Daytime Functional Usage Versus Night-Time Wearing: Identifying the Optimal Wearing Regimen for a Custom-Made Orthosis in the Treatment of Trapeziometacarpal Osteoarthritis.

OBJECTIVE: To compare the functional (daytime) use to the nightly use of an orthosis for patients affected by trapeziometacarpal osteoarthritis (OA). DESIGN: Randomized, controlled single-blind trial. SETTING: The rheumatology outpatient clinic of the University. PARTICIPANTS: Sixty participants diagnosed with trapeziometacarpal OA. INTERVENTIONS: Participants were randomly assigned into 2 groups: a functional group that used a functional hand-based thumb immobilization orthosis during activities of daily living and a night-time group that used the same orthosis at night. MAIN OUTCOMES MEASURES: The patients were evaluated at baseline and after 45, 90, 180, and 360 days considering: pain at the base of the thumb and in the hand, range of motion of the thumb, grip, and pinch strength, manual dexterity, and hand function. RESULTS: The groups were homogeneous at the beginning of the trial. No statistically significant difference was observed between groups over time for trapeziometacarpal pain (P=.646). For general hand pain, no statistically significant difference was found between groups over time (P=.594). Although both groups improved from baseline, there were no statistically significant differences between the groups in the vast majority of the assessed parameters. Statistically significant differences between the groups were found only in the following outcomes: thumb palmar abduction of the right hand (P=.023), pick-up test with closed eyes of the right hand (P=.048), and tripod grip strength of the right hand (P=.006). CONCLUSIONS: Both groups showed improvement in pain and function from baseline to the end of the intervention. However, there were no reported differences in these outcomes after a 1-year follow-up between the functional (daytime) and night-time use of orthosis in patients with trapeziometacarpal OA. This suggests that both types of usage can be offered to patients.

Effect of combined red and infrared wavelengths on inflammation, hemorrhage, and muscle damage caused by Bothrops leucurus snake venom.

To evaluate the effects of red and infrared wavelengths, separately and combined, on the inflammatory process and collagen deposition in muscle damage caused by B. leucurus venom. 112 mice were inoculated with diluted venom (0.6mg/kg) in the gastrocnemius muscle. The animals were divided into four groups: one control (CG) and three treatments, namely: 1) red laser (λ=660 nm) (RG), 2) infrared laser (λ=808 nm) (IG) and 3) red laser (λ=660 nm) + infrared (λ=808 nm) (RIG). Each group was subdivided into four subgroups, according to the duration of treatment application (applications every 24 hours over evaluation times of up to 144 hours). A diode laser was used (0.1 W, CW, 1J/point, ED: 10 J/cm2). Both wavelengths reduced the intensity of inflammation and the combination between them significantly intensified the anti-inflammatory response. Photobiomodulation also changed the type of inflammatory infiltrate observed and RIG had the highest percentage of mononuclear cells in relation to the other groups. Hemorrhage intensity was significantly lower in treated animals and RIG had the highest number of individuals in which this variable was classified as mild. As for collagen deposition, there was a significant increase in RG in relation to CG, in RIG in relation to CG and in RIG in relation to IG. Photobiomodulation proved to be effective in the treatment of inflammation and hemorrhage caused by B. leucurus venom and stimulated collagen deposition. Better results were obtained with the combined wavelengths.

Antifungal activity of sustainable histone deacetylase inhibitors against planktonic cells and biofilms of Candida spp. and Cryptococcusneoformans.

The limited therapeutic options for fungal infections and the increased incidence of fungal strains resistant to antifungal drugs, especially Candida spp., require the development of new antifungal drugs and strategies. Histone deacetylase inhibitors (HDACi), like vorinostat, have been studied in cancer treatment and have antifungal effects, acting alone or synergistically with classical antifungals. Here we investigated the antifungal activity of two novel sustainable HDACi (LDT compounds) based on vorinostat structure. Molecular docking simulation studies reveal that LDT compounds can bind to Class-I HDACs of Candida albicans, C. tropicalis, and Cryptococcus neoformans, which showed similar binding mode to vorinostat. LDT compounds showed moderate activity when tested alone against fungi but act synergistically with antifungal azoles against Candida spp. They reduced biofilm formation by more than 50% in C. albicans (4 µg/mL), with the main action in fungal filamentation. Cytotoxicity of the LDT compounds against RAW264.7 cells was evaluated and LDT536 demonstrated cytotoxicity only at the concentration of 200 µmol/L, while LDT537 showed IC50 values of 29.12 µmol/L. Our data indicated that these sustainable and inexpensive HDACi have potential antifungal and antibiofilm activities, with better results than vorinostat, although further studies are necessary to better understand the mechanism against fungal cells.

Fungal infections are neglected diseases that affect more than a billion people worldwide. Some histone deacetylase inhibitors can act against fungal cells. Our data reveal that HDACi LDT536 and LDT537 have potential antibiofilm and antifungal activities.

INCIDENCE OF NEW DIABETIC MACULAR EDEMA IN FELLOW EYES OF PATIENTS IN THE VISTA AND VIVID STUDIES.

PURPOSE: To characterize diabetic macular edema (DME) incidence in fellow eyes of patients treated for DME in the study eye. METHODS: This post hoc analysis of VISTA/VIVID data evaluated fellow eyes without DME at baseline through Week 100. Diabetic macular edema presence in the fellow eye was inferred by investigator-reported DME adverse events and use of DME treatments. RESULTS: Over 100 weeks, 44.9%, 44.2%, and 42.9% of fellow eyes developed DME in the intravitreal aflibercept injection 2 mg every 4 weeks (n = 245), intravitreal aflibercept injection 2 mg every 8 weeks (n = 258), and laser control (n = 252) groups, respectively. Mean time to DME development in combined treatment groups was ∼6 months. Multivariable regression analysis confirmed patients with shorter diabetes duration (hazard ratio per 10-year decrease, 1.16; 95% confidence interval, 1.03-1.30; P = 0.0160) and thicker baseline study eye central subfield thickness (hazard ratio per 10- µ m increase, 1.01; 95% confidence interval, 1.01-1.02; P = 0.0002) were at higher risk of developing DME in the fellow eye. CONCLUSION: Among patients with DME in one eye at baseline, almost half developed DME in the fellow eye over 2 years. Shorter duration of diabetes and thicker study eye central subfield thickness were predictors of DME development in the fellow eye.

Transcranial direct current stimulation during a prolonged cognitive task: the effect on cognitive and shooting performances in professional female basketball players.

The negative effect of prolonged cognitive demands on psychomotor skills in athletes has been demonstrated. Transcranial direct current stimulation (tDCS) could be used to mitigate this effect. This study examined the effects of tDCS over the left dorsolateral prefrontal cortex (DLPFC) during a 30-min inhibitory Stroop task on cognitive and shooting performances of professional female basketball players. Following a randomised, double-blinded, sham-controlled, cross-over design, players were assigned to receive anodal tDCS (a-tDCS, 2 mA for 20 min) or sham-tDCS in two different sessions. Data from 8 players were retained for analysis. Response Time decreased significantly over time (p < 0.001; partial η2 = 0.44; no effect of condition, or condition vs. time interaction). No difference in mean accuracy and shooting performance was observed between tDCS conditions. The results suggest that a-tDCS exert no additional benefits in reducing the negative effects of prolonged cognitive demands on technical performance compared to sham (placebo).Practitioner summary: Prolonged cognitive demands can negatively affect the athletes' performance. We tested whether transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) could attenuate these effects on cognitive and shooting performance in professional female basketball players. However, tDCS did not exert any additional benefits compared to sham.Abbreviations: tDCS: transcranial direct current stimulation; a-tDCS: anodal transcranial direct current stimulation; PFC: prefrontal cortex; DLPFC: dorsolateral prefrontal cortex; PCT: prolonged cognitive task; TT: time trial; RT: response time; NASA-TLX: National Aeronautics and Space Administration Task Load Index; RPE: ratings of perceived exertion; CR-10 scale: category rating scale; EEG: electroencephalogram; AU: arbitrary units.

SARS-COV-2 genomic monitoring in the state of São Paulo unveils two emerging AY.43 sublineages.

Delta VOC is highly diverse with more than 120 sublineages already described as of November 30, 2021. In this study, through active monitoring of circulating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants in the state of São Paulo, southeast Brazil, we identified two emerging sublineages from the ancestral AY.43 strain which were classified as AY.43.1 and AY.43.2. These sublineages were defined by the following characteristic nonsynonymous mutations ORF1ab:A4133V and ORF3a:T14I for the AY.43.1 and ORF1ab:G1155C for the AY.43.2 and our analysis reveals that they might have a likely-Brazilian origin. Much is still unknown regarding their dissemination in the state of São Paulo and Brazil as well as their potential impact on the ongoing vaccination process. However, the results obtained in this study reinforce the importance of genomic surveillance activity for timely identification of emerging SARS-CoV-2 variants which can impact the ongoing SARS-CoV-2 vaccination and public health policies.

The use of social media as a tool for patient blood management and transfusion medicine education.

BACKGROUND AND OBJECTIVES: Transfusion is one of the most performed medical procedures. Wrong indications are common and are probably related to the scarcity of transfusion teaching during medical education. The development of a new way to improve transfusion education is paramount. Social media has the potential to reach larger audiences for rapid communication of medical content. The use of social media for transfusion education in Brazil has not been published. The aim of this article is to describe a new tool to improve transfusion learning. MATERIALS AND METHODS: Evidence-based cards were created. Initially, these cards were sent by WhatsApp. Later, Instagram and Facebook pages were created. EducaSangue, as this e-learning project was called, is a tool for the spreading of transfusion knowledge that permits the exchange of experiences. RESULTS: By April 2021, Facebook and Instagram pages had 8300 and 5100 followers, respectively. Cards about single red blood cell (RBC) unit, alternatives to transfusion, transfusion reactions and pre-transfusion tests were published. Doctors and other health professionals follow EducaSangue. RBC transfusions reduced in Ceara and single-unit RBC increased by 28%, although not statistically significant. In Brazil, the minority of medical schools have transfusion as a discipline. The scarcity of transfusion education is related to the poorer care of the patient. Technological innovation has been used for educational changes and is an alternative to formal education. CONCLUSION: Social media is an interesting tool to provide quality to medical services, since they can reach a broader public, especially where personal contact is difficult.

Cyclopeptide Alkaloids from Discaria chacaye (Rhamnaceae) as Result of Symbiosis with Frankia (Actinomycetales).

Cyclopeptide alkaloids with different biological activities are present in plants of the family Rhamnaceae. Plants of this family grow in a symbiotic relationship with aerobic Gram-positive actinomycetes belonging to the genus Frankia. This goal of this research was a study of the comparative profile of alkaloids present in Discaria chacaye and to establish a connection between the presence or absence of Frankia sp. and the alkaloids. In addition, insecticidal activities of the alkaloidal extract were examined. A total of 24 alkaloids were identified, of which 12 have a benzylisoquinoline skeleton, 9 were cyclopeptides, 2 isoquinolines, and 1 aporphine. The presence of cyclopeptide alkaloids is associated with Frankia nodules in the plant root. The alkaloid extracts showed insecticidal activity with mortality dose-dependence and LD50 values between 44 to 71 µg/mL.

Evaluating the implementation of user embracement in the healthcare system of Jaboatão dos Guararapes city, Brazil.

BACKGROUND: The advent of the Family Health Strategy required healthcare teams to strengthen bonding and accountability towards users. In this sense, humanisation has been the key to a successful care provision and to the acceptance of interventions that can meet demands. Our study aimed to evaluate the implementation of user embracement in Family Health Units of Jaboatão dos Guararapes, Pernambuco, Brazil. METHODS: The studied population belonged to 48 Family Health teams. Eighty-five healthcare workers with higher education answered the questionnaire, and the registration forms of 272 users were examined, from which sociodemographic information was gathered. These data were analysed according to the degree of vulnerability. Questionnaire results were collected and tabulated using the HCMaps software. Dimensions were analysed through a Likert-type grading scale ranging from 1 to 5. This is an evaluative, cross-sectional study with a quantitative approach, considering the dimensions proposed in the RE-AIM framework. RESULTS: User embracement was considered unsatisfactory, as were Reach and Adoption. The Effectiveness, Implementation, and Maintenance dimensions yielded satisfactory results. The main ones were the perception of user embracement as a screening process, and the delimitation of open slots and/or schedules. CONCLUSIONS: The study shows that user embracement has been effective in strengthening bonds, reducing queues, and solving demands. However, the potential user embracement sustainability and implementation have been hampered by factors related to the Adoption of the intervention.

Influence of different PEG/salt aqueous two-phase system on the extraction of 2,3-butanediol.

The production of 2,3-butanediol (2,3-BDO), a dialcohol of great interest for the food, chemical, and pharmaceutical industry, through the fermentation of biomass, is a sustainable process strategic position for countries with abundant biomass generated by the agribusiness. However, the downstream process of 2,3-BDO is onerous due to the complexity of fermentation broth and the physical-chemical characteristics of the 2,3-BDO. This study investigated the feasibility of 2,3-BDO extraction from model aqueous solutions using aqueous two-phase systems (ATPS). A central composite rotational design (CCRD) was employed to evaluate different ATPS compositions and the influences on the 2,3-BDO recovery and partition coefficient. The polyethylene glycol (PEG) and different concentrations of sodium citrate, ammonium sulfate, and potassium phosphate were investigated. The concentration of salt and PEG in the ATPS was identified as the most significant factors influencing the recovery and partition coefficient of 2,3-BDO. The recovery of 2,3-BDO reached 94.5% and was obtained when the system was composed of 36.22% (w/w) of PEG 4000 and 4.47% (w/w) of potassium phosphate. The results indicate that ATPS based on PEG-salt has a high potential for industrial application, using mild conditions and a simple process for recovering and purifying the 2,3-BDO produced from microbiological synthesis.

What predicts employer discrimination? The role of implicit and explicit racial attitudes.

Hiring discrimination against black jobseekers remains prevalent in the United States. Yet, despite strong evidence about the existence of employer discrimination, we know relatively little about what motivates employers' discriminatory behavior. I draw on an original two-wave study with a sample of white hiring agents to examine whether respondents' explicit (deliberate) and implicit (automatic) racial attitudes predict their evaluations of white and black job applicants. Building on dual-process models of the attitude-behavior relationship, I theorize that the hiring process at many U.S. organizations-characterized by ambiguity, time pressure and distractions, and the legitimacy of emotions as a decision-making tool-encourages decision-making based on implicit rather than explicit cognition. Consistent with this theorization, I find implicit, but not explicit, racial attitudes predict respondents' evaluations of white applicants, and of black applicants relative to white applicants. This suggests hiring agents' behavior reflects implicit biases, rather than deliberate avoidance. The results further highlight the role of pro-white bias, not solely anti-black sentiment, in explaining discrimination: implicit attitudes were associated with bias in favor of white jobseekers, not only with discrimination against black jobseekers relative to white jobseekers. Finally, in open-ended responses, hiring agents explain their racially-motivated evaluations without invoking race, suggesting the ambiguity of the hiring process enables them to justify their behavior as colorblind. Together, these findings illustrate how employers can portray an egalitarian image while engaging in racially-motivated behavior.

Comparative proteomic analyses reveal the metabolic aspects and biotechnological potential of nitrate assimilation in the yeast Dekkera bruxellensis.

The yeast Dekkera bruxellensis is well-known for its adaptation to industrial ethanol fermentation processes, which can be further improved if nitrate is present in the substrate. To date, the assimilation of nitrate has been considered inefficient because of the apparent energy cost imposed on cell metabolism. Recent research, however, has shown that nitrate promotes growth rate and ethanol yield when oxygen is absent from the environment. Given this, the present work aimed to identify the biological mechanisms behind this physiological behaviour. Proteomic analyses comparing four contrasting growth conditions gave some clues on how nitrate could be used as primary nitrogen source by D. bruxellensis GDB 248 (URM 8346) cells in anaerobiosis. The superior anaerobic growth in nitrate seems to be a consequence of increased cell metabolism (glycolytic pathway, production of ATP and NADPH and anaplerotic reactions providing metabolic intermediates) regulated by balanced activation of TORC1 and NCR de-repression mechanisms. On the other hand, the poor growth observed in aerobiosis is likely due to an oxidative stress triggered by nitrate when oxygen is present. These results represent a milestone regarding the knowledge about nitrate metabolism and might be explored for future use of D. bruxellensis as an industrial yeast. KEY POINTS: • Nitrate can be regarded as preferential nitrogen source for D. bruxellensis. • Oxidative stress limits the growth of D. bruxellensis in nitrate in aerobiosis. • Nitrate is a nutrient for novel industrial bioprocesses using D. bruxellensis.

Evaluation of quality and gene expression of goat embryos produced in vivo and in vitro after cryopreservation.

In the present study, we aimed to identify morphological and molecular changes of in vivo and in vitro-produced goat embryos submitted to cryopreservation. In vivo embryos were recovered by transcervical technique from superovulated goats, whereas in vitro produced embryos were produced from ovaries collected at a slaughterhouse. Embryos were frozen by two-steps slow freezing method, which is defined as freezing to -32 °C followed by transfer to liquid nitrogen. Morphological evaluation of embryos was carried out by assessing blastocoel re-expansion rate and the total number of blastomeres. The expression profile of candidate genes related to thermal and oxidative stress, apoptosis, epigenetic, and implantation control was measured using RT-qPCR based SYBR Green system. In silico analyses were performed to identify conserved genes in goat species and protein-protein interaction networks were created. In vivo-produced embryos showed greater blastocoel re-expansion and more blastomere cells (P < 0.05). The expression level of CTP2 and HSP90 genes from in vitro cryopreserved embryos was higher than their in vivo counterparts. Unlikely, no significant difference was observed in the transcription level of SOD gene between groups. The high similarity of CPT2 and HSP90 proteins to their orthologs among mammals indicates that they share conserved functions. In summary, cryopreservation negatively affects the morphology and viability of goat embryos produced in vitro and changes the CPT2 and HSP90 gene expression likely in response to the in vitro production process.

Combining fruit pulp and rice protein agglomerated with collagen to potencialize it as a functional food: particle characterization, pulp formulation and sensory analysis.

In this study, agglomeration process was applied in concentrated rice protein (RP) powder using hydrolyzed collagen (HC) as binder to improve wetting time and flowability, aiming at its application in the food industry, namely for fruit pulp supplementation. Fruit pulps from acerola (Malpighia emarginata), cashew (Anarcadium occidentale), guava (Psidium guajava), soursop (Annona muricate), passion fruit (Passiflora edulis) and mandarin (Citrus reticulata) replaced in 1-5% (w/w) by RP or RP agglomerated with collagen were evaluated in terms of viscosity/color and sensory attributes. The addition of RP led to changes in the color of the pulps analyzed, resulting in a red and yellowish color. Viscosity analysis showed that the agglomeration process increased RP dispersion as a function of collagen concentration. The percentage of concentrated RP and RP agglomerated with collagen was limited to 1-3% in order to generate acceptance levels higher than 80%, which is similar to the acceptance rate of pulps without any addition (control-NA).

A green method for determination of ethanol in homeopathic medicines using thermal infrared enthalpimetry.

In this work, a simple and fast method is proposed for the determination of ethanol in homeopathic medicines using thermal infrared enthalpimetry (TIE). Samples containing alcohol in a wide concentration range (from 5% to 95% v/v) were used. Purified water or absolute ethanol was added directly into homeopathic medicine and increase of temperature was monitored using an infrared camera. Total volume, stirring speed and dispensing rate of solutions were the most significant parameters studied for method optimization. A response surface methodology (RSM) was used for optimization of the experimental conditions. The method was validated in the following parameters: selectivity, linearity, linear range, precision (repeatability and intermediate precision), limit of detection and quantification, accuracy and robustness. Linear range was obtained from 4% to 55% (ethanol, v/v). The proposed method showed accuracy in agreement with the conventional one. The proposed method it was demonstrated a good alternative for determination of ethanol in homeopathic medicines, presenting low cost, fast analysis and agreement with the principles of green analytical chemistry.

Effectiveness of Nighttime Orthoses in Controlling Pain for Women With Hand Osteoarthritis: A Randomized Controlled Trial.

IMPORTANCE: Hand osteoarthritis is a musculoskeletal problem that is associated with hand pain, stiffness, functional limitation, decreased grip strength, and reduced quality of life. OBJECTIVE: To evaluate the effectiveness of nighttime orthoses on the second or third finger of the dominant hand in controlling pain in women with symptomatic osteoarthritis (OA) in the interphalangeal joint. DESIGN: Randomized controlled trial. SETTING: Outpatient clinic. PARTICIPANTS: Fifty-two women with symptomatic OA and presence of Heberden's and Bouchard's nodes, allocated randomly to the intervention group or the control group. INTERVENTION: The intervention group used a nighttime orthosis on the second or third finger of the dominant hand. Both groups participated in an educational session. OUTCOMES AND MEASURES: The following parameters were measured: pain (numerical rating scale, Australian/Canadian Osteoarthritis Hand Index), grip and pinch strength, function (Cochin Hand Functional Scale), and manual performance (Moberg Pick Up Test). RESULTS: The intervention group showed a statistically significant improvement in pain (p < .001) and hand function. The improvement in pain correlated with Cochin Hand Functional Scale scores and the absence of Bouchard's nodes in the third finger, which are predictors of the best prognosis for treatment with a nighttime orthosis. CONCLUSIONS AND RELEVANCE: This study demonstrates that nighttime orthoses are effective in reducing pain and lead to improvement in hand function in women with hand OA. They are therefore specifically recommended for nonpharmacological treatment of hand OA. WHAT THIS ARTICLE ADDS: Orthoses can be considered, together with manual exercises and joint protection, as an intervention to reduce symptoms and improve hand function in people with hand OA. This study is an important step in empowering occupational therapists to determine appropriate and effective intervention for clients with OA.

PATHOLOGIC FINDINGS IN 36 SLOTHS FROM BRAZIL.

Sloths are xenarthrans from Central and South America with a highly adapted morphophysiology. Five of the six known species of sloths are found in Brazil, among which Bradypus torquatus (maned three-toed sloth) is considered a vulnerable species by International Union for Conservation of Nature. Nevertheless, knowledge on health and disease of sloths is very scarce, thus this study aimed to describe macroscopic and microscopic findings in 36 Brazilian sloths. The most common findings included iron storage disorder, probable bacterial pneumonia, gastric and intestinal nematode parasitism, and a presumptive diagnosis of systemic mastocytosis.

Canine visceral leishmaniasis: Detection of Leishmania spp. genome in peripheral blood of seropositive dogs by real-time polymerase chain reaction (rt-PCR).

Visceral leishmaniasis (VL) is a zoonosis caused by the protozoa of the genus Leishmania. Among the species, L. infantum and/or L. infantum (chagasi) are the most important species affecting the Americas. Domestic dogs are the main reservoir of the parasite and participate effectively in the parasite' transmission cycle. The Canine Visceral Leishmaniasis Control Program (PCLV) adopted in Brazil present as strategies the vector control, health education and serological diagnosis of CVL in dogs followed by culling of the seropositive ones. The resolution to eliminate seropositive dogs by euthanasia, when necessary, are the most controversial and least accepted by society. The diagnostic methods for canine visceral leishmaniasis, currently indicated and approved in Brazil by the Ministry of Health from Brazil are the Dual Path Platform (DPP)® as a screening test and the Enzyme immunoassay test (ELISA®). This study aimed to verify the presence of Leishmania spp. DNA in peripheral blood samples of dogs presenting positive serological results byDPP® and ELISA® tests,throughreal-time polymerase chain reaction (rt-PCR), using the pair of primers 150-152 already described. For this purpose, were collected blood samples from 185 seropositive dogs among them, 41 (22%) exhibited some clinical signal of disease, whereas 144 (78%) was asymptomatic. The animals were also analyzed according to gender, race and hair size. According to the results of rt-PCR, it was observed that among the185 seropositive dogs analyzed, only 132 (71%) presented positive results for CVL and 53 (29%) presented negative results. From this, 41/41 symptomatic dogs were positive (100%), while among the asymptomatic dogs, 91/144 were positive (63, 2%) and 53/144 were negative (36, 8%). Concerning the hair size of seropositive dogs, we found that 41 (22%) had long hair, while 144 (78%) had short hair. No statistical significance occurred between the results of rt-PCR, ELISA and DPP tests and the profile of the animals (gender, size of the dogs and hair size), probably due to the small number of samples and the sampling differences of each profile. But statistical significance occurred between the results of rt-PCR and the clinical evaluation, since the rt-PCR was positive in all symptomatic dogs. Thus, through these results, we reached at the following question, which may contribute to an important current debate: the dogs presenting CVL seropositive diagnosis confirmed by tests distributed by the Ministry of Health were in reality ill or were they seropositive by living in an endemic area of the disease? Would these asymptomatic seropositive dogs spread the disease to the inhabitants even presenting a low parasite charge circulating in the blood.

Manual Therapy as Treatment for Chronic Musculoskeletal Pain in Female Breast Cancer Survivors: A Systematic Review and Meta-Analysis.

OBJECTIVE: The purpose of this systematic review was to investigate the effectiveness of manual therapy (MT) for chronic musculoskeletal pain (CMP) in the upper limbs and thorax of female breast cancer survivors and to investigate the changes in the quality of life and function of these patients. METHODS: Systematic searches were performed in the databases MEDLINE/PubMed, Cumulative Index of Nursing and Allied Health/EBSCO, Web of Science, and Physiotherapy Evidence Database, through March 2018, to identify randomized controlled trials investigating whether MT was effective to treat CMP pain in female breast cancer survivors (PROSPERO number CDR42017074175). RESULTS: The database searches retrieved 1562 titles, and after screening, 5 papers were included for full analysis. The manual therapy techniques described in the included studies involved myofascial induction, myofascial release, classic massage, ischemic compression of trigger points, and myofascial therapy. A meta-analysis, using a fixed-effects model, found that MT decreased CMP intensity (standardized mean difference: 0.32; 95% CI 0.06-0.57), but no significant difference was observed in quality of life after the MT intervention in comparison with a control condition (standardized mean difference: 0.14; 95% CI 0.17-0.46). CONCLUSION: Current evidence suggests that MT is considered effective for treating CMP in the upper limbs and thorax of female breast cancer survivors.

Paracoccidioidomycosis: Detection of Paracoccidioides brasiliensis´ genome in biological samples by quantitative chain reaction polymerase (qPCR).

Paracoccidioidomycosis (PCM) is a chronic mycosis caused by the saprobic and dimorphic species Paracoccidioides brasiliensis and P. lutzii. This disease is prevalent in Latin American countries. PCM appears as a relevant concern and challenge for the mycologists, since until now there is no a methodology suitable for an efficient and safe diagnosis and species identification. Thus, the present study aimed to validate a methodology for PCM´s diagnosis, using quantitative Polymerase Chain Reaction (qPCR) through target amplification of the gene encoding the recombinant protein Pb27, a common protein to the both species Paracoccidioides brasiliensis and P. lutzii. The experiments were performed in vitro to determine the specificity, efficiency and detection limit of qPCR assay, using specific primers and probe, which sequences were subject to a patent deposited in Brazilian CTIT, under the registration number: BR1020160078830. According to the results the technique showed sensitivity of 94% and specificity of 100%, demonstrating that it will be possible to develop a new fast and safe diagnostic PCM and can be standardized in order to present a low cost, accessible to the patient served by the public health system in Brazil and Latin America.