Old but still good: genetic diversity of ancient pecan genotypes from southern Brazil.

Pecan [Carya illinoinensis (Wangenh.) K. Koch] is a crop fruit native to the USA and Mexico currently cultivated in several countries, including Brazil, Uruguay, Argentina, Chile, Peru, China, South Africa, and Australia. Supported by the increasing consumption and market prices, the interest in the cultivation of this fruit crop is strongly growing around the world. In this study, AFLP and S-SAP markers were employed to characterize the genetic diversity of ancient accessions of pecan from southern Brazil. The evaluated plants were selected and preserved by the farmers and are remnants of the first introduction of seedlings from the U.S.A into southern Brazil aiming at developing research towards establishing commercial orchards. High levels of genetic diversity were estimated, suggesting that these plants have an important genetic background for the establishment of a germplasm collection with a wide genetic basis, for the development of breeding programs for this fruit crop. Cluster analysis of the genetic datasets revealed some correlation between the nuts' morphometric traits and genetic markers. Such correlation should be further exploited. These ancient genotypes must be evaluated for other agronomic traits of interest and included in core collections of pecans.

Seaweeds and Corals from the Brazilian Coast: Review on Biotechnological Potential and Environmental Aspects.

Brazil has a megadiversity that includes marine species that are distributed along 800 km of shoreline. This biodiversity status holds promising biotechnological potential. Marine organisms are important sources of novel chemical species, with applications in the pharmaceutical, cosmetic, chemical, and nutraceutical fields. However, ecological pressures derived from anthropogenic actions, including the bioaccumulation of potentially toxic elements and microplastics, impact promising species. This review describes the current status of the biotechnological and environmental aspects of seaweeds and corals from the Brazilian coast, including publications from the last 5 years (from January 2018 to December 2022). The search was conducted in the main public databases (PubChem, PubMed, Science Direct, and Google Scholar) and in the Espacenet database (European Patent Office-EPO) and the Brazilian National Property Institute (INPI). Bioprospecting studies were reported for seventy-one seaweed species and fifteen corals, but few targeted the isolation of compounds. The antioxidant potential was the most investigated biological activity. Despite being potential sources of macro- and microelements, there is a literature gap regarding the presence of potentially toxic elements and other emergent contaminants, such as microplastics, in seaweeds and corals from the Brazilian coast.

Word Reading and Spelling Processing and Acquired Dyslexia post Unilateral Stroke.

This study investigates the performance of adults with cerebrovascular lesion in the right hemisphere (RHL) or left hemisphere (LHL) in word reading (TLPP) and spelling (TEPP) tasks based on the dual-route models. A total of 85 adults were assessed, divided into three groups: 10 with RHL, 15 with LHL, and 60 neurologically healthy ones. The performance of the three groups was compared in terms of the characteristics of the words (regularity, frequency, and length) and pseudowords (length), error types, and psycholinguistic effects. A cluster analysis was performed to investigate the profiles of the reading. The LHL group showed lower scores in reading and spelling tasks of words and pseudowords, as well as a higher frequency of errors. Four LHL cases were found to have an acquired dyslexia profile. This study highlights that the tasks developed in Brazil are in accordance with theoretical models of written language, and the results point to the heterogeneous performance of the cases with acquired dyslexia.

Multielement determination (essential and potentially toxic elements) in eye shadows exposed to consumption in Brazil using ICP OES.

Worldwide, cosmetics (especially eye shadows) are widely consumed and have a great impact on the economy. The aim of this study was to determine the multielement composition, focusing on essential and potentially toxic elements, in cosmetics (eye shadow) exposed to consumption in Brazil. Concentrations of 17 elements (Al, As, Ba, Cd, Co, Cr, Cu, Mn, Mo, Ni, Pb, Sb, Se, Sr, Ti, V and Zn) were determined in samples (produced in China and Brazil) using a sequential optical emission spectrometer with inductively coupled plasma (ICP OES) after acid digestion, assisted by a closed digester block (6 mL of HNO3 + 2 mL of H2O2 + 1 mL of Triton ×-100 + 1 mL of ultrapure water). The method was validated by linearity, precision, accuracy, limits of detection (LoD) and quantification (LoQ). The elements were quantified (in µg g-1): Al (852-21,900), Ba (3.47-104), Cd (1.70-6.93), Cr (< 8.53-66.6), Cu (< 0.480-14.5), Mn (92.20-1,190), Ni (< 4.23-40.7), Pb (< 2.16-5.06), Sb (1.10-10.5), Sr (0.760-46.0), Ti (32.0-440), V (< 0.85-1.7) and Zn (24.90-2,600). As, Co, Mo and Se in all the investigated samples were found to be below the LoQ values of ICP OES. In this study, regardless of sample compositions and origins (Brazilian or Chinese), high levels of Al, Cd, Cr, Cu, Mn, Ni, Pb, Sb, Ti, V and Zn were observed, exceeding the recommended maximum tolerable limits, according to Brazilian and global legislations, which may present potential risks to human health and the environment.

Laparoscopy assisted abomasal cannulation in cadavers of bovine fetuses.

BACKGROUND: Due to the complexity of ruminant digestion, cannulation of organs of the digestive tract has been carried out in order to advance the understanding of digestive physiology, nutrient degradability, gastrointestinal diseases and biotechnological research. The abomasal cannulation is interesting for nutritional studies, especially in suckling calves, to obtain fluid and abomasal content, evaluation of abomasal flow and function, and infusion of nutrients and drugs when it is intended to reach high concentrations in the organ. Conventionally, access and cannulation of digestive organs of ruminants has been performed by laparotomy, a method often criticized and classified as cruel by some sectors related to ethics and animal welfare. The aim of this present study is to describe and standardize a minimally invasive by laparoscopy assisted abomasal cannulation in bovine fetuses (cadavers), which had been previously slaughtered by accident and would be discarded in local slaughterhouses. RESULTS: The abomasal cannulation technique was feasible, simple and did not present major difficulties. The surgical time for cannulation of the abomasum, from the insertion of the trocars to the completion of the technique with fixation of the organ to the abdominal wall, ranged from 9 to 27 min, with an average of 15.5 ± 6.62 min. CONCLUSIONS: The Laproscopic assisted abomasal cannulation in bovine fetuses was feasible and safe with minimal tissue injury to the abdominal wall and with short surgical time. More studies in the clinical routine related to minimally invasive abomasal content collection, abomasopexy and abomasotomy are required in order to demonstrate its impact and importance in bovine clinic.

Schools reopening and the COVID-19 pandemic: a case study from Macaé, Rio de Janeiro, Brazil.

Since the first reported case of COVID-19 in Brazil, the public and private educational system started to close. Up to November 2020, scientific discussions about the return of schooling activities have been rarely performed by the national scientific community and police-makers. The great delay of school returning in Brazil contrasts with successful international strategies of school reopening worldwide and seems counterintuitive with the reopening of non-essential activities. Here, important issues to be considered before and during school reopening are reviewed and discussed. COVID-19 testing is essential to avoid disease spreading, but high cost of individual RT-qPCRs impairs an extensive testing strategy for school returning. To reduce costs and increase the speed of diagnosis, we tested the efficiency of a pooled-sample PCR strategy in a cohort of the educational staff in the city of Macaé/RJ, finding five asymptomatic individuals (0,66%) among the 754 people tested. Thus, a polled-sample PCR testing strategy of the educational staff might prevent infection spreading in schools at a reasonable cost. We discuss how our test strategy could be coupled with internationally recognized safety rules to allow for a safe school return and how countries from different world regions are dealing with educational activities during COVID-19 pandemic.

Establishment of suitable reference genes for studying relative gene expression during the transition from trophozoites to cyst-like stages and first evidences of stress-induced expression of meiotic genes in Trichomonas vaginalis.

Trichomonas vaginalis is a parasite of the human urogenital tract and the causative agent of trichomoniasis, a sexually transmitted disease of worldwide importance. This parasite is usually found as a motile flagellated trophozoite. However, when subjected to stressful microenvironmental conditions, T. vaginalis trophozoites can differentiate into peculiar cyst-like stages, which exhibit notable physiological resistance to unfavourable conditions. Although well documented in morphological and proteomic terms, patterns of gene expression changes involved in the cellular differentiation into cyst-like stages are mostly unknown. The real-time reverse transcription polymerase chain reaction (RT-qPCR) is recognized as a sensitive and accurate method for quantification of gene expression, providing fluorescence-based data that are proportional to the amount of a target RNA. However, the reliability of relative expression studies depends on the validation of suitable reference genes, which RNAs exhibit a minimum of variation between tested conditions. Here, we attempt to determine suitable reference genes to be used as controls of invariant expression during cold-induced in vitro differentiation of T. vaginalis trophozoites into cyst-like forms. Furthermore, we reveal that the mRNA from the meiotic recombinase Dmc1 is upregulated during this process, indicating that cryptic sexual events may take place in cyst-like stages of T. vaginalis.

Evolution and multiple roles of the Pancrustacea specific transcription factor zelda in insects.

Gene regulatory networks (GRNs) evolve as a result of the coevolutionary processes acting on transcription factors (TFs) and the cis-regulatory modules they bind. The zinc-finger TF zelda (zld) is essential for the maternal-to-zygotic transition (MZT) in Drosophila melanogaster, where it directly binds over thousand cis-regulatory modules to regulate chromatin accessibility. D. melanogaster displays a long germ type of embryonic development, where all segments are simultaneously generated along the whole egg. However, it remains unclear if zld is also involved in the MZT of short-germ insects (including those from basal lineages) or in other biological processes. Here we show that zld is an innovation of the Pancrustacea lineage, being absent in more distant arthropods (e.g. chelicerates) and other organisms. To better understand zld´s ancestral function, we thoroughly investigated its roles in a short-germ beetle, Tribolium castaneum, using molecular biology and computational approaches. Our results demonstrate roles for zld not only during the MZT, but also in posterior segmentation and patterning of imaginal disc derived structures. Further, we also demonstrate that zld is critical for posterior segmentation in the hemipteran Rhodnius prolixus, indicating this function predates the origin of holometabolous insects and was subsequently lost in long-germ insects. Our results unveil new roles of zld in different biological contexts and suggest that changes in expression of zld (and probably other major TFs) are critical in the evolution of insect GRNs.

Morphological and molecular characterization of a species of Tetratrichomonas present in feces of Brazilian sheep (Ovis aries) and goats (Capra hircus).

The trichomonads form part of the phylum Parabasalia, a complex assemblage of diverse species of flagellated protists, with some members recognized as pathogens of men and/or animals. Associations, probably as commensals, between the species Tetratrichomonas ovis and sheep were reported in North America during the 1960s based on morphological and cultural characteristics. Intriguingly, no subsequent studies of this topic have been published. Feces, collected from sheep (n = 55) and goats (n = 14), reared on small-scale, production facilities in Southeastern Brazil, were examined for parabasalids. Protozoa, demonstrating morphologies and motility characteristic of trichomonads, were detected by direct microscopy in 64% of sheep and 43% of goat samples. In contrast to T. ovis, none of the samples could be cultured in Diamond's medium; however, cultures were obtained for three goat and seventeen sheep samples in peptonized broth. Based on morphological analyses, all isolates were classified as members of the genus Tetratrichomonas. Sequencing of the ITS1-5.8S rRNA gene-ITS2 region revealed three highly similar genotypes that were essentially identical to sequences reported for Tetratrichomonas spp. isolated from the preputial cavity of cattle in the USA and Southern Brazil. The findings of this study extend and enhance our knowledge of parasitism in small ruminants by parabasalids.

Reduced expression of adherens and gap junction proteins can have a fundamental role in the development of heart failure following cardiac hypertrophy in rats.

Hypertension causes cardiac hypertrophy, cardiac dysfunction and heart failure (HF). The mechanisms implicated in the transition from compensated to decompensated cardiac hypertrophy are not fully understood. This study was aimed to investigate whether alterations in the expression of intercalated disk proteins could contribute to the transition of compensated cardiac hypertrophy to dilated heart development that culminates in HF. Male rats were submitted to abdominal aortic constriction and at 90 days post surgery (dps), three groups were observed: sham-operated animals (controls), animals with hypertrophic hearts (HH) and animals with hypertrophic + dilated hearts (HD). Blood pressure was evaluated. The hearts were collected and Western blot and immunofluorescence were performed to desmoglein-2, desmocollin-2, N-cadherin, plakoglobin, Bcatenin, and connexin-43. Cardiac systolic function was evaluated using the Vevo 2100 ultrasound system. Data were considered significant when p b 0.05. Seventy percent of the animals presented with HH and 30% were HD at 90 dps. The blood pressure increased in both groups. The amount of desmoglein-2 and desmocollin-2 expression was increased in both groups and no difference was observed in either group. The expression of N-cadherin, plakoglobin and B-catenin increased in the HHgroup and decreased in the HDgroup; and connexin-43 decreased only in theHDgroup. Therewas no difference between the ejection fraction and fractional shortening at 30 and 60 dps; however, they were decreased in the HD group at 90 dps. We found that while some proteins have increased expression accompanied by the increase in the cell volume associated with preserved systolic cardiac function in theHHgroup, these same proteins had decreased expression evenwithout significant reduction in the cell volume associated with decreased systolic cardiac function in HD group. The increased expression of desmoglein-2 and desmocollin-2 in both the HH and HD groups could work as a protective compensatory mechanism, helping tomaintain the dilated heart.We can hypothesize that inappropriate intercellular mechanical and electrical coupling associated with necrosis and/or apoptosis are important factors contributing to the transition to HF.

Mineral composition, nutritional properties, total phenolics and flavonoids compounds of the atemoya fruit (Annona squamosa L. x Annona cherimola Mill.) and evaluation using multivariate analysis techniques.

The atemoya is a hybrid fruit obtained by crossing of cherimoya (Annona cherimola Mill.) with sweet sop (Annona squamosa L.). The information about chemical composition of atemoya is scarce. The mineral composition was evaluated employing Inductively Coupled Plasma Optical Emission Spectrometry (ICP OES) and the centesimal composition and the physico-chemical parameters were assessed employing procedures described in the AOAC methods. The total phenolic compounds (TPC) and total flavonoids (TF) were determined using spectroanalytical methods. Considering the Reference Daily Intake (RDI), the concentrations of K, Cu and Vitamin C found in atemoya were the highest, representing about 32, 23 and 37% of the RDI, respectively. The total carbohydrates were 32 g 100g-1 and the soluble solids was equivalent to (32.50 ± 0.03) °Brix. The result for TPC was 540.47 ± 2.32 mgGAE 100 g-1 and the TF was 11.56 ± 1.36 mgQE 100 g-1. The exploratory evaluation of 42 atemoya samples was performed through Principal Component Analysis (PCA), which discriminated green and ripe fruits according to their mineral composition. The elements that contributed most for the variability between green and ripe fruits were: Ba, Ca, Cu, K, Mg and P.

Longitudinal neuropsychological performance of post-stroke adults with and without rehabilitation.

This study compared the neuropsychological performance of two post-stroke groups, one undergoing rehabilitation and the other not receiving any intervention, on the acute and chronic stroke phases, and explored sociodemographic and neurological variables associated with changes in performance over time. Sixty-three adults underwent neuropsychological assessment with the Cognitive Screening Instrument (TRIACOG) less than thirty days after having a stroke and were reassessed three to six months after stroke. Thirty-eight participants did not undertake rehabilitation and twenty-five did physiotherapy and/or speech therapy between the two time points. The frequency of cognitive deficits (between groups) and the range of cognitive assessment scores over time (between and within groups) were analyzed. There was a significant decrease in the frequency of neuropsychological deficits and improvement on neuropsychological assessment scores over time only in the group undergoing rehabilitation. Severity of the neurological condition, years of education and being in rehabilitation explained the longitudinal changes in several cognitive domains measured by TRIACOG. Engaging in rehabilitation within three to six months post-stroke is crucial for enhancing the recovery of neuropsychological deficits. Cognitive screening instruments like TRIACOG can be used by health professionals to identify stroke-related neuropsychological changes and plan interventions.

The mlpt smORF gene is essential for digestive physiology and molting during nymphal stages in the kissing bug Rhodnius prolixus.

Chagas disease affects around 8 million people globally, with Latin America bearing approximately 10,000 deaths each year. Combatting the disease relies heavily on vector control methods, necessitating the identification of new targets. Within insect genomes, genes harboring small open reading frames (smORFs - < 100 amino acids) present numerous potential candidates. In our investigation, we elucidate the pivotal role of the archetypal smORF-containing gene, mille-pattes/polished-rice/tarsalless (mlpt/pri/tal), in the post-embryonic development of the kissing bug Rhodnius prolixus. Injection of double-stranded RNA targeting mlpt (dsmlpt) during nymphal stages yields a spectrum of phenotypes hindering post-embryonic growth. Notably, fourth or fifth stage nymphs subjected to dsmlpt do not undergo molting. These dsmlpt nymphs display heightened mRNA levels of JHAMT-like and EPOX-like, enzymes putatively involved in the juvenile hormone (JH) pathway, alongside increased expression of the transcription factor Kr-h1, indicating changes in the hormonal control. Histological examination reveals structural alterations in the hindgut and external cuticle of dsmlpt nymphs compared to control (dsGFP) counterparts. Furthermore, significant changes in the vector's digestive physiology were observed, with elevated hemozoin and glucose levels in the posterior midgut of dsmlpt nymphs. Importantly, dsmlpt nymphs exhibit impaired metacyclogenesis of Trypanosoma cruzi, the causative agent of Chagas disease, underscoring the crucial role of proper gut organization in parasite differentiation. Thus, our findings constitute the first evidence of a smORF-containing gene's regulatory influence on vector physiology, parasitic cycle, and disease transmission.

Genomic surveillance and serological profile of SARS-CoV-2 variants circulating in Macaé and nearby cities, southeastern Brazil.

Introduction: A characteristic of the COVID-19 pandemic has been the sequential emergence and global dissemination of SARS-CoV-2 variants, noted for their enhanced transmission efficiency. These variants with mutations in the Spike glycoprotein (S-glycoprotein), which interacts with ACE2 receptors in human cells is critical for infection, affects the transmissibility of the virus, which is a matter of great concern for public health. Objective: This research analyses the effects these variants on a cohort of vaccinated and naturally infected individuals from the cities of Macaé-RJ, Rio das Ostras-RJ, and Campos dos Goytacazes-RJ, Brazil, from March 2021 to March 2023. Methods: This investigation encompasses the Alpha (B.1.1.7), Gamma (P.1), Delta (B.1.617.2, B.1.671.3), and Omicron (BQ.1, BQ.1.1 sublines, and BF.7) variants, focusing on their genomic surveillance and implications for the disease's epidemiology. The experimental analysis included a control group (vaccinated and uninfected subjects), and an infected group (post-vaccinated subjects). Samples from nasopharyngeal swabs underwent viral detection via RT-qPCR for diagnosis confirmation. RNase H-dependent RT-qPCR (rhAmp-PCR) and third-generation sequencing were used to detect SARS-CoV-2 variants. Anti-S-glycoprotein immunoglobulins were also evaluated for vaccinated infected and noninfected volunteers. Symptoms from infected individuals were compiled in order to reveal patterns of clinical signs associated with viral infection. Results: The study included 289 participants, with infections identified by Gamma (n = 44), Delta (n = 189), and Omicron (n = 56) variants. The prevalent symptoms among the naturally infected participants were cough, fever, sore throat, headache, and runny nose. For Omicron, cognitive symptoms such as memory loss and concentration issues were reported. Interestingly, the infected vaccinated group had higher anti-S-glycoprotein IgM production (n = 28, 0.2833 ± 0.09768 OD) compared to the uninfected vaccinated group (n = 14, 0.1035 ± 0.03625 OD). Conversely, anti-S-glycoprotein IgG production was higher in the control group (n = 12, 1.770 ± 0.1393 OD) than in the infected vaccinated group (n = 26, 1.391 ± 0.1563 OD). Conclusion: This comprehensive study enables monitoring of predominant variants and their correlation with clinical cases, providing valuable insights for public health. Our research group continues to survey circulating variants, contributing to the global understanding of the pandemic.

Respiratory system impedance in different decubitus evaluated by impulse oscillometry in individuals with obesity.

BACKGROUND AND OBJECTIVE: The body posture can influence gas exchange, respiratory mechanics, and mucociliary clearance and different positions can be used as a therapeutic strategy to improve in gas exchange and can also help physiotherapists to assist patients who have difficult or restrictions to stay seated or the ones who stay in the same position for a long period. The objective of this study was to evaluate the effect of different positions on respiratory system impedance in obese and eutrophic subjects, using Impulse Oscillometry System (IOS). METHODS: The IOS parameters were evaluated in seated (Se), right lateral decubitus (RL), left lateral decubitus (LL), and supine (Su). RESULTS: Sixty two volunteers were allocated in obese group (OG) or eutrophic group (EG) according to BMI. In seated position, OG showed higher impedance than EG for R5: 0.55 (0.31; 0.93) and 0.33 (0.24; 0.52); R20: 0.39 (0.23; 0.54) and 0.32 (0.03; 0.41); R5-R20: 0.13 (0.02; 0.47) and 0.01 (-0.08; 0.27); X5: -0.20 (-0.51; 0.16) and -0,10 (-0.016; -0.04); Fres: 20.59 (11.54; 36.45 and 10.69 (7.56; 24.7) (p<0.05) and the impedance were higher in the Su for both groups. Compared to Se, there were differences with Su (R5, R5-20, X5), with RL (R20), and with LL (R5, R20) for OG; and with Su (R5, R5-20, X5, Fres), with RL and LL (X5) for EG. Compared to Su, there were differences with RL and LL (R5-20, X5) for OG; and with RL (R5, R5-20, X5, Fres), and LL (R5-20, X5, Fres) for EG. There were no differences between RL and LL for OG and EG. CONCLUSION: The respiratory system impedance is increased in OG, with greater contribution of peripheral resistance. The higher values of resistance and reactance were obtained in the supine position, in both groups, with lower differences obtained in the right and left lateral decubitus.

Mineral and Trace Elements in Nutritious Flours: Total Contents, In Vitro Bioaccessibility and Contribution to Dietary Intake.

The consumption of fruits, vegetables, and cereals in the form of flour has been an alternative for the intake of nutrients, currently seen in a society that seeks a healthier diet. Thus, the assessment of total contents and bioaccessibility is important to better understand the actual intake of nutrients or contaminants present in foods. The objective of this study was to determine the total content and estimate the bioaccessible fraction of Cu, Fe, and Zn in nutritious flours by inductively coupled plasma optical emission spectrometry (ICP OES) after microwave acid digestion. Bioaccessibility was assessed using the in vitro method, taking into account the entire gastrointestinal tract (Unified Bioaccessibility Method (UBM)). The following concentration ranges, in µg g-1, were found: Ca (341-6275), K (2984-13,953), P (476-6110), Na (< 0.39-2995), Fe (1.4-167), Cu (< 0.01-59.6), and Zn (< 0.07-30.3). Principal component analysis (PCA) and hierarchical cluster analysis (HCA) showed a tendency towards the formation of three groups. The bioaccessible fractions for Cu, Fe, and Zn were considered low, ranging from 0.96 to 40% in the gastrointestinal phase and from 4.1 to 100% in the gastric phase.

Increased airway resistance can be related to the decrease in the functional capacity in obese women.

BACKGROUND AND OBJECTIVE: Obesity can increase the airways resistance, mainly in the periphery, leading to dyspnea perception that can impair the functional capacity. This study aimed to analyze if airways resistance could be related to the walking capacity of women with morbid obesity. METHODS: Thirty-seven women with grade III obesity in preoperative bariatric surgery were evaluated using the spirometry test, impulse oscillometry system (IOS), and six-minute walk test (6MWT). Additionally, data about their daily dyspnea perception and physical activity level were collected. RESULTS: Variables of the spirometry test did not detect ventilator disorders. Compared to the predicted values, the IOS identified significant increase in airways resistance (kPa/L/s) (R5: 0.36 (0.34; 0.36) and 0.53 (0.47; 0.61); R20: 0.30 (0.28; 0.30) and 0.41 (0.35; 0.45); R5-20: 0.06 (0.06; 0.06) and 0.14 (0.10; 0.15); X5: -0.03 (-0.04; -0.01) and -0.20 (-0.27; -0.18), respectively). The distance walked in the 6MWT, 491.4±60.4m was significantly correlated to R5 (rho = -0.41, p = 0.01), R5-20 (rho = -0.52, p = 0.001), and X5 (rho = 0.54, p = 0.0006). CONCLUSION: The IOS is able to identify changes in airway resistance even before the onset of symptoms. When evaluated by IOS women with severe obesity and normal spirometry exhibited central and peripheral airways obstruction. The correlations between the IOS and six-minute walk distance suggest that increased peripheral airways resistance could be related to worsening functional capacity.

Effects of physical therapy with neuromuscular electrical stimulation in acute and late septic shock patients: A randomised crossover clinical trial.

BACKGROUND: Patients with sepsis and immobility in the intensive care unit are associated with muscle weakness, and early mobilisation can counteract it. However, during septic shock, mobilisation is often delayed due to the severity of the illness. Neuromuscular electrical stimulation (NMES) may be an alternative to mobilise these patients early. This study aims to identify whether NMES performed within the first 72 hours of septic shock diagnosis or later is safe from a metabolic perspective. METHODS: This is the analysis of two randomised controlled crossover studies. Patients with acute septic shock (within the first 72 hours of diagnosis) and sepsis and septic shock in the late phase (after 72 hours of diagnosis) were eligible. Patients were submitted in a random order to the intervention protocol (dorsal decubitus position with the lower limbs raised and NMES) and control (dorsal decubitus position with the lower limbs raised without NMES). The patients were allocated in group 1 (intervention and control) or group 2 (control and intervention) with a wash-out period of 4 to 6 hours. Metabolic variables were evaluated by indirect calorimetry. RESULTS: Sixteen patients were analysed in the acute septic shock study and 21 in the late sepsis/septic shock study. There were no significant differences between Oxygen Consumption (VO2) values in the acute phase of septic shock when the baseline period, intervention, and control protocols were compared (186.59 ± 46.10; 183.64 ± 41.39; 188.97 ± 44.88, p>0.05- expressed in mL/Kg/min). The same was observed when the VO2 values in the late phase were compared (224.22 ± 53.09; 226.20 ± 49.64; 226.79 ± 58.25, p>0.05). The other metabolic variables followed the same pattern, with no significant differences between the protocols. When metabolic variables were compared between acute to late phase, significant differences were observed (p<0.05). CONCLUSIONS: As metabolic rates in septic shock patients had no increase during NMES, either in the first 72 hours of diagnosis or later, NMES can be considered safe from a metabolic viewpoint, even despite the higher metabolic demand in the acute phase of shock. TRIAL REGISTRATION: NCT03193164; NCT03815994. Registered on June 5, 2017; November 13, 2018 (clinicaltrials.gov/).

Correlation among clinical, functional and morphological indexes of the respiratory system in non-cystic fibrosis bronchiectasis patients.

BACKGROUND: Non-cystic fibrosis bronchiectasis (NCFB) is a heterogeneous disease, which assessment and severity can't be defined by one particular instrument but using a multidimensional score. Thus, in additional to traditional methods, alternative tools have been developed to assist these patients' evaluation. OBJECTIVE: To correlate functional and morphological indexes with severity and dyspnea in NCFB patients, focusing on the correlation between the impulse oscillometry system (IOS) and the quantitative analysis of computed tomography (CT). METHODS: Clinically stable NCFB patients, between 18 and 80 years old were submitted to clinical, functional and morphological evaluations assessed by Bronchiectasis Severity Index (BSI) and Medical Research Council (MRC) scale; spirometry and IOS; and subjective and quantitative Chest CT scans analysis, respectively. RESULTS: This study included 38 patients. The best correlations obtained between functional and morphological airway indexes were: resistance at 5 Hz-R5 and the normalized thickness of bronchial walls-Pi10 (r = 0.57), and the mean forced expiratory flow (FEF25-75%) and CT score (r = -0.39). BSI as well as MRC showed higher correlations with the quantitative automated analysis of CT (BSI and Pi10: r = 0.41; MRC and Pi10: r = 0.35) than with subjective CT score (BSI and CT score: r = 0.41; MRC and CT score: r = 0.15); and moderate and weak correlations were obtained on both functional airway indexes (BSI and peripheral airways resistance - R5-R20: r = 0.53; BSI and forced expiratory volume at the first second-FEV1: R = -0,64; MRC and R5-R20: r = 0.42; and MRC and VEF1: r = -0.45). CONCLUSION: In NCFB patients, compartmentalized methods for assessing the respiratory system (IOS and the automated quantitative CT analysis) have a good correlation with severity and dyspnea.

Effect of losartan potassium, metformin hydrochloride, and simvastatin on in vitro bioaccessibility of Cu, Fe, Mn, and Zn in oat flour from Brazil.

BACKGROUND: The simultaneous administration of drugs with food can compromise the bioaccessibility and absorption of nutrients. The objective of this study was to evaluate the influence of the use of losartan potassium (LP), metformin hydrochloride (MH), and simvastatin (S) on the in vitro bioaccessibility of micronutrients (Cu, Fe, Mn, and Zn) in oat flour from Bahia, Brazil. METHODS: The experimental procedure consisted of the in vitro extraction of the bioaccessible fraction of Cu, Fe, Mn, and Zn in oat flour-with and without LP (50 mg), MH (500 mg), and S (20 mg)-using the unified bioaccessibility method (UBM), simulating the conditions of the gastrointestinal tract. For decomposition of the samples (oat flour and residue), a digester block with a closed system was used. To determine the total content (flour and residual fraction) and bioaccessible micronutrients, inductively coupled plasma optical emission spectrometry (ICP OES) was used. RESULTS: The bioaccessible contents (µg g-1) without the addition of drugs were: Cu 5.86 ± 0.21, Fe 32.80 ± 1.32, Mn 87.90 ± 1.90, and Zn 30.33 ± 2.05, with bioaccessibility ranging from 31.5 % for Fe to 99 % for Mn. The in vitro extraction method was validated by mass balance with recovery values from 89.78 % for Cu to 101.94 % for Mn. The range of bioaccessible contents (µg g-1) were: Cu (<4.14), Fe (32.10 ± 0.20-54.10 ± 2.03), Mn (81.40 ± 0.93-93.22 ± 0.80), and Zn (<10.80-29.11 ± 2.20). The estimation of the bioaccessibility of Cu, Mn, and Zn in oat flour were compromised in the presence of LP, MH, and S (p < 0.05). CONCLUSION: Chemical interactions can occur between drugs and micronutrients. Taken together, our results highlight that LP, MH, and S can interfere with the bioaccessibility of Cu, Fe, Mn, and Zn in oat flour in patients who use these drugs, suggesting its rational use in further investigations.