Severe traumatic brain injury and acute kidney injury patients: factors associated with in-hospital mortality and unfavorable outcomes.

OBJECTIVE: The purpose of this study was to identify the occurrence of AKI, and factors associated with in-hospital mortality and unfavorable outcomes in patients with severe traumatic brain injury (TBI) and acute kidney injury (AKI) severity. METHOD: A retrospective cohort study which analyzed data with severe TBI between 2013 and 2017. We examined demographic and clinical information, and outcome by in-hospital mortality, and the Glasgow Outcome Scale six months after TBI. We associated factors to in-hospital mortality and unfavorable outcome in severe TBI and AKI with an association test. RESULTS: A total of 219 patients were selected, 39.3% had an AKI, and several factors associated with AKI occurrence after severe TBI. Stage 2 or 3 of AKI (OR 12.489; 95% CI = 4.45-37.94) were independent risk for both outcomes in multivariable models, severity injury by the New Trauma Injury Severity Score (OR 0.97; 95% CI = 0.96-0.99) for mortality, and the New Injury Severity Score (OR1.07; 95% CI = 1.04-1.10) and Trauma and Injury Severity Score (OR = 0.98; 95% CI = 0.965-0.997) for unfavorable outcome. CONCLUSION: The findings of our study confirmed that AKI severity and severity of injury was also related to increased mortality and unfavorable outcome after severe TBI.

Thermosensitive polymer-assisted extraction and purification of fungal laccase from citrus pulp wash effluent.

BACKGROUND: This study explores the use of liquid-liquid extraction with thermosensitive polymers for producing laccase (Lac) from Pleurotus sajor-caju. This process leverages liquid waste from the citrus industry, specifically pulp wash. The research delves into extractive fermentation and thermoseparation, both processes being facilitated by a polymer exhibiting a lower critical solution temperature transition. RESULTS: Key factors considered include the choice of polymer, its concentration, pH, separation temperature, and the behavior of the polymer-rich phase post-extractive fermentation concerning the lower critical solution temperature. Notably, under conditions of 45% by weight of Pluronic L-61 and pH 5.0 at 25 °C, the Lac resulted in an enhancement in the purification factor of 28.4-fold, compared with the Lac obtained directly from the fermentation process on the eighth day. There was an 83.6% recovery of the Lac enzyme in the bottom phase of the system. Additionally, the unique properties of Pluronic L-61, which can induce phase separation and also allow for thermoseparation, led to a secondary fraction (aqueous solution) of Lac with purification factor of 2.1 ± 0.1-fold (at 32 ± 0.9 °C and 30 ± 0.3 min without stirring) from the polymeric phase (top phase). Fourier-transform infrared analysis validated the separation data, particularly highlighting the α-helix content in the amide I region (1600-1700 cm-1 ). CONCLUSION: In summary, the insights from this study pave the way for broader industrial applications of these techniques, underscoring benefits like streamlined process integration, heightened selectivity, and superior separation efficacy. © 2023 Society of Chemical Industry.

Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A randomized clinical trial.

BACKGROUND: Reducing preoperative anxiety can help optimize surgical care. AIM: To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents. METHODS: We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups. FINDINGS: The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups. APPLICATION TO PRACTICE: Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.

Exploring the Links between Obesity and Psoriasis: A Comprehensive Review.

Obesity is a major public health issue worldwide since it is associated with the development of chronic comorbidities such as type 2 diabetes, dyslipidemias, atherosclerosis, some cancer forms and skin diseases, including psoriasis. Scientific evidence has indicated that the possible link between obesity and psoriasis may be multifactorial, highlighting dietary habits, lifestyle, certain genetic factors and the microbiome as leading factors in the progress of both pathologies because they are associated with a chronic pro-inflammatory state. Thus, inflammation management in obesity is a plausible target for psoriasis, not only because of the sick adipose tissue secretome profile but also due to the relationship of obesity with the rest of the immune derangements associated with psoriasis initiation and maintenance. Hence, this review will provide a general and molecular overview of the relationship between both pathologies and present recent therapeutic advances in treating this problem.

Influence of Aldehyde Dehydrogenase Inhibition on Stemness of Endometrial Cancer Stem Cells.

Endometrial cancer is one of the most common gynaecological malignancies. Although often diagnosed at an early stage, there is a subset of patients with recurrent and metastatic disease for whom current treatments are not effective. Cancer stem cells (CSCs) play a pivotal role in triggering tumorigenesis, disease progression, recurrence, and metastasis, as high aldehyde dehydrogenase (ALDH) activity is associated with invasiveness and chemotherapy resistance. Therefore, this study aimed to evaluate the effects of ALDH inhibition in endometrial CSCs. ECC-1 and RL95-2 cells were submitted to a sphere-forming protocol to obtain endometrial CSCs. ALDH inhibition was evaluated through ALDH activity and expression, sphere-forming capacity, self-renewal, projection area, and CD133, CD44, CD24, and P53 expression. A mass spectrometry-based proteomic study was performed to determine the proteomic profile of endometrial cancer cells upon N,N-diethylaminobenzaldehyde (DEAB). DEAB reduced ALDH activity and expression, along with a significant decrease in sphere-forming capacity and projection area, with increased CD133 expression. Additionally, DEAB modulated P53 expression. Endometrial cancer cells display a distinct proteomic profile upon DEAB, sharing 75 up-regulated and 30 down-regulated proteins. In conclusion, DEAB inhibits ALDH activity and expression, influencing endometrial CSC phenotype. Furthermore, ALDH18A1, SdhA, and UBAP2L should be explored as novel molecular targets for endometrial cancer.

Evidence of Validity and Normative Values of a New Auditory Backward Masking Test.

There are still no valid, clinically feasible instruments to assess backward masking (BM), an auditory temporal processing (ATP) phenomenon. The aim of this study was to develop, standardize and present evidence of validity for a behavioral test for BM assessment. Young adults were submitted to a BM test (BMT), where they were asked to identify a 1000 Hz pure tone followed by a narrowband noise with interstimulus intervals of 0 to 400 ms and signal-to-noise ratio (SNR) between -20 and -30 dB. The correct response rate and target sound detection threshold were calculated, and the results compared with those of young adults with abnormal ATP tests and older adults. Diagnostic accuracy analyses were carried out. Young adults with normal ATP obtained an average correct response rate of 89 and 87% for SNR -20 and -30 dB, respectively, with average thresholds between 10 and 15 ms and no difference between the left and right ears. Results were more consistent at SNR -20 dB, and the best diagnostic accuracy was obtained for SNR -20 dB, with good specificity, but low sensitivity. Normative values were obtained for the BMT, which proved to be clinically feasible, with preliminary evidence of validity.

Medicinal plant use in primary health care: an integrative review. / O uso de plantas medicinais na atenção primária à saúde: revisão integrativa.

Medicinal plant (MP) use supports comprehensiveness of care in Primary Health Care (PHC), enabling appreciation of popular knowledge and self-care. This integrative literature review aims to analyze researches that approach the insertion of using MP in PHC. PICO strategy was used as a guideline in search of evidence, reuniting 18 articles published between January 2015 and August 2020, in the Virtual Health Library and PubMed databases. The variables of analysis were knowledge of PHC healthcare professionals about MP and associated policies, MP use by its users, highlighting their profile, the reasons that lead to the use and lack of security in MP use. The results show insufficient knowledge of healthcare professionals about Integrative and Complementary Practices policies and the medicinal uses of plants. The main users are women, elderly, with low income and education, either in Brazil or other countries. Regarding safety in MP use, frequently there is no correct identification of species, its origin, its preparation and the appropriate dose for each case. Finally, failure to approach these contents during training of healthcare professionals generates less knowledge, less research and more prejudice due to lack of information, impairing incentive and dissemination to the community.

O uso de plantas medicinais (PM) favorece a integralidade do cuidado na atenção primária à saúde (APS), valorizando o saber popular e o autocuidado. Esta revisão integrativa de literatura objetiva analisar estudos sobre a inserção do uso de PM na APS. A estratégia PICO norteou a busca de evidências, reunindo 18 artigos publicados de janeiro de 2015 a agosto de 2020 nos bancos de dados Biblioteca Virtual de Saúde e PubMed. As variáveis de análise foram o conhecimento dos profissionais da saúde da APS sobre PM e políticas associadas, o uso de PM pelos usuários, destacando seu perfil, fatores que favorecem o uso e a falta de segurança no uso de PM. A literatura aponta insuficiência de conhecimento dos profissionais de saúde sobre as políticas de práticas integrativas e complementares e o uso de plantas para fins medicinais. Os principais usuários são mulheres, idosas, com baixa renda e escolaridade, tanto no Brasil quanto em outros países. Sobre a segurança no uso de PM, frequentemente não há correta identificação de espécie, origem, preparo e dose adequada para cada caso. Por fim, a não abordagem desses conteúdos durante a formação de profissionais da saúde gera menos conhecimento, menos pesquisas e mais preconceito por falta de informação, prejudicando o incentivo e divulgação à comunidade.

Applications of Photodynamic Therapy in Endometrial Diseases.

Photodynamic therapy (PDT) is a medical procedure useful for several benign conditions (such as wound healing and infections) and cancer. PDT is minimally invasive, presents few side effects, good scaring, and is able to minimal tissue destruction maintaining organ anatomy and function. Endoscopic access to the uterus puts PDT in the spotlight for endometrial disease treatment. This work systematically reviews the current evidence of PDT's potential and usefulness in endometrial diseases. Thus, this narrative review focused on PDT applications for endometrial disease, including reports regarding in vitro, ex vivo, animal, and clinical studies. Cell lines and primary samples were used as in vitro models of cancer, adenomyosis and endometrioses, while most animal studies focused the PDT outcomes on endometrial ablation. A few clinical attempts are known using PDT for endometrial ablation and cancer lesions. This review emphasises PDT as a promising field of research. This therapeutic approach has the potential to become an effective conservative treatment method for endometrial benign and malignant lesions. Further investigations with improved photosensitisers are highly expected.

Update of Argentina's Regulatory Policies on the Environmental Risk Assessment.

The Environmental Risk Assessment (ERA) of genetically modified (GM) crops in Argentina is carried out by the National Advisory Commission on Agricultural Biotechnology (CONABIA) and the Innovation and Biotechnology Coordination (CIyB). Both have a large experience with this assessment, since 1991, when CONABIA was created. The continuous support to biotechnology as a state policy and as part of the decision to encourage developers in the regulatory process has helped make progress in the revision of the regulations. The experience gained during the last 30 years and the worldwide scientific advances supported the bases to update the regulatory framework. Focusing on the biosafety strengthening and the improvement of the applicant's experience in the GM crops evaluation process, during 2020 and 2021, the ERA went through a reviewing process. Some important modifications were made, such as (i) the assessment of stacked GM crops with focus on the possible interactions between transgenes and the expression products, (ii) the strengthening of the ERA taking into account the transportability of data and conclusions from the Confined Field Trials (CFTs), (iii) the adoption of Familiarity and History of Safe Use (HOSU) concepts on the risk assessment of the expression products, (iv) the special considerations for the unintended effects of insertional sites, and (v) as a post commercial release of GM crops, the Insect Resistance Management Plan (IRMP) was reformulated. These novel approaches enhance the ERA; they make it more efficient by applying the science criteria and the accumulated experience and scientific bibliography on the topic.