Burnout em lideranças de enfermagem durante a pandemia da COVID-19 / Burnout in nursing leaderships during the COVID-19 pandemic / Burnout en líderes de enfermería durante la pandemia de COVID-19

Objetivo: analisar a relação entre o contexto de trabalho das lideranças de enfermagem na pandemia da COVID-19 e o Burnout. Método: estudo de método misto, com uma amostra quantitativa de 64 líderes de enfermagem, de todos os setores de quatro hospitais gaúchos. A coleta de dados ocorreu de agosto a outubro de 2020, após aprovação do Comitê Nacional de Ética em Pesquisa. Foi realizada a análise inferencial dos dados quantitativos (n=64), aplicados os testes de Mann-Whitney e correlações bivariadas de Spearman, considerando diferenças estatisticamente significativas "p" bicaudal menor que 0,05. Realizaram-se entrevistas qualitativas (n=12) acerca dos impactos da pandemia. Resultados: identificou-se 6,3% de prevalência de Síndrome de Burnout. Houve associação entre os domínios Desgaste Emocional e Despersonalização e as variáveis medo, aumento do consumo de álcool e impacto na saúde (p<0,05). Evidenciaram-se mudanças no contexto laboral, aumento do nível de exigência e da carga de trabalho e impactos na saúde. Conclusão: conclui-se que há associação entre o contexto de trabalho na pandemia e o Burnout. O aumento da sobrecarga de trabalho repercutiu em prejuízos na saúde mental(AU)

Objective: to analyze the relationship between the work context of nursing leaders in the COVID-19 pandemic and Burnout. Method: mixed method study, with a quantitative sample of 64 nursing leaders, from all sectors of four hospitals in Rio Grande do Sul. Data collection carried out from August to October 2020, after approval by the National Research Ethics Committee. Inferential analysis of quantitative data (n=64) was performed, applying Mann-Whitney tests and bivariate Spearman correlations, considering statistically significant two-tailed "p" differences less than 0.05. Qualitative interviews (n=12) were carried out about the impacts of the pandemic. Results: a 6.3% prevalence of Burnout Syndrome was identified. There was an association between the Emotional Exhaustion and Depersonalization domains and the variables fear, increased alcohol consumption and impact on health (p<0.05). There were changes in the work context, an increase in the level of demand and workload, and impacts on health. Conclusion: it is concluded that there is an association between the work context in the pandemic and Burnout. The increase in work overload had negative effects on mental health(AU)

Objetivo: analizar la relación entre el contexto de trabajo de los líderes de enfermería en la pandemia de COVID-19 y el Burnout. Método: estudio de método mixto, con muestra cuantitativa de 64 líderes de enfermería, de todos los sectores de cuatro hospitales de Rio Grande do Sul. La recolección de datos tuvo lugar de agosto a octubre de 2020, previa aprobación del Comité Nacional de Ética en Investigación. Se realizó el análisis inferencial de datos cuantitativos (n=64), se aplicaron pruebas de Mann-Whitney y correlaciones bivariadas de Spearman, considerando diferencias estadísticamente significativas "p" de dos colas menor a 0,05. Se realizaron entrevistas cualitativas (n=12) sobre los impactos de la pandemia. Resultados: se identificó una prevalencia del Síndrome de Burnout del 6,3%. Hubo asociación entre los dominios Cansancio Emocional y Despersonalización y las variables miedo, aumento del consumo de alcohol e impacto en la salud (p<0,05). Se han producido cambios en el contexto laboral, aumento en el nivel de exigencia y en la carga de trabajo e impactos en la salud. Conclusión: se concluye que existe asociación entre el contexto laboral en la pandemia y el Burnout. El aumento de la sobrecarga de trabajo tuvo efectos negativos sobre la salud mental(AU)

The Complex Role of the Microbiome in Non-Small Cell Lung Cancer Development and Progression.

In recent years, there has been a growing interest in the relationship between microorganisms in the surrounding environment and cancer cells. While the tumor microenvironment predominantly comprises cancer cells, stromal cells, and immune cells, emerging research highlights the significant contributions of microbial cells to tumor development and progression. Although the impact of the gut microbiome on treatment response in lung cancer is well established, recent investigations indicate complex roles of lung microbiota in lung cancer. This article focuses on recent findings on the human lung microbiome and its impacts in cancer development and progression. We delve into the characteristics of the lung microbiome and its influence on lung cancer development. Additionally, we explore the characteristics of the intratumoral microbiome, the metabolic interactions between lung tumor cells, and how microorganism-produced metabolites can contribute to cancer progression. Furthermore, we provide a comprehensive review of the current literature on the lung microbiome and its implications for the metastatic potential of tumor cells. Additionally, this review discusses the potential for therapeutic modulation of the microbiome to establish lung cancer prevention strategies and optimize lung cancer treatment.

Pulpal calcifications in orthodontically moved teeth: Scoping review.

Background: The application of forces during orthodontic treatment can induce pulpal calcifications, characterized by the deposition of mineralized tissue in the pulp cavity space, there may be repercussions on dental procedures, especially endodontic treatment. The objective of this article is to map the scientific evidence and any gaps in knowledge regarding the relationship between orthodontics and dental pulp calcifications. Material and Methods: The study comprised a scoping review whose guiding question was: "What is the scientific evidence of the association between pulpal calcifications and orthodontic treatment?" Two independent reviewers searched the PubMed, Scopus, and Web of Science databases and the grey literature. Original articles and observational and clinical trials, which addressed the repercussions on the pulp cavity of teeth submitted to orthodontic treatment, were included. There was no language restriction or limitation of the year of publication until October 2022. Results: After critical reading and applying the eligibility criteria, 11 studies were included in this scoping review: six observational and five experimental studies. A statistically significant association of orthodontic treatment with changes in pulp cavity volume and increased incidence of pulp stones was observed among the studies findings. Conclusions: The orthodontic force can promote changes in the dental pulp that may cause direct implications in other dental treatments, especially endodontic treatment. Key words:Dental pulp calcifications, pulp node, pulp obliteration, orthodontic treatment, orthodontics.

Development and international validation of custom-engineered and code-free deep-learning models for detection of plus disease in retinopathy of prematurity: a retrospective study.

BACKGROUND: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, is diagnosed through interval screening by paediatric ophthalmologists. However, improved survival of premature neonates coupled with a scarcity of available experts has raised concerns about the sustainability of this approach. We aimed to develop bespoke and code-free deep learning-based classifiers for plus disease, a hallmark of ROP, in an ethnically diverse population in London, UK, and externally validate them in ethnically, geographically, and socioeconomically diverse populations in four countries and three continents. Code-free deep learning is not reliant on the availability of expertly trained data scientists, thus being of particular potential benefit for low resource health-care settings. METHODS: This retrospective cohort study used retinal images from 1370 neonates admitted to a neonatal unit at Homerton University Hospital NHS Foundation Trust, London, UK, between 2008 and 2018. Images were acquired using a Retcam Version 2 device (Natus Medical, Pleasanton, CA, USA) on all babies who were either born at less than 32 weeks gestational age or had a birthweight of less than 1501 g. Each images was graded by two junior ophthalmologists with disagreements adjudicated by a senior paediatric ophthalmologist. Bespoke and code-free deep learning models (CFDL) were developed for the discrimination of healthy, pre-plus disease, and plus disease. Performance was assessed internally on 200 images with the majority vote of three senior paediatric ophthalmologists as the reference standard. External validation was on 338 retinal images from four separate datasets from the USA, Brazil, and Egypt with images derived from Retcam and the 3nethra neo device (Forus Health, Bengaluru, India). FINDINGS: Of the 7414 retinal images in the original dataset, 6141 images were used in the final development dataset. For the discrimination of healthy versus pre-plus or plus disease, the bespoke model had an area under the curve (AUC) of 0·986 (95% CI 0·973-0·996) and the CFDL model had an AUC of 0·989 (0·979-0·997) on the internal test set. Both models generalised well to external validation test sets acquired using the Retcam for discriminating healthy from pre-plus or plus disease (bespoke range was 0·975-1·000 and CFDL range was 0·969-0·995). The CFDL model was inferior to the bespoke model on discriminating pre-plus disease from healthy or plus disease in the USA dataset (CFDL 0·808 [95% CI 0·671-0·909, bespoke 0·942 [0·892-0·982]], p=0·0070). Performance also reduced when tested on the 3nethra neo imaging device (CFDL 0·865 [0·742-0·965] and bespoke 0·891 [0·783-0·977]). INTERPRETATION: Both bespoke and CFDL models conferred similar performance to senior paediatric ophthalmologists for discriminating healthy retinal images from ones with features of pre-plus or plus disease; however, CFDL models might generalise less well when considering minority classes. Care should be taken when testing on data acquired using alternative imaging devices from that used for the development dataset. Our study justifies further validation of plus disease classifiers in ROP screening and supports a potential role for code-free approaches to help prevent blindness in vulnerable neonates. FUNDING: National Institute for Health Research Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and the University College London Institute of Ophthalmology. TRANSLATIONS: For the Portuguese and Arabic translations of the abstract see Supplementary Materials section.

Development of nintedanib nanosuspension for inhaled treatment of experimental silicosis.

Silicosis is an irreversible and progressive fibrotic lung disease caused by massive inhalation of crystalline silica dust at workplaces, affecting millions of industrial workers worldwide. A tyrosine kinase inhibitor, nintedanib (NTB), has emerged as a potential silicosis treatment due to its inhibitory effects on key signaling pathways that promote silica-induced pulmonary fibrosis. However, chronic and frequent use of the oral NTB formulation clinically approved for treating other fibrotic lung diseases often results in significant side effects. To this end, we engineered a nanocrystal-based suspension formulation of NTB (NTB-NS) possessing specific physicochemical properties to enhance drug retention in the lung for localized treatment of silicosis via inhalation. Our NTB-NS formulation was prepared using a wet-milling procedure in presence of Pluronic F127 to endow the formulation with nonadhesive surface coatings to minimize interactions with therapy-inactivating delivery barriers in the lung. We found that NTB-NS, following intratracheal administration, provided robust anti-fibrotic effects and mechanical lung function recovery in a mouse model of silicosis, whereas a 100-fold greater oral NTB dose given with a triple dosing frequency failed to do so. Importantly, several key pathological phenotypes were fully normalized by NTB-NS without displaying notable local or systemic adverse effects. Overall, NTB-NS may open a new avenue for localized treatment of silicosis and potentially other fibrotic lung diseases.

Disentangling a Neotropical pest species complex: genetic diversity and population structure of the native rice stink bug Oebalus poecilus and the invasive O. ypsilongriseus.

BACKGROUND: A first step in any pest management initiative is recognizing the existing problem - identifying the pest species and its abundance and dispersal capacities. This is not simple and even more challenging when insidious (invasive) species are involved constituting a pest complex. Understanding a species' population diversity and structure can provide a better understanding of its adaptation and relative pest potential. Such is the need for the native rice stink bug Oebalus poecilus and the invasive O. ypsilongriseus in low and high flatlands of South America. RESULTS: The genetic structure differed between both rice stink bug species (FST  = 0.157, P = 0.001), where 84% of the overall genetic variability takes place within species and three genetic groups were recognized through Bayesian approach (K = 3). Oebalus poecilus exhibited slightly higher genetic diversity (HE  = 0.253) and structuring (FST  = 0.050, P = 0.001) than the invasive O. ypsilongriseus (HE  = 0.211; FST  = 0.038, P = 0.013). Nonetheless, only the former exhibited significant correlation between genetic and geographic distances (r = 0.48, P = 0.013). CONCLUSION: Despite the pointed peculiarities, the obtained results indicate overlap in both species' occurrence and similar genetic structure allowing for a compound problem to be dealt with as the complex requires managing without, as yet, a prevailing species or a niche specialization. © 2022 Society of Chemical Industry.

Dystrophic calcinosis cutis in chronic venous disease of the lower limbs.

Lower limb ulcers secondary to chronic venous disease (CVD) are a significant public health problem in Brazil and account for about 70% of these ulcers. Despite recent technological advances and the various therapeutic options for treatment of these chronic injuries, several factors may be involved in resistance to treatment. Dystrophic calcinosis cutis (DCC) is a rare and often underdiagnosed condition that, when in conjunction with CVD, may be associated with a refractory healing process. In this article, we report a case of DCC in a patient with CVD and discuss its etiology, pathophysiology and possible treatment options.

Overexpression of mir-135b and mir-210 in mesenchymal stromal cells for the enrichment of extracellular vesicles with angiogenic factors.

Extracellular vesicles (EVs) are known as molecular carriers involved in cell communication and the regulation of (patho)physiological processes. miRNAs and growth factors are the main contents of EVs which make them a good candidate for the treatment of diseases caused by ischemia, but the low production of EVs by a cell producer and a significant variation of the molecular contents in EVs according to the cell source are the main limitations of their widespread use. Here, we show how to improve the therapeutic properties of mesenchymal stromal cell (MSC)-derived EVs (MSC-EVs) by modifying MSCs to enrich these EVs with specific angiomiRs (miR-135b or miR-210) using lentiviral vectors carrying miR-135b or miR-210. MSCs were obtained from the mouse bone marrow and transduced with a corresponding lentivector to overexpress miR-135b or miR-210. The EVs were then isolated by ultracentrifugation and characterized using a flow cytometer and a nanoparticle tracking analyzer. The levels of 20 genes in the MSCs and 12 microRNAs in both MSCs and EVs were assessed by RT‒qPCR. The proangiogenic activity of EVs was subsequently assessed in human umbilical vein endothelial cells (HUVECs). The results confirmed the overexpression of the respective microRNA in modified MSCs. Moreover, miR-135b overexpression upregulated miR-210-5p and follistatin, whereas the overexpression of miR-210 downregulated miR-221 and upregulated miR-296. The tube formation assay showed that EVs from MSCs overexpressing miR-210-5p (EVmiR210) significantly promoted tubular structure formation in HUVECs. A significant increase in angiogenic proteins (PGF, endothelin 1, and artemin) and genes (VEGF, activin A, and IGFBP1) in HUVECs treated with VEmiR210 justifies the better tubular structure formation of these cells compared with that of EVmiR135b-treated HUVECs, which showed upregulated expression of only artemin. Collectively, our results show that the EV cargo can be modified by lentiviral vectors to enrich specific miRNAs to achieve a specific angiogenic potential.

Combination Effect of Diurnal Exposure to Sucrose and Nocturnal Exposure to Lactose on Enamel Demineralization.

We have hypothesized that the association between human milk and caries in breastfeeding children could be explained by the combination of a diurnal cariogenic diet with the nocturnal lactose fermentation, conditions simulated in this experimental study. Cariogenic biofilm was formed on bovine enamel slabs, which were exposed 8x/day for 3 min to a 10% sucrose solution, simulating a highly cariogenic diurnal diet, or 50 mM NaCl solution (control). Simulating the nocturnal retention of milk in mouth, biofilms were transferred to culture medium containing 0.7% lactose for 2 h, or only to culture medium (control). Four groups were designed (n = 12): Ctrl, no exposure to diurnal sucrose or nocturnal lactose; Lac, only nocturnal exposure to lactose (2 h); Suc, only diurnal exposure to sucrose (8x/day); and Suc→Lac, diurnal exposure to sucrose (8x/day) followed by nocturnal exposure to lactose (2 h). The medium was changed 3x/day, at the beginning of the day and after diurnal and nocturnal exposures. Calcium in the medium was determined as a chemical indicator of partial demineralizations occurred during the diurnal and the nocturnal treatments; the medium pH was also determined. After 96 h of growth, biofilms were harvested to evaluate CFU, biomass, and extracellular polysaccharides, soluble and insoluble. The percentage of enamel surface hardness loss (%SHL) was evaluated as cumulative demineralization. Data were analyzed by one-way ANOVA and Tukey's test (α = 5%). Highest %SHL (p < 0.05) was found for the Suc→Lac (40.6%) group when compared to Suc (32.1%), Lac (6.6%), and Ctrl (2.4%) groups. Calcium released during the diurnal and nocturnal treatments was, respectively, Suc→Lac = Suc > Lac = Ctrl and Suc→Lac > Lac > Suc = Ctrl (p < 0.05). Regarding the Ctrl group, calcium released from nocturnal lactose fermentation by the Suc→Lac group was 4-fold greater than that provoked by the Lac group. The findings were supported by the pH of the media. The data suggest that the biofilm formed under diurnal exposure to sucrose enhances the cariogenicity of nocturnal exposure to lactose.

Politização do útero: entre tecnologias e representações de gênero nas campanhas preventivas de HPV e câncer de colo do útero desenvolvidas pelo Ministério da Saúde de 2014 a 2020 / Politicization of the uterus: between technologies and gender representations in HPV and cervical cancer preventive campaigns developed by the Ministry of Health from 2014 to 2020

Neste trabalho analisamos as campanhas preventivas de papilomavírus humano (HPV) e câncer no colo do útero (CCU) desenvolvidas pelo Instituto Nacional de Câncer / Ministério da Saúde, de 2014 a 2020. À luz de um olhar socioantropológico, nosso objetivo principal é compreender como estas campanhas acionam representações de gênero, e, enquanto tecnologias de saúde, como co-constroem sentidos e usuários. As campanhas evidenciam uma certa politização do útero que mantém um excessivo escrutínio do corpo feminino, através da medicalização e do monitoramento da saúde sexual e reprodutiva das mulheres. Entre as controvérsias, deslocamentos e continuidades que atravessam a discussão, as campanhas preventivas apontam para uma materialidade que não apenas faz, mas também deixa de fazer ­ promovendo silenciamentos e ausências. Assim, acreditamos que os elementos gráficos dessas campanhas nos permitem compreender alguns aspectos importantes do lugar do útero nas políticas públicas em saúde. Em adição, apresentamos algumas campanhas privadas e não governamentais, como contraponto à análise. Criamos sete categorias de análise ("Geracionalidade do cuidado", "Escolarização", "Infância e Juventude", "Gamificação", "Risco à saúde", "Saúde do Homem" e "Neutralidade") que nos permitiram discutir e realizar costuras entre as temáticas que surgiam nas peças gráficas. Ainda que o Brasil, historicamente, seja considerado um país que possui uma cultura robusta de imunização, a adesão à vacina do HPV ainda é considerada baixa. Devido a isso, tanto a vacinação contra HPV quanto o acometimento de CCU são apresentados enquanto "alarmantes problemas de saúde". As especificidades do contexto brasileiro, de certo modo, embaralham noções de risco e cuidado, proteção e submissão, autonomia e negacionismo. As peças gráficas analisadas iluminam um universo simbólico em relação ao tema e a peculiaridade da biografia da vacina de HPV, atravessando questões como o aumento do público alvo das vacinas, a recente ampliação da vacina para homens, a baixa adesão na segunda e terceira dose, a desconfiança familiar, as influências anti-vacinistas, moralidades em torno de gênero e sexualidades, etc. As campanhas contextualizadas com a história da vacina no Brasil, o atual modo de gestão e os atores em cena engendram um fenômeno que merece atenção pelos estudos das ciências humanas em saúde. Portanto, nos debruçamos justamente na tentativa de seguir parte da trajetória que as campanhas vacinais de HPV e preventivas de CCU têm traçado no Brasil, principalmente através das articulações estabelecidas entre gênero e saúde, partindo de uma perspectiva que encara ciência e cultura como indissociáveis

In this paper we analyze the preventive campaigns of human papillomavirus (HPV) and cervical cancer (CC) developed by the National Cancer Institute / Ministry of Health, from 2014 to 2020. In the light of a socioanthropological view, our main objective is to understand how these campaigns trigger gender representations, and, as health technologies, how to co-construct meanings and users. The campaigns highlight a certain politicization of the uterus that maintains excessive scrutiny of the female body, through medicalization and monitoring of the sexual and reproductive health of women. Among the controversies, displacements and continuities that cross the discussion, preventive campaigns point to a materiality that not only does, but also ceases to do ­ promoting silences and absences. Thus, we believe that the graphic elements of these campaigns allow us to understand some important aspects of the place of the uterus in public health policies. In addition, we present some private and non-governmental campaigns, as a counterpoint to the analysis. We created seven categories of analysis ("Generationality of care", "Schooling", "Childhood and Youth", "Gamification", "Risk to Health", "Men's Health" and "Neutrality") that allowed us to discuss and make seams between the themes that emerged in the layouts. Although Brazil has historically been considered a country with a robust immunization culture, HPV vaccine adhering is still considered low. Because of this, both HPV vaccination and CC involvement are presented as "alarming health problems". The specificities of the Brazilian context, in a way, scramble the senses of risk and care, protection and submission, autonomy and denialism. The graphic pieces analyzed illuminate a symbolic universe in relation to the theme and the peculiarity of the biography of the HPV vaccine, going through issues such as the increase in the target audience of vaccines, the recent expansion of the vaccine for men, the low adoption in the second and third dose, family distrust, anti-vacinist influences, morality around gender and sexualities, and so on. The campaigns contextualized with the history of the vaccine in Brazil, the current mode of management and the actors on the scene engender a phenomenon that deserves attention for the studies of the human sciences in health. Therefore, we focus precisely on the attempt to follow part of the trajectory that HPV vaccine and CC preventive campaigns have mapped in Brazil, mainly through the articulations established between gender and health, starting from a perspective that sees science and culture as inseparable

Calcinose distrófica cutânea na doença venosa crônica de membros inferiores / Dystrophic calcinosis cutis in chronic venous disease of the lower limbs

Resumo As úlceras de membros inferiores, secundárias à doença venosa crônica (DVC), constituem um problema significativo de saúde pública no Brasil e representam cerca de 70% do total dessas úlceras. Apesar dos recentes avanços tecnológicos e das diversas opções terapêuticas utilizadas para essas lesões crônicas, existem diversos fatores que podem estar implicados na resistência ao tratamento. A calcificação distrófica cutânea (CDC) é uma condição rara e frequentemente subdiagnosticada, que, quando associada à DVC, pode estar associada à refratariedade no processo cicatricial. Neste artigo, relatamos um caso de CDC em paciente portador de DVC e discutimos a sua etiologia, fisiopatologia e possíveis opções de tratamento.

Abstract Lower limb ulcers secondary to chronic venous disease (CVD) are a significant public health problem in Brazil and account for about 70% of these ulcers. Despite recent technological advances and the various therapeutic options for treatment of these chronic injuries, several factors may be involved in resistance to treatment. Dystrophic calcinosis cutis (DCC) is a rare and often underdiagnosed condition that, when in conjunction with CVD, may be associated with a refractory healing process. In this article, we report a case of DCC in a patient with CVD and discuss its etiology, pathophysiology and possible treatment options.

Condição bucal de comunidades em vulnerabilidade social: análise descritiva de um projeto voluntário paranaense / Oral health condition of communities in social vulnerability: descriptive analysis of a volunteer project in Paraná

O presente trabalho relata o impacto social e o papel do cirurgião--dentista nas ações do Projeto Pró-Riso por meio de análise descritiva das ações. O projeto Pró-Riso é uma iniciativa voluntária, sem fins políticos, religiosos ou lucrativos, que leva atendimento odontológico, assistência médica e educação em saúde a comunidades em vulnerabilidade social. Foi realizada a análise dos prontuários dos pacientes atendidos pelo projeto em 2019. As ações ocorreram nas comunidades do Pilarzinho e Caximba (Bairros do município de Curitiba) e Amparo (comunidade isolada em Área de Proteção Ambiental no município litorâneo de Paranaguá), locais de elevada prevalência de doenças bucais. Tal situação reflete uma importante questão de Saúde Pública para o país. Os resultados mostram que foram atendidos 260 pacientes, com diversas necessidades de tratamento bucal. Destes, 63% tiveram seus tratamentos concluídos nas ações. Ressalta-se, assim, a importância de trabalhos sociais que proporcionem melhor qualidade de vida e saúde a comunidades em vulnerabilidade social. (AU)

This paper reports the social impact and role of the dentist in the actions of the Pró-Riso Project through descriptive actions analysis. The Pró-Riso project is a voluntary, non-political, religious or for profit initiative that takes dental care, medical assistance and health education to communities in social vulnerability. An analysis of the medical patients records assisted by the project in 2019 was carried out. The actions took place in the communities of Pilarzinho and Caximba (Curitiba Municipality neighborhoods) and Amparo (isolated community in an Environmental Protection Area in the coastal municipality of Paranaguá), places of high prevalence of oral diseases. This situation reflects an important Public Health issue for the country. The results show that 260 patients were treated, with different needs for oral treatment. Of these, 63% had their treatments completed in the actions. Thus, the importance of social work that provides better health life quality to communities in social vulnerability is highlighted. (AU)

Trypanosoma cruzi infection in triatomines (Hemiptera: Reduviidae) from rural areas of the state of Pará, Brazil.

The present study aimed to identify the triatomine species and evaluate Trypanosoma cruzi infection in insects captured in endemic areas of Pará State, Brazil. Triatomines were captured in nine rural communities in the municipality of São Domingos do Capim in August, September and December 2014 using active searches and Malaise and Noireau traps. Additionally, from 2014 to 2018, residents and community health agents submitted captured triatomines to the study team. The analysis of T. cruzi infection in the insects was performed by direct parasitological examination and nested-PCR. A total of 225 triatomines were captured and identified: Rhodnius robustus (n = 111), Rhodnius pictipes (n = 54), Panstrongylus geniculatus (n = 44), Eratyrus mucronatus (n = 11), Panstrongylus lignarius (n = 4), and Panstrongylus rufotuberculatus (n = 1). Direct parasitological examination was performed in 27 living triatomines R. robustus (n = 14), P. geniculatus (n = 7) and R. pictipes (n = 6) and metacyclic trypomastigote forms similar to those of T. cruzi were observed in 66.6% (18/27) samples. Of 174 samples analysed by nested-PCR, 81.6% were positive for T. cruzi DNA: R. robustus (84.7%; 72/85), R. pictipes (84.1%; 37/44), P. geniculatus (69.4%; 25/36), P. lignarius (100%; 4/4), E. mucronatus (75%; 3/4) and P. rufotuberculatus (100%; 1/1). R. robustus, R. pictipes and P. geniculatus were the main vectors of T. cruzi in the studied areas; however, the detection of infections in P. lignarius, E. mucronatus and P. rufotuberculatus indicated that these species can also act as potential vectors of T. cruzi in the study areas.

Intestinal microbiota and active systemic lupus erythematosus: a systematic review.

BACKGROUND: Systemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by being multi-systemic and, therefore, reaching various organs and affecting mainly young women. Its pathogenesis comprehends many factors, including the interaction between microbiota and immune system. This systematic review assessed the relationship between intestinal microbiota and SLE in activity, highlighting microbiota representative patterns regarding quantity and diversity. METHODS: This study considered researches carried out in patients with SLE, with no restriction of age or gender, which fulfilled the classification criteria of either Systemic Lupus International Collaborating Clinic (SLICC), American College of Rheumatology (ACR) or European League Against Rheumatism (EULAR) and used the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) to classify disease in activity or remission were included. The search was carried out from October, 2020 to January, 2021 using the following databases: Medline via Pubmed, Scopus, and Embase. Five papers were included with a total of 288 participants with SLE. RESULTS: Regarding microbiota in patients with SLE in activity, there was significant increase in the following genera: Lactobacillus, Streptococcus, Megasphaera, Fusobacterium, Veillonella, Oribacterium, Odoribacter, Blautia, and Campylobacter. On the other hand, decrease in Faecalibacterium and Roseburia genera as well as Ruminococcus gnavus species was observed in remission cases, showing differences between the microbiota profile in SLE in activity and in remission. CONCLUSIONS: Results suggest that dysbiosis may be involved in the disease activity process. TRIAL REGISTRATION: CRD42021229322 .

Mitochondria-Rich Fraction Isolated From Mesenchymal Stromal Cells Reduces Lung and Distal Organ Injury in Experimental Sepsis.

OBJECTIVES: To ascertain whether systemic administration of mitochondria-rich fraction isolated from mesenchymal stromal cells would reduce lung, kidney, and liver injury in experimental sepsis. DESIGN: Animal study. SETTING: Laboratory investigation. SUBJECTS: Sixty C57BL/6 male mice. INTERVENTIONS: Sepsis was induced by cecal ligation and puncture; sham-operated animals were used as control. At 24 hours after surgery, cecal ligation and puncture and Sham animals were further randomized to receive saline or mitochondria-rich fraction isolated from mesenchymal stromal cells (3 × 106) IV. At 48 hours, survival, peritoneal bacterial load, lung, kidney, and liver injury were analyzed. Furthermore, the effects of mitochondria on oxygen consumption rate and reactive oxygen species production of lung epithelial and endothelial cells were evaluated in vitro. MEASUREMENTS AND MAIN RESULTS: In vitro exposure of lung epithelial and endothelial cells from cecal ligation and puncture animals to mitochondria-rich fraction isolated from mesenchymal stromal cells restored oxygen consumption rate and reduced total reactive oxygen species production. Infusion of exogenous mitochondria-rich fraction from mesenchymal stromal cells (mitotherapy) reduced peritoneal bacterial load, improved lung mechanics and histology, and decreased the expression of interleukin-1ß, keratinocyte chemoattractant, indoleamine 2,3-dioxygenase-2, and programmed cell death protein 1 in lung tissue, while increasing keratinocyte growth factor expression and survival rate in cecal ligation and puncture-induced sepsis. Mitotherapy also reduced kidney and liver injury, plasma creatinine levels, and messenger RNA expressions of interleukin-18 in kidney, interleukin-6, indoleamine 2,3-dioxygenase-2, and programmed cell death protein 1 in liver, while increasing nuclear factor erythroid 2-related factor-2 and superoxide dismutase-2 in kidney and interleukin-10 in liver. CONCLUSIONS: Mitotherapy decreased lung, liver, and kidney injury and increased survival rate in cecal ligation and puncture-induced sepsis.

Intestinal microbiota and active systemic lupus erythematosus: a systematic review

Abstract Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by being multi-systemic and, therefore, reaching various organs and affecting mainly young women. Its pathogenesis comprehends many factors, including the interaction between microbiota and immune system. This systematic review assessed the relationship between intestinal microbiota and SLE in activity, highlighting microbiota representative patterns regarding quantity and diversity. Methods: This study considered researches carried out in patients with SLE, with no restriction of age or gender, which fulfilled the classification criteria of either Systemic Lupus International Collaborating Clinic (SLICC), American College of Rheumatology (ACR) or European League Against Rheumatism (EULAR) and used the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) to classify disease in activity or remission were included. The search was carried out from October, 2020 to January, 2021 using the following databases: Medline via Pubmed, Scopus, and Embase. Five papers were included with a total of 288 participants with SLE. Results: Regarding microbiota in patients with SLE in activity, there was significant increase in the following genera: Lactobacillus, Streptococcus, Megasphaera, Fusobacterium, Veillonella, Oribacterium, Odoribacter, Blautia, and Campylobacter. On the other hand, decrease in Faecalibacterium and Roseburia genera as well as Ruminococcus gnavus species was observed in remission cases, showing differences between the microbiota profile in SLE in activity and in remission. Conclusions: Results suggest that dysbiosis may be involved in the disease activity process. Trial registration: CRD42021229322 .

Niclosamide attenuates lung vascular remodeling in experimental pulmonary arterial hypertension.

Despite advances in medical therapy, pulmonary arterial hypertension (PAH) remains an inexorably progressive and highly lethal disease. Signal transducer and activator of transcription (STAT)-3 is one of the main intracellular transcription factors implicated in PAH vascular remodeling. We hypothesized that niclosamide, a STAT3 inhibitor, would reduce vascular remodeling in an established pulmonary arterial hypertension model, thus enhancing cardiac function. Male Wistar rats were treated either with monocrotaline (60 mg/kg), to induce PAH, or saline (C group) by intraperitoneal injection. On day 14, PAH animals were randomly assigned to receive oral (1) saline (PAH-SAL); (2) niclosamide (75 mg/kg/day) (PAH-NICLO); (3) sildenafil (20 mg/kg/day) (PAH-SIL); or (4) niclosamide + sildenafil (PAH-NICLO + SIL), once daily for 14 days. On day 28, right ventricular systolic pressure was lower in all treated groups compared to PAH-SAL. Pulmonary vascular collagen content was lower in PAH-NICLO (37 ± 3%) and PAH-NICLO + SIL (37 ± 6%) compared to PAH-SAL (68 ± 4%), but not in PAH-SIL (52 ± 1%). CD-34, an endothelial cell marker, was higher, while vimentin, a mesenchymal cell marker, was lower in PAH-NICLO and PAH-NICLO + SIL compared to PAH-SAL, suggesting attenuation of endothelial-mesenchymal transition. Expression of STAT3 downstream targets such as transforming growth factor (TGF)-ß, hypoxia-inducible factor (HIF)-1, and provirus integration site for Moloney murine leukemia virus (PIM-1) in lung tissue was reduced in PAH-NICLO and PAH-NICLO + SIL compared to PAH-SAL. In conclusion, niclosamide, with or without sildenafil, mitigated vascular remodeling and improved right ventricle systolic pressure. This new role for a well-established drug may represent a promising therapy for PAH.

Successful growth of fresh retinoblastoma cells in chorioallantoic membrane.

The authors developed a retinoblastoma model using fresh harvested cells from an enucleated eye that were transplanted in chick embryos (chorioallantoic membrane model). The transplanted embryos were treated with escalating doses of Melphalan. This exploratory model was developed with the goal of testing drug sensitivity. Our findings suggest this tumor model could be employed to personalize treatment for patients with retinoblastoma, especially those with bilateral and more refractory disease.

Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review.

Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.

Magnetic targeting increases mesenchymal stromal cell retention in lungs and enhances beneficial effects on pulmonary damage in experimental silicosis.

Silicosis is a pneumoconiosis caused by inhaled crystalline silica microparticles, which trigger inflammatory responses and granuloma formation in pulmonary parenchyma, thus affecting lung function. Although systemic administration of mesenchymal stromal cells (MSCs) ameliorates lung inflammation and attenuates fibrosis in experimental silicosis, it does not reverse collagen deposition and granuloma formation. In an attempt to improve the beneficial effects of MSCs, magnetic targeting (MT) has arisen as a potential means of prolonging MSC retention in the lungs. In this study, MSCs were incubated with magnetic nanoparticles and magnets were used for in vitro guidance of these magnetized MSCs and to enhance their retention in the lungs in vivo. In vitro assays indicated that MT improved MSC transmigration and expression of chemokine receptors. In vivo, animals implanted with magnets for 48 hours had significantly more magnetized MSCs in the lungs, suggesting improved MSC retention. Seven days after magnet removal, silicotic animals treated with magnetized MSCs and magnets showed significant reductions in static lung elastance, resistive pressure, and granuloma area. In conclusion, MT is a viable technique to prolong MSC retention in the lungs, enhancing their beneficial effects on experimentally induced silicosis. MT may be a promising strategy for enhancing MSC therapies for chronic lung diseases.