Liraglutide Pretreatment Does Not Improve Acute Doxorubicin-Induced Cardiotoxicity in Rats.

Doxorubicin is an effective drug for cancer treatment; however, cardiotoxicity limits its use. Cardiotoxicity pathophysiology is multifactorial. GLP-1 analogues have been shown to reduce oxidative stress and inflammation. In this study, we evaluated the effect of pretreatment with liraglutide on doxorubicin-induced acute cardiotoxicity. A total of 60 male Wistar rats were allocated into four groups: Control (C), Doxorubicin (D), Liraglutide (L), and Doxorubicin + Liraglutide (DL). L and DL received subcutaneous injection of liraglutide 0.6 mg/kg daily, while C and D received saline for 2 weeks. Afterwards, D and DL received a single intraperitoneal injection of doxorubicin 20 mg/kg; C and L received an injection of saline. Forty-eight hours after doxorubicin administration, the rats were subjected to echocardiogram, isolated heart functional study, and euthanasia. Liraglutide-treated rats ingested significantly less food and gained less body weight than animals that did not receive the drug. Rats lost weight after doxorubicin injection. At echocardiogram and isolated heart study, doxorubicin-treated rats had systolic and diastolic function impairment. Myocardial catalase activity was statistically higher in doxorubicin-treated rats. Myocardial protein expression of tumor necrosis factor alpha (TNF-α), phosphorylated nuclear factor-κB (p-NFκB), troponin T, and B-cell lymphoma 2 (Bcl-2) was significantly lower, and the total NFκB/p-NFκB ratio and TLR-4 higher in doxorubicin-treated rats. Myocardial expression of OPA-1, MFN-2, DRP-1, and topoisomerase 2ß did not differ between groups (p > 0.05). In conclusion, doxorubicin-induced cardiotoxicity is accompanied by decreased Bcl-2 and phosphorylated NFκB and increased catalase activity and TLR-4 expression. Liraglutide failed to improve acute doxorubicin-induced cardiotoxicity in rats.

Platypnea-orthodeoxia syndrome: an intriguing perioperative hypoxemia case report

Abstract Platypnea-orthodeoxia syndrome (POS) is a rare condition of positional hypoxemia and dyspnea. The following is a case of hypoxemia for no obvious reason in the perioperative scenario. A 70-year-old male patient was submitted to a radical prostatectomy. On several occasions after anesthetic induction, peripheral oxygen saturation decreased without any understandable cause. In the postanesthesia care unit, severe hypoxemia occurred in the upright position, oddly correcting with recumbency. An echocardiography showed a right-to-left intracardiac shunt through a patent foramen ovale with no pulmonary hypertension, establishing POS. Achieving this diagnosis required a broad workup with a high degree of suspicion.

Genetic variants in miR-146a and miR-196a2 in endometriosis: a Brazilian study

SUMMARY OBJECTIVE: The aim of this study was to determine the allelic and genotypic frequencies of the polymorphisms, rs2910164 miR-146a and rs11614913 miR-196a2, by investigating their association with endometriosis. METHODS: This is a case-control study performed with approximately 120 women. The polymorphisms were determined by real-time polymerase chain reaction. For the statistical analysis, the chi-square and logistic regression tests were used. RESULTS: There were no significant differences in the genotype and allele frequencies of rs2910164 and rs11614913 between cases and controls. The frequencies in both polymorphisms are in accordance with Hardy-Weinberg equilibrium regarding miR-146a (patients: χ2=1.64, p=0.20; controls: χ2=0.25, p=0.62) and miR-196a2 (patients: χ2=0.58, p=0.44; controls: χ2=2.78, p=0.10). No relationship was observed between rs2910164 and rs11614913 and endometriosis in the inheritance models analyzed. CONCLUSION: In this study, our results show that the studied polymorphisms are not implicated in the development of endometriosis.

Hanseníase e COVID-19: repercussões na vida de pessoas afetadas e promoção de intervenções / Leprosy and COVID-19: repercussions on the lives of affected people and promotion of interventions / Lepra y COVID-19: repercusiones en la vida de las personas afectadas y promoción de intervenciones

Objetivo: analisar as repercussões da COVID-19 na vida das pessoas afetadas pela hanseníase e promover intervenções de enfrentamento aos problemas vivenciados pelos usuários. Método: estudo qualitativo do tipo pesquisa participante, realizado de dezembro de 2021 a junho de 2022 na região metropolitana de Recife em oito serviços de saúde de referência para hanseníase. Realizaram-se entrevistas semiestruturadas, telemonitoramento e intervenções nos grupos de autocuidado com usuários acometidos pela hanseníase, e oficinas com profissionais e gestores. Resultados: observaram-se repercussões financeiras, no acesso aos serviços de saúde e na socialização dos usuários. As intervenções realizadas com usuários promoveram melhores práticas de conhecimento sobre a patologia, empoderamento e autocuidado. As oficinas com gestores e profissionais propiciaram a retomada e implementação de novos grupos de autocuidado, atividades comprometida na pandemia. Conclusão: a COVID-19 trouxe repercussões na situação financeira, socialização e acesso a serviços de saúde, com piora da situação de vulnerabilidade social e isolamento, já presentes no contexto da hanseníase(AU)

Objective: to analyze the repercussions of COVID-19 on the lives of people affected by leprosy and to promote interventions to cope with the problems experienced by users. Method: qualitative study of the participant research type, carried out from December 2021 to June 2022 in the metropolitan region of Recife in eight reference health services for leprosy. Semi-structured interviews, telemonitoring and interventions were carried out in self-care groups with users affected by leprosy, and workshops with professionals and managers. Results: there were financial repercussions, on access to health services and on the socialization of users. Interventions carried out with users promoted better knowledge practices about the pathology, empowerment and self-care. The workshops with managers and professionals facilitated the resumption and implementation of new self-care groups, activities compromised in the pandemic period. Conclusion: COVID-19 had repercussions on the financial situation, socialization and access to health services, with a worsening of the situation of social vulnerability and isolation, already present in the context of leprosy(AU)

Objetivo: analizar las repercusiones del COVID-19 en la vida de las personas afectadas por la lepra y promover intervenciones para el enfrentamiento de los problemas vividos por los usuarios. Método: estudio cualitativo de tipo investigación participante, realizado de diciembre de 2021 a junio de 2022 en la región metropolitana de Recife en ocho servicios sanitarios de referencia para la lepra. Se realizaron entrevistas semiestructuradas, telemonitoreo e intervenciones en grupos de autocuidado junto a usuarios afectados por lepra y talleres con profesionales y gestores. Resultados: hubo repercusiones financieras en el acceso a los servicios de salud y en la socialización de los usuarios. Las intervenciones realizadas con los usuarios promovieron mejores prácticas de conocimiento sobre la patología, empoderamiento y autocuidado. Los talleres con directivos y profesionales facilitaron la reanudación e implementación de nuevos grupos de autocuidado, actividades comprometidas en la pandemia. Conclusión: el COVID-19 tuvo repercusiones en la situación económica, socialización y acceso a los servicios de salud, con empeoramiento de la situación de vulnerabilidad social y aislamiento, ya presente en el contexto de la lepra(AU)

Rituximab therapy for childhood onset idiopathic nephrotic syndrome: experience of a Portuguese tertiary center / Terapia com Rituximabe para síndrome nefrótica idiopática de início na infância: experiência de um centro terciário português

ABSTRACT Introduction: Rituximab (RTX) is a therapeutic option in pediatric difficult-to-treat idiopathic nephrotic syndrome (NS). We aimed to assess the efficacy and safety of RTX use in these patients. Method: A retrospective study of all patients with idiopathic NS treated with RTX was conducted in a pediatric nephrology division of a tertiary hospital. Demographic, anthropometric, clinical and analytical data were collected prior to treatment and at 6, 12, and 24 months. Results: Sixteen patients were included (11 males), with a median (25th-75th percentile, P25-P75) age at diagnosis of 2 (2.0-2.8) years. Fifteen were steroid-sensitive and 1 was steroid-resistant and sensitive to cyclosporine. The median age at administration of RTX was 10 (6.3-14.0) years. Throughout a median follow-up time of 2.5 (1.0-3.0) years, 6 (37.5%) patients achieved partial remission and 7 (43.8%) had no relapses and were not taking any immunosuppressants at the 24-month follow-up visit. Regarding complications, 1 patient presented persistent hypogammaglobulinemia. Compared with the 12-month period before RTX, there was a decrease in the median number of relapses at 6 and 12 months [3 (3.0-4.0) vs 0 (0-0.8) and 0.50 (0-1.0), respectively; p = 0.001] and in the daily steroids dose (mg/kg/day) at 6, 12, and 24 months [0.29 (0.15-0.67)vs [0.10 (0.07-0.13); p = 0.001], [0.12 (0.05-0.22); p = 0.005] and [0.07(0.04-0.18); p = 0.021]], respectively. There was also a reduction in the median BMI z score at 24 months [2.11 (0.45-3.70) vs. 2.93 (2.01-3.98); p = 0.049]. Conclusion: Our results confirm the efficacy and safety of RTX use in pediatric idiopathic NS and highlight its' potential cardiometabolic benefits.

Resumo Introdução: Rituximabe (RTX) é uma opção terapêutica na síndrome nefrótica (SN) idiopática pediátrica de difícil tratamento. Visamos avaliar eficácia e segurança do uso de RTX nestes pacientes. Método: Realizou-se estudo retrospectivo de todos os pacientes com SN idiopática tratados com RTX, em uma unidade de nefrologia pediátrica de um hospital terciário. Dados demográficos, antropométricos, clínicos e analíticos foram coletados antes do tratamento e aos 6, 12 e 24 meses. Resultados: Incluímos 16 pacientes (11 do sexo masculino), com idade mediana (percentil 25-75, P25-P75) de 2 (2,0-2,8) anos ao diagnóstico. Quinze eram sensíveis a esteroides, e 1 resistente a esteroides e sensível à ciclosporina.A idade mediana na administração do RTX foi 10 (6,3-14,0) anos. Durante um tempo mediano de acompanhamento de 2,5(1,0-3,0) anos, 6 (37,5%) pacientes alcançaram remissão parcial e 7 (43,8%) não tiveram recidivas e não estavam tomando imunossupressor no acompanhamento aos 24 meses. Quanto às complicações,1 paciente apresentou hipogamaglobulinemia persistente. Comparado ao período de12 meses anterior ao RTX, houve diminuição no número mediano de recidivas em 6 e 12 meses [3 (3,0-4,0) vs 0 (0-0,8) e 0,50 (0-1,0), respectivamente; p = 0,001] e na dose diária de esteroides (mg/kg/dia) aos 6, 12 e 24 meses [0,29 (0,15-0,67) >vs [0,10 (0,07-0,13); p = 0,001], [0,12 (0,05-0,22); p = 0,005] e [0,07 (0,04-0,18); p = 0,021], respectivamente. Houve também redução na mediana do escore z do IMC aos 24 meses [2,11 (0,45-3,70) vs 2,93 (2,01-3,98);p = 0,049]. Conclusões: Nossos resultados confirmam a eficácia e segurança do uso de RTX em SN idiopática pediátrica, destacando seus potenciais benefícios cardiometabólicos.

Centro especializado em reabilitação da rede de cuidados à pessoa com deficiência: dos documentos norteadores às práticas cotidianas / Specialized rehabilitation center of the health care network for people with disabilities: from the guiding documents to daily practices

As pessoas com deficiência representam uma parcela da população usuária do SUS que para além das necessidades básicas apresentam especificidades de cuidado. Nesse sentido, em 2012 foi instituída a Rede de Cuidados à Pessoa com Deficiência (RCPcD) que propõe o Centro Especializado em Reabilitação (CER) como serviço de referência para atenção e reabilitação das pessoas nessas condições. Há diversas formas de compreensão da deficiência, que se constituíram histórica e socialmente e induzem a forma de se relacionar com ela e os modelos de "tratamento" e reabilitação. Existem também os modelos assistenciais em saúde que conduzem as intervenções nos processos de saúde-doença. O objetivo desse estudo é compreender como essas concepções se relacionam com os processos de trabalho do CER e este para os processos de cuidado e reabilitação na RCPcD no que tange às orientações documentos norteadores e às práticas desenvolvidas no cotidiano do serviço estudado. Para isso, foi realizada pesquisa documental sobre a legislação e documentos norteadores da RCPcD, observação participativa de atividades desenvolvidas em um CER da cidade de São Paulo, e grupos de discussão com profissionais do serviço e entrevistas com profissionais da gestão. Nos resultados foram apresentadas as narrativas históricas e processos de implantação da rede e do CER; a compreensão de deficiência, e reabilitação e modelos norteadores presentes nos documentos, discursos e observadas na prática; os processos de trabalho e atividades desenvolvidos no serviço; e considerações quanto à formação profissional e educação permanente, revelando avanços, mas também contradições e desafios. Ainda há heterogeneidade e tensões entre os conceitos e modelos, predominando o paradigma médico tradicional e tem sido buscado nas proposições sobre integralidade de atenção e clínica ampliada subsídio para sua superação. No entanto, a prática ainda se mostra muito pautada em ações baseadas no individuo, evidenciando a necessidade de investir em ações coletivas e compartilhadas para favorecer mudanças sociais com o objetivo de garantir participação e inclusão social efetivas. Para essa mudança de paradigma, ressalta-se a importância de mais participação das pessoas com deficiência nos processos de reabilitação, no apoio de nível gerencial e instrumental de monitoramento e avaliação, nas ações e processos de educação permanente em sintonia e na direção de um novo paradigma. Nesse sentido, como Produto Educacional do Mestrado Profissional que contribua para possíveis processos de mudança, propõe-se uma oficina de sensibilização sobre as práticas de reabilitação e atividades profissionais e possíveis mudanças a serem desenvolvidas em conjunto com trabalhadores de reabilitação

Influence of Isolated Resistance Exercise on Cardiac Remodeling, Myocardial Oxidative Stress, and Metabolism in Infarcted Rats.

INTRODUCTION: Exercise is an important therapeutic strategy for preventing and treating myocardial infarction (MI)-induced cardiac remodeling and heart failure. However, the myocardial effects of resistance exercise on infarcted hearts are not completely established. In this study, we investigated the effects of resistance exercise on structural, functional, and molecular cardiac alterations in infarcted rats. METHODS: Three months after MI induction or simulated surgery, Wistar rats were assigned into three groups: Sham (n = 14); MI (n = 9); and exercised MI (MI-Ex, n = 13). Exercised rats performed, 3 times a week for 12 weeks, four climbs on a ladder with progressive loads. Cardiac structure and left ventricle (LV) function were analyzed by echocardiogram. Myocyte diameters were evaluated in hematoxylin- and eosin-stained histological sections as the smallest distance between borders drawn across the nucleus. Myocardial energy metabolism, lipid hydroperoxide, malondialdehyde, protein carbonylation, and antioxidant enzyme activities were evaluated by spectrophotometry. Gene expressions of NADPH oxidase subunits were evaluated by RT-PCR. Statistical analyses were performed using ANOVA and Tukey or Kruskal-Wallis and Dunn's test. RESULTS: Mortality did not differ between the MI-Ex and MI groups. MI had dilated left atrium and LV, with LV systolic dysfunction. Exercise increased the maximum load-carrying capacity, with no changes in cardiac structure or LV function. Myocyte diameters were lower in MI than in Sham and MI-Ex. Lactate dehydrogenase and creatine kinase activity were lower in MI than in Sham. Citrate synthase and catalase activity were lower in MI and MI-Ex than in Sham. Lipid hydroperoxide concentration was lower in MI-Ex than in MI. Nox2 and p22phox gene expressions were higher in MI-Ex than in Sham. Gene expression of Nox4 was higher in MI and MI-Ex than in Sham, and p47phox was lower in MI than in Sham. CONCLUSION: Late resistance exercise was safe in infarcted rats. Resistance exercise improved maximum load-carrying capacity, reduced myocardial oxidative stress, and preserved myocardial metabolism, with no changes in cardiac structure or left ventricle function in infarcted rats.

Effects of dietary fiber on intestinal iron absorption, and physiological status: a systematic review of in vivo and clinical studies.

The benefits of dietary fiber on intestinal health have been well established. However, there is no consensus on the dietary fiber effects on mineral absorption. The objective of this systematic review is to discuss the evidence on the dietary fiber effects on iron absorption and iron status-related biomarkers. A comprehensive search of 3 databases: PubMed, Scopus and Web of Science was carried out. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and a total of 32 studies were included with 9 of them clinical studies and 23 in vivo. The studies included assessment of dietary fiber in the form of fructo-oligosaccharides, galacto-oligosaccharides, inulin, pectin, guar gum, oligofructose, xylo-oligosaccharides, and mannan-oligosaccharide. Hemoglobin (n = 21) and fractional iron absorption (n = 6) were the most frequently reported outcomes. The results showed no significant correlations between consumption of dietary fiber to iron absorption/status-related biomarkers. However, the current evidence may not be substantial to invalidate the recommendation of dietary fiber as an agent to improve dietary iron bioavailability, and absorption. In conclusion, there is a need to conduct further clinical trials with long dietary fiber intervention focusing on population at high risk for iron deficiency.

Association of syndemic conditions and quality of life among people living with HIV/AIDS.

The syndemics theory seeks to understand the effect of multiple synergic problems in promoting poor health outcomes. To disentangle which and how syndemic conditions affect the quality of life (QoL) may be important to improve well-being of people living with HIV/AIDS (PLWHA). This study evaluates the association between syndemic conditions and QoL among PLWHA. We performed a secondary analysis using data obtained between 2014 and 2017 among PLWHA under care in Rio de Janeiro, Brazil. The outcomes were the six QoL domains (physical, psychological, level of independence, social relationships, environmental, and spirituality) measured through the World Health Organization Quality of Life in HIV infection scale, abbreviated version (WHOQOL-HIV-BREF). The independent variables were demographic and clinical characteristics, syndemic conditions (binge drinking, compulsive sexual behavior, polysubstance use, intimate partner violence, and depression), and syndemics (two or more syndemic conditions simultaneously). Bivariate analysis (t-test and ANOVA) and linear regressions were performed for each quality-of-life domain. The analytical sample comprised 1530 participants, mostly male at birth (64%) and with median age of 43 years. The syndemic conditions most frequently observed were binge drinking (56%), IPV (13%), and depression (9%). Both individual syndemic conditions and syndemics were associated with worse QoL. In the multivariate analysis, positive screening for depression was associated with worse QoL in all domains. Polysubstance users presented worse QoL at social and environmental domains. Intimate partner violence was associated with worse QoL at environment domain while binge drinking was associated with worse scores in the physical domain. The presence of syndemics increased the likelihood of worse scores in the psychological, social, and environment domains. Our study expands the understanding of QoL in PLWHA, as it considers a holistic/integral, multifactorial, and synergistic approach to the determinants of QoL. Seeking strategies that target syndemics may be important to improve patient-centered outcomes in health.Abbreviations: HIV/AIDS: human immunodeficiency virus/acquired immunodeficiency syndromeWHO: World Health OrganizationQoL: quality of lifeHRQoL: health-related quality of lifePLWHA: people living with HIV/AIDScART: combined antiretroviral therapyIPV: intimate partner violenceINI/FIOCRUZ: Evandro Chagas National Institute of Infectious DiseasesOswaldo Cruz FoundationSRH: self-rated healthVL: viral loadCD4: CD4 cell countNIAAA: National Institute on Alcohol Abuse and AlcoholismCSBcompulsive sexual behaviorWHO-ASSIST: alcoholsmoking and substance involvement screening test developed by the World Health OrganizationPHQ-2: Patient Health Questionnaire-2.

Effects of Hyaluronic Acid With Intra-articular Corticosteroid Injections in the Management of Subtalar Post-traumatic Osteoarthritis - Randomized Comparative Trial.

We investigated the potential of exogenous hyaluronic acid (HA) associated with corticosteroid injections to improve pain and function for the treatment of post-traumatic subtalar osteoarthritis, in comparison with isolated intra-articular corticosteroid. Twenty-five symptomatic participants (50 ± 8 years) with a minimum follow-up of 1 year after surgery for calcaneus fractures were enrolled. Participants were randomly assigned into a therapeutic group that underwent isolated corticosteroid intra-articular subtalar injection (Corticosteroid Group, n = 12) or a combination of HA plus corticosteroid (HA+C Group, n = 13). All participants underwent three repeated injections with intervals of 1 week. We assessed the visual analog scale of pain (VAS) and the AOFAS scores at 4 moments: before treatment (pre), 4-, 12-, and 24-weeks following the last injection. HA+C Group showed lower VAS at the 12th (p = .003) and 24th weeks (p = .003) and greater AOFAS at the 4th (p = 0.040), 12th (p = .014), and 24th weeks (p = .021), in comparison to Corticosteroid Group. We observed a reduction in VAS in the Corticosteroid Group only at the 4th week (p = .007), compared with pretreatment values. In the HA+C Group, VAS presented lower levels at the 4- (p < .001), 12- (p < .001), and 24 weeks (p < .001). In the Corticosteroid Group, participants presented higher AOFAS score only at the 4th week (p < .001), while in the HA+C Group, the AOFAS scores were greater at the 4th, 12th, and 24th weeks compared to baseline (p < .001). The combination of exogenous HA and corticosteroid showed greater and longer analgesic effects and function improvement in comparison with isolated intra-articular corticosteroids.

The Impact of the Enhanced Recovery After Surgery (ERAS) Protocol on Colorectal Surgery in a Portuguese Tertiary Hospital.

INTRODUCTION: The benefits of the multimodal Enhanced Recovery After Surgery® (ERAS) program have been described all over the world. The adoption of several perioperative strategies translates into an improvement in the quality of the healthcare provided. The aim of this study was to report the results of the implementation of the ERAS® program for colorectal surgery in a tertiary hospital. MATERIAL AND METHODS: In this single-center observational study, 534 patients who underwent colorectal surgery between December 2018 and May 2021 were included. Two groups were considered: before and after the implementation of the ERAS® program. The primary outcome measure was 30-day morbidity. The length of hospital stay, readmission rate, reintervention and mortality among the two groups were also evaluated. RESULTS: The pre-ERAS group included 102 patients and the ERAS group included 432 patients. There was a statistically significant reduction in morbidity at 30 days (37.3% vs 26.5%, p < 0.05), length of stay (7 days vs 5 days, p < 0.001) and readmission rate (12.9% vs 6%, p < 0.05) after the implementation of the ERAS program. CONCLUSION: The ERAS® protocol for colorectal surgery was successfully and safely implemented in our hospital, contributing to an improvement in perioperative care provided to patients.

Atendimento na atenção primária à saúde: olhares de pessoas trans / Service in primary health care: perspectives of trans people / Atención primaria de salud: perspectivas de personas transgénero

Objetivo: conhecer as vivências e demandas de pessoas transexuais ao buscar serviços de Atenção Primária à Saúde. Método: pesquisa descritiva com abordagem qualitativa, realizada com pessoas autodeclaradas transexuais que utilizam os serviços de Atenção Primária à Saúde. A coleta de dados se deu por meio de questionário on-line, esses foram submetidos à análise através de software livre para dados qualitativos e o corpus textual de pesquisa passou pela análise do tipo temático-categorial. Resultados: com a análise dos dados, foi criada a categoria: vivências e demandas no atendimento na Atenção Primária à Saúde, que representou 51,6% das Unidades de Registro. Conclusão: no cenário atual, a população trans ainda padece com dificuldades de acesso aos serviços de saúde e, portanto de terem seus direitos garantidos

Objectives: to know the experiences and demands of transgender people when seeking primary health care services. Method: descriptive research with a qualitative approach, conducted with self-declared transsexual scare people who use primary health care services. Data collection was performed through an online questionnaire, which were submitted to analysis through free software for qualitative data and the textual corpus of research was analyzed by thematic-category analysis. Results: with data analysis, two categories were created: experiences in primary health care, which represented 51.6% of the Registry Units. Conclusion: in the current scenario, the trans population still suffers from difficulties in accessing health services and therefore having their rights guaranteed

Objetivos: conocer las experiencias y demandas de las personas transgénero a la hora de buscar servicios de atención primaria de salud. Método: investigación descriptiva con enfoque cualitativo, realizada con personas autodeclaradas transexuales que utilizan los servicios de atención primaria de salud. La recolección de datos se realizó a través de un cuestionario en línea, que se sometió a análisis a través de software libre para obtener datos cualitativos y el corpus textual de investigación se analizó mediante análisis de categoría temática. Resultados: con el análisis de datos se crearon dos categorías: experiencias en atención primaria de salud, que representaron el 51,6% de las Unidades de Registro. Conclusión: en el escenario actual, la población trans aún sufre dificultades para acceder a los servicios de salud y, por lo tanto, tener garantizados sus derechos

A Concise Review on Electrospun Scaffolds for Kidney Tissue Engineering.

Chronic kidney disease is one of the deadliest diseases globally and treatment methods are still insufficient, relying mostly on transplantation and dialysis. Engineering of kidney tissues in vitro from induced pluripotent stem cells (iPSCs) could provide a solution to this medical need by restoring the function of damaged kidneys. However, implementation of such approaches is still challenging to achieve due to the complexity of mature kidneys in vivo. Several strategies have been defined to obtain kidney progenitor endothelial and epithelial cells that could form nephrons and proximal tube cells, but these lack tissue maturity and vascularisation to be further implemented. Electrospinning is a technique that has shown promise in the development of physiological microenvironments of several tissues and could be applied in the engineering of kidney tissues. Synthetic polymers such as polycaprolactone, polylactic acid, and poly(vinyl alcohol) have been explored in the manufacturing of fibres that align and promote the proliferation and cell-to-cell interactions of kidney cells. Natural polymers including silk fibroin and decellularised extracellular matrix have also been explored alone and in combination with synthetic polymers promoting the differentiation of podocytes and tubular-specific cells. Despite these attempts, further work is still required to advance the applications of electrospun fibres in kidney tissue engineering and explore this technique in combination with other manufacturing methods such as bioprinting to develop more organised, mature and reproducible kidney organoids.

Análise das alterações de paladar durante o transplante de célulastronco hematopoiéticas / Analysis of taste alterations during hematopoietic cell transplantation

As alterações do paladar durante o transplante de células tronco hematopoiéticas (TCTH) são frequentemente descritas em períodos após a finalização do transplante, porém pouco se conhece sobre quais sabores e que tipo de alterações de percepção são vivenciadas pelos pacientes durante o transplante. O objetivo deste trabalho foi caracterizar as alterações do paladar e de despapilação presentes no período de neutropenia do TCTH, bem como verificar se há associação entre essas alterações e variáveis clínicas relacionadas ao transplante e à toxicidade na mucosa oral. Também se avaliou o impacto das alterações do paladar e da mucosa oral na qualidade de vida dos pacientes. Foram selecionados 52 pacientes de TCTH autólogo e alogênico, que realizaram testes de acuidade do paladar antes do condicionamento e durante a neutropenia. Os pacientes foram ainda submetidos a oroscopia para avaliação de mucosite oral e despapilação no dorso da língua. Foi também realizado inquérito quanto a xerostomia e a alterações no paladar. Foi realizado teste de acuidade na percepção dos sabores doce, amargo, azedo e salgado, ofertados em soluções contendo concentrações baixas e altas de substâncias estimuladoras desses sabores. A qualidade de vida foi avaliada pelo questionário EORTC QLQ-C30 e QLQ-H&N35. Detectou-se que os 46,1% dos pacientes exibiram alterações do paladar antes do condicionamento do TCTH, mas que essa frequência aumentou para 90,5% durante a neutropenia (teste do c2, p=0.042). O tipo de alteração mais comum foi a hipogeusia dos sabores de concentração mais forte, principalmente do amargo. Alta frequência de pacientes (72,0%) foi detectada exibindo despapilação no período de neutropenia, porém essa despapilação não foi associada às alterações de percepção de cada tipo de sabor. Não houve associação entre alterações do paladar e tipo de transplante, tipo de condicionamento e variáveis relacionadas à toxicidade na cavidade oral e no trato gastrointestinal. Houve associação significativa entre despapilação e duração da mucosite oral >=8 dias (OR= 5,62, IC95% = 0,98-60,30, p=0.039). As alterações salivares e do paladar reduziram significativamente na qualidade de vida durante a neutropenia em comparação ao período que antecedeu o condicionamento. Concluiu-se que as alterações do paladar já estão presentes antes do TCTH, mas há aumento da frequência dessas alterações, principalmente de hipogeusia. A despapilação na língua ocorreu após o condicionamento, e foi associada a maior tempo de duração da mucosite oral. O impacto das alterações salivares e do paladar na qualidade de vida do paciente durante a neutropenia é alto e devem ser minimizados mediante a adoção de estratégias mais abrangentes, que incluam manutenção da integridade da mucosa oral.

Polymorphisms rs2010963 and rs833061 of the VEGF gene in polycystic ovary syndrome.

OBJECTIVE: The polycystic ovary syndrome is the most common endocrine disorder, characterized by the dysregulation of ovarian angiogenesis. This alteration can be related to changes in the activities of the vascular endothelial growth factor (VEGF) gene. Single-nucleotide polymorphisms have been observed in the promoter, intronic, and untranslated regions of the VEGF gene, and several studies have suggested that these polymorphisms may be associated with the risk of polycystic ovary syndrome. This study aimed to investigate the association between rs2010963 and rs833061 polymorphisms and haplotypes of VEGF in the etiology of polycystic ovary syndrome. METHODS: A total of 210 women, 102 diagnosed with polycystic ovary syndrome and 108 controls, participated in this study. The genotyping of the samples was performed by PCR-RFLP and real-time PCR for rs2010963 and rs833061 polymorphisms, respectively. The statistical analyses were performed by the chi-square test and logistic regression model. RESULTS: The clinical characteristics of the patients showed that 75.8% of the patients did not become pregnant, 36.3% had a family history of polycystic ovary syndrome, 58.6% were obese, and about 60% had clinical characteristics of hyperandrogenism. There were no associations between the distribution of rs2010963 (OR 1.24; 95%CI 0.60-2.57; p=0.56) and rs833061 (OR 0.78; 95%CI 0.32-1.92; p=0.59) in patients and controls. CONCLUSIONS: The patients with polycystic ovary syndrome have similar rates of VEGF polymorphisms rs2010963 and rs833061 on the general population.

Polymorphisms rs2010963 and rs833061 of the VEGF gene in polycystic ovary syndrome

SUMMARY OBJECTIVE: The polycystic ovary syndrome is the most common endocrine disorder, characterized by the dysregulation of ovarian angiogenesis. This alteration can be related to changes in the activities of the vascular endothelial growth factor (VEGF) gene. Single-nucleotide polymorphisms have been observed in the promoter, intronic, and untranslated regions of the VEGF gene, and several studies have suggested that these polymorphisms may be associated with the risk of polycystic ovary syndrome. This study aimed to investigate the association between rs2010963 and rs833061 polymorphisms and haplotypes of VEGF in the etiology of polycystic ovary syndrome. METHODS: A total of 210 women, 102 diagnosed with polycystic ovary syndrome and 108 controls, participated in this study. The genotyping of the samples was performed by PCR-RFLP and real-time PCR for rs2010963 and rs833061 polymorphisms, respectively. The statistical analyses were performed by the chi-square test and logistic regression model. RESULTS: The clinical characteristics of the patients showed that 75.8% of the patients did not become pregnant, 36.3% had a family history of polycystic ovary syndrome, 58.6% were obese, and about 60% had clinical characteristics of hyperandrogenism. There were no associations between the distribution of rs2010963 (OR 1.24; 95%CI 0.60-2.57; p=0.56) and rs833061 (OR 0.78; 95%CI 0.32-1.92; p=0.59) in patients and controls. CONCLUSIONS: The patients with polycystic ovary syndrome have similar rates of VEGF polymorphisms rs2010963 and rs833061 on the general population.

Produção sobre a assistência pré-natal nas dissertações e teses das ciências da saúde: estudo bibliométrico / Production on prenatal care in health science dissertations and theses: a bibliometric study / Producción sobre la atención prenatal en disertaciones y tesis de ciencias de la salud: estudio bibliométrico

Objetivo: descrever a produção científica brasileira das dissertações e teses das ciências da saúde acerca da assistência prénatal no Brasil. Método: estudo bibliométrico das produções disponibilizadas no Portal de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Foram aplicadas as Leis de Lotka, Bradford e Zipf e estatística descritiva. Resultados: das 864 produções incluídas, 682 (78,9%) eram dissertações, a maioria produzida na região Sudeste (44,6%), por autores enfermeiros (45,7%), orientadores médicos (39,9%) e enfermeiros (32,5%). Predominaram estudos descritivoexploratórios (75%), com abordagem quantitativa (64%), que investigaram a assistência/avaliação pré-natal (25%), com as gestantes como população (66%) e a Unidade Básica de Saúde como principal cenário (50,8%). A palavra-chave mais frequente foi cuidado pré-natal. Conclusão: observou-se a predominância de estudos do tipo descritivo, quantitativos, oriundos das regiões Sudeste e Sul, nível de evidência 6.

Objective: to describe Brazilian scientific production in health science dissertations and theses on prenatal care in Brazil. Method: this bibliometric study examined the production available on the Theses and Dissertations Portal of Brazil's Coordination for the Improvement of Higher Education Personnel, applying Lotka, Bradford and Zipf Laws and descriptive statistics. Results: of the 864 productions included, 682 (78.9%) were dissertations, most produced in the Southeast region (44.6%), by nurse authors (45.7%), medical and nursing advisors and nurses (39,9% and 32.5%, respectively). Descriptiveexploratory studies predominated (75%), with quantitative approaches (64%), investigating prenatal care/assessment (25%), in populations of pregnant women (66%) and with primary health care facilities as the main scenarios (50.8%). The most frequent keyword was "prenatal care". Conclusion: the studies were predominantly descriptive, quantitative, from the Southeast and South regions and at evidence level 6.

Objetivo: describir la producción científica brasileña de disertaciones y tesis en ciencias de la salud sobre la atención prenatal en Brasil. Método: estudio bibliométrico de las producciones puestas a disposición en el Portal de Tesis y Disertaciones de la Coordinación para el Perfeccionamiento del Personal de Educación Superior. Se aplicaron las leyes Lotka, Bradford y Zipf y la estadística descriptiva. Resultados: de las 864 producciones incluidas, 682 (78,9%) fueron disertaciones, la mayoría producidas en el Sureste (44,6%), por enfermeras autoras (45,7%), asesores médicos y de enfermaría (39,9%, 32,5% respectivamente). Predominaron los estudios descriptivos-exploratorios (75%), con abordaje cuantitativo (64%), que investigaron la atención / valoración prenatal (25%), con gestantes como población (66%) y la Unidad Básica de Salud como escenario principal (50,8%). La palabra clave más frecuente fue atención prenatal. Conclusión: se observó el predomínio de estudios descriptivos, cuantitativos, provenientes de las regiones Sudeste y Sur, nivel de evidencia 6.