Interspecific facilitation of micronutrient uptake between cluster-root-bearing trees and non-cluster rooted-shrubs in a Banksia woodland.

Background and aims: Belowground interspecific plant facilitation is supposed to play a key role in enabling species co-existence in hyperdiverse ecosystems in extremely nutrient-poor, semi-arid habitats, such as Banksia woodlands in southwestern-Australia. Manganese (Mn) is readily mobilised by Banksia cluster root activity in most soils and accumulates in mature leaves of native Australian plant species without significant remobilisation during leaf senescence. We hypothesised that neighbouring shrubs are facilitated in terms of Mn uptake depending on distance to surrounding cluster root-forming Banksia trees. Methods: We mapped all Banksia trees and selected neighbouring shrubs within a study site in Western Australia. Soil samples were collected and analysed for physical properties and nutrient concentrations. To assesses the effect of Banksia tree proximity on leaf Mn concentrations [Mn] of non-cluster-rooted woody shrubs, samples of similarly aged leaves were taken. We used multiple linear models to test for factors affecting shrub leaf [Mn]. Results: None of the assessed soil parameters showed a significant correlation with shrub leaf Mn concentrations. However, we observed a significant positive effect of very close Banksia trees (2 m) on leaf [Mn] in one of the understorey shrubs. We found additional effects of elevation and shrub size. Conclusions: Leaf micronutrient concentrations of understorey shrubs were enhanced when growing within 2 m of tall Banksia trees. Our model predictions also indicate that belowground facilitation of Mn uptake was shrub size-dependent. We discuss this result in the light of plant water relations and shrub root system architecture. Supplementary Information: The online version contains supplementary material available at 10.1007/s11104-023-06092-6.

High value-added lignin extracts from sugarcane by-products.

This study evaluates the production of lignin bioactive extracts from sugarcane bagasse (SCB) and straw (SCS) alkaline black liquors using greener precipitating agents (methane sulfonic acid (MSA), formic acid (FA) and lactic acid (LA)) as replacers of sulfuric acid (SA), the most common one used in industry. Results showed that the highest precipitation yield was achieved by LA when applied to SCB (14.5 g extract/100 g SCB). Lignin SCB extracts were similar in composition in terms of total carbohydrates (61-70 %), lignin (22-30 %) and inorganics (1.6-2.6 %). Regarding the SCS extracts, similar yields were obtained among all extracts, however, differences in composition were observed between SA and greener precipitating agents, particularly in terms of sugar content. All extracts exhibited radical scavenging activity; overall the extracts were more effective in the scavenging of ABTS radical. FA was the most promising alternative to SA to recover lignin bioactive extracts. This work suggests organic acids as good candidates for obtaining valuable extracts from alkaline pulping of SCB and SCS instead of the conventional sulfuric acid.

Combined physiological and behavioral approaches as tools to evaluate environmental risk assessment of the water accommodated-fraction of diesel oil.

There is an increasing concern related to the toxic effects of the soluble portion of diesel oil on aquatic ecosystems and the organisms living in them. In this context, the aim of this study was to analyze the effects of diesel water accommodated-fraction (WAF) on behavioral and biochemical responses of mussels Perna perna. Animals were exposed to 5 and 20% of WAF for 96 h. Prior to the beginning of the experiments, Hall effect sensors and magnets were attached to the valves of the mussels. Valve gaping behavior was continuously recorded for 12 h of exposure and tissues (gills and digestive gland) were separated after 96 h of exposure. Overall, both behavior and biochemical biomarkers were altered due to WAF exposure. Animals exposed to WAF reduced the average amplitude of the valves and the fraction of time opened, and presented greater transition frequency, demonstrating avoidance behavior over the 12 h period. Furthermore, the biochemical biomarkers (GSH, GST, SOD and CAT) were altered following the 96 h of exposure to WAF. Considering the results presented, this study demonstrates the toxic potential of WAF in both shorter and longer exposure periods.

Pequi oil (Caryocar brasilense Cambess.) nanoemulsion alters cell proliferation and damages key organelles in triple-negative breast cancer cells in vitro.

Pequi oil is extracted from the fruit of a Brazilian native plant (Caryocar brasiliense Camb) that contains some molecules with anticancer potential. Due to its hydrophobic property, the administration of pequi oil associated with nanoemulsion systems represents a successful strategy to improve oil bioavailability. Breast cancer is the most frequent type of cancer among women and conventional therapies used are frequently associated with several side effects. Thus, the aim of this study was to investigate the effects of pequi oil-based nanoemulsion (PeNE) on triple-negative breast cancer cells (4T1), in vitro. PeNE presented a dose- and time-dependent cytotoxic effect with lower IC50 than free pequi oil after 48 h of exposure (p < 0.001). At 180 µg/mL, PeNE demonstrated numerous cell alterations, when compared to free pequi oil, such as morphological alterations, reduction in cell proliferation and total cell number, damage to plasmatic membrane, induction of lysosomal membrane permeability and depolarization of mitochondrial membrane, alteration of intracellular ROS production and calcium level, and increase in phosphatidylserine exposure. Taken together, the results suggest an interesting induction of cell death mechanisms involving a combined action of factors that impair nucleus, mitochondria, lysosome, and ER function. In addition, more pronounced effects were observed in cells treated by PeNE at 180 µg/mL when compared to free pequi oil, thereby reinforcing the advantages of using nanometric platforms. These promising results highlight the use of PeNE as a potential complementary therapeutic approach to be employed along with conventional treatments against breast cancer in the future.

Nature and Mindfulness to Cope with Work-Related Stress: A Narrative Review.

In recent years, work-related stress has grown exponentially and the negative impact that this condition has on people's health is considerable. The effects of work-related stress can be distinguished in those that affect workers (e.g., depression and anxiety) and those that affect the company (e.g., absenteeism and productivity). It is possible to distinguish two types of prevention interventions. Individual interventions aim at promoting coping and individual resilience strategies with the aim of modifying cognitive assessments of the potential stressor, thus reducing its negative impact on health. Mindfulness techniques have been found to be effective stress management tools that are also useful in dealing with stressful events in the workplace. Organizational interventions modify the risk factors connected to the context and content of the work. It was found that a restorative workplace (i.e., with natural elements) reduces stress and fatigue, improving work performance. Furthermore, practicing mindfulness in nature helps to improve the feeling of wellbeing and to relieve stress. In this paper, we review the role of mindfulness-based practices and of contact with nature in coping with stressful situations at work, and we propose a model of coping with work-related stress by using mindfulness in nature-based practices.

Metal accumulation induces oxidative stress and alters carbonic anhydrase activity in corals and symbionts from the largest reef complex in the South Atlantic ocean.

We evaluated the influence of metal accumulation on the oxidative status [lipid peroxidation (LPO) and total antioxidant capacity (TAC)] and carbonic anhydrase (CA) activity in host and symbionts of the coral Mussismilia harttii and the hydrocoral Millepora alcicornis collected in Abrolhos Reef Banks (Northeast Brazil), potentially impacted by a major mine dam rupture. Considering metal levels measured in reefs worldwide, Abrolhos corals had higher Fe and Mn levels than expected for preserved offshore reefs. Increasing concentrations of arsenic (As), chromium (Cr) and manganese (Mn) drove inhibition of CA and increased oxidative damage in the hydrocoral M. alcicornis. The impairment of enzymatic activity in the symbiotic algae of M. alcicornis may be related to the oxidative stress condition. The hydrocoral M. alcicornis was more affected by metals than the coral M. harttii, which did not show the expected CA inhibition after metal exposure. Our results suggest that CA activity can be applied as a complementary biomarker to evaluate the physiological impacts of environmental metal contamination in reefs. Also, the metal levels and biochemical biomarkers reported in the present study may provide reference data to monitor the health of reefs impacted by a relevant dam rupture.

Chemotherapeutic and Safety Profile of a Fraction from Mimosa caesalpiniifolia Stem Bark.

Mimosa caesalpiniifolia (Fabaceae) is used by Brazilian people to treat hypertension, bronchitis, and skin infections. Herein, we evaluated the antiproliferative action of the dichloromethane fraction from M. caesalpiniifolia (DFMC) stem bark on murine tumor cells and the in vivo toxicogenetic profile. Initially, the cytotoxic activity of DFMC on primary cultures of Sarcoma 180 (S180) cells by Alamar Blue, trypan, and cytokinesis block micronucleus (CBMN) assays was assessed after 72 h of exposure, followed by the treatment of S180-bearing Swiss mice for 7 days, physiological investigations, and DNA/chromosomal damage. DFMC and betulinic acid revealed similar in vitro antiproliferative action on S180 cells and induced a reduction in viable cells, induced a reduction in viable cells and caused the emergence of bridges, buds, and morphological features of apoptosis and necrosis. S180-transplanted mice treated with DFMC (50 and 100 mg/kg/day), a betulinic acid-rich dichloromethane, showed for the first time in vivo tumor growth reduction (64.8 and 80.0%) and poorer peri- and intratumor quantities of vessels. Such antiproliferative action was associated with detectible side effects (loss of weight, reduction of spleen, lymphocytopenia, and neutrophilia and increasing of GOT and micronucleus in bone marrow), but preclinical general anticancer properties of the DFMC were not threatened by toxicological effects, and these biomedical discoveries validate the ethnopharmacological reputation of Mimosa species as emerging phytotherapy sources of lead molecules.

High rate of biological removal of sulfate, organic matter, and metals in UASB reactor to treat synthetic acid mine drainage and cheese whey wastewater as carbon source.

The anaerobic biological treatment of sulfate-rich effluents, such as acid mine drainage (AMD), is mediated by sulfate-reducing bacteria (SRB). This process involves the reduction of sulfates in the presence of an electron donor. Complex carbon compounds can be used as electron donors. In the present study, was used an upflow anaerobic sludge blanket (UASB) reactor to co-treat a low-pH synthetic AMD and cheese whey wastewater (CWW). Were observed higher sulfate and COD removal rates (1,114 ± 88 and 1,214 ± 128 mg L-1  day-1 , respectively) at higher sulfate and applied COD loading rates (1,500 mg L-1  day-1 ). The overall pH of the effluent remained above 6.4 without any bicarbonate supplementation. Almost 100% of the Fe, Zn, and Cu was removed and the presence of metals improved the process. The use of a single reactor to treat AMD and CWW is promising. PRACTITIONER POINTS: Wastewater cheese whey was electron donor for treating acid mine drainage in an UASB reactor. Metals additions in the system indicated an increased removal of COD. About 99% of the metals were removed with the treatment.

Microbiomes of Velloziaceae from phosphorus-impoverished soils of the campos rupestres, a biodiversity hotspot.

The rocky, seasonally-dry and nutrient-impoverished soils of the Brazilian campos rupestres impose severe growth-limiting conditions on plants. Species of a dominant plant family, Velloziaceae, are highly specialized to low-nutrient conditions and seasonal water availability of this environment, where phosphorus (P) is the key limiting nutrient. Despite plant-microbe associations playing critical roles in stressful ecosystems, the contribution of these interactions in the campos rupestres remains poorly studied. Here we present the first microbiome data of Velloziaceae spp. thriving in contrasting substrates of campos rupestres. We assessed the microbiomes of Vellozia epidendroides, which occupies shallow patches of soil, and Barbacenia macrantha, growing on exposed rocks. The prokaryotic and fungal profiles were assessed by rRNA barcode sequencing of epiphytic and endophytic compartments of roots, stems, leaves and surrounding soil/rocks. We also generated root and substrate (rock/soil)-associated metagenomes of each plant species. We foresee that these data will contribute to decipher how the microbiome contributes to plant functioning in the campos rupestres, and to unravel new strategies for improved crop productivity in stressful environments.

Double-Blind, Randomized, Three-Armed, Placebo-Controlled, Clinical Investigation to Evaluate the Benefit and Tolerability of Two Dosages of IQP-AE-103 in Reducing Body Weight in Overweight and Moderately Obese Subjects.

Objective: This study was performed to determine the efficacy and tolerability/safety of IQP-AE-103 on body weight reduction in overweight to moderately obese adults. Methods: A double-blind, randomized, placebo-controlled trial involved one hundred and eight subjects (BMI between 25 and 35 kg/m2) that were randomly assigned to either the low-dose or the high-dose IQP-AE-103 group, or the placebo group. Following a 2-week run-in period, subjects received two capsules of investigational product after three daily main meals for 12 weeks. Subjects were instructed to maintain a nutritionally balanced hypocaloric diet according to the individual's energy requirement. Body weight, body fat, and waist and hip circumference were measured at baseline, and after 2, 4, 8, and 12 weeks. Subjects also rated their feelings of hunger and fullness using visual analogue scales, and food craving on a 5-point scale at the same time intervals. Blood samplings for safety laboratory parameters were taken before and at the end of the study. Results: After 12 weeks of intake, the high-dose IQP-AE-103 group had a significantly greater weight loss compared with the placebo (5.03 ± 2.50 kg vs. 0.98 ± 2.06 kg, respectively; p < 0.001) and the low-dose group (3.01 ± 2.19 kg; p=0.001). The high-dose group experienced a decrease in body fat of 3.15 ± 2.41 kg compared with a decrease of 0.23 ± 2.74 kg for the placebo group (p < 0.001). High-dose IQP-AE-103 also decreased the feeling of hunger in 66% subjects. A beneficial effect of IQP-AE-103 on the lipid metabolism was also demonstrated in the subgroup of subjects with baseline total cholesterol levels above 6.2 mmol/L. No side effects related to the intake of IQP-AE-103 were reported. Conclusions: These findings indicate that IQP-AE-103 could be an effective and safe weight loss intervention. This trial is registered with NCT03058367.

Endophytic Actinomycetes as Potential Producers of Hemicellulases and Related Enzymes for Plant Biomass Degradation

Abstract Tailor made enzymatic preparation must be design to hydrolyze efficiently plant biomass, once that each plant biomass possesses a distinct cell wall composition. Most of actinomycetes used for plant cell wall degradation are focused on the cellulases and xylanases production. However, a wide range of enzymes must be produced for an efficient degradation of lignocellulose materials. During the last decade several unusual environments were studied to obtain strains that produce glycohydrolases with innovator characteristics. In this context, the present work concerned the selection of endophytic actinomycetes as producers of hemicellulases and related enzymes with different enzymatic profiles, for use in the deconstruction of lignocellulosic biomass. A total of 45 Brazilian actinomycetes previously isolated from plants (endophytics) and soil were prospected for hemicellulases and β-glucosidase production. Four strains highlighted for hemicellulase production (DR61, DR63, DR69 and DR66) and were selected for cultivation under other inductors substrates (xylan and pectin). All strains belong to Streptomyces genera and have their extracts tested for degradation of several hemicellulolytic substrates. The strains presented different glicohydrolyse enzymes profiles mainly for xylans and glucans that can be used for specific formulations of enzymes applied on the biomass deconstruction, principally on sugar cane bagasse.

Himatanthus drasticus (Apocynaceae) latex reduces oxidative stress and modulates CD4+, CD8+, FoxP3+ and HSP-60+ expressions in Sarcoma 180-bearing mice.

ETHNOPHARMACOLOGICAL RELEVANCE: In Brazil, latex of Himatanthus drasticus is used to treat inflammation, wound healing and cancer. The present study evaluated the antitumoral potential of H. drasticus latex (HdCL) in Sarcoma 180-bearing mice (S180). MATERIALS AND METHODS: HdCL was obtained in Crato-CE, Brazil. Qualitative phytochemicals assays, nuclear magnetic resonance (NMR) and microbiological analyzes were performed. Swiss mice were divided into six groups, according to tumor forms: 1) ascitic model, GI (Control; 0.9% saline), GII (S180asc) and GIII (S180asc/HdCL/14 days); 2) solid model, GIV (Control; 0.9% saline), GV (S180sol) and GVI (S180sol/HdCL/10 days). HdCL and 0.9% saline were administered at 0.2 mL, SID, by gavage, for 10 or 14 days. For ascitic model, 0.5 mL of S180 suspension (4×106 cells/mL) was inoculated intraperitoneally and for solid model, cells were inoculated subcutaneously (25 µL) on the right hind paw of mice. Blood samples were collected for hematological and oxidative stress evaluation. Thickness, volume and weight of paws were measured in solid model. After euthanasia, spleen, liver and kidney were collected in order to assess the relative organ weight. Tissue fragments of paws and popliteal lymph nodes (PLN) were analyzed by H&E and CD4+, CD8+, HSP-60+ and Foxp3+ immunohistochemistry. RESULTS: HdCL presented milky aspect and pinkish supernatant. Phenols, flavonols, flavanones, free steroids and cinnamoyl derivatives of lupeol, α-amyrin and ß-amyrin were detected at the phytochemistry analysis. HdCL did not alter the relative weight of organs, hematological parameters and volume of ascitic fluid recovered. In solid model, HdCL reduced (P < 0.05) paw volume, but did not altered thickness, paw weight and histological parameters. S180sol induced necrosis, metastasis and destruction of bone, cartilage and muscles. Bleeding, vessel congestion and oncocytes were observed in PLN. In paw, HdCL did not alter FoxP3+ and HSP-60+ expressions but reduced the CD4+ and CD8+ expressions, while at PLN, HdCL reduced the expressions of all markers. HdCL decreased (P < 0.05) serum levels of malondialdehyde in ascitic model. CONCLUSIONS: Treatment with HdCL reduced oxidative damage and modulated the expressions of CD4+, CD8+, FoxP3+and HSP-60+ in S180 solid tumor model, which can be associated to the presence of triterpenes, such as α-amyrin, ß-amyrin and lupeol cinnamate. Present data emphasizes the importance of immune system in cancer and highlights the evaluation of the pharmacological properties of plants used by population as phytoterapics.

Metabolic profile and biological activities of Lavandula pedunculata subsp. lusitanica (Chaytor) Franco: studies on the essential oil and polar extracts.

We investigated the metabolic profile and biological activities of the essential oil and polar extracts of Lavandula pedunculata subsp. lusitanica (Chaytor) Franco collected in south Portugal. Gas chromatography-mass spectrometry (GC-MS) analysis revealed that oxygen-containing monoterpenes was the principal group of compounds identified in the essential oil. Camphor (40.6%) and fenchone (38.0%) were found as the major constituents. High-performance liquid chromatography with diode array detection (HPLC-DAD) analysis allowed the identification of hydroxycinnamic acids (3-O-caffeoylquinic, 4-O-caffeoylquinic, 5-O-caffeoylquinic and rosmarinic acids) and flavones (luteolin and apigenin) in the polar extracts, with rosmarinic acid being the main compound in most of them. The bioactive compounds from L. pedunculata polar extracts were the most efficient free-radical scavengers, Fe(2+) chelators and inhibitors of malondialdehyde production, while the essential oil was the most active against acetylcholinesterase. Our results reveal that the subspecies of L. pedunculata studied is a potential source of active metabolites with a positive effect on human health.

Inhibition of metastatic potential of B16-F10 melanoma cell line in vivo and in vitro by biflorin.

AIM: The aim of this study was to determine the antimetastatic potential of biflorin using in vivo and in vitro approaches. MAIN METHODS: Biflorin was isolated from Capraria biflora collected in Fortaleza, Ceará, Brazil. Adhesion, migration and invasion assays were performed to avail of the antimetastatic potential of this quinone. Experimental metastasis was performed to avail of the antimetastatic potential of bilflorin using in vivo assay. KEY FINDINGS: Treatment with biflorin (25 and 50mg/kg/day) was shown to be effective in reducing B16-F10 melanoma metastasis in C57BL/6 mice. The administration of biflorin at 25mg/kg/day intraperitoneally inhibited the formation of metastases by about 57% compared to untreated control animals. When the animals were treated with 50mg/kg/day intraperitoneally, there was a 71% decrease in the number of lung metastases. Morphological assays showed the presence of hemosiderin and erythrocytes in the lung parenchyma, indicating the occurrence of hemorrhage, probably a side effect of biflorin. Biflorin at non-toxic concentrations (0.5, 1.0 and 1.5g/mL) was tested directly on B16-F10 cells in vitro, and it inhibited cell adhesion to type I collagen and cell motility using the wound-healing assay. SIGNIFICANCE: These data suggest that biflorin has a promising antimetastatic potential, as shown by its anti-adhesion, anti-migration and anti-invasion properties against a metastatic melanoma cell line. However, further studies are essential to elucidate its mechanism of action.

Accumulation of phenolic compounds in in vitro cultures and wild plants of Lavandula viridis L'Hér and their antioxidant and anti-cholinesterase potential.

In this study, we evaluated the phenolic profile, antioxidant and anti-cholinesterase potential of different extracts from wild plants and in vitro cultures of Lavandula viridis L'Hér. The HPLC-DAD analysis allowed the identification and quantification of 3-O-caffeoylquinic, 4-O-caffeoylquinic, 5-O-caffeoylquinic and rosmarinic acids, and luteolin and pinocembrin. Water/ethanol extract from in vitro cultures contained the highest amount of the identified phenolic compounds (51652.92 mg/kg). To investigate the antioxidant activity we used Trolox equivalent antioxidant capacity, oxygen radical absorbance capacity, Fe(2+) chelation activity and the inhibition of Fe(2+)-induced lipid peroxidation in mouse brain homogenates (in vitro). Overall, all the extracts from both wild plants and in vitro cultures exhibited ability to scavenge free radicals, to chelate Fe(2+) and to protect against lipid peroxidation. In addition, the extracts from L. viridis were active in inhibiting both acetylcholinesterase and butyrylcholinesterase (Ellman's method). Our findings suggest that L. viridis in vitro cultures represent a promising alternative for the production of active metabolites with antioxidant and anti-cholinesterase activity.

Thymus lotocephalus wild plants and in vitro cultures produce different profiles of phenolic compounds with antioxidant activity.

We compared the phenolic metabolites and antioxidant activities of Thymus lotocephalus G. López & R. Morales wild plants and in vitro cultures using different extraction solvents. HPLC-DAD analysis allowed the identification and quantification of phenolic (caffeic and rosmarinic) acids and flavones (luteolin and apigenin) in extracts from both sources. The in vitro cultures accumulated large amounts of rosmarinic acid. However, extracts from both sources were able to neutralise free radicals in different test systems (TEAC and ORAC assays), to form complexes with Fe(2+) and to protect mouse brains against Fe(2+)-induced lipid peroxidation. The solvent significantly influenced the phenolic content and antioxidant activity of the extracts, water/ethanol being the most efficient for the extraction of antioxidant phytochemicals. We conclude that in vitro cultures of T. lotocephalus represent a promising alternative for the production of valuable natural antioxidants and an efficient tool for the in vitro biosynthesis of rosmarinic acid, therefore avoiding the need to exploit populations of wild plants.

Treinamento muscular respiratório na revascularização do miocárdio / Respiratory muscle training in patients submitted to coronary arterial bypass graft

OBJETIVOS: 1) Evidenciar a perda de capacidade ventilatória no período de pós-operatório, em pacientes submetidos à revascularização do miocárdio. 2) Testar a hipótese de que o treinamento muscular respiratório (TMR), realizado após a cirurgia, pode melhorar a capacidade ventilatória nessa população. MÉTODOS: Estudo randomizado, onde 38 pacientes (idade: 65 ± 7 anos, 29 masculinos), submetidos à revascularização miocárdica com circulação extracorpórea, foram divididos em dois grupos: 23 pacientes no grupo TMR e 15 no grupo controle (CO). O grupo TMR realizou fisioterapia convencional + TMR, o grupo CO realizou apenas fisioterapia convencional. Avaliaram-se, em três momentos (pré-operatório, primeiro dia de pós-operatório e alta hospitalar), as variáveis: pressões inspiratória e expiratória máximas (Pimáx e Pemáx), dor, dispneia (Borg), pico de fluxo expiratório (PFE), volume corrente e dias de internação. RESULTADOS: A Pimáx do grupo TMR foi maior no momento da alta (90 ± 26 vs. 55 ± 38 cmH2O, P=0,01), assim como a Pemáx (99 ± 30 vs. 53 ± 26 cmH2O, P=0,02). O PFE do grupo TMR foi maior após a internação (237 ± 93 vs. 157 ± 102 lpm, P=0,02). O volume corrente dos grupos foi também diferente no momento da alta (TMR: 0,71 ± 0,21 vs. CO: 0,44 ± 0,12 litros, P=0,00). Não houve diferenças entre os grupos com relação aos dias de internação, dispneia ou dor. CONCLUSÕES: Ocorre perda de força muscular respiratória em pacientes submetidos à revascularização miocárdica. O TMR, realizado no período pós-operatório, foi eficaz em restaurar os seguintes parâmetros: Pimáx, Pemáx, PFE e volume corrente, nessa população.

OBJECTIVES: 1) To demonstrate the impaired ventilatory capacity during the post operatory period, in patients submitted to coronary arterial bypass graft surgery (CABG). 2) To test the hypothesis that the respiratory muscle training (RMT), performed after the surgery, may increase the ventilatory capacity in this population. METHODS: Thirty-eight patients (age: 65±7 years, 29 male), whose underwent CABG with extra-corporeal circulation. Patients were randomized in two groups: 23 patients in the RMT group and 15 in the control group (CO). RMT group received conventional physiotherapy plus RMT. The CO group received the conventional physiotherapy. Evaluated parameters: maximum inspiratory and expiratory pressures (MIP) (MEP), dyspnea (Borg), peak expiratory flow (PEF), pain, tidal volume and hospitalization days. Measures were performed at pre, first post operatory day and also at the patients discharge from the hospital). RESULTS: MIP and MEP in the RMT group were higher when compared with CO at the patients discharge (MIP: 90±26 vs. 55±38 cmH2O, P=0.01) (MEP: 99±30 vs. 53±26 cmH2O, P=0.02). The PEF was higher after hospitalization in the RMT group (237±93 vs. 157±102 lpm, P=0.02). Tidal volume was also higher in the RMT group at discharge (0.71±0.21 vs. 0.44±0.12 liters, P=0,00). No differences were observed among the groups in the aspects: admission days, dyspnea and pain. CONCLUSIONS: Patients submitted to CABG presents an impaired respiratory muscle strength in their post operatory. RMT performed in this phase was effective to restore the ventilatory capacity in the following parameters: MIP, MEP, PEF and tidal volume, in this group of patients.

Respiratory muscle training in patients submitted to coronary arterial bypass graft.

OBJECTIVES: 1) To demonstrate the impaired ventilatory capacity during the post operatory period, in patients submitted to coronary arterial bypass graft surgery (CABG). 2) To test the hypothesis that the respiratory muscle training (RMT), performed after the surgery, may increase the ventilatory capacity in this population. METHODS: Thirty-eight patients (age: 65 ± 7 years, 29 male), whose underwent CABG with extra-corporeal circulation. Patients were randomized in two groups: 23 patients in the RMT group and 15 in the control group (CO). RMT group received conventional physiotherapy plus RMT. The CO group received the conventional physiotherapy. Evaluated parameters: maximum inspiratory and expiratory pressures (MIP) (MEP), dyspnea (Borg), peak expiratory flow (PEF), pain, tidal volume and hospitalization days. Measures were performed at pre, first post operatory day and also at the patients discharge from the hospital). RESULTS: MIP and MEP in the RMT group were higher when compared with CO at the patients discharge (MIP: 90 ± 26 vs. 55 ± 38 cmH2O, P = 0.01) (MEP: 99 ± 30 vs. 53 ± 26 cmH2O, P = 0.02). The PEF was higher after hospitalization in the RMT group (237 ± 93 vs. 157 ± 102 lpm, P=0.02). Tidal volume was also higher in the RMT group at discharge (0.71 ± 0.21 vs. 0.44 ± 0.12 liters, P = 0,00). No differences were observed among the groups in the aspects: admission days, dyspnea and pain. CONCLUSIONS: Patients submitted to CABG presents an impaired respiratory muscle strength in their post operatory. RMT performed in this phase was effective to restore the ventilatory capacity in the following parameters: MIP, MEP, PEF and tidal volume, in this group of patients.

Desafios da regulação no Brasil / Challenges of regulation in Brazil

O presente trabalho tem por objetivo apresentar a visão da Associação Brasileira de Agências de Regulação (Abar) quanto aos desafios da regulação no Brasil. Tal visão tem a finalidade de propor uma reflexão sobre as condutas das agências reguladoras, depois de pouco mais de 10 anos de seu surgimento na administração pública brasileira, no formato de entidades independentes.

[Intraoperative adjustable strabismus surgery under drop anesthesia in patients with Graves' orbitopathy]. / Cirurgia de estrabismo ajustável no peroperatório com anestesia tópica em pacientes com orbitopatia de Graves.

PURPOSE: To report the clinical features of strabismus associated with Graves' orbitopathy, and the results of surgery with adjustable suture under drop anesthesia. METHODS: The charts of 13 patients who had surgical treatment for strabismus related to Graves' orbitopathy at Hospital das Clínicas of University of São Paulo were retrospectively reviewed. Ocular motility, sensorial examination and the follow-up after strabismus correction were studied. RESULTS: Preoperatively, the most common type of deviation was esotropia with hypotropia. Adjustable recession was done in nine patients and a second surgery occurred in 3 patients. After follow-up of at least six months, 8 of 13 patients were orthotropic or had a small phoria with some degree of binocular vision. CONCLUSION: In this study, 62% (8/13) of patients showed hypotropia with esotropia, probably because fibrotic and restrictive muscles (medial and inferior rectus). In nine of 13 patients adjustable recession with a good postoperative alignment of the eyes was performed. Adjustment of strabismus surgery under drop anesthesia in patients with Graves' orbitopathy was successful in restoring binocular vision with minimum complications.