Refits, cobbles, and fire: Approaching the temporal nature of an expedient Gravettian lithic assemblage from Lagar Velho (Leiria, Portugal).

Upper Paleolithic lithic assemblages have traditionally been considered a paramount example of the high level of complexity characterizing the technological behavior of prehistoric modern humans. The diversity and standardization of tools, as well as the systematic production of blades and bladelets, show the high investment of time, energy and knowledge often associated with Upper Paleolithic technocomplexes. However, more expedient behaviors have also been documented. In some cases, such low-cost behaviors can be dominant or almost exclusive, giving assemblages of Upper Paleolithic age an "archaic" appearance. In this paper, we address these expedient Upper Paleolithic technologies through the study of a lithic assemblage recovered from a Gravettian-age layer from the Lagar Velho rockshelter (Leiria, Portugal). Due to the specific formation processes characterizing this site, we also discuss the distinction between artifacts and geofacts, an aspect that is particularly difficult in expedient assemblages. Moreover, the combination of lithic refitting and data on thermal damage allows us to approach the temporal nature of the lithic assemblage and the timing of the different agents contributing to its formation.

Evaluation of Functional and Joint Health and Associated Factors in Adults With Hemophilia From a Developing Country With Government-Backed Efforts to Improve Hemophilia Care.

Introduction Hemophilic arthropathy affects people with hemophilia (PwH) and causes joint dysfunction and disability. Brazil has a unique situation and implemented policies to improve health care for PwH. The aim of this study was to evaluate the Functional Independence Score in Hemophilia (FISH), Hemophilia Joint Health Score (HJHS), and associated factors among adult PwH attending a Hemophilia Comprehensive Care Center in Brazil. Methods A post hoc analysis was conducted, including 31 patients who had submitted to a physical evaluation during a previously published cross-sectional study performed from June 2015 to May 2016 at the Brasília Blood Center Foundation, Brazil. Results The mean age was 30.8±9.4 years, and 80.6% had severe hemophilia. FISH was 27.0±3.8, and HJHS 18.0±10.8. The ankle was the most often affected joint (25/31, 80.6%). There were significant correlations between FISH and HJHS scores and the Hemophilia Quality of Life Questionnaire for Adults. Patients with severe hemophilia (P = 0.029) and PwH aged ≥ 30 years (P = 0.049) had lower FISH scores. Monthly household income > 2 Brazilian minimum wages was independently associated with improved HJHS (P = 0.033). The factors simultaneously associated with better HJHS and FISH were age < 30 years (P = 0.021) and monthly household income < 2 minimum wages (P = 0.013). Conclusion FISH and HJHS showed favorable scores despite being performed in a country with unfavorable socioeconomic conditions. In addition to hemophilia severity and age, monthly household income was independently associated with functional and articular state of PwH. The results highlight the importance of the free provision of coagulation factors in Brazil.

The characterization of bearded vulture (Gypaetus barbatus) coprolites in the archaeological record.

The archaeological record of the Lagar Velho rock shelter (Lapedo Valley, Leiria, Portugal) bears testimony to several significant Upper Palaeolithic occupations, most notably the Lapedo Child burial (LV1) dating from the Gravettian. Excavations undertaken at the site since 2018 have seen the recovery of a large quantity of coprolites, above all in layer 143 (c. 29 ka cal BP). The study of these fossilized remains points to the bearded vulture (Gypaetus barbatus) as the main coprogenic agent and provides the first descriptions of these avian coprolites in archaeological assemblages. The analyses reported involved the comparison of the coprogenic samples with modern bearded vulture scats. A new morphotype is proposed for discriminating the faeces of this avian scavenger based on (1) macroscopic analyses, (2) morphometric comparisons with other fossil and modern scats and (3) their mineralogical and elemental composition. Among the criteria proposed here to identify the coprolites of the bearded vulture are their cylindrical shape, diameter, pointed extremities and homogeneous porous texture, as well as their massive internal texture, hard consistency and total absence of bone inclusions (attributable in all likelihood to a high digastric juice acidity capable of dissolving bones). Our results indicate that, as well as being used by humans for short-term stays, the Lagar Velho rock shelter was used by the bearded vulture as a nesting site. We provide new evidence from Iberia of the activity of this avian scavenger as a bone accumulator in archaeological sites.

O ensino de cuidados paliativos na graduação do curso de medicina: um olhar multicêntrico / The teaching of palliative care in undergraduate medicine courses: a multicentric view / La enseñanza de cuidados paliativos en cursos de pregrado en medicina: una visión multicéntrica

Cuidados Paliativos (CP) consiste em uma modalidade multiprofissional onde pacientes fora de possibilidade de cura e sua família, recebem cuidados totais, ativos e integrais amparados pelo direito do paciente de morrer com dignidade. Apesar de ser uma modalidade assistencial crescente no mundo, ainda é pouco abordada na formação médica brasileira. Os objetivos do presente trabalho são discutir a importância da incorporação do tema na formação médica sob a luz da legislação vigente, a visão e o cuidado ofertado pelos CP e apresentar como sugestão uma disciplina sobre cuidados paliativos para a matriz curricular do curso de medicina. O avanço das tecnologias médicas tem prolongado e, possibilitado melhorias para a qualidade de vida da população, mesmo diante de casos de doenças graves, sem possibilidade terapêutica, incapacitantes e progressivas. A formação adequada de profissionais médicos com os recursos da paliação tem exigido que escolas médicas atendam às necessidades de saúde dos pacientes e de seus familiares. Estudantes de medicina devem ter acesso à comunicação compassiva e efetiva com pacientes, gerenciamento de dor e outros sintomas, princípios e boas práticas de cuidados paliativos. O conhecimento dos critérios para indicação de cuidados paliativos precoces e o manejo dos cuidados de fim de vida incluindo, além do controle de sintomas de sofrimento físico, a abordagem de aspectos psicossociais, espirituais e culturais dos pacientes e a identificação de riscos potenciais de luto são primordiais para a prática. Diante disso, a necessidade da inserção do ensino em CP na graduação tornou- se evidente, culminando nas publicações de Resoluções para abranger as prerrogativas previstas nas Diretrizes Curriculares Nacionais (DCNs) para o Curso de medicina. Essa discussão torna-se fundamental diante do cenário que atravessamos com a expansão de escolas médicas no país. Discute-se que uma proposta multicêntrica de disciplina transversal sobre cuidados paliativos inserida na matriz curricular do curso de medicina como um modelo factível para a sua abordagem.

Palliative Care (PC) consists of a multidisciplinary modality where patients beyond the possibility of cure and their families receive total, active and integral care supported by the patient's right to die with dignity. Despite being a growing care modality in the world, it is still little addressed in Brazilian medical training. The objectives of this paper are to discuss the importance of incorporating the vision and care offered by the PC into medical training and to suggest a course on palliative care to be included in the curriculum of the medical course. The advancement of medical technologies has extended and improved the quality of life of the population, even in the case of serious, disabling and progressive illnesses. Adequate preparation of medical professionals with palliation resources requires medical schools to meet the health needs of patients and their families. Medical students should have access to compassionate and effective communication with patients, management of pain and other symptoms, principles and good practices of palliative care, as well as indication criteria for early palliative care and indication and management of end-of-life care including, in addition to controlling symptoms of physical suffering, addressing psychosocial, spiritual and cultural aspects of care and also identifying potential risks of grief. In view of this, the need to insert PC teaching in graduation became evident, culminating in the new National Curricular Guidelines (NCGs), and it was precisely for this reason that this article also brings, as a multicentric proposal, a discipline on palliative care to be inserted in the curricular matrices of medical courses. It can be concluded that the incorporation of PC in the curricular matrix of the medical course will allow doctors who have just left the university to offer comfort and prevention of suffering to patients who need PC, thus improving their quality of life and that of their families.

Los Cuidados Paliativos (CP) consisten en una modalidad multidisciplinar donde los pacientes sin posibilidad de curación y sus familiares reciben una atención total, activa e integral sustentada en el derecho del paciente a morir con dignidad. A pesar de ser una modalidad de atención en crecimiento en el mundo, todavía es poco abordada en la formación médica brasileña. Los objetivos del presente trabajo son discutir la importancia de incorporar la temática en la formación médica a la luz de la legislación vigente, la visión y el cuidado que ofrece la AP y sugerir una temática sobre cuidados paliativos para la matriz curricular de la carrera de medicina. El avance de las tecnologías médicas ha prolongado y permitido mejoras en la calidad de vida de la población, incluso frente a casos de enfermedades graves, no terapéuticas, incapacitantes y progresivas. La adecuada formación de los profesionales médicos con recursos paliativos ha requerido que las facultades de medicina atiendan las necesidades de salud de los pacientes y sus familias. Los estudiantes de medicina deben tener acceso a una comunicación compasiva y efectiva con los pacientes, manejo del dolor y otros síntomas, principios de cuidados paliativos y mejores prácticas. El conocimiento de los criterios para indicar los cuidados paliativos tempranos y el manejo de los cuidados al final de la vida que incluyen, además del control de los síntomas del sufrimiento físico, el abordaje de los aspectos psicosociales, espirituales y culturales de los pacientes y también la identificación de los riesgos potenciales de duelo son esenciales para la práctica. Ante ello, se hizo evidente la necesidad de insertar la enseñanza de la CP en la graduación, culminando con la publicación de Resoluciones para dar cobertura a las prerrogativas previstas en las Directrices Curriculares Nacionales (DCN) de la Carrera de Medicina. Esta discusión se torna fundamental ante el escenario que atravesamos con la expansión de las facultades de medicina en el país. Se argumenta que una propuesta multicéntrica de una disciplina transversal sobre cuidados paliativos se inserta en la matriz curricular de la carrera de medicina como modelo factible para su abordaje. Se considera que la incorporación de la CP en la matriz curricular posibilitará que los médicos egresados de las universidades ofrezcan en el currículo las bases teóricas y prácticas para subsidiar la provisión a los pacientes de la necesidad de CP, confort, prevención del sufrimiento, mejorando así su calidad de vida y la de sus familiares.

Estratégias preventivas no enfrentamento da covid-19 na população indígena: revisão de escopo

Objetivo: Mapear as produções científicas sobre as estratégias preventivas utilizadas pelos serviços de saúde no enfrentamento da Covid-19 na população indígena do continente americano no período de 2019 a 2022. Material e Método: Revisão de escopo, realizada nas bases de dados: LILACS, MEDLINE, SCOPUS, EMBASE, WOS e Science Direct. Seguindo os critérios estabelecidos pela estratégia do mnemônico PCC, utilizaram-se descritores controlados e não controlados. Foram incluídos estudos primários, relatos de experiências, revisões de literatura, perspectivas, reflexões e editoriais, publicados no período dezembro de 2019 a março de 2022, nos idiomas português, inglês e espanhol. Resultados: Foram identificados nas estratégias de buscas 237 estudos e, a partir da leitura dos textos na íntegra, seis artigos foram selecionados para esta revisão. A exploração dos estudos publicados nos periódicos internacional e nacional, permitiram o mapeamento das estratégias preventivas utilizadas pelos serviços de saúde e pelas comunidades indígenas, que incluíram isolamento nas aldeias, remoção de pacientes, tratamento de doenças não relacionadas a Covid-19 nas aldeias, compra de equipamentos de proteção individual, educação em saúde com materiais linguisticamente apropriados e apoio financeiro. Também houve estudos que apresentavam possíveis sugestões para a prevenção e o combate à Covid-19. Conclusão: As estratégias preventivas tinham a finalidade de conter a disseminação desta doença infectocontagiosa nas comunidades indígenas, mas também observou-se uma escassez de estratégias no âmbito da enfermagem que atuem de acordo com as especificidades culturais desses povos originários.

Objective: To map the scientific production on the preventive strategies used by health services to combat Covid-19 in the indigenous population of the American continent from 2019 to 2022. Materials and Methods: Scoping review carried out in the databases: LILACS, MEDLINE, SCOPUS, EMBASE, WOS and Science Direct. Controlled and non-controlled descriptors were used following the criteria established by the PCC mnemonic strategy. Primary studies, experience reports, literature reviews, perspectives, reflections and editorials, published between December 2019 and March 2022, in Portuguese, English and Spanish were included. Results: 237 studies were identified in the search strategies, and after reading the full texts, six articles were selected for this review. The exploration of studies published in international and national journals allowed the mapping of preventive strategies used by health services and indigenous communities, which included isolation in the villages, transfer of patients, treatment of diseases not related to Covid-19 in the villages, purchase of personal protective equipment, health education with linguistically appropriate materials and financial support. There were also studies that presented possible suggestions for preventing and combating Covid-19. Conclusion: The preventive strategies were intended to contain the spread of this infectious disease in indigenous communities, but there was also a lack of strategies in the nursing field that respond to the cultural specificities of the indigenous population.

Objetivo: Mapear la producción científica sobre las estrategias preventivas utilizadas por los servicios de salud para el abordaje del Covid-19 en la población indígena del continente americano entre los años 2019 y 2022. Material y Método: Revisión de alcance realizada en las bases de datos: LILACS, MEDLINE, SCOPUS, EMBASE, WOS y Science Direct. Siguiendo los criterios establecidos por la estrategia mnemotécnica PCC, se utilizaron descriptores controlados y no controlados. Se incluyeron estudios primarios, informes de experiencias, revisiones bibliográficas, perspectivas, reflexiones y editoriales, publicados entre diciembre de 2019 y marzo de 2022, en portugués, inglés y español. Resultados: Se identificaron 237 estudios en las estrategias de búsqueda, y después de leer los textos completos, se seleccionaron seis artículos para esta revisión. La exploración de estudios publicados en revistas internacionales y nacionales permitió mapear las estrategias preventivas utilizadas por los servicios de salud y las comunidades indígenas, que incluían el aislamiento en las aldeas, el traslado de pacientes, el tratamiento de enfermedades no relacionadas con el Covid-19 en las aldeas, la compra de equipos de protección personal, la educación sanitaria con materiales lingüísticamente apropiados y el apoyo financiero. También hubo estudios que presentaban posibles sugerencias para prevenir y combatir el Covid-19. Conclusión: Las estrategias preventivas tuvieron como objetivo contener la propagación de esta enfermedad infecciosa en las comunidades indígenas, pero también se pudo observar la falta de estrategias en el campo de la enfermería que actúen de acuerdo con las especificidades culturales de la población indígena.

The different faces of metastatic melanoma in the gastrointestinal tract.

Melanoma is the most aggressive form of skin cancer, with tendency to spread to any organ of the human body, including the gastrointestinal tract (GIT). The diagnosis of metastases to the GIT can be difficult, as they may be clinically silent for somewhile and may occur years after the initial melanoma diagnosis. CT imaging remains the standard modality for staging and surveillance of melanoma patients, and in most cases, it will be the first imaging modality to identify GIT lesions. However, interpretation of CT studies in patients with melanoma can be challenging as lesions may be subtle and random in distribution, as well as sometimes mimicking other conditions. Even so, early diagnosis of GIT metastases is critical to avoid emergency hospitalisations, whilst surgical intervention can be curative in some cases. In this review, we illustrate the various imaging presentations of melanoma metastases within the GIT, discuss the clinical aspects and offer advice on investigation and management. We offer tips intended to aid radiologists in their diagnostic skills and interpretation of melanoma imaging scans.

Effect of Passiflora setacea juice and its phenolic metabolites on insulin resistance markers in overweight individuals and on microglial cell activity.

Passiflora setacea (PS) is a species of wild Brazilian passion fruit, rich in bioactive compounds. Scientific evidence suggests that food rich in polyphenols can modulate inflammation, thereby playing an important role in preventing chronic non-communicable diseases, such as type 2 diabetes (DT2) and cardiovascular diseases (CVD). This study aimed to investigate the effect of PS consumption on metabolic and inflammatory biomarkers in overweight male volunteers and to identify the underlying mechanism of action using an in vitro study using phenolic metabolites isolated from the plasma of volunteers at physiologically relevant concentrations. Volunteers participated in a double-blind, placebo-controlled (PB) study with two phases: phase I (acute study) and phase II (chronic study). In phase I, 15 volunteers ingested a single dose of 50 g, 150 g of PS pulp and PB in three different interventions. In phase II, nine volunteers ingested 50 g of PS or PB for 14 days. Blood samples were collected before (T0 h) and 3 h (T3 h) (phase I) or 15 days after (phase II) ingestion of PS or PB. Blood biochemical markers, HOMA IR, and inflammatory markers were analyzed and data on BMI, waist circumference, and consumption of polyphenol-rich foods were collected. Phenolic metabolites were extracted from plasma by solid-phase separation and were used to treat BV-2 cells stimulated by LPS or anacardic acid to assess p50, p65 and PPAR-γ activation. It was observed that the consumption of a single dose of PS juice significantly reduced basal insulin levels and HOMA IR. After prolonged consumption for two weeks, PS contributed to the reduction of circulating levels of IL-6. BV-2 cells treated with PS phenolic metabolites showed increased PPAR-γ activity, which resulted in an anti-inflammatory and anti-diabetic effect of PS metabolites. In conclusion, PS juice consumption exerts beneficial effects on inflammatory markers in overweight individuals, being a possible and important tool in the prevention of T2D and CVD in risk groups.

Comprometimento cognitivo e presença de dor em idosos acometidos por acidente vascular encefálico / Deterioro cognitivo y presencia de dolor em ancianos afectados por um ictus / Cognitive impairment and presence of pain in elderly people affected by stroke

Objetivo: Avaliar a cognição e presença de dor em idosos após AVE que residem no interior de Coari, Amazonas. Método: Trata-se de um estudo transversal e observacional realizado com 50 idosos pós-AVE no município de Coari, Amazonas. A coleta de dados foi realizada no período de outubro e dezembro de 2019 até janeiro de 2020. Resultados: No MEEM, 78,0% (39) apresentam grave déficit cognitivo demonstrando estarem abaixo da nota de corte para analfabetos (≥20). Sobre o teste de fluência verbal, a maioria dos idosos apresentaram dificuldades de linguagem e memória e não conseguiram no tempo estipulado falar e/ou lembrar de nomes de frutas e animais. 72% (36) dos idosos relataram sentir dor, maioria apresentou dor de intensidade moderada a forte 68,0% (34). Os locais mais referidos de dor foram os membros inferiores 26,0% (13). Conclusão: Após o AVE os idosos deste estudo apresentaram consideráveis alterações cognitivas e piora da dor.(AU)

Objective: To evaluate cognition and presence of pain in elderly people after CVA living in the countryside of Coari, Amazonas. Method: This is a cross-sectional and observational study conducted with 50 post-CVA elderly in the municipality of Coari, Amazonas. Data collection was performed in the period from October and December 2019 to January 2020. Results: In the MMSE, 78.0% (39) present severe cognitive deficit demonstrating to be below the cutoff score for illiterate (≥20). On the verbal fluency test, most of the elderly presented language and memory difficulties and were unable in the stipulated time to speak and/or remember names of fruits and animals. 72% (36) of the elderly reported feeling pain, majority presented pain of moderate to strong intensity 68.0% (34). The most referred sites of pain were the lower limbs 26.0% (13). Conclusion: After the CVA, the elderly in this study presented considerable cognitive changes and worsening of pain.(AU)

Objetivo: Evaluar la cognición y la presencia de dolor en ancianos después del ACV que viven en el campo de Coari, Amazonas. Método: Se trata de un estudio transversal y observacional realizado con 50 ancianos post-CVA en el municipio de Coari, Amazonas. La recogida de datos se realizó en el periodo comprendido entre octubre y diciembre de 2019 y enero de 2020. Resultados: En el MMSE, el 78,0% (39) presentan un déficit cognitivo severo demostrando estar por debajo de la puntuación de corte para analfabetos (≥20). En la prueba de fluidez verbal, la mayoría de los niños presentaban dificultades de lenguaje y memoria y no conseguían, en el tiempo estipulado, decir y/o memorizar nombres de frutas y animales. El 72% (36) de los ancianos dijeron sentir dolor, la mayoría presentó dolor de intensidad moderada a fuerte 68,0% (34). Los lugares de dolor más referidos fueron las extremidades inferiores 26,0% (13). Conclusión: Tras el ACV, los ancianos de este estudio presentaron considerables cambios cognitivos y empeoramiento del dolor(AU)

Avaliação Radiográfica da Maxila e da Mandíbula de Pacientes Diagnosticados com Mieloma Múltiplo: Estudo Retrospectivo / Radiographic Evaluation of the Maxilla and Mandible of Patients Diagnosed with Multiple Myeloma: Retrospective Study Evaluación / Radiográfica del Maxilar y de la Mandíbula de Pacientes Diagnosticados de Mieloma Múltiple: Estudio Retrospectivo

Introdução: O mieloma múltiplo é caracterizado como uma neoplasia maligna plasmocitária com a proliferação anormal de plasmócitos clonais na medula óssea de etiologia desconhecida. Objetivo: Caracterizar os pacientes com mieloma múltiplo atendidos no Setor de Estômato-Odontologia e Prótese do INCA, por meio de dados sociodemográficos, clínicos, laboratoriais e radiográficos. Método: Estudo transversal retrospectivo de pacientes com diagnóstico de mieloma múltiplo, no período de 2000 a 2018, que realizaram radiografia panorâmica no período do diagnóstico da doença. Os dados sociodemográficos e clínico-radiográficos da população em estudo foram coletados nos prontuários dos pacientes, armazenados em banco de dados, analisados de forma descritiva e submetidos ao teste não paramétrico X2 (qui-quadrado). Resultados: Na amostra final, foram totalizados 163 casos. A maioria era de homens (56,4%), brancos (55,8%), com idade ≤55 anos (54%), ensino fundamental incompleto (30,7%), não fumantes (54,6%) e não bebedores (54,6%). Havia lesões líticas em 46 pacientes (28,2%) com predileção pela mandíbula (82,6%; p=0,000). Houve maior frequência de margens parcialmente definidas (50,0%), não escleróticas (78,2%) e de aspecto unilocular (43,5%). Dos 46 pacientes que apresentaram lesão lítica maxilomandibular, 27 pacientes tinham >55 anos (p=0,042). Conclusão: Há maior ocorrência de lesões ósseas na mandíbula quando comparada à maxila

Introduction: Multiple myeloma is defined as a plasma cells malignant neoplasm with abnormal proliferation of clonal plasma cells in the bone marrow of unknown etiology. Objective: To characterize patients with multiple myeloma treated at INCA's Department of Stomato-Dentistry and Prosthodontics, utilizing sociodemographic, clinical, laboratory and radiographic data. Method: Retrospective cross-sectional study of patients diagnosed with multiple myeloma from 2000 to 2018 who underwent panoramic radiography at the diagnosis of the disease. The sociodemographic and clinical-radiographic data of the study population were collected from the patients' medical records stored in a database, analyzed descriptively and submitted to the X2 non-parametric test (chisquare). Results: In the final sample, 163 cases were totaled, mostly men (56.4%), white (55.8%), aged ≤55 years (54%), with incomplete elementary education (30.7%), non-smokers (54.6%), and non-alcoholics (54.6%). There were lytic lesions in 46 patients (28.2%) concentrated in the mandible (82.6%; p=0.000). Higher frequency of partially defined margins (50.0%), non-sclerotic (78.2%) and unilocular aspect (43.5%) were found. Of the 46 patients who presented with a maxillomandibular lytic lesion, 27 were older than 55 years (p=0.042). Conclusion: There was higher occurrence of bone lesions in the mandible when compared to the maxila

Introducción: El mýeloma multiple se caracteriza por ser una neoplasia maligna de células plasmáticas con proliferación anormal de células plasmáticas clonales en la médula ósea de etiología desconocida. Objetivo: Caracterizar a los pacientes con mýeloma multiple atendidos en el Departamento de Estomato-Odontología y Prostodoncia del INCA, utilizando datos sociodemográficos, clínicos, de laboratorio y radiográficos. Método: Estudio transversal retrospectivo de pacientes diagnosticados de mýeloma multiple de 2000 a 2018 a los que se les realizó una radiografía panorámica durante el período de diagnóstico de la enfermedad. Los datos sociodemográficos y clinicorradiográficos de la población de estudio fueron recolectados de la historia clínica de los pacientes, almacenados en una base de datos, analizados descriptivamente y sometidos a la prueba no paramétrica X2 (chi-cuadrado). Resultados: En la muestra final, había un total de 163 casos, en su mayoría hombres (56,4%), blancos (55,8%), edad ≤55 años (54%), con educación primaria incompleta (30,7%), no fumadores (54,6%) y no bebedores (54,6) %). Hubo lesiones líticas en 46 pacientes (28,2%) con predilección por la mandíbula (82,6%; p=0,000). Hubo una mayor frecuencia de márgenes parcialmente definidos (50,0%), no escleróticos (78,2%) y de apariencia unilocular (43,5%). De los 46 pacientes que tenían lesión lítica maxilomandibular, 27 pacientes tenían >55 años (p=0,042). Conclusión: Existe una mayor ocurrencia de lesiones óseas en la mandíbula en comparación con el maxilar

Brazilian passion fruit as a new healthy food: from its composition to health properties and mechanisms of action.

The Brazilian biodiversity is one of the largest in the world, with about 41 000 species cataloged within two global biodiversity hotspots: Atlantic Forest and Cerrado, the Brazilian savannah. Passiflora, known also as passion flowers, is a genus of which 96% of its species are distributed in the Americas, mainly Brazil and Colombia. Passion fruit extracts have a commercial value on a global scale through the pharmaceutical, nutraceutical, self-care, and food and beverage industries. Passiflora are widely studied due to their potential antioxidant, anti-inflammatory, anxiolytic, antidepressant and vascular and neuronal protective effects, probably owing to their content of polyphenols. Passiflora setacea DC is a species of wild passion fruit from the Brazilian Cerrado, rich in flavonoid C-glycosides, homoorientin, vitexin, isovitexin and orientin. Intake of these plant food bioactives has been associated with protection against chronic non-communicable diseases (CNDCs), including cardiovascular diseases, cancers, and neurodegenerative diseases. In this review, we aimed to discuss the varieties of Passiflora, their content in plant food bioactives and their potential molecular mechanisms of action in preventing or reversing CNDCs.

Judicialization of coagulation factors in severe hemophilia: compliance with the care protocol and associated factors Judicialization and severe hemophilia.

OBJECTIVE: This study aimed to analyze the compliance with the assistance protocol and factors associated with the judicialization of coagulation factors in severe hemophilia patients. METHODS: A retrospective, cross-sectional study was conducted from June 2015 to May 2016 in adults with severe hemophilia in the Federal District, Brazil using data from their medical records and the Hemovida Web Coagulopathies System. RESULTS: One-hundred and three patients from Federal District, the capital of Brazil, were included in the study. The mean age of the patients was 34.6±10.1. Ninety-three received prophylactic treatment (90.3%) and 53 received recombinant coagulation factors (51.7%). Judicialization occurred in 21 cases (20.4%), 13 of whom disagreed with the assistance protocol (12.6%). In the univariate analysis, an association was observed between reduced judicialization and treatment (4.8 vs. 47.6%; p<0.001) in the hemophilia treatment center and an increase that was associated with use of the recombinant coagulation factor in disagreement with the protocol (38.1 vs. 6.1%; p<0.001). In the multivariate analysis, the odds ratio for judicialization was 0.081 (95% confidence interval [CI] 0.010-0.055) for treatment at the hemophilia treatment center and 5.067 (95%CI 1.392-18.446) for the use of recombinant coagulation factor not in compliance with the protocol. More inhibitor development in judicialized patients (33.3 vs. 4.9%; p<0.001) was found. CONCLUSIONS: The effectiveness of judicialization should be questioned, especially regarding coagulation factor prescriptions that are not in compliance with the protocol. The expense resulting from judicialization has not shown any benefit, and an even greater development of inhibitors during treatment in judicialized patients was found.

Brazilian native passion fruit (Passiflora tenuifila Killip) is a rich source of proanthocyanidins, carotenoids, and dietary fiber.

Passiflora tenuifila is a Brazilian native passion fruit consumed by the local population and is a dietary source of bioactive compounds with potential biological activity. The aim of this study is to evaluate the nutritional value of P. tenuifila fruit and its bioactive compounds at two ripening stages. Three batches of fruit were collected at mature-green and ripe stages, and phenolic compounds, carotenoids, and polyamines were analyzed by HPLC-DAD and LC-MS/MS. The fruit is a good source of dietary fiber. Proanthocyanidin dimers are the major phenolic compounds (up to 84%) at both stages, followed by the C-glycosylated luteolin. Lutein and ß-carotene are the major carotenoids, contributing up to 50% of total carotenoids. The OPLS-DA segregates the mature-green and ripe fruits, as carotenoids are responsible for this separation. In conclusion, passion fruit can be consumed at both stages of maturation without losses of bioactive compound contents or nutritional value.

O corpo enquanto produto da escrita na fantasia / The body as a product of writing in fantasy / Le corps comme produit de l'écriture dans le fantasme / El cuerpo como producto de la escritura de la fantasía

A presente pesquisa se propõe a articular a relação entre corpo, escrita e fantasia, buscando verificar até que ponto o corpo pode ser efeito de uma escrita da fantasia ou produto daquilo que da fantasia não se escreve. A escrita deixa vestígios que apontam para o percurso da pulsão e podem revelar indícios dos suportes e construções corporais, evidenciando a fantasia que está em sua base.

This research examines the relationship of the body to writing and to fantasy to find out to what extent the body may be either the effect of fantasy writing or a product of what is not written from fantasy. Writing leaves traces that guide to the path of the drive and may reveal signs of supports and body constructions, highlighting the fantasy that is at its foundation.

Cette recherche vise à articuler la relation entre corps, écriture et fantasme, cherchant à vérifier dans quelle mesure le corps peut être effet d'une écriture du fantasme ou produit de ce que du fantasme ne s'écrit pas. L'écriture laisse des traces qui indiquent le chemin de la pulsion et peuvent révéler des indices de supports et de constructions corporelles, révélant ainsi le fantasme qui se trouve à son origine.

Esta investigación propone articular la relación entre el cuerpo, la escritura y la fantasía, buscando verificar hasta qué punto el cuerpo puede ser el efecto de una escritura de la fantasía o el producto de lo que no se escribe de la fantasía. La escritura deja huellas que señalan el rumbo de la pulsión y pueden revelar indicios de los soportes y de las construcciones corporales, revelando la fantasía que se encuentra en su base.

One-minute and green synthesis of magnetic iron oxide nanoparticles assisted by design of experiments and high energy ultrasound: Application to biosensing and immunoprecipitation.

The present study is focused on the ultrafast and green synthesis, via the co-precipitation method, of magnetic nanoparticles (MNPs) based on iron oxides using design of experiments (DOE) and high energy sonochemical approach, considering two main factors: amplitude (energy) of the ultrasound probe and sonication time. The combination of these techniques allowed the development of a novel one-minute green synthesis, which drastically reduced the amount of consumed energy, solvents, reagents, time and produced residues. This green sonochemical synthesis permitted to obtain mean particle sizes of 11 ± 2 nm under the optimized conditions of amplitude = 40% (2826 J) and time = 1 min. Their composition, structure, size, morphology and magnetic properties were assessed through X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), scanning and transmission electron microscopy (SEM & TEM), and vibrating sample magnetometry (VSM). The characterization results indicate the proper formation of MNPs, and the correct functionalization of MNPs with different coating agents. The functionalized MNPs were used as: i) biosensor, which could detect mercury in water in the range of 0.030-0.060 ppm, and ii) support onto which polyclonal antibodies were anchored and successfully bound to an osteosarcoma cell line expressing the target protein (TRIB2-GFP), as part of an immunoprecipitation assay.