Publication trends of the Journal of Esthetic and Restorative Dentistry: A bibliometric analysis.

OBJECTIVE: The Journal of Esthetic and Restorative Dentistry (JERD) stands out as one of the most prominent international journals publishing research in esthetic dentistry. This study analyzed articles published by JERD since the year 2000 through bibliometric analysis. METHODOLOGY: The search was conducted in January 2024 using Scopus. The following data were extracted from the articles: citation count, year, language, access type, funding agency, study design, theme (general and specific), country, institution, authors, and keywords. The VOSviewer software was used to generate collaborative network maps among the data. Dimensions were consulted to measure altmetric data. Google Trends was used to investigate the global popularity of JERD research. RESULTS: A total of 1394 articles were included in this analysis. Citation count ranged from 0 to 625 (average: 16.9). Articles were published between 2000 and 2023. Laboratory studies were more prevalent (n = 850), with the most investigated general theme being restorative procedures (n = 882), and the highlighted specific theme being the use of composite resin (n = 327). The United States had the highest number of articles (n = 640), with the diverse distribution among other countries. The most common keyword was "cad/cam" (n = 63). VOSviewer demonstrated high collaboration among countries. Intense mentions were identified primarily on Facebook. According to Google Trends, Egypt was the country that searched for JERD the most. CONCLUSIONS: JERD exhibited significant growth in the number of published articles and their diversity by topics, types, origin (country), number of citations, and impact factor. CLINICAL SIGNIFICANCE: The JERD is a journal that publishes studies influencing clinical practice. Identifying the key characteristics of this journal is essential for charting future paths.

Percepción de apoyo social en padres de niños con diabetes mellitus tipo 1

Fundamento: el apoyo de familiares y del equipo de salud a los padres cuidadores de sus hijos diabéticos es fundamental para el afrontamiento a los cambios que provoca esta enfermedad en la dinámica familiar. Objetivo: describir la percepción de los padres cuidadores sobre el apoyo familiar y de los Sistemas de Salud en el comienzo de sus hijos con diabetes mellitus tipo 1. Métodos: estudio cualitativo descriptivo realizado mediante entrevista semiestructurada a cuatro padres cuidadores de niños con diagnóstico de diabetes tipo 1. El consentimiento informado fue realizado vía Google Forms y la entrevista fue vía plataforma ZOOM. Las entrevistas tuvieron una duración de 30 minutos. El análisis de las entrevistas se realizó utilizando el programa ATLAS.ti versión 22. Resultados: el comienzo de la enfermedad de los niños fue recibido por los padres con mucha confusión y falta de conocimiento. En cuanto a las redes de apoyo, los padres declararon la soledad como vivencia en el cuidado de los niños y, en relación a los equipos de salud, relataron que está enfocada en los cuidados básicos que tenían que cumplir, como la alimentación y el control glucémico, con ausencia de preocupación por el apoyo emocional. Conclusiones: las necesidades de apoyo desde los equipos de salud, a los padres cuidadores, más allá del control de la enfermedad, es una necesidad explícita desde la evidencia, que aún no ha sido considerada por los Sistemas de Salud. El apoyo debe trascender la familia, con una actuación importante de los profesionales de la salud y todo el contexto en que están insertos los niños, para contribuir a un manejo adecuado de la enfermedad.

Foundation: the support of family members and the health team for parents caring for their diabetic children is essential for facing with the changes that this disease causes in family dynamics. Objective: to describe the perception of parent caregivers about family support and Health Systems at the beginning of their children with type 1 diabetes mellitus. Methods: qualitative descriptive study carried out through semi-structured interviews with four parent caregivers of children with a diagnosis of type 1 diabetes. Informed consent was carried out via Google forms and the interview was via the ZOOM platform. The interviews lasted 30 minutes. The analysis of the interviews was carried out using the ATLAS.ti version 22 program. Results: the beginning of the children's illness was received by parents with much confusion and lack of knowledge. Regarding the support networks, the parents declared loneliness in the experience of caring for the children and, in relation to the health teams, they reported that it is focused on the basic care that they had to fulfill, such as food and hygiene, glycemic control, with absence of concern for emotional support. Conclusions: the support needs from health teams to parent caregivers, beyond disease control, is an explicit need from the evidence, which has not yet been considered by Health Systems. Support must go beyond the family, with important action by health professionals and the entire context in which children are inserted, to contribute to adequate management of the disease.

Reversible cerebral vasoconstriction syndrome associated with probable drug poisoning.

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical condition characterized by arterial involvement of the intracranial vessels, manifesting with vasospasm. The most common clinical manifestation related to the syndrome is the thunderclap headache, which consists of a severe headache that reaches the peak of pain within minutes. The imaging study assumes a leading role in the complementary investigation. Laboratory tests and cerebrospinal fluid analysis are often nonspecific and without significant diagnostic importance. Non-contrast studies of the brain parenchyma reveal variable results that can often be normal. Angiographic findings, which initially may not reveal any changes, allow the visualization of diffuse narrowing of the vessels, with the posterior cerebral circulation being preferentially affected. The present study reports the case of a 19-year-old woman with no relevant medical history, except that she was a regular user of marijuana and a drug based on chloroform and ether. The patient showed clinical and imaging signs compatible with RCVS, and the narcotics used by her were considered precipitating factors.

The ethanolic extract of the fungus Trichoderma stromaticum decreases the Toxoplasma gondii replication in vitro and ameliorates the experimental toxoplasmosis in vivo.

Trichoderma are fungi that are well-known to inhibit the growth of a variety of plant pathogens. Currently, there is an increasing search for new drugs to treat toxoplasmosis. The aims of this study were to investigate the effect of ExtTs in the control of Toxoplasma gondii proliferation in vitro and the course of toxoplasmosis in a mouse model. Firstly, the cytotoxicity of the ExtTs was evaluated by cultivating macrophages with different concentrations of the extract and cell viability was assessed by the MTT assay. Next, the infectivity of the T. gondii treated with extract was analyzed by infecting J774 macrophages. To evaluate the effect of the ExtTs in vivo, C57BL/6 mice were infected orally with T. gondii, ME-49, treated daily with ExtTs, and clinical, biochemical and histological changes were monitored. It was demonstrated that the extract did not affect the host cellular viability and, the treatment of parasites with ExtTs altered their morphology and decreased their ability to proliferate inside macrophages. Additionally, the treatment of mice with ExtTs decreased the parasitism and inflammation in the small intestine and liver of infected mice in parallel with increased IL-10/TNF ratio systemically and prevented alterations to serum VLDL and triglyceride levels. Thus, ExtTs could be considered an alternative/complementary therapy to control toxoplasmosis.

Effects of Notch signaling pathway inhibition by dibenzazepine in acute experimental toxoplasmosis.

Notch signaling pathway plays a crucial role in cellular fate across species, being important for the differentiation and development of several cell types. The aim of this study was to evaluate the effect of Notch inhibition pathway by dibenzazepine (DBZ) in histological and inflammatory alterations and, tissue parasitism in acute Toxoplasma gondii infection. For this, C57BL/6 mice were treated with DBZ before infection with T. gondii, and the small intestine, lungs and liver were analyzed. The genes related to Notch signaling pathway were assayed through qPCR in the organs, and cytokine measurement was performed in serum samples. In the small intestine, T. gondii infection impaired the Hes1 and Math1 mRNA expressions, increased the inflammation and decreased goblet and Paneth cell numbers. The DBZ-treatment was able to partially preserve these cells, however, the parasitism and inflammation were not altered. In parallel, the high IL-2, IL-6, TNF and, IFN-γ levels induced by infection were not changed with the DBZ treatment, with the IFN-γ levels even higher. In contrast, in the liver and lungs, the DBZ-treatment diminished parasitism and inflammation. Our results highlight that Notch pathway inhibition in T.gondii infection results in different parasitological and inflammatory outcomes depending on the organ analyzed.

Toxoplasma gondii Infection Decreases Intestinal 5-Lipoxygenase Expression, while Exogenous LTB4 Controls Parasite Growth.

5-Lipoxygenase (5-LO) is an enzyme required for the production of leukotrienes and lipoxins and interferes with parasitic infections. In vitro, Toxoplasma gondii inhibits leukotriene B4 (LTB4) production, and mice deficient in 5-LO are highly susceptible to infection. The aim of this study was to investigate the effects of the pharmacological inhibition of the 5-LO pathway and exogenous LTB4 supplementation during experimental toxoplasmosis. For this purpose, susceptible C57BL/6 mice were orally infected with T. gondii and treated with LTB4 or MK886 (a selective leukotriene inhibitor through inhibition of 5-LO-activating protein [FLAP]). The parasitism, histology, and immunological parameters were analyzed. The infection decreased 5-LO expression in the small intestine, and treatment with MK886 reinforced this reduction during infection; in addition, MK886-treated infected mice presented higher intestinal parasitism, which was associated with lower local interleukin-6 (IL-6), interferon gamma (IFN-γ), and tumor necrosis factor (TNF) production. In contrast, treatment with LTB4 controlled parasite replication in the small intestine, liver, and lung and decreased pulmonary pathology. Interestingly, treatment with LTB4 also preserved the number of Paneth cells and increased α-defensins expression and IgA levels in the small intestine of infected mice. Altogether, these data demonstrated that T. gondii infection is associated with a decrease in 5-LO expression, and on the other hand, treatment with the 5-LO pathway product LTB4 resulted in better control of parasite growth in the organs, adding to the knowledge about the pathogenesis of T. gondii infection.

The imbalance of TNF and IL-6 levels and FOXP3 expression at the maternal-fetal interface is involved in adverse pregnancy outcomes in a susceptible murine model of congenital toxoplasmosis.

Vertical transmission of Toxoplasma gondii leads to adverse pregnancy outcomes depending on the time at which the infection occurs and the immunological state of the mother. C57BL/6 and BALB/c mice have been described as susceptible and resistant mouse lineages to congenital T. gondii infection, respectively. This study aimed to elucidate the systemic and local cytokine profile of pregnant mice infected with T. gondii and whether the expression of the transcription factor FOXP3, related to T regulatory cells, is associated with the resistance/susceptibility of these lineages of mice in the context of experimental congenital toxoplasmosis. For this purpose, C57BL/6 and BALB/c females were orally infected with the T. gondii ME-49 strain on the day of vaginal plug detection or day 14 of gestation, examined 7 or 5 days later, respectively, as models of early and late pregnancy. Cytokine levels were measured systemically and in the uterus/placenta. Additionally, the uterus/placenta were evaluated macroscopically for resorption rates and histologically for parasite and FOXP3 immunostaining. The FOXP3 protein expression was also evaluated by western blotting assay. It was found that, during early pregnancy, the infection leads to high IFN-γ, TNF and IL-6 levels systemically, with the TNF levels being higher in C57BL/6 mice. At the maternal-fetal interface, the infection induced high levels of IFN-γ in both mouse lineages; however, higher levels were observed in BALB/c, while high TNF and IL-6 levels were found in C57BL/6, but not in BALB/c mice. In contrast, in late gestation, T. gondii interfered less strongly with the cytokine profile. In early pregnancy, a reduction of FOXP3 expression at the maternal-fetal interface of infected mice was also observed, and the reduction was larger in C57BL/6 compared with BALB/c mice. Additionally, the parasite was seldom found in the uterus/placenta. Thus, the worse pregnancy outcomes observed in C57BL/6 mice were associated with higher TNF systemically, and TNF and IL-6 at the maternal-fetal interface, with lower FOXP3 expression.

Anti-parasitic activity of Annona muricata L. leaf ethanolic extract and its fractions against Toxoplasma gondii in vitro and in vivo.

ETHNOPHARMACOLOGICAL RELEVANCE: Sulfadiazine and pyrimethamine are the two drugs used as part of the standard therapy for toxoplasmosis, however; they may cause adverse side effects and fail to prevent relapse in many patients, rendering infected individuals at risk of reactivation upon becoming immunocompromised. Extracts from various parts of Annona muricata have been widely used medicinally for the management, control and/or treatment of several human diseases, acting against parasites that cause diseases in humans. AIM OF THE STUDY: This study was performed to investigate the action of the ethanolic extract of A. muricata (EtOHAm) and its fractions in the control of the apicomplexan parasite Toxoplasma gondii in vitro and in vivo, and the effect of EtOHAm on the inflammatory response and lipid profile alteration induced by in vivo T. gondii infection. MATERIALS AND METHODS: The cytotoxicity of EtOHAm and its fractions ethyl acetate (EtOAcAm), n-butanol (BuOHAm), aqueous (H2OAm), hexane (HexAm) and dichloromethane (CH2Cl2Am) was evaluated in NIH/3T3 fibroblasts using the (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The cells were infected with T. gondii, treated with the extracts, and parasite proliferation was analyzed. For the in vivo experiments, C57BL/6 mice were orally infected with T. gondii and, treated with different concentrations of extract fractions that were effective in vitro (EtOHAm, EtOAcAm, HexAm and CH2Cl2Am). Tissue parasitism, histological alterations, systemic cytokine and lipid profile were investigated. RESULTS: EtOHAm, EtOAcAm, BuOHAm, H2OAm presented low cytotoxicity until doses of 200 µg/mL, while HexAm and CH2Cl2Am presented toxicity from doses of 100µg/mL. EtOHAm, HexAm and CH2Cl2Am decreased the parasitism in vitro, presenting a therapeutic index of 2.62, 2.44, and 2.96, respectively. In vivo, EtOHAm, HexAm and CH2Cl2Am improved the survival rate of infected animals, however, only EtOHAm was able to decrease the parasitism in the small intestine and lung. Additionally, EtOHAm decreased the systemic interferon (IFN)-γ and tumor necrosis factor (TNF) systemically in infected mice, and was able to maintain the triglycerides and very-low-density lipoprotein (VLDL) lipid fractions at similar levels to uninfected animals. Although treatment with EtOHAm could not control the inflammation induced by oral infection in the tissues analyzed, it was able to preserve the number of goblet cells in the small intestine. CONCLUSIONS: Ethanolic A. muricata leaf extract could be considered as a good candidate for the development of a complementary/alternative therapy against toxoplasmosis, and also as an anti-inflammatory alternative for decreasing TNF and IFN-γ concentrations and lipid fractions in specific diseases.

miRNA profiling in renal carcinoma suggest the existence of a group of pro-angionenic tumors in localized clear cell renal carcinoma.

Renal cell carcinoma comprises a variety of entities, the most common being the clear-cell, papillary and chromophobe subtypes. These subtypes are related to different clinical evolution; however, most therapies have been developed for clear-cell carcinoma and there is not a specific treatment based on different subtypes. In this study, one hundred and sixty-four paraffin samples from primary nephrectomies for localized tumors were analyzed. MiRNAs were isolated and measured by microRNA arrays. Significance Analysis of Microarrays and Consensus Cluster algorithm were used to characterize different renal subtypes. The analyses showed that chromophobe renal tumors are a homogeneous group characterized by an overexpression of miR 1229, miR 10a, miR 182, miR 1208, miR 222, miR 221, miR 891b, miR 629-5p and miR 221-5p. On the other hand, clear cell renal carcinomas presented two different groups inside this histological subtype, with differences in miRNAs that regulate focal adhesion, transcription, apoptosis and angiogenesis processes. Specifically, one of the defined groups had an overexpression of proangiogenic microRNAs miR185, miR126 and miR130a. In conclusion, differences in miRNA expression profiles between histological renal subtypes were established. In addition, clear cell renal carcinomas had different expression of proangiogenic miRNAs. With the emergence of antiangiogenic drugs, these differences could be used as therapeutic targets in the future or as a selection method for tailoring personalized treatments.

Manejo de la intolerancia a estatinas: un desafío cotidiano en la práctica clínica / Management of statin intolerance: a daily challenge in clinical practice / Manejo da intolerância à estatina: um desafio diário na prática clínica

Resumen: La enfermedad cardiovascular ateromatosa continúa siendo la primera causa de morbimortalidad en el mundo a pesar de los avances tanto en las estrategias de cardiología intervencionista, como en el abordaje integral de los factores de riesgo cardiovascular. Las estatinas constituyen los fármacos de elección para el manejo del riesgo cardiovascular y la mayoría de las dislipemias. Existe evidencia robusta acerca de la reducción de eventos cardiovasculares mayores, cuyo beneficio es dosis dependiente. De esta forma un gran número de personas tienen indicación de estatinas, existiendo un porcentaje próximo a 20% de pacientes que refieren no tolerarlas. Sin embargo, tan solo un 5% de los que reciben estatinas son realmente intolerantes. Dado su probado beneficio, los clínicos deben asegurarse de que los efectos adversos que manifiesta el paciente estén realmente asociados a estas drogas. De otro modo se estaría privando a algunos pacientes, en forma injustificada, de la reducción de la morbimortalidad asociada al uso de estatinas.

Summary: Atherosclerotic cardiovascular disease remains the leading cause of morbidity and mortality in the world despite advances in both interventional cardiology strategies and comprehensive approach to cardiovascular risk factors. Statins constitute the drugs of choice for the management of cardiovascular risk and most dyslipidemias. There is robust evidence about the reduction of major cardiovascular events, whose benefit is dose dependent. In this way a large number of people have an indication of statins, but a percentage close to 20% report to be intolerant. Nevertheless only 5% of the patients treated with statins, are real intolerant. Clinicians should confirm that the adverse effects are really associated with these drugs, to avoid losing the benefit before discontinuation.

Resumo: A doença cardiovascular ateromatosa ainda é a principal causa de morbidade e mortalidade do mundo, apesar dos avanços nas estratégias de cardiologia intervencionista, tais como a abordagem abrangente de fatores de risco cardiovascular. As estatinas são drogas de escolha para a gestão de risco cardiovascular e a maioria das dislipidemias. Há evidências robustas sobre a redução de grandes eventos cardiovasculares maiores cujo benefício é dose-dependente. Desta forma, um grande número de pessoas tem indicação de estatinas, há uma porcentagem cerca de 20% dos pacientes, referindo-se a não tolerá-las. No entanto, apenas 5% de pessoas tratadas são realmente intolerantes. Dado o benefício comprovado das estatinas, os clínicos devem assegurar os efeitos adversos que o paciente se manifesta são realmente associados com estas drogas. Caso contrário o benefício claro na redução da morbidade e mortalidade se retira de maneira injustificada.

Inhibidores de la PCSK9: una nueva era en el control del riesgo cardiovascular / PCSK9 inhibitors: a new era in the control of cardiovascular risk / Inibidores da PCSK9: uma nova era no controle do risco cardiovascular

Resumen: Las estatinas constituyen aún la pieza fundamental para el manejo del riesgo cardiovascular. Utilizadas en dosis de alta intensidad logran reducciones de colesterol asociado a lipoproteínas de baja densidad (C-LDL) de 50%-60%. Sin embargo, en pacientes con hipercolesterolemia severa, las estatinas solas o asociadas a ezetimibe pueden no ser suficientes para alcanzar los objetivos de descenso de C-LDL. Tal es el caso de las dislipemias genéticas como la hipercolesterolemia familiar. Lo mismo ocurre en pacientes con intolerancia total o parcial a estatinas, en los que se requiere de alternativas farmacológicas modernas que permitan reducir el riesgo cardiovascular elevado. En este escenario, los inhibidores de la proproteína convertasa subtilisina kexina tipo 9, se han convertido en una piedra angular para lograr no solo una reducción jamás antes vista del C-LDL, sino también del riesgo cardiovascular. La nueva evidencia posiciona a estos fármacos en un lugar de privilegio, siendo eficaces y bien tolerados, con el costo como principal limitante, a pesar de su marcado descenso en los últimos años.

Summary: Statins are still the fundamental piece for cardiovascular risk management. Used in doses of high intensity achieve reductions in cholesterol associated with low density lipoproteins of 50%-60%. However, in patients with severe hypercholesterolemia, statins alone or associated with ezetimibe may not be sufficient to achieve cholesterol associated with low density lipoproteins decrease targets. Such is the case of genetic dyslipidemias as familial hypercholesterolemia. Also in patients with total or partial statin intolerance, a modern pharmacological alternative is required to reduce high cardiovascular risk. In this scenario, proprotein convertase subtilisin kexin type 9 inhibitors have become a cornerstone to achieve not only a reduction never seen before of cholesterol associated with low density lipoproteins levels, but also of cardiovascular risk. These drugs are in a privilege position due to the new evidence, being effective and well tolerated, with cost as its main limitation despite its marked decline in recent years.

Resumo: As estatinas ainda são a peça fundamental da gestão de risco cardiovascular. Utilizada em dose de alta intensidade atinge reduções associadas com colesterol da lipoproteína de baixa densidade de 50%-60%. No entanto em pacientes com hipercolesterolemia grave, estatinas, sozinhas ou associadas a ezetimiba podem não ser suficientes para alcançar os objetivos de redução de colesterol da lipoproteína de baixa densidade. Tal é o caso das dislipidemias genéticas como a hipercolesterolemia familiar. O mesmo ocorre em pacientes com intolerância total ou parcial de estatinas, que exige modernas alternativas farmacológicas que permitem reduzir o risco cardiovascular alto. Neste panorama, os inibidores da pró-proteína convertasa subtilisina kexina tipo 9, se tornaram uma pedra angular para alcançar não apenas uma redução em nunca antes visto colesterol da lipoproteína de baixa densidade, mas de risco cardiovascular. Novas provas colocam essas drogas em um lugar de privilégio, por ser eficaz e bem tolerado, com o custo como sua principal limitante a pesar do seu grande declínio nos últimos anos.

Eosinopenia como factor de severidad en pacientes con infección por Clostridium difficile / Eosinopenia as severity factor in patients with Clostridium difficile infection

Introducción. La diarrea por Clostridium difficile es la infección intrahospitalaria más frecuente y se asocia a tasas de mortalidad de entre 20 y 30% en pacientes mayores de 65 años. Su epidemiología va modificándose, reportándose con más frecuencia casos en poblaciones que antes no eran consideradas de riesgo. Investigaciones en fase preclínica demostraron que las cepas de C. difficile productoras de toxina binaria producen eosinopenia, asociado al aumento de la severidad de la infección. Materiales y métodos. Se realizó un estudio retrospectivo y descriptivo incluyendo 60 pacientes mayores de 18 años internados en el Hospital Británico de Buenos Aires en el periodo de 2015 a 2017 con toxina de C. difficile positiva en muestra de materia fecal. Resultados. El 51.6% (n=31) de los pacientes analizados fueron mujeres y el 56.6% (n=34), mayores de 65 años. Se evidenció una progresiva disminución del recuento de eosinófilos a medida que aumentan los signos de severidad. No se observaron diferencia significativa entre el recuento de eosinófilos en relación con la edad (p<0.32). Discusión. Consideramos que el recuento de eosinófilos podría constituir una herramienta precoz, rutinaria y accesible para evaluar la severidad de la infección por C. difficile (AU)

Annona muricata Linn. leaf as a source of antioxidant compounds with in vitro antidiabetic and inhibitory potential against α-amylase, α-glucosidase, lipase, non-enzymatic glycation and lipid peroxidation.

Annona muricata leaves are used in traditional medicine to manage diabetes mellitus and its complications. The aim of this study was to evaluate the potential in vitro antidiabetic properties of Annona muricata leaf by identifying its main phytochemical constituents and characterizing the phenolic-enriched fractions for their in vitro antioxidant capacity and inhibitory activities against glycoside and lipid hydrolases, advanced glycation end-product formation and lipid peroxidation. Ethanol extract of A. muricata leaf was subjected to a liquid-liquid partitioning and its fractions were used in enzymatic assays to evaluate their inhibitory potential against α-amylase, α-glucosidase and lipase, as well as their antioxidant (DPPH, ORAC, FRAP and Fe2+-ascorbate-induced lipid peroxidation assays) and anti-glycation (BSA-fructose, BSA-methylglyoxal and arginine-methylglyoxal models) capacities. In addition, identification of the main bioactive compounds of A. muricata leaf by HPLC-ESI-MS/MS analysis was carried out. Ethyl acetate (EtOAc) and n-butanol (BuOH) fractions showed, respectively, antioxidant properties (ORAC 3964 ±â€¯53 and 2707 ±â€¯519 µmol trolox eq g-1, FRAP 705 ±â€¯35 and 289 ±â€¯18 µmol trolox eq g-1, and DPPH IC50 4.3 ±â€¯0.7 and 9.3 ±â€¯0.8 µg mL-1) and capacity to reduce liver lipid peroxidation (p < .01). Also, EtOAc and BuOH, respectively, inhibited glycation in BSA-fructose (IC50 45.7 ±â€¯13.5 and 61.9 ±â€¯18.2 µg mL-1), BSA-methylglyoxal (IC50 166.1 ±â€¯21.6 and 413.2 ±â€¯49.5 µg mL-1) and arginine-methylglyoxal (IC50 437.9 ±â€¯89.0 and 1191.0 ±â€¯199.0 µg mL-1) assays, α-amylase (IC50 9.2 ±â€¯2.3 and 6.1 ±â€¯1.6 µg mL-1), α-glucosidase (IC50 413.1 ±â€¯121.1 and 817.4 ±â€¯87.9 µg mL-1) and lipase (IC50 74.2 ±â€¯30.1 and 120.3 ±â€¯50.5 µg.mL-1), and presented lower cytotoxicity, when compared to the other fractions and crude extract. Various biomolecules known as potent antioxidants were identified in these fractions, such as chlorogenic and caffeic acids, procyanidins B2 and C1, (epi)catechin, quercetin, quercetin-hexosides and kaempferol. This study presents new biological activities not yet described for A. muricata, which contributes to the understanding of the potential effectiveness in the use of the A. muricata leaf, especially its polyphenols-enriched fractions, for the management of diabetes mellitus and its complications.

Peel of araticum fruit (Annona crassiflora Mart.) as a source of antioxidant compounds with α-amylase, α-glucosidase and glycation inhibitory activities.

Annona crassiflora Mart., whose fruit is popularly known as araticum, is a member of the Annonaceae family found in the Brazilian Cerrado. Although this plant has several medicinal uses, its bioactive molecules are not fully understood. A bioguided assay was performed to identify the main bioactive compounds of A. crassiflora fruit peel from the ethanol extract fractions with antioxidant capacity and α-amylase, α-glucosidase and glycation inhibitory activities. Ethyl acetate and n-butanol fractions showed, respectively, higher antioxidant capacity (DPPH IC50 1.5±0.1 and 0.8±0.1µgmL-1, ORAC 3355±164 and 2714±79µmoltroloxeq/g, and FRAP 888±16 and 921±9µmoltroloxeq/g) and inhibitory activities against α-amylase (IC50 4.5±0.8 and 1.7±0.3µgmL-1), α-glucosidase (IC50 554.5±158.6 and 787.8±140.6µgmL-1) and glycation (IC50 14.3±3.3 and 16.0±4.2µgmL-1), and lower cytotoxicity, compared to the other fractions and crude ethanol extract. The HPLC-ESI-MS/MS analysis identified various biomolecules known as potent antioxidants, such as chlorogenic acid, (epi)catechin, procyanidins, caffeoyl-hexosides, quercetin-glucosides and kaempferol. The fruit peel of A. crassiflora, a specie from Cerrado, the Brazilian Savanna, provided a source of antioxidant compounds with properties to block carbohydrate digestive enzymes and formation of glycation products. Thus, there is potential to use the by-products of araticum in order to identify and isolate phytochemicals for application in nutraceutical supplements, food additives and pharmaceuticals products.

Ouabain-induced alterations of the apical junctional complex involve α1 and ß1 Na,K-ATPase downregulation and ERK1/2 activation independent of caveolae in colorectal cancer cells.

Studies have reported that Na,K-ATPase interacts with E-cadherin to stabilize (AJs) and regulate the expression of claudins, the main proteins present in the tight junction (TJ) in epithelial cells containing caveolae. However, the role of this ATPase in the regulation of the AJ and TJ proteins in colorectal cancer cells as well as the molecular events underlying this event in a caveolae-independent system remain undefined. In the present study, we used ouabain, a classic drug known to inhibit Na,K-ATPase, and Caco-2 cells, which are a well-established human colorectal cancer model that does not exhibit caveolae. We demonstrated that ouabain treatment resulted in a reduction of the ß1 Na,K-ATPase protein and cell redistribution of the AJ proteins E-cadherin and ß-catenin, as well as the α1 Na,K-ATPase subunit. Furthermore, ouabain increased claudin-3 protein levels, impaired the TJ barrier function and increased cell viability and proliferation during the early stages of treatment. Additionally, the observed ouabain-induced events were dependent on the activation of ERK1/2 signaling; but in contrast to previous studies, this signaling cascade was caveolae-independent. In conclusion, our findings strongly suggest that α1 and ß1 Na,K-ATPase downregulation and ERK1/2 activation induced by ouabain are interlinked events that play an important role during cell-cell adhesion loss, which is an important step during the tumor progression of colorectal carcinomas.

Claudin-3 overexpression increases the malignant potential of colorectal cancer cells: roles of ERK1/2 and PI3K-Akt as modulators of EGFR signaling.

The altered expressions of claudin proteins have been reported during the tumorigenesis of colorectal cancer. However, the molecular mechanisms that regulate these events in this cancer type are poorly understood. Here, we report that epidermal growth factor (EGF) increases the expression of claudin-3 in human colorectal adenocarcinoma HT-29 cells. This increase was related to increased cell migration and the formation of anchorage-dependent and anchorage-independent colonies. We further showed that the ERK1/2 and PI3K-Akt pathways were involved in the regulation of these effects because specific pharmacological inhibition blocked these events. Genetic manipulation of claudin-1 and claudin-3 in HT-29 cells showed that the overexpression of claudin-1 resulted in decreased cell migration; however, migration was not altered in cells that overexpressed claudin-3. Furthermore, the overexpression of claudin-3, but not that of claudin-1, increased the tight junction-related paracellular flux of macromolecules. Additionally, an increased formation of anchorage-dependent and anchorage-independent colonies were observed in cells that overexpressed claudin-3, while no such changes were observed when claudin-1 was overexpressed. Finally, claudin-3 silencing alone despite induce increase proliferation, and the formation of anchoragedependent and -independent colonies, it was able to prevent the EGF-induced increased malignant potential. In conclusion, our results show a novel role for claudin-3 overexpression in promoting the malignant potential of colorectal cancer cells, which is potentially regulated by the EGF-activated ERK1/2 and PI3K-Akt pathways.

O agendamento dos jogos Rio 2016: temas e termos para debate / Rio 2016 game's schedule: terms and topics for discussion

A formação da agenda compreende um momento decisivo na formulação de políticas públicas, delimitando objetos de intervenção governamental. Neste sentido, buscamos analisar os temas e termos que perpassam o agendamento dos Jogos Rio 2016. A pesquisa se baseou em levantamento documental construído a partir de fontes institucionais e mídia impressa, discutidos com apoio na técnica de análise de conteúdo. Permitiu mapear os interesses que perpassaram a candidatura carioca a sede dos Jogos Olímpicos, identificar as tendências da política esportiva brasileira e discutir a relação público-­privado no contexto de organização dos Jogos, bem como apontar desafios para a agenda de pesquisas sobre megaeventos esportivos...

The training schedule comprises a turning point in public policy formulation, defining objects of government intervention. In this sense, we analyzed the terms and themes that go through the scheduling of 2016 Games. The research was based on documentary survey constructed from institutional sources and printed media, discussed with technical support in the content analysis. Allowed to map the interests which permeated Rio bid to host the Olympics, to identify trends in Brazilian sports policy and discuss the public ­private relationship in the context of organizing the Games, as well as identifying challenges for the research agenda on sports mega­events...

La formación de la agenda consta de un punto de inflexión en la formulación de políticas públicas y la definición de los objetos de la intervención del gobierno. En este sentido, se analizan los temas y las condiciones del agendamiento de los Juegos Rio 2016. La investigación se basa en el estudio documental construido a partir de fuentes institucionales y medios de comunicación impresos, discutido con el apoyo técnico en el análisis de contenido. Fue posible mapear los intereses que permean la candidatura de Río para albergar los Juegos Olímpicos, para identificarlas tendencias en la política deportiva brasileña y discutir las relaciones público privadas en el contexto de la organización de los Juegos, así como la identificación de desafíos para la agenda de investigación en megaeventos deportivos...

Teaching tobacco cessation skills to Uruguayan physicians using information and communication technologies.

INTRODUCTION: Since 2004, with the ratification of the Framework Convention on Tobacco Control, Uruguay has implemented a wide range of legal restrictions designed to reduce the devastating impacts of tobacco. This legal process generated an increase in demand for tobacco cessation treatment, which led to the need to train a large number of physicians. Information and Communication Technologies (ICTs) are evolving constantly, creating new opportunities to make online education more interactive. The evolution of ICTs presents an opportunity to develop innovative continuing medical education (CME) experiences to meet the increasing demand for this topic. METHODS: A blended-learning course on tobacco cessation was developed and implemented, combining face-to-face and online activities. Educational strategy focused on (1) facilitating interaction among generalists and between generalists and experts, and (2) providing high impact CME incorporating multifaceted interventions with wiki-type collaborative construction of practical knowledge. Multiple-choice tests and commitments-to-change were used for evaluation. RESULTS: Three hundred thirty-five health professionals participated in the course. Of these, 145 (43.3%) attended the on-site workshop, 216 (64.5%) participated in the online activities, and 109 (32.5%) completed both phases. Fifty of the 105 (47.6%) participants completing the pretest had a passing score, while 78.1% received a passing score on the final test (p < .001). Differences between mean pretest and posttest scores among those who completed both phases compared with those who only did the online phase were statistically significant (p = .003 and p = .009, respectively). DISCUSSION: The need to train physicians on tobacco cessation skills can be addressed via ICTs and educational activities that include participant interaction.

[AMPK as a cellular energy sensor and its function in the organism]. / La AMPK come un sensor de energía celular y su función en el organismo.

The adenine monophosphate (AMP) activated protein kinase (AMPK), is a heterotrimeric complex that is activated by an increase in the AMP/ATP ratio, and is considered to be a cellular energy sensor that contributes to regulate energy balance and caloric intake. AMPK is activated by LKB1 hinase and it can phophorylate several enzymes involved in anabolism to prevent further ATP consumption, and induces some catabolic enzymes to increase ATP generation. Furthermore, AMPK regulates the expression of genes involved in lipogenesis and mitochondrial biogenesis, among others. AMPK is distributed in most organs including, liver, skeletal muscle, heart and hypothalamus; and even in adipose cells. In addition, AMPK is activated in the hypothalamus stimulating appetite due to energy depletion. AMPK also participates in glycolysis regulation, glucose uptake, lipid oxidation, fatty acid synthesis, cholesterol synthesis and gluconeogenesis, and it has been considered as a possible target enzyme in the treatment of some diseases such as obesity, type 2 diabetes and hepatic steatosis. This review provides a general overview of AMPK structure, its activators and its function in the organism.