Dual-Energy CT-based Opportunistic Volumetric Bone Mineral Density Assessment of the Distal Radius.

Background In patients with distal radius fractures (DRFs), low bone mineral density (BMD) is associated with bone substitute use during surgery and bone nonunion, but BMD information is not regularly available. Purpose To evaluate the feasibility of dual-energy CT (DECT)-based BMD assessment from routine examinations in the distal radius and the relationship between the obtained BMD values, the occurrence of DRFs, bone nonunion, and use of surgical bone substitute. Materials and Methods Scans in patients who underwent routine dual-source DECT in the distal radius between January 2016 and December 2021 were retrospectively acquired. Phantomless BMD assessment was performed using the delineated trabecular bone of a nonfractured segment of the distal radius and both DECT image series. CT images and health records were examined to determine fracture severity, surgical management, and the occurrence of bone nonunion. Associations of BMD with the occurrence of DRFs, bone nonunion, and bone substitute use at surgical treatment were examined with generalized additive models and receiver operating characteristic analysis. Results This study included 263 patients (median age, 52 years; IQR, 36-64 years; 132 female patients), of whom 192 were diagnosed with fractures. Mean volumetric BMD was lower in patients who sustained a DRF (93.9 mg/cm3 vs 135.4 mg/cm3; P < .001), required bone substitutes (79.6 mg/cm3 vs 95.5 mg/cm3; P < .001), and developed bone nonunion (71.1 mg/cm3 vs 96.5 mg/cm3; P < .001). Receiver operating characteristic curve analysis identified these patients with an area under the curve of 0.71-0.91 (P < .001). Lower BMD increased the risk to sustain DRFs, develop bone nonunion, and receive bone substitutes at surgery (P < .001). Conclusion DECT-based BMD assessment at routine examinations is feasible and could help predict surgical bone substitute use and the occurrence of bone nonunion in patients with DRFs. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Carrino in this issue.

Phytochemical and biological characterization of aqueous extract of Vassobia breviflora on proliferation and viability of melanoma cells: involvement of purinergic pathway.

Vassobia breviflora belongs to the Solanaceae family, possessing biological activity against tumor cells and is a promising alternative for therapy. The aim of this investigation was to determine the phytochemical properties V. breviflora using ESI-ToF-MS. The cytotoxic effects of this extract were examined in B16-F10 melanoma cells and the relationship if any to purinergic signaling was involved. The antioxidant activity of total phenols, (2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) was analyzed, as well as production of reactive oxygen species (ROS) and nitric oxide (NO) was determined. Genotoxicity was assessed by DNA damage assay. Subsequently, the structural bioactive compounds were docked against purinoceptors P2X7 and P2Y1 receptors. The bioactive compounds found in V. breviflora were N-methyl-(2S,4 R)-trans-4-hydroxy-L-proline, calystegine B, 12-O-benzoyl- tenacigenin A and bungoside B. In vitro cytotoxicity was demonstrated at concentration ranges of 0.1-10 mg/ml, and plasmid DNA breaks only at the concentration of 10 mg/ml. V. breviflora extracts affected hydrolysis by ectoenzymes, such as ectonucleoside triphosphate diphosphohydrolase (E-NTPDase) and ectoadenosine deaminase (E-ADA) which control levels of degradation and formation of nucleosides and nucleotides. In the presence of substrates ATP, ADP, AMP and adenosine, the activities of E-NTPDase, 5´-NT or E-ADA were significantly modulated by V. breviflora. N-methyl-(2S,4 R)-trans-4-hydroxy-L-proline presented higher binding affinity (according to receptor-ligand complex estimated binding affinity as evidenced by ∆G values) to bind to both P2X7 and P2Y1purinergic receptors.Our results suggest a putative interaction of V. breviflora bioactive compounds with growth inhibitory potential in B16-F10 melanoma and suggest that may be considered as promising compounds in melanoma and cancer treatment.

Spatiotemporal distribution, trend, forecast, and influencing factors of transboundary and local air pollutants in Nagasaki Prefecture, Japan.

The study of PM2.5 and NO2 has been emphasized in recent years due to their adverse effects on public health. To better understand these pollutants, many studies have researched the spatiotemporal distribution, trend, forecast, or influencing factors of these pollutants. However, rarely studies have combined these to generate a more holistic understanding that can be used to assess air pollution and implement more effective strategies. In this study, we analyze the spatiotemporal distribution, trend, forecast, and factors influencing PM2.5 and NO2 in Nagasaki Prefecture by using ordinary kriging, pearson's correlation, random forest, mann-kendall, auto-regressive integrated moving average and error trend and seasonal models. The results indicated that PM2.5, due to its long-range transport properties, has a more substantial spatiotemporal variation and affects larger areas in comparison to NO2, which is a local pollutant. Despite tri-national efforts, local regulations and legislation have been effective in reducing NO2 concentration but less effective in reducing PM2.5. This multi-method approach provides a holistic understanding of PM2.5 and NO2 pollution in Nagasaki prefecture, which can aid in implementing more effective pollution management strategies. It can also be implemented in other regions where studies have only focused on one of the aspects of air pollution and where a holistic understanding of air pollution is lacking.

Ethyl Acetate Fraction of Harpagophytum procumbens Prevents Oxidative Stress In Vitro and Amphetamine-Induced Alterations in Mice Behavior.

Microglial activation has been associated to the physiopathology of neurodegenerative diseases, such as schizophrenia, and can occur during inflammation and oxidative stress. Pharmacological treatment is associated with severe side effects, and studies for use of plant extracts may offer alternatives with lower toxicity. Harpagophytum procumbens (HP) is a plant known for its anti-inflammatory properties. In the present study, we characterized the ethyl acetate fraction of HP (EAF HP) by ESI-ToF-MS and investigated the effects EAF HP in a lipopolysaccharide (LPS) induced inflammation model on microglial cells (BV-2 lineage). MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), DCFH-DA (2',7'-dichlorofluorescein diacetate) and cell cycle flow cytometer analysis were performed. In vivo was investigated the amphetamine-induced psychosis model through behavioral (locomotor and exploratory activities, stereotypies and working memory) and biochemical (DCFH-DA oxidation and protein thiols) parameters in cortex and striatum of mice. EAF HP reduced activation and proliferation of microglial cells in 48 h (300 µg/mL) and in 72 h after treatments (50-500 µg/mL). Reactive oxygen species levels were lower at the concentration of 100 µg/mL EAF HP. We detected a modulatory effect on the cell cycle, with reduction of cells in S and G2/M phases. In mice, the pre-treatment with EAF HP, for 7 days, protected against positive and cognitive symptoms, as well as stereotypies induced by amphetamine. No oxidative stress was observed in this amphetamine-induced model of psychosis. Such findings suggest that EAF HP can modulate the dopaminergic neurotransmission and be a promising adjuvant in the treatment of locomotor alterations, cognitive deficits, and neuropsychiatric disorders.

Prenatal restraint stress downregulates the hypothalamic kisspeptidergic system transcripts genes, reduces the estrogen plasma levels, delayed the onset of puberty, and reduced the sexual behavior intensity in female rats.

AIMS: This study investigated the possible relationships between the expression of the Kiss1 and Gpr54 gene expressions and the pituitary-gonadal hormones with the female onset of puberty and sexual behavior. The Kiss1 and Gpr54 gene expressions were examined because they are critical to controlling the hypothalamic activation of GnRH neurons and, in turn, the pituitary-gonadal hormones related to the early onset of puberty and sexual behavior. Further, it was evaluated that the pituitary and gonadal hormones involved in the vaginal opening and the expression of sexual behavior. METHODS: Pregnant rats exposed to PRS from gestation days 17 to 20 were evaluated for maternal and open-field behaviors. The maternal behavior was analyzed because it may alter brain sexual organization affecting the pups development. It was observed in female pups the physical and development and, in adult age, the open-field behavior, the anxiety-like behavior, the estrous cycle, the sexual behavior, the serum FSH, LH, estrogen, progesterone, and testosterone levels, and the gene expression of kisspeptin protein (Kiss1) and Gpr54 in the hypothalamus. RESULTS: the maternal and open-field behaviors were unaffected. In the F1 generation, PRS reduced weight at weaning, delayed the day of the vaginal opening and reduced the intensity of lordosis, the estrogen levels, and the Kiss1 and Gpr54 gene expression. These effects were attributed to hypothalamic kisspeptidergic system downregulation of transcripts genes and the reduced estrogen levels affected by the PRS.

Detection of new phytochemical compounds from Vassobia breviflora (Sendtn.) Hunz: antioxidant, cytotoxic, and antibacterial activity of the hexane extract.

Vassobia breviflora (Sendtn.) Hunz is a plant of the Solanaceae family from South America and there are no apparent studies reported on the biological activity of the hexane extract. The aim of this investigation was to conduct phytochemical analyses using ESI-TOF-MS, while antioxidant activities were evaluated by the following methods 1,1-diphenyl-2-picrylhydrazyl (DPPH) 2,2"-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) radical capture (ABTS), ferric reducing antioxidant power (FRAP), total antioxidant capacity (TAC), and total oxidant status (TOS). Antimicrobial activities were performed by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and antibiofilm formed. Cytotoxicity was measured by MTT and dsDNA PicoGreen tests, beyond the production of reactive oxygen species (ROS) determined by Dichlorodihydrofluorescein diacetate (DCFH-DA). The hexane extract showed the presence of 5 (choline, pantothenic acid, calystegine B, lanciphodylactone I, and 15"-cis-zeaxanthin) compounds detected. V. breviflora extract demonstrated reliable results utilizing different antioxidant methods. In antibacterial activity, V. breviflora extract exhibited inhibitory, bactericidal, and antibiofilm action in biofilm-forming bacteria. The hexane extract exhibited cytotoxicity against melanoma, lung cancer, glioblastoma, leukemia, uterine colon, and hepatocarcinoma tumor cells. In addition, all tested strains resulted in increased production of ROS. This plant extract may be considered in future as an alternative for development of new therapeutic options aimed at the treatment of diverse pathologies.

Insights of ethyl acetate fraction from Vassobia breviflora in multidrug-resistant bacteria and cancer cells: from biological to therapeutic.

Cancer and infectious diseases are among the leading causes of death in the world. Despite the diverse array of treatments available, challenges posed by resistance, side effects, high costs, and inaccessibility persist. In the Solanaceae plant family, few studies with Vassobia breviflora species relating to biological activity are known, but promising results have emerged. The phytochemicals present in the ethyl acetate fraction were obtained using ESI-MS-QTOF, and the antioxidants assays 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) radical capture (ABTS), plasma ferric reduction capacity (FRAP), and total antioxidant capacity (TAC). Cytotoxic activity was evaluated by MTT, Neutral Red, and lactate dehydrogenase (LDH) released. The production of reactive oxygen species, nitric oxide, and purinergic enzymes was also investigated. Antibacterial activity was measured through minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and antibiofilm activity, in addition to genotoxicity in plasmid DNA. Five major masses were identified D-glucopyranose II, allyl disulfide, γ-lactones, pharbilignoside, and one mass was not identified. V. breviflora exhibited relevant antioxidant and cytotoxic activity against the HeLa cell line and enhanced expression effect in modulation of purinergic signaling. Antibacterial activities in the assays in 7 ATCC strains and 8 multidrug-resistant clinical isolates were found. V. breviflora blocked biofilm formation in producing bacteria at the highest concentrations tested. However, there was no plasmid DNA cleavage at the concentrations tested. Data demonstrated that V. breviflora exhibited an antioxidant effect through several methods and proved to be a promising therapeutic alternative for use against tumor cells via purinergic signaling and multidrug-resistant microorganisms, presenting an anti-biofilm effect.

Changes in antiparasitical activity of gold nanorods according to the chosen synthesis.

Gold nanorods (GNRs) are increasingly being studied for diagnostic and therapeutic purposes. Green synthesis based methods with natural compounds as additives stand out as a hope in terms of better synthesis methodology, with advantages of producing potentially less toxic and, perhaps, biologically active GNRs due to influence of natural additives used during synthesis. Exploring green chemistry using different natural phenolic compounds, the present work reveals different in vitro activity of GNRs evaluated against different parasites that causes skin infectious diseases compared to GNRs produced by convencional seed mediated method. This approach brings advantages in producing active GNRs, with ease calling, less cytotoxic and with a better selectivity index (SI) than GNRs synthesized by conventional seed mediated synthesis, opening new possibilities for therapies. Natural compounds used in green syntheses were gallic acid (GA), resveratrol (RSV) and a purified fraction of the hydroalcoholic extract of Stryphnodendron obovatum. GNRs exhibited great activity against Leishmania braziliensis, and the dermatophytes Tricophyton rubrum, T. interdigitale and Microsporum gypseum. The anti-Leishmania and antidermatophytic activity of GNRs reinforce the applicability of GNRs in biomedical field and the influence of synthesis method in biological activity, showing benefits related to the seedless synthesis with natural compounds. In addition, these preliminary results indicate the possibility of exploring at maximum the physical and chemical properties of GNRs in addition to the biological activity itself, such as the development of topical antiparasitic formulations for association with phototherapy.

Amazonian Guarana- and Açai-Conjugated Extracts Improve Scratched Fibroblast Healing and Eisenia fetida Surgical Tail Amputation by Modulating Oxidative Metabolism.

Background: Previous studies have suggested that guarana (Paullinia cupana) and açai (Euterpe oleracea) have antioxidant, anti-inflammatory, and proliferative properties, indicating their potential therapeutic action in wound healing. We produced a conjugated guarana-açai (GA) extract and tested its healing action on earthworms (Eisenia fetida) subjected to tail amputation by surgical incision. Methods: Extract from roasted guarana seeds and fresh açai seed berries was produced. The antioxidant and genoprotective capacity of GA extract was tested. The concentration with the most remarkable healing potential was used in subsequent tests. The last three posterior segments of the clitellate earthworm tail reared under standardized conditions were surgically amputated. Next, topical PBS or GA extract was applied to the surgical wound. The rate of cell migration and tissue regeneration at the local wound site was histologically evaluated after the procedure. Expression of the SOX4 gene that acts in epithelial-to-mesenchymal transition was determined by RT-qPCR. Results: Sixteen bioactive molecules, including some previously described substances, were identified. All tested concentrations exhibited antioxidant and genoprotective effects. The GA extract accelerated the healing processes as observed through macroscopic and histological analyses and increased expression of SOX4. Conclusion: The GA extract has a potential role in the healing of surgically induced wounds.

Short- and long-term follow-up of patients with non-neoplastic esophageal perforation.

PURPOSE: Esophageal perforation is associated with high morbidity and mortality. In addition to surgical treatment, endoscopic endoluminal stent placement and endoscopic vacuum therapy (EVT) are established methods in the management of this emergency condition. Although health-related quality of life (HRQoL) is becoming a major issue in the evaluation of any therapeutic intervention, not much is known about HRQoL, particularly in the long-term follow-up of patients treated for non-neoplastic esophageal perforation with different treatment strategies. The aim of this study was to evaluate patients' outcome after non-neoplastic esophageal perforation with focus on HRQoL in the long-term follow-up. METHODS: Patients treated for non-neoplastic esophageal perforation at the University Hospital Cologne from January 2003 to December 2014 were included. Primary outcome and management of esophageal perforation were documented. Long-term quality of life was assessed using the Gastrointestinal Quality of Life Index (GIQLI), the Health-Related Quality of Life Index (HRQL) for patients with gastroesophageal reflux disease (GERD), and the European Organization for Research and Treatment of Cancer (EORTC) questionnaires for general and esophageal specific QoL (QLQ-C30 and QLQ-OES18). RESULTS: Fifty-eight patients were included in the study. Based on primary treatment, patients were divided into an endoscopic (n = 27; 46.6%), surgical (n = 20; 34.5%), and a conservative group (n = 11; 19%). Short- and long-term outcome and quality of life were compared. HRQoL was measured after a median follow-up of 49 months. HRQoL was generally reduced in patients with non-neoplastic esophageal perforation. Endoscopically treated patients showed the highest GIQLI overall score and highest EORTC general health status, followed by the conservative and the surgical group. CONCLUSION: HRQoL in patients with non-neoplastic esophageal perforation is reduced even in the long-term follow-up. Temporary stent or EVT is effective and provides a good alternative to surgery, not only in the short-term but also in the long-term follow-up.

Acute oral toxicity, antinociceptive and antimicrobial activities of kava dried extracts and synthetic kavain.

Piper methysticum G. Forst, popularly known as kava, is a traditional medicinal plant widely used for the treatment of anxiety and insomnia. The aim of this study was to investigate new therapeutic applications of this plant. Nociceptive response induced by heat (hot-plate) was used as pain model. Susceptibility of different strains to kava ethanolic dried extracts was evaluated by broth microdilution method. Acute oral toxicity was performed according to Organisation for Economic Cooperation and Development (OECD) guideline. Administration of kava dried extracts and kavain inhibited the nociceptive response in the hot-plate model and did not affect the time mice spent in the rota-rod apparatus. The samples showed no significant antibacterial activity, however slight antifungal activity was verified. The extracts may be considered of low oral acute toxicity. Kava extracts exhibited promising antinociceptive activity in model of nociceptive pain, which should be deeper explored as a new therapeutic application of kava.

[Structured reporting and artificial intelligence]. / Strukturierte Befundung und künstliche Intelligenz.

BACKGROUND: There are a multitude of application possibilities of artificial intelligence (AI) and structured reporting (SR) in radiology. The number of scientific publications have continuously increased for many years. There is an extensive portfolio of available AI algorithms for, e.g. automatic detection and preselection of pathologic patterns in images or for facilitating the reporting workflows. Even machines already use AI algorithms for improvement of operating comfort. METHOD: The use of SR is essential especially for the extraction of automatically evaluable semantic data from radiology results reports. Regarding eligibility in certification processes, the use of SR is mandatory for the accreditation of the German Cancer Society as an oncological center or outside Germany, such as the European Cancer Center. RESULTS: The data from SR can be automatically evaluated for the purpose of patient care, research and educational purposes and quality assurance. Lack of information and a high degree of variability often hamper the extraction of valid information from free-text reports using neurolinguistic programming (NLP). Against the background of supervised training, AI algorithms or k­nearest neighbors (KNN) require a considerable amount of validated data. The semantic data from SR can also be processed by AI and used for training. CONCLUSION: The AI and SR are separate entities within the field of radiology with mutual dependencies and significant added value. Both have a high potential for profound upcoming changes and further developments in radiology.

Phytochemical characterization and antimicrobial activity of Cymbopogon citratus extract for application as natural antioxidant in fresh sausage.

The development of natural additives is considered an important research topic. In this work, the use of Cymbopogon citratus (CC) extract as a natural additive for chicken sausage refrigerated was investigated. The CC extract was characterized by electrospray ionization with high-resolution time-of-flight mass spectrometry (ESI-ToF-MS) and the identified compounds were directly related to the antioxidant activity demonstrated by CC in the fresh sausage. In total, 31 phytochemical compounds were identified, and 27 of these still were not described in the literature for CC. The antimicrobial activity showed that CC extract is a potential antibacterial agent. Besides, the results showed that CC extract reduced lipid oxidation compared to synthetic additive. The sensorial characteristics were maintained, demonstrating good acceptability by the consumer. The results confirmed that CC can keep the quality of chicken sausage refrigerated for up to 42 days of storage.

Espiritualidade e resiliência na atenção domiciliar / Spirituality and resilience in home care / Espiritualidad y resiliencia en la atención domiciliaria

Introdução: A atenção domiciliar (AD) caracteriza-se por práticas de cuidado que realizam abordagem integral do paciente em seu contexto familiar, socioeconômico e cultural. Religiosidade e espiritualidade atuam como mecanismos de fortalecimento da resiliência. Objetivo: Avaliar a relação entre religiosidade e espiritualidade com resiliência em pacientes em AD de Unidades de Saúde de Atenção Primária à Saúde (US-APS) de Porto Alegre (RS), Brasil. Métodos: estudo quantitativo transversal e descritivo, incluindo 44 adultos de quatro US-APS em AD por condições crônicas e problemas de saúde controlados/compensados com alguma dependência para atividades da vida diária. Foram utilizadas escalas de religiosidade (DUREL), espiritualidade (ARES), resiliência (RS-14), funcionalidade (Katz), sintomas depressivos (PHQ-2), suporte social (mMOS-SS), classificação econômica (ABEP 2016) e grau de severidade das condições clínicas (CIRS-G). Resultados: Pacientes avaliados são majoritariamente de sexo feminino (72,7 %), idosas (média 74 anos), viúvas, brancas, de baixo estrato socioeconômico, baixa escolaridade, aposentadas, com tempo médio de 7,5 anos de restrição domiciliar e grau moderado de resiliência. Os entrevistados apresentam altos índices de religiosidade e espiritualidade, sendo que 90,9% apresentam alta religiosidade intrínseca e 79,6% realizam práticas religiosas privadas uma ou mais vezes ao dia. A maioria (88,6%) considera importante que sua religiosidade e espiritualidade seja abordada em seus atendimentos de saúde, mas somente 20,5% já foram questionados sobre tal temática. Resiliência associou-se à maior espiritualidade (B=0,44; p=0,02), controlando-se este efeito para suporte social e sintomas depressivos; e à maior idade (B=0,18; p=0,02). Conclusão: O estudo corrobora a relevância da dimensão de religiosidade e espiritualidade e indica seu papel na promoção de resiliência nesta população em AD. Recomenda-se a abordagem da religiosidade e espiritualidade com esses indivíduos, fortalecendo o cuidado integral preconizado pela APS.

Introduction: Home Care (HC) is characterized by practices that perform integral approach of the patient in their family, socioeconomic and cultural context. Religiosity and spirituality as mechanisms for strengthening resilience. Objective: To evaluate the relationship between religiosity and spirituality with resilience in HC patients from Primary Health Care Units (PHC-U) of Porto Alegre (RS), Brazil. Methods: Cross-sectional and descriptive quantitative study including 44 adults from four PHC-U in HC due to chronic conditions and controlled/compensated health problems with some dependence on activities of daily living. We used religiousness (DUREL), spirituality (ARES), resilience (RS-14), functionality (Katz), depressive symptoms (PHQ-2), social support (mMOS-SS), economic classification (ABEP 2016) and severity of clinical conditions (CIRS-G) scales. Results: Most of the evaluated patients were female (72.7%), elderly (average 74 years), widows, white, low socioeconomic status, low education, retired, with an average time of 7.5 years of home restriction and with moderated degree of resilience. Respondents have high religiosity and spirituality rates, with 90.9% presenting high intrinsic religiosity and 79.6% performing private religious practices one or more times a day. Most (88.6%) consider important that their religiosity and spirituality is addressed in their health care, but only 20.5% have been asked about it. Resilience was associated with higher spirituality (B=0,44; p=0,02), controlling this effect for social support and depressive symptoms; and older age (B=0,18; p=0,02). Conclusion: The study corroborates the relevance of the religiosity and spirituality dimension and indicates its role in promoting resilience in this population in HC. The approach to religiosity and spirituality with these individuals is recommended, strengthening the integral care recommended by PHC.

Introducción: la atención domiciliaria (AD) se caracteriza por prácticas de atención que realizan un enfoque integral del paciente en su contexto familiar, socioeconómico y cultural. La religiosidad y la espiritualidad actúan como mecanismos para fortalecer la resiliencia. Objetivo: evaluar la relación entre la religiosidad y la espiritualidad con resiliencia en pacientes en AD de las Unidades de Salud de la Atención Primaria a la Salud (US-APS) de Porto Alegre (RS), Brasil. Métodos: estudio cuantitativo descriptivo y transversal que incluyó a 44 adultos de cuatro US-APS en AD debido a afecciones crónicas y problemas de salud controlados/compensados con cierta dependencia de las actividades de la vida diaria. Utilizamos escalas de religiosidad (DUREL), espiritualidad (ARES), resiliencia (RS-14), funcionalidad (Katz), síntomas depresivos (PHQ-2), apoyo social (mMOS-SS), clasificación económica (ABEP 2016) y gravedad de las condiciones clínicas (CIRS - G). Resultados: la mayoría de los pacientes evaluados eran mujeres (72.7%), ancianas (edad promedio 74 años), viudas, blancas, de bajo nivel socioeconómico, baja educación, jubiladas, con un tiempo promedio de 7.5 años de restricción domiciliaria y grado moderado de resiliencia. Los encuestados tienen altas tasas de la religiosidad y la espiritualidad, 90.9% tienen una alta religiosidad intrínseca y 79.6% realizan prácticas religiosas privadas una o más veces al día. La mayoría (88,6%) considera importante que su la religiosidad y la espiritualidad se aborde en su atención médica, pero solo al 20,5% se les ha preguntado al respecto. La resiliencia se asoció con una mayor espiritualidad (B=0,44; p=0,02), controlando este efecto para apoyo social y los síntomas depresivos, y la edad avanzada (B=0,18; p=0,02). Conclusión: el estudio corrobora la relevancia de la dimensión religiosa y espiritual e indica su papel en la promoción de la resiliencia en esta población en AD. Se recomienda el enfoque de la religiosidad y la espiritualidad con estas personas, fortaleciendo la atención integral recomendada por la APS.

N-acetylcysteine reduces amphotericin B deoxycholate nephrotoxicity and improves the outcome of murine cryptococcosis.

Cryptococcosis is a life-threatening fungal infection, and its current treatment is toxic and subject to resistance. Drug repurposing represents an interesting approach to find drugs to reduce the toxicity of antifungals. In this study, we evaluated the combination of N-acetylcysteine (NAC) with amphotericin B (AMB) for the treatment of cryptococcosis. We examined the effects of NAC on fungal morphophysiology and on the macrophage fungicidal activity 3 and 24 hours post inoculation. The therapeutic effects of NAC combination with AMB were investigated in a murine model with daily treatments regimens. NAC alone reduced the oxidative burst generated by AMB in yeast cells, but did not inhibit fungal growth. The combination NAC + AMB decreased capsule size, zeta potential, superoxide dismutase activity and lipid peroxidation. In macrophage assays, NAC + AMB did not influence the phagocytosis, but induced fungal killing with different levels of oxidative bursts when compared to AMB alone: there was an increased reactive oxygen species (ROS) after 3 hours and reduced levels after 24 hours. By contrast, ROS remained elevated when AMB was tested alone, demonstrating that NAC reduced AMB oxidative effects without influencing its antifungal activity. Uninfected mice treated with NAC + AMB had lower concentrations of serum creatinine and glutamate-pyruvate transaminase in comparison to AMB. The combination of NAC + AMB was far better than AMB alone in increasing survival and reducing morbidity in murine-induced cryptococcosis, leading to reduced fungal burden in lungs and brain and also lower concentrations of pro-inflammatory cytokines in the lungs. In conclusion, NAC + AMB may represent an alternative adjuvant for the treatment of cryptococcosis.

Acute Effects of Hip Mobilization With Movement Technique on Pain and Biomechanics in Females With Patellofemoral Pain: A Randomized, Placebo-Controlled Trial.

CONTEXT: People with patellofemoral pain (PFP) present altered lower-limb movements during some activities. Perhaps, joint misalignment in the hip is one of the reasons for altered movement patterns in people with PFP. Some mobilization techniques have been designed to address joint misalignments. OBJECTIVE: To investigate the acute effects of hip mobilization with movement (MWM) technique on pain and biomechanics during squats and jumps in females with and without PFP. DESIGN: Randomized, placebo-controlled trial. SETTING: Movement analysis laboratory. PATIENTS: Fifty-six physically active females (28 with PFP and 28 asymptomatic) were divided into 4 groups: experimental group with PFP, sham group with PFP, experimental group without PFP, and sham group without PFP. INTERVENTION(S): The experimental groups received MWM for the hip, and the sham groups received sham mobilization. MAIN OUTCOME MEASURES: Pain, trunk, and lower-limb kinematics, and hip and knee kinetics during single-leg squats and landings. RESULTS: After the interventions, no difference between groups was found for pain. The PFP experimental group decreased hip internal rotation during squats compared with the PFP sham group (P = .03). There was no other significant difference between PFP groups for kinematic or kinetic outcomes during squats, as well as for any outcome during landings. There was no difference between asymptomatic groups for any of the outcomes in any of the tasks. CONCLUSIONS: Hip mobilization was ineffective to reduce pain in people with PFP. Hip MWM may contribute to dynamic lower-limb realignment in females with PFP by decreasing hip internal rotation during squats. Therefore, hip MWM could be potentially useful as a complementary intervention for patients with PFP.

Effects of the combination of low-level laser therapy and anionic polymer membranes on bone repair.

In view of the limitations of bone reconstruction surgeries using autologous grafts as a gold standard, tissue engineering is emerging as an alternative, which permits the fabrication and improvement of scaffolds to stimulate osteogenesis and angiogenesis, processes that are essential for bone repair. Polymers are used to mimic the extracellular bone matrix and support cell growth. In addition, bone neoformation can be induced by external factors such as laser irradiation, which stimulates bone metabolism. The objective of this study was to evaluate the regeneration of bone defects using collagen and elastin membranes derived from intestinal serosa and bovine auricular cartilage combined with low-level laser application. Thirty-six Wistar rats were operated to create a 3-mm defect in the distal metaphysis of the left femur and divided into six groups: G1 (control, no treatment); G2 (laser); G3 (elastin graft), G4 (elastin+laser); G5 (collagen graft); G6 (collagen+laser). The animals were sacrificed 6 weeks after surgery and the femurs were removed for analysis of bone repair. Macroscopic and radiological results showed the absence of an infectious process in the surgical area. This was confirmed by histological analysis, which revealed no inflammatory infiltrate. Histomorphometry showed that the formation of new bone started from the margins of the bone defect and its volume was greater in elastin+laser and collagen+laser. We conclude that newly formed bone in the graft area was higher in the groups that received the biomaterials and laser. The collagen and elastin matrices showed biocompatibility.

Measuring early childhood development in multiple contexts: the internal factor structure and reliability of the early Human Capability Index in seven low and middle income countries.

BACKGROUND: The fourth year of the Sustainable Development Agenda era calls for countries to continue to invest not only in interventions and policies that will promote global equity and sustainability, but also in the monitoring systems required to track progress against these targets. A more pragmatic solution to measuring children's early development in low and middle income countries in particular, is required. This study explores the psychometric properties of the early Human Capability Index (eHCI), a population measure of holistic development for children aged 3-5 years, designed with the vision of being flexible and feasible for use in low resource and capacity settings. METHODS: Utilizing data from seven low and middle income countries: Brazil (n = 1810), China (n = 11,421), Kiribati (n = 8339), Lao People's Democratic Republic (n = 7493), Samoa (n = 12,191), Tonga (n = 6214), and Tuvalu (n = 549), analyses explored the internal factor structure and reliability of scores produced by the tool within each country. RESULTS: Confirmatory factor analyses and internal consistency coefficients demonstrated that after local adaptation, translation, and different implementation methods across countries, the eHCI maintained the same factor structure of nine theoretically-based developmental domains: Physical Health, Verbal Communication, Cultural Knowledge, Social and Emotional Skills, Perseverance, Approaches to Learning, Numeracy, Reading, and Writing. CONCLUSIONS: Findings support the aims of the eHCI in being adaptable and applicable for use within a range of low and middle income countries to facilitate measurement and monitoring of children's early development, as is required for the tracking of progress towards the Sustainable Development Agenda.

Sensibilização das mães de crianças com microcefalia na promoção da saúde de seus filhos / Sensibilización de las madres de niños con microcefalia en la promoción de la salud de sus hijos / Sensitizing mothers of children with microcephaly in promoting the health of their children

RESUMO Objetivo Relatar as experiências educativas das mães ou cuidadoras de crianças com microcefalia, desenvolvidas por equipe acadêmica na temática da promoção da saúde dessas crianças. Método Trata-se de relato de experiência vivenciado por alunos do curso de graduação em enfermagem, discentes e docentes do programa de Pós-Graduação em Saúde e Ambiente da Universidade Tiradentes sobre intervenções educativas realizadas em três unidades de referência no atendimento à criança com microcefalia no estado de Sergipe. A amostra do estudo foi de conveniência. Resultados Participaram da pesquisa 70 mães ou cuidadoras principais de crianças com diagnóstico confirmado de microcefalia, durante os meses de setembro a dezembro. Os eixos temáticos-teóricos selecionados para descrever as atividades foram promoção da alimentação saudável, importância do vínculo mãe e filho e estimulação precoce de crianças com microcefalia. Conclusão A experiência relatada demostrou a importância das estratégias educativas na promoção da saúde de crianças com microcefalia, proporcionando capacitação adicional às mães/cuidadoras para que estas ofereçam um cuidado holístico e humanizado a essas crianças.

RESUMEN Objetivo Relatar las experiencias educativas de las madres o cuidadoras de niños con microcefalia, desarrolladas por equipo académico en la temática de la promoción de la salud de esos niños. Método Se trata de relato de experiencia vivida por alumnos de la carrera universitaria de enfermería, discentes y docentes del programa de Posgrado en Salud y Ambiente de la Universidad Tiradentes acerca de intervenciones educativas realizadas en tres unidades de referencia en la atención al niño con microcefalia en el Estado de Sergipe. La muestra del estudio fue de conveniencia. Resultados Participaron en la investigación 70 madres o cuidadoras principales de niños con diagnóstico de microcefalia, durante los meses de septiembre a diciembre. Los ejes temáticos-teóricos seleccionados para describir las actividades fueron promoción de la alimentación sana, importancia del vínculo madre e hijo y estimulación precoz de niños con microcefalia. Conclusión La experiencia relatada demostró la importancia de las estrategias educativas en la promoción de la salud de niños con microcefalia, proporcionando capacitación adicional a las madres/cuidadoras a fin de que estas proporcionen un cuidado holístico y humanizado a esos niños.

ABSTRACT Objective To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. Method This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. Results A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. Conclusion The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.

Sensitizing mothers of children with microcephaly in promoting the health of their children. / Sensibilização das mães de crianças com microcefalia na promoção da saúde de seus filhos.

OBJECTIVE: To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. METHOD: This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. RESULTS: A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. CONCLUSION: The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.