Impact and effectiveness of meningococcal vaccines: a review.

OBJECTIVES: To summarize and critically evaluate the evidence on the impact and effectiveness of meningococcal vaccination programs around the world in order to inform decisionmaking in Latin America and the Caribbean. METHODS: A review of the literature was conducted following several components of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed Central® was searched for papers published in any language from January 1999 - March 2017. RESULTS: In all, 32 studies were included, most of which evaluated the meningococcal C conjugate vaccine. Fourteen studies measured effectiveness and 30 measured impact. The effectiveness of polysaccharide vaccines was 65% - 83.7% (different age groups), while the effectiveness of the conjugate vaccines was 66% - 100%. Incidence decline of laboratory-confirmed meningococcal disease for the conjugate vaccine ranged from 77% - 100% among different ages groups. The only study that evaluated the protein subunit vaccine reported a vaccine effectiveness of 82.9%. CONCLUSIONS: The studies reviewed show impact and effectiveness of both polysaccharide vaccines and conjugate vaccines on vaccine-serogroup meningococcal disease. The conjugate vaccines, however, show higher impact and effectiveness with longer-lasting protection over the polysaccharide vaccines. Given the variance in potential use of a meningococcal vaccine, epidemiological surveillance systems should be strengthened to inform national decisions.

Knowing the scope of meningococcal disease in Latin America.

Opportunities for strengthening surveillance of meningococcal disease exist between and within countries in Latin America. In August of 2015, a workshop was convened in the city of São Paulo, Brazil, to address the following objectives: 1) to review meningococcal disease burden and vaccine use in Latin America; 2) to evaluate the effectiveness of current meningococcal surveillance practices in the region; 3) to identify challenges to meningococcal surveillance in the region; and 4) to outline steps for strengthening meningococcal surveillance and disease control in the region. Based on the workshop's discussions, recommendations for strengthening surveillance and controlling meningococcal disease in Latin America focus on improving: a) laboratory capabilities for diagnostic testing; b) communication regarding epidemiologic- and laboratory-based analyses; c) communication during outbreaks; d) monitoring of long-term disease outcomes; e) knowledge of vaccines against serogroup B disease; and f) criteria for defining and controlling meningococcal outbreaks. Overall, improving surveillance will help guide strategies for meningococcal disease prevention and control in Latin America.

Existen distintas oportunidades para reforzar los procedimientos de vigilancia de la enfermedad meningocócica entre los países de América Latina y dentro de ellos. En agosto del 2015, se llevó a cabo un taller en la ciudad de São Paulo (Brasil) en el que se trataron los siguientes puntos: 1) examen de la carga de la enfermedad meningocócica y el uso de la vacuna en América Latina; 2) evaluación de la eficacia de los actuales procedimientos de vigilancia de la enfermedad meningocócica en la región; 3) especificación de los retos para la vigilancia de la enfermedad meningocócica en la región; y 4) definición de los pasos para fortalecer los procedimientos de vigilancia de la enfermedad meningocócica y el control de esta enfermedad en la región. Como resultado del taller se formularon recomendaciones para reforzar los procedimientos de vigilancia y control de la enfermedad meningocócica en América Latina que hacían hincapié en mejorar: a) las capacidades de laboratorio con respecto a las pruebas diagnósticas; b) la comunicación sobre los análisis epidemiológicos y de laboratorio; c) la comunicación durante los brotes; d) el seguimiento de las consecuencias de la enfermedad a largo plazo; e) el conocimiento sobre las vacunas contra la enfermedad causada por el serogrupo B; y f) los criterios para definir y controlar los brotes meningocócicos. En términos generales, la mejora de los procedimientos de vigilancia ayudará a delinear las estrategias para la prevención y el control de la enfermedad meningocócica en América Latina.

Existem oportunidades para o reforço da vigilância da doença meningocócica entre os países e em cada país na América Latina. Em agosto de 2015, foi realizado um seminário na cidade de São Paulo, Brasil, com os seguintes objetivos: 1) avaliar a carga da doença meningocócica e o uso da vacina na América Latina; 2) avaliar a eficácia das atuais práticas de vigilância da doença meningocócica na Região; 3) identificar os desafios para a vigilância meningocócica na Região e 4) definir medidas para reforçar a vigilância da doença meningocócica e o controle da doença na Região. Partindo dos debates realizados durante o seminário, foram feitas as seguintes recomendações para reforçar a vigilância e o controle da doença meningocócica na América Latina, dando-se ênfase a melhorar: a) a infraestrutura laboratorial para exames diagnósticos; b) a comunicação das análises epidemiológicas e laboratoriais; c) a comunicação nos surtos; d) o monitoramento dos desfechos da doença a longo prazo; e) o conhecimento sobre as vacinas contra o meningococo do sorogrupo B e f) os critérios para definir e controlar os surtos de doença meningocócica. Em geral, a melhoria da vigilância contribuirá para orientar as estratégias para prevenção e controle da doença meningocócica na América Latina.

Low-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers.

OBJECTIVE: To evaluate the effects of low-level laser therapy isolated and associated with Calendula officinalis oil in treating diabetic foot ulcers. METHOD: An experimental, randomized, controlled, prospective, interventional clinical case study using a quantitative approach. The sample consisted of 32 diabetic patients of both genders. Participants were randomly divided into four groups. Doppler Ultrasound evaluation of the Ankle-Brachial Index, brief pain inventory and analog pain scale were performed at baseline and after 30 days. RESULTS: Reduced pain was observed in the Low-level laser therapy and Low-level laser therapy associated with Essential Fatty Acids groups (p<0.01). Regarding the Ankle-Brachial Index and Doppler Ultrasound, all groups remained stable. By analyzing lesion area reduction, Low-level laser therapy associated with Essential fatty acids group showed a significance of p=0.0032, and the Low-level laser therapy group showed p=0.0428. CONCLUSION: Low-level laser therapy, performed alone or associated with the Calendula officinalis oil was effective in relieving pain and accelerating the tissue repair process of diabetic foot. OBJETIVO: Avaliar os efeitos da Terapia a Laser de Baixa Intensidade isolada e associada ao óleo de Calendula officinalis no reparo de úlceras em pé diabético. MÉTODO: Estudo de caso clínico, experimental, controlado, randomizado, prospectivo, intervencional, de caráter quantitativo. A amostra foi composta de 32 pacientes diabéticos, de ambos os gêneros. Os participantes foram distribuídos aleatoriamente em quatro grupos. Ultrassom Doppler, avaliação do Índice Tornozelo-Braquial, Inventário breve de dor e escala de dor analógica foram realizados no início e após 30 dias. RESULTADOS: Houve redução da dor nos grupos Terapia a Laser de Baixa Intensidade e Terapia a Laser de Baixa intensidade associada aos Ácidos Graxos Essenciais, com p<0,01. Quanto ao Índice Tornozelo-Braquial e Ultrassom Doppler, todos os grupos mantiveram-se estáveis. Na análise da redução de área da lesão, o grupo Terapia a Laser de Baixa Intensidade associada aos Ácidos Graxos Essenciais apresentou uma significância p=0,0032, e o grupo Terapia a Laser de Baixa Intensidade, p=0,0428. CONCLUSÃO: A Terapia a Laser de Baixa Intensidade, realizada tanto isoladamente quanto associada ao óleo de Calendula officinalis, foi eficaz no alívio da dor e na aceleração do processo de reparo tecidual de pé diabético.

Screening of Xylanolytic Aspergillus fumigatus for Prebiotic Xylooligosaccharide Production Using Bagasse.

Sugarcane bagasse is an important lignocellulosic material studied for the production of xylooligosaccharides (XOS). Some XOS are considered soluble dietary fibre, with low caloric value and prebiotic effect, but they are expensive and not easily available. In a screening of 138 fungi, only nine were shortlisted, and just Aspergillus fumigatus M51 (35.6 U/mL) and A. fumigatus U2370 (28.5 U/mL) were selected as the most significant producers of xylanases. These fungi had low ß-xylosidase activity, which is desirable for the production of XOS. The xylanases from Trichoderma reesei CCT 2768, A. fumigatus M51 and A. fumigatus U2370 gave a significantly higher XOS yield, 11.9, 14.7 and 7.9% respectively, in a 3-hour reaction with hemicellulose from sugarcane bagasse. These enzymes are relatively thermostable at 40-50 °C and can be used in a wide range of pH values. Furthermore, these xylanases produced more prebiotic XOS (xylobiose and xylotriose) when compared with a commercial xylanase. The xylanases from A. fumigatus M51 reached a high level of XOS production (37.6%) in 48-72 h using hemicellulose extracted from sugarcane bagasse. This yield represents 68.8 kg of prebiotic XOS per metric tonne of cane bagasse. In addition, in a biorefinery, after hemicellulose extraction for XOS production, the residual cellulose could be used for the production of second-generation ethanol.

Design and development of orally disintegrating films: A platform based on hydroxypropyl methylcellulose and guar gum.

From a design of experiments (DOE) performed under four independent variables, with the filmogenicity conditions and shortest disintegration time as the answers, a new oral disintegrating film (ODF) based on hydroxypropyl methylcellulose (HPMC) and guar gum (GG) with the essential oil of Plectranthus amboinicus L. (EOPA) was developed. Sixteen formulations were tested for filmogenicity, homogeneity, and viability. The better selected ODF required 230.1 s for complete disintegration. The retention rate of the EOPA was quantified using the nuclear magnetic resonance hydrogen technique (H1 NMR), which identified the presence of 0.14 % carvacrol. The scanning electron microscopy showed a smooth and homogeneous surface with the presence of small white dots. Through the disk diffusion test, the EOPA was able to inhibit the growth of clinical strains of the Candida genus and gram-positive and gram-negative bacterial strains. This work opens new perspectives for the development of antimicrobial ODFS used in clinical practice.

Renal changes and acute kidney injury in covid-19: a systematic review.

OBJECTIVE: We aimed to present a review of renal changes in patients with COVID-19. METHODS: We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION: Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION: Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.

The potential of tailoring the conditions of steam explosion to produce xylo-oligosaccharides from sugarcane bagasse.

In this study, the potential of the steam explosion (SE) method to produce high levels XOS from sugarcane bagasse, a xylan-rich hemicellulosic feedstock, was assessed. The effect of different operating conditions on XOS production yield and selectivity were investigated using a mini-pilot scale SE unit. The results show that even under a non-optimized condition (190 °C, 5 min and 0.5% H2SO4 as catalyst), SE led to about 40% xylan recovery as XOS, which was comparable to the well-known, multi-step, enzymatic production of XOS from alkaline-extracted xylan, and other commonly employed chemical methods. In addition, the XOS-rich hydrolysate from SE constituted of greater diversity in the degree of polymerization, which has been shown to be desirable for prebiotic application.

Comparative Study Between Low Level Laser and Therapeutic Ultrasound in Second Intention Ulcers Repair in Mice.

Introduction: An ulcer is an injury that affects the skin and has many causes. Healing is a way of protecting the body against any infectious agent that tries to infect you through the wound. Low level laser (LLL) in the treatment of ulcers, aims at maintaining the stability of the physiological process of tissue repair and ultrasound (US) acts by increasing the elasticity of tissue and scarring. The aim of this study was to analyze the effects of LLL and US in wound healing of ulcers induced in mice. Methods: In this experimental study, a sample of 36 guinea pigs was divided into 6 groups of 6 mice, 2 groups as control (C7) and (C14), 2 treated with laser (GL7) and (GL14) and the others 2 treated with ultrasound (GU7) and (GU14). The ulcer was induced and after 7 days, 6 mice from each group were sacrificed to obtain the histological sections for analysis, and the remaining 6 mice from each group continued under treatment and in day 14, they were sacrificed to obtain histologic specimens while macroscopic image was also carried out. Results: Three aspects were analyzed, the percentage of wound regression where it was observed that there was a significant difference in the first 7 days. Regarding the inflammatory process, it was observed that in the first 7 days GL7 and GU7 improved significantly and within 14 days of the experimental period GU14 showed a significant difference when compared to C14. The number of fibroblasts present in the GL at 7 days showed a significant difference compared to the others, and at 14 days, the US group had a significant difference compared to the other groups. Conclusion: Thus, it was evident that the US had more effective results with anti-inflammatory action, better organization and increased deposition of collagen and fibroblasts. Therefore, it can be concluded that other studies are consistent with this taking into account the laser must be used during the early days of the initial healing process and the US during the end of this process.

The xylooligosaccharide addition and sodium reduction in requeijão cremoso processed cheese.

The addition of xylooligosaccharide (XOS), sodium reduction and flavor enhancers (arginine and yeast extract) on the manufacture of requeijão cremoso processed cheese was investigated. The addition of XOS resulted in a denser and compact structure, with increased apparent viscosity, elasticity (G') and firmness (G*). The addition of XOS and yeast extract improved the rheological and physicochemical properties (decrease in viscosity and particle size and increase in melting rate) and sensory characteristics (improvement in salty and acid taste, greater homogeneity, and lower bitter taste). In addition, a positive effect of arginine was observed in the sensory characteristics of the requeijão cremoso processed cheese, but without improvements in the physicochemical and rheological characteristics. Overall, the XOS addition and sodium reduction proportionated the development of a healthier processed cheese formulation.

Chemical input reduction in the arabinoxylan and lignocellulose alkaline extraction and xylooligosaccharides production.

Lignocellulosic material breakdown by hydrolysis is an important step to open new perspectives for bioenergy and special foods production like prebiotic xylooligosaccharides. Improvement of lignocellulose and arabinoxylan alkaline extraction from sugarcane bagasse and enzymatic hydrolysis were performed. Treatments 1 (10% KOH at 70°C), 3 (5% KOH at 121°C) and ZD method (24% KOH at 35°C) showed solid lignocellulose recovery of respectively 75.2%, 74.2% and 73%. A range of 24.8-27% extracted material with high arabinoxylan content (72.1-76.3%) was obtained with these treatments. Treatment 1 and 3 exhibited great KOH reduction in the method reaction, 54.1% and 76.2%, respectively. Likewise, in treatment 3 there was a decrease in ethanol consumption (40.9%) when compared to ZD method. The extracted arabinoxylan showed susceptibility to enzymatic hydrolysis with high solid loading (7%) since Trichoderma reesei xylanases were advantageous for xylose production (54.9%), while Aspergillus fumigatus xylanases achieved better XOS production (27.1%).

A specific short dextrin-hydrolyzing extracellular glucosidase from the thermophilic fungus Thermoascus aurantiacus 179-5.

The thermophilic fungus Thermoascus aurantiacus 179-5 produced large quantities of a glucosidase which preferentially hydrolyzed maltose over starch. Enzyme production was high in submerged fermentation, with a maximal activity of 30 U/ml after 336 h of fermentation. In solid-state fermentation, the activity of the enzyme was 22 U/ml at 144 h in medium containing wheat bran and 5.8 U/ml at 48 h when cassava pulp was used as the culture medium. The enzyme was specific for maltose, very slowly hydrolyzed starch, dextrins (2-7G) and the synthetic substrate (alpha-PNPG), and did not hydrolyze sucrose. These properties suggest that the enzyme is a type II alpha-glucosidase. The optimum temperature of the enzyme was 70 degrees . In addition, the enzyme was highly thermostable (100% stability for 10 h at 60 degrees and a half-life of 15 min at 80 degrees), and stable within a wide pH range.

Estratégias defensivas contra o sofrimento psíquico entre trabalhadores / Estrategias defensivas contra el malestar psicológico entre los trabajadores / Defensive strategies against psychic suffering among workers

O artigo propõe contribuir para a saúde mental dos trabalhadores. Para tanto, buscou-se, como pano de fundo, um breve contexto histórico do trabalho. A expansão do modelo capitalista, na segunda metade do século XX, acarretou um aumento progressivo do tempo e da dedicação ininterrupta ao emprego, o que repercutiu sobre a saúde do trabalhador. Este trabalho avaliou o perfil do trabalhador de sucesso, o sofrimento presente no contexto do trabalho e como Dejours e Nietzsche percebem tragicamente o sofrimento, como inerente à vida, inevitável. Além disso, buscou entender como ambos percebem a utilização de defesas contra o sofrimento nessas organizações de trabalho e as estratégias defensivas contra o sofrimento, que podem trazer o equilíbrio ou o desequilíbrio. E, por último, enfatizou a importância de profissionais críticos e de um espaço que facilite o processo de sofrimento como equilíbrio. A pesquisa adotou o método qualitativo, por meio de uma revisão de literatura, utilizando como referencial teórico a Psicodinâmica do Trabalho e a Filosofia. Identificou-se, com base nos autores estudados, que a dor e o sofrimento são inerentes ao trabalho e que ambos têm caráter constituinte na subjetividade dos trabalhadores.(AU)

This article is meant to consist in a contribution towards worker's mental health understanding. To achieve this goal, we tried to briefly present, as background scenery, the context of work from a historical perspective. The expansion of the capitalist model, in the second half of the 20th century, engendered a progressive increase in the number of average working hours per worker and a continuous increase in time expenditure related to work issues, which seem to be issues that caused tangible effects on workers general health. This work has tried to pursue an evaluation of the successful worker profile, seeing suffering as a relatable presence in his or her working context and, as Dejours and Nietzsche tragically realize, in the understanding of suffering as an unavoidable and inherent feature of life. Besides that, the present article sought to understand precisely how these authors relate themselves with the perception of suffering within working organizational context and how they relate to defensive strategies aimed at mitigating it - which may bring dubious results given that they may either increase or decrease workers mental health condition. Finally, the present study emphasizes the importance of professionals capable of critical thinking and, also, of a working space that enables the perception of suffering process as a form of making mental health equilibrium achievable to the average worker. The research methods of choice were qualitative analysis review of bibliographic sources, and the adopted theoretical framework was technically related with literature in the fields of Psychodynamics of Work and Philosophy. The established result is that pain and suffering are meant to be understood as something inherent to every form of work activity that has a defining character in worker's subjectivity.(AU)

El artículo estudia la contribución a la salud mental de los trabajadores. Para ello, buscamos, como antecedente, un breve contexto histórico de la obra. La expansión del modelo capitalista en la segunda mitad del siglo XX supuso un progresivo aumento del tiempo y una dedicación ininterrumpida al empleo, lo que repercutió en la salud de los trabajadores. Este trabajo evaluó el perfil del trabajador exitoso, el sufrimiento presente en el contexto laboral y cómo Dejours y Nietzsche perciben trágicamente el sufrimiento como inherente a la vida, inevitable. Además, se buscó comprender cómo se percibe tanto el uso de defensas contra el sufrimiento en estas condiciones laborales como las estrategias defensivas frente al sufrimiento, que pueden traer equilibrio o desequilibrio. Y, finalmente, destacó la importancia de los profesionales necesarios y un espacio que facilite el proceso de sufrimiento como equilibrio. La búsqueda adoptó el método cualitativo, a través de una revisión de la literatura, utilizando como marco teórico la Psicodinámica del Trabajo y la Filosofía. A partir de los autores estudiados, se identificó que el dolor y el sufrimiento son inherentes al trabajo y que ambos tienen un carácter constituyente en la subjetividad de los trabajadores.(AU)

Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review.

BACKGROUND: Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs. OBJECTIVES: We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region. METHODS: We conducted a systematic review of the literature on impact or effectiveness of PCVs on deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, meningitis and sepsis. We searched Medline, WoS, Lilacs, Scopus, Central and gray literature published in any language from 2009 to January 2016. We included studies addressing the outcomes of interest in children in the target age group, and with the following designs: randomized trials, cohort or case-control, interrupted time series with at least three data points before and after the intervention, and before-after studies. Screening of citations, data extraction, and risk of bias assessment were conducted in duplicate by independent reviewers, according to the study protocol registered on PROSPERO. Descriptive analysis of the effectiveness measurements and sensitivity analysis were conducted. Effectiveness is reported as 1-OR or 1-RR for case control or cohort/clinical trials, and as percent change of disease incidence rates for before-after studies. RESULTS: We identified 1,085 citations, 892 from databases and 193 from other sources. Of these, 22 were further analyzed. Studies were from Brazil, Chile, Uruguay, Argentina, Peru and Nicaragua. Effectiveness ranged from 8.8-37.8% for hospitalizations due to X-ray confirmed pneumonia, 7.4-20.6% for clinical pneumonia, and 13.3-87.7% for meningitis hospitalizations, and 56-83.3% for IPD hospitalization, varying by age, outcome definition, type of vaccine and study design. CONCLUSIONS: Available evidence to date indicates significant impact of both PCV-10 and PCV-13 in the outcomes studied, with no evidence of the superiority of one vaccine over the other on pneumonia, IPD or meningitis hospitalization reduction in children under 5 years old.

Tratamento de lesão traumática em UTI: relato de caso / Treatment of traumatic injury in the ICU: case report

O objetivo desse trabalho é relatar um caso clínico de tratamento de úlcera traumática labial utilizando protetor bucal em paciente internado em uma Unidade de Terapia Intensiva. Paciente do sexo feminino diagnosticada com uma doença neurodegenerativa apresentou uma lesão de aspecto ulcerado, de aproximadamente 12 mm na mucosa do lábio inferior. O diagnóstico foi de úlcera traumática decorrente de espasmos musculares involuntários em face. O tratamento proposto foi instalação de protetor bucal confeccionado a partir de uma moldeira pré-fabricada de EVA (etil-vinil-acetato) borrachóide associado à medicação tópica a base de corticosteroide sobre a lesão. Após 5 dias foi observada cicatrização completa da úlcera, dispensando o uso do dispositivo. Nos dias seguintes de internação não foram observadas novas lesões. O protetor bucal instalado mostrou-se efetivo no afastamento do tecido traumatizado de novos traumas, protegeu os tecidos não lesionados e proporcionou qualidade de vida e segurança à paciente. Este relato reforça a importância da Odontologia na assistência do paciente crítico... (AU)

The objective of this work is to report a clinical case of treatment of traumatic lip ulcers using mouth guard in a patient admitted to an Intensive Care Unit. Female patient diagnosed with a neurodegenerative disease presented with an ulcerated lesion, of approximately 12 mm in the mucosa of the lower lip. The diagnosis was a traumatic ulcer resulting from involuntary muscle spasms in the face. The proposed treatment was the installation of a mouthguard made from a prefabricated EVA (ethyl vinyl acetate) rubber mold associated with topical corticosteroid medication on the lesion. After 5 days, complete healing oh the ulcer was observed, dispensing with the use of the intraoral device. In the following days of hospitalization, no new injuries were observed. The installed mouthguard proved to be effective in removing traumatized tissue from new traumas, protecting uninjured tissues and providing quality of life and safety to the patient. This report reinforces the importance of Dentistry in the care of critical patients... (AU)

Production of saccharogenic and dextrinogenic amylases by Rhizomucor pusillus A 13.36.

A newly-isolated thermophilic strain of the zygomycete fungus Rhizomucor pusillus 13.36 produced highly active dextrinogenic and saccharogenic enzymes. Cassava pulp was a good alternative substrate for amylase production. Dextrinogenic and saccharogenic amylases exhibited optimum activities at a pH of 4.0-4.5 and 5.0 respectively and at a temperature of 75 degrees C. The enzymes were highly thermostable, with no detectable loss of saccharogenic or dextrinogenic activity after 1 h and 6 h at 60 degrees C, respectively. The saccharogenic activity was inhibited by Ca(2+) while the dextrinogenic was indifferent to this ion. Both activities were inhibited by Fe(2+) and Cu(2+) Hydrolysis of soluble starch by the crude enzyme yielded 66% glucose, 19.5% maltose, 7.7% maltotriose and 6.6% oligosaccharides.

Immobilization of Papain on Chitin and Chitosan and Recycling of Soluble Enzyme for Deflocculation of Saccharomyces cerevisiae from Bioethanol Distilleries.

Yeast flocculation (Saccharomyces cerevisiae) is one of the most important problems in fuel ethanol production. Yeast flocculation causes operational difficulties and increase in the ethanol cost. Proteolytic enzymes can solve this problem since it does not depend on these changes. The recycling of soluble papain and the immobilization of this enzyme on chitin or chitosan were studied. Some cross-linking agents were evaluated in the action of proteolytic activity of papain. The glutaraldehyde (0.1-10% w·v(-1)), polyethyleneimine (0.5% v·v(-1)), and tripolyphosphate (1-10% w·v(-1)) inactivated the enzyme in this range, respectively. Glutaraldehyde inhibited all treatments of papain immobilization. The chitosan cross-linked with TPP in 5 h of reaction showed the yield of active immobilized enzyme of 15.7% and 6.07% in chitosan treated with 0.1% PEI. Although these immobilizations have been possible, these levels have not been enough to cause deflocculation of yeast cells. Free enzyme was efficient for yeast deflocculation in dosages of 3 to 4 g·L(-1). Recycling of soluble papain by centrifugation was effective for 14 cycles with yeast suspension in time perfectly compatible to industrial conditions. The reuse of proteases applied after yeast suspension by additional yeast centrifugation could be an alternative to cost reduction of these enzymes.

Effects of the Low-Level Laser Therapy (LLLT) in the process of healing diabetic foot ulcers.

PURPOSE: To evaluate the effects of the low-level laser therapy applying Laser on the tissue repair in ulcer carriers due to diabetes. METHODS: Sixteen type II diabetic patients, ulcer carriers in the lower limbs, participated in the research from which eight were in the control group and eight were submitted to the low-level laser therapy with a pulsed wave form, visible ray, wave length of 632.8 nm, 30 mW peak power, (Laser - HTM). The application time was of 80 (4J/cm2) seconds. The application was punctual without contact (approximately 1mm of distance), the pen being held in a perpendicular position related to the wound, in equidistant points. There were 12 appointments, of which three were done weekly in alternated days. Photograph records and an application of the brief inventory of pain were done before and after 30 days of follow-up. RESULTS: There was a significant decrease in the size of the wound when compared to the control group (p<0.05). The pain was also reported as having an intense improvement in the treated group. CONCLUSION: The low-level laser treatment seems to be an efficient method, viable, painless and of low costs concerning the tissue repair ulcers in a diabetic foot.

Dimorfismo sexual em adultos brasileiros por meio de medidas cranianas / Sexual dimorphism in Brazilian adults through cranial measurements

O presente estudo buscou validar a metodologia desenvolvida por Galvão in Vanrell (2016) para determinação de dimorfismo sexual e criar um modelo de regressão logística para a estimativa do sexo. Foram estudadas onze medidas a saber: (Meato acústico externo (MAE) ao gnátio, Meato acústico externo ao próstio, Meato acústico externo à espinha nasal anterior, Meato acústico externo à glabela, Meato acústico externo ao bregma, Meato acústico externo ao vértex, Meato acústico externo ao lâmbda, Meato acústico externo ao opistocrânio, Meato acústico externo ao ínio, Meato acústico externo ao mastoideo esquerdo, Meato acústico externo ao gônio) em 200 crânios, sendo 109 masculinos e 91 femininos, com idades compreendidas entre 23 e 100 anos, com sexo, idade, ancestralidade e causa da morte conhecidas, devidamente catalogadas junto ao Biobanco Osteológico e Tomográfico Prof. Eduardo Daruge da FOP/UNICAMP. Para a análise estatística utilizou-se o programa IBM® SPSS® 25 Statistics (Nova Iorque/Estados Unidos). Foram aplicados os testes de Kolmogorov-Smirnov e Teste t para análise dos dados e regressão logística Stepwise-Forward (Wald). Por meio deste estudo foi possível concluir que dentre as 11 medidas analisadas, quatro não foram dimórficas (MAE-BREGMA, MAE-VÉRTEX, MAE-OPISTOCRÂNIO, MAE-ÍNIO) tendo em vista os testes estatísticos aplicados, o que significa que estas medidas lineares não fornecem segurança para a determinação do dimorfismo sexual, considerando a amostra estudada.

The low-level laser on acute myositis in rats.

PURPOSE: To analyze the effects of the low-level laser therapy in the acute myositis induced in rats. METHODS: Twelve rats were subjected to bilateral ovariectomy for inducing osteoporosis. After surgery, they were divided into two groups: Ovariectomy-control group (G1, n=6), receiving 0.5 ml distilled water by gavage for 30 days, and Ovariectomy plus mastruz group (G2, n=6), receiving 0.5 ml of the hydroalcoholic extract of mastruz at 10% concentration (50mg) daily, for the same period. Then, the blood of the animals was collected for further biochemical analysis (liver function) and tibia and liver were removed for histological and histomorphometric analyses. RESULTS: In the MT group there was a statistic significant decrease in the number of inflammatory cells, related to the MI group (p<0.05), increase in the fibroblastic proliferation, when compared to groups C and MI related to MT group (p<0.01) and statistic significant edema regression (p=0.0400) in the MT group CONCLUSION: The low-level laser therapy was efficient in the reduction of the inflammatory process, increase of the fibroblastic proliferation and the reduction of the edema.

Renal changes and acute kidney injury in covid-19: a systematic review

SUMMARY OBJECTIVE We aimed to present a review of renal changes in patients with COVID-19. METHODS We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords "COVID-19", "coronavirus", "SARS-CoV-2", "kidney injury" and "kidney disease". Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.

RESUMO OBJETIVO Apresentar uma revisão sobre as alterações renais nos pacientes com COVID-19. MÉTODOS Foi realizada uma revisão sistemática de literatura para buscar estudos referentes a pacientes com alterações renais clínicas, laboratoriais e anatomopatológicas durante a infecção por SARS-CoV-2. A busca foi realizada nas bases de dados eletrônicos PubMed, Scopus e Embase, com as palavras-chaves: "COVID-19", "coronavirus", "Sars-CoV-2", "kidney injury" e "kidney disease", para identificar artigos originais publicados na literatura até 07 de maio de 2020. Quinze estudos trouxeram alterações renais clínicas e laboratoriais dos pacientes com COVID-19, e três abordaram análises anatomopatológicas. DISCUSSÃO A Lesão renal aguda (LRA) foi um achado relevante nos pacientes com COVID-19. Houve também alterações significativas nos exames laboratoriais que indicam lesão renal, como o nível de creatinina e ureia séricas, proteinúria e hematúria. As alterações laboratoriais e a LRA foram importantes nos pacientes que desenvolveram o quadro grave da doença. Há considerável prevalência de LRA nos grupos de pacientes que vieram a óbito. Na análise histopatológica de pacientes com SARS-CoV-2 foram encontrados achados renais sugestivos que o vírus poderia ter efeitos diretos sobre o rim. CONCLUSÃO A COVID-19 é uma doença que, apesar de acometer principalmente os pulmões, também acomete os rins. Aumento das escórias nitrogenadas, hematúria, proteinúria e LRA foram achados frequentes em pacientes com quadros graves da COVID-19. Esses achados foram relacionados a maior mortalidade. É necessária a realização de mais estudos com enfoque nas alterações renais e suas implicações no quadro clínico causadas pelo novo coronavírus.