Sustainable scenarios in a plants-rhizobacteria-plant consumers system are in risk when biotic or abiotic factors change.

The ecological relationship among plants, rhizobacteria and plant consumers has attracted the attention of researchers due to its implications in field crops. It is known that, the rhizosphere is occupied not only by rhizobacteria which grant benefits to the plants but also by bacteria which are detrimental for them. In this work, we construct and analyze a plants-rhizobacteria-plant consumers system. In the modeling process, it is assumed that there is a conditioned interaction between plants and bacteria in the rhizosfera such that there is a mutualistic relationship at low densities of rhizobacteria and the relationship is parasitic or competitive at higher densities of them. Benefits granted by rhizobacteria include mechanisms that increase the plant growth and defense mechanisms against plant consumers. From the analysis of the model and its simplified version, we show that scenarios of coexistence of all populations can occur for a wide range of values of the parameters which describe biotic or abiotic factors; however, these scenarios are in risk since scenarios of exclusion of species can occur simultaneously due to the presence of bistability phenomena. The results obtained can be useful for the decision makers to design interventions strategies on field crops when plant growth-promoting rhizobacteria are used.

Evaluation and discovery of novel benzothiazole derivatives as promising hits against Leishmania infantum.

An early exploration of the benzothiazole class against two kinetoplastid parasites, Leishmania infantum and Trypanosoma cruzi, has been performed after the identification of a benzothiazole derivative as a suitable antileishmanial initial hit. The first series of derivatives focused on the acyl fragment of its class, evaluating diverse linear and cyclic, alkyl and aromatic substituents, and identified two other potent compounds, the phenyl and cyclohexyl derivatives. Subsequently, new compounds were designed to assess the impact of the presence of diverse substituents on the benzothiazole ring or the replacement of the endocyclic sulfur by other heteroatoms. All compounds showed relatively low cytotoxicity, resulting in decent selectivity indexes for the most active compounds. Ultimately, the in vitro ADME properties of these compounds were assessed, revealing a satisfying water solubility, gastrointestinal permeability, despite their low metabolic stability and high lipophilicity. Consequently, compounds 5 and 6 were identified as promising hits for further hit-to-lead exploration within this benzothiazole class against L. infantum, thus providing promising starting points for the development of antileishmanial candidates.

Unlocking the potential of biosurfactants: Production, applications, market challenges, and opportunities for agro-industrial waste valorization.

Biosurfactants are eco-friendly compounds with unique properties and promising potential as sustainable alternatives to chemical surfactants. The current review explores the multifaceted nature of biosurfactant production and applications, highlighting key fermentative parameters and microorganisms able to convert carbon-containing sources into biosurfactants. A spotlight is given on biosurfactants' obstacles in the global market, focusing on production costs and the challenges of large-scale synthesis. Innovative approaches to valorizing agro-industrial waste were discussed, documenting the utilization of lignocellulosic waste, food waste, oily waste, and agro-industrial wastewater in the segment. This strategy strongly contributes to large-scale, cost-effective, and environmentally friendly biosurfactant production, while the recent advances in waste valorization pave the way for a sustainable society.

Trunk muscles influence lower limb performance in crossfit athletes: A cross-sectional study.

INTRODUCTION: Crossfit is a sport that combines cardio-respiratory and muscle endurance, strength, flexibility, muscle power, speed, coordination, agility and balance. However, there is no information in the literature regarding functional performance of the lower limbs and the endurance of core muscles in this population. The objective of this study was to evaluate the correlation between trunk strength/endurance and lower limb function through lower limb symmetry and balance tests. METHODS: Forty-one young adults aged 19-41 years (26.3 ± 5.4) participated, 15 sedentary and 26 cross fit practitioners for at least one year. The tests were as follows: Biering-Sørensen Test of trunk extensor endurance, Trunk Flexors Endurance Test at 60°, Side Plank Endurance Test, Lumbar Dynamometry, Single-Leg Hop Test and Star Excursion Balance Test. RESULTS AND DISCUSSION: Although there were higher values, there was no significant difference (p > 0.05) between the groups for lower limb symmetry and strength of trunk flexor muscles. For balance, strength and resistance variables of trunk extensor muscles, the values found were higher in crossfit practitioners than in sedentary subjects. CONCLUSION: There is a relationship between trunk muscle strength and endurance and lower limb balance. Moreover, cross fit athletes showed higher values of trunk muscle strength/endurance and lower limb balance compared to sedentary adults.

Synbiotic Sapota-do-Solimões (Quararibea cordata Vischer) Juice Improves Gut Microbiota and Short-Chain Fatty Acid Production in an In Vitro Model.

Sapota-do-Solimões (Quararibea cordata Vischer) is Amazon South América fruit found in Brazil, Colombia, Ecuador, and Peru. The orange-yellow fruit is usually eaten out of hand or as juice. Despite being a source of carotenoids and dietary fibers (pectin) that can reach the colon and act as an energy source for intestinal microbiota, the fruit is rarely known outside of South America. The symbiotic juice was prepared by fermenting the fruit juice with Lacticaseibacillus casei B-442 and adding prebiotic fructooligosaccharides (FOS, 7% w/v). This study evaluated the functional juice immediately after L. casei fermentation (SSJ0) and after 30 days of cold storage (SSJ30) regarding its effect on human colonic microbiota composition after in vitro fermentation. Fecal samples were collected from two healthy female volunteers, and the 16s rRNA gene sequencing analyzed the fecal microbiota composition. In vitro, colonic fermentation was performed using a batch bioreactor to simulate gastrointestinal conditions. The L. casei viability did not change significantly after 30 days of the synbiotic juice cold storage (4 °C). After the colonic fermentation, the relative abundance of Firmicutes decreased while Proteobacteria and Actinobacteria increased. Regarding short-chain fatty acid (SCFA) production by fecal colonic microbiota, the butyric acid was higher after sample SSJ0 fecal fermentation. In contrast, propionic, isobutyric, and acetic acids were higher after SSJ30 sample fecal fermentation. This study contributes to understanding the interactions between specific foods and the gut microbiota, which can affect human health and well-being.

Phase angle values and ultra-processed food consumption are associated with changes in oxidative stress in inflammatory bowel disease patients.

BACKGROUND & AIMS: Changes in dietary habits including increased intake of refined sugars and fats and decreased intake of fiber have been suggested as potential risk factors for the development of inflammatory bowel diseases (IBD). Bioelectrical impedance analysis-derived phase angle (PhA) has been gaining attention in the clinical evaluation of nutritional status. In this study, we for the first time investigated the relationship of PhA and ultra-processed food intake with oxidative stress, body composition and biochemical parameters in adult patients with IBD. METHODS: Body composition and PhA were evaluated through electrical bioimpedance. Nitrite (Nox), myeloperoxidase (MPO), glutathione (GSH), malondialdehyde (MDA) and superoxide dismutase (SOD) levels were determined in both groups. Food consumption was obtained by a food frequency questionnaire (FFQ). RESULTS: In comparison with the control group, the IBD group had increased (p < 0.05) concentrations of Nox (19.95 ± 1.4 vs. 35.43 ± 7.7 µM), MDA (0.70 ± 0.31 vs. 4.56 ± 0.62 nmol/L), and GSH (9.35 ± 0.38 vs. 10.74 ± 0.51 mg NPSH/µL plasma). PhA was positively correlated with GSH (R2:0.22; p:0.02) and SOD (R2:0.25; p:0.01). IBD patients ingested higher amounts of ultra-processed foods (IBD:17.04 ± 2.76 vs. Control:24.88 ± 2.30%). However, IBD patients had better consumption of unprocessed or minimally processed foods (IBD:79.06 ± 3.07 vs. Control:67.83 ± 2.32%). We found a positive correlation between ultra-processed food consumption and MDA (R2 0.43; p:0.01). CONCLUSIONS: PhA may be a practical and effective measure in clinical follow-up of IBD patients, being associated with bilirubin levels and antioxidant enzymes. Also, we recommend evaluating consumption of ultra-processed foods, since this was related with increasing oxidative stress markers in clinical follow-up of IBD patients.

Evaluation of cardiac autonomic control during the 6-min walk test in women with systemic sclerosis.

OBJECTIVE: To evaluate the association between sympathovagal balance and exercise performance, as measured by the 6-min walk test (6MWT), in women with systemic sclerosis (SSc) without cardiac involvement. RESULTS: This was a cross-sectional study in which 69 women with SSc [median age 51 (40-63 years)] without cardiac involvement underwent the 6MWT. Throughout the 6MWT, heart rate variability (HRV) was assessed using dedicated software. METHODS: The median 6-min walking distance (6MWD) was 451 (392-498) meters, and 29 (42%) participants did not achieve 80% of the predicted value for healthy adults. Desaturation during the 6MWT (SpO2 ≤ 4%) was observed in 10.1% of participants. Significant correlations were observed between the 6MWD and the following HRV parameters: number of successive normal-to-normal RR interval differences > 50 ms (rs=-0.397, P = 0.013), low-frequency range (rs=0.374, P = 0.023), high-frequency range (rs=-0.372, P = 0.023), and parasympathetic nervous system index (rs=-0.342, P = 0.045). CONCLUSION: In women with SSc, there is an interrelationship of the 6MWD with both vagal withdrawal and sympathetic hyperactivation. This relationship between autonomic imbalance and worse exercise performance might increase cardiovascular risk, even in patients without apparent cardiac involvement. Control of the heart by the autonomic nervous system may be a potential target for treating patients with SSc.

Reference value for the 6-min walking distance in women with systemic sclerosis considering the impact of muscle strength.

BACKGROUND: Early triage, the search for new therapies, and closer monitoring of patients with systemic sclerosis before their lung function irreversibly deteriorates are urgent concerns. Because it is an independent predictor of systemic sclerosis-related mortality, the 6-min walk test is a potentially useful tool to evaluate outcomes, along with pulmonary function and computed tomography. This study aimed to establish a reference value for the 6-min walking distance in women with diffuse cutaneous systemic sclerosis-associated interstitial lung disease that takes into account the effects of muscle and lung function. METHODS: This was a cross-sectional study in which 69 women with systemic sclerosis underwent the 6-min walk test, Health Assessment Questionnaire-Disability Index, pulmonary function, handgrip strength test, and quadriceps strength test. FINDINGS: The mean 6-min walking distance was 447 ± 78 m, and 43.5% of the participants did not reach 80% of their predicted value. 6-min walking distance correlated positively with quadriceps strength (r = 0.418, P = 0.0004), forced vital capacity (r = 0.306, P = 0.011), pulmonary diffusion (r = 0.360, P = 0.002), maximum inspiratory pressure (r = 0.268, P = 0.029), and maximum expiratory pressure (r = 0.288, P = 0.019) and negatively with age (r = -0.378, P = 0.001), body mass index (r = -0.248, P = 0.039), and Health Assessment Questionnaire-Disability Index (r = -0.438, P = 0.0001). In the multiple linear regression analysis, quadriceps strength, body mass index, pulmonary diffusion, age, and maximum expiratory pressure explained 72% of the 6-min walking distance variability. INTERPRETATION: Muscle function and, to a lesser extent, lung function are key contributors in determining the reference value for the 6-min walking distance in women with diffuse cutaneous systemic sclerosis-associated interstitial lung disease.

Feasibility of the Glittre-ADL test in the preoperative period of thoracic surgery.

BACKGROUND: The Glittre-ADL test (TGlittre) broadly meets the need for an objective evaluation of physical function, using similar activities to those of daily living. OBJECTIVE: To assess whether TGlittre in the preoperative assessment of patients who are candidates for thoracic surgery is associated with measures of pulmonary function, body balance, and quality of life and, secondarily, whether TGlittre may be related to postoperative complications. METHODS: This study evaluated 34 patients in the preoperative period of thoracic surgery. Participants underwent the following assessments: TGlittre; pulmonary function tests; St. George's Respiratory Questionnaire; and Berg Balance Scale. For participants who underwent thoracic surgery (n = 18), the following variables were taken: surgical time; time in intensive care unit; chest drain duration; and hospital stay after surgery. RESULTS: The median time to perform TGlittre tasks compared to the predicted was 137 (116-179) % predicted. There was significant correlation between TGlittre time and the diffusing capacity for carbon monoxide (rs = -0.334, p = .042). TGlittre time correlated significantly with the Berg Balance Scale (rs = -0.359, p = .036). We observed a significant correlation between TGlittre time and chest drain duration in the postoperative period (rs = 0.651, p = .003). CONCLUSION: Patients in the preoperative period of thoracic surgery have a reduced functional capacity to exertion, which can be explained at least in part by worse pulmonary gas exchange and body imbalance. Furthermore, TGlittre is possibly a prognostic test for postoperative complications, especially with respect to chest tube duration.

Physical exercise alleviates oxidative stress in brown adipose tissue and causes changes in body composition and nutritional behavior in rats with polycystic ovary syndrome.

AIM: Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder in women. We investigate the effect of physical exercise on body composition, nutritional parameters, and oxidative stress in rats with PCOS. METHODS: Female rats were into three groups: Control, PCOS, and PCOS + Exercise. PCOS was induced by letrozole (1 mg/kg via p.o.) for 21 days consecutively. Physical exercise was swimming, for 21 consecutive days, 1 h/day with 5 % load. In all groups, we assessed the nutritional and murinometric parameters, body composition, thermography, and oxidative stress in brown adipose tissue (BAT) and peri-ovarian adipose tissue (POAT). KEY FINDINGS: In PCOS we observed an increase (P < 0.05) in body weight vs. the Control group. But, the PCOS + Exercise group prevent this weight gain (P < 0.05). The temperature in BAT, decrease (P < 0.05) in the PCOS group vs. Control group. PCOS + Exercise prevented this reduction (P < 0.05) in BAT temperature vs. PCOS groups. We observed decreases (P < 0.05) in Lee Index and BMI in POS + Exercise vs. PCOS group. In PCOS rats, we observed an increase (P < 0.05) in murinometric (SRWG, EI, and FE) and body composition parameters (TWB, ECF, ICF, and FFM) vs. the Control group. The PCOS + Exercise prevents (P < 0.05) these changes in all groups, compared with PCOS. Regarding the BAT, we observe an increase (P < 0.05) in MPO and MDA levels in the PCOS vs. Control group. PCOS + Exercise prevents (P < 0.05) these increases vs. the PCOS group. SIGNIFICANCE: PCOS modifies body composition, and nutritional parameters, and induces changes in oxidative stress in BAT. Physical exercise prevented these alterations.

Predictive factors for the diagnosis of permanent congenital hypothyroidism and its temporal changes in Sergipe, Brazil - A real-life retrospective study.

Objective: Congenital hypothyroidism (CH) can be permanent (PCH) or transient (TCH). While the importance of thyroxine in myelination of the brain is undisputed, the benefits to neurodevelopmental outcomes of TCH treatment are controversial. Our objectives were to determine predictive factors for PCH and verify its prevalence changes over time. Subjects and methods: A total of 165 children were evaluated at 3 years of age to verify the diagnosis of PCH. 130 were submitted to a two-step cluster analysis, with the aim of grouping them into homogeneous clusters. The mean incidence of PCH and TCH was calculated from 2004 to 2010 and 2011 to 2015. Results: Sixty-six children were diagnosed with PCH, and 99 were diagnosed with TCH. Eighty-one percent of PCH children and all TCH children with thyroid imaging had glands in situ. Eighty children (61.5%) were in Cluster 1, 8 children (6.2%) were in Cluster 2 and 42 children (32.3%) were in Cluster 3. No children had PCH in Cluster 1, while 87.5% of children in Cluster 2 and all children in Cluster 3 had PCH. The most important predictor for PCH was the initial serum TSH, which was marginally higher in importance than the blood spot TSH, followed by the initial serum free T4. The mean incidence of PCH (odds ratio: 1.95, 95% CI 1.36 to 2.95, p < 0.0001) and TCH (odds ratio 1.33, 95%, CI 1.02 to 1.77, p = 0,038) increased over time. Conclusion: The most important PCH predictors are the initial serum TSH and the blood spot TSH. The mean incidence of both PCH and TCH in our series increased.

TRPA1 participation in behavioral impairment induced by chronic corticosterone administration.

RATIONALE: Major depressive disorder (MDD) is one of the most diagnosed mental disorders. Despite this, its pathophysiology remains poorly understood. In this context, basic research aims to unravel the pathophysiological mechanisms of MDD as well as investigate new targets and substances with therapeutic potential. Transient receptor potential ankyrin 1 (TRPA1) is a transmembrane channel considered a sensor for inflammation and oxidative stress. Importantly, both inflammation and oxidative stress have been suggested as participants in the pathophysiology of MDD. However, the potential participation of TRPA1 in depressive disorder remains poorly investigated. OBJECTIVE: To investigate the involvement of the TRPA1 channel in the behavioral changes induced by chronic corticosterone administration (CCA) in male mice. METHODS: Swiss male mice were exposed to 21 days of CCA protocol and then treated with HC-030031 or A-967079, TRPA1 antagonists. Behavioral tests, analyzes of oxidative parameters and TRPA1 immunocontent were performed in the prefrontal cortex (PFC) and hippocampus (HIP). RESULTS: CCA induced despair-like behavior in mice accompanied by an increase in the levels of hydrogen peroxide (H2O2), a TRPA1 agonist, which was reversed by TRPA1 antagonists and ketamine (positive control). In addition, CCA protocol reduced the immunocontent of this channel in the HIP and showed a tendency to increase the TRPA1 protein expression in the PFC. CONCLUSION: Our work suggests that TRPA1 channel appears crucial to mediate the behavioral impairment induced by CCA in male Swiss mice.

Biosurfactant Production from Pineapple Waste and Application of Experimental Design and Statistical Analysis.

The use of non-conventional carbon sources for biosurfactant-producing microorganisms is a promising alternative in fermentation to substitute costly substrates. So, the current research used pineapple peel as a cost-effective and renewable substrate because of its rich composition in minerals and sugars and high availability. Following a 22 full factorial design, a bacterial strain of Bacillus subtilis produced biosurfactants in fermentative media containing different concentrations of glucose and concentrated pineapple peel juice (CPPJ). The influence of these two independent variables was evaluated according to three different responses: surface tension reduction rate (STRR), emulsification index (EI24), and concentration of semi-purified biosurfactant (SPB). The maximum value for STRR (57.63%) was obtained in media containing 0.58% glucose (w/v) and 5.82% CPPJ (v/v), while the highest EI24 response (58.60%) was observed at 2% glucose (w/v) and 20% CPPJ (v/v) and maximum SPB (1.28 g/L) at 3.42% glucose (w/v) and 34.18% CPPJ (v/v). Statistical analysis indicated that the CPPJ variable mostly influenced the STRR and SPB responses, whereas the EI24 was significantly influenced by pineapple peel juice and glucose contents.

Predictive factors for the diagnosis of permanent congenital hypothyroidism and its temporal changes in Sergipe, Brazil - A real-life retrospective study

ABSTRACT Objectives: Congenital hypothyroidism (CH) can be permanent (PCH) or transient (TCH). While the importance of thyroxine in myelination of the brain is undisputed, the benefits to neurodevelopmental outcomes of TCH treatment are controversial. Our objectives were to determine predictive factors for PCH and verify its prevalence changes over time. Subjects and methods: A total of 165 children were evaluated at 3 years of age to verify the diagnosis of PCH. 130 were submitted to a two-step cluster analysis, with the aim of grouping them into homogeneous clusters. The mean incidence of PCH and TCH was calculated from 2004 to 2010 and 2011 to 2015. Results: Sixty-six children were diagnosed with PCH, and 99 were diagnosed with TCH. Eighty-one percent of PCH children and all TCH children with thyroid imaging had glands in situ. Eighty children (61.5%) were in Cluster 1, 8 children (6.2%) were in Cluster 2 and 42 children (32.3%) were in Cluster 3. No children had PCH in Cluster 1, while 87.5% of children in Cluster 2 and all children in Cluster 3 had PCH. The most important predictor for PCH was the initial serum TSH, which was marginally higher in importance than the blood spot TSH, followed by the initial serum free T4. The mean incidence of PCH (odds ratio: 1.95, 95% CI 1.36 to 2.95, p < 0.0001) and TCH (odds ratio 1.33, 95%, CI 1.02 to 1.77, p = 0,038) increased over time. Conclusions: The most important PCH predictors are the initial serum TSH and the blood spot TSH. The mean incidence of both PCH and TCH in our series increased.

Transplante de células-tronco hematopoiéticas: iniquidades na distribuição em território brasileiro, 2001 a 2020 / Hematopoietic stem-cell transplants in Brazil: inequities in the distribution in Brazilian territory, 2001 to 2020

Resumo O objetivo deste artigo é descrever a distribuição de Centros Transplantadores (CTs) e transplantes de células-tronco hematopoiéticas (TCTH) no território brasileiro. Estudo descritivo, que reúne informações sobre a distribuição CTs e o número de procedimentos realizados entre 2001 e 2020, a partir das fontes dos dados: Sociedade Brasileira de Terapia celular e Transplantes de Medula Óssea (SBTMO); Associação Brasileira de Transplante de Órgãos (ABTO); Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS); e Ministério da Saúde (MS). Foram identificados 86 CTs, com predominância na região Sudeste do país (64%). A região Norte não possui CTs. No período contabilizaram-se mais de 30 mil procedimentos, concentrados nas regiões Sudeste e Sul. O TCTH do tipo alogênico foi prevalente. Constataram-se divergências entre os números de transplantes realizados a depender da fonte consultada. Apesar do crescimento do número de procedimentos no período do estudo, tanto a distribuição de CTs quanto o número de TCTHs se concentrou em regiões mais desenvolvidas. Essa heterogeneidade pode ter propiciado iniquidades no acesso ao tratamento pela população.

Abstract The scope of this article is to describe the distribution of Transplant Centers (TCs) and hematopoietic stem-cell transplants (HSCTs) in the Brazilian territory. It is a descriptive study, which brings together information on the distribution of TCs and the number of procedures performed between 2001 and 2020, based on the following data sources: the Brazilian Cell Therapy and Bone Marrow Transplant Society of (SBTMO); the Brazilian Organ Transplant Association (ABTO); the Hospital Information System of the Unified Health System (SIH/SUS); and the Ministry of Health (MS). A total of 86 TCs were identified, predominantly in the Southeastern region of the country (64%). There are no TCs in the Northern region. Throughout the period, there were more than 30,000 procedures, concentrated in the Southeastern and Southern regions. The allogeneic type of HSCT was prevalent. Differences were found between the numbers of transplants performed depending on the source consulted. Despite the increase in the number of procedures during the period studied, both the distribution of TCs and the number of HSCTs were concentrated in more developed regions. This heterogeneity may have led to inequities in the access of the population to treatment.

[Hematopoietic stem-cell transplants in Brazil: inequities in the distribution in Brazilian territory, 2001 to 2020]. / Transplante de células-tronco hematopoiéticas: iniquidades na distribuição em território brasileiro, 2001 a 2020.

The scope of this article is to describe the distribution of Transplant Centers (TCs) and hematopoietic stem-cell transplants (HSCTs) in the Brazilian territory. It is a descriptive study, which brings together information on the distribution of TCs and the number of procedures performed between 2001 and 2020, based on the following data sources: the Brazilian Cell Therapy and Bone Marrow Transplant Society of (SBTMO); the Brazilian Organ Transplant Association (ABTO); the Hospital Information System of the Unified Health System (SIH/SUS); and the Ministry of Health (MS). A total of 86 TCs were identified, predominantly in the Southeastern region of the country (64%). There are no TCs in the Northern region. Throughout the period, there were more than 30,000 procedures, concentrated in the Southeastern and Southern regions. The allogeneic type of HSCT was prevalent. Differences were found between the numbers of transplants performed depending on the source consulted. Despite the increase in the number of procedures during the period studied, both the distribution of TCs and the number of HSCTs were concentrated in more developed regions. This heterogeneity may have led to inequities in the access of the population to treatment.

O objetivo deste artigo é descrever a distribuição de Centros Transplantadores (CTs) e transplantes de células-tronco hematopoiéticas (TCTH) no território brasileiro. Estudo descritivo, que reúne informações sobre a distribuição CTs e o número de procedimentos realizados entre 2001 e 2020, a partir das fontes dos dados: Sociedade Brasileira de Terapia celular e Transplantes de Medula Óssea (SBTMO); Associação Brasileira de Transplante de Órgãos (ABTO); Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS); e Ministério da Saúde (MS). Foram identificados 86 CTs, com predominância na região Sudeste do país (64%). A região Norte não possui CTs. No período contabilizaram-se mais de 30 mil procedimentos, concentrados nas regiões Sudeste e Sul. O TCTH do tipo alogênico foi prevalente. Constataram-se divergências entre os números de transplantes realizados a depender da fonte consultada. Apesar do crescimento do número de procedimentos no período do estudo, tanto a distribuição de CTs quanto o número de TCTHs se concentrou em regiões mais desenvolvidas. Essa heterogeneidade pode ter propiciado iniquidades no acesso ao tratamento pela população.

The Development of Geriatric Assessment and Intervention Guidelines for an Online Geriatric Assessment Tool: A Canadian Modified Delphi Panel Study.

BACKGROUND: There are no guidelines available for what assessment tools to use in a patient's self-completed online geriatric assessment (GA) with management recommendations. Therefore, we used a modified Delphi approach with Canadian expert clinicians to develop a consensus online GA plus recommendations tool. METHODS: The panel consisted of experts in geriatrics, oncology, nursing, and pharmacy. Experts were asked to rate the importance and feasibility of assessments and interventions to be included in an online GA for patients. The items included in the first round were based on guidelines for in-person GA and literature review. The first two rounds were conducted using an online survey. A virtual 2 h meeting was held to discuss the items where no consensus was reached and then voted on in the final round. RESULTS: 34 experts were invited, and 32 agreed to participate. In round 1, there were 85 items; in round 2, 50 items; and in round 3, 25 items. The final tool consists of fall history, assistive device use, weight loss, medication review, need help taking medication, social supports, depressive symptoms, self-reported vision and hearing, and current smoking status and alcohol use. CONCLUSION: This first multidisciplinary consensus on online GA will benefit research and clinical care for older adults with cancer.

Lower antidepressant response to fluoxetine is associated with anxiety-like behavior, hippocampal oxidative imbalance, and increase on peripheral IL-17 and IFN-γ levels.

Major depression is a leading contributor to the global burden of disease. This is mainly related to the disorder chronic and recurrent nature, and to high rates of refractoriness to treatment. Limited efficacy with currently available antidepressants highlights the need for more effective options for treating drug-resistant patients and emphasizes the importance of developing specific preclinical models for treatment-resistant populations. Treatment-resistant depression (TRD) is commonly defined as failure to respond to two or more trials of antidepressants. In this study, we investigated the effect of fluoxetine treatment for fourteen days on the depressive-like behavior and the oxidative and inflammatory parameters of mice submitted to chronic corticosterone administration. After 21 days of subcutaneous corticosterone administration (20 mg/kg/day) and 14 days of oral fluoxetine treatment (10 mg/kg/day, started on day 7 of induction protocol), we separated animals into two groups according to the tail suspension test (TST) results: antidepressant responders (good response to antidepressant, GRA) and non-responders (resistance to antidepressant, AR). Forced swimming test (FST), elevated plus maze test (EPMT), and open field test (OFT) were performed. We found that animals classified as AR (i.e., those with higher immobility values in the TST) demonstrated anxiety-like behavior in the EPMT, increased H2O2 levels, and decreased catalase activity in the hippocampus, as well as increased serum levels of IL-17 and IFN-γ. Our findings suggest that a redox imbalance in the hippocampus, combined with increased levels of peripheral IL-17 and INF-γ, may be involved with an impaired response to fluoxetine.

Self-management interventions for issues identified in a geriatric assessment: A systematic review.

BACKGROUND: With the development of electronic geriatric assessment (GA), recommendations for self-management can be provided to patients without the presence of health care providers. Our research question was to identify what self-management interventions can be used by patients to address issues identified in GA and to determine their effect on patient-centered outcomes such as quality of life, health, mood, cognition, and functional status. METHODS: Searches were conducted on July 13, 2021, by a health sciences librarian in Medline, Embase, CINAHL, PsycInfo, and the Cochrane Library. A combination of database-specific subject headings and text word searches was used such as self-management, a key word for each of the geriatric assessment domains and older adults. Two independent reviewers reviewed abstracts and full texts for inclusion and abstracted data. Narrative synthesis was used to summarize findings. RESULTS: Among 28,520 abstracts reviewed, 34 randomized controlled trials were included. The most frequently studied geriatric domains were mood (n = 13 studies), mobility/falls (n = 12), quality of life (n = 11), and functional status (n = 7). The majority of studies demonstrated positive effects on mobility/falls (9 of 12), pain (3 of 5), comorbidity (4 of 4), and medication management (4 of 4). Most studies were of low to moderate quality. All geriatric domains were targeted in at least one study. CONCLUSIONS: Low- to moderate-quality studies show a variety of effective self-efficacy-targeted interventions exist for older adults to improve several important geriatric domains and related outcomes. However, long-term effects, validation, and scalability of these interventions remain largely unknown.