Heparin-Bead Extraction Enhanced Fluorogenic Aptamer-Thrombin Composite Reporter Enables Sensitive and Rapid Detection of Functional Antithrombin.

Antithrombin (AT) deficiency in the extracorporeal circulation during cardiac surgery leads to uncontrolled inflammation and vascular damage in patients. AT levels decrease in sepsis, major trauma, extracorporeal membrane oxygenation, and eclampsia. Monitoring plasma AT levels facilitates the accurate restoration of AT to baseline values through precise supplementation. Traditional methods of chromogenic assay and enzyme-linked immunosorbent assay (ELISA) kits encounter challenges, such as interference, inconsistency, and delayed response times, making real-time, reliable antithrombin monitoring a clinical gap. To address this critical need, we develop a heparin-bead extraction enhanced fluoroGenic aptamer-thrombin composite reporter (HExGATOR) for the rapid, sensitive, and precise detection of functional AT in plasma. Our design employs thrombin-binding aptamers and a fluorescence "turn on" technology such that a signal is produced upon the interaction of AT with the otherwise "turned off" aptamer-thrombin complex. The prominent signal-background interference originating from plasma is remarkably diminished by using a heparin-bead solid-phase extraction of AT. We achieved highly sensitive and rapid detection of AT in 5 to 20 min with a limit of detection of 15.11 nM. This approach offers a promising alternative to traditional AT tests in clinical settings, potentially facilitating personalized anticoagulant therapy.

Melaleuca alternifolia essential oil in a natural product-based formulation: Antimicrobial and healing effects in Staphylococcus aureus-infected wounds.

Owing to its exposed nature, the skin can be injured by various factors, including by Staphylococcus aureus, which inhabits its innate microbiota. Treatment of infected wounds presents an important challenge, making it imperative to develop new treatment options. Plant-derived formulations, such as those containing Melaleuca alternifolia essential oil (MaEO), are used for wound treatment because of their healing, anti-inflammatory, and antimicrobial properties. This study presents a cream containing 2% MaEO (2% CMa) and evaluates its effects in an S. aureus-infected wound murine model. The 2% CMa was subjected to quality control testing and pH and analysis of density, organoleptic characteristics, and microbiological effects. The quality control parameters all revealed the good stability of the 2% CMa. The formulation strongly reduced the S. aureus ATCC 6538 colony-forming unit (CFU) count in an ex vivo porcine skin model. In the murine model, daily topical application of 2% CMa reduced the severity and size of S. aureus-infected wounds and the bacterial load. These effects may be due to the presence of terpinen-4-ol, which exhibits anti-inflammatory activity. Based on these findings, the formulation exhibits good quality and safety. We suggest the topical application of this formulation, which exhibited an antimicrobial effect, as an interesting treatment strategy for wound healing.

Carbohydrate counting and insulin analogs to treat type 1 diabetes mellitus. How to improve metabolic control?

Abstract Objectives: Clinical-laboratory comparison of a population of children and adolescents with DM1 followed at a Brazilian outpatient university clinic, at two different periods (2014 and 2020), regarding changes made both to the insulin therapy scheme and to the nutritional approach to carbohydrate counting. Methods: The data of patients with DM1 aged 0-19 years enrolled in the service in 2014 and 2020 were collected. Student's t-test was performed to compare the means of HbA1c and the variables of interest. Results: NPH + regular insulin was predominantly used in 2014 (49.1%), while in 2020, the predominance shifted to insulin analogs (48.4%). Pump use tripled from 1.3% in 2014 to 4.4% in 2020, and the percentage of patients performing carbohydrate counting reduced from 28.3% to 17.8%. Regarding HbA1c, the 2014 group of patients had a mean of 9.8%, while the 2020 group had a mean of 9.6% (p = 0.49). Conclusion: The change in treatments between 2014 and 2020 did not result in a significant improvement in HbA1c levels. However, it was identified the importance of carbohydrate counting and the use of insulin analogs to improve metabolic control in this population at both times.

The essential oil of Melaleuca alternifolia incorporated into hydrogel induces antimicrobial and anti-inflammatory effects on infected wounds by Staphylococcus aureus.

Staphylococcus aureus is one of the most common bacterial isolates found in wounds. Thus, innovative dressings, such as hydrogels, are interesting vehicles for incorporating bioactive compounds like those from Melaleuca alternifolia essential oil (MaEO). In this study, we evaluated the antimicrobial and anti-inflammatory potential of MaEO incorporated into an alginate and chitosan hydrogel for treating wounds infected by S. aureus. The hydrogel incorporated with MaEO 1% (HMa 1%) was homogeneous with a bright pale-yellow color and the characteristic smell of Melaleuca. The incorporation of MaEO 1% does not affect the stability of the hydrogel, which was stable up to 90 days of storage. The Scanning electron microscopy analysis revealed that hydrogels showed irregular surfaces and interconnected porous structures with accumulations of oil crystals distributed throughout the formulation. HMa 1% has a high moisture content (95.1%) and can absorb simulated wound fluid. Regarding the antimicrobial effects, HMa 1% reduced the growth of S. aureus ATCC 6538 in both in vitro conditions and in an ex vivo model of wounds using porcine skin. In addition, the dairy topical treatment of murine skin lesions with HMa 1% induced a significant reduction of the wound area, inflammation score, and bacterial load, as well as tissue re-epithelialization and modulation of inflammatory mediators. Therefore, hydrogel incorporated with MaEO 1% has excellent potential to be used in the pharmacotherapy of infected wounds.

Carbohydrate counting and insulin analogs to treat type 1 diabetes mellitus. How to improve metabolic control?

OBJECTIVES: Clinical-laboratory comparison of a population of children and adolescents with DM1 followed at a Brazilian outpatient university clinic, at two different periods (2014 and 2020), regarding changes made both to the insulin therapy scheme and to the nutritional approach to carbohydrate counting. METHODS: The data of patients with DM1 aged 0-19 years enrolled in the service in 2014 and 2020 were collected. Student's t-test was performed to compare the means of HbA1c and the variables of interest. RESULTS: NPH + regular insulin was predominantly used in 2014 (49.1%), while in 2020, the predominance shifted to insulin analogs (48.4%). Pump use tripled from 1.3% in 2014 to 4.4% in 2020, and the percentage of patients performing carbohydrate counting reduced from 28.3% to 17.8%. Regarding HbA1c, the 2014 group of patients had a mean of 9.8%, while the 2020 group had a mean of 9.6% (p = 0.49). CONCLUSION: The change in treatments between 2014 and 2020 did not result in a significant improvement in HbA1c levels. However, it was identified the importance of carbohydrate counting and the use of insulin analogs to improve metabolic control in this population at both times.

Nutritional interventions in children and adolescents with cerebral palsy: systematic review / Intervenções nutricionais em crianças e adolescentes com paralisia cerebral: revisão sistemática

ABSTRACT Objective: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). Data source: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. Data synthesis: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. Conclusions: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.

RESUMO Objetivo: Revisar sistematicamente a literatura em busca das intervenções e indicações nutricionais mais adequadas e eficazes para o tratamento nutricional de crianças e adolescentes com paralisia cerebral (PC). Fontes de dados: Esta revisão foi conduzida de acordo com as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses — PRISMA. Os artigos foram selecionados em sete bases de dados (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Foram incluídos estudos de um grupo pediátrico (zero a 18 anos) com diagnóstico de PC e a estratégia de busca incluiu os descritores: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". A qualidade metodológica foi avaliada utilizando a lista de verificação para estudos transversais analíticos, escala Newcastle-Ottawa ou ferramenta da Cochrane Collaboration, para ensaios clínicos. Síntese dos dados: Quinze estudos (n=658) publicados de 1990 a 2020 preencheram os critérios de inclusão. Todos tiveram baixo risco de viés. Os dados mostraram que crianças e adolescentes com PC apresentam pior estado nutricional do que os normalmente desenvolvidos. Aqueles que receberam suplementação nutricional hipercalórica e hiperproteica beneficiaram-se de seu uso. Estudos demonstram que a nutrição enteral deve ser considerada quando as necessidades nutricionais não são supridas pela dieta oral, principalmente nos casos em que as funções oromotoras estão prejudicadas. Além disso, houve relação direta entre a consistência dos alimentos, o nível de função motora e o estado nutricional. Conclusões: Crianças e adolescentes com PC têm maior risco de desnutrição. O uso de suplementação nutricional pode auxiliar no ganho de peso desses pacientes. Além disso, a nutrição enteral e a modificação da textura dos alimentos têm sido artifícios utilizados para a melhora do estado nutricional neste grupo.

Nutritional interventions in children and adolescents with cerebral palsy: systematic review.

OBJECTIVE: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). DATA SOURCE: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde - Lilacs, Embase, United States National Library of Medicine - PubMed, Scientific Electronic Library Online - SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. DATA SYNTHESIS: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. CONCLUSIONS: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.

Double perinatal stress reduces the sexual response of adult female Wistar rats.

BACKGROUND: Early-life stress affects physiological development and produces changes in various aspects of emotional behavior. AIM: We sought to examine the effects of double perinatal stress (DPS)-a combination of prenatal systemic hypoxic-ischemic (HI) insults and repeated early maternal separation-on the estrus cycle and sexual behavior of adult rats. METHODS: HI was induced by clamping the uterine arteries of pregnant rats for 45 minutes on the 18th day of gestation (HI group). Sham control animals received laparotomy and anesthesia only. Pups were born at term. Maternal separation was performed from postnatal day 1 (P1) (P0 = day of birth) to P15. At P90, the sexual response of females in estrus was evaluated. Statistical analysis was performed using 2-way analysis of variance followed by Tukey's test. OUTCOMES: We considered the estrous cycle and sexual behavior of female rats submitted to DPS, as well as the influence of female behavior on the sexual response of male rats. RESULTS: Rats submitted to DPS showed a reduction in the lordosis quotient and in the lordosis rate, suggesting a reduction in female sexual receptivity. DPS female rats showed a reduction in the number of hops and darts and in the genital exploration time rate, suggesting a reduction in sexual proceptivity. In addition, males that interacted with DPS females showed a reduction in the number of ejaculations and in copulatory efficiency. CLINICAL IMPLICATIONS: Developing a deeper understanding of perinatal factors that affect adult female sexual response will allow for more effective interventions to prevent and treat such changes. On the other hand, the analysis of the sexual response allows assessing the quality of life and the general state of health. STRENGTHS AND LIMITATIONS: The development of animal models to investigate the environmental factors that interfere in the female sexual response may allow researchers to propose and test new therapeutic strategies. On the other hand, care must be exercised when interpreting animal data and extrapolating these results to estimate the possible effects of perinatal stressors on the human sexual response. CONCLUSION: Our results revealed that females subjected to DPS showed long-term effects on sexual behavior. In conclusion, managing stressors in prenatal life and early postnatal life can prevent problems in adult sexual life and improve overall health.

Nutritional interventions in children and adolescents with cerebral palsy: systematic review / Intervenções nutricionais em crianças e adolescentes com paralisia cerebral: revisão sistemática

ABSTRACT Objective: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). Data source: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. Data synthesis: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. Conclusions: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.

RESUMO Objetivo: Revisar sistematicamente a literatura em busca das intervenções e indicações nutricionais mais adequadas e eficazes para o tratamento nutricional de crianças e adolescentes com paralisia cerebral (PC). Fontes de dados: Esta revisão foi conduzida de acordo com as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses — PRISMA. Os artigos foram selecionados em sete bases de dados (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Foram incluídos estudos de um grupo pediátrico (zero a 18 anos) com diagnóstico de PC e a estratégia de busca incluiu os descritores: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". A qualidade metodológica foi avaliada utilizando a lista de verificação para estudos transversais analíticos, escala Newcastle-Ottawa ou ferramenta da Cochrane Collaboration, para ensaios clínicos. Síntese dos dados: Quinze estudos (n=658) publicados de 1990 a 2020 preencheram os critérios de inclusão. Todos tiveram baixo risco de viés. Os dados mostraram que crianças e adolescentes com PC apresentam pior estado nutricional do que os normalmente desenvolvidos. Aqueles que receberam suplementação nutricional hipercalórica e hiperproteica beneficiaram-se de seu uso. Estudos demonstram que a nutrição enteral deve ser considerada quando as necessidades nutricionais não são supridas pela dieta oral, principalmente nos casos em que as funções oromotoras estão prejudicadas. Além disso, houve relação direta entre a consistência dos alimentos, o nível de função motora e o estado nutricional. Conclusões: Crianças e adolescentes com PC têm maior risco de desnutrição. O uso de suplementação nutricional pode auxiliar no ganho de peso desses pacientes. Além disso, a nutrição enteral e a modificação da textura dos alimentos têm sido artifícios utilizados para a melhora do estado nutricional neste grupo.

Ganho de peso interdialítico e fatores associados em pacientes em tratamento hemodialítico / Interdialytic weight gain and associated factors in patients undergoing hemodialysis treatment

Objetivo: Estimar a prevalência do ganho de peso interdialítico (GPI) e verificar sua correlação com indicadores sociodemográficos, antropométricos, clínicos e bioquímicos em pacientes em tratamento hemodialítico. Métodos: Realizou-se estudo transversal com pacientes adultos e idosos, de ambos os sexos, cadastrados em uma unidade de hemodiálise. A coleta de dados foi realizada a partir da aplicação de questionário estruturado, aferição de medidas antropométricas e análise dos prontuários. As associações entre as variáveis foram verificadas utilizando-se modelos de regressão linear simples e múltipla. A análise dos dados foi realizada com o auxílio do software Stata 13.1. Resultados: Foram avaliados 123 pacientes, com predominância do sexo masculino (63,4%), faixa etária superior a 40 anos (66,6%) e nível socioeconômico baixo (50,4%). A prevalência de GPI excessivo entre os participantes do estudo foi de 10,5% e associou-se de forma negativa com o aumento da idade (ß= -0,019; 95% IC: -0,037; -0,006). Foram observadas associações positivas entre o GPI e o aumento da circunferência da cintura (ß= 0,022; 95% IC: 0,003; 0,041), o tempo de hemodiálise dado em meses (ß= 0,017; 95% IC: 0,009; 0,026) e o aumento da concentração sérica de creatinina (ß= 0,091; 95% IC: 0,016; 0,166). Conclusão: Constatou-se que o GPI foi maior em pacientes mais jovens e se associou de forma positiva à circunferência da cintura, ao tempo em hemodiálise e à concentração sérica de creatinina. Esses achados demonstram a importância de intervenções multiprofissionais para que pacientes submetidos à hemodiálise apresentem melhor qualidade de vida

Objective: Estimate the prevalence of interdialytic weight gain (IDWG) and assess its correlation with sociodemographic, anthropometric, clinical, and biochemical indicators in patients undergoing hemodialysis. Methods: A cross-sectional study was carried out with adult and elderly patients of both sexes referred to a hemodialysis center. Data collection consisted of the application of a structured questionnaire, measurement of anthropometric parameters, and analysis of medical records. Associations between variables were assessed using simple and multiple linear regression models. Data analysis was performed using Stata 13.1 software. Results: A total of 123 patients were evaluated, the majority of which were male (63.4%), aged over 40 years (66.6%), and of low socioeconomic status (50.4%). The prevalence of excessive IDWG among study participants was 10.5% and was negatively associated with increased age (ß = −0.019; 95% CI: −0.037; −0.006). Positive associations were observed between IDWG and increased waist circumference (ß = 0.022; 95% CI: 0.003; 0.041), hemodialysis treatment time (expressed in months) (ß = 0.017; 95% CI: 0.009; 0.026), and increased serum creatinine concentration (ß = 0.091; 95% CI: 0.016; 0.166). Conclusion: It was found that IDWG was greater in younger patients and was positively associated with waist circumference, hemodialysis treatment time, and serum creatinine concentration. These findings demonstrate the importance of multi- professional interventions to improve the quality of life of patients undergoing hemodialysis.

Exploring the Potentiality of Natural Products from Essential Oils as Inhibitors of Odorant-Binding Proteins: A Structure- and Ligand-Based Virtual Screening Approach To Find Novel Mosquito Repellents.

Odorant-binding proteins (OBPs) are the main olfactory proteins of mosquitoes, and their structures have been widely explored to develop new repellents. In the present study, we combined ligand- and structure-based virtual screening approaches using as a starting point 1633 compounds from 71 botanical families obtained from the Essential Oil Database (EssOilDB). Using as reference the crystallographic structure of N,N-diethyl-meta-toluamide interacting with the OBP1 homodimer of Anopheles gambiae (AgamOBP1), we performed a structural and pharmacophoric similarity search to select potential natural products from the library. Thymol acetate, 4-(4-methyl phenyl)-pentanal, thymyl isovalerate, and p-cymen-8-yl demonstrated a favorable chemical correlation with DEET and also had high-affinity interactions with the OBP binding pocket that molecular dynamics simulations showed to be stable. To the best of our knowledge, this is the first study to evaluate on a large scale the potentiality of NPs from essential oils as inhibitors of the mosquito OBP1 using in silico approaches. Our results could facilitate the design of novel repellents with improved selectivity and affinity to the protein binding pocket and can shed light on the mechanism of action of these compounds against insect olfactory recognition.

Frequency of the morphological criteria of prostate adenocarcinoma in 387 consecutive prostate needle biopsies: emphasis on the location and number of nucleoli / Frequência de critérios morfológicos de adenocarcinoma da próstata em 387 biópsias de agulha da próstata consecutivas: com ênfase na localização e no número de nucléolos

ABSTRACT Introduction and objectives: We evaluated the sensitivity and specificity of morphological criteria for the diagnosis of prostate adenocarcinoma in consecutive, prostate needle biopsies specimens with emphasis on the location and number of nucleoli. Methods: The morphological features of 387 consecutive prostate needle biopsies specimens, in 2013, were systematically examined and stratified according to the final diagnosis of benign, suspicious and malignant lesions. We also tested how well each criterion predicted the final diagnosis after the immunohistochemical evaluation for expression of the basal cell markers (p63 and high molecular weight cytokeratin) and racemase. Results: A prominent nucleoli is the most common feature of carcinoma; however it is also relatively common in benign cases. The frequencies of prominent central nucleoli in malignant, suspicious and benign cases were 99%, 89% and 27%, respectively. Marginated nucleoli (85%, 60% and 7%), double nucleoli (86%, 53% and 10%), and multiple nucleoli (47%, 14% and 2%) were less common in benign cases, with significant difference among the groups. From the 36 cases initially diagnosed as suspicious, the presence of marginated nucleoli and mitoses were associated with the final diagnosis of malignancy. Prominent central nucleoli were more associated with cases which the final diagnosis after immunohistochemistry was benign. Conclusion: The location and number of nucleoli may be valuable morphological markers to identify suspicious lesions, since these features are more specific for malignancy than nucleolar prominence. The presence of prominent nucleoli commonly leads to the initial diagnosis of suspicious lesion that, subsequently, will be resulted in benignity confirmed by immunohistochemistry.

RESUMO Introdução e objetivos: Avaliamos a sensibilidade e a especificidade de critérios morfológicos para diagnóstico de adenocarcinoma da próstata em biópsias de agulha da próstata, consecutivas, com ênfase na localização e no número de nucléolos. Métodos: A morfologia de 387 biópsias de agulha consecutivas do ano de 2013 foi sistematicamente examinada e estratificada como diagnóstico de benigno, lesão suspeita ou maligno. Também testamos como cada critério previu o diagnóstico final após avaliação imuno-histoquímica para expressão de marcadores de células basais (p63 e citoqueratina de alto peso) e racemase. Resultados: Um nucléolo proeminente foi o achado mais comum do carcinoma, mas também foi relativamente comum em casos benignos. As frequências de um nucléolo proeminente central em lesões malignas, suspeitas e benignas foi de 99%, 89% e 27%, respectivamente. Nucléolo marginado (85%, 60% e 7%), nucléolos duplos (86%, 53% e 10%) e nucléolos múltiplos (47%, 14% e 2%) foram menos comuns em casos benignos, com diferenças significativas entre os grupos. Dos 36 casos com diagnóstico inicial de suspeito, a presença de nucléolo marginado e mitoses foi associada ao diagnóstico final de malignidade. Um nucléolo proeminente central foi mais associado a casos cujo diagnóstico final após imuno-histoquímica foi benigno. Conclusão: A localização e o número de nucléolos pode ser um marcador morfológico valioso para identificar lesões suspeitas, uma vez que esses achados são mais específicos para malignidade do que a proeminência nucleolar. A presença de nucléolo proeminente comumente leva ao diagnóstico inicial de lesão suspeita que, posteriormente, terá a conclusão de benignidade confirmada pela imuno-histoquímica.

Properties of chlorophyll and derivatives in homogeneous and microheterogeneous systems.

Chlorophyll (Mg-Chl) and its derivatives, zinc chlorophyll (Zn-Chl), copper chlorophyll (Cu-Chl), pheophytin (Pheo), pheophorbide (Pheid), and zinc chlorophyllide (Zn-Chld), were studied as to their acid-base equilibrium properties, hydrophobicity, stability, binding, and relative localization in neutral surfactant micellar systems. The stability order of metalochlorophyll (pH(M)) in acidic medium was found to be Cu-Chl > Zn-Chld > Zn-Chl > Mg-Chl. The apparent pK(a) for protonation of porphyrin ring nitrogens was around 1.0 for all derivatives. The pK(a) for protonation of carboxylate phorbide was 5.9 for Pheid and 2.4 for Zn-Chld. This difference was attributed to complexation of carboxylate with zinc. The hydrophobicity of chlorophyll in relation to the ability of partitioning the cell membrane lipid layer was estimated in the octanol/water biphasic system. Pheo, a more hydrophobic molecule, presented the highest partition coefficient (K(P)) in the organic phase, followed by Cu-Chl, Mg-Chl, Zn-Chl, Pheid, and Zn-Chld. The hydrophobic character was the key to relative drug location in the micellar systems. All studied derivatives interacted strongly with Tween 80 micellar systems, and particularly with P-123. For both surfactants, the order followed by binding constant (K(b)) was Zn-Chld > Pheo > Cu-Chl > Mg-Chl > Zn-Chl > Pheid, while binding constants estimated for the Chl containing the phytyl group correlated with K(P). Fluorescence quenching studies have shown that phorbides are located in a less hydrophobic region than the phytyl chain-containing derivatives, which are located preferentially in a deeper micellar microenvironment. Thus, the association of the chlorophylls with specific binding sites of micellar systems is strongly modulated by the presence of phytyl chains and metal coordinated to the porphyrinic ring.

Effects of metal and the phytyl chain on chlorophyll derivatives: physicochemical evaluation for photodynamic inactivation of microorganisms.

Chlorophyll compounds and their derivatives containing metal or phytyl chain can be used as photosensitizer in photodynamic inactivation of microorganisms (PDI). So, the physicochemical properties and antimicrobial effect of chlorophyll derivatives were investigated: Mg-chlorophyll (Mg-Chl), Zn-chlorophyll (Zn-Chl), Zn-chlorophyllide (Zn-Chlde), Cu-chlorophyll (Cu-Chl), pheophytin (Pheo) and pheophorbide (Pheid). The photobleaching experiments showed photostability according to Cu-Chl > Pheo ∼ Pheid ≫ Zn-Chl ∼ Zn-Chlde > Mg-Chl. This order was discussed in terms of metal and the phytyl chain presences. Pheid and Zn-Chl in aqueous Tween 80 solution exhibited highest singlet oxygen yield compared with the other derivatives. Chlorophyll derivatives (CD) with phytyl chain was limited by the self-aggregation phenomenon at high concentrations, even in micellar systems (Tween 80 and P-123). The antimicrobial effect of CD derivatives was investigated against Staphylococcus aureus, Escherichia coli, Candida albicans and Artemia salina. Pheid showed the best results against all organisms tested, Zn-Chlde was an excellent bactericide in the dark and Cu-Chl had no PDI effect. No correlation with CD uptake by microorganisms and darkness cytotoxicity was found. The physicochemical properties allied to bioassays results indicate that Mg-Chl, Pheo, Zn-Chl and Pheid are good candidates for PDI.

Prevalência de sintomas depressivos em idosos institucionalizados na cidade do Salvador / Prevalence of depressive symptons in the hospitalized elderly in the city of Salvador

A depressão no idoso é considerada um problema de saúde pública devido a sua alta prevalência e, como tal, merece atenção especial por parte dos órgãos competentes. Este trabalho tem como objetivo estimar a prevalência de sintomas depressivos em idosos institucionalizados e as variáveis associadas a este evento. Realizou-se um estudo de corte transversal. Participaram do presente estudo 151 idosos, com idade maior ou igual a 60 anos e de ambos os sexos nas duas unidades asilares na cidade do Salvador. Para a coleta de dados, utilizou-se um questionário semi-estruturado, abordando as variáveis demográficas, socioeconômicas e comportamentais, o Mini-Exame do Estado Mental (MEEM) e a Escala de Depressão Geriátrica (GDS-15). A prevalência de sintomas depressivos na população investigada foi de 21,1por cento sendo 24,7por cento no sexo feminino, 29,7por cento nos idosos viúvos, 27,5por cento nos idosos brancos e 26,3por cento naqueles que não desenvolviam nenhuma atividade na instituição. Embora os dados do presente estudo não tenham sido estatisticamente significantes, os resultados apontam para a importância de se dedicar à saúde mental desses idosos, objetivando o diagnóstico precoce e tratamento adequado da depressão, condição tão freqüente na terceira idade.

Depression in the elderly is considered a public health problem due to its high prevalence, and because of this, it deserves especial attention from the proper public agencies. The objective of this study is to estimate the prevalence of depressive symptoms in the hospitalized elderly and the variables associated to this event. This is a cross-sectional study with 151 elderly patients 60 years of age or older, male and female, from both elderly institutions in the city of Salvador. For the data gathering, a semi-structured questionnaire was utilized treating demographic, socioeconomic, and behavioral variables. A Mini-Exam of Mental Health (MEEM) and the Geriatric Depression Scale (GDS-15) were also utilized. The prevalence of depressive symptoms in the population studied was 21.1%, being 24.7% female, 29.7% widowed, 27.5% White, and 26.3% in those that did not take part in any activity in the institutions. Even though the data gathered in the study does not represent significant statistics, the results illustrate the importance of more dedication to the mental health of the elderly, aiming for an early diagnose and adequate treatment for depression, a condition very frequent in this population.