When the fever will not stop, stop the pills! A case report

ABSTRACT Neuroleptic malignant syndrome (NMS) is a neurologic emergency potentially fatal. This rare side effect is most commonly associated with first-generation antipsychotics and less frequently with atypical or second-generation antipsychotics. The diagnosis relies on both clinical and laboratory criteria, with other organic and psychiatric conditions being ruled out. CASE REPORT: A 39-year-old female patient, who is institutionalized and completely dependent, has a medical history of recurrent urinary infections and colonization by carbapenem-resistant Klebsiella pneumoniae. Her regular medication regimen included sertraline, valproic acid, quetiapine, risperidone, lorazepam, diazepam, haloperidol, baclofen, and fentanyl. The patient began experiencing dyspnea. Upon physical examination, she exhibited hypotension and a diminished vesicular murmur at the right base during pulmonary auscultation. Initially, after hospitalization, she developed high febrile peaks associated with hemodynamic instability, prompting the initiation of antibiotic treatment. Despite this, her fever persisted without an increase in blood inflammatory parameters, and she developed purulent sputum, necessitating antibiotherapy escalation. The seventh day of hospitalization showed no improvement in symptoms, suggesting NNMS as a differential diagnosis. All antipsychotic and sedative drugs, as well as antibiotherapy, were discontinued, after which the patient showed significant clinical improvement. CONCLUSION: Antipsychotic agents are commonly employed to manage behavioral changes linked to various disorders. However, their severe side effects necessitate a high degree of vigilance, the cessation of all medications, and the implementation of supportive care measures. A prompt and accurate diagnosis of NMS is crucial to alleviating the severe, prolonged morbidity and potential mortality associated with this syndrome.

When the fever will not stop, stop the pills! A case report.

BACKGROUND: Neuroleptic malignant syndrome (NMS) is a neurologic emergency potentially fatal. This rare side effect is most commonly associated with first-generation antipsychotics and less frequently with atypical or second-generation antipsychotics. The diagnosis relies on both clinical and laboratory criteria, with other organic and psychiatric conditions being ruled out. CASE REPORT: A 39-year-old female patient, who is institutionalized and completely dependent, has a medical history of recurrent urinary infections and colonization by carbapenem-resistant Klebsiella pneumoniae. Her regular medication regimen included sertraline, valproic acid, quetiapine, risperidone, lorazepam, diazepam, haloperidol, baclofen, and fentanyl. The patient began experiencing dyspnea. Upon physical examination, she exhibited hypotension and a diminished vesicular murmur at the right base during pulmonary auscultation. Initially, after hospitalization, she developed high febrile peaks associated with hemodynamic instability, prompting the initiation of antibiotic treatment. Despite this, her fever persisted without an increase in blood inflammatory parameters, and she developed purulent sputum, necessitating antibiotherapy escalation. The seventh day of hospitalization showed no improvement in symptoms, suggesting NNMS as a differential diagnosis. All antipsychotic and sedative drugs, as well as antibiotherapy, were discontinued, after which the patient showed significant clinical improvement. CONCLUSION: Antipsychotic agents are commonly employed to manage behavioral changes linked to various disorders. However, their severe side effects necessitate a high degree of vigilance, the cessation of all medications, and the implementation of supportive care measures. A prompt and accurate diagnosis of NMS is crucial to alleviating the severe, prolonged morbidity and potential mortality associated with this syndrome.

Evaluation of the Effects of Radiation Therapy on Muscle Contractibility and Skin Healing: An Experimental Study of the Cancer Treatment Implications.

BACKGROUND: Radiotherapy can affect healthy cells, resulting in side effects. This study aimed to assess the impact of radiotherapy on soft tissue in surgical wounds in rats. METHODS: The animals were divided into four groups: control (S) group without irradiation, immediate irradiation (S-IIr) group receiving irradiation right after surgery, late irradiation (S-LIr) group receiving irradiation four weeks after surgery, and early irradiation (Ir-S) group receiving irradiation before surgery. The irradiated groups underwent two fractional stages of 15 Gy. Muscle contractibility (EMG) was evaluated at two different time points, and after 2 and 7 weeks, the animals were euthanized for histological analysis of the muscles and skin. RESULTS: There was no significant difference between the EMG1 and EMG2 values of the S and S-LIr groups, but both S-IIr and Ir-S groups exhibited a statistically significant difference. The S group demonstrated a larger diameter of muscle fiber compared to other groups, showing a significant difference. In terms of skin analysis, the S-IIr group had the least inflammatory infiltrate and the highest amount of red fibers, differing significantly from the other groups. CONCLUSIONS: Regardless of the duration, radiotherapy was found to have effects on the surrounding soft tissues, as concluded by this study.

Empowering frail older adults: multicomponent elastic-band exercises and BCAA supplementation unleash physical health and preserve haematological biomarkers.

The effectiveness of Branched Chain Amino Acids (BCAAs) supplementation on enhancing exercise performance in both young and older adults remains a topic of debate. Recent research suggests that BCAAs combined with regular exercise might have an impact on human erythropoiesis, blood dynamics, and iron homeostasis. Given the increasing longevity of the global population, it is crucial to investigate the potential benefits of BCAA supplementation and regular exercise as non-pharmacological interventions for improving the overall health of frail older adults. To assess the influence of a 40-week multicomponent exercise intervention (MEP) combined BCCA supplementation on the haematological indicators of frail older adults (83-93 years old) residing in nursing homes. A prospective, naturalistic, controlled clinical trial employing an intervention-washout-intervention was conducted for this purpose. The study included four experimental groups: MEP plus BCAA supplementation (MEP + BCAA, n = 8), MEP only (n = 7), BCAA supplementation only (n = 7), and control group non exercising (CG, n = 13). Fried's physical frailty (PF) protocol was employed to stratify the participants. Additionally, the assessment included the evaluation of nutritional status, comorbidities, and anthropometric measurements. Among the several haematological markers examined, only mean cellular Haemoglobin Concentration (MCH) [F = 4.09; p < 0.03] and Mean Cell haemoglobin Concentration (MCHC) [F = 10, 323; p < 0,0001] showed significant effects of time group. Our findings demonstrate that a long-term intervention with BCAA plus MEP did not lead to significant alterations in the haematological profile. An 8-week withdrawal from interventions did not affect the frailty status in the MEP and MEP + BCAA groups, whereas the control group exhibited an increase in PF status. The findings, demonstrating the potential pro-immune effect and maintenance of MCH and MCHC levels, highlight the relevance of incorporating exercise and nutritional strategies to promote healthy aging. This study contributes to the achievement of the United Nations Sustainable Development Goals 3 (good health and well-being) and 10 (reduced Inequalities) for all.

l-Glutamine supplementation reduces gastrointestinal permeability and biomarkers of physiological stress in preweaning Holstein heifer calves.

l-Glutamine supplementation improves gastrointestinal and immune function in dairy calves during controlled immune and stress challenges. However, it is unknown whether supplementing milk replacer (MR) with l-glutamine improves preweaning dairy calf health and welfare under production conditions. Therefore, the study objective was to evaluate the effects of supplementing MR with l-glutamine on gastrointestinal permeability, immune function, growth performance, postabsorptive metabolic biomarkers, and physiological stress response in preweaning dairy calves. In 3 repetitions, Holstein heifer calves (n = 30; 1.5 ± 0.5 d old; 37.1 ± 0.86 kg body weight) were blocked by serum total protein, body weight, and age, and provided MR (3.8 L/calf per d; 24% CP, 17% fat, 12.5% solids) supplemented with l-glutamine (GLN; 10g/kg MR powder; n = 5 calves/repetition) or nonsupplemented (NSMR; n = 5 calves/repetition). Calves were individually housed with ad libitum starter grain and water access until weaning (56.4 ± 0.5 d old). At 1 and 6 wk of age, urinary catheters were placed, and calves were orally dosed with 1 L of chromium (Cr)-EDTA. Urine samples were collected over a 24-h period for Cr output analysis as an in vivo biomarker of gastrointestinal permeability. Blood was collected on study d 1, 5, 7, 14, 21, 42, and 56 to measure white blood cell counts, cortisol, insulin, glucose, nonesterified fatty acids, serum amyloid A, haptoglobin, and neutrophil: lymphocytes. Two study intervals were used in the statistical analyses, representing greater (P1; wk 1-3) and reduced (P2; wk 4-8) enteric disease susceptibility. Data were analyzed using PROC GLIMMIX in SAS 9.4 (SAS Institute Inc.) with calf as the experimental unit. Overall, total urinary Cr output was reduced in GLN versus NSMR calves. Total Cr output was reduced at 1 wk of age in GLN versus NSMR calves, but no differences were detected at 6 wk of age. Neutrophil:lymphocyte was decreased both overall and during P2 in GLN versus NSMR calves, and neutrophil counts tended to be reduced in GLN versus NSMR calves during P2. No MR treatment differences were detected for average daily feed intake, average daily gain, body measurements, postabsorptive metabolic biomarkers, disease scores, and therapeutic treatments between GLN and NSMR calves. In summary, l-glutamine supplementation reduced gastrointestinal permeability and biomarkers of physiological stress in preweaning Holstein heifer calves.

Increased Risk of American Tegumentary Leishmaniasis in an Urban and Rural Area of Caratinga, Brazil between 2016 and 2021.

We used spatial analysis tools to examine the epidemiological situation and spatial distribution of American tegumentary leishmaniasis in the municipality of Caratinga between 2016 and 2021. In addition, potential sandfly vectors were captured. All information used in this study was retrieved from public health archives and confirmed in the state health services databases. All cases were analyzed using Geographic Information Systems software. In addition, sandfly collections and molecular detection of Leishmania were carried out in areas with the highest number of cases. During the analyzed period, American tegumentary leishmaniasis (ATL) cases increased and remained high in the last years. The hotspots included urban areas of Caratinga city and the districts of Patrocínio of Caratinga and Sapucaia. The species Nyssomyia whitmani, Nyssomyia intermedia, and Migonemyia migonei were the most abundant species and the ITS1-polymerase chain reaction technique detected Leishmania DNA in these species. On the basis of our analyses, the urbanization of ATL in Caratinga has taken place in recent years. Because of the increase in the number of human cases and the presence of vectors, it is recommended that health authorities focus on control measures in hotspots.

Salivary Markers Responses in the Post-Exercise and Recovery Period: A Systematic Review.

The use of saliva to monitor immune and hormonal responses in training, competitions, and during recovery is an easy and non-invasive alternative means of collecting samples compared to serum collection. Saliva can provide insight into a number of interesting biomarkers such as cortisol, testosterone, immunoglobulins, alpha-amylase, and melatonin, among others. High-intensity and exhaustive exercises, such as training or competition, provide variations in immune, protein and hormonal markers. An adequate recovery period, calming down, and recovery methods can contribute to a fast normalization of these markers, decreasing illness, as well as the likelihood of overtraining and injuries, but their effectiveness is still inconclusive. The aim of this review was to investigate the evidence of salivary markers in post-exhaustive exercise during the recovery period. This study is a systematic review from three electronic databases with studies from 2011 to 2021 within healthy humans. The search found 213 studies, and after applying the inclusion and exclusion criteria, while excluding duplicated studies, 14 studies were included in this review. The most cited salivary markers were cortisol and testosterone, as well as their ratio, alpha-amylase and IgA. Half of the studies applied a variety of recovery methods that showed controversial results over salivary markers' impact. However, they showed an impact on the markers from the exercise, which was still dependent on exercise intensity, methodology, and duration.

Forecasting study of food-related patents protected by the University of Brasilia, Brazil: Case study.

Patents are important tools to protect innovations in the food industry. They are also indicators of the research and development of an institution. Universities play a significant role in generating and developing innovative technologies. Center for Support to Technological Development (CDT is the Technological innovation center (NIT) that is responsible for protecting the technologies developed by the academic community of the University of Brasilia (UnB). This case study analyzes the patents and patent applications related to food deposited by the UnB. For this purpose, a search was conducted on the National Institute of Industrial Property (INPI) institutional page through the patent database. The results show diverse applications to the food area that are mainly related to biotechnology. Half of the protections are still in progress in the INPI workflow. The requirements issued were primarily related to national genetic heritage. Archiving processes were identified due to non-payment, but we highlighted that it could be a strategic decision of NIT/CDT. Rejections were mainly related to the lack of novelty or inventive steps. Currently, two food-related patents are in force that took, on average, nine and a half years to be granted. Although UnB exclusively owns the majority, the results also evidence co-ownership with other universities and companies. Finally, this study highlights possible partnerships between UnB and the food industry through technology transfer. The technology transfer indicators pointed out that UnB has expertise in this area and that there is a potential to be explored. These results contribute to strategic decision-making in developing new technologies related to food and nutrition and their transfer to society. The scale-up and the increased degree of maturity require greater interaction with the productive sector to ensure the transfer of technology for innovation arising from the research conducted at UnB.

Relationship between calcium dynamics and inflammatory status in the transition period of dairy cows.

Improvements in nutrition, management, and genetics of dairy cows over the last several decades have shifted research focus from clinical diseases to subclinical disorders, to which transition cows are particularly vulnerable. Recent studies on the characterization of subclinical hypocalcemia (SCH) indicate that the combined analysis of the degree, timing of suboptimal blood Ca concentration, and duration are most reflective of the disorder. Therefore, the understanding of blood Ca dynamics in early postpartum cows has emerged as an avenue to investigate the paths leading to a successful metabolic adaptation to lactation or not. The conundrum has been in defining whether SCH is the cause or a reflection of a greater underlying disorder. Immune activation and systemic inflammation have been proposed to be the root cause of SCH. However, there is a paucity of data investigating the mechanisms of how systemic inflammation can lead to reduced blood Ca concentration in dairy cows. The objective of this review is to discuss the links between systemic inflammation and reduced blood Ca concentration, and studies needed to advance knowledge on the interface between systemic inflammation and Ca metabolism for the transition dairy cow.

Diferenças clínicas, radiológicas e espirométricas entre os pacientes póscovid- 19 estratificados de acordo com a gravidade inicial da doença / Clinical, radiological and spirometric differences between post-covid-19 patients stratified according to initial disease severity

Introdução: em março de 2020, a pandemia do SARS-CoV-2 foi declarada pela OMS, contabilizando mais de seis milhões de mortes e 600 milhões de casos confirmados. São necessários estudos para compreender a persistência dos sintomas após a infecção aguda, que podem se correlacionar com a gravidade inicial da doença. Objetivo: avaliar e comparar as características clínicas, espirométricas e radiológicas dos pacientes acometidos pela síndrome pós-COVID, estratificados conforme gravidade da infecção aguda pelo SARS-CoV-2. Metodologia: trata-se de estudo de corte transversal, realizado a partir de consultas ambulatoriais em amostra de conveniência. O estudo incluiu 232 pacientes, atendidos de novembro de 2020 a outubro de 2021. Os pacientes foram divididos em 2 grupos: com COVID-19, sem internamento em unidade de terapia intensiva; e com internamento em unidade de terapia intensiva. Resultados: foram avaliados 232 pacientes acometidos pela COVID-19, sendo 69,4% do sexo feminino; idade média de 50 ± 12,8 anos. As comorbidades mais frequentes foram hipertensão arterial sistêmica (44,0%) e diabetes mellitus (21,1%). Dos pacientes estudados, 45,7% foram internados durante a fase aguda da doença, sendo que cinquenta (21,6%) foram alocados em unidade de terapia intensiva (UTI). Em relação à espirometria, o padrão de distúrbio restritivo foi verificado apenas nos pacientes internados em UTI. Na tomografia de tórax, o padrão de pneumonia em organização foi associado a pacientes que precisaram de internamento em unidade de terapia intensiva. Conclusão: este estudo evidencia que o distúrbio ventilatório restritivo e a presença de pneumonia em organização tiveram associação com quadros iniciais mais graves.

Introduction: in March 2020, the SARS-CoV-2 pandemic was declared by the WHO, accounting for more than six million deaths and 600 million confirmed cases. Studies are required to understand the persistence of symptoms after acute infection, which may correlate with the initial severity of the disease. Objective: to evaluate and compare the clinical, spirometric and radiological characteristics of patients affected by the post-COVID syndrome, stratified according to the severity of the acute infection by SARS-CoV-2. Methodology: this is a cross-sectional study, carried out from outpatient consultations in a convenience sample. The study included 232 patients, seen from November 2020 to October 2021. Patients were divided into 2 groups: with COVID-19, without admission to an intensive care unit; and with admission to the intensive care unit. Results: 232 patients affected by COVID-19 were evaluated, 69.4% of whom were female; average age of 50 ± 12.8 years. The most common comorbidities were systemic arterial hypertension (44.0%) and diabetes mellitus (21.1%). Of the patients studied, 45.7% were hospitalized during the acute phase of the disease, and fifty (21.6%) were allocated to an intensive care unit (ICU). Regarding spirometry, the pattern of restrictive disorder was verified only in patients admitted to the ICU. On chest tomography, the pattern of organizing pneumonia was associated with patients who required admission to the intensive care unit. Conclusion: this study shows that restrictive ventilatory disorder and the presence of organizing pneumonia were associated with more severe initial conditions.

The association of hyperketonemia with fecal and rumen microbiota at time of diagnosis in a case-control cohort of early lactation cows.

BACKGROUND: Many dairy cows experience a state of energy deficit as they transition from late gestation to early lactation. The aims of this study were to 1) determine if the development of hyperketonemia in early lactation dairy cows is indicated by their gut microbiome, and 2) to identify microbial features which may inform health status. We conducted a prospective nested case-control study in which cows were enrolled 14 to 7 days before calving and followed through their first 14 days in milk (DIM). Hyperketonemic cows (HYK, n = 10) were classified based on a blood ß-hydroxybutyrate (BHB) concentration 1.2 mmol/L within their first 14 DIM. For each HYK cow, two non-HYK (CON, n = 20) cows were matched by parity and 3 DIM, with BHB < 1.2 mmol/L. Daily blood BHB measures were used to confirm CON cows maintained their healthy status; some CON cows displayed BHB 1.2 mmol/L after matching and these cows were reclassified as control-HYK (C-HYK, n = 9). Rumen and fecal samples were collected on the day of diagnosis or matching and subjected to 16S rRNA profiling. RESULTS: No differences in taxa abundance, or alpha and beta diversity, were observed among CON, C-HYK, and HYK health groups for fecal microbiomes. Similar microbiome composition based on beta diversity analysis was detected for all health statuses, however the rumen microbiome of CON and HYK cows were found to be significantly different. Interestingly, highly similar microbiome composition was observed among C-HYK cow rumen and fecal microbiomes, suggesting that these individual animals which initially appear healthy with late onset of hyperketonemia were highly similar to each other. These C-HYK cows had significantly lower abundance of Ruminococcus 2 in their rumen microbiome compared to CON and HYK groups. Multinomial regressions used to compute log-fold changes in microbial abundance relative to health status were not found to have predictive value, therefore were not useful to identify the role of certain microbial features in predicting health status. CONCLUSIONS: Lower relative abundance of Ruminococcus 2 in C-HYK cow rumens was observed, suggesting these cows may be less efficient at degrading cellulose although the mechanistic role of Ruminococcus spp. in rumen metabolism is not completely understood. Substantial differences in fecal or rumen microbiomes among cows experiencing different levels of energy deficit were not observed, suggesting that hyperketonemia may not be greatly influenced by gut microbial composition, and vice versa. Further studies using higher resolution -omics approaches like meta-transcriptomics or meta-proteomics are needed to decipher the exact mechanisms at play.

Technical Note: A procedure to place urinary catheters in 1- and 6-week-old preweaned Holstein heifer calves for the in vivo evaluation of intestinal permeability.

Oral administration of indigestible markers and subsequent urine collection is a useful method to determine in vivo gastrointestinal tract (GIT) permeability in cattle for research purposes. However, urine sampling techniques often rely on total waste collection, which reduces the ability to perform more frequent sampling and obtain accurate volumes and sterile samples. An alternative is urethral catheterization, though the feasibility of this technique has not been thoroughly tested in preweaned Holstein heifer calves. The study objective was to develop a urethral catheter placement procedure in preweaned Holstein heifer calves for continuous and accurate urine collection to evaluate GIT permeability using an indigestible marker. Fifteen Holstein heifer calves had catheters placed at approximately 1 wk (8.0 ± 1.5 d) and 6 wk (40.0 ± 1.5 d) of age. During the procedure, calves were individually housed and restrained. The vulva was sterilized and then a sterile, lubricated speculum was inserted into the vagina. A sterile 0.09 cm diameter guidewire was guided into a lubricated, sterile 10 French Foley catheter. The catheter was inserted at approximately 5 through 7 cm into the urethral opening, guided into the bladder, and the catheter balloon was filled with 10 mL of water. The guidewire was removed, and urine flow confirmed correct placement before a 4-L urinary drainage bag was attached to the catheter. After catheterization (24 h), 1 L of chromium (Cr)-ethylenediaminetetraacetic acid was orally dosed to the calves. Calf health observations were made six times over a 48-h period, and any occurrence of vaginal discharge, tissue discharge in catheter, bleeding, inflammation, or abnormal urine was considered a localized reaction. The proportion of localized reactions for each age group was determined using Microsoft Excel, and the total Cr output was analyzed using PROC GLIMMIX. Localized reactions occurred for 20.0% of the 1-wk-old calves and 13.3% of the 6-wk-old calves. In the first 4 h, urine was collected every 15 min, and there were no overall Cr output differences (P = 0.38; 10.28 ± 3.21 mg Cr) when comparing 1- and 6-wk-old calves. However, 1-wk-old calves tended (P = 0.08) to have greater overall Cr output at 480 min (19.2%) and 1,440 min (41.9%) when compared with 6-wk-old calves. In summary, urinary catheterization is a viable urinary collection method for the determination of in vivo GIT permeability in preweaned Holstein heifer calves.

Neonatal calves are highly susceptible to enteric disease during their first few weeks of life, and enteric disease is the leading cause of preweaning morbidity and mortality. A consequence of enteric disease is greater gastrointestinal tract (GIT) permeability in neonatal calves, which is also influenced by reduced intestinal maturity and environmental factors. Therefore, an accurate and precise method of evaluating GIT permeability in neonatal calves is necessary to develop appropriate treatment and mitigation strategies. The oral administration of indigestible markers and measurement of their presence in urine is an accepted method to determine the total GIT permeability in mature heifers. However, current urine collection methods in preweaned heifer calves may not be reliable. Therefore, the study objective was to develop a urinary catheterization method to collect urine accurately and precisely for the in vivo determination of GIT permeability in 1- and 6-wk-old Holstein heifer calves. It was determined that the urinary catheterization procedure and collection system developed in this study were viable and could be applied when evaluating GIT permeability in preweaned Holstein heifer calves using orally dosed indigestible markers.

Iron rich self-assembly micelles on the Doce River continental shelf.

After the Fundão iron ore mining dam rupture in November 2015, yellow/ocher emulsions never before reported on the continental shelf adjacent to the Doce River began to be seen, both in coalesced and foam forms. XRD analyses pointed to a prevailing composition of iron and kaolinite with a substantial contribution of an organic-metallic compound, measured in multiple periods over 2 years of sampling. Optical microscopy images allowed the identification of micelles composed of nanoparticles of iron oxyhydroxide making up this emulsion. The generation of dendritic snowflake-shaped microcrystals on fiber filters after water sample filtration and heating confirmed the presence of micelles composed of iron oxyhydroxide nanoparticles enveloped by organic polymers. After losing water, the micelles may act as a self-assembly template seed, where the polymer acts in the oriented adsorption of nanoparticles according to their crystallographic structure. The study brought to light the distinct behavior of a portion of the tailings material, which has already been reported to not have the same flocculation process as the clay minerals previously found in the suspended particulate material (SPM) before the dam rupture.

A Randomized Clinical Trial Evaluating the Effect of an Oral Calcium Bolus Supplementation Strategy in Postpartum Jersey Cows on Mastitis, Culling, Milk Production, and Reproductive Performance.

The objectives of this study were to evaluate the effects of a postpartum oral calcium supplementation strategy in multiparous Jersey cows on (1) the odds of clinical mastitis in the first 60 days in milk (DIM); (2) the odds of culling up to 60 DIM; (3) the risk of pregnancy in the first 150 DIM; (4) milk production in the first 15 weeks of lactation. A randomized clinical trial was performed in a dairy herd located in west Texas, United States. A total of 809 cows were used in the final analyses. Overall, postpartum oral calcium supplementation did not influence milk production, reproductive performance, or culling. Among second parity cows, oral calcium supplementation tended to decrease the odds of clinical mastitis in the first 60 DIM compared to controls; however, no differences were observed for cows in parities three and greater. To date, data evaluating the effect of postpartum oral calcium supplementation in multiparous Jersey cows are limited. In our study, oral calcium supplementation tended to reduce clinical mastitis in second parity cows. No positive benefits based on the reduction of culling, and improvement of milk production and reproductive performance were evident for the herd included in this study.

A follow-up study (2007-2018) on American Tegumentary Leishmaniasis in the municipality of Caratinga, Minas Gerais State, Brazil: Spatial analyses and sand fly collection.

BACKGROUND: The municipality of Caratinga is an important endemic area for American Tegumentary Leishmaniasis (ATL) and no epidemiological studies were performed during the past two decades. Here, we analyzed the epidemiological situation and the geographical distribution of ATL cases in the municipality of Caratinga from 2007 to 2018 using geographic information systems (GIS). Also, we evaluated the impact of several demographic parameters in ATL distribution and the sand flies incriminated in its transmission. METHODS: All demographic information (gender, age, educational level, clinical form, diagnostic criteria and case evolution) used in this study was retrieved from the public health archives and confirmed in the State Health Services databases. All cases were analyzed using GIS software based on ATL distribution. Also, non-systematic sand fly collections and molecular detection of Leishmania were performed in the hotspots. RESULTS AND CONCLUSIONS: During the period, ATL cases continued and increased especially in the past years (2016-2018). Hotspots included urban Caratinga areas and the districts of Patrocínio de Caratinga and Sapucaia. The species Nyssomyia whitmani, Nyssomyia intermedia, Migonemyia migonei and Evandromyia cortelezzii complex were captured. However, ITS1-PCR did not detect Leishmania DNA in those insects. Based on our analyses, urbanization of ATL in Caratinga has occurred in the past years. Due to the increase in the number of cases and vectors presence, it is recommended that health authorities focus on control measures in the most affected areas (Patrocínio of Caratinga and Sapucaia districts and urban Caratinga).

Effect of Training-Detraining Phases of Multicomponent Exercises and BCAA Supplementation on Inflammatory Markers and Albumin Levels in Frail Older Persons.

Nowadays, it is accepted that the regular practice of exercise and branched-chain amino acids supplementation (BCAAs) can benefit the immune responses in older persons, prevent the occurrence of physical frailty (PF), cognitive decline, and aging-related comorbidities. However, the impact of their combination (as non-pharmacological interventions) in albumin and the inflammatory markers is not fully understood. Therefore, we investigated the effect of a 40-week multifactorial intervention [MIP, multicomponent exercise (ME) associated or not with BCAAs] on plasma levels of inflammatory markers and albumin in frail older persons (≥75 years old) living at residential care homes (RCH). This study consisted of a prospective, naturalistic, controlled clinical trial with four arms of multifactorial and experimental (interventions-wahshout-interventions) design. The intervention groups were ME + BCAAs (n = 8), ME (n = 7), BCAAs (n = 7), and control group (n = 13). Lower limb muscle-strength, cognitive profile, and PF tests were concomitantly evaluated with plasma levels of albumin, anti- and pro-inflammatory cytokines [Interleukin-10 (IL-10) and Tumor Necrosis Factor-alpha (TNF-α) respectively], TNF-α/IL-10 ratio, and myeloperoxidase (MPO) activity at four different time-points: Baseline (T1), after 16 weeks of multifactorial intervention (T2), then after a subsequent 8 weeks washout period (T3) and finally, after an additional 16 weeks of multifactorial intervention (T4). Improvement of cognitive profile and muscle strength-related albumin levels, as well as reduction in the TNF-α levels were found particularly in ME plus BCAAs group. No significant variations were observed over time for TNF-α/IL-10 ratio or MPO activity. Overall, the study showed that MIP triggered slight alterations in the inflammatory and physical function of the frail older participants, which could provide independence and higher quality of life for this population.

Aceitação entre estudantes do ensino básico do desenho animado O X na Xistose para construção de conhecimentos sobre esquistossomose / Acceptance of the cartoon O X na Xistose for the knowledge construction about schistosomiasis among middle school students / Aceptación entre estudiantes del ciclo básico de lo dibujo animado O X na Xistose para el desarrollo del conocimiento sobre la esquistosomiasis

O trabalho dos educadores pode ser enriquecido com o uso de recursos pedagógicos importantes no processo de ensino e aprendizagem. Considerando este aspecto, uma animação baseada no livro O feitiço da lagoa, de Virginia Schall, que trata do tema esquistossomose foi construída para estimular o conhecimento sobre a doença entre escolares e exibida para alunos do ensino básico em quatro municípios endêmicos: Jaboticatubas, Malacacheta e Santa Luzia, em Minas Gerais; e João Pessoa, na Paraíba. Após sua exibição, um questionário foi aplicado com a finalidade de verificar a aceitação e o entendimento do material. De acordo com as respostas, o desenho animado apresentou boa aceitação. Todos identificaram a esquistossomose como a doença retratada e o caramujo como o transmissor do esquistossomo. Os resultados apontaram que o desenho pode ser um importante recurso pedagógico no processo educativo, auxiliando os programas de controle da endemia, especialmente quando desenvolvidos no espaço escolar.

The educators' work can be enriched with the use of pedagogical resources which are important in the teaching and learning process. With this aspect in mind, a cartoon with the theme schistosomiasis was created, so as to promote knowledge about the disease among middle school students, and exhibited in four endemic municipalities - Jaboticatubas, Malacacheta and Santa Luzia in the state of Minas Gerais; and João Pessoa in the state of Paraíba. The animation was based on the book O feitiço da lagoa by Virginia Schall and it was shown to students in those four towns. A questionnaire was answered by them after the respective exhibitions in order to verify the acceptance and understanding of the material that was shown. According to the responses, the cartoon presented good acceptance. Everyone identified schistosomiasis as the disease displayed, and the snail that transmits the schistosome. The results showed that the cartoon can be an important pedagogical resource in the educational process, helping endemic control programs, especially when these programs are developed in the school environment.

El trabajo de los educadores puede ser enriquecido con el uso de recursos pedagógicos importantes en el proceso de enseñanza y aprendizaje. Considerando este aspecto, un dibujo animado sobre el tema esquistosomiasis fue realizado para estimular el conocimiento, entre estudiantes del ciclo básico, acerca de la enfermedad y exhibido en cuatro municipios endémicos: Jaboticatubas, Malacacheta y Santa Luzia en Minas Gerais; y João Pessoa en Paraíba. La animación fue basada en el libro O feitiço da lagoa de Virginia Schall y fue mostrada a alumnos en las cuatro localidades. Un cuestionario fue aplicado, después de cada proyección, con la finalidad de verificar la aceptación y el entendimiento del material exhibido. De acuerdo con las respuestas, el dibujo tuvo buena aceptación. Todos identificaron la esquistosomiasis como la enfermedad retratada y el caracol como el transmisor del esquistosoma. Los resultados indicaran que el dibujo animado puede ser un importante recurso pedagógico en el proceso educativo, auxiliando a los programas de control de la endemia, especialmente cuando desarrollados en el espacio escolar.

The Effect of Metaphylactic Use of Tildipirosin for the Control of Respiratory Disease in Long-Distance Transported Dairy Calves.

The objective of this study was to evaluate the efficacy of two metaphylactic strategies using tildipirosin for the control of bovine respiratory disease (BRD) in dairy calves transported to a heifer raising facility within their first week of life. A total of 2,100 calves were enrolled in the study. Animals were transported for ~1,715 km, from dairies located in Minnesota to a calf raising facility located in New Mexico, where they were housed in individual hutches until weaning. Three days after arrival, calves were randomly allocated into three groups: (1) META1: single subcutaneous (SQ) injection of tildipirosin (Zuprevo™, Merck Animal Health) at enrollment at 4 mg/kg; (2) META2: SQ injection of tildipirosin at enrollment and 17 days later; (3) CON: untreated controls. The BRD incidence was 11.4, 10.8, and 9.4% for calves enrolled in the CON, META1, and META2, respectively (P = 0.44). Lung lesions diagnosed through ultrasonography was found in 21.0, 21.0, and 21.8% of calves enrolled in CON, META1, and META2, respectively (P = 0.99). Mortality tended to be greater for CON calves in comparison to META2 calves (1.5 vs. 0.6%, P = 0.06), but did not differ between calves enrolled in CON and META1 groups (1.5 vs. 1.2%, P = 0.55). Growth was not affected by metaphylaxis. The average daily gain for calves enrolled in CON, META1, and META2 was 517, 518 and 525 g, respectively (P = 0.25). Blood analysis revealed that some of the markers of inflammation assessed were influenced by metaphylaxis. At 27 days after enrollment, META2 calves had decreased concentrations of haptoglobin, serum amyloid A, and aspartate aminotransferase, compared to CON calves (P < 0.05). Additionally, CON calves had increased concentrations of globulins and lower albumin to globulin ratio than META2 calves at the end of the weaning period (P < 0.05). In conclusion, tildipirosin metaphylaxis did not decrease the incidence of BRD nor did it have an impact on weight gain. However, metaphylaxis with two injections of tildipirosin at enrollment and 17 days later tended to reduce mortality and improved the systemic inflammatory status of calves during the preweaning period.

The Effects of Concurrent Training Combining Both Resistance Exercise and High-Intensity Interval Training or Moderate-Intensity Continuous Training on Metabolic Syndrome.

To date, there are several knowledge gaps on how to properly prescribe concurrent training to achieve the best dose-response, especially regarding the optimal intensity or volume of the aerobic component. Thus, the objective of this study is to analyze the effects of different aerobic exercise modes and intensities [i.e. aerobic high-intensity interval training (HIIT) versus moderate-intensity continuous aerobic training (MICT) combined with a resistance training (RT) program] on metabolic outcomes in participants with metabolic syndrome (MetS). Thirty-nine men and women (67.0 ± 6.7 years) volunteered to a 12-weeks exercise intervention (3 week-1, 50 min/session) and were randomly assigned to one of three groups: (a) RT plus MICT (RT+MICT) (2 males; 11 females); (b) RT plus HIIT (RT+HIIT) (4 males; 9 females); and (c) control group (CON) - without formal exercise (4 males; 9 females). Intensity was established between 60 and 70% of maximum heart rate (HRmax) in RT+MICT and ranged from 55-65% to 80-90% HRmax in the RT+HIIT group. Dependent outcomes included morphological, metabolic and hemodynamic variables. Both training groups improved waist circumference (RT+MICT: P = 0.019; RT+HIIT: P = 0.003), but not body weight, fat mass or fat-free mass (P ≥ 0.114). RT+HIIT group improved fasting glucose (P = 0.014), low density lipoprotein [LDL (P = 0.022)], insulin (P = 0.034) and homeostatic model assessment (P = 0.028). RT+MICT group reduced triglycerides (P = 0.053). Both exercise interventions did not change high sensitivity C-reactive protein, glycated hemoglobin, high density lipoprotein and total cholesterol, systolic, diastolic or mean arterial blood pressure (P ≥ 0.05). The CON group reduced the LDL (P = 0.031). This trial suggests that short-term exercise mode and intensity may differently impact the metabolic profile of individuals with MetS. Further, our data suggests that both concurrent trainings promote important cardiometabolic gains, particularly in the RT+HIIT. Nonetheless, due to the small-to-moderate effect size and the short-term intervention length, our data suggests that the intervention length also has an important modulating role in these benefits in older adults with MetS. Therefore, more research is needed to confirm our results using longer exercise interventions and larger groups.

Systemic and local effects of radiotherapy: an experimental study on implants placed in rats.

OBJECTIVES: Evaluate the modulating effect of ionizing radiation, blood cytokine levels, and bone remodeling of the interface around the implant to understand the radiation mechanisms which can impair the implants receptor site. MATERIAL AND METHODS: Sixty rats were submitted to grade V titanium implants in the femurs and were divided into the following groups: no-irradiation (N-Ir): control group with implant only; early-irradiation (E-Ir): implant + irradiation after 24 h; late-irradiation (L-Ir): implant + irradiation after 4 weeks; and previous-irradiation (P-Ir): irradiation + implant after 4 weeks. The animals in the E-Ir, L-Ir, and P-Ir groups were irradiated in two fractional stages of 15 Gy. At 3 days, 2 weeks, and 7 weeks after the final procedure, five animals were randomly euthanized per group. Serum levels of TNF-ɑ, IL-1ß, TGF-ß, IL-6, M-CSF, and IL-10 were measured from blood collected prior to euthanasia using the ELISA test. The pieces containing the implants were subjected to immunohistochemical labeling using the tartrate acid resistant to phosphatase, osteocalcin, and caspase-3 markers and mCT. The ANOVA test was used for statistical analysis, and the Tukey multiple comparison test (p < 0.05) was applied. RESULTS: The results indicated that ionizing radiation modifies the production of pro- and anti-inflammatory serum cytokines, the expression of proteins involved in bone remodeling and cellular apoptosis, as well as changes in bone formation. CONCLUSIONS: The results suggests that a longer period between radiotherapy and implant placement surgery when irradiation occurs prior to implant installation would allow the recovery and renewal of bone cells and avoid future failures in osseointegration. CLINICAL RELEVANCE: The search for modifications caused by ionizing irradiation in bone tissue can indicate the ideal period for implant placement without affecting the osseointegration process.