Trilobatin contributes to the improvement of myopathy in a mouse model of Duchenne muscular dystrophy.

Duchenne muscular dystrophy (DMD) occurs due to genetic mutations that lead to a deficiency in dystrophin production and consequent progressive degeneration of skeletal muscle fibres, through oxidative stress and an exacerbated inflammatory process. The flavonoid trilobatin (TLB) demonstrates antioxidant and anti-inflammatory potential. Its high safety profile and effective action make it a potent therapy for the process of dystrophic muscle myonecrosis. Thus, we sought to investigate the action of TLB on damage in a DMD model, the mdx mouse. Eight-week-old male animals were treated with 160 mg/kg/day of trilobatin for 8 weeks. Control animals were treated with saline. Following treatment, muscle strength, serum creatine kinase (CK) levels, histopathology (necrotic myofibres, regenerated fibres/central nuclei, Feret's diameter and inflammatory area) and the levels of catalase and NF-κB (western blotting) of the quadriceps (QUA), diaphragm (DIA) and tibialis anterior (TA) muscles were measured. TLB was able to significantly increase muscle strength and reduce serum CK levels in dystrophic animals. The QUA of mdx mice showed a reduction in catalase and the number of fibres with a centralized nucleus after treatment with TLB. In the DIA of dystrophic animals, TLB reduced the necrotic myofibres, inflammatory area and NF-κB and increased the number of regenerated fibres and the total fibre diameter. In TA, TLB increased the number of regenerated fibres and reduced catalase levels in these animals. It is concluded that in the mdx experimental model, treatment with TLB was beneficial in the treatment of DMD.

Treponema pallidum: percepção de vulnerabilidade à infecção pelas mulheres trabalhadoras da segurança pública de Goiás / Treponema pallidum: perception of vulnerability to infection among female public safety workers in Goiás

O estudo objetivou analisar a percepção de risco para à infecção pelo Treponema pallidum em trabalhadores da segurança pública do sexo feminino, na capital do Estado de Goiás, Goiânia. Trata-se de pesquisa qualitativa, descritiva com 47 mulheres por meio da aplicação de instrumento semiestruturado. Para análise dos acervos das narrativas utilizou-se o método de análise de conteúdo. Verificou-se a emergência de 03 (três) categorias temáticas: (Des) Conhecimento geral sobre a sífilis; Tabus em relação ao uso de preservativo em relacionamento monogâmico; e Novas ferramentas e educação em saúde. Os principais achados revelam a baixa percepção de conhecimento sobre sífilis, a sensação de invulnerabilidade e a baixa adesão ao uso de preservativos entre as mulheres na força policial. Esses resultados reforçam a necessidade de programas eficazes de intervenção para prevenir essa infecção, que tem proporções epidêmicas e projeções de aumento, entre as trabalhadoras da segurança pública.

The study aimed to analyze the perception of risk for infection by Treponema pallidum in female public security workers, in the capital of the State of Goiás, Goiânia. This is a qualitative, descriptive research with 47 women through the application of a semi-structured instrument. To analyze the collections of narratives, the content analysis method was used. There was the emergence of 03 (three) thematic categories: (Mis) General knowledge about syphilis; Taboos regarding the use of condoms in a monogamous relationship; and New tools and health education. The main findings reveal the low perception of knowledge about syphilis, the feeling of invulnerability and the low adherence to the use of condoms among women in the police force. These results reinforce the need for effective intervention programs to prevent this infection, which has epidemic proportions and is projected to increase, among public security workers.

Effects of Red and Infrared Laser Therapy in Patients with Tinnitus: A Double-Blind, Clinical, Randomized Controlled Study Combining Light with Ultrasound, Drugs and Vacuum Therapy.

BACKGROUND: tinnitus is a symptom with no specific cause known to date, and there are no associated pharmacogenomics of hearing disorders and no FDA-approved drugs for tinnitus treatment. The effectiveness of drug treatments is not reproducible on idiopathic patients and inexistent in refractory patients. Personalized treatments for these patients are a great clinical need. Our study investigated the outcome of potential alternative and complementary treatment modalities for idiopathic and refractory tinnitus patients. METHODS: we were the first to evaluate the tinnitus handicap inventory (THI) score changes over the course of treatment up to 15 days after complete cessation of treatment for novel transmeatal low-level laser therapy (LLLT) modalities using light alone, as well as LLLT combined with vacuum therapy (VT), ultrasound (US), Ginkgo biloba (GB) and flunarizine dihydrochloride (FD), while also comparing all treatment outcomes with laser puncture (LP), FD alone and GB alone. RESULTS: a positive treatment outcome (superior to a placebo effect) was achieved by using either LP or transmeatal LLLT, whereas short-term antagonistic effects of VT, US, GB and FD when combined with LLLT. For transmeatal LLLT, an improvement in the treatment outcome was observed by increasing the irradiation time from 6 min to 15 min (with 100-mW of applied laser power at 660 nm). Finally, a lasting therapeutic effect higher than the placebo was observed at 15 days after treatment upon combining LLLT with VT, GB or by using FD alone, by using the transmeatal LLLT alone or by using LP. CONCLUSIONS: LP and Transmeatal LLLT can be promising alternative treatments for idiopathic and refractory tinnitus patients. Future studies should investigate the long-term effects of LLLT in tinnitus patients, as well as the dosimetry and wavelength of transmeatal LLLT.

Can photobiomodulation restore anosmia and ageusia induced by COVID-19? A pilot clinical study.

Along with other COVID-19 clinical manifestations, management of both olfactory and gustatory dysfunction have drawn a considerable attention. Photobiomodulation (PBM) has emerged to be a possible effective therapy in restoring taste and smell functionality, but the evidence is scarce. Hence, the present pilot study is aimed to evaluate the effectiveness of intranasal and intraoral PBM administrations in management of anosmia and ageusia respectively. Twenty Caucasian subjects who diagnosed with anosmia and ageusia were recruited. Visual analogue scale was utilised to evaluate patients' self-reported for both olfactory and gustatory functionality. The laser-PBM parameters and treatment protocols for anosmia and ageusia were as follows respectively: 660 nm, 100 mW, two points intranasally, 60 J/session, 12 sessions; dual wavelengths (660 nm and 808 nm), 100 mW, three points intraorally, 216 J/session, 12 sessions. Our results showed a significant functionality improvement of both olfactory and gustatory functionality. Extensive studies with large data and long-term follow-up period are warranted.

Perivascular cells induce microglial phagocytic states and synaptic engulfment via SPP1 in mouse models of Alzheimer's disease.

Alzheimer's disease (AD) is characterized by synaptic loss, which can result from dysfunctional microglial phagocytosis and complement activation. However, what signals drive aberrant microglia-mediated engulfment of synapses in AD is unclear. Here we report that secreted phosphoprotein 1 (SPP1/osteopontin) is upregulated predominantly by perivascular macrophages and, to a lesser extent, by perivascular fibroblasts. Perivascular SPP1 is required for microglia to engulf synapses and upregulate phagocytic markers including C1qa, Grn and Ctsb in presence of amyloid-ß oligomers. Absence of Spp1 expression in AD mouse models results in prevention of synaptic loss. Furthermore, single-cell RNA sequencing and putative cell-cell interaction analyses reveal that perivascular SPP1 induces microglial phagocytic states in the hippocampus of a mouse model of AD. Altogether, we suggest a functional role for SPP1 in perivascular cells-to-microglia crosstalk, whereby SPP1 modulates microglia-mediated synaptic engulfment in mouse models of AD.

Investigation of Carcinogenic Impurities of N-Nitrosamines in Sartan Pharmaceutical Products Marketed in Brazil: Development and Validation of Method Based on High-Performance Liquid Chromatography-Tandem Mass Spectrometry.

N-nitrosamines (NA) impurities have unexpectedly been found in sartan products, angiotensin II receptor antagonists that are used to control hypertension, representing an urgent concern for industry, global regulators and for the patients. In this study, an HPLC-MS/MS method was developed and validated for the quantification of six NA (N-nitrosodimethylamine, N-Nitroso-N-methyl-4-aminobutyric acid, N-Nitrosodiethylamine, N-ethyl-N-nitroso-2-propanamine, N-nitroso-diisopropylamine and N-nitroso-di-n-butylamine) in losartan, valsartan, olmesartan, irbesartan, candesartan and telmisartan products. The method was validated in terms of sensitivity, linearity, accuracy, precision, robustness and stability. The limits of quantification were 100, 31.25, 250, 33, 312.5 and 125 µg kg-1 in losartan, valsartan, olmesartan, irbesartan, candesartan and telmisartan samples, respectively, which met the sensitivity requirements for the limits set by Food and Drug Administration of the United States. The standard curves showed good linearity. The recoveries ranged from 93.06 to 102.23% in losartan matrix, 83 to 85.9% in valsartan, 96.1 to 101.2% in olmesartan, 89.2 to 97.5% in irbesartan, 93.4 to 132.0% in candesartan and 62.3 to 106.2% in telmisartan matrix. The other parameters met the validation criteria, the good sensitivity and precision, high accuracy and simple and fast analysis provides a reliable method for quality control of NA in sartan pharmaceutical products. The developed method was successfully applied for the determination of N-nitrosamines in 71 sartan products marketed in Brazil.

Congenital toxoplasmosis and auditory disorders: a literature review.

Background: Congenital toxoplasmosis (CT) occurs mainly by primary maternal infection during pregnancy. It is estimated that the incidence of vertical transmission to the fetus is 20% and that infected women are more likely to have a premature birth or low birth weight neonate since there is an association between CT and the rate of premature birth and low birth weight. In addition to severe neurological and ophthalmic consequences, hearing disorders such as hearing loss are also among the clinical manifestations seen in children with CT. Given the above, the objective of this study is to verify what are the auditory disorders seen in children with CT. Methods: This literature review was structured according to the PRISMA statement and based on the terms of Study Target Population, Intervention, Comparison, Outcomes, and Study Types (PICOS). To obtain the studies, the following electronic databases were consulted: PubMed, Web of Science, Scopus, and Lilacs. The combined terms used for the search were: ("auditory evoked potentials" OR "hearing" OR "hearing loss") AND ("congenital toxoplasmosis"). The selection of articles was carried out independently, blindly, by two of the authors, to minimize risk of bias. Results: The search in the databases identified 172 articles, after excluding duplicate articles, 105 studies were identified. From the selection made by reading the titles and abstracts, 11 studies were selected for full-text reading. A total of 94 studies were excluded. An article was selected from the list of references. Therefore, 12 studies were included in the final analysis. It was observed that a significant percentage of studies sought to study the peripheral auditory pathway, verifying the occurrence or association between hearing loss and the presence of congenital infection. Only two studies evaluated the central auditory pathway, using the Brainstem Auditory Evoked Potential (BAEP) and the Frequency Following Response (FFR). Conclusion: Toxoplasmosis affects not only the peripheral areas but central areas as well. Most studies suggest this pathology as a risk factor for both peripheral and central impairment. Research has found a greater association between CT and mild to moderate hearing loss, in addition to alterations in exams such as BAEP and FFR. These data recommend that CT be reported as a global public health problem and can help assess complications and impacts of hearing disorders as a result of CT. There is a gap about studies that retract the co-occurrence between CT and other Risk Indicators for Hearing Loss (RIHL), such as prematurity, permanence in the intensive care unit, and use of ototoxic medications, lack of longitudinal studies, that accompany the development of hearing and language of children with CT, since the consequences of this infection may be late.

Hearing and language development in children with brainstem implants: a systematic review

Abstract Objective: To present scientific evidence, based on a systematic review of the literature, on the benefit of brainstem implants in auditory rehabilitation and language development in children. Methods: A systematic search was used to identify studies that contain information about the benefit of brainstem implants in the auditory rehabilitation and language development of children. The review was conducted based on a structured literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The search was carried out in the PubMed, Web of Science and Scopus databases, using the combination "Auditory brainstem implants" AND "Pediatric", without restriction of language, period, and location. The quality assessment of the articles was performed using the Study Quality Assessment Tools. Results: Regarding hearing, children with brainstem implants showed sound detection, access to most speech sounds, basic auditory perception skills, recognition of ambient sounds, recognition of some frequently used words and phrases, in addition to some closed-set word discrimination capability. Expressive and comprehensive language were identified in children using auditory brainstem implants, increasing significantly in the short and long terms in most cases; however, in some of the children, such skills remained stable. Conclusion: The auditory brainstem implant can be considered an effective alternative for children with cochlear malformation and/or auditory nerve deficiency and for those who cannot benefit from cochlear implant surgery.

The effect of child development on the components of the Frequency Following Response: Child development and the Frequency Following Response.

During childhood, neuronal modifications occur so that typical childhood communicative development occurs. This work aims to contribute to the understanding of differences in the speech encoding of infants and school-age children by assessing the effects of child development, in different phases of early childhood, on the encoding of speech sounds. There were 98 subjects of both sexes, aged from 1 day to 8 years and 9 months who participated in the study. All subjects underwent a Frequency Following Response (FFR) assessment. A regression and linear correlation showed the effects of age in the FFR components, i.e., significant decrease in the latency and increased amplitude of all FFR waves with age. An increase in the slope measure was also observed. Younger infants require more time and show less robust responses when encoding speech than their older counterparts, which were shown to have more stable and well-organized FFR responses.

Hearing and language development in children with brainstem implants: a systematic review.

OBJECTIVE: To present scientific evidence, based on a systematic review of the literature, on the benefit of brainstem implants in auditory rehabilitation and language development in children. METHODS: A systematic search was used to identify studies that contain information about the benefit of brainstem implants in the auditory rehabilitation and language development of children. The review was conducted based on a structured literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The search was carried out in the PubMed, Web of Science and Scopus databases, using the combination "Auditory brainstem implants" AND "Pediatric", without restriction of language, period, and location. The quality assessment of the articles was performed using the Study Quality Assessment Tools. RESULTS: Regarding hearing, children with brainstem implants showed sound detection, access to most speech sounds, basic auditory perception skills, recognition of ambient sounds, recognition of some frequently used words and phrases, in addition to some closed-set word discrimination capability. Expressive and comprehensive language were identified in children using auditory brainstem implants, increasing significantly in the short and long terms in most cases; however, in some of the children, such skills remained stable. CONCLUSION: The auditory brainstem implant can be considered an effective alternative for children with cochlear malformation and/or auditory nerve deficiency and for those who cannot benefit from cochlear implant surgery.

Functional Analysis of the Cortical Transcriptome and Proteome Reveal Neurogenesis, Inflammation, and Cell Death after Repeated Traumatic Brain Injury In vivo.

The pathological effects of repeated traumatic brain injuries (TBIs) are largely unknown. To gain a detailed understanding of the cortical tissue acute biological response after one or two TBIs, we utilized RNA-sequencing and protein mass spectrometry techniques. Using our previously validated C57Bl/6 weight-drop model, we administered one or two TBIs of a mild or moderate severity. Double injury conditions were spaced 7 days apart, and cortical tissue was isolated 24 h after final injury. Analysis was carried out through functional gene annotation, utilizing Gene Ontology, for both the proteome and transcriptome. Major themes across the four different conditions include: neurogenesis; inflammation and immune response; cell death; angiogenesis; protein modification; and cell communication. Proteins associated with neurogenesis were found to be upregulated after single injuries. Transcripts associated with angiogenesis were upregulated in the moderate single, mild double, and moderate double TBI conditions. Genes associated with inflammation and immune response were upregulated in every condition, with the moderate single condition reporting the most functional groups. Proteins or genes involved in cell death, or apoptosis, were upregulated in every condition. Our results emphasize the significant differences found in proteomic and transcriptomic changes in single versus double injuries. Further, cortical omics analysis offers important insights for future studies aiming to deepen current knowledge on the development of secondary injuries and neurobehavioral impairments after brain trauma.

Photobiomodulation therapy for treatment olfactory and taste dysfunction COVID-19-related: A case report.

It is postulated that the inflammatory process resulting from SARS-CoV-2 infection is the main cause of smell and taste dysfunctions in patients. In view of this, photobiomodulation, due to its anti-inflammatory and antioxidant effects, may be a promising therapeutic modality to treat these disorders. In the present case report, we observed clinical improvement in the symptoms of anosmia and ageusia related to COVID-19 after treatment with photobiomodulation. Due to the inflammatory nature of COVID-19 and the anti-inflammatory effects, photobiomodulation antioxidants already proven in the literature make it a promising therapeutic modality, especially sequela COVID-related, including olfactory (anosmia) and taste (ageusia) dysfunction. In the present case report, the patient's olfactory and gustatory functions were re-established after 10 treatment sessions with photobiomodulation.

Impact of COVID-19 pandemic on psychological aspects and bruxism in the Brazilian population: observational study / Impacto da pandemia por COVID-19 em aspectos psicológicos e bruxismo na população brasileira: estudo observacional

ABSTRACT BACKGROUND AND OBJECTIVES: The aim of the present study was to evaluate the impact of the COVID-19 pandemic on psychological aspects and its relationship with bruxism from a representative sample of the Brazilian population. METHODS: A cross-sectional Internet-based survey was conducted in a nationally representative sample of Brazilian adults to estimate the sociodemographic correlates and characteristics of bruxism, the quality of life of individuals World Health Organization Quality of Life-BREF (WHOQOL) and Self-Compassion Scale (SCS) in the Brazilian population during the COVID-19 pandemic. Research was collected from May to August 2020. The data were analyzed using qualitative analysis. RESULTS: A total of 1476 Survey forms were completed, and 1265 (85.70%) respondents declared presenting daytime clenching; over half of respondents (843, 57.11%) reported that they have grinding of teeth; and 1054 (71.41%) reported both clenching and grinding of teeth. Most of the respondents (1128, 76.42%) reported a negative perception of oral symptoms on the last month and all (1476, 100.00%) were feeling nervous or stressed during the period of social withdrawal induced by the COVID-19 pandemic. Moreover, 289 (19.58%) started having symptoms of fatigue or pain in the muscles of the face upon awakening and 318 (21.54%) started having muscle fatigue and discomfort in the teeth upon awakening. CONCLUSION: Findings have shown that all respondents were feeling nervous or stressed during the period of social withdrawal induced by the COVID-19 pandemic and reported bruxism symptoms. They also had lower averages of WHOQOL and SCS, suggesting worse perception of quality of life and self-compassion.

RESUMO JUSTIFICATIVA E OBJETIVOS: O objetivo do presente estudo foi avaliar o impacto da pandemia de COVID-19 nos aspectos psicológicos e sua relação com o bruxismo a partir de amostra representativa da população brasileira. MÉTODOS: Foi conduzida uma pesquisa transversal baseada na internet em uma amostra representativa de adultos brasileiros para estimar os correlatos sociodemográficos e as características do bruxismo, a qualidade de vida (WHOQOL) dos indivíduos e a autocompaixão (SCS) na população brasileira durante a pandemia por COVID-19. A pesquisa foi coletada de maio a agosto de 2020. Os dados foram analisados por meio de análise qualitativa. RESULTADOS: Foram preenchidos 1.476 formulários da Pesquisa e 1.265 (85,70%) respondentes declararam apresentar apertamento diurno; mais da metade dos entrevistados (843, 57,11%) relatou ranger de dentes; e 1.054 (71,41%) relataram tanto apertamento quanto ranger de dentes. A maioria dos entrevistados (1.128, 76,42%) relatou percepção negativa dos sintomas de bruxismo no último mês e todos (1.476, 100,00%) estavam se sentindo nervosos ou estressados durante o período de afastamento social induzido pela pandemia de COVID-19. Além disso, 289 (19,58%) iniciaram sintomas de fadiga ou dor nos músculos da face ao acordar e 318 (21,54%) iniciaram com fadiga muscular e desconforto nos dentes ao acordar. CONCLUSÃO: Os resultados mostraram que todos os entrevistados estavam se sentindo nervosos ou estressados durante o período de afastamento social induzido pela pandemia de COVID-19 e relataram sintomas de bruxismo. Também apresentaram médias mais baixas no WHOQOL e SCS, sugerindo pior percepção de qualidade de vida e autocompaixão.

Infralimbic medial prefrontal cortex alters electroacupuncture effect in animals with neuropathic chronic pain.

INTRODUCTION: Morphological reorganization in the neural networks of the medial prefrontal cortex (mPFC) may be involved in the development of chronic neuropathic pain (NP). OBJECTIVES: We investigated whether inactivation and neurostimulation of the infralimbic division (IFL) of the mPFC alter electroacupuncture-induced analgesia (EIA) at 2 Hz and 2/100 Hz in animals with chronic NP. METHODS: Wistar rats were submitted to chronic constrictor injury of the ischiadicus nerve (CCI). Von Frey and acetone tests were performed to evaluate mechanical or cold allodynia. Animals were submitted to electroacupuncture (EA) at 2 Hz and 2/100 Hz for 20 min. After EA, the IFL cortex synaptic contacts were inactivated by cobalt chloride (200 nL of 1.0 mM CoCl2). Neurostimulation of the IFL cortex was also performed at 20 µA for 15 s, after EA, using a deep brain stimulation device. RESULTS: EA at 2 Hz and 2/100 Hz attenuated mechanical or cold allodynia in CCI rats. Microinjection of CoCl2 into the IFL division of the mPFC blocked the EA effect. EA at 2 Hz and 2/100 Hz, in association with neurostimulation of the IFL cortex, attenuated mechanical and thermal allodynia. CONCLUSION: EA induces antinociception in CCI rats. The analgesia was potentiated in association with neurostimulation in the IFL division of the mPFC.

Auditory Brainstem Response with the iChirp stimuli in the infant's audiological diagnosis.

OBJECTIVE: to investigate the use of the iChirp stimulus in the infant's audiological diagnosis compared to stimuli typically used in the ABR in infants, in addition to suggesting reference values for the assessment of this population. METHODS: 62 infants participated in the study, 29 females and 33 males. The subjects underwent the recording of the Auditory Brainstem Response in the Smart Ep equipment, with the stimuli click, iChirp-broadband, tone burst and iChirp-narrowband, which were presented at three levels of intensity (20 dB, 40 dB and 60 dB) and, for tone burst and iChirp-narrowband stimuli, at different frequencies (0.5, 1 k, 2 k and 4 KHz). The data were later analyzed using Student's t-test. RESULTS: In general, the iChirp-broadband and iChirp-narrowband stimuli showed higher latency values and greater amplitudes when compared to click and tone burst stimuli. Furthermore, better signal-to-noise ratios were observed when contrasting iChirp-narrowband with tone burst. Additionally, reference values were established for the assessment of ABR in infants with the iChirp-broadband and iChirp-narrowband in the Smart-Ep equipment. CONCLUSION: The iChirp stimulus appears to be promising in the infant's audiological diagnosis, as its use promoted greater amplitudes and better wave morphology, which facilitates to mark the waveforms and provides greater efficiency in the investigation of the auditory thresholds. The indication of normative data also enables the clinical use of these stimuli in the infant's audiological diagnosis.

Linfoma de Burkitt Primário de Mama: Relato de Caso / Primary Breast Burkitt Lymphoma: Case Report / Linfoma de Burkitt Primario de Mama: Relato de Caso

Introdução: O linfoma primário de mama (LPM) representa cerca de 0,5% das neoplasias mamárias, sendo considerado um tipo raro de tumor. Alguns dos tipos de LPM, por sua vez, possuem ligação intensa com o período gravídico e pós-parto em virtude do estímulo hormonal. O objetivo deste estudo é relatar um caso de LPM com apresentação rara de linfoma de Burkitt, considerando propostas terapêuticas eficazes para o seguimento. Relato do caso: Paciente do sexo feminino, 23 anos, portadora de tumoração periareolar em mama direita com aspecto de casca de laranja e crescimento rápido há um mês, queixas flogísticas no local da lesão, bom estado geral e sem outros sintomas associados. O quadro relatado iniciou-se sete meses após a expulsão fetal com feto morto. A paciente foi submetida à biópsia da lesão e encaminhada para seguimento ambulatorial sem sucesso, necessitando de retorno ao ambiente hospitalar por piora das condições clínicas e extensão da tumoração. Houve diagnóstico de linfoma de Burkitt, com tratamento multidisciplinar, sendo submetida a protocolo CODOX-M de quimioterapia, com óbito após 22 dias de acompanhamento hospitalar. Conclusão: Este relato demonstra uma situação rara em uma paciente jovem, ressaltando a importância de investigar as alterações mamárias, de maneira eficaz, para um diagnóstico precoce correto e um tratamento adequado, em todas as faixas etárias

Introduction: Primary breast lymphoma (PML) represents about 0.5% of breast cancers, being considered a rare type of tumor. Some of the types of PML, in turn, have an intense connection with the pregnancy and postpartum period due to hormonal stimulation. The aim of this study is to report a case of PML with a rare presentation of Burkitt's lymphoma, considering effective therapeutic proposals for follow-up. Case report: A 23-year-old female patient with a peri-areolar tumor in the right breast with orange peel aspect and rapid growth for one month, phlogistic complaints at the lesion site, good general condition and no other associated symptoms. The reported condition started seven months after fetal expulsion with a dead fetus. The patient underwent lesion biopsy and was referred to an outpatient follow-up with unsuccessful outcome, requiring return to the hospital due to worsening of clinical conditions and extension of the tumor. There was a diagnosis of Burkitt's lymphoma, with multidisciplinary treatment. She underwent the CODOX-M chemotherapy protocol, and died after 22 days of hospital follow-up. Conclusion: This report demonstrates a rare situation in a young patient, emphasizing the importance of effective investigation of breast changes so that correct early diagnosis and appropriate treatment can be made for all age groups

Introducción: El linfoma primario de mama (LMP) representa aproximadamente el 0,5% de los cánceres de mama, siendo considerado un tipo de tumor poco común. Algunos de los tipos de LPM, a su vez, tienen una conexión intensa con el embarazo y el posparto debido a la estimulación hormonal. El objetivo de este estudio es reportar un caso de LMP con rara presentación de linfoma de Burkitt, considerando propuestas terapéuticas efectivas para el seguimiento. Relato del caso: Paciente, 23 años, con un tumor periareolar en la mama derecha con aspecto de piel de naranja y rápido crecimiento durante un mes, quejas flogísticas en el sitio de la lesión, buen estado general y ningún otro. síntomas asociados. La condición reportada comenzó siete meses después de la expulsión fetal con un feto muerto. El paciente fue sometido a biopsia de la lesión y fue derivado sin éxito a seguimiento ambulatorio, requiriendo el retorno al entorno hospitalario por empeoramiento de la clínica y extensión del tumor. Hubo un diagnóstico de linfoma de Burkitt, con tratamiento multidisciplinario. Se sometió al protocolo de quimioterapia CODOX-M y murió a los 22 días de seguimiento hospitalario. Conclusión: Este informe demuestra una situación poco común en una paciente joven, enfatizando la importancia de investigar de manera efectiva los cambios en los senos para un diagnóstico temprano correcto y un tratamiento adecuado en todos los grupos de edad

Monitoramento audiológico de lactentes em diferentes programas de triagem auditiva neonatal: uma revisão sistemática / Audiological monitoring of infants in different newborn hearing screening programs: a systematic review

RESUMO Objetivos Buscar na literatura informações quanto aos aspectos que guiam o monitoramento audiológico infantil, descrevendo os procedimentos utilizados, a idade em que são realizados, qual a população monitorada e os países que mais estudam sobre o assunto. Além de discutir a importância dessa etapa e a eficácia desses aspectos. Estratégia de pesquisa A revisão foi conduzida com base nas recomendações PRISMA e registrada na plataforma PROSPERO. Os estudos foram pesquisados nas bases de dados eletrônicas Medline (Pubmed), Web of Science e SciELO, com os descritores hearing, neonatal screening e follow up. Critérios de seleção Foram incluídos estudos que descrevessem o monitoramento audiológico. Não foram empregados filtros do ano de publicação, tampouco para os idiomas dos mesmos. Resultados Foram encontrados 432 artigos e 21 foram incluídos nesse estudo, sendo que a maioria foi produzida em países desenvolvidos. O Potencial Evocado Auditivo de Tronco Encefálico e a Avaliação Comportamental foram os procedimentos mais utilizados. Quanto a idade e população, a maioria realiza o monitoramento até os três anos e em crianças com Indicadores para a Deficiência Auditiva. Conclusão Os estudos demonstraram que não há padrão entre os protocolos para a realização do monitoramento audiológico, porém foi possível identificar que as pesquisas apresentam uma maior concordância quanto a idade em que tal monitoramento acontece e qual a população que deve ser monitorada. Entretanto, embora haja discordâncias, os métodos de avaliação utilizados pelos estudos são eficazes para a detecção de perdas auditiva de caráter leve, progressivo e/ou tardio, além dos casos de falso negativo.

ABSTRACT Purpose To search the literature for guidelines on infant's audiological monitoring, most commonly used procedures, the age at which they are performed, which population should be monitored and the countries that study the subject the most. Besides, the importance and effectiveness of these measures will be discussed. Research strategy The review was conducted based on the PRISMA recommendations, registered on the PROSPERO platform. The studies were searched for in the electronic databases Medline (Pubmed), Web of Science and SciELO, using the descriptors hearing, neonatal screening and follow up. Selection criteria studies reporting the audiological monitoring were included. No filters on year and language of publication were used. Results A total of 432 articles were found and 21 were included in this study, mostly produced in developed countries. The Auditory Brainstem Response and the Behavioral Assessment were the most frequently used procedures. As to age and population, most infants are subjected to audiological monitoring up to three years of age and have Risk Factors for Hearing Loss in their clinical history. Conclusion The studies pointed that there is no standard among the protocols for performing audiological monitoring, but it was possible to identify agreement as to the age at which such monitoring takes place and which population should be monitored. However, although there is some disagreement, the assessment methods used in the studies are effective in detecting mild, progressive and/or late hearing loss, in addition to false negative cases.

Congenital Zika Syndrome Is Associated With Interferon Alfa Receptor 1.

Host factors that influence Congenital Zika Syndrome (CZS) outcome remain elusive. Interferons have been reported as the main antiviral factor in Zika and other flavivirus infections. Here, we accessed samples from 153 pregnant women (77 without and 76 with CZS) and 143 newborns (77 without and 66 with CZS) exposed to ZIKV conducted a case-control study to verify whether interferon alfa receptor 1 (IFNAR1) and interferon lambda 2 and 4 (IFNL2/4) single nucleotide polymorphisms (SNPs) contribute to CZS outcome, and characterized placenta gene expression profile at term. Newborns carrying CG/CC genotypes of rs2257167 in IFNAR1 presented higher risk of developing CZS (OR=3.41; IC=1.35-8.60; Pcorrected=0.032). No association between IFNL SNPs and CZS was observed. Placenta from CZS cases displayed lower levels of IFNL2 and ISG15 along with higher IFIT5. The rs2257167 CG/CC placentas also demonstrated high levels of IFIT5 and inflammation-related genes. We found CZS to be related with exacerbated type I IFN and insufficient type III IFN in placenta at term, forming an unbalanced response modulated by the IFNAR1 rs2257167 genotype. Despite of the low sample size se findings shed light on the host-pathogen interaction focusing on the genetically regulated type I/type III IFN axis that could lead to better management of Zika and other TORCH (Toxoplasma, Others, Rubella, Cytomegalovirus, Herpes) congenital infections.

Putative pathogen-selected polymorphisms in the PKLR gene are associated with mycobacterial susceptibility in Brazilian and African populations.

Pyruvate kinase (PK), encoded by the PKLR gene, is a key player in glycolysis controlling the integrity of erythrocytes. Due to Plasmodium selection, mutations for PK deficiency, which leads to hemolytic anemia, are associated with resistance to malaria in sub-Saharan Africa and with susceptibility to intracellular pathogens in experimental models. In this case-control study, we enrolled 4,555 individuals and investigated whether PKLR single nucleotide polymorphisms (SNPs) putatively selected for malaria resistance are associated with susceptibility to leprosy across Brazil (Manaus-North; Salvador-Northeast; Rondonópolis-Midwest and Rio de Janeiro-Southeast) and with tuberculosis in Mozambique. Haplotype T/G/G (rs1052176/rs4971072/rs11264359) was associated with leprosy susceptibility in Rio de Janeiro (OR = 2.46, p = 0.00001) and Salvador (OR = 1.57, p = 0.04), and with tuberculosis in Mozambique (OR = 1.52, p = 0.07). This haplotype downregulates PKLR expression in nerve and skin, accordingly to GTEx, and might subtly modulate ferritin and haptoglobin levels in serum. Furthermore, we observed genetic signatures of positive selection in the HCN3 gene (xpEHH>2 -recent selection) in Europe but not in Africa, involving 6 SNPs which are PKLR/HCN3 eQTLs. However, this evidence was not corroborated by the other tests (FST, Tajima's D and iHS). Altogether, we provide evidence that a common PKLR locus in Africans contribute to mycobacterial susceptibility in African descent populations and also highlight, for first, PKLR as a susceptibility gene for leprosy and TB.

Effect of Auditory Maturation on the Encoding of a Speech Syllable in the First Days of Life.

(1) Background: In neonates and infants, the physiological modifications associated with language development are reflected in their Frequency Following Responses (FFRs) in the first few months of life. (2) Objective: This study aimed to test the FFRs of infants in the first 45 days of life in order to evaluate how auditory maturation affects the encoding of a speech syllable. (3) Method: In total, 80 healthy, normal-hearing infants, aged 3 to 45 days old, participated in this study. The sample was divided into three groups: GI, 38 neonates from 3 to 15 days; GII, 25 infants from 16 to 30 days; and GIII, 17 infants from 31 to 45 days. All participants underwent FFR testing. Results: With age, there was a decrease in the latency of all FFR waves, with statistically significant differences among the groups studied for waves V, A, E, F, and O. The mean amplitudes showed an increase, with a statistically significant difference only for wave V. The slope measure increased over the 45 days, with a statistically significant difference between GIII and GI and between GIII and GII. (4) Conclusions: The encoding of a speech sound changes with auditory maturation over the first 45 days of an infant's life.