Novel naphthoquinone-1H-1,2,3-triazole hybrids: Design, synthesis and evaluation as inductors of ROS-mediated apoptosis in the MCF-7 cells.

The search for novel anticancer drugs is essential to expand treatment options, overcome drug resistance, reduce toxicity, promote innovation, and tackle the economic impact. The importance of these studies lies in their contribution to advancing cancer research and enhancing patient outcomes in the battle against cancer. Here, we developed new asymmetric hybrids containing two different naphthoquinones linked by a 1,2,3-1H-triazole nucleus, which are potential new drugs for cancer treatment. The antitumor activity of the novel compounds was tested using the breast cancer cell lines MCF-7 and MDA-MB-231, using the non-cancer cell line MCF10A as control. Our results showed that two out of twenty-two substances tested presented potential antitumor activity against the breast cancer cell lines. These potential drugs, named here 12g and 12h were effective in reducing cell viability and promoting cell death of the tumor cell lines, exhibiting minimal effects on the control cell line. The mechanism of action of the novel drugs was assessed revealing that both drugs increased reactive oxygen species production with consequent activation of the AMPK pathway. Therefore, we concluded that 12g and 12h are novel AMPK activators presenting selective antitumor effects.

Diagnostic accuracy of non-contrast MRI in frozen shoulder.

INTRODUCTION: Despite being the most used exam today, few studies have evaluated the accuracy of findings on non-contrast magnetic resonance imaging (MRI). The primary objective of the study was to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of non-contrast MRI findings in frozen shoulder, isolated and in combination. The secondary objectives were to define the interobserver and intraobserver agreement of the assessments and the odds ratio for frozen shoulder because of the various findings of MRI. METHODS: A retrospective diagnostic accuracy study comparing non-contrast MRI findings between the frozen shoulder group and the control group. Sensitivity, specificity, positive and negative predictive value, accuracy, odds ratio, interobserver and intraobserver agreement were calculated for each finding and their possible associations. RESULTS: The hyperintensity on capsule in the axillary recess presented 84% sensitivity, 94% specificity, and 89% accuracy. The obliteration of the subcoracoid fat triangle in the rotator interval had sensitivity 34%, specificity 82% and accuracy 58%. For coracohumeral ligament thickness ≥ 2 mm had specificity 66%, 48% specificity and 57% accuracy. Capsule thickness in the axillary recess ≥ 4 mm resulted in 54% sensitivity, 82% specificity, and 68% accuracy. Regarding interobserver agreement, only the posteroinferior and posterosuperior quadrants showed moderate results, and all the others showed strong reliability. The odds ratio for hyperintensity in the axillary recess was 82.3 for frozen shoulder. The association of these findings increased specificity (95%). CONCLUSION: The accuracy of non-contrast magnetic resonance imaging is high for diagnosing frozen shoulder, especially when evaluating the hyperintensity of the axillary recess. The exam has high reliability and reproducibility. The presence of an association of signs increases the specificity of the test. LEVEL OF EVIDENCE: Level III, study of diagnostic test.

Exploring the folding landscape of leptin: Insights into threading pathways.

The discovery of new protein topologies with entanglements and loop-crossings have shown the impact of local amino acid arrangement and global three-dimensional structures. This phenomenon plays a crucial role in understanding how protein structure relates to folding and function, affecting the global stability, and biological activity. Protein entanglements encompassing knots and non-trivial topologies add complexity to their folding free energy landscapes. However, the initial native contacts driving the threading event for entangled proteins remains elusive. The Pierced Lasso Topology (PLT) represents an entangled topology where a covalent linker creates a loop in which the polypeptide backbone is threaded through. Compared to true knotted topologies, PLTs are simpler topologies where the covalent-loop persists in all conformations. In this work, the PLT protein leptin, is used to visualize and differentiate the preference for slipknotting over plugging transition pathways along the folding route. We utilize the Energy Landscape Visualization Method (ELViM), a multidimensional projection technique, to visualize and distinguish early threaded conformations that cannot be observed in an in vitro experiment. Critical contacts for the leptin threading mechanisms were identified where the competing pathways are determined by the formation of a hairpin loop in the unfolded basin. Thus, prohibiting the dominant slipknotting pathway. Furthermore, ELViM offers insights into distinct folding pathways associated with slipknotting and plugging providing a novel tool for de novo design and in vitro experiments with residue specific information of threading events in silico.

MESENCHYMAL CELLS IN ROTATOR CUFF REPAIR - TECHNIQUE DESCRIPTION AND CASE REPORTS.

Objective: To describe a protocol of obtention of mesenchymal stem cells and to report their use as a biological adjuvant in three patients undergoing arthroscopic rotator cuff repair. Methods: Case series of patients who underwent arthroscopic repair of isolated full-thickness supraspinatus tear using mesenchymal stem cells obtained from the bone marrow as a biological adjuvant. All patients were operated on at the same institution, by a surgeon with 13 years of experience. The cells were applied at the end of the procedure, at the tendon-bone interface, at an approximate concentration of 2,000,000 mesenchymal cells/mm3 and a total volume of 5 ml. Results: All patients improved with the procedure, with one excellent and two good results. All cases overcame the minimally important clinical difference. All cases reached tendon healing, without partial or complete re-tears. We observed no complications. Conclusion: Arthroscopic rotator cuff repair with added mesenchymal cells obtained from bone marrow and submitted to a cell expansion process led to good functional results and healing in all cases in the sample, with no complications. Level of Evidence IV, Case Series.

Objetivo: Descrever o protocolo de obtenção de células mesenquimais e relatar seu uso como adjuvante biológico em três pacientes submetidos ao reparo artroscópico do manguito rotador. Métodos: Série de casos de pacientes submetidos ao reparo artroscópico de rotura transfixante do músculo supraespinal utilizando como adjuvante biológico células mesenquimais obtidas da medula óssea. Todos ospacientes foram operados na mesma instituição por um cirurgião com 13 anos de experiência. As células foram aplicadas ao final do procedimento, na interface do tendão com o osso, na concentração aproximada de 2 milhões de células mesenquimais/mm3 e volume total de 5 ml. Resultados: Todos os pacientes melhoraram após o procedimento, havendo um resultado excelente e dois bons. Todos superaram a diferença clínica minimamente importante. Em todos os casos ocorreu cicatrização tendínea, sem a presença de rerroturas parciais ou completas. Não observamos complicações. Conclusão: O reparo do manguito rotador artroscópico com adição de células mesenquimais obtidas da medula óssea e submetidas a processo de expansão celular levou a bons resultados funcionais e cicatrização, sem complicações, em todos os casos da amostra. Nível de Evidência IV, Série de Casos.

Comparative study of patients with midshaft clavicle fracture fixed with a locked plate via an open versus percutaneous approach.

OBJECTIVE: To compare the results of surgical treatment of midshaft clavicle fractures, treated with the technique of minimally invasive plate osteosynthesis (MIPO) with locking compression plate versus open reduction and internal fixation (ORIF) with locked plate. METHODS: Quasi-randomized comparative study, evaluating displaced midshaft clavicle fractures treated with MIPO versus ORIF, with procedures performed by a single surgeon. We evaluated patients at 12 months using the University of California at Los Angeles (UCLA) scale and radiographically at 8, 12, 26 and 52 weeks, in addition to describing complications. RESULTS: We evaluated 44 patients; 22 submitted to MIPO and 22 to ORIF. The median UCLA scores at 12 months were 35 in the ORIF group and 35 in the MIPO group (p = 0.712). All patients had fracture healing at 3 months (p > 0.999). The mean surgery time was 87.5 min in the ORIF group and 47.5 in the MIPO (p < 0.001) group. As complications, 1 suture dehiscence (4.5%), 2 protruding plates (9.1%) and 1 change in sensitivity around the surgical wound (4.5%) were observed in the MIPO group, while in the ORIF group, 15 changes in sensitivity (68.2%) and 3 hypertrophic scars (13.6%) were observed. The only complication that showed a difference between the groups was the change in sensitivity (p < 0.001). No cases of pseudarthrosis or failure of osteosynthesis were identified in either technique. CONCLUSION: This study demonstrated that the two treatments, ORIF and MIPO, are equally effective in the treatment of displaced middle third clavicle fractures. However, MIPO is superior to ORIF in regard to reduced surgical time and preservation of supraclavicular nerve sensitivity.

Tumor necrosis factor α, and agonist and antagonists of cannabinoid receptor type 1 and type 2 alter the immunophenotype of stem cells from human exfoliated deciduous teeth.

OBJECTIVE: To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. METHODS: Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. RESULTS: The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. CONCLUSION: Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules. Inhibition of endocannabinoid receptors and TNF-α led to an increase in HLA-DR, PD-L1, and PD-L2 levels in stem cells from human exfoliated deciduous teeth. This study shows the interaction between mesenchymal stromal cells and the immune and endocannabinoid systems.

Using Machine Learning to Predict Nonachievement of Clinically Significant Outcomes After Rotator Cuff Repair.

Background: Although some evidence suggests that machine learning algorithms may outperform classical statistical methods in prognosis prediction for several orthopaedic surgeries, to our knowledge, no study has yet used machine learning to predict patient-reported outcome measures after rotator cuff repair. Purpose: To determine whether machine learning algorithms using preoperative data can predict the nonachievement of the minimal clinically important difference (MCID) of disability at 2 years after rotator cuff surgical repair with a similar performance to that of other machine learning studies in the orthopaedic surgery literature. Study Design: Case-control study; Level of evidence, 3. Methods: We evaluated 474 patients (n = 500 shoulders) with rotator cuff tears who underwent arthroscopic rotator cuff repair between January 2013 and April 2019. The study outcome was the difference between the preoperative and 24-month postoperative American Shoulder and Elbow Surgeons (ASES) score. A cutoff score was calculated based on the established MCID of 15.2 points to separate success (higher than the cutoff) from failure (lower than the cutoff). Routinely collected imaging, clinical, and demographic data were used to train 8 machine learning algorithms (random forest classifier; light gradient boosting machine [LightGBM]; decision tree classifier; extra trees classifier; logistic regression; extreme gradient boosting [XGBoost]; k-nearest neighbors [KNN] classifier; and CatBoost classifier). We used a random sample of 70% of patients to train the algorithms, and 30% were left for performance assessment, simulating new data. The performance of the models was evaluated with the area under the receiver operating characteristic curve (AUC). Results: The AUCs for all algorithms ranged from 0.58 to 0.68. The random forest classifier and LightGBM presented the highest AUC values (0.68 [95% CI, 0.48-0.79] and 0.67 [95% CI, 0.43-0.75], respectively) of the 8 machine learning algorithms. Most of the machine learning algorithms outperformed logistic regression (AUC, 0.59 [95% CI, 0.48-0.81]); nonetheless, their performance was lower than that of other machine learning studies in the orthopaedic surgery literature. Conclusion: Machine learning algorithms demonstrated some ability to predict the nonachievement of the MCID on the ASES 2 years after rotator cuff repair surgery.

Adenitis as Initial Mycobacterium marinum Presentation.

Mycobacterium marinum is a ubiquitous and opportunist agent that may cause infections related to water activities in humans. It causes mainly skin and soft tissue infections, and other forms of presentation are uncommon. A 27-year-old man presented to the Emergency Department of a tertiary hospital due to a cervical foreign-body sensation that evolved into right cervical swelling and consumption symptoms. He was a waiter on a cruise in the Douro river. Weeks after the initial presentation, the diagnosis of Mycobacterium marinum infection was made by positive nucleic acid amplification tests (NAAT) in tissues obtained by excisional biopsy of cervical adenopathy. Treatment with rifampicin and clarithromycin was started. The symptoms improved, and there was a decrease in the adenopathy number and size. Although Mycobacterium marinum adenitis as initial presentation of the disease is rare, the identification of the agent by NAAT and favorable response to treatment supported the diagnosis.

The conventional diagnosis challenge: Real-time PCR and nested PCR correlation with the scoring system for individuals at high-risk of Pneumocystis jirovecii pneumonia

Introduction. Pneumocystis jirovecii is an opportunistic fungus that affects mainly people living with HIV (CD4 cell count lower than 200 cells/ml) and other immunosuppressed patients. Since P. jirovecii does not grow on routine mycological media, diagnosis of P. jirovecii pneumonia relies on indirect evidence of its presence in respiratory samples. Objectives. To associate the results of direct immunofluorescence and two molecular methods with a score to predict P. jirovecii pneumonia in patients with AIDS. Materials and methods. A prospective study was conducted with 40 patients. A respiratory sample collected before treatment was subjected to direct immunofluorescence using the Merifluor kit, to nested PCR targeting the mitochondrial large subunit ribosomal RNA, and to the VIASURE real-time PCR kit. Results. These three techniques revealed P. jirovecii in 6, 12, and 15 samples, respectively. All positive samples by direct immunofluorescence were positive by nested PCR, and all positive samples by nested PCR amplified by real-time PCR. There was a statistically significant association between the P. jirovecii pneumonia score and the molecular methods. Two patients were early diagnosed and responded well to treatment. Conclusion. Molecular methods, especially real-time PCR, are recommended for early diagnosis of P. jirovecii pneumonia in AIDS patients.

Introducción. Pneumocystis jirovecii es un hongo oportunista que afecta principalmente a personas con HIV (recuento de CD4 menor de 200 células/ml) y a otros pacientes inmunosuprimidos. Como P. jirovecii no crece en los medios micológicos de rutina, el diagnóstico de neumonía por P. jirovecii se basa en la evidencia presente en muestras respiratorias. Objetivos. Asociar los resultados de la inmunofluorescencia directa y los de dos métodos moleculares con un puntaje para predecir la neumonía causada por P. jirovecii en pacientes con sida. Materiales y métodos. Se realizó un estudio prospectivo de 40 pacientes. Se recolectó una muestra respiratoria antes del inicio de tratamiento y se sometió a una prueba de inmunofluorescencia directa con el kit Merifluor, una PCR anidada para la amplificación de la subunidad larga del ribosoma mitocondrial y una PCR en tiempo real usando el kit VIASURE. Resultados. Estas tres técnicas evidenciaron la presencia de P. jirovecii en 6, 12 y 15 muestras, respectivamente. Todas las muestras positivas por inmunofluorescencia directa fueron positivas en la PCR anidada y todas las muestras positivas en la PCR anidada amplificaron por PCR en tiempo real. Se encontró una asociación estadística entre los valores de la neumonía causada por P. jirovecii y los métodos moleculares. Dos pacientes con diagnóstico temprano respondieron satisfactoriamente al tratamiento. Conclusión. Se recomiendan los métodos moleculares, especialmente la PCR en tiempo real, para el diagnóstico temprano de neumonía causada por P. jirovecii en pacientes con sida.

Repurposing Benzimidazoles against Causative Agents of Chromoblastomycosis: Albendazole Has Superior In Vitro Activity Than Mebendazole and Thiabendazole.

Chromoblastomycosis (CBM) is a neglected human implantation mycosis caused by several dematiaceous fungal species. Currently available therapy is usually associated with physical methods, especially surgery, and with high refractoriness. Therefore, drug discovery for CBM is essential. Drug repositioning is a strategy used to facilitate the discovery of new treatments for several diseases. The aim of this study was to discover substances with antifungal activity against CBM agents from a collection of drugs previously approved for use in human diseases. A screening was performed with the NIH Clinical Collection against Fonsecaea pedrosoi. Ten substances, with clinical applicability in CBM, inhibited fungal growth by at least 60%. The minimum inhibitory concentration (MIC) of these substances was determined against other CBM agents, and the benzimidazoles albendazole, mebendazole and thiabendazole presented the lowest MIC values. The selectivity index, based on MIC and cytotoxicity of these substances, revealed albendazole to be more selective. To investigate a possible synergism of this benzimidazole with itraconazole and terbinafine, the chequerboard method was used. All interactions were classified as indifferent. Our current results suggest that benzimidazoles have repositioning potential against CBM agents. Albendazole seems to be the most promising, since it presented the highest selectivity against all dematiaceous fungi tested.

The Influence of (Poly)phenol Intake in Saliva Proteome: Short- and Medium-Term Effects of Apple.

The relationship between salivary proteome and dietary habits was studied in previous works, where a relationship between salivary proteins like cystatins and polyphenol/tannin levels in diet was observed. However, it remains to be elucidated if this association results from an effect of polyphenol-rich food ingestion on saliva composition. The aim of this work was to test the effects of apple intake on the saliva proteome, both in the short and medium term (after 4 days of continuous intake). By incubating saliva samples with apple phenolic-rich extract, protein bands containing α-amylase, S-type cystatins, and proline-rich proteins (PRPs) appeared in the fraction that precipitated, showing the potential of these (poly)phenols to precipitate salivary proteins. Among these, it was salivary cystatins that presented changes in their levels both in the saliva samples collected immediately after apple intake and in the ones collected after 4 days of intake of an extra amount of apple. These results support the thought that intake is reflected in the salivary proteome. The effect of a polyphenol-rich food, like the apple, on salivary cystatin levels is in line with results observed in animal models and, due to the involvement of these proteins in oral food perception, it would be interesting to explore in future studies the effect of these changes on sensory perception and acceptance of polyphenol-rich food.

Rotator cuff repair in patients 50 years of age or younger: A comparative study of functional outcomes in relation to older patients.

BACKGROUND: Few studies have evaluated the clinical results of surgical treatment of rotator cuff tears in young patients and most of the publications are only case series and with a small number of evaluated individuals. The aim of this study is to compare the clinical outcomes of patients undergoing arthroscopic rotator cuff repair according to age at the time of the procedure. HYPOTHESIS: Patients with 50 years of age or younger undergoing surgical treatment of rotator cuff tear have similar clinical outcomes to older patients. MATERIALS AND METHODS: Retrospective cohort study comparing results obtained after surgical treatment of rotator cuff tears between patients aged 50 years or younger and the older patients by the ASES and UCLA functional scales. Patients undergoing arthroscopy full-thickness rotator cuff repair were included. RESULTS: We evaluated 390 shoulders (377 patients), 94 aged 50 years or younger (median=46.5 years) and 296 aged over 50 years (median=60 years). Both groups significantly improved with the procedure after 24 months of follow-up, according to the ASES and UCLA scales (p<0.001). The groups did not differ in the scores obtained in the preoperative assessments and at 24 months of follow-up. The score obtained on the ASES scale at 24 months of follow-up had a median of 87.2 (IQR=38) among patients aged 50 years or younger and 90 points (IQR=26.4) among older patients (p=0.253). The scores obtained by the UCLA scale were 31 points (IQR=9) and 33 points (IQR =7) respectively (p=0.156). DISCUSSION: Our results showed that, after 24 months, the functional results of arthroscopic full-thickness rotator cuff repair did not differ between patients younger than 50 years and older patients. These results are similar to those found by other authors. Both groups of patients achieved significant improvement after the surgical procedure, achieving approximately 90 points on the ASES scale and 32 points on the UCLA scale. LEVEL OF EVIDENCE: III Retrospective cohort study.

Sentidos de Intolerância Religiosa Contra Religiões Afro-brasileiras por Grupos com e sem Religião / Meanings of Religious Intolerance Against Afro-Brazilian Religions by Groups with and without Religion / Sentidos de Intolerancia Religiosa Contra las Religiones Afrobrasileñas por Grupos con y sin Religión

Neste artigo, discutimos os resultados de pesquisa sobre sentidos atribuídos às minorias religiosas, Religiões Afro-brasileiras (RAb's) por participantes com e sem religião e suas relações com a Intolerância Religiosa (IR). Adotamos a Teoria das Representações Sociais em articulação com as Relações Intergrupais e Identidades Sociais. O método é qualitativo com técnicas de análise auxiliadas pelo software Iramuteq em questionários de associação livre de palavras aplicados a 165 participantes e análises de conteúdo das justificativas das associações evocadas. Os resultados sugerem mudanças e permanências: de uma parte, um pensamento social de exclusão influenciado pelos discursos religiosos dominantes; de outra, a representação das RAb's como religiões, com indícios de ambiguidades no Núcleo Central. Foi observada objetivação com elementos novos (religião e cultura) e antigos (rituais, espírito, terreiro, orixás). Nos núcleos de sentido do grupo com religião: exclusão de negros e ancoragem em rituais; ênfase na corporalidade ritualística, visual e performática expressando sentidos simbólicos de malignidade e demonização das pessoas de bem (com religião) X pessoas do mal (Rab's). Os resultados sugerem crença institucionalizada nas pessoas e sentido de pertencimento social, inclusão à identidade grupal e exclusão dos "diferentes", o que pode provocar acirramento da intolerância.

In this article we discuss the results of research on meanings attributed to religious minorities, Afro-Brazilian Religions (RAb's) by participants with and without religion and their relations with Religious Intolerance (IR). We adopted the Theory of Social Representations in conjunction with Intergroup Relations and Social Identities. The method is qualitative with analysis techniques aided by the Iramuteq software in free word association questionnaires applied to 165 participants and content analysis of the justifications for the evoked associations. The results suggest changes and continuities: on the one hand, a social thought of exclusion influenced by dominant religious discourses; on the other hand, the representation of RAb's as religions, with indications of ambiguities in the Central Nucleus. Objectification with new elements (religion and culture) and old ones (rituals, spirit, terreiro, orixás) was observed. In the nuclei of meaning of the group with religion: exclusion of black people and anchoring in rituals; emphasis on ritualistic, visual and performative corporeality expressing symbolic meanings of malignity demonization of good people (with religion) X evil people (Rab's). The results suggest an institutionalized belief in people and a sense of social belonging, inclusion in the group identity and exclusion of the 'different', which can lead to an intensification of intolerance.

En este artículo, discutimos los resultados de investigación los significados a las minorías religiosas, Religiones Afrobrasileñas (RAb's) por los participantes con/sin religión y sus relaciones con la Intolerancia Religiosa -IR. Adoptamos la Teoría de las Representaciones Sociales en conjunto con las Relaciones Intergrupales y las Identidades Sociales. El método es cualitativo con técnicas de análisis auxiliadas por el software Iramuteq en cuestionarios de asociación libre de palabras aplicados a 165 participantes y análisis de contenido de las justificaciones de las asociaciones evocadas. Los resultados sugieren cambios y continuidades: por un lado, un pensamiento social de exclusión influido por los discursos religiosos dominantes; por otro lado, la representación de los RAb como religiones, con indicios de ambigüedades en el Núcleo Central. Objetivación con elementos nuevos (religión y cultura) y antiguos (rituales, espíritu, terrero, orixás). En los núcleos de significación del grupo con la religión: exclusión de negros y anclaje en rituales; énfasis en la corporalidad ritualista, visual y performativa que expresa significados simbólicos de malignidad y demonización de personas buenas (con religión) X personas malas (Rab's). Los resultados sugieren creencia institucionalizada en las personas un sentido de pertenencia social e inclusión en la identidad grupal exclusión de los 'diferentes', lo que puede conducir a intensificación de la intolerancia.

Ferrans and Powers Quality of Life Index Applied to Nursing Students during the COVID-19 Pandemic / Índice de Qualidade de Vida de Ferrans e Powers Aplicado a Estudantes de Enfermagem Durante a Pandemia de COVID-19

COVID-19 pandemic can have a significant impact on an individual's physical and emotional well-being. However, it is important to note that not all experiences of the pandemic are negative. This study aims to evaluate the perception of quality of life of students enrolled in a nursing course during the COVID-19 pandemic by administering a global questionnaire. A quantitative, exploratory, cross-sectional, and descriptive study to investigate perception of quality of life of students during the COVID-19 pandemic. Participants comprised 80 students graduating with a nursing qualification between 2020 and 2021. The Ferrans and Powers Quality of Life Index was used in the study. The mean scores are reported as follows: health/functioning domain (22.06), socioeconomic domain (21.40), psychological/spiritual domain (23.34), and family domain (23.06), with an average general quality of life index of 22.46. After evaluating the domains, it was found that there was a higher perception of the psychological/spiritual domain and lower perception of the socioeconomic domain. The results supported the internal consistency reliability of the entire Quality of Life (QLI; alpha=0.95) and the four subscales (alpha=0.88, 0.71, 0.92, and 0.80). The study suggests that the COVID-19 pandemic did not have an impact on the perceived quality of life among students.(AU)

Pandemia de COVID-19 pode ter um impacto significativo no bem-estar físico e emocional de um sujeito. No entanto, é importante notar que nem todas as experiências da pandemia são negativas. Este estudo teve como objetivo avaliar a percepção da qualidade de vida de estudantes matriculados em um curso de enfermagem durante a pandemia de COVID-19 por meio da aplicação de um questionário global. Estudo quantitativo, exploratório, transversal e descritivo para investigar a percepção da qualidade de vida de escolares durante a pandemia de COVID-19. Participaram 80 estudantes concluintes do curso de enfermagem entre 2020 e 2021. O Índice de Qualidade de Vida de Ferrans e Powers foi utilizado no estudo. Os escores médios foram relatados da seguinte forma: domínio saúde/funcionamento (22,06), domínio socioeconômico (21,40), domínio psicológico/espiritual (23,34) e domínio família (23,06), com média geral do índice de qualidade de vida de 22,46. Após a avaliação dos domínios, constatou-se maior percepção do domínio psicológico/espiritual e menor percepção do domínio socioeconômico. Os resultados apoiaram a confiabilidade da consistência interna de toda a Qualidade de Vida (QLI; alfa=0,95) e as quatro subescalas (alfa=0,88, 0,71, 0,92 e 0,80). O estudo sugere que a pandemia de COVID-19 não teve impacto na qualidade de vida percebida entre os estudantes.(AU)

Prognostic Factors for Clinical Outcomes After Arthroscopic Rotator Cuff Repair.

Background: Limited knowledge exists regarding prognostic factors after rotator cuff repair. Purpose: To identify pre- and perioperative predictors for functional outcomes after arthroscopic rotator cuff repair. Study Design: Case-control study; Level of evidence, 3. Methods: This study included patients who underwent arthroscopic rotator cuff repair between January 2013 and April 2019 and who had preoperative magnetic resonance imaging scans. The procedures were performed by 4 shoulder surgeons at a single institution. Excluded were patients who had previous surgeries, those who underwent open surgery, and those without 12- and 24-month follow-up clinical data. Patient-reported outcomes (American Shoulder and Elbow Surgeons [ASES] Standardized Shoulder Assessment Form and University of California, Los Angeles [UCLA] Shoulder Rating Scale scores) were assessed preoperatively and at 6, 12, and 24 months postoperatively. Using multiple linear regression analysis, the authors evaluated the influence of 29 variables relating to patient, lesion, and procedure characteristics on postoperative outcomes, with the 24-month ASES score as the dependent variable. Results: The study sample consisted of 474 patients (500 shoulders). The median ASES score increased from 41.6 preoperatively to 88.3 at 24 months (P < .001), and the median UCLA score increased from 14 preoperatively to 32 in the same period (P < .001). The following variables were found to be independent predictors for higher 24-month postoperative ASES score: male sex, absence of rheumatologic disease, older age, lower degree of supraspinatus muscle fatty degeneration, acromioplasty, and a higher preoperative ASES score. Conclusion: The prognostic factors for better clinical results at 24 months after arthroscopic rotator cuff repair were male sex, absence of rheumatologic disease, older age, lower degree of fatty degeneration of the supraspinatus muscle, concomitant acromioplasty, and higher preoperative ASES score.

A multiepitope chimeric antigen from Rhipicephalus microplus-secreted salivary proteins elicits anti-tick protective antibodies in rabbit.

Rhipicephalus (Boophilus) microplus, the Cattle Fever Tick, causes significant economic losses in livestock in tropical and subtropical regions of the world. As the usual control strategy based on chemical acaricides presents different drawbacks, alternative control strategies have been considered for tick control. In recent decades, several tick proteins have been evaluated as targets for the development of anti-tick vaccines. Thus, in the present work, coding sequences from three different proteins present in tick saliva were employed together to construct a recombinant chimeric protein that was evaluated as an antigen in rabbit immunization. Then, the elicited antibodies were tested in a tick artificial feeding experiment to verify the protective effect against the parasites. In addition to Rhipicephalus microplus subtilisin inhibitor 7 (RmSI-7), a serine protease inhibitor member of the TIL (Trypsin Inhibitory Like) family, an interdomain region from the Kunitz inhibitor BmTI-A, and a new cysteine-rich AMP-like microplusin, called RmSEI (previously identified as an elastase inhibitor), were selected to compose the chimeric protein. Anti-chimeric IgG antibodies were able to affect R. microplus female egg production after artificial feeding. Moreover, antibodies elicited in infested tick-resistant and tick-susceptible cattle recognized the recombinant chimera. Additionally, the functional characterization of recombinant RmSEI was performed and revealed antimicrobial activity against gram-positive bacteria. Moreover, the antimicrobial protein was also recognized by antibodies elicited in sera from cattle previously exposed to R. microplus bites. Together, these data suggest that the chimeric protein composed of three salivary antigens is suitable for anti-tick vaccine development.

Exploring the Antimicrobial and Antitumoral Activities of Naphthoquinone-Grafted Chitosans.

Biopolymers obtained from natural macromolecules are noteworthy among materials presenting high biocompatibility and adequate biodegradability, as is the case of chitosan (CS), making this biopolymeric compound a suitable drug delivery system. Herein, chemically-modified CS were synthetized using 2,3-dichloro-1,4-naphthoquinone (1,4-NQ) and the sodium salt of 1,2-naphthoquinone-4-sulfonic acid (1,2-NQ), producing 1,4-NQ-CS and 1,2-NQ-CS by three different methods, employing an ethanol and water mixture (EtOH:H2O), EtOH:H2O plus triethylamine and dimethylformamide. The highest substitution degree (SD) of 0.12 was achieved using water/ethanol and triethylamine as the base for 1,4-NQ-CS and 0.54 for 1,2-NQ-CS. All synthesized products were characterized by FTIR, elemental analysis, SEM, TGA, DSC, Raman, and solid-state NMR, confirming the CS modification with 1,4-NQ and 1,2-NQ. Chitosan grafting to 1,4-NQ displayed superior antimicrobial activities against Staphylococcus aureus and Staphylococcus epidermidis associated with improved cytotoxicity and efficacy, indicated by high therapeutic indices, ensuring safe application to human tissue. Although 1,4-NQ-CS inhibited the growth of human mammary adenocarcinoma cells (MDA-MB-231), it is accompanied by cytotoxicity and should be considered with caution. The findings reported herein emphasize that 1,4-NQ-grafted CS may be useful in protecting injured tissue against bacteria, commonly found in skin infections, until complete tissue recovery.

TREATMENT OF RECURRENT ANTERIOR SHOULDER DISLOCATION USING THE LATARJET TECHNIQUE.

Objective: To describe the functional results, recurrence rate, postoperative radiographic appearance, and complications of patients undergoing the Latarjet procedure over 24 months. Methods: Retrospective case series, including adult patients with recurrent traumatic anterior glenohumeral dislocation undergoing the Latarjet procedure. We clinically evaluated patients preoperatively by the Rowe score and at six, 12, and 24 months after the procedure. The positioning, consolidation, and resorption of the graft were analyzed by plain radiography. The recurrence rates and other complications were also described. Results: We analyzed 40 patients (41 shoulders). The Rowe score median increased from 25 before surgery to 95 at 24 months after surgery (p < 0.001). We observed graft resorption in three cases (7.3%) and consolidation in 39 (95.1%). Most grafts presented adequate placement. We observed two recurrences (4.8%), one case of dislocation and one of subluxation. Seven patients (17.1%) had a positive apprehension test. The study had no cases of infection, neuropraxia, or graft breakage. Conclusion: Latarjet surgery is a safe and effective procedure in the treatment of recurrent anterior dislocation of the shoulder. This surgery enables a statistically significant improvement according to the Rowe score, with a low number of recurrences. Level of Evidence IV, Case Series.

Objetivo: Descrever os resultados funcionais, a taxa de recidiva, o aspecto radiográfico pós-operatório e as complicações de pacientes submetidos ao procedimento de Latarjet ao longo de 24 meses. Métodos: Série de casos retrospectiva que inclui pacientes adultos com luxação glenoumeral recidivante anterior traumática submetidos ao procedimento de Latarjet. Avaliamos clinicamente os pacientes pela escala de Rowe pré-operatória e aos 6, 12 e 24 meses após o procedimento. O posicionamento, a consolidação e a reabsorção do enxerto foram analisados por radiografia simples. Descrevemos ainda as taxas de recidiva e as demais complicações. Resultados: Analisamos 40 pacientes (41 ombros). A mediana da escala de Rowe evoluiu de 25,0 antes da cirurgia para 95,0 passados 24 meses desde a cirurgia (p < 0,001). Foi observada reabsorção do enxerto em três casos (7,3%), e consolidação em 39 (95,1%). A maioria dos enxertos apresentava posicionamento adequado. Ocorreram duas recidivas (4,8%), sendo um caso de luxação e outro de subluxação. Sete pacientes (17,1%) referiam sensação de apreensão. Não ocorreram casos de infecção, neuropraxia ou quebra do enxerto. Conclusão: A cirurgia de Latarjet é um procedimento seguro e eficaz no tratamento da luxação anterior recidivante do ombro, possibilitando melhora funcional significativa de acordo com a escala de Rowe, com baixo número de recidivas. Nível de Evidência IV, Série de Casos.

Dynamic cystoscopy to optimize preoperative assessment of bladder endometriosis.

PURPOSE: Bladder endometriosis (BE) accounts for 84% of cases of urinary tract involvement. The use of cystoscopy for preoperative evaluation is limited. The aim of this study was to evaluate the accuracy of preoperative dynamic cystoscopy (DC) in patients undergoing surgery for deep endometriosis and to describe the main findings and their impact on surgical planning. MATERIALS AND METHODS: This cross-sectional observational study was conducted from January 2011 to March 2022. DC findings were divided into two groups according to the depth of involvement. To estimate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), laparoscopic findings of bladder involvement and histopathological report were used as the gold standard. RESULTS: We included 157 patients in this study. 41 had abnormalities in DC. Of these, 39 had abnormalities that were confirmed intraoperatively. The sensitivity and specificity of the test were 58.21% and 97.78%, respectively. PPV was 95.12%, and NPV was 75.86%. The presence of any lesions in the DC had a diagnostic odds ratio (OR) of 61.28 for BE. Patients with BE type 2 had a higher rate of partial cystectomy than those with BE type 1 lesions (OR 9.72 CI 95% 1.9-49.1) Conclusion: DC appears to be a highly specific test with lower sensitivity. DC abnormalities are associated with a higher ratio of bladder surgery for the treatment of deep endometriosis, and BE type 2 seems to be associated with a greater ratio (9.72) of partial cystectomy.

Synthesis, Biological Evaluation and Molecular Modeling Studies of Naphthoquinone Sulfonamides and Sulfonate Ester Derivatives as P2X7 Inhibitors.

ATP acts in the extracellular environment as an important signal, activating a family of receptors called purinergic receptors. In recent years, interest in the potential therapeutics of purinergic components, including agonists and antagonists of receptors, has increased. Currently, many observations have indicated that ATP acts as an important mediator of inflammatory responses and, when found in high concentrations in the extracellular space, is related to the activation of the P2X7 purinergic receptor. In this sense, the search for new inhibitors for this receptor has attracted a great deal of attention in recent years. Sulfonamide derivatives have been reported to be potent inhibitors of P2X receptors. In this study, ten naphthoquinone sulfonamide derivatives and five naphthoquinone sulfonate ester derivatives were tested for their inhibitory activity on the P2X7 receptor expressed in peritoneal macrophages. Some compounds showed promising results, displaying IC50 values lower than that of A740003. Molecular docking and dynamic studies also indicated that the active compounds bind to an allosteric site on P2X7R. The binding free energy indicates that sulfonamides have an affinity for the P2X7 receptor similar to A740003. Therefore, the compounds studied herein present potential P2X7R inhibition.