Spontaneous Splenic Rupture Unveiled: A Non-traumatic Case Associated With Infective Endocarditis.

Spontaneous splenic rupture (SSR) is a rare and potentially life-threatening condition often associated with trauma. However, SSR can occur without evident trauma, presenting unique diagnostic challenges. We present a case report of a 32-year-old postpartum female who experienced sudden-onset abdominal pain and was diagnosed with SSR. Despite the absence of trauma, she exhibited hypovolemic shock, requiring rapid intervention. Diagnostic imaging, including CT scans, revealed a substantial splenic laceration, which led to an emergent splenectomy. The patient's postoperative course was complicated by infective endocarditis (IE) with aortic involvement, elucidated as the underlying cause of SSR. The patient underwent aortic valve replacement, received antibiotic therapy, and achieved a successful recovery. This case underscores the importance of early recognition, timely intervention, and collaboration among diverse medical specialties in managing SSR cases. Furthermore, it highlights the potential link between SSR and IE, emphasizing the meaning of considering infectious etiologies even in non-traumatic scenarios. Early identification of the underlying cause is crucial for effective management and positive patient outcomes in cases of SSR.

Tracking Bacterial Nanocellulose in Animal Tissues by Fluorescence Microscopy.

The potential of nanomaterials in food technology is nowadays well-established. However, their commercial use requires a careful risk assessment, in particular concerning the fate of nanomaterials in the human body. Bacterial nanocellulose (BNC), a nanofibrillar polysaccharide, has been used as a food product for many years in Asia. However, given its nano-character, several toxicological studies must be performed, according to the European Food Safety Agency's guidance. Those should especially answer the question of whether nanoparticulate cellulose is absorbed in the gastrointestinal tract. This raises the need to develop a screening technique capable of detecting isolated nanosized particles in biological tissues. Herein, the potential of a cellulose-binding module fused to a green fluorescent protein (GFP-CBM) to detect single bacterial cellulose nanocrystals (BCNC) obtained by acid hydrolysis was assessed. Adsorption studies were performed to characterize the interaction of GFP-CBM with BNC and BCNC. Correlative electron light microscopy was used to demonstrate that isolated BCNC may be detected by fluorescence microscopy. The uptake of BCNC by macrophages was also assessed. Finally, an exploratory 21-day repeated-dose study was performed, wherein Wistar rats were fed daily with BNC. The presence of BNC or BCNC throughout the GIT was observed only in the intestinal lumen, suggesting that cellulose particles were not absorbed. While a more comprehensive toxicological study is necessary, these results strengthen the idea that BNC can be considered a safe food additive.

Corema album spp: Edible wild crowberries with a high content in minerals and organic acids.

Edible wild plants are part of the ethnobotanical and gastronomic heritage of different geographical areas. Corema album (L.) D. Don is an endemic species of the dune systems of the Atlantic coast of the Iberian Peninsula. The aerial parts of Corema album are a source of nutrients and antioxidants. The Corema album white berry (Portuguese crowberry) is rich in calcium, iron, and zinc. The plant also shows high phenolic content and antioxidant capacity associated with the leaves, fruit, and flowers. The presence of organic acids, namely phenolic acids, such as hydroxycinnamic acids, and long chain polyunsaturated fatty acids (PUFAs) omega-3 and omega-6 has also been confirmed. Toxicity studies evaluated by cell viability tests with human intestinal epithelium model cells (Caco-2) have shown that, at low concentrations, plant extracts may present beneficial effects.

Using Artificial Intelligence for Pattern Recognition in a Sports Context.

Optimizing athlete's performance is one of the most important and challenging aspects of coaching. Physiological and positional data, often acquired using wearable devices, have been useful to identify patterns, thus leading to a better understanding of the game and, consequently, providing the opportunity to improve the athletic performance. Even though there is a panoply of research in pattern recognition, there is a gap when it comes to non-controlled environments, as during sports training and competition. This research paper combines the use of physiological and positional data as sequential features of different artificial intelligence approaches for action recognition in a real match context, adopting futsal as its case study. The traditional artificial neural networks (ANN) is compared with a deep learning method, Long Short-Term Memory Network, and also with the Dynamic Bayesian Mixture Model, which is an ensemble classification method. The methods were used to process all data sequences, which allowed to determine, based on the balance between precision and recall, that Dynamic Bayesian Mixture Model presents a superior performance, with an F1 score of 80.54% against the 33.31% achieved by the Long Short-Term Memory Network and 14.74% achieved by ANN.

Prevalence of Hypersensitivity in Teeth Affected by Molar-Incisor Hypomineralization (MIH).

AIM: This study aimed to investigate the prevalence of hypersensitivity in molar-incisor hypomineralization (MIH)-affected molars through a census carried out in 8-year-old schoolchildren. METHODS: Examinations were conducted by a calibrated examiner, using the Nyvad criteria for caries diagnosis and a new criterion for MIH assessment. For hypersensitivity assessment, all MIH-affected molars were included. Nonaffected molars from the same child were used as controls. Air blast reaction was measured using the Visual Analogue Scale (VAS) and the Schiff Cold Air Sensitivity Scale (SCASS) scale, while tactile hypersensitivity was scored using VAS only. Statistical analysis was performed using the Kruskal-Wallis test followed by Dunn's multiple comparisons test for quantitative data. χ2 was used for the comparison of categorical data. RESULTS: In total, 631 children were assessed, of whom 102 had MIH-affected molars (16.1%). Of these, 51.7 and 8.7% presented enamel and dentin carious lesions, respectively. Regarding the number of teeth, 239 molars were MIH affected (59.8%), with 188 (78.7%) being classified as mild (opacities only), 20 (8.4%) as moderate (posteruptive enamel breakdown), and 31 (13%) as severe (posteruptive breakdown involving dentin/atypical restorations). Hypersensitivity was recorded in only one control molar, while the prevalence of hypersensitivity in MIH-affected molars was 34.7%, being of low intensity and more prevalent in moderate (55%) and severe cases (51.6 %) than in mild cases (29.8%, p = 0.008). An association between hypersensitivity and the presence of mild and moderate cases was observed. Although the same association was observed for severe cases, it was not considered a reliable information as 90% of the MIH-affected molars with posteruptive breakdown involving dentin were affected by carious lesions. It is known that dental caries is a confounding factor for the presence of hypersensitivity. CONCLUSIONS: Hypersensitivity was significantly higher in MIH-affected molars than in nonaffected molars, being associated with MIH teeth presenting opacities and posteruptive enamel breakdown.

Response surface statistical optimization of bacterial nanocellulose fermentation in static culture using a low-cost medium.

This work aimed at the optimization of bacterial nanocellulose (BNC) production by static culture, using Komagataeibacter xylinus BPR 2001 (K. xylinus). Response surface methodology - central composite design was used to evaluate the effect of inexpensive and widely available nutrient sources, namely molasses, ethanol, corn steep liquor (CSL) and ammonium sulphate, on BNC production yield. The optimized parameters for maximum BNC production were % (m/v): molasses 5.38, CSL 1.91, ammonium sulphate 0.63, disodium phosphate 0.270, citric acid 0.115 and ethanol 1.38% (v/v). The experimental and predicted maximum BNC production yields were 7.5 ± 0.54 g/L and 6.64 ± 0.079 g/L, respectively and the experimental and predicted maximum BNC productivity were 0.829 ± 0.046 g/L/day and 0.734 ± 0.079 g/L/day, after 9 days of static culture fermentation, at 30 °C. The effect of surface area and culture medium depth on production yield and productivity were also studied. BNC dry mass production increased linearly with surface area, medium depth and fermentation time. So long as nutrients were still available in the culture media, BNC mass productivity was constant. The results show that a high BNC production yield can be obtained by static culture of K. xylinus BPR 2001 using a low-cost medium. These are promising conditions for the static industrial scale BNC production, since as compared to agitated bioreactors, higher productivities may be reached, while avoiding high capital and operating costs.

A Review on the toxicology and dietetic role of bacterial cellulose.

Bacterial cellulose (BC) is a biopolymer synthesized by certain acetic acid bacteria strains. The safety of BC regarding its potential use in food applications is here reviewed. The acute, sub-acute and subchronic oral toxicity assays showed that consumption of BC had no adverse effects in rats. Several studies demonstrated that BC is not genotoxic, did not induce chromosomal aberrations in CHO cells under both non-activating and metabolic activating conditions, is inactive in the in vitro Rat Primary Hepatocyte Unscheduled DNA Synthesis Assay, had no reproductive toxicity in mice and exerted no embryotoxicity and teratogenicity effects in rats. Several studies on the BC in biomedical applications further reinforces its safety: a primary eye and dermal irritation studies in the rabbit showed that BC was non-irritating. The inflammatory reaction to subcutaneously implanted BC has been evaluated in animal models and for different periods of time, demonstrating that BC is biocompatible and does not trigger a harsh inflammatory reaction. Altogether, and considering its longstanding history of human consumption in Asian countries, as well as its utilization in biomedical devices, it may be concluded that BC is safe for applications in food technology.

Celluclast and Cellic® CTec2: Saccharification/fermentation of wheat straw, solid-liquid partition and potential of enzyme recycling by alkaline washing.

The hydrolysis/fermentation of wheat straw and the adsorption/desorption/deactivation of cellulases were studied using Cellic(®) CTec2 (Cellic) and Celluclast mixed with Novozyme 188. The distribution of enzymes - cellobiohydrolase I (Cel7A), endoglucanase I (Cel7B) and ß-glucosidase - of the two formulations between the residual substrate and supernatant during the course of enzymatic hydrolysis and fermentation was investigated. The potential of recyclability using alkaline wash was also studied. The efficiency of hydrolysis with an enzyme load of 10 FPU/g cellulose reached >98% using Cellic(®) CTec2, while for Celluclast a conversion of 52% and 81%, was observed without and with ß-glucosidase supplementation, respectively. The decrease of Cellic(®) CTec2 activity observed along the process was related to deactivation of Cel7A rather than of Cel7B and ß-glucosidase. The adsorption/desorption profiles during hydrolysis/fermentation revealed that a large fraction of active enzymes remained adsorbed to the solid residue throughout the process. Surprisingly, this was the case of Cel7A and ß-glucosidase from Cellic, which remained adsorbed to the solid fraction along the entire process. Alkaline washing was used to recover the enzymes from the solid residue. This method allowed efficient recovery of Celluclast enzymes; however, this may be achieved only when minor amounts of cellulose remain present. Regarding the Cellic formulation, neither the presence of cellulose nor lignin restricted an efficient desorption of the enzymes at alkaline pH. This work shows that the recycling strategy must be customized for each particular formulation, since the enzymes found e.g. in Cellic and Celluclast bear quite different behaviour regarding the solid-liquid distribution, stability and cellulose and lignin affinity.

Cellulase recycling in biorefineries--is it possible?

On a near future, bio-based economy will assume a key role in our lives. Lignocellulosic materials (e.g., agroforestry residues, industrial/solid wastes) represent a cheaper and environmentally friendly option to fossil fuels. Indeed, following suitable processing, they can be metabolized by different microorganisms to produce a wide range of compounds currently obtained by chemical synthesis. However, due to the recalcitrant nature of these materials, they cannot be directly used by microorganisms, the conversion of polysaccharides into simpler sugars being thus required. This conversion, which is usually undertaken enzymatically, represents a significant part on the final cost of the process. This fact has driven intense efforts on the reduction of the enzyme cost following different strategies. Here, we describe the fundamentals of the enzyme recycling technology, more specifically, cellulase recycling. We focus on the main strategies available for the recovery of both the liquid- and solid-bound enzyme fractions and discuss the relevant operational parameters (e.g., composition, temperature, additives, and pH). Although the efforts from the industry and enzyme suppliers are primarily oriented toward the development of enzyme cocktails able to quickly and effectively process biomass, it seems clear by now that enzyme recycling is technically possible.

Cellulase stability, adsorption/desorption profiles and recycling during successive cycles of hydrolysis and fermentation of wheat straw.

The potential of enzymes recycling after hydrolysis and fermentation of wheat straw under a variety of conditions was investigated, monitoring the activity of the enzymes in the solid and liquid fractions, using low molecular weight substrates. A significant amount of active enzymes could be recovered by recycling the liquid phase. In the early stage of the process, enzyme adsorb to the substrate, then gradually returning to the solution as the saccharification proceeds. At 50°C, normally regarded as an acceptable operational temperature for saccharification, the enzymes (Celluclast) significantly undergo thermal deactivation. The hydrolysis yield and enzyme recycling efficiency in consecutive recycling rounds can be increased by using high enzyme loadings and moderate temperatures. Indeed, the amount of enzymes in the liquid phase increased with its thermostability and hydrolytic efficiency. This study contributes towards developing effective enzymes recycling strategies and helping to reduce the enzyme costs on bioethanol production.

Recycling of cellulases in lignocellulosic hydrolysates using alkaline elution.

The recovery of cellulases from lignin, lignocellulosic hydrolysates and cellulose by alkaline washes at pH 9 and 10 was examined. The effect of the pH on the structural stability of purified Cel7A was analyzed by circular dichroism. Purified Cel7A showed conformational changes at pH 9 and 10 that were reversible at pH 4.8. Temperature influenced the enzymatic hydrolysis of wheat straw and may be critical for the efficiency of cellulase recycling from wheat straw hydrolysates. Operation at moderate temperatures (37°C) resulted in a rate of saccharification 19% higher than that obtained at 50° C, improving cellulase recycling by 49%. Over 60% of the enzyme activity on the synthetic substrate 4-methylumbelliferyl-ß-d-cellobioside (MUC) may be recovered by using a simple alkaline wash. This is thus a promising strategy for enzyme recycling that is simple to implement at industrial scale, economical and effective.

Wound healing activity of the human antimicrobial peptide LL37.

Antimicrobial peptides (AMPs) are part of the innate immune system and are generally defined as cationic, amphipathic peptides, with less than 50 amino acids, including multiple arginine and lysine residues. The human cathelicidin antimicrobial peptide LL37 can be found at different concentrations in many different cells, tissues and body fluids and has a broad spectrum of antimicrobial and immunomodulatory activities. The healing of wound is a complex process that involves different steps: hemostasis, inflammation, remodeling/granulation tissue formation and re-epithelialization. Inflammation and angiogenesis are two fundamental physiological conditions implicated in this process. We have recently developed a new method for the expression and purification of recombinant LL37. In this work, we show that the recombinant peptide P-LL37 with a N-terminus proline preserves its immunophysiological properties in vitro and in vivo. P-LL37 neutralized the activation of macrophages by lipopolysaccharide (LPS). Besides, the peptide induced proliferation, migration and tubule-like structures formation by endothelial cells. Wound healing experiments were performed in dexamethasone-treated mice to study the effect of LL37 on angiogenesis and wound regeneration. The topical application of synthetic and recombinant LL37 increased vascularization and re-epithelialization. Taken together, these results clearly demonstrate that LL37 may have a key role in wound regeneration through vascularization.

Qualidade de vida do idoso: um levantamento da produção científica nos últimos dez anos / Calidad de vida de las personas de edad: un estudio de producción científica en los últimos diez años / Quality of life of elderly: a survey of scientific literature in the last ten years

A projeção mundial e também brasileira quanto ao envelhecimento populacional coloca a sociedade diantede um grandedesafio: o de proporcionar garantias eficazes paraessa população. Nesse sentido, nos últimos anos, aavaliação daqualidade de vida, sob a perspectiva do próprio indivíduo, surgiu como instrumento importantíssimo para a determinaçãodos fatores inerentes a satisfação com a vida de cada idoso. Diante disso, objetivou-se identificar eanalisar oconhecimento construído nos últimos 10 (dez) anos acerca do tema qualidade de vida do idoso. Trata-sede um estudobibliográfico retrospectivo e descritivo que teve como recorte temporal o período entre 2000 e 2009. Na busca dasproduções científicas em geral observou-se que o universo de estudos sobre a qualidade de vida é imenso. Entretanto,quando se analisa a qualidade de vida do idoso, osestudos diminuíam consideravelmente. Como resultadodeste trabalho,os relacionamentos familiares foram os mais mencionados como sinônimo de qualidade de vida. Subsequentementeapareceram os grupos de convivências entre os idosos, a autonomia e a independência, o estado de saúde, a estabilidadefinanceira, atividades físicas e religiosidade.

The projection of world and also about the Brazilian population aging society puts on a great challenge: to provideeffective safeguards for this population. Accordingly, in recent years, the assessment of quality of life, from theperspective of the individual, has emerged as a very important tool for determining the factors related to satisfactionwith life of each senior. The research objective was to identify and analyze the knowledge constructedin the last 10 (ten)years on the subject quality of life of elderly. This is a bibliographic retrospective descriptive study which comprehendedthe period between 2000 and 2009. In search of scientific production in general it was observed that the universe ofstudies on quality of life is immense. However, when analyzing the quality of life of the elderly, studies have diminishedconsiderably. As a result of this work, family relationships were most often mentioned as synonymous of quality of life.Subsequently were mentioned groups of cohabitationamong older people, autonomy and independence, health, financialstability, physical activity and religiosity.

La proyección del mundo y también sobre el envejecimiento de la población brasileña pone un gran desafío a la sociedad:establecer garantías eficaces para esa población. En consecuencia, en los últimos años, la evaluaciónde la calidad devida, desde la perspectiva del individuo, se ha convertido en herramienta muy importante para determinar los factoresrelacionados con la satisfacción con la vida de cada edad. El objetivo de la investigación fue identificar y analizar losconocimientos construidos en los últimos 10 (diez)años en el tema de la calidad de vida de los ancianos. Se trata de unestudio bibliográfico retrospectivo y descriptivo que consideró el período entre 2000 y 2009. En buscade la produccióncientífica en general, se observó que el universo de los estudios sobre calidad de vida es inmenso. Sin embargo, al analizarla calidad de vida de los ancianos, los estudios disminuían considerablemente. Como resultado de estetrabajo, lasrelaciones familiares son más a menudo mencionadascomo sinónimo de calidad de vida. Posteriormente aparecen losgrupos de convivencia entre las personas mayores, la autonomía y la independencia, la salud, estabilidad financiera, laactividad física y la religiosidad.

Aprendizagem baseada em problemas: uma nova referência para a construção do currículo médico / Problems-based learning: a new reference for constructing the medical curriculum

A necessidade de reforma da educação médica foi apontada, pela primeira vez, porFlexner (1910), nos Estados Unidos, e por Osler (1913), no Reino Unido. A implantaçãoda aprendizagem baseada em problemas (PBL) a partir da Universidade de McMaster,em 1969, foi uma das principais inovações da educação médica nos últimos 30 anos.O objetivo deste trabalho é rever a dinâmica de funcionamento do PBL e avaliar osprincipais resultados observados com a implantação desta estratégia educacional emcursos médicos. O PBL foi desenvolvido a partir do melhor conhecimento do modo deaprendizado do adulto e da compreensão do funcionamento da memória humana etem quatro propósitos básicos: a) a motivação para o aprendizado; b) o desenvolvimentodo raciocínio clínico; c) a estruturação do conhecimento em contexto clínico; e d) o desenvolvimento de habilidades de auto-aprendizado. Os grupos tutoriais, formados por sete a 10 alunos, são a estratégia central do PBL. Neles são analisados problemas estruturados a partir do currículo, que visam a permitir a discussão contextualizada dos tópicos, favorecendo a recuperação do conhecimento prévio e a aquisição de novos conhecimentos. Além disso, os grupos tutoriais favorecem o desenvolvimento de outras habilidades, como comunicação, trabalho em equipe, solução de problemas e desenvolvimento de postura crítica. A comparação entre o método de ensino tradicionale o PBL apresenta dificuldades metodológicas. Existem poucos estudos randomizados que comparam os dois métodos simultaneamente. A maioria dos trabalhos faz comparações históricas entre turmas da mesma instituição nas provas de qualificação dos Estados Unidos (NBME ou USMLE) e Canadá (MCC). Pode-se concluir que o PBL éum método adequado às necessidades atuais do ensino médico.

The need for the medical education reform was first suggested by Flexner (1910), in the United States, and by Osler (1913), in the United Kingdom. The implantation of problems based learning (PBL) in the McMaster University (Universidade McMaster), in 1969, was one of the main innovations in medical education in the last 30 years...

Saccharomyces cerevisiae strain 905 reduces the translocation of Salmonella enterica serotype Typhimurium and stimulates the immune system in gnotobiotic and conventional mice.

Previous results in the laboratory of the authors showed that Saccharomyces cerevisiae strain 905, isolated during 'cachaça' production, was able to colonize and survive in the gastrointestinal tract of germ-free and conventional mice, and to protect these animals against oral challenge with Salmonella enterica serotype Typhimurium or Clostridium difficile. In the present work, the effects of S. cerevisiae 905 on the translocation of Salm. Typhimurium (mesenteric lymph nodes, Peyer's patches, spleen, liver) as well as on the immune system (number of Küpffer cells, immunoglobulin production, clearance of Escherichia coli B41) were evaluated in gnotobiotic and/or conventional mice. The treatment with the yeast reduced significantly the translocation of Salm. Typhimurium to liver in gnotobiotic animals and to all the organs tested in conventional mice. The number of Küpffer cells per 100 hepatocytes in liver was significantly higher (P<0.05) in yeast mono-associated mice (52.9+/-15.7) than in germ-free controls (38.1+/-9.0). Probably as a consequence, clearance of E. coli B41 from the bloodstream was more efficient in yeast mono-associated animals when compared to germ-free mice. Higher levels (P<0.05) of secretory IgA in intestinal content and of IgA and IgM in serum were observed in yeast mono-associated mice when compared to germ-free group. Concluding, the protection against pathogenic bacteria observed in a previous study was probably due to a modulation of both local and systemic immunity of mice treated with S. cerevisiae 905.

Caracterizaçäo das alteraçöes miofuncinais orais e auditivas em indivíduos com disfunçäo craniomandibular / Characterization of oral and auditory functions in subjects with craniomandibular disorders

O presente estudo buscou caracterizar os sintomas miofuncionais orais e auditivos de 11 indivíduos com disfunçäo craniomandibular (DCM), por meio de entrevista e avaliaçäo fonoaudiológica e otorrinolaringológica. Os resultados obtidos mostraram alteraçöes nas funçöes de mastigaçäo, deglutiçäo, respiraçäo, fonoarticulaçäo e audiçäo

Fatores que levam ao diagnóstico de câncer de mama em estágios avançados

O câncer da mama é o tipo de câncer que mais acomete as mulheres em todo o mundo. Grande parte dos casos é diagnosticado em estágios avançados da doença, quando a possibilidade do tratamento é limitada. Somente com a detecção precoce e o tratamento realizado no início do desenvolvimento do câncer de mama, há um bom aumento na sobrevida e consequentemente, a possibilidade de óbito diminui. O objetivo desse estudo foi identificar fatores que levam ao diagnóstico do câncer de mama em estágios avançados. Através da revisão, proporcionar subsídios para intervenções profissionais e propor estratégias para diminuir o índice de mulheres com altos índices de alterações mamográficas e descobertas de câncer de mama em estágios avançados. Pôde-se concluir que infelizmente o diagnóstico tardio do câncer de mama está prevalecendo em relação à detecção precoce. Apesar de toda divulgação e importância do tema, o que mais se observou durante a pesquisa bibliográfica foram os atrasos na descoberta do câncer de mama, gerando uma menor possibilidade de cura e menor sobrevida da população acometida. Encontramos como causadores dos atrasos no diagnóstico a demora entre a descoberta do nódulo e a primeira consulta com especialista, a falta de informações entre os paciente sobre a doença e o diagnóstico precoce e a falta de capacitação dos profissionais de saúde quanto à execução do exame clínico. A raça negra e a menor condição socioeconômica, também foram relatadas como motivos de atrasos tanto no diagnóstico quanto no tratamento da doença, quando comparadas àquelas de raça branca e de maior condição socioeconômica. Espera-se que, a partir dos resultados deste estudo, mais ações de saúde possam ser estabelecidas para a prevenção e o controle do câncer de mama na atenção primária e que os profissionais possam estar atentos ao diagnóstico precoce.