The Body Appreciation Scale-2: Psychometric evaluation of the Puerto Rican Spanish version among women aged ≥ 50 years who are breast cancer survivors.

PURSPOSE: Self-perceived body image may impact women's well-being and levels of depressive symptomatology after cancer-related treatment. The Body Appreciation Scale-2 (BAS-2) is a 10-item, unidimensional tool used to assess body appreciation, a facet of body image. A culturally relevant version of the BAS-2 was needed for the Spanish spoken in Puerto Rico. A cross-cultural adaptation of the BAS-2 for Spanish spoken in Puerto Rico was conducted and tested its psychometric properties, using a methodological design. It was hypothesized that the BAS-2 adapted for Puerto Rican Spanish would have an internal consistency with a Cronbach α value greater than 0.70 and a unidimensional structure; and that body appreciation would be positively and significantly correlated to mental health and would be negatively and significantly correlated to depression and body mass index. METHODS: One hundred-nine participants were recruited with a diagnosis of breast cancer (stages 0 to III) who completed adjuvant curative therapy at least two months to five years prior to recruitment. RESULTS: Participants had an average age of 61.5 years (SD = 7.1), and 64.2% had a bachelor's degree or higher educational level. The internal consistency of the BAS-2 adapted for the Puerto Rican Spanish was Cronbach α = 0.92. Exploratory factor analysis indicated one-dimensionality of the test. Body appreciation was negatively correlated with higher levels of depressive symptomatology and with a higher body mass index, and positively correlated with higher levels of mental health. CONCLUSION: The BAS-2 adapted for the Spanish of Puerto Rico is a psychometrically sound instrument to assess body image.

Microbial Diversity in Children with Gastroenteritis in the Amazon Region of Brazil: Development and Validation of a Molecular Method for Complete Sequencing of Viral Genomes.

INTRODUCTION: Metagenomic sequencing is a powerful tool that is widely used in laboratories worldwide for taxonomic characterization of microorganisms in clinical and environmental samples. In this study, we utilized metagenomics to investigate comprehensively the microbial diversity in fecal samples of children over a four-year period. Our methods were carefully designed to ensure accurate and reliable results. MATERIAL AND METHODS: Validated and analyzed were metagenomic data obtained from sequencing 27 fecal samples from children under 10 years old with gastroenteritis over a four-year period (2012-2016). The fecal specimens were collected from patients who received care at public health facilities in the northern region of Brazil. Sequencing libraries were prepared from cDNA and sequenced on the Illumina HiSeq. Kraken-2 was utilized to classify bacterial taxonomy based on the 16S rRNA gene, using the Silva rRNA database. Additionally, the Diamond program was used for mapping to the non-redundant protein database (NR database). Phylogenomic analyses were conducted using Geneious R10 and MEGA X software, and Bayesian estimation of phylogeny was performed using the MrBayes program. The results indicate significant heterogeneity among norovirus strains, with evidence of recombination and point mutations. This study presents the first complete genome of parechovirus 8 in the region. Additionally, it describes the bacterial populations and bacteriophages present in feces, with a high abundance of Firmicutes and Proteobacteria, including an increased proportion of the Enterobacteriaceae family. The presented data demonstrate the genetic diversity of microbial populations and provide a comprehensive report on viral molecular characterization. These findings are relevant for genomic studies in gastrointestinal infections. The metagenomic approach is a powerful tool for investigating microbial diversity in children with gastroenteritis. However, further studies are imperative to conduct genomic analysis of identified bacterial strains and thoroughly analyze antimicrobial resistance genes.

Evaluating the persistence of malachite green residues in tilapia and pacu fish.

Although banned in food-producing animals, residues of malachite green (MG) and its primary metabolite, leucomalachite green (LMG), have been found in fish due to illegal use in aquaculture and the release of industrial wastewater, which represent a serious risk to food and environmental securities. This study aimed to investigate the residue depletion profile of MG and LMG in edible tissues of Nile tilapia (Oreochromis niloticus) and pacu (Piaractus mesopotamicus) cultured simultaneously under the same environmental conditions to support control measures in case of abuse. An analytical method involving QuEChERS sample preparation and liquid chromatography coupled to tandem mass spectrometry was developed, validated, and applied to quantify MG and LMG residues in fish fillets from two depletion experiments after treatment by immersion bath (MG at 0.10 mg L-1 for 60 min). During the experiment, the average water temperature was 30 ºC, while the pH was 6.9. The method is selective, precise (CV = 0.4 - 22%) and accurate (recovery 92 - 114%). The limits of detection and quantification are 0.15 and 0.5 ng g-1, respectively. In both species, the sum of MG and LMG residues were quantified up to the 32nd day post-exposure, and the concentrations were significantly higher in the pacu fillets (up to 3284 ng g-1) than in Nile tilapia (up to 432 ng g-1). The sums of MG and LMG residues were below 2 ng g-1 at 44 days and 342 days for Nile tilapia and pacu, respectively - the Minimum Required Performance Limit (MRPL) for analytical methods intended to monitor forbidden substances in food according to old European Commission guidelines. The persistence of MG residues in pacu may be attributed to its higher lipid content, which favors the accumulation of the non-polar metabolite LMG. These results provide insights into the concern about human, animal, and environmental health risks resulting from unauthorized use or aquatic contamination by industrial wastewater containing MG residues.

Preliminary results in tracheal replacement using stented aortic matrices for primary extensive tracheal cancer.

Objective: Recent studies have demonstrated the feasibility and favorable long-term results of tracheobronchial replacement using stented cryopreserved aortic allografts. We propose to investigate the outcomes of this emerging technique in the subgroup of patients with extensive tracheal cancer. Methods: This study was based on 13 patients with primary extensive tracheal cancer extracted from the prospective registry TRITON-01 (ClinicalTrials.gov Identifier: NCT04263129), which included 40 patients in total. We analyzed early and late outcomes in this subset of patients. Results: From March 2019 to September 2022, 13 patients were included in the study. There were 9 female and 4 male patients, with a mean age of 53.9 years [36-71 years]. They had tracheal replacement for extended adenoid cystic carcinoma (n = 11), squamous cell carcinoma (n = 1), and mucoepidermoid carcinoma (n = 1). A venovenous extracorporeal membrane oxygenation was used in the 6 last cases. The mean length of resection was 81 mm [50-120 mm]. There was no 30-day postoperative mortality. A complete resection (R0) was achieved in 11 patients. The main late complications consisted of tracheal granulomas related to the stent and requiring repeated bronchoscopies (n = 9), pneumonia (n = 3), airway infection (n = 1), bronchoesophageal fistula (n = 1), mechanical stent obstruction requiring change (n = 2), and mediastinitis treated by antibiotics, drainage, and omentoplasty (n = 1). With a maximal follow-up of 3 years and 7 months, cancer recurrence was observed in 2 patients. All patients were alive at last follow-up except 2 (84.6%). Conclusions: Airway replacement using stented CAA represents a feasible and promising solution for extensive tracheal cancer.

Residue Depletion Profile and Estimation of Withdrawal Period for Sulfadimethoxine and Ormetoprim in Edible Tissues of Nile Tilapia (Oreochromis sp.) on Medicated Feed.

Sulfadimethoxine (SDM) and ormetoprim (OMP) are antimicrobials used in combination to treat bacterial infections in fish farming. The use of this drug combination is not yet regulated in some countries, such as Brazil. Due to the lack of regulated drugs for aquaculture in Brazil, this study investigated the residue depletion profile of SDM and OMP in Nile tilapia (Oreochromis sp.) after oral administration. Fish were treated with medicated feed containing a 5:1 ratio of SDM:OMP at the dose of 50 mg kg BW-1 for five consecutive days with an average water temperature of 28 °C. The drugs were incorporated into the feed by using a gelatin coating process which promoted homogeneity in drug concentration and prevented the drug leaching into the water during medication. The SDM and OMP determination in fish fillets (muscle plus skin in natural proportions) was performed using the QuEChERS approach followed by LC-MS/MS quantification. The analytical method was validated according to Brazilian and selected international guidelines. A withdrawal period of 9 days (or 252 °C days) was estimated for the sum of SDM and OMP residues at concentration levels below the maximum residue level of 100 µg kg-1.

Riparian forest response to extreme drought is influenced by climatic context and canopy structure.

Droughts significantly impact forest ecosystems, reducing forest health and productivity, compromising ecosystem functioning, and nature-based solutions for climate change. The response and resilience of riparian forests to drought are poorly understood despite their key role in the functioning of aquatic and terrestrial ecosystems. Here we investigate riparian forest drought responses and resilience to an extreme drought event at a regional scale. We also examine how drought event characteristics, average climate conditions, topography, soil, vegetation structure, and functional diversity shape the resilience of riparian forests to drought. We used a time series of the Normalized Difference Vegetation Index (NDVI) and Normalized Difference Water Index (NDWI) to calculate the resistance to and recovery after an extreme drought (2017-2018) in 49 sites across an Atlantic-Mediterranean climate gradient in North Portugal. We used generalized additive models and multi-model inference to understand which factors best explained drought responses. We found a trade-off between drought resistance and recovery (maximum r = -0.5) and contrasting strategies across the climatic gradient of the study area. Riparian forests in the Atlantic regions showed comparatively higher resistance, while Mediterranean forests recovered more. Canopy structure and climate context were the most relevant predictors of resistance and recovery. However, median NDVI and NDWI had not returned to pre-drought levels (RcNDWI mean = 1.21, RcNDVI mean = 1.01) three years after the event. Our study shows that riparian forests have contrasting drought response strategies and may be susceptible to extended legacy effects associated with extreme and/or recurring droughts, similarly to upland forests. This work highlights the drought vulnerability of riparian ecosystems and emphasises the need for further studies on long-term resilience to droughts.

Response-effect trait overlap and correlation in riparian plant communities suggests sensitivity of ecosystem functioning and services to environmental change.

Environmental changes and biodiversity loss have emphasized the need to understand how communities affect ecosystem functioning and services. In riparian ecosystems, integrative, generalizable, broad-scale models of ecosystem functioning are still required to fulfill this need. However, few studies have explored the links between functional traits, ecosystem functions, and the services of riparian vegetation. Here we adapt the response-effect trait framework to link drivers, traits, ecosystem functions, and services in riparian ecosystems and assess ecosystem functioning sensitivity to environmental changes. The response-effect trait framework distinguishes between traits related to responses to the environment (response traits) and effects on ecosystem functioning (effect traits). The framework predicts that if response and effect traits are tightly linked, shifts in environmental drivers may alter communities' traits and ecosystem functioning. We adapted the response-effect trait framework for riparian plant communities and used it to assess the overlap between response and effect traits. We tested for correlation among traits identified in the framework and for community functional responses to climatic, topographic, soil, and land cover factors using riparian plant communities along a Temperate-Mediterranean climate gradient in North Portugal. We found a high overlap between response and effect traits, with seven out of thirteen traits identified as both response and effect. Additionally, we found trait linkages in four groups of positively correlated community mean traits. Precipitation and aridity were the most predictive drivers of community functional structure, and life form and leaf area were the most responsive traits. Overall, our findings suggest riparian plant communities are likely to propagate the effects of environmental changes to ecosystem functioning and services, affecting several regulation ecosystem services. This work highlights the sensitivity of riparian ecosystems to environmental changes and how it can affect ecosystem services. Similar functional approaches can be useful for adaptive ecosystem management to sustain biodiversity and ecosystem services.

Caminhos de um comitê de ética: 10 anos da Plataforma Brasil / Trajectory of an ethics commitee: 10 years of Plataforma Brasil / Trayectoria de un comité de ética: 10 años de la Plataforma Brasil

Resumo Esta pesquisa buscou traçar o perfil do Comitê de Ética da Universidade Estadual Vale do Acaraú, Ceará, nos 10 anos da Plataforma Brasil. Levantaram-se pesquisas realizadas entre 2012 e 2021, conforme atores ou processos, seguindo a análise descritiva. Houve prevalência feminina e do campo da saúde ou ciências biológicas, e pareceristas tiveram maior formação acadêmica, tempo de experiência e número de projetos em relação a pesquisadores. Das 2.295 pesquisas analisadas, houve flutuações temporais, com concentração de projetos anteriormente aprovados até 2015, finalizados em 2016 e em trâmite em 2021, com evidente diminuição em 2020 e 2021. Foram mais frequentes pesquisas originais de centros coordenadores, institucionais, brasileiras, autofinanciadas, sem área temática, com decisão ética favorável, em até três meses e tempo de fluxo reduzido entre quinquênios. Termo de consentimento livre e esclarecido e riscos destacaram-se como principais óbices éticos. Esse panorama valoriza a importância da plataforma para o progresso científico.

Abstract This study outlines the profile of the Ethics Committee of the Acaraú Valley State University, Ceará, Brazil, after 10 years of Plataforma Brasil. Bibliographic search surveyed research conducted between 2012 and 2021 according to actors and processes, following descriptive analysis. Results showed a prevalence of female researchers from the health or biological sciences field, and reviewers had a greater academic background, length of experience, and number of projects than researchers. Of the 2,295 studies analyzed, most were approved by 2015, completed in 2016 and under evaluation in 2021, with clear decrease in 2020 and 2021. Original research from national self-funded institutional coordinating centers without thematic area, with a favorable ethical opinion within three months, and reduced flow time between quinquennia stood out. Main ethical obstacles concerned the informed consent and risks. This overview highlights the importance of the platform for scientific progress.

Resumen Esta investigación rastreó el perfil del Comité de Ética de la Universidad Estadual Vale do Acaraú, Ceará, Brasil, en los 10 años de la Plataforma Brasil. Los estudios ocurrieron entre 2012 y 2021 según actores o procesos, siguiendo el análisis descriptivo. Predominaron mujeres del campo de la salud o las ciencias biológicas y, comparados con los investigadores, los árbitros tenían alto nivel de formación académica, mayor tiempo de experiencia y proyectos. En 2.295 estudios hubo fluctuaciones temporales, con concentración de proyectos aprobados hasta 2015, completados en 2016 y en curso en 2021, con disminución evidente entre 2020-2021. Los estudios más frecuentes provienen de los centros coordinadores, institucionales, brasileños, autoapoyados, sin área temática, con decisión ética favorable hasta tres meses y tiempo de flujo reducido entre quinquenios. El formulario de consentimiento y los riesgos fueron los principales obstáculos éticos. Este panorama valora la importancia de la plataforma al progreso científico.

Airway replacement using stented aortic matrices: Long-term follow-up and results of the TRITON-01 study in 35 adult patients.

Over the past 25 years, we have demonstrated the feasibility of airway bioengineering using stented aortic matrices experimentally then in a first-in-human trial (n = 13). The present TRITON-01 study analyzed all the patients who had airway replacement at our center to confirm that this innovative approach can be now used as usual care. For each patient, the following data were prospectively collected: postoperative mortality and morbidity, late airway complications, stent removal and status at last follow-up on November 2, 2021. From October 2009 to October 2021, 35 patients had airway replacement for malignant (n = 29) or benign (n = 6) lesions. The 30-day postoperative mortality and morbidity rates were 2.9% (n = 1/35) and 22.9% (n = 8/35) respectively. At a median follow-up of 29.5 months (range 1-133 months), 27 patients were alive. There have been no deaths directly related to the implanted bioprosthesis. Eighteen patients (52.9%) had stent-related granulomas requiring a bronchoscopic treatment. Ten among 35 patients (28.6%) achieved a stent free survival. The actuarial 2- and 5-year survival rates (Kaplan-Meier estimates) were respectively 88% and 75%. The TRITON-01 study confirmed that airway replacement using stented aortic matrices can be proposed as usual care at our center. Clinicaltrials.gov Identifier: NCT04263129.

Endobronchial Seeding of Squamous Lung Carcinoma with Mediastinal Lymph Involvement Node after EBUS: A Case Report.

In locally advanced non-small-cell lung cancer (NSCLC), mediastinal staging is the cornerstone of the therapeutic decision and echoendoscopy is the most practiced exam to assess the lymph node involvement. We describe a rare case of endobronchial involvement by cells originating from a metastatic lymph node after endobronchial ultrasound (EBUS). A 64-year-old man was diagnosed with a squamous cell lung cancer with mediastinal nodal involvement proven by EBUS. The patient received neoadjuvant chemotherapy with partial response and was scheduled for a lobectomy. Before surgery, a fibroscopy was performed which demonstrated a 1-cm polypoid lesion settled on the internal face of the main right bronchus corresponding to the EBUS puncture site. The histological analysis confirmed tumoral cell in this lesion. The patient was rejected for surgery and undergo chemoradiation. This case highlights the need for a careful endoscopic control before surgical resection in case of prior positive EBUS followed by an interval of time.

Evolutionary and Molecular Analysis of Complete Genome Sequences of Norovirus From Brazil: Emerging Recombinant Strain GII.P16/GII.4.

Noroviruses (NoVs) are enteric viruses that cause acute gastroenteritis, and the pandemic GII.4 genotype is spreading and evolving rapidly. The recombinant GII.P16/GII.4_Sydney strain emerged in 2016, replacing GII.P31/GII.4_Sydney (GII.P31 formerly known as GII.Pe) in some countries. We analyzed the complete genome of 20 NoV strains (17 GII.P31/GII.4_ Sydney and 3 GII.P16/GII.4_Sydney) from Belém and Manaus, Brazil, collected from 2012 to 2016. Phylogenetic trees were constructed by maximum likelihood method from 191 full NoV-VP1 sequences, demonstrated segregation of the Sydney lineage in two larger clades, suggesting that GII.4 strains associated with GII.P16 already have modifications compared with GII.P31/GII.4. Additionally, the Bayesian Markov Chain Monte Carlo method was used to reconstruct a time-scaled phylogenetic tree formed by GII.P16 ORF1 sequences (n = 117) and three complete GII.P16 sequences from Belém. The phylogenetic tree indicated the presence of six clades classified into different capsid genotypes and locations. Evolutionary rates of the ORF1 gene of GII.P16 strains was estimated at 2.01 × 10-3 substitutions/site/year, and the most recent common ancestors were estimated in 2011 (2011-2012, 95% HPD). Comparing the amino acid (AA) sequence coding for ORF1 with the prototype strain GII.P16/GII.4, 36 AA changes were observed, mainly in the non-structural proteins p48, p22, and RdRp. GII.P16/GII.4 strains of this study presented changes in amino acids 310, 333, 373, and 393 of the antigenic sites in the P2 subdomain, and ML tree indicating the division within the Sydney lineage according to the GII.P16 and GII.P31 polymerases. Notably, as noroviruses have high recombination rates and the GII.4 genotype was prevalent for a long time in several locations, additional and continuous evolutionary analyses of this new genotype should be needed in the future.

Elective extra corporeal membrane oxygenation for high-risk rigid bronchoscopy.

The use of extracorporeal membrane oxygenation for high-risk rigid bronchoscopy has been reported in few urgent cases. We report our experience with this approach which was planned electively in five cases on 202 procedures (2.5%). It was proposed because of the potential inability to ventilate the lungs using conventional techniques due to extensive tracheobronchial lesions or the risk of major intraoperative bleeding related to disease characteristics. There were no intraoperative complications and postoperative course was favourable in all patients. With a maximum follow-up of 3 years and 7 months, all patients are alive with no tracheostomy despite major morbidities.

Clinical and Molecular Description of 16 Families With Heterozygous IHH Variants.

CONTEXT: Heterozygous variants in the Indian hedgehog gene (IHH) have been reported to cause brachydactyly type A1 and mild hand and feet skeletal anomalies with short stature. Genetic screening in individuals with short stature and mild skeletal anomalies has been increasing over recent years, allowing us to broaden the clinical spectrum of skeletal dysplasias. OBJECTIVE: The objective of this article is to describe the genotype and phenotype of 16 probands with heterozygous variants in IHH. PATIENTS AND METHODS: Targeted next-generation sequencing or Sanger sequencing was performed in patients with short stature and/or brachydactyly for which the genetic cause was unknown. RESULTS: Fifteen different heterozygous IHH variants were detected, one of which is the first reported complete deletion of IHH. None of the patients showed the classical phenotype of brachydactyly type A1. The most frequently observed clinical characteristics were mild to moderate short stature as well as shortening of the middle phalanx on the fifth finger. The identified IHH variants were demonstrated to cosegregate with the short stature and/or brachydactyly in the 13 probands whose family members were available. However, clinical heterogeneity was observed: Two short-statured probands showed no hand radiological anomalies, whereas another 5 were of normal height but had brachydactyly. CONCLUSIONS: Short stature and/or mild skeletal hand defects can be caused by IHH variants. Defects in this gene should be considered in individuals with these findings, especially when there is an autosomal dominant pattern of inheritance. Although no genotype-phenotype correlation was observed, cosegregation studies should be performed and where possible functional characterization before concluding that a variant is causative.

Food safety evaluation for the use of albendazole in fish: residual depletion profile and withdrawal period estimation.

Due to the lack of drugs regulated for aquaculture, we have evaluated the use of albendazole (ABZ) - a potential drug to be regulated for fish - under food safety perspectives assessing the depletion profile of ABZ and its main metabolites (albendazole sulphoxide - ABZSO, albendazole sulphone - ABZSO2 and albendazole amino sulphone - ABZ-2-NH2SO2) in fish fillets (muscle and skin) after single dose oral administration of 10 mg ABZ kg-1 body weight. For the drug administration, a suitable procedure for ABZ incorporation into fish feed was employed, obtaining good homogeneity of ABZ concentration among feed pellets (CV<4.1%) and low drug leaching when medicated feed remained in the water for up to 60 min (<2.7%). After medication, fish were euthanised at 8, 12, 24, 48, 72, 96 and 120 h and fillets collected. Depletion studies in various fish species (patinga and tilapia) were conducted simultaneously, under water temperature at 30.4 ± 0.3 °C and pH 6.8 ± 0.1. The highest concentrations for the sum of residues (ABZ, ABZSO, ABZSO2 and ABZ-2-NH2SO2) in fish fillet were 1210 ng g-1 in patinga and 637 ng g-1 in tilapia. Under the employed rearing conditions, the obtained results did not indicate a requirement for a minimum withdrawal period to be proposed for tilapia considering the maximum residue limit of 100 µg g-1, since the determined residual concentration was

[Development and evaluation of educational material directed to fall prevention in pregnant women]. / Desarrollo y evaluación de material educativo dirigido a prevención de caídas en mujeres embarazadas.

OBJECTIVE: One in four pregnant women has at least one fall during their pregnancy. The objective of this research was to develop a written educational material on fall prevention for pregnant women, promoting self-efficacy and the expectations of results based on the social cognitive theory. It was also intended to evaluate the validity of the content of the educational material, its understanding and actionability. METHODS: This methodological study was carried out in two phases: the first was based on the development of educational material and its evaluation by two panels of experts (n=13). Secondly, the educational material was evaluated for organization, clarity, appearance, relevance, content, self-efficacy and expectations of results, using an evaluation sheet created by the researchers, as well as its understanding and actionability using the PEMAT instrument. Descriptive statistics are used for sociodemographic variables and the results of the evaluation instruments. RESULTS: Recommendations on the organization, clarity of information, appearance in terms of image quality, relevance, self-efficacy, expectation of results and safety aspects were met. In the evaluation carried out by the content expert panel, an average of 87.8% and 91.6% was obtained in the areas of actionability and understanding of PEMAT-P, respectively. CONCLUSIONS: This study develops an educational material with content validity, highly understandable and actionable on the falls incident, their causes and consequences, strategies to prevent them, the benefits of exercising and the recommendation of exercises to prevent falls during pregnancy.

OBJETIVO: Una de cada cuatro mujeres embarazadas tiene al menos una caída durante su período de gestación. El objetivo de esta investigación fue desarrollar un material educativo escrito sobre prevención de caídas para mujeres embarazadas, promoviendo la autoeficacia y las expectativas de resultados basados en la teoría social cognitiva. Igualmente se pretendió evaluar la validez del contenido del material educativo, su comprensión y capacidad de acción. METODOS: Este estudio metodológico se llevó a cabo en dos fases: la primera se fundamentó en el desarrollo del material educativo y su evaluación por dos paneles de personas expertas (n=13). En segundo lugar, el material educativo fue evaluado con respecto a la organización, claridad, apariencia, relevancia, contenido, autoeficacia y expectativas de resultados, utilizando una hoja de evaluación creada por las investigadoras, así como su comprensión y capacidad de acción utilizando el instrumento PEMAT. Se utilizaron estadísticas descriptivas para las variables sociodemográficas y los resultados de los instrumentos de evaluación. RESULTADOS: Se atendieron las recomendaciones sobre la organización, claridad de la información, apariencia en términos de la calidad de las imágenes, relevancia, autoeficacia, expectativa de resultados y aspectos de seguridad. En la evaluación realizada por el panel de personas expertas en el contenido, se obtuvo un promedio del 87,8% y del 91,6% en los apartados de capacidad de acción y comprensión del PEMAT-P respectivamente. CONCLUSIONES: Este estudio logra desarrollar un material educativo con validez de contenido, altamente comprensible y accionable sobre incidencia de las caídas, sus causas y consecuencias, estrategias para prevenirlas, los beneficios de ejercitarse y recomendación de ejercicios para prevenir caídas durante el embarazo.

Microgliosis is associated with visual memory decline in patients with temporal lobe epilepsy and hippocampal sclerosis: A clinicopathologic study.

Hippocampal sclerosis (HS) is characterized by neuronal loss and gliosis. The intensity and distribution of these histopathological findings over the Cornu Ammonis (CA) subfields are important for the classification of HS and prognostication of patients with temporal lobe epilepsy (TLE). Several studies have associated the neuronal density reduction in the hippocampus with cognitive decline in patients with TLE. The current study aimed at investigating whether the expression of glial proteins in sclerotic hippocampi is associated with presurgical memory performance of patients with TLE. Before amygdalohippocampectomy, patients were submitted to memory tests. Immunohistochemical and morphometric analyses with glial fibrillary acidic protein (GFAP) for astrogliosis and human leucocyte antigen DR (HLA-DR) for microgliosis were performed in paraffin-embedded HS and control hippocampi. Sclerotic hippocampi exhibited increased gliosis in comparison with controls. In patients with TLE, the area and intensity of staining for HLA-DR were associated with worse performance in the memory tests. Glial fibrillary acidic protein was neither associated nor correlated with memory test performance. Our data suggest association between microgliosis, but not astrogliosis, with visual memory decline in patients with TLE.

Antimicrobial activity and inhibition of the NorA efflux pump of Staphylococcus aureus by extract and isolated compounds from Arrabidaea brachypoda.

Arrabidaea brachypoda is a native shrub of the Brazilian Cerrado widely used in the folk medicine for treatment of renal diseases and articular pains. This study aimed to, first, evaluate the antimicrobial activity of both extracts and isolated molecules Brachydins BR-A and BR-B obtained from the flowers of A. brachypoda against Staphylococcus aureus, Escherchia coli and Candida albicans species. A second objective was to investigate if these natural products were able to potentiate the Norfloxacin activity against the strain Staphylococcus aureus SA1199-B that overexpress the norA gene encoding the NorA efflux pump. Extracts and isolated compounds were analyzed by HPLC-PDA and LC-ESI-MS respectively. Minimal inhibitory concentrations of Norfloxacin or Ethidium Bromide (EtBr) were determined in the presence or absence of ethanolic extract, dichloromethane fraction, as well as BR-A or BR-B by microdilution method. Only BR-B showed activity against Candida albicans. Addition of ethanolic extract, dichloromethane fraction or BR-B to the growth media at sub-inhibitory concentrations enhanced the activity of both Norfloxacin and EtBr against S. aureus SA1199-B, indicating that these natural products and its isolated compound BR-B were able to modulate the fluoroquinolone-resistance possibly by inhibition of NorA. Moreover, BR-B inhibited the EtBr efflux in the SA1199-B strain confirming that it is a NorA inhibitor. Isolated BR-B was able to inhibit an important mechanism of multidrug-resistance very prevalent in S. aureus strains, thus its use in combination with Norfloxacin could be considered as an alternative for the treatment of infections caused by S. aureus strains overexpressing norA.

Molecular and evolutionary characterization of norovirus GII.17 in the northern region of Brazil.

BACKGROUND: Currently, norovirus (NoV) is associated with one-fifth of all acute gastroenteritis (AGE) cases worldwide. The NoV GII.17_2014 variant has been associated with gastroenteritis outbreaks in several Asian countries, replacing the previously dominant Sydney 2012 variant. There is limited data about circulation of this new strain in Brazil. This study aimed to describe the phylogenetic and evolutionary characteristics of the GII.17_2014 strains in the Northern region of Brazil. METHODS: NoV was detected by enzyme immunoassay (EIA) in 645 stool samples of AGE cases that were reported in Pará and Amazonas states during 2015-2016. All positive samples were tested for NoV GI and GII by reverse transcription polymerase chain reaction (RT-PCR) and the amplicons were subjected to genome sequencing. The GII.17-positive samples were retested by PCR using different sets of designed primers, which target a highly conserved capsid gene region. Next, the amplicons were sequenced and phylogenetically analyzed using Bayesian inferences. RESULTS: Of the 645 samples tested, 208 (32.2%) tested were positive for NoV by EIA, among which 95 (45.7%) were genotyped. Among the genotyped samples, 12 (12.6%) were characterized as GII.17_2014 with the first case detected in November 2015 (1/30, 3.3%) and the others in 2016 (11/65, 16.9%). All strains found in our study were clustered in clade D (epidemic strain). The uncorrelated log-normal model estimations calculated the rate of evolution for GII-17 strains as 1.95 × 10- 3 (1.28 × 10- 3-2.63 × 10- 3). In total, 36 nucleotide changes were observed after analyzing the VP1 sequence, among which 28 occurred in the P2 region. CONCLUSIONS: These data demonstrate the evolutionary dynamics in NoV GII.17_2014 strains, which indicated high mutation rates with nucleotide substitutions and indels that are related to the elevated levels of antigenic diversity. This partly explains the increase in viral prevalence.

Bcl-2/Bax ratio increase does not prevent apoptosis of glia and granular neurons in patients with temporal lobe epilepsy.

Temporal lobe epilepsy (TLE) is usually associated with hippocampal sclerosis (HS), characterized by gliosis and neuronal loss, mainly in the cornus ammonis (CA). Regardless the type of HS, gliosis is associated with neuronal loss. Indeed, glial reactivation seems to induce both neuronal and glial apoptosis. Anti-apoptotic mechanisms are also activated in order to contain the cell death in chronic epilepsy. However, the role of the intrinsic apoptosis pathway in human TLE is unclear, mainly in relation to glial death. The purpose of this study was to evaluate the reactive gliosis areas in parallel with Bcl-2/Bax ratio and active caspase 3 immunoreactivity in hippocampi of TLE patients in comparison with control hippocampi. We also sought to investigate whether the levels of these markers were correlated with TLE clinical parameters. Paraffin-embedded sclerotic and control hippocampi were collected for immunohistochemical analyses of glial fibrillary acidic protein (GFAP), human leucocyte antigen DR (HLA-DR), neuronal nuclei protein (NeuN), Bax, Bcl-2 and active caspase 3. Sclerotic hippocampi presented higher immunoreactivity areas of GFAP and HLA-DR than controls, with similar values in HS types 1 and 2. Bcl-2 protein expression was increased in epileptic hippocampi, while Bax expression was similar to controls. Despite Bcl2/Bax ratio increase, granular neurons and glia exhibited active caspase 3 expression in TLE hippocampi, while controls did not show staining for the same marker. In conclusion, glial and neuronal death is increased in sclerotic hippocampi, independently of HS type, and co-localized with gliosis. Furthermore, Bcl-2/Bax ratio increase does not prevent expression of active caspase 3 by glia and granular neurons in TLE.