Formulaciones de almuerzos con textura modificada para personas disfágicas, a partir de materias primas dominicanas / Modified texture lunch formulations for dysphagic people, from Dominican raw materials

Introducción: La disfagia es una condición que afecta la eficiencia de la deglución de los alimentos. Mundialmente, una tercera parte de los ancianos padece de algún grado de disfagia, representando un alto riesgo de malnutrición debido a que las carentes opciones alimenticias destinadas a este público no satisfacensus requerimientos nutricionales. Objetivo: Esta investigación tuvo como objetivo desarrollar formulaciones de almuerzos con textura modificada para pacientes con disfagia, a partir de materias primas típicas dominicanas. Materiales y métodos: Se realizaron dos almuerzos de diferentes composiciones [sancocho (S) y arroz con habichuelas y carnes (AHC)] y viscosidades (néctar: 51-350 mPa.s; miel: 351-1,750 mPa.s y pudín: 1,751- 2,500 mPa.s), a los cuales se les evaluó el análisis químico aproximado y la aceptación sensorial. Se utilizó un diseño completamente al azar, bajo arreglo factorial (2 x 3). Resultados: Se evidenciaron diferencias entre las medias de los tratamientos (p<0.05) para el contenido de humedad y de carbohidratos en relación con las composiciones; el análisis por viscosidades presentó diferencias en el contenido de humedad, grasa, proteínas y carbohidratos, en cuanto a la interacción entre las composiciones y las viscosidades hubo similitudes estadísticas en el porcentaje de cenizas y grasas. Se encontró que los tratamientos más viscosos y la composición S fueron mejor valorados y que el desempeño sensorial global de los almuerzos fue satisfactorio. Conclusiones: El alimento (tipo crema) con materias primas dominicanas, sensorialmente aceptado, podría ser utilizado y también aceptado, en pacientes con disfagia(AU)

Introduction: Dysphagia is a condition that affects the efficiency of food swallowing. Globally, one-third of the elderly population suffers from some degree of dysphagia, representing a high risk of malnutrition due to the lack of dietary options tailored to their nutritional requirements. Objective: This research aimed to develop modified texture lunch formulations for dysphagia patients using typical Dominican raw materials. Materials and methods: Two lunches of different compositions [sancocho (S) and rice with beans and meat (AHC)] and viscosities (nectar: 51-350 mPa.s; honey: 351-1,750 mPa.s and pudding: 1,751-2,500 mPa.s) were made and evaluated for proximate chemical analysis and sensory acceptance. A completely randomized design was used, under factorial arrangement (2 x 3). Results: Differences were observed between treatment means (p<0.05) for moisture and carbohydrate content concerning compositions; viscosity analysis showed differences in moisture, fat, protein, and carbohydrate content, while compositional and viscosity interactions exhibited statistical similarities in ash and fat percentage. It was found that the more viscous treatments and composition S were better rated, and overall sensory performance of the lunches was satisfactory. Conclusions: The food (cream type) with Dominican raw materials, sensorially accepted, could be used and also accepted in patients with dysphagia(AU)

La suplementación con fructosa aumenta la expresión de factores lipogénicos y la esteatosis hepática inducida por una dieta alta en grasa / Fructose supplementation increases lipogenic factor expression and hepatic steatosis induced by a high-fat diet

La enfermedad de hígado graso no alcohólico (EHGNA) abarca desde una acumulación simple de lípidos neutros, triacilglicéridos (TAG) y colesterol en más del 5% de los hepatocitos, hasta una forma más avanzada llamada esteatohepatitis no alcohólica (EHNA), la que incluye inflamación lobular, balonamiento hepático y, en algunos casos, se asocia con fibrosis hepática. La creciente prevalencia de la EHGNA asociada a la dieta, especialmente aquellas ricas en grasas y carbohidratos, como la fructosa, ha orientado el enfoque de esta investigación. Nuestro objetivo fue analizar cómo la suplementación de fructosa, junto a una dieta alta en grasas, contribuye a la progresión desde EHGNA a EHNA, evaluando su efecto en marcadores lipogénicos y fibróticos. Ratones macho de la cepa C57BL/6 (n=9) fueron alimentados con dieta alta en grasa (DAG) (n=5) o dieta alta en grasa más fructosa (DAG+F) (n=4) durante 17 semanas. Se evaluaron parámetros generales (peso corporal, de tejido adiposo y hepático), niveles de glicemia e insulinemia, HOMA, histología hepática y adiposa; niveles de expresión de marcadores inflamatorios (TNF-α e IL-1b), lipogénicos (SREBP-1c, FAS) y fibrogénicos (TGF-ß, α-SMA). La suplementación con fructosa no generó diferencias respecto al peso corporal, peso del hígado o del tejido adiposo, ni sobre la glicemia basal y el HOMA-IR en comparación con la DAG, pero incrementó los niveles de insulina. Además, indujo esteatosis macrovesicular, junto con un incremento en el balonamiento celular, inflamación lobulillar y fibrosis. Concluimos que la suplementación de fructosa junto con la DAG indujo un estado pre-fibrótico, caracterizado por el incremento de α-SMA y de marcadores lipogénicos.

Non-alcoholic fatty liver disease (NAFLD) ranges from a simple accumulation of neutral lipids, triacylglycerides (TAG) and cholesterol in more than 5% of hepatocytes, to a more advanced form called non-alcoholic steatohepatitis (NASH), which includes lobular inflammation, hepatic ballooning and, in some cases, is associated with hepatic fibrosis. The increasing prevalence of NASH associated with diet, especially those rich in fats and carbohydrates, such as fructose, has guided the focus of this research. Our aim was to analyze how fructose supplementation, together with a high-fat diet, contributes to the progression from NAFLD to NASH, evaluating its effect on lipogenic and fibrotic markers. Male C57BL/6 strain mice (n=9) were fed high-fat diet (HFD) (n=5) or high-fat diet plus fructose (HFD+F) (n=4) for 17 weeks. General parameters (body, adipose and liver tissue weight), glycemia and insulinemia levels, HOMA, liver and adipose histology; expression levels of inflammatory (TNF-α and IL-1b), lipogenic (SREBP-1c, FAS) and fibrogenic (TGF-ß, α-SMA) markers were evaluated. Fructose supplementation did not generate differences with respect to body weight, liver or adipose tissue weight, nor on basal glycemia and HOMA-IR compared to DAG, but increased insulin levels. In addition, it induced macrovesicular steatosis, along with increased cell ballooning, lobular inflammation and fibrosis. We conclude that fructose supplementation together with DAG induced a pre-fibrotic state, characterized by increased α-SMA and lipogenic markers.

Formulación de galletas fortificadas por sustitución parcial de harina de moringa y suero lácteo / Formulation of fortified cookies by partial substitution of moringa flour and whey

El suero lácteo y la moringa poseen alto valor nutricional; sin embargo, su uso en la elaboración de productos alimenticios es una alternativa viable pero poco utilizada. Objetivo. Elaborar una galleta fortificada por sustitución parcial de harina de moringa (HM) y polvo de suero lácteo (PSL). Materiales y métodos. Durante septiembre-diciembre 2021, se desarrollaron cuatro formulaciones con sustitución parcial de harina de trigo por HM y PSL (F0=100:0:0; F1=90:5:5; F2=80:10:10; F3=70:15:15). La aceptación del producto se determinó mediante una evaluación sensorial considerando los atributos sabor, olor, color, textura y aceptación general. Se realizó el análisis químico proximal a la HM, al PSL, a la formulación de mayor aceptación y a F0. Se compararon los distintos parámetros químico proximales y de aceptación mediante una anova de una vía, seguido de una prueba de comparación de medias de Tukey (p<0,05). Resultados. Conforme se incrementa el porcentaje de sustitución de harina de trigo por HM y PSL se obtiene menor aceptación de las galletas, siendo F1 la más aceptada. F1 registró un contenido proteico de 6,90±0,04%, significativamente mayor al observado en F0. Conclusiones. La buena aceptabilidad de F1 indica que la sustitución parcial por HM y PSL no influyen en su aceptación; además, F1 mostró un enriquecimiento de proteinas, lípidos y cenizas, así como contenido adecuado de humedad y carbohidratos(AU)

Introduction. Whey and moringa have high nutritional value; however, their use in the production of food products is a viable but rarely used alternative. Objective. To make a biscuit fortified by partial substitution of moringa flour (MF) and whey powder (WP). Materials and methods. During September-December 2021, four formulations were developed with different degrees of partial substitution of wheat flour for MF and WP (F0=100:0:0; F1=90:5:5; F2=80:10:10; F3=70:15:15). The acceptance of the product was determined through a sensory evaluation considering the attributes taste, odor, color, texture and general acceptance. A proximal chemical analysis was performed on the MF, WP, the most widely accepted formulation and F0. Proximal chemical parameters and acceptance attributes were compared using a one-way anova, followed by a Tukey mean comparison test (p<0.05). Results. As the percentage of substitution of wheat flour by MF and WP increases less acceptance of the biscuits is obtained, with F1 as the most accepted formulation. F1 registered a protein content of 6.90±0.04%, significantly higher than that observed in F0. Conclusions: The good acceptability of F1 indicates that the partial substitution of wheat flour for MF and WP do not influence its acceptance; in addition, F1, showed an enrichment of protein, lipid and ash, as well as adequate moisture and carbohydrate content(AU)

Clinical characteristics of hypersensitivity pneumonitis: non-fibrotic and fibrotic subtypes / 中华医学杂志(英文版)

BACKGROUND@#The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis (HP) guidelines. The present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis (NFHP) and fibrotic hypersensitivity pneumonitis (FHP) and explore factors associated with the presence of fibrosis.@*METHODS@#In this prospective cohort study, patients diagnosed with HP through a multidisciplinary discussion were enrolled. Collected data included demographic and clinical characteristics, laboratory findings, and radiologic and histopathological features. Logistic regression analyses were performed to explore factors related to the presence of fibrosis.@*RESULTS@#A total of 202 patients with HP were enrolled, including 87 (43.1%) NFHP patients and 115 (56.9%) FHP patients. Patients with FHP were older and more frequently presented with dyspnea, crackles, and digital clubbing than patients with NFHP. Serum levels of carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 153, gastrin-releasing peptide precursor, squamous cell carcinoma antigen, and antigen cytokeratin 21-1, and count of bronchoalveolar lavage (BAL) eosinophils were higher in the FHP group than in the NFHP group. BAL lymphocytosis was present in both groups, but less pronounced in the FHP group. Multivariable regression analyses revealed that older age, <20% of lymphocyte in BAL, and ≥1.75% of eosinophil in BAL were risk factors for the development of FHP. Twelve patients developed adverse outcomes, with a median survival time of 12.5 months, all of whom had FHP.@*CONCLUSIONS@#Older age, <20% of lymphocyte in BAL, and ≥1.75% of eosinophil in BAL were risk factors associated with the development of FHP. Prognosis of patients with NFHP was better than that of patients with FHP. These results may provide insights into the mechanisms of fibrosis in HP.

Effect of preoperative carbohydrates intake on the gastric volume and the risk of reflux aspiration in patients positioning in trendelenburg undergoing gynecological laparoscopic procedures / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of 300 mL carbohydrates intake two hours before sur-gery on the gastric volume (GV) in patients positioning in trendelenburg undergoing gynecological laparoscopic procedures by using gastric antrum sonography, and further assess the risk of reflux aspiration.@*METHODS@#From June 2020 to February 2021, a total of 80 patients, aged 18-65 years, body mass index (BMI) 18-35 kg/m2, falling into American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, scheduled for gynecological laparoscopic procedures positioning in trendelenburg were recruited and divided into two groups: the observation group (n =40) and the control group (n=40). In the observation group, solid food was restricted after 24:00, the patients were required to take 300 mL carbohydrates two hours before surgery. In the control group, solid food and liquid intake were restricted after 24:00 the night before surgery. The cross-sectional area (CSA) of gastric antrum was measured in supine position and right lateral decubitus position before anesthesia. Primary outcome was gastric volume (GV) in each group. Secondary outcome included Perlas A semi-quantitative grading and gastric volume/weight (GV/W). All the patients received assessment of preoperative feeling of thirsty and hunger with visual analogue scale (VAS).@*RESULTS@#Complete data were available in eighty patients. GV was (58.8±23.6) mL in the intervention group vs. (56.3±22.1) mL in the control group, GV/W was (0.97±0.39) mL/kg vs. (0.95±0.35) mL/kg, respectively; all the above showed no significant difference between the two groups (P > 0.05). Perlas A semi-quantitative grading showed 0 in 24 patients (60%), 1 in 15 patients (37.5%), 2 in 1 patient (2.5%) in the intervention group and 0 in 25 (62.5%), 1 in 13 (32.5%), 2 in 2 (5%) in the control group, the proportion of Perlas A semi-quantitative grading showed no significant difference between the two groups (P > 0.05). A total of 3 patients (1 in the intervention group and 2 in the control group) with Perlas A semi-quantitative grading 2 were treated with special intervention, no aspiration case was observed in this study. The observation group endured less thirst and hunger (P＜0.05).@*CONCLUSION@#Three hundred mL carbohydrates intake two hours before surgery along with ultrasound guided gastric content monitoring does not increase gastric volume and the risk of reflux aspiration in patients positioning in trendelenburg undergoing gynecological laparoscopic surgery, and is helpful in minimizing disturbance to the patient's physiological needs, therefore leading to better clinical outcome.

Evaluation of gastric emptying after drinking carbohydrates before cesarean section by gastric ultrasonography / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of gastric antrum ultrasonography in evaluating gastric emptying after oral administration of 300 mL carbohydrates two hours before cesarean section, and to analyze the risk factors of gastric emptying in pregnant women.@*METHODS@#From August 2020 to February 2021, a total of 80 patients, aged 22-43 years, body mass index (BMI) < 35 kg/m2, gestational age≥36 weeks, falling into American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, scheduled for cesarean sections in Peking University International Hospital were recruited and divided into two groups: the intervention group (n=40)and the control group (n=40). In the intervention group, solid food was restricted after 22:00, the patients were required to take 300 mL carbohydrates two hours before cesarean section. In the control group, solid food and liquid intake were restricted after 22:00 the night before surgery. All the patients received assessment of preoperative feeling of thirst and starvation with visual analogue scale (VAS). The cross-sectional area (CSA)of gastric antrum was measured in supine position and right supine position before anesthesia, the gastric volume (GV)and the gastric volume/weight(GV/W)of the two groups was further calculated. Perlas A semi-quantitative grading assessments were performed in each patient. The blood pressure and heart rate were recorded at admission(T0), 5 minutes after anesthesia (T1), immediately after fetal delivery (T2) and at the end of the surgery (T3). The occurrence of nausea and vomiting during the operation and 24 hours after the operation were recorded.@*RESULTS@#One case in each group was excluded because the antrum was not clearly identified during the ultrasound assessments. In the semi-sitting position, the CSA was (5.07±1.73) cm2 in the intervention group vs. (5.24±1.96) cm2 in the control group, respectively; in the right lateral decubitus position, CSA was (7.32±2.17) cm2 in the intervention group vs. (7.25±2.24) cm2 in the control group, GV was (91.74±32.34) mL vs. (90.07±31.68) mL, GV/W was (1.27±0.40) mL/kg vs. (1.22±0.41) mL/kg, respectively; all the above showed no significant difference between the two groups (P > 0.05). Perlas A semi-quantitative grading showed 0 in 20 patients (51.3%), 1 in 16 (41%), 2 in 3 (7.7%)in the intervention group and 0 in 22 (56.4%), 1 in 15 (38.5%), 2 in 2 (5.1%)in the control group, the proportion of Perlas A semi-quantitative grading showed no significant difference between the two groups (P > 0.05). For the patients with Perlas A semi-quantitative grade 2 (3 cases in the intervention group and 2 cases in the control group), metoclopramide 0.2 mg/kg was intravenously injected before anesthesia. No aspiration case was observed in this study. The intervention group was endured less thirst and hunger (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups at each time point (P > 0.05). There was no significant difference in the incidence of intraoperative hypotension between the two groups (P > 0.05). There was no significant difference in the incidence of nausea intraoperatively and postoperatively between the two groups (P > 0.05).@*CONCLUSION@#Ultrasonography of gastric antrum can provide objective basis for evaluating gastric emptying of pregnant women perioperatively. 300 mL carbohydrates intake two hours before surgery, which does not increase GV and the risk of reflux aspiration, and is helpful in minimizing disturbance to the patient's physiological status, therefore leading to better clinical outcome.

Cytopathological characterization of ascites for the diagnosis of serous ovarian carcinoma / 中华肿瘤杂志

Objective: To investigate the cytomorphological and immunocytochemical features of tumor cells in the ascites of ovarian plasmacytoma (SOC). Methods: Specimens of serous cavity effusions were collected from 61 tumor patients admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2015 to July 2021, including ascites from 32 SOC, 10 gastrointestinal adenocarcinomas, 5 pancreatic ductal adenocarcinomas, 6 lung adenocarcinomas, 4 benign mesothelial hyperplasia and 1 malignant mesothelioma patients, pleural effusions from 2 malignant mesothelioma patients and pericardial effusion from 1 malignant mesothelioma. Serous cavity effusion samples of all patients were collected, conventional smears were made through centrifugation, and cell paraffin blocks were made through centrifugation of remaining effusion samples. Conventional HE staining and immunocytochemical staining were applied to observe and summarize cytomorphological characteristics and immunocytochemical characteristics. The levels of serum tumor markers carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were detected. Results: Of the 32 SOC patients, 5 had low-grade serous ovarian carcinoma (LGSOC) and 27 had high-grade serous ovarian carcinoma (HGSOC). 29 (90.6%) SOC patients had elevated serum CA125, but the difference was not statistically significant between them and patients with non-ovarian primary lesions included in the study (P>0.05); The serum CEA was positive in 9 patients with gastrointestinal adenocarcinoma and 5 patients with lung adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.001); The serum CA19-9 was positive in 5 patients with gastrointestinal adenocarcinoma and 5 patients with pancreatic ductal adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.05). The serum CA125, CEA and CA19-9 were within the normal range in 4 patients with benign mesothelial hyperplasia. LGSOC tumor cells were less heterogeneous and aggregated into small clusters or papillary pattern, and psammoma bodies could be observed in some LGSOC cases. The background cells were fewer and lymphocytes were predominant; the papillary structure was more obvious after making cell wax blocks. HGSOC tumor cells were highly heterogeneous, with significantly enlarged nuclei and varying sizes, which could be more than 3-fold different, and nucleoli and nuclear schizophrenia could be observed in some cases; tumor cells were mostly clustered into nested clusters, papillae and prune shapes; there were more background cells, mainly histiocytes. Immunocytochemical staining showed that AE1/AE3, CK7, PAX-8, CA125, and WT1 were diffusely positively expressed in 32 SOC cases. P53 was focally positive in all 5 LGSOCs, diffusely positive in 23 HGSOCs, and negative in the other 4 HGSOCs. Most of adenocarcinomas of the gastrointestinal tract and lung had a history of surgery, and tumor cells of pancreatic ductal adenocarcinoma tend to form small cell nests. Immunocytochemistry can assist in the differential diagnosis of mesothelial-derived lesions with characteristic "open window" phenomenon. Conclusion: Combining the clinical manifestations of the patient, the morphological characteristics of the cells in the smear and cell block of the ascites can provide important clues for the diagnosis of SOC, and the immunocytochemical tests can further improve the accuracy of the diagnosis.

Variations in nutritional profile of honey produced by various species of genus Apis / Variações no perfil nutricional do mel produzido por várias espécies do gênero Apis

Abstract The medicinal attributes of honey appears to overshadow its importance as a functional food. Consequently, several literatures are rife with ancient uses of honey as complementary and alternative medicine, with relevance to modern day health care, supported by evidence-based clinical data, with little attention given to honey's nutritional functions. The moisture contents of honey extracted from University of Veterinary and Animal Sciences, Lahore honey bee farm was 12.19% while that of natural source was 9.03 ± 1.63%. Similarly, ash and protein contents of farmed honey recorded were 0.37% and 5.22%, respectively. Whereas ash and protein contents of natural honey were 1.70 ± 1.98% and 6.10 ± 0.79%. Likewise fat, dietary fiber and carbohydrates contents of farmed source documented were 0.14%, 1.99% and 62.26% respectively. Although fat, dietary fiber and carbohydrates contents of honey taken from natural resource were 0.54 ± 0.28%, 2.76 ± 1.07% and 55.32 ± 2.91% respectively. Glucose and fructose contents of honey taken out from honeybee farm were 27% and 34% but natural source were 22.50 ± 2.12% and 28.50 ± 3.54%. Glucose and fructose contents of honey taken out from honeybee farm were 27% and 34% but natural source were 22.50 ± 2.12% and 28.50 ± 3.54%. Similarly, sucrose and maltose contents of farmed honey were 2.5% and 12% while in natural honey were 1.35 ± 0.49% and 8.00 ± 1.41% respectively. The present study indicates that such as moisture, carbohydrates, sucrose and maltose contents were higher farmed honey as compared to the natural honey. In our recommendation natural honey is better than farmed honey.

Resumo Os atributos medicinais do mel parecem ofuscar sua importância como alimento funcional. Consequentemente, várias literaturas estão repletas de usos antigos do mel como medicina complementar e alternativa, com relevância para os cuidados de saúde modernos, apoiados por dados clínicos baseados em evidências, com pouca atenção dada às funções nutricionais do mel. O teor de umidade do mel extraído da Universidade de Veterinária e Ciências Animais, fazenda de abelhas de Lahore, foi de 12,19%, enquanto o de fonte natural foi de 9,03 ± 1,63%. Da mesma forma, os teores de cinzas e proteínas do mel cultivado foram de 0,37% e 5,22%, respectivamente. Já os teores de cinzas e proteínas do mel natural foram de 1,70 ± 1,98% e 6,10 ± 0,79%. Da mesma forma, os teores de gordura, fibra dietética e carboidratos de origem cultivada documentados foram de 0,14%, 1,99% e 62,26%, respectivamente. Embora os teores de gordura, fibra alimentar e carboidratos do mel retirado dos recursos naturais fossem de 0,54 ± 0,28%, 2,76 ± 1,07% e 55,32 ± 2,91%, respectivamente. Os conteúdos de glicose e frutose do mel retirado da fazenda de abelhas foram de 27% e 34%, mas a fonte natural foi de 22,50 ± 2,12% e 28,50 ± 3,54%. Os conteúdos de glicose e frutose do mel retirado da fazenda de abelhas foram de 27% e 34%, mas a fonte natural foi de 22,50 ± 2,12% e 28,50 ± 3,54%. Da mesma forma, os teores de sacarose e maltose no mel cultivado foram de 2,5% e 12%, enquanto no mel natural foram de 1,35 ± 0,49% e 8,00 ± 1,41%, respectivamente. O presente estudo indica que os teores de umidade, carboidratos, sacarose e maltose foram maiores no mel cultivado em comparação ao mel natural. Em nossa recomendação, o mel natural é melhor que o mel de cultivo.

Recomendaciones para la práctica clínica sobre el manejo de la actividad física, ejercicio y deporte en niños, niñas y adolescentes con diabetes mellitus tipo 1 / Management of type 1 diabetes mellitus about physical activity, exercise and sports in children and adolescents

La presente recomendación busca brindar un marco de seguridad para la prescripción de actividad física en niños, niñas y adolescentes con diabetes mellitus tipo 1 (DM1), considerando la evaluación de las situaciones que puedan presentarse antes, durante y después de su práctica. Incluye las estrategias terapéuticas sobre el tipo de ejercicio, el control glucémico capilar (o mediante el uso de monitoreo continuo de glucosa, MCG) y la adecuación de la insulinoterapia y de la ingesta de hidratos de carbono. Se prioriza que, para optimizar los beneficios del ejercicio como parte del tratamiento de la DM1, es importante una completa y constante educación diabetológica para el paciente y sus cuidadores brindada por un equipo interdisciplinario entrenado en el manejo integral de niños, niñas y adolescentes con DM1.

These recommendations seek to provide a safety framework for the prescription of physical activity in children and adolescents with DM1, considering the evaluation of the situations that may arise before, during and after the practice of physical activity. It includes therapeutic strategies on the type of exercise, intensive capillary glycemic control or through the use of continuous glucose monitoring (CGM) and the adequacy of insulin therapy and carbohydrate intake. It is prioritized that to optimize the benefits of exercise as part of the treatment of DM1, a complete and constant diabetes education is important, provided by an interdisciplinary team trained in the comprehensive management of children and adolescents with DM1

Fórmula artesanal a base de lactosuero: complemento alimenticio para niños preescolares / Artisanal whey-based formula: food supplement for preschool children

Resumen Se pretendió desarrollar una fórmula artesanal, a base de lactosuero, como complemento alimenticio para niños preescolares. Se realizó una investigación descriptiva ejecutada en tres fases: 1. Ensayos preliminares para la determinación del esquema tecnológico; 2. Evaluación fisicoquímica para la caracterización del producto y determinación de macronutrientes y 3. Evaluación sensorial donde se midió el nivel de agrado del producto final. Los datos obtenidos de los análisis se tabularon en cuatro repeticiones y se analizaron a través de estadísticas descriptivas de tendencia central y en frecuencias expresadas en tablas y gráficos mediante el programa estadístico SPSS versión 20.0. Se obtuvo que en el análisis proximal del requesón deshidratado, éste aportó por cada 100 gramos de producto: 480,28 kcal, 46,5% de proteínas, 22,36% de grasas y 23,26% de hidratos de carbono. La formulación final de la bebida constó de 2,9 g de requesón deshidratado, 3,6 g de arroz previamente cocido y 1,8 g de azúcar diluidos por cada onza preparada. Se determinó que es una fórmula hipocalórica-hiperproteica e isoosmolar, con una viscosidad de 275cP, un pH de 5,1 y con 0,291% de ácido láctico. La fórmula artesanal a base de lactosuero fue de agrado para 41 niños que participaron en el análisis sensorial. Se recomienda su uso en niños que se encuentren en condición de vulnerabilidad nutricional.

Abstract The main objective of this research was to develop an artisan formula based on whey as food supplement directed to preschool children. It was a descriptive study carried out in three phases: 1. Preliminary tests, for the determination of the technological scheme; 2. Physical-chemical evaluation, for the characterisation of the product and determination of nutrients and, 3. Sensory evaluation: the level of satisfaction of the final product measured. The data obtained from the analysis were tabulated in four repetitions and analysed through descriptive statistics of central tendency and in frequencies expressed in tables and graphs using the statistical program SPSS version 20.0. As a result, for each 100 grams of dehydrated cottage cheese this malnuprovides: 480.28 kcal, 46.5% protein; 22.36% fat and 23.26% carbohydrates. The final formulation of the drink consisted of 2.9 g of dehydrated cottage cheese, 3.6 g of previously cooked rice and 1.8 g of diluted sugar for each prepared ounce. It was determined as a hypocaloric-hyperproteic and isomolar formula, with a viscosity of 275cP, a pH of 5.1 and with 0.291% lactic acid. The artisan formula based on whey was liked by 41 children who participated in the sensory analysis. As a conclusion, it can be recommended as food supplement in children with nutritional vulnerability conditions.

Resumo O objetivo principal desta pesquisa foi desenvolver uma fórmula artesanal à base de soro de leite como suplemento alimentar direcionado a crianças pré-escolares. Foi realizado um estudo descritivo em três fases: 1. Ensaios preliminares, para determinação do esquema tecnológico; 2. Avaliação físico-química, para caracterização do produto e determinação de macronutrientes e 3. Avaliação sensorial: mediu-se o grau de satisfação do produto final. Os dados obtidos das análises foram tabulados em quatro repetições e analisados por meio de estatísticas descritivas de tendência central e em frequências expressas em tabelas e gráficos utilizando o programa estatístico SPSS versão 20.0. Como resultado da análise proximal, para cada 100 gramas de requeijão desidratado fornece: 480,28 kcal, 46,5% de proteína; 22,36% de gordura e 23,26% de carboidratos. A formulação final da bebida consistiu em 2,9 g de requeijão desidratado, 3,6 g de arroz previamente cozido e 1,8 g de açúcar diluído para cada onça preparada. O resultado concluiu que é uma fórmula hipocalórica-hiperproteica e isoosmolar, com viscosidade de 275cP, pH de 5,1 e com 0,291% de ácido lático. A fórmula artesanal à base de soro de leite foi apreciada por 41 crianças que participaram da análise sensorial. É recomendado seu uso em crianças que se encontrem em condições de vulnerabilidade nutricional.

Carbohydrate-based gold nanoparticles as colorimetric sensor for cysteine

Background@#Gold nanoparticles have been studied extensively for their potential application in the detection of important analytes. Their relative ease of synthesis through numerous procedures makes possible their implementation in a variety of assays. Cysteine (cys), a thiol-containing amino acid implicated in numerous pathologies such as obstructive sleep apnea (OSA), has been routinely detected through expensive fluorometric assay kits. @*Objectives@#As such, this study aimed to develop a carbohydrate-based gold nanoparticle colorimetric assay for the convenient and straightforward detection of cys. @*Methodology@#Carbohydrate-based gold nanoparticles (c-AuNPs) were synthesized following a microwaveassisted procedure. The as-prepared c-AuNPs were used to detect cys by plotting the ratio of the absorbances of the aggregated and dispersed gold nanoparticles against the concentration of cys. @*Results@#The c-AuNP solutions were able to detect cys in the micromolar range, with the glucose-based AuNPs (glc-AuNPs) showing the widest linear range (16.7 μm to 167 μm), and the fructose-based gold nanoparticles (frc-AuNPs) exhibiting the lowest detection limit (9.0 μm) for cys. Aside from being able to detect cys, the c-AuNPs were also responsive to tyr and lys.@*Conclusion@#This study demonstrates that carbohydrate-based gold nanoparticles prepared following a microwave-assisted procedure using sugars as reducing agents and capping agents can be used successfully in the detection of cysteine.

Chemical synthesis of a synthetically useful L-galactosaminuronic acid building block / 中国天然药物

Most bacterial cell surface glycans are structurally unique, and have been considered as ideal target molecules for the developments of detection and diagnosis techniques, as well as vaccines. Chemical synthesis has been a promising approach to prepare well-defined oligosaccharides, facilitating the structure-activity relationship exploration and biomedical applications of bacterial glycans. L-Galactosaminuronic acid is a rare sugar that has been only found in cell surface glycans of gram-negative bacteria. Here, an orthogonally protected L-galactosaminuronic acid building block was designed and chemically synthesized. A synthetic strategy based on glycal addition and TEMPO/BAIB-mediated C6 oxidation served well for the transformation of commercial L-galactose to the corresponding L-galactosaminuronic acid. Notably, the C6 oxidation of the allyl glycoside was more efficient than that of the selenoglycoside. In addition, a balance between the formation of allyl glycoside and the recovery of selenoglycoside was essential to improve efficiency of the NIS/TfOH-catalyzed allylation. This synthetically useful L-galactosaminuronic acid building block will provide a basis for the syntheses of complex bacterial glycans.

The application of carbohydrate binding module-Thermobifida fusca cutinase fusion protein in polyethylene terephthalate degradation / 生物工程学报

With the development of global economy, the dramatically increased production of polyethylene terephthalate (PET) plastics has led to a remarkably increased amount of plastic waste. PET waste can be treated by landfill, incineration, or biodegradation. While landfilling and incineration may cause secondary pollution, biodegradation has since received increased attentions due to its environmental friendliness. Recent studies have indicated that the carbohydrate binding module (CBM) can effectively enhance the binding of PET degrading enzymes to PET, and consequently increasing PET degradation rate. Here we constructed a fusion protein BaCBM2-Tfuc containing the BaCBM2 from Bacillus anthraci and the cutinase Tfuc from Thermobifida fusca, by megaprimer PCR of whole plasmids (MEGAWHOP). Notabaly, the PET film degradation efficiency (at 60 ℃) of BaCBM2-Tfuc was 2.8 times that of Tfuc. This study may provide technical support for constructing fusion proteins capable of efficiently degrading PET.

Vitamin D concentrations and their relationship with iron parameters in patients with chronic kidney disease / Concentrações de vitamina D e sua relação com parâmetros de ferro em pacientes com doença renal crônica

ABSTRACT Objective To investigate the relationship between calcidiol (25(OH)D3) concentrations and iron parameters in patients with chronic kidney disease. Methods This is a cross-sectional, descriptive, and quantitative study. The sample consisted of 86 adult patients of both sexes undergoing dialysis. 25(OH)D3 concentrations were determined by chemiluminescence; food consumption was assessed using 24-hour recalls, and the serum levels of hemoglobin, iron, ferritin, and transferrin saturation were assessed. Data analysis was performed using the program Stata, with a significance level of p<0.05. Results The results pointed to 25(OH)D3 concentrations compatible with sufficiency, iron levels consistent with normality, and ferritin and transferrin saturation above the reference values. The consumption of carbohydrates and lipids was higher in females. There was no relationship between the adequacy of 25(OH)D3 and the presence of anemia and iron parameters. Conclusion Considering that the mean serum levels of iron and 25(OH)D3 were adequate, it is suggested that resistance to erythropoietin and the inflammatory process may have contributed to the percentage of anemic individuals found in the study.

RESUMO Objetivo Investigar a relação entre as concentrações de calcidiol (25(OH)D3) e os parâmetros de ferro em pacientes com doença renal crônica. Métodos É um estudo transversal, descritivo e quantitativo. A amostra foi composta por 86 pacientes, adultos, de ambos os sexos, em terapia dialítica. As concentrações de 25(OH)D3 foram determinadas pelo método de quimioluminescência; o consumo alimentar foi avaliado pela aplicação de Recordatórios de 24 horas e foram avaliados os níveis séricos de hemoglobina, ferro, ferritina e saturação de transferrina. A análise dos dados foi realizada no programa Stata, com nível de significância p<0.05. Resultados Os resultados apontaram para concentrações de 25(OH)D3 compatíveis com suficiência, níveis de ferro compatíveis com a normalidade e ferritina e saturação de transferrina superiores à referência. O consumo de carboidratos e lipídios foi superior no sexo feminino. Não foi verificada relação entre a adequação de 25(OH)D3 e a presença de anemia e parâmetros de ferro. Conclusão Tendo em vista que os níveis médios séricos de ferro e 25(OH)D3 estavam adequados, sugere-se que a resistência à eritropoietina e o processo inflamatório podem ter contribuído para o percentual de anêmicos constatado no estudo.

Biopelícula cariogénica de Streptococcus mutans y efecto hemostático de ácido tánico en la hemorragia post-exodoncia / Streptococcus mutans cariogenic biofilm and hemostatic effect of tannic acid in post-extraction hemorrhage

La caries dental y la placa dental se encuentran entre las enfermedades más comunes en todo el mundo y son causadas por una mezcla de microorganismos y restos de alimentos. Tipos específicos de bacterias productoras de ácido, especialmente Streptococcus mutans, colonizan la superficie dental y causan daño a la estructura dental dura en presencia de carbohidratos fermentables, por ejemplo, sacarosa y fructosa. Por otro lado, el sangrado posterior a la extracción es una complicación reconocida y frecuente en la práctica dental, que se define como la pérdida de sangre que continúa más allá de las 8 a 12 horas después de la exodoncia. Existe una amplia gama de técnicas sugeridas y sustancias para el tratamiento del sangrado post-extracción, que incluyen intervenciones dirigidas tanto a causas locales como sistémicas. El ácido tánico es una de las sustancias astringente que precipitan proteínas, pero no penetran en las células, por lo que inciden solo en la capa superficial. Su objetivo se enfoca a robustecer la superficie para acrecentar su resistencia mecánica y reducir la exudación. El objetivo de este estudio fue determinar la presencia de S. mutans en las biopelículas dentales y al mismo tiempo evaluar la actividad del ácido tánico como inhibidor del sangrado profuso en las extracciones dentales. S. mutans se aisló en el 92,5% de los pacientes evaluados. Los tiempos de hemostasia post-exodoncia fue significativamente menor en el grupo de pacientes a los que se les aplicó el ácido tánico en comparación a los que no se les aplicó(AU)

Tooth decay and dental plaque are among the most common diseases worldwide and are caused by a mix of microorganisms and food debris. Specific types of acid-producing bacteria, especially Streptococcus mutans, colonize the tooth surface and cause damage to hard tooth structure in the presence of fermentable carbohydrates, for example, sucrose and fructose. On the other hand, post-extraction bleeding is a recognized and frequent complication in dental practice, defined as blood loss that continues beyond 8 to 12 hours after extraction. There is a wide range of suggested techniques and substances for the treatment of post-extraction bleeding, including interventions targeting both local and systemic causes. Tannic acid is one of the astringent substances that precipitate proteins, but does not penetrate the cells, so it affects only the superficial layer. Its objective is focused on strengthening the surface to increase its mechanical resistance and reduce exudation. The objective of this study was to determine the presence of S. mutans in dental biofilms and at the same time to evaluate the activity of tannic acid as an inhibitor of profuse bleeding in dental extractions. S. mutans was isolated in 92.5% of the patients evaluated. Post-extraction hemostasis times were significantly shorter in the group of patients who received tannic acid compared to those who did not(AU)

Desenvolvimento de barrinha de proteína à base de vegetais / Development of vegetable-based protein bars

As pessoas vêm se preocupando com a saúde e a alimentação cada dia mais. O número de pessoas que se declara vegetariana no Brasil é cerca de 14% da população, o que já é uma preocupação para a indústria de alimentos. Com essa alta demanda pela busca de produtos de origem vegetal, se viu a necessidade de inovar trazendo produtos fontes de proteína vegetal, os quais estão disponíveis no mercado, mas não são muito facilmente encontrados ou se não, possuem um valor bem alto se comparado aos produtos de origem animal. Visando a solução deste problema, o presente trabalho teve como objetivo desenvolver uma barrinha fonte de proteína a base de vegetais. Ao final da realização da receita, foi desenvolvida uma tabela nutricional contendo informações a respeito da sua composição de acordo com a RDC 359. Foram feitas tabelas de comparação dos teores de carboidratos, proteínas, gorduras totais, gorduras saturadas, gorduras trans, fibra e sódio. A barrinha desenvolvida atingiu níveis adequados de proteínas, carboidratos e um teor significativo de fibras e cálcio

People are worrying about health and food more and more. The number of people who declare themselves vegetarian in Brazil is about 14% of the population, which is already a concern for the food industry. With this high demand for the search for products of vegetable origin, there was a need to innovate by bringing products that are sources of vegetable protein, which are available on the market, but are not very easily found or, if not, have a very high value compared to animal products. Aiming at solving this problem, the present work aimed to develop a vegetable-based protein source bar. At the end of the recipe, a nutritional table was developed containing information about its composition in accordance with RDC 359. Tables were made comparing the levels of carbohydrates, proteins, total fats, saturated fats, trans fats, fiber and sodium. The developed bar reached adequate levels of proteins, carbohydrates and a significant content of fiber and calcium

Anafilaxia a alfa-gal: um relato de caso paraibano / Alpha-gal anaphylaxis: a case report from Paraíba, Brazil

O presente relato apresenta um caso de anafilaxia tardia ao carboidrato alfa-gal em um adolescente da cidade de Belém, na Paraíba, Brasil. O paciente desenvolveu reação tardia à ingesta de carne e vísceras de animais. Ele mora em fazenda e tem contato próximo com animais potencialmente contaminados por carrapatos. Essa causa de reação alérgica é nova, e estudos começaram a atribuí-la a casos antes ditos idiopáticos. A anafilaxia é uma reação potencialmente fatal, que deve ser prontamente diagnosticada e tratada. Sendo assim, a descoberta de seu fator desencadeante é um dos principais itens que direcionam o tratamento. No Brasil, nenhum caso de anafilaxia por alfa-gal foi antes descrito na literatura local.

This report presents a case of late anaphylaxis to alpha-gal carbohydrate in a teenager living in the city of Belém, Paraíba, Brazil. The patient developed a late reaction to eating meat and offal of animals; he lives on a farm and has close contact with animals potentially contaminated by ticks. This cause of allergic reaction is new, and studies have started to attribute it to cases previously said to be idiopathic. Anaphylaxis is a potentially fatal reaction that must be promptly diagnosed and treated. Thus, the discovery of its triggering factor is one of the main items that guide treatment. In Brazil, no case of alpha-gal anaphylaxis had been described in the local literature.

Niveles séricos de interleucina-6 en pacientes con diabetes tipo 2 y su correlación con el perfil lipídico / Serum levels of interleukin-6 in patients with type 2 diabetes and its correlation with the lipid profile

La diabetes mellitus es una enfermedad metabólica caracterizada por hiperglucemia, a consecuencia de defectos en la producción, secreción y/o acción de la insulina, produciendo alteraciones en el metabolismo de los hidratos de carbono, lípidos y proteínas; asociado a un proceso inflamatorio crónica en un plazo variable, que provocara lesiones macro y microvasculares. Objetivo: Evaluar los niveles séricos de interleucina-6 (IL-6) en pacientes diabéticos tipo 2 y su correlación con el perfil lipídico. Métodos: Se realizó estudio descriptivo analítico y transversal, comprendido por 60 adultos de ambos sexos entre 30 a 60 años, con diabetes mellitus tipo 2 que acudieron a consulta de Endocrinología del Hospital Militar Universitario Dr. Carlos Arvelo. Se les determino glucemia basal, interleucina-6, perfil lipídico, resultados relacionados con parámetros antropométricos, composición corporal, la edad y tiempo de evolución de la diabetes. Resultados: La edad promedio de 51,60 años ± 6,51, donde el 71,6% correspondieron al sexo femenino y el 28,3% al masculino, tiempo de evolución de la diabetes entre 1 mes y 37 años, con un promedio de 10,97 años. Se presentó correlación positiva baja y estadísticamente significativa entre interleucina 6 y los parámetros de triglicéridos, VLDL y no-HDL Conclusión: Se encontró valores elevados de IL-6 en todos los pacientes diabéticos tipo 2, así como una correlación positiva entre IL-6 y las lipoproteínas ricas en triglicéridos. Esto respalda la idea de que la hipertrigliceridemia puede causar cambios inflamatorios en pacientes diabéticos y esto elevaría el riesgo cardiovascular de estos pacientes(AU)

Hormônio do crescimento versus treinamento de força: alterações nas estruturas colágenas, lipídicas e glicídicas / Growth hormone (gh) versus strength training: changes in collagen, lipid and glucidic structures

O objetivo deste estudo foi avaliar o efeito da aplicação de hormônio do crescimento (Growth Hormone - GH) e treinamento de força (TF) na composição do tecido ósseo de ratos Wistar a partir da Espectroscopia Raman. 40 ratos machos foram distribuídos de forma aleatória em quatro grupos: controle (C [n=10]), controle a aplicação de GH (GHC [n=10]), treinamento de força (T [n=10]) e treinamento de força e aplicação de GH (GHT [n=10]). O treinamento foi composto por quatro séries de 10 saltos aquáticos, realizados três vezes por semana, com sobrecarga correspondente a 50% do peso corpóreo e duração de quatro semanas. O GH foi aplicado na dose de 0,2 UI/Kg em cada animal, três vezes por semana e em dias alternados. Ao final do experimento, os animais foram eutanasiados e coletados os fêmures direitos para realização da análise da composição óssea. A espectroscopia Raman (ER) foi utilizada para observar os seguintes compostos a partir de suas respectivas bandas: colágeno e fosfolipídio (1445 cm-1), colesterol (548 cm-1), glicerol (607 cm-1), glicose (913 cm-1), Pico de carboidrato (931 cm-1 ) e prolina (918 cm-1 ). Para a análise estatística, foram realizados os testes de normalidade de Shapiro-Wilk e análise de variâncias ANOVA one-way, seguida pelo pós-teste de Tukey. Os resultados revelaram aumento nas concentrações de colágeno e fosfolipidio, colesterol, glicerol, glicose, pico de carboidrato e prolina em todos os grupos experimentais, associados ou não à realização do ST e/ou aplicação de GH. Porém, somente o grupo T diferiu significativamente do grupo C (p<0,05). Conclui-se que todas intervenções puderam promover ganho no tecido ósseo, porém, somente o grupo T demonstrou diferença significativa nos compostos minerais analisados. (AU)

The objective of this study was to evaluate the effect of the application of growth hormone (GH) and strength training (TF) on the bone tissue composition of Wistar rats using Raman Spectroscopy. 40 male rats were randomly assigned to four groups: control (C [n = 10]), control the application of GH (GHC [n = 10]), strength training (T [n = 10]) and training of strength and application of GH (GHT [n = 10]). The training consisted of four series of 10 water jumps, performed three times a week, with an overload corresponding to 50% of body weight and lasting four weeks. GH was applied at a dose of 0.2 IU / kg to each animal, three times a week and on alternate days. After four weeks, the animals were euthanized and the right femurs were collected to carry out the analysis of the bone composition. Raman spectroscopy (ER) was used to observe the following compounds from their respective bands: collagen and phospholipid (1445 cm-1), cholesterol (548 cm-1), glycerol (607 cm-1), glucose (913 cm-1), Peak carbohydrate (931 cm-1), proline (918 cm-1). For statistical analysis, the Shapiro-Wilk normality tests and ANOVA One-Way analysis of variances were performed, followed by the Tukey post-test. The results revealed an increase in the concentrations of collagen and phospholipid, cholesterol, glycerol, glucose, peak carbohydrate and proline in all experimental groups, associated or not with the performance of ST and / or application of GH. However, only group T differed significantly from group C (p <0.05). It was concluded that all intervention could promote gain in bone tissue, however, only the T group showed a significant difference in the analyzed mineral compounds. (AU)

Carbohydrate antigen 15-3 as a marker of disease severity in patients with chronic hypersensitivity pneumonitis* / Antígeno carboidrato 15-3 como marcador de gravidade da doença em pacientes com pneumonite de hipersensibilidade crônica

ABSTRACT Objective: Biomarkers associated with mucin 1, such as Krebs von den Lungen-6 and carbohydrate antigen (CA) 15-3, are increased in various interstitial lung diseases. Our aim was to determine whether CA 15-3 could be considered a biomarker of disease severity in patients with chronic hypersensitivity pneumonitis (cHP). Methods: This was a prospective observational study involving adult patients with cHP. Serum levels of CA 15-3 were measured and were correlated with variables related to disease severity and extension. HRCT scans were quantitatively analyzed using a computational platform and an image analysis tool (Computer Aided Lung Informatics for Pathology Evaluation and Rating). CA 15-3 levels were normalized by logarithmic transformation. Results: The sample comprised 41 patients. The mean age of the patients was 60.1 ± 11.6 years. The mean FVC in % of predicted was 70.3% ± 17.3%, and the median of the serum level of CA 15-3 was 48.1 U/mL. CA 15-3 levels inversely correlated with FVC in % of predicted (r = −0,30; p = 0,05), DLCO in % of predicted (r = −0,54; p < 0,01), and SpO2 at the end of a 4-min step test (r = −0,59; p < 0,01), but they directly correlated with total quantitative HRCT scores (r = 0,47; p = 0,004), especially regarding ground-glass opacities (r = 0.58; p < 0,001). Conclusions: CA 15-3 is likely to be a biomarker of disease severity of patients with cHP, particularly regarding gas exchange abnormalities.

RESUMO Objetivo: Biomarcadores associados à mucina-1, tais como Krebs von den Lungen-6 e carbohydrate antigen (CA, antígeno carboidrato) 15-3, encontram-se aumentados em diversas doenças pulmonares intersticiais. Nosso objetivo foi determinar se CA 15-3 poderia ser considerado um biomarcador de gravidade de doença em pacientes com pneumonite de hipersensibilidade crônica (PHc). Métodos: Estudo prospectivo observacional envolvendo pacientes adultos com PHc. Os níveis séricos de CA 15-3 foram medidos e correlacionados com variáveis relacionadas à gravidade e extensão da doença. As imagens de TCAR foram analisadas quantitativamente utilizando uma plataforma computacional e uma ferramenta de análise de imagem (Computer-Aided Lung Informatics for Pathology Evaluation and Rating). Os níveis de CA 15-3 foram normalizados por transformação logarítmica. Resultados: A amostra foi composta por 41 pacientes. A média de idade dos pacientes foi de 60,1 ± 11,6 anos. A média da CVF em % do previsto foi de 70,3% ± 17,3%, e a mediana do nível sérico de CA 15-3 foi de 48,1 U/mL. Os níveis de CA 15-3 se correlacionaram inversamente com CVF em % do previsto (r = −0,30; p = 0,05), DLCO em % do previsto (r = −0,54; p < 0,01) e SpO2 ao final de um teste de degrau de 4 minutos (r = −0,59; p < 0,01), mas se correlacionaram diretamente com a pontuação quantitativa total da TCAR (r = 0,47; p = 0,004), especialmente quanto a opacidades em vidro fosco (r = 0,58; p < 0,001). Conclusões: É provável que o CA 15-3 seja um biomarcador de gravidade de doença em pacientes com PHc, particularmente quanto a anormalidades nas trocas gasosas.