Development, validation and application of a questionnaire to qualify the indoor environmental exposure of patients with respiratory allergy.

OBJECTIVE: Environmental control includes measures to prevent exposure to common aeroallergens in an individual's home. Questionnaires are part of the clinical practice of health assessment, and are also widely used in research. Our aim was to develop and validate a questionnaire to identify possible sources of aeroallergens present in the indoor environment. METHODS: This study describes the development, validation and application of a questionnaire. For content validation the Content Validation Index and Ordinal Cronbach's Alpha Index have been used; Polychoric Correlations for the agreement between judges; and an Exploratory Factor Analysis for the structure of the questionnaire, while for reliability assessment, Intraclass Correlation Coefficient has been applied. RESULTS: Twenty-one doctors participated as judges to validate the questionnaire, which 204 patients answered. The Content Validity Index for all the questions on the "Clarity" aspect was 0.846 ± 0.152 and on the "Relevance" aspect, 0.954 ± 0.080. Cronbach's alpha coefficient for the "Clarity" aspect was 0.88 with a 95% confidence intervals (CI) and the "Relevance" aspect, 0.94 with a 95% CI. The average Intraclass Correlation Coefficient was 0.94 and all the F tests were highly significant. CONCLUSIONS: The questionnaire developed by our group was considered valid and reliable, and is capable of portraying the home environment without the need for a personal visit to the patient's home. This questionnaire would be a good tool to use in research or during patient consultations to assess the patient's home environment, as this latter assessment is essential for the management of patients with respiratory allergies.

Transcriptomics analysis of Ccl2/Cx3cr1/Crb1rd8 deficient mice provides new insights into the pathophysiology of progressive retinal degeneration.

Chronic oxidative stress and immune dysregulation are key mechanisms involved in the pathogenesis of most retinal degenerative diseases, including age-related macular degeneration. The Ccl2-/-/Cx3cr1-/-/Crb1rd8/rd8 mouse model develops a progressive degeneration phenotype, with photoreceptor atrophy, drusen-like lesions or pigment alterations at an early age; however, the role of oxidative stress and immune function in the pathogenesis of the model is poorly understood. We performed a comprehensive characterization of the Ccl2-/-/Cx3cr1-/-/Crb1rd8/rd8 mouse to evaluate how these pathways influence pathogenesis. We generated a Ccl2-/-/Cx3cr1-/- double-knockout (DKO) mouse on a C57BL/6N background (with the rd8 mutation of the Crb1 gene), assessed its retina status and function during 9 months in both in vivo and post-mortem analysis, and performed a comprehensive transcriptomic analysis. DKOrd8 mice presented focal retinal lesions with increased infiltration of microglia and involvement of Müller cells. Lesions progressed to thinning of the photoreceptor nuclear layer, causing a loss in retinal function. Transcriptomics analysis revealed major differential expression of genes involved in oxidative stress and neuronal function, in particular genes related to the mitochondrial electron transport chain and antioxidant cellular response. Our results suggest that alterations in chemokine signaling combined with the rd8 mutation in Ccl2-/-/Cx3cr1-/-/Crb1rd8/rd8 mice involve early changes in several pathways associated with age-related macular degeneration, highlighting the relevance of these processes in the pathological retinal degeneration in the DKOrd8 model.

Effectiveness of a school-based randomized controlled trial aimed at increasing physical activity time in adolescents.

BACKGROUND: This study aimed to evaluate the effectiveness of obesity prevention educational activities, isolated or combined with the modification of the school environment on total physical activity time. METHODS: This is a school-based randomized controlled trial, conducted with 2511 students from fifth and sixth-grade in Brazil, that employed a parallel, three-group experimental arms: control group (CG), PAAPPAS group (PG) and PAAPPAS-environment group (PEG). During the 2016 school year, the PG received educational activities in the classroom, providing a general basis for a healthy lifestyle. The PEG received the same educational activities and also modifications in the school environment to stimulate physical activity practice during one month. Physical activity was evaluated through a validated physical activity questionnaire. Intention-to-treat analysis was performed to evaluate the rate of change of physical activity time between groups using PROC GENMOD procedure. All analyses were performed using SAS. RESULTS: Total physical activity time increased by 22% in PEG compared with CG (P = 0.003). No difference was observed between PEG and PG (Δ = 60.20 vs. 36.37, respectively; P = 0.27) and between PG and CG (Δ = 36.37 vs. 9.70, respectively; P = 0.23). The proportion of individuals who attended at least 150 min week-1 of physical activity increased in PEG compared with PG (P = 0.04); however, no difference was observed between PEG and CG (P = 0.19) and between PG and CG (P = 0.26). For 300 min week-1, no difference was observed between groups. CONCLUSION: A school-based multi-component intervention including modification of the school environment was effective for increasing physical activity time among adolescents.

Occurrence and patterns of orofacial injury in CrossFit practitioners.

BACKGROUND: CrossFit is an activity that can provide positive influences on body composition and physical fitness. However, the occurrence or pattern of possible injuries, especially in the orofacial region, has not yet been studied. The aim of this study was to investigate the occurrence and patterns of orofacial injuries in CrossFit practitioners. MATERIAL AND METHODS: This was a cross-sectional study carried out using an online questionnaire on the Google Forms platform. The volunteers were self-selected men and women who practice CrossFit and reside in Brazilian municipalities. The online survey was conducted during April 2020 and comprised 12 questions. The data were analyzed, categorized, and presented as percentages. RESULTS: These were 65 (27.8%) participants who reported having suffered at least one episode of orofacial trauma and they were more prevalent during training sessions 58 (89.2%). Among the regions with the highest frequency of injuries, the head 23 (21%), mental protuberance 22 (19.6%), upper lip 19 (16.9%), and maxillary teeth 14 (12.5%) were the most cited. CONCLUSIONS: The prevalence of injuries in the head region indicates a potential concern. Preference should be given to making mouthguards for the maxillary teeth, as they are significantly more affected by trauma during CrossFit when compared to the mandibular teeth.

Papass clinical trial protocol: a multi-component school-based intervention study to increase acceptance and adherence to school feeding.

BACKGROUND: One of the largest school feeding programs in the world is the National School Feeding Program of Brazil. However, results from the 2012 National School Health Survey indicated that only 22.8% of 9th grade students in Brazilian public school system consumed school meals. The literature presents few studies aiming to promote healthy food consumption in the school environment from interventions, which found inconclusive results. Thus, this study aims to present a protocol to evaluate the effectiveness of multi-component school-level interventions to increase adherence and acceptance to school feeding. METHODS: School-based multi-component clinical trial with students from 4th-9h grade from 3 municipal schools of Sumidouro, Rio de Janeiro, Brazil, in 2019. The study design will be parallel, with 3 arms: Control group (without intervention); Intervention group 1 (changes in school environment) and Intervention group 2 (changes in menu and school environment). Interventions in the environment will be based on the principles of choices architecture and, the modification in the dishes that make up the menus offered to the students, on the factors that contribute to poor adherence and acceptance to school feeding, identified by focus groups. Adherence to school feeding will be assessed through a specific question in the questionnaire directed to the frequency of consuming school meals in the week, applied by researchers in three moments. Acceptance will be assessed from the acceptability test application with dishes served to students during the year. Statistical analyses will be performed using generalized linear models, which will be used to assess the impact of the intervention, and will include 3 main variables: intervention, time and the intervention x time interaction. DISCUSSION: This study will investigate if the impact of the implementation of interventions in the environment and in the dishes served to students may increase adherence and acceptance to school feeding. Positive results could show the effect of implementing interventions throughout Sumidouro's public school system, as well as throughout the country, aiming to improve the consumption of school meals. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-7mf794. Date of registration: December 27, 2018.

Niobic acid as a support for microheterogeneous nanocatalysis of sodium borohydride hydrolysis under mild conditions.

This study explores the stabilization by niobic acid, of Pt, Ni, Pd, and Au nanoparticles (NPs) for the efficient microheterogeneous catalysis of NaBH4 hydrolysis for hydrogen production. Niobic acid is the most widely studied Nb2O5 polymorph, and it is employed here for the first time for this key reaction relevant to green energy. Structural insights from XRD, Raman, and FTIR spectroscopies, combined with hydrogen production data, reveal the role of niobic acid's Brønsted acidity in its catalytic activity. The supported NPs showed significantly higher efficiency than the non-supported counterparts regarding turnover frequency, average hydrogen production rate, and cost. Among the tested NPs, PtNPs and NiNPs demonstrate the most favorable results. The data imply mechanism changes during the reaction, and the kinetic isotope assay indicates a primary isotope effect. Reusability assays demonstrate consistent yields over five cycles for PtNPs, although catalytic efficiency decreases, likely due to the formation of reaction byproducts.

Dietary approach to hypertension based on low glycaemic index and principles of DASH (Dietary Approaches to Stop Hypertension): a randomised trial in a primary care service.

Hypertension is one of the leading causes of morbidity and mortality in Brazil. Diet may play an important role in reducing blood pressure (BP), as has been shown for diets high in fruits, vegetables and low-fat dairy products and low in salt (Dietary Approaches to Stop Hypertension (DASH)-Na). A low-glycaemic index Brazilian diet combined with the principles of the DASH-Na diet was evaluated in a randomised study of 206 individuals who were followed for 6 months. In the control group (CG), counselling was based on standard care and mainly focused on salt intake reduction. An intention-to-treat analysis showed that, after 6 months, systolic BP was reduced by 14·4 mmHg and diastolic BP by 9·7 mmHg in the experimental group (EG), compared with 6·7 and 4·6 mmHg, respectively, in the CG. After adjusting for body weight, BP at baseline and age, these changes were 12·1 and 7·9 mmHg, respectively. Urinary Na excretion was also reduced by 43·4 mEq/24 h in the EG. Food intake was modified accordingly during the intervention with an increase in the consumption of vegetables (2·97-5·85 frequency of consumption measured in three non-consecutive days), fruits (4·09-7·18), beans (1·94-3·13) and fish (1·80-2·74) by the EG. The present study showed the feasibility of a Brazilian dietary approach to treating hypertension by reducing urinary Na excretion and BP, changes that may have a great impact on public health and promote the benefits of controlling hypertension.

Amorphous breast calcifications: is BI-RADS 4a appropriate?

Objective: To evaluate the positive predictive value (PPV) of amorphous calcifications and to analyze the imaging variables that could alter the risk of malignancy associated with this finding. Materials and Methods: This was a retrospective study of 138 stereotactically guided percutaneous vacuum-assisted biopsies of amorphous calcifications, performed between January 2012 and December 2017. All of the patients included were referred for radiological follow-up for a minimum of one year (if the histopathology showed a benign lesion) or for surgical treatment (if the histopathology showed malignancy or a lesion of uncertain malignant potential). Results: We found that the PPV of amorphous calcifications was 9.42%. However, most of the malignant amorphous calcifications were in cases of invasive carcinoma or high-grade ductal carcinoma in situ, indicating clinically relevant disease. The relative risk of malignancy associated with amorphous calcifications was 6.15 times higher in patients with a family or personal history of breast or ovarian cancer. Neither being postmenopausal nor having dense breasts was found to be predictive of malignancy in patients with amorphous calcifications. Conclusion: Amorphous calcifications in the breast had a PPV for malignancy of 9.42%, indicating the possibility of placing the finding in subcategory 4a, which requires histopathological analysis. Our finding that the risk of malignancy associated with this subtype of calcifications is up to 6.15 times higher in patients with a family or personal history of breast cancer warrants greater concern regarding the clinical, radiologic, and histopathologic correlations after biopsy.

Objetivo: Avaliar o valor preditivo positivo (VPP) das calcificações amorfas e possíveis variáveis clínicas e de imagem que possam influenciar no risco de malignidade deste achado de imagem. Materiais e Métodos: Foram revisados, retrospectivamente, 138 resultados de biópsias percutâneas estereotáxicas a vácuo de calcificações amorfas, entre janeiro de 2012 e dezembro de 2017. Todas as pacientes incluídas apresentavam seguimento radiológico mínimo de um ano (histopatológico benigno) ou tratamento cirúrgico (histopatológico maligno). Resultados: O VPP das calcificações amorfas foi de 9,42%. As lesões malignas corresponderam predominantemente a carcinomas invasivos, indicando doença clinicamente relevante. O risco relativo de malignidade das calcificações amorfas foi 6,15 vezes maior em pacientes com história familiar ou pessoal de neoplasia de mama ou ovário. Status pós-menopausa e mamas densas não foram preditores de malignidade nessas pacientes. Conclusão: As calcificações amorfas na mama apresentaram VPP de malignidade de 9,42%, sugerindo possibilidade de classificação do achado na subcategoria 4a, com necessidade de investigação histopatológica. Em pacientes com história familiar ou pessoal de câncer de mama, o risco de malignidade deste subtipo de calcificações pode ser até 6,15 vezes maior, justificando maior preocupação na correlação clínica, radiológica e histopatológica após biópsia.

Development and characterization of a temozolomide-loaded nanoemulsion and the effect of ferrocene pre and co-treatments in glioblastoma cell models.

BACKGROUND: Glioblastoma is a severe brain tumor that requires aggressive treatment involving surgery, radiotherapy, and chemotherapy, offering a survival rate of only 15 months. Fortunately, recent nanotechnology progress has enabled novel approaches and, alongside ferrocenes' unique properties of cytotoxicity, sensitization, and interaction with reactive oxygen species, have brought new possibilities to complement chemotherapy in nanocarrier systems, enhancing treatment results. METHODS: In this work, we developed and characterized a temozolomide-loaded nanoemulsion and evaluated its cytotoxic potential in combination with ferrocene in the temozolomide-resistant T98G and temozolomide-sensitive U87 cell lines. The effects of the treatments were assessed through acute assays of cell viability, cell death, mitochondrial alterations, and a treatment protocol simulation based on different two-cycle regimens. RESULTS: Temozolomide nanoemulsion showed a z-average diameter of 173.37 ± 0.86 nm and a zeta potential of - 6.53 ± 1.13 mV. Physicochemical characterization revealed that temozolomide is probably associated with nanoemulsion droplets instead of being entrapped within the nanostructure, allowing a rapid drug release. In combination with ferrocene, temozolomide nanoemulsion reduced glioblastoma cell viability in both acute and two-cycle regimen assays. The combined treatment approach also reversed T98G's temozolomide-resistant profile by altering the mitochondrial membrane potential of the cells, thus increasing reactive oxygen species generation, and ultimately inducing cell death. CONCLUSIONS: Altogether, our results indicate that using nanoemulsion containing temozolomide in combination with ferrocene is an effective approach to improve glioblastoma therapy outcomes.

In Vitro Screening of Non-Antibiotic Components to Mitigate Intestinal Lesions Caused by Brachyspira hyodysenteriae, Lawsonia intracellularis and Salmonella enterica Serovar Typhimurium.

Swine dysentery, ileitis, and porcine salmonellosis are production-limiting diseases of global importance for swine production. They are caused by infection with Brachyspira hyodysenteriae, Lawsonia intracellularis, and Salmonella enterica serovar Typhimurium, respectively. Currently, the prevention, treatment, and control of these diseases still relies on antimicrobials. The goal of this study was to evaluate the effectiveness of four commercially available non-antimicrobial compounds in preventing lesions caused by the bacteria cited above using an in vitro intestinal culture model. A total of five pigs per pathogen were used and multiple compounds were evaluated. For compound F (a fungal fermented rye), S (a blend of short and medium chain fatty acids), and P (a synergistic blend of short and medium chain fatty acids, including coated butyrates), a total of four explants/pig for each treatment were used, while for compound D (an extract of carob and thyme) only 12 explants/pig for each treatment were used. Explants were exposed to a combination of pathogen only (n = 4/compound/pig), compound only (n = 4/compound/pig), or pathogen and compound (n = 4/compound/pig) and sampled at two time-points. Histopathology and gene expression levels were evaluated to investigate the treatment effect on explants. Short and medium-chain fatty acids, and an extract of carob and thyme, was found to mitigate lesions due to B. hyodysenteriae exposure. A fungal fermented prebiotic increased healthy epithelial coverage when explants were exposed to L. intracellularis or S. Typhimurium. These findings represent a step towards finding alternatives to antimicrobials usage and control of swine dysentery, ileitis, and salmonellosis in pork production.

Dietary sodium intake remains high in Brazil: Data from the Brazilian National Dietary Surveys, 2008-2009 and 2017-2018.

Reducing salt intake is considered one of the most cost-effective interventions to decrease morbidity and mortality resulting from noncommunicable diseases. This study aimed to describe changes in sodium intake in the Brazilian population using data from the National Dietary Surveys (NDS) conducted in 2008-2009 and 2017-2018. We hypothesized that over the 10-year period evaluated, sodium intake has remained high in Brazil. Nationwide representative samples of 34,003 and 46,164 individuals (aged ≥10 years) from NDS 2008-2009 and 2017-2018, respectively, were evaluated. Food consumption data were obtained from 2 nonconsecutive food records (NDS 2008-2009) and two 24-hour food recalls (NDS 2017-2018). Trends, percentiles of distribution, and proportions of the population exceeding the age-specific tolerable upper intake level for sodium were estimated. Dietary sodium intake was also estimated as a function of energy intake (mg/1000 kcal). Overall, mean crude daily sodium intake was slightly lower in 2017-2018 than in 2008-2009 (2489 mg/d vs. 2529 mg/d). The decrease in sodium intake (mg/day) was statistically significant (P < .05) only among female adolescents and subjects in the highest income level. Additionally, an overall statistically significant increase in dietary sodium density was observed independent of age, sex, and income level for energy-adjusted data (P < .05). Our findings indicate that sodium intake has not significantly changed over time in the Brazilian population; thus, policies aimed at reducing sodium intake in Brazil are necessary.

Nanoencapsulation and bioaccessibility of polyphenols of aqueous extracts from Bauhinia forficata link.

Bauhinia forficata Link is a plant rich in polyphenols that has been used mainly for its hypoglycemic activity, which is related to its antioxidant and anti-inflammatory potential. However, the beneficial effect of these bioactive compounds is directly dependent on their bioaccessibility and bioavailability, requiring processing techniques that can improve and preserve their biological activities. This work aimed to obtain nanocapsulated extracts from the infusion (ESIN) and decoction (ESDC) of B. forficata Link leaves, by spray drying. The encapsulating agents used were maltodextrin and colloidal silicon dioxide. The nanocapsules were characterized by HPLC-PDA-ESI-IT-MS n , evaluated the bioaccessibility of polyphenols after simulated digestion and their antioxidant activity. Additionally, an extensive physicochemical characterization of the nanocapsulated extracts was carried out and their stability and technological parameters were evaluated. The ESIN and ESDC extracts had yields of 57.3 % and 62.7 %, with average nanocapsules sizes of 0.202 µm and 0.179 µm, low humidity and water activity (<0.5), powder density and proper flow properties (Hausner ratio ≤ 1.25; Carr index 18-19 %). Scanning electron microscopy showed a spherical and amorphous morphology and low viscosity, which may have favored the solubility profile. The phenolic compounds of the nanocapsules degraded after 400 °C, showing high thermal stability. The infrared spectra identified the presence of maltodextrin and phenolic compounds and that there were no reactions between them. Chromatography confirmed the presence of phenolic compounds, mainly flavonols and their O-glycosylated derivatives, as well as carbohydrates, probably maltodextrin. Simulated in vitro digestion showed that polyphenols and flavonoids from ESIN and ESDC nanocapsules were bioaccessible after the gastric phase (49.38 % and 64.17 % of polyphenols and 64.08 % and 36.61 % of flavonoids) and duodenal (52.68 % and 79.06 % of polyphenols and 13.24 % and 139.03 % of flavoids), with a variation from 52.27 % to 70.55 % of the antioxidant activity maintained, by the ORAC method, after gastric digestion and still 25 %, after duodenal. Therefore, the nanoencapsulation of extracts of B. forficata is a viable option for the preservation of their bioactive compounds, making them bioaccessible and with antioxidant activity, which make them suitable for incorporation into various nutraceutical formulations, such as capsules, tablets and sachets.

Dietary habits and inadequate control of blood pressure in hypertensive adults assisted by a Brazilian Family Doctor Program.

OBJECTIVE: To estimate dietary habits and other factors associated with inadequate blood pressure (BP) control in hypertensive patients adherent to antihypertensive drug treatment assisted by a Brazilian Family Doctor Program (FDP). DESIGN: A cross-sectional study. SETTING: FDP units, Niterói, Rio de Janeiro, Brazil. SUBJECTS: We included data from both male and female participants aged ≥20 years. Participants completed a standardized questionnaire containing questions related to demographics, socio-economic factors, comorbidities and lifestyle, as well as a validated FFQ and eleven additional qualitative questions to investigate dietary habits. Food items were divided into sixteen groups. Medical consultations were performed, BP measurements were taken, blood and urine samples were assessed and anthropometric and nutritional status was evaluated. RESULTS: Individuals with inadequate BP control presented higher BMI values (prevalence ratio (PR) = 1·027, 95% CI 1·009, 1·045) and also consumed more meat (PR = 1·091, 95% CI 1·022, 1·165), which are potentially modifiable variables. Higher levels of serum creatinine (PR = 1·894, 95% CI 1·241, 2·892) were also associated with inadequate BP control, as were skin colour (white). After inclusion of the Na excretion index, which is an indirect measure of salt intake, a slight decrease was observed in the PR for meat, which resulted in loss of statistical significance. CONCLUSIONS: The results indicate that salt consumption, skin colour, BMI and serum creatinine are associated with inadequate BP control.

Cell therapy with hiPSC-derived RPE cells and RPCs prevents visual function loss in a rat model of retinal degeneration.

Photoreceptor loss is the principal cause of blindness in retinal degenerative diseases (RDDs). Whereas some therapies exist for early stages of RDDs, no effective treatment is currently available for later stages, and once photoreceptors are lost, the only option to rescue vision is cell transplantation. With the use of the Royal College of Surgeons (RCS) rat model of retinal degeneration, we sought to determine whether combined transplantation of human-induced pluripotent stem cell (hiPSC)-derived retinal precursor cells (RPCs) and retinal pigment epithelial (RPE) cells was superior to RPE or RPC transplantation alone in preserving retinal from degeneration. hiPSC-derived RPCs and RPE cells expressing (GFP) were transplanted into the subretinal space of rats. In vivo monitoring showed that grafted cells survived 12 weeks in the subretinal space, and rats treated with RPE + RPC therapy exhibited better conservation of the outer nuclear layer (ONL) and visual response than RPE-treated or RPC-treated rats. Transplanted RPE cells integrated in the host RPE layer, whereas RPC mostly remained in the subretinal space, although a limited number of cells integrated in the ONL. In conclusion, the combined transplantation of hiPSC-derived RPE and RPCs is a potentially superior therapeutic approach to protect retina from degeneration in RDDs.

Periodontal Disease Impairs Muscle Recovery by Modulating the Recruitment of Leukocytes.

The purpose of this study is to analyze the impact of periodontal disease (PD) associated with physical exercise on inflammatory mediators and muscle repair. Twenty-four Wistar rats were divided into four groups: control (SH), healthy trained (TH), sedentary with PD (SP), and trained with PD (TP). PD was induced in groups SP and TP while the trained groups performed treadmill exercises for 8 weeks. For the analysis of IL-6, IL-10, TNF-α, and leukocyte count, we collected blood samples. Cryolesions were induced in the tibialis anterior and gastrocnemius, which were analyzed for morphological changes. The presence of PD modified leukocyte counts, while exercise showed an additive role. PD increased levels of IL-6, IL-10, and TNF-α, and physical exercise changed only values of IL-10. The association between physical exercise and PD was responsible for an increased concentration of leukocytes in the region of the inflammation. Serum levels of inflammatory markers were modified by PD and, when combined with exercise, may negatively modulate inflammation. The association between PD and physical exercise showed the most significant changes in the number of inflammatory cells and may negatively influence the process of muscle repair.

Correction to: Periodontal Disease Impairs Muscle Recovery by Modulating the Recruitment of Leukocytes.

The original version of this article contained mistakes, and the authors would like to correct them.

Trauma in Curitiba: multifactorial assessment of victims admitted to a university hospital. / Trauma em Curitiba: avaliação multifatorial de vítimas admitidas em um hospital universitário.

OBJECTIVE: to describe the epidemiological profile of trauma patients admitted to a referral hospital in Curitiba (PR). Also, to investigate trauma mechanisms and to evaluate trauma severity scores. METHODS: descriptive observational cross-sectional study. Data were collected by applying a questionnaire to victims admitted in the emergency room from December 2016 to February 2018. RESULTS: a total of 1354 trauma victims were included in the study, of which 60% were transported by SIATE and 40% by SAMU. Regarding gender, 70% of the patients were male. The mean age was 39.48 years. About the time and day of the calls, the largest proportion was concentrated on Friday night. In relation to the mechanism of trauma, in patients transported by SIATE, the most frequent in men was motorcycle collision (34.3%), while in women was same-level fall (21.42%). In SAMU, the most frequent mechanism regardless of gender was same-level fall (20.06% and 40.66%, respectively). Analyzing the severity scores, it was observed that 95.5% of the patients were classified as mild by the Glasgow Coma Scale. CONCLUSION: the profile of trauma victims analyzed in this large study is quite similar to what other national smaller studies have already described: young men victims of traffic accidents. Therefore, the economically active population is the most affected, reflecting in high cost to society.

OBJETIVO: descrever o perfil epidemiológico das vítimas de trauma atendidas em um hospital de referência no município de Curitiba (PR), bem como investigar os mecanismos do trauma, além de avaliar os escores de gravidade. MÉTODOS: estudo descritivo observacional transversal, cujos dados foram obtidos através da aplicação de questionário em vítimas atendidas na sala de emergência, entre dezembro de 2016 e fevereiro de 2018. RESULTADOS: foram incluídos no estudo 1354 vítimas de trauma, das quais 60% tiveram como transporte pré-hospitalar o Serviço Integrado de Atendimento ao Trauma em Emergência (SIATE), e 40%, o Serviço de Atendimento Móvel de Urgência (SAMU). Quanto ao sexo, 70% dos pacientes eram do sexo masculino. A média de idade foi de 39,48 anos. Sobre o horário e dia dos atendimentos, a maior proporção se concentrou no período noturno na sexta-feira. Quanto ao mecanismo do trauma, nos pacientes atendidos pelo SIATE, o mais frequente em homens foi a colisão de motocicleta (34,3%), enquanto que em mulheres foi a queda de mesmo nível (21,42%). Já no SAMU, o mecanismo mais frequente independentemente do sexo foi queda de mesmo nível (20,06% e 40,66%, respectivamente). Analisando-se os escores de gravidade, observou-se que 95,5% dos pacientes eram classificados como leves pela escala de coma de Glasgow. CONCLUSÕES: o perfil das vítimas analisadas neste grande estudo muito se assemelha a outros estudos nacionais menores: homens, jovens, vítimas de acidentes de trânsito. A população economicamente ativa, portanto, é a mais afetada, refletindo em alto custo para a sociedade.

Major food groups contributing to sodium intake in school-attending adolescents.

BACKGROUND: Excessive sodium intake is a risk factor for developing systemic arterial hypertension. Increased blood pressure during childhood increases the risk of hypertension in adulthood. Assessing sodium intake across different eating places is important, as the meals offered in different places can influence dietary quality. OBJECTIVE: This study aimed to assess the contribution of different food groups to the mean of sodium intake of school-attending adolescents in the city of Niterói, a metropolitan area of Rio de Janeiro, Brazil. SUBJECTS: A total of 347 public school students aged between 10 and 18 years participated in the study. METHODS: Food consumption was based on two 24-h dietary recalls. The reported items were grouped into 31 food groups and the percentage of contribution of each food group to total mean sodium intake was estimated. Sodium intake according to eating place was also estimated. RESULTS: The food groups mostly contributing to total sodium intake were rice, beans, savory biscuits, breads, beef, poultry, processed meat, filled cookies, pasta and potatoes. The highest sodium intake within the food groups occurred at home, except for savory biscuits and pizza, which showed a higher sodium intake percentage at school. Savory biscuits were the third-most consumed item contributing to the total sodium intake and were the main source of sodium when consumed at school (48.9%). CONCLUSION: Most sodium intake stemmed from ultra-processed food consumed at school. Therefore, actions to promote healthy eating habits within the school environment are necessary.

Bauhinia forficata in the treatment of diabetes mellitus: a patent review.

INTRODUCTION: Diabetes Mellitus has been considered an epidemic by the World Health Organization, with a high risk of morbidity and mortality. The treatment of this pathology consists in glycemic control, which can be done by oral hypoglycemic agents, insulin therapy, dietary guidance, regular physical activity, and psychosocial support. In addition, other adjuvant treatments are employed, such as phytotherapic, and one of the most used plants is Bauhinia forficata. AREAS COVERED: In the current review, patents using Bauhinia forficata for the Diabetes Mellitus treatment have been analyzed. There were 03 patents in WIPO, 01 in Espacenet, 01 in USPTO, and 02 in INPI. EXPERT OPINION: Patents on the adjuvant treatment of Diabetes Mellitus by Bauhinia forficata are discussed. Although there are some phytotherapy products containing this medicinal plant which has hypoglycemic effect here is still a need for the development of more products based on natural resources, for the treatment of this pathology, without side effects and with other benefits, to assist in the glycemia control in diabetic patients, and to improve their quality of life.

Design of a school randomized trial for nudging students towards healthy diet and physical activity to prevent obesity: PAAPAS Nudge study protocol.

OBJECTIVE: To evaluate the effectiveness of nudge activities at school on the students' body mass index (BMI). DESIGN: School-based factorial randomized community trial. SETTING: Eighteen public schools in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. PARTICIPANTS AND INTERVENTION: The 18 schools will be randomized into 4 group arms: group 1-control (without any activity); group 2-will receive educational activities in the classroom; group 3-will receive changes in the school environment (nudge strategies); group 4-will receive educational activities and changes in the school environment. Activities will occur during the 2018 school-year. MAIN OUTCOME MEASURE(S): The primary (BMI) and secondary (body fat percentage) outcomes will be assessed at baseline and after the study using a portable electronic scale with a segmental body composition monitor. The height will be measured by a portable stadiometer. ANALYSIS: Statistical analyses for each outcome will be conducted through linear mixed models that took into account the missing data and cluster effect of the schools.