learning effect of the Upper Extremity Function Test - simplified version (UEFT_S) functional test and to characterize its performance for adults with moderate-severe asthma and COPD. METHODS: The UEFT_S was performed twice, and the number of elbow flexions in 20 s was the outcome. In addition, spirometry, 6-min walk test (6MWT), handgrip dynamometry (HGD), and usual and maximum timed-up-and-go tests (TUG_usual and TUG_max) were also performed. RESULTS: Eighty-four individuals with moderate-severe CRD and 84 control individuals matched by anthropometric data were analyzed. Individuals with CRD presented better performance in the UEFT_S than controls (P = .023). UEFT_S correlated significantly with HGD, TUG_usual, TUG_max, and 6MWT (P < .047 for all). The test-retest intraclass correlation coefficient was 0.91 [0.86-0.94], and the MDD was 0.4%. CONCLUSIONS: The UEFT_S is a valid and reproducible tool to assess the functionality of the ULs in people with moderate-severe asthma and COPD. When applied in the modified form, the test can be considered simple, fast, and inexpensive, with an easy outcome to interpret.

Novel CaLB-like Lipase Found Using ProspectBIO, a Software for Genome-Based Bioprospection.

Enzymes have been highly demanded in diverse applications such as in the food, pharmaceutical, and industrial fuel sectors. Thus, in silico bioprospecting emerges as an efficient strategy for discovering new enzyme candidates. A new program called ProspectBIO was developed for this purpose as it can find non-annotated sequences by searching for homologs of a model enzyme directly in genomes. Here we describe the ProspectBIO software methodology and the experimental validation by prospecting for novel lipases by sequence homology to Candida antarctica lipase B (CaLB) and conserved motifs. As expected, we observed that the new bioprospecting software could find more sequences (1672) than a conventional similarity-based search in a protein database (733). Additionally, the absence of patent protection was introduced as a criterion resulting in the final selection of a putative lipase-encoding gene from Ustilago hordei (UhL). Expression of UhL in Pichia pastoris resulted in the production of an enzyme with activity towards a tributyrin substrate. The recombinant enzyme activity levels were 4-fold improved when lowering the temperature and increasing methanol concentrations during the induction phase in shake-flask cultures. Protein sequence alignment and structural modeling showed that the recombinant enzyme has high similarity and capability of adjustment to the structure of CaLB. However, amino acid substitutions identified in the active pocket entrance may be responsible for the differences in the substrate specificities of the two enzymes. Thus, the ProspectBIO software allowed the finding of a new promising lipase for biotechnological application without the need for laborious and expensive conventional bioprospecting experimental steps.

Enzymes and pathways in microbial production of 2,3-butanediol and 3-acetoin isomers.

2,3-Butanediol (BD) and acetoin (AC) are products of the non-oxidative metabolism of microorganisms, presenting industrial importance due to their wide range of applications and high market value. Their optical isomers have particular applications, justifying the efforts on the selective bioproduction. Each microorganism produces different isomer mixtures, as a consequence of having different butanediol dehydrogenase (BDH) enzymes. However, the whole scene of the isomer bioproduction, considering the several enzymes and conditions, has not been completely elucidated. Here we show the BDH classification as R, S or meso by bioinformatics analysis uncovering the details of the isomers production. The BDH was compared to diacetyl reductases (DAR) and the new enoyl reductases (ER). We observed that R-BDH is the most singular BDH, while meso and S-BDHs are similar and may be better distinguished through their stereo-selective triad. DAR and ER showed distinct stereo-triads from those described for BDHs, agreeing with kinetic data from the literature and our phylogenetic analysis. The ER family probably has meso-BDH like activity as already demonstrated for a single sequence from this group. These results are of great relevance, as they organize BD producing enzymes, to our known, never shown before in the literature. This review also brings attention to nontraditional enzymes/pathways that can be involved with BD/AC synthesis, as well as oxygen conditions that may lead to the differential production of their isomers. Together, this information can provide helpful orientation for future studies in the field of BD/AC biological production, thus contributing to achieve their production on an industrial scale.

Structure and expression of Rhodnius prolixus GH18 chitinases and chitinase-like proteins: Characterization of the physiological role of RpCht7, a gene from subgroup VIII, in vector fitness and reproduction.

Chitinases are enzymes responsible for the hydrolysis of glycosidic linkages within chitin chains. In insects, chitinases are typically members of the multigenic glycoside hydrolase family 18 (GH18). They participate in the relocation of chitin during development and molt, and in digestion in detritivores and predatory insects, and they control the peritrophic membrane thickness. Chitin metabolism is a promising target for developing vector control strategies, and knowledge of the roles of chitinases may reveal new targets and illuminate unique aspects of their physiology and interaction with microorganisms. Rhodnius prolixus is an important vector of Chagas disease, which is caused by the parasite Trypanosoma cruzi. In this study, we performed annotation and structural characterization of nine chitinase and chitinase-like protein genes in the R. prolixus genome. The roles of their corresponding transcripts were studied in more depth; their physiological roles were studied through RNAi silencing. Phylogenetic analysis of coding sequences showed that these genes belong to different subfamilies of GH18 chitinases already described in other insects. The expression patterns of these genes in different tissues and developmental stages were initially characterized using RT-PCR. RNAi screening showed silencing of the gene family members with very different efficiencies. Based on the knockdown results and the general lack of information about subgroup VIII of GH18, the RpCht7 gene was chosen for phenotype analysis. RpCht7 knockdown doubled the mortality in starving fifth-instar nymphs compared to dsGFP-injected controls. However, it did not alter blood intake, diuresis, digestion, molting rate, molting defects, sexual ratio, percentage of hatching, or average hatching time. Nevertheless, female oviposition was reduced by 53% in RpCht7-silenced insects, and differences in oviposition occurred within 14-20 days after a saturating blood meal. These results suggest that RpCht7 may be involved in the reproductive physiology and vector fitness of R. prolixus.

Prevalence of burnout among healthcare workers in six public referral hospitals in northeastern Brazil during the COVID-19 pandemic: a cross-sectional study

ABSTRACT BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed considerable psychological stress on frontline healthcare workers (HCWs). OBJECTIVE: To evaluate the prevalence of burnout syndrome among HCWs facing the COVID-19 outbreak. DESIGN AND SETTING: Cross-sectional study conducted in six public intensive care units (ICUs) in the city of Fortaleza, Brazil. METHODS: An online survey was conducted among HCWs to measure the three dimensions of burnout. RESULTS: A total of 62 physicians (23.4%), 65 nurses (24.5%), 58 nurse technologists (21.9%) and 80 physiotherapists (30.2%) completed the questionnaire. Nearly half of the participants (48.6%) had high levels of emotional exhaustion, and almost one-third of them (29.4%) had high levels of depersonalization. Low levels of professional efficacy were observed in 18.1% of the sample. The independent determinants of depersonalization burnout were age < 33 years (odds ratio, OR 2.03; 95% confidence interval, CI 1.15-3.56; P = 0.01) and female gender (OR 0.33; 95% CI 0.18-0.62; P = 0.01). Increased workload was associated with both depersonalization (OR 2.37; 95% CI 2.02-5.50; P = 0.04) and emotional exhaustion (OR 1.89; 95% CI 1.04-3.58; P = 0.030). CONCLUSION: The COVID-19 pandemic has had a great impact on the dimensions of depersonalization and emotional exhaustion. Consideration of these dimensions is important when designing future burnout prevention programs for frontline personnel.

Prevalence of burnout among healthcare workers in six public referral hospitals in northeastern Brazil during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed considerable psychological stress on frontline healthcare workers (HCWs). OBJECTIVE: To evaluate the prevalence of burnout syndrome among HCWs facing the COVID-19 outbreak. DESIGN AND SETTING: Cross-sectional study conducted in six public intensive care units (ICUs) in the city of Fortaleza, Brazil. METHODS: An online survey was conducted among HCWs to measure the three dimensions of burnout. RESULTS: A total of 62 physicians (23.4%), 65 nurses (24.5%), 58 nurse technologists (21.9%) and 80 physiotherapists (30.2%) completed the questionnaire. Nearly half of the participants (48.6%) had high levels of emotional exhaustion, and almost one-third of them (29.4%) had high levels of depersonalization. Low levels of professional efficacy were observed in 18.1% of the sample. The independent determinants of depersonalization burnout were age < 33 years (odds ratio, OR 2.03; 95% confidence interval, CI 1.15-3.56; P = 0.01) and female gender (OR 0.33; 95% CI 0.18-0.62; P = 0.01). Increased workload was associated with both depersonalization (OR 2.37; 95% CI 2.02-5.50; P = 0.04) and emotional exhaustion (OR 1.89; 95% CI 1.04-3.58; P = 0.030). CONCLUSION: The COVID-19 pandemic has had a great impact on the dimensions of depersonalization and emotional exhaustion. Consideration of these dimensions is important when designing future burnout prevention programs for frontline personnel.

Effects of Pulmonary Rehabilitation on Systemic Inflammation and Exercise Capacity in Bronchiectasis: A Randomized Controlled Trial.

INTRODUCTION: Bronchiectasis is a chronic condition that is becoming a global health concern. OBJECTIVE: To examine the effects of pulmonary rehabilitation (PR) on systemic inflammation, exercise capacity, and quality of life in participants with bronchiectasis. METHODS: Participants were randomized to receive PR (outpatient, three weekly sessions for 3 months) or control intervention (usual care + airway clearance therapy + breathing exercises). Data on laboratory (fibrinogen level) and patient-centered outcomes such as physical fitness [6-min walk test (6MWT)] and quality of life were collected. RESULTS: A total of 41 participants were evaluated (20 in the intervention group and 21 in the control group). The magnitude of change between baseline and the end of study was greater in the PR group than in the control group-the 6MWT distance increased by a mean of 54 m (54 vs 12 m; p < 0.01), fibrinogen showed a significant reduction (fibrinogen - 92.8 versus - 47.1 mg/dl; p < 0.01), and quality of life improved according to Saint George's Respiratory Questionnaire (SGRQ) (- 7.5 vs 3.2; p < 0.01), which exceeded the minimal clinically important difference of 4 points. CONCLUSION: PR effectively improved physical fitness, quality of life, and the degree of systemic inflammation, as reflected by changes in 6 MWT, fibrinogen levels and SGRQ scores. This study supports the inclusion of people with bronchiectasis in supervised PR programs.

Meningitis caused by Capnocytophaga canimorsus in a COVID-19 patient: a rare complication of dog bites.

Capnocytophaga canimorsus is a gram-negative rod that is part of the commensal microbiota of dogs' and cats' mouths. In this case, we report an 85-year-old man with COVID-19 who had his right arm bitten by a dog. His symptoms were impaired consciousness, agitation and aggressive behavior. Physical examination revealed neck stiffness and Brudzinski's sign. The cerebrospinal fluid culture was compatible with Capnocytophaga canimorsus. He required intensive care and received a 14-day prescription of meropenem. After 40 days of hospitalization, the patient was fully recovered and was discharged. This case highlights the importance of physician and microbiologist be awareness of this disease, mainly in patients with neurological symptoms after a dog or cat bite.

Sleep quality and associated factors amongst Brazilian physiotherapists during the COVID-19 pandemic.

OBJECTIVE: To investigate the prevalence of sleep problems and associated factors among Brazilian physiotherapists during the Coronavirus Disease 2019 (COVID-19) pandemic. METHODS: Cross-sectional online survey of physiotherapists in Brazil. Sociodemographic data, sleep quality (Pittsburgh Sleep Quality Index - PSQI) and symptoms of anxiety, depression and stress (21-item Depression, Anxiety and Stress Scale - DASS-21) were assessed. RESULTS: 342 physiotherapists responded the survey (18% male, median age 31 [27-38] years, 78% frontline workers). The three biggest fears reported by frontline physiotherapists were fear of being infected (48%), shortage of personal protective equipment (24%) and the severity of the disease (16%). The overall prevalence of poor sleep quality was 86%. Frontline physiotherapists showed worse scores on all PSQI components but sleep latency, disturbances and daytime dysfunction (p ≤ 0.037). Symptoms of anxiety and stress were highest in frontline workers (p ≤ 0.032). Being a frontline worker was independently associated with a poor sleep quality (odds ratio [95% CI] 1.99 [1.01 to 3.93]). CONCLUSION: Poor sleep quality was highly prevalent among Brazilian physiotherapists during the COVID-19 outbreak. Frontline physiotherapists showed worse sleep quality and more symptoms of anxiety and stress than non-frontline physiotherapists. Being at the frontline was associated with a higher chance of poor sleep quality.

Spirituality and religiosity are associated with physical and psychological status in patients with chronic obstructive pulmonary disease.

BACKGROUND: Management strategies that incorporate spirituality and religiosity (S/R) have been associated with better health status in clinical populations. However, few data are available for patients with chronic obstructive pulmonary disease (COPD) to improve the traditional disease-model treatment. AIMS: The objectives of this study were to evaluate the association between S/R and physical and psychological status in patients with stable COPD. DESIGN: This is a cross-sectional study. METHODS: Religiosity, spiritual well-being and S/R Coping were measured. Physical status was evaluated with the activity of daily living, dyspnoea and the impact of the disease. Psychological status was assessed with anxiety and depression symptoms and quality of life. Spearman correlation coefficients were calculated, multivariate linear regression was applied in the analyses. This study is reported following the STROBE recommendations. RESULTS: Seventy-two patients with stable COPD (male 58%, aged 68 ± 9 years, forced expiratory volume in 1s (FEV1 ) of 49.2 ± 19.6% predicted) were included. There was no association between S/R and activity of daily living. However, higher spiritual well-being and lower Negative S/R Coping was associated with reduced dyspnoea and burden of the disease. Increased S/R and lower Negative S/R Coping was also associated with less anxiety, depression and better quality of life. Multivariate linear regression showed that S/R variables explained the physical and psychological health status in people with stable COPD. CONCLUSIONS: Higher spirituality and less negative S/R Coping are associated with reduced dyspnoea, the burden of the disease, anxiety and depression symptoms, and better quality of life in patients with stable COPD. RELEVANCE TO CLINICAL PRACTICE: Understanding how religiosity and spirituality are associated with physical and psychological features in patients with COPD may contribute to the long-term management of this patient population.

Reference Values for 7 Different Protocols of Simple Functional Tests: A Multicenter Study.

OBJECTIVES: To establish reference values and equations (ages 20-80y) for 7 simple functional tests based on a multicenter study. DESIGN: Cross-sectional data collection in 4 research centers across different regions of a continental dimension country. SETTING: Healthy subjects from general community were assessed in different research laboratories. PARTICIPANTS: Data collection of 296 volunteer subjects (N=296; 45% men; aged 50±18y, forced expiratory volume in the first second 95±13% pred, body mass index 26.9±4.5 kg/m2) aged 20-80 years; representing both sexes; with the ability to understand and perform all proposed assessments; and with no severe and/or unstable condition that could limit functional assessments occurred simultaneously in all centers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: All participants randomly performed the following 7 functional tests twice: (1) the 4-meter gait speed test at usual walking speed; (2) the 4-meter gait speed test at maximal walking speed; (3) the Sit-to-Stand test performed with 5 repetitions; (4) the Sit-to-Stand test performed in 30 seconds; (5) the Sit-to-Stand test performed in 1 minute; (6) the Timed Up and Go test at usual speed; and (7) the Timed Up and Go test at maximal speed. Spirometry, quality of life, depression, anxiety, physical activity, and comorbidities were also assessed to better characterize the sample. The best performance of each test was used to propose reference values for men and women and reference equations for all. RESULTS: Participants similarly distributed by age groups from the 4 centers were included. All tests were correlated with age (0.34

Religiosity and Religious Coping in Patients with COPD: A Cross-Sectional Comparison Between Brazil and the Netherlands and Associations with Physical and Psychological Health.

This study aimed to compare religiosity and religious coping (RC) between Brazilian and Dutch patients with chronic obstructive pulmonary disease (COPD) and to examine associations with physical and psychological health. Religiosity, RC, and physical and psychological health were cross-sectionally assessed in 161 patients with COPD (74 from Brazil and 87 from the Netherlands). Brazilian participants showed the greatest religiosity (p < 0.05), and weak correlations were observed between religiosity/RC and exercise capacity and quality of life (p < 0.05 for all analyses). Brazilian patients with COPD had higher religiosity than Dutch patients, and religiosity correlated with functional exercise capacity and quality of life.

Meningitis caused by Capnocytophaga canimorsus in a COVID-19 patient: a rare complication of dog bites

ABSTRACT Capnocytophaga canimorsus is a gram-negative rod that is part of the commensal microbiota of dogs' and cats' mouths. In this case, we report an 85-year-old man with COVID-19 who had his right arm bitten by a dog. His symptoms were impaired consciousness, agitation and aggressive behavior. Physical examination revealed neck stiffness and Brudzinski's sign. The cerebrospinal fluid culture was compatible with Capnocytophaga canimorsus. He required intensive care and received a 14-day prescription of meropenem. After 40 days of hospitalization, the patient was fully recovered and was discharged. This case highlights the importance of physician and microbiologist be awareness of this disease, mainly in patients with neurological symptoms after a dog or cat bite.

Influência dos Cânceres Gástrico e Hematológico na Qualidade de Vida e na Funcionalidade de Pacientes Oncológicos / Influence of Gastric and Hematological Cancers on the Quality of Life and the Functionality of Oncological Patientss / Influencia de los Cánceres Gástrico y Hematológico em la Calidad de Vida y Funcionalidad de los Pacientes Oncológico

Introdução: O câncer é uma doença complexa, sendo a segunda maior causa de morte no Brasil e no mundo, com uma média de 9,8 milhões de óbitos ao ano. Objetivo: Verificar a influência do tipo de câncer, gástrico ou hematológico, na qualidade de vida e na funcionalidade dos indivíduos. Método: Trata-se de um estudo clínico, transversal, analítico e de abordagem quantitativa. Utilizaram-se na coleta de dados uma ficha com dados demográficos, antropométricos, habituais e da doença, o Quality of Life Questionnaire-Core30 da European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) e a Escala de Performance de Karnofsky (KPS). Resultados: Foram avaliados 29 pacientes no total; destes, 19 pacientes com câncer hematológico (Grupo A) e dez com câncer gástrico (Grupo B). A correlação entre idade, EORTC QLQ-C30 e KPS foi positiva entre a idade e os sintomas (r=,571, p=0,011) e a idade e a somatória total do EORTC QLQ-C30 (r=,548, p=0,015); e negativa entre a KPS e os sintomas (r=-,495, p=0,031) e a KPS e a somatória total do EORTC QLQ-C30 (r=,-580, p=0,009) no grupo A. No grupo B, não foi observada nenhuma correlação entre essas variáveis. Conclusão: Pacientes com câncer hematológico e câncer gástrico apresentam redução da qualidade de vida, sendo observada uma diminuição da funcionalidade nos pacientes com câncer hematológico quando comparado ao câncer gástrico. A redução da função nesses indivíduos pode estar diretamente relacionada com a idade e os sintomas físicos apresentados

Introduction: Cancer is a complex disease, being the second leading cause of death in Brazil and in the world, with an average of 9.8 million deaths per year. Objective: Verify the influence of the type of cancer, gastric or hematological, on the quality of life and functionality of individuals. Method: This is a clinical, cross-sectional, analytical and quantitative study. In the data collection, a form with demographic, anthropometric, habitual and disease data, the Quality-of-Life Questionnaire-Core30 da European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) and the Karnofsky Performance Scale (KPS) were used. Results: 29 patients were evaluated in total, of these 19 patients with hematological cancer (Group A) and 10 with gastric cancer (Group B). The correlation between age, EORTC QLQ-C30 and KPS, was positive between age and symptoms (r=,571, p=0.011) and age and total sum of EORTC QLQ-C30 (r=,548, p=0.015); and negative between the KPS and symptoms (r=-,495, p=0.031) and the KPS and total sum of the EORTC QLQ-C30 (r =,-580, p=0.009) in group A. In group B no correlation was observed between these variables. Conclusion: Patients with hematological and gastric cancer have reduced quality of life, with a reduction in functionality in patients with hematological cancer when compared to gastric cancer. The reduction in function in these individuals may be directly y related to age and physical Symptoms

Introducción: El cáncer es una enfermedad compleja, sien dola segunda causa de muerte en Brasil y e nel mundo, con un promedio de 9,8 millones de muertes por año. Objetivo: Verificar la influencia del tipo de cáncer, gástrico o hematológico, en la calidad de vida y funcionalidad de los individuos. Método: Se trata de un estudio clínico, transversal, analítico y cuantitativo. Em la recogida de datos se utilizó un formulario con datos demográficos, antropométricos, habituales y de enfermedad, el Quality of Life Questionnaire-Core30 da European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) y la Escala de Performance de Karnofsky (KPS). Resultados: Se evaluaron un total de 29 pacientes, de estos 19 pacientes con cáncer hematológico (Grupo A) y 10 con cáncer gástrico (Grupo B). La correlación entre edad, EORTC QLQ-C30 y KPS, fue positiva entre edad y síntomas (r=,571, p=0.011) y edad y suma total de EORTC QLQ-C30 (r=,548, p=0,015); y negativo entre la KPS y síntomas (r=-,495, p=0.031) y la KPS y suma total de la EORTC QLQ-C30 (r=,-580, p=0.009) e nel grupo A. Enel grupo B no se observó correlación entre estas variables. Conclusión: Los pacientes con cáncer hematológico y cáncer gástrico tienen una calidad de vida reducida, observando se una reducción de la funcionalidad en los pacientes con cáncer hematológico em comparación con el cáncer gástrico. La reducción de la funcione en estos individuos puede estar directamente relacionada con la edad y los síntomas físicos

Occurrence of genes associated with virulence in Escherichia coli isolates from chicken carcasses at different stages of processing at a slaughterhouse.

Escherichia coli is a bacterium frequently found in chicken carcasses, causing carcass condemnation with losses to the industry and when present in food, it carries a risk to public health as there is evidence that some strains pathogenic to birds (APEC - Avian Pathogenic E. coli) have zoonotic potential. Carcass contamination can occur at the slaughterhouse, but the influence of the different stages of processing in the selection of potential extraintestinal pathogenic E. coli strains is unknown. This study aimed to analyze the influence of the processing steps in the slaughterhouse on the detection of E. coli isolates carrying APEC predictor's virulence-associated genes (VAGs), and to relate their presence with post-mortem condemnation. A sample consisted of four pooled carcasses collected at seven different stages of slaughter (before scalding, after scalding, after plucking, before evisceration/after shower wash, after evisceration, after pre-coolers, and after packing) from 15 batches of broilers. The total samples obtained was 105 pools with four carcasses each, totaling 420 carcasses analyzed. Enterobacteriaceae were counted from each pool and E. coli were subsequently selected, which were submitted to pentaplex PCR to identify the five VAG APEC predictor's: iroN, ompT, hlyF, iss, and iutA. The Enterobacteriaceae count demonstrated a reduction of 4.25 log CFU per gram of carcass from the first to the last stage analyzed, with scalding and pre-cooling by immersion being the procedures that contributed most to this reduction. The presence of VAGs and potential APEC (presence of two or more of these gene predictors) was observed at all points evaluated in the slaughterhouse, which suggested that bacteria carrying these genes could reach the consumer.

Evolution of Toll, Spatzle and MyD88 in insects: the problem of the Diptera bias.

BACKGROUND: Arthropoda, the most numerous and diverse metazoan phylum, has species in many habitats where they encounter various microorganisms and, as a result, mechanisms for pathogen recognition and elimination have evolved. The Toll pathway, involved in the innate immune system, was first described as part of the developmental pathway for dorsal-ventral differentiation in Drosophila. Its later discovery in vertebrates suggested that this system was extremely conserved. However, there is variation in presence/absence, copy number and sequence divergence in various genes along the pathway. As most studies have only focused on Diptera, for a comprehensive and accurate homology-based approach it is important to understand gene function in a number of different species and, in a group as diverse as insects, the use of species belonging to different taxonomic groups is essential. RESULTS: We evaluated the diversity of Toll pathway gene families in 39 Arthropod genomes, encompassing 13 different Insect Orders. Through computational methods, we shed some light into the evolution and functional annotation of protein families involved in the Toll pathway innate immune response. Our data indicates that: 1) intracellular proteins of the Toll pathway show mostly species-specific expansions; 2) the different Toll subfamilies seem to have distinct evolutionary backgrounds; 3) patterns of gene expansion observed in the Toll phylogenetic tree indicate that homology based methods of functional inference might not be accurate for some subfamilies; 4) Spatzle subfamilies are highly divergent and also pose a problem for homology based inference; 5) Spatzle subfamilies should not be analyzed together in the same phylogenetic framework; 6) network analyses seem to be a good first step in inferring functional groups in these cases. We specifically show that understanding Drosophila's Toll functions might not indicate the same function in other species. CONCLUSIONS: Our results show the importance of using species representing the different orders to better understand insect gene content, origin and evolution. More specifically, in intracellular Toll pathway gene families the presence of orthologues has important implications for homology based functional inference. Also, the different evolutionary backgrounds of Toll gene subfamilies should be taken into consideration when functional studies are performed, especially for TOLL9, TOLL, TOLL2_7, and the new TOLL10 clade. The presence of Diptera specific clades or the ones lacking Diptera species show the importance of overcoming the Diptera bias when performing functional characterization of Toll pathways.