Modulation of monocyte subtypes in diabetes after non-surgical periodontal treatment.

OBJECTIVES: The current study aims to evaluate the effect of non-surgical periodontal treatment on the modulation of monocyte phenotype, in the presence or absence of diabetes. MATERIALS AND METHODS: The identification, quantification, and phenotypic characterization of monocyte subtypes (classical, intermediate, and non-classical) were performed by flow cytometry, at baseline and 1 month after the end of non-surgical periodontal treatment, in patients with periodontitis, associated or not with diabetes. RESULTS: There was an increase in non-classical monocytes after treatment and a reduction in intermediate monocytes, without differences for the classical subtype, regardless of the diabetes status. Furthermore, there was a reduction in intermediate monocytes and an increase in non-classical and classical monocytes after treatment in the diabetes group, while no significant differences were observed for classical, intermediate, and non-classical monocytes in the group without diabetes. Comparisons between the two groups showed significant differences for classical, intermediate, and non-classical monocytes at baseline; these differences were not found one month after treatment. CONCLUSIONS: Non-surgical periodontal treatment leads to modulation of monocytes to a less inflammatory phenotype, especially in individuals with diabetes. CLINICAL RELEVANCE: A better understanding of the role of these biomarkers in the periodontitis contex may constitute a new strategic target for a better treatment of patiens with diabetes associated to periodontitis. CLINICAL TRIAL REGISTRATION: Brazilian Registry of Clinical Trials-RBR-35szwc. Jhefferson Miranda Alves and Danielle Borges Germano contributed equality to this study and should be considered first authors.

Quality of Randomized Controlled Trials Published By Plastic Surgeons: Long-Term Follow-Up.

INTRODUCTION: In two previous studies, the quality of randomized controlled trials (RCTs) with the participation of at least one plastic surgeon was evaluated in two periods: 1966-2003 and 2004-2008. OBJECTIVE: To evaluate the evolution of the quality of RCT publications by plastic surgeons in the subsequent 5-year period, from 2009 to 2013. METHODS: RCTs published from 2009 to 2013 in English with the participation of at least one plastic surgeon were identified by electronic search and classified for concealment of allocation by two independent evaluators. The studies with adequate allocation concealment had their quality evaluated by two evaluators using the Delphi List and the Jadad Quality Scale. RESULTS: Of the 6997 identified studies, 261 were classified as to concealment of allocation. Of these, 43 (16.47%) had adequate allocation concealment. According to the evaluation in the Delphi List, there was an improvement, in relation to 1966-2003, in the items "most important characteristics of the prognosis" (p < 0.001), "use of independent evaluator" (p = 0.0029), and "measures of variability and point estimate for the primary variable" (p = 0.0057); there was no difference in relation to 2004-2008. Regarding the Jadad Quality Scale, there was an increase in scores in relation to 1966-2003 (p < 0.0004) but not in relation to the 2004-2008 period. CONCLUSION: There was no difference in the quality of publications of RCTs by plastic surgeons in the period 2009-2013 compared to the previous 5 years (2004-2008), but both periods presented higher quality than the period 1966-2003. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Impact of Fractional Ablative Carbon Dioxide Laser on the Treatment of Rhinophyma.

BACKGROUND: Rhinophyma results in nasal deformity, which may lead to significant distress, embarrassment, social isolation, and low self-esteem. Fractional carbon dioxide (CO2) laser treatment is a simple, noninvasive, outpatient procedure with a low complication rate that has proved useful in rhinophyma treatment. OBJECTIVES: The aim of this study was to assess the impact of fractional ablative CO2 laser treatment on self-esteem in patients with rhinophyma. METHODS: Twelve patients with rhinophyma, between 50 and 80 years of age, received 4 monthly treatment sessions with a fractional ablative CO2 laser. The laser parameters were chosen based on the severity of the condition of each patient. Patient satisfaction was assessed through a study-specific questionnaire administered 1 month after treatment. Self-esteem was assessed by the Rosenberg Self-Esteem (RSE) Scale, which was administered before treatment, and at 1, 6, and 12 months after treatment. RESULTS: A decrease in RSE scores was observed in the post-treatment period, indicating an improvement in self-esteem among patients. All patients were satisfied with the aesthetic results and would recommend the treatment to a friend. CONCLUSIONS: Fractional ablative CO2 laser treatment is associated with high levels of rhinophyma patient satisfaction, and significant improvements in self-esteem.

Breast Reconstruction May Improve Work Ability and Productivity After Breast Cancer Surgery.

OBJECTIVE: The aim of this study was to evaluate work ability and productivity in women who had undergone different types of surgical treatment for breast cancer, as well as breast reconstruction after mastectomy. METHODS: This cross-sectional study assessed 152 women between 30 and 60 years of age, who worked outside the home in formal or informal jobs, or as self-employed. Thirty-eight of them had no history of breast cancer (control group), and 114 had undergone surgical treatment for breast cancer at least 1 year before their enrollment in the study, and were allocated as follows: mastectomy group (n = 38), breast-conserving surgery group (n = 38), or breast reconstruction breast reconstruction group (n = 38). The validated Brazilian versions of the Work Productivity and Activity Impairment-General Health questionnaire and Work Limitations Questionnaire were self-administered. RESULTS: The groups were homogeneous regarding age, education level, and other sociodemographic characteristics. Patients in the mastectomy and breast-conserving surgery groups showed reduced work performance and productivity compared with women in the breast reconstruction and control groups (P = 0.0004 and P = 0.0006, respectively). In addition, women in the mastectomy group had more difficulty in performing activities of daily living compared with those in other groups (P = 0.0121). CONCLUSIONS: Women who had undergone mastectomy or breast-conserving surgery had decreased work ability and productivity compared with women without a history of breast cancer and to those who had undergone breast reconstruction.

Use of the BREAST-Q™ Survey in the Prospective Evaluation of Reduction Mammaplasty Outcomes.

INTRODUCTION: BREAST-Q™ is a patient-reported outcomes survey instrument with a specific module that evaluates breast reduction surgery. It allows assessment of patient's satisfaction with received treatment and evaluates the impact of surgery on different aspects of the patient's quality of life. This article aims to assess the satisfaction and quality of life of patients who underwent reduction mammaplasty. MATERIALS AND METHODS: Women aged between 18 and 60 years, with a body mass index ranging from 19 to 30 kg/m2, who were already scheduled for reduction mammaplasty, were included in the study. The Brazilian version of the BREAST-Q™ Reduction/Mastopexy Module (preoperative 1.0 and postoperative 1.0 versions) was self-applied preoperatively and 1 and 6 months after the operation. RESULTS: One hundred and seven patients were included in the study and completed the 6-month follow-up. The median age was 33 years, and the median preoperative body mass index was 25 kg/m2. The superomedial pedicle was used in 96.3% of the cases, and the total median weight of the resected breast was 1115 g. There was a significant improvement in the scores of the scales: Psychosocial well-being, Sexual well-being, Physical well-being, and Satisfaction with the breasts compared to the preoperative assessment (p < 0.0001). The scales Satisfaction with the NAC and Satisfaction with the outcome, available only in the postoperative version, demonstrated high satisfaction rates at the two postoperative periods evaluated. CONCLUSION: Reduction mammaplasty improved the quality of life and provided high levels of patient satisfaction with outcomes 1 and 6 months postoperatively. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Increased Capacity for Work and Productivity After Breast Reduction.

BACKGROUND: Breast hypertrophy is a prevalent condition among women worldwide, which can affect different aspects of their quality of life. The physical and emotional impact of breast hypertrophy may harm daily activities, including work. OBJECTIVES: To assess the impact of reduction mammaplasty on the ability to work and productivity of women with breast hypertrophy. METHODS: A total of 60 patients with breast hypertrophy, already scheduled for breast reduction, aged 18 to 60 years and who had formal or autonomous employment were prospectively enrolled. The Brazilian versions of two validated tools, Work Productivity and Activity Impairment - General Health (WPAI-GH) and Work Limitations Questionnaire (WLQ) were self-administered at the preoperative evaluation and six months following surgery. RESULTS: The median age was 33 years, median body mass index was 24 kg/m2, and the median total weight of resected breast tissue was 617.5 g. According to the Brazilian classification of occupation, most patients (53%) had technical, scientific, artistic and similar occupations. There was a significant improvement in work capacity and productivity six months after the reduction mammaplasty, denoted by a decrease in presenteeism, absenteeism, and WLQ Productivity Loss Score (Wilcoxon analysis of variance: P < .0001 for each of these domains). CONCLUSIONS: Reduction mammaplasty increases the work capacity and productivity of Brazilian women with breast hypertrophy. LEVEL OF EVIDENCE 4.

Sexual Function and Depression Outcomes Among Breast Hypertrophy Patients Undergoing Reduction Mammaplasty: A Randomized Controlled Trial.

PURPOSE: The breasts are important symbols of femininity and sensuality. Alterations such as breast hypertrophy can affect several aspects of women's quality of life. Breast hypertrophy is a prevalent health condition, which is treated by reduction mammaplasty. The aim of the present study was to assess sexual function and depression outcomes among breast hypertrophy patients undergoing reduction mammaplasty. METHODS: Sixty breast hypertrophy patients were randomly allocated to a control group (CG) (n = 30) or a breast reduction group (BRG) (n = 30). The patients in the CG were assessed at the first appointment as well as 3 and 6 months later. The patients in the BRG were assessed preoperatively as well as 3 and 6 months postoperatively. Validated instruments, the Female Sexual Function Index and the Beck Depression Inventory, were used to assess sexual function and depression among the subjects. The results of these assessments were compared within and between groups. RESULTS: Twenty-seven and 29 patients in the CG and the BRG, respectively, completed the 6-month follow-up period. At baseline, the groups did not differ significantly with regard to the main demographic data. In the initial assessment, the groups did not differ significantly with regard to Female Sexual Function Index or Beck Depression Inventory scores. Compared with the CG, the BRG reported better sexual function 3 (P = 0.015) and 6 (P = 0.009) months postoperatively. Regarding depression scores, the reduction mammaplasty group had better results 6 months postoperatively (P = 0.014). CONCLUSIONS: Reduction mammaplasty positively affected sexual function and depression levels in breast hypertrophy patients.

Tap water versus sterile saline solution in the colonisation of skin wounds.

Irrigating wounds with tap water does not increase colonisation, but controlled studies are required for further evidence. Microbial colonisation was assessed in skin wounds, before and after irrigation with tap water, and was compared with irrigation using 0·9% sodium chloride sterile solution. The study included 120 subjects with chronic, traumatic, vascular, pressure or neuropathic wounds. A total of 60 wounds were randomly assigned to be irrigated with tap water (tap water group) and another 60 to be irrigated with 0·9% sodium chloride sterile solution (saline group), at a pressure of 0·46-0·54 PSI. Samples were collected from the centre of each wound using Levine's technique, before and after irrigation, and cultivated in thioglycollate, hypertonic mannitol agar, eosin methylene blue (EMB) agar, blood agar and Sabouraud agar at 37°C for 72 hours. There was concordance (kappa test) and discordance (McNemar test) regarding the count of positive and/or negative samples before and after irrigation in each group. The proportion of reduction of positive samples was similar for both groups in all cultures. Colony-forming unit count before and after irrigation was similar in both groups and in all cultures, except for the culture in hypertonic mannitol agar from the tap water group, for which the count was lower after irrigation (Wilcoxon z = 2·05, P = 0·041). It is concluded that skin wound irrigation with tap water leads to further reduction of Gram-positive bacteria compared with 0·9% sodium chloride sterile solution, with no difference in colonisation of haemolytic bacteria, Gram-negative bacteria and fungi.

Health-Related Quality of Life in Elderly Patients With Pressure Ulcers in Different Care Settings.

PURPOSE: The purpose of this study was to measure and compare health-related quality of life in elderly patients with pressure ulcers in different health care settings (home care acute care facility, and long-term care facility [LTCF]). DESIGN: Cross-sectional comparative study. SUBJECTS AND SETTING: One hundred ten elderly patients with (n = 36) and without (n = 74) pressure ulcers living in LTCFs, hospitals, or at home. The research setting included 1 tertiary and 2 community-based hospitals, 10 LTCFs, and 18 community health centers in Brazil. METHODS: The Mini-Mental State Examination, Braden Scale for Predicting Pressure Sore Risk, and Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were used to assess cognitive status, pressure ulcer risk, and health-related quality of life, respectively. RESULTS: Compared with those without pressure ulcers, elderly patients with pressure ulcers reported significantly lower (worse) SF-36 scores on physical functioning (P < .001) and role physical (P < .05) in all settings, and on social functioning (P = .045) and role emotional (P = .036) in LTCFs. Subjects in hospitals with pressure ulcers scored significantly higher (better) SF-36 scores on mental health (P = .046) and vitality (P = .009). Hospitalized patients without pressure ulcers had lower SF-36 scores on bodily pain (P = .007) and general health (P = .026) than those living in LTCFs or at home. Patients without pressure ulcers in LTCFs had significantly lower Mini-Mental State Examination scores (lower cognitive status) than those living in other settings (P = .001). CONCLUSIONS: Elderly patients with pressure ulcers who were hospitalized and living at home or in LTCFs reported low scores on physical functioning and role physical, and LTCF residents also reported low scores on social functioning and role emotional. This shows the need for an environment that includes health care professionals prepared to implement strategies for pressure ulcer prevention.

Epidemiological profile and genetic resistance of Neisseria gonorrhoeae infection in women in a poor region of São Paulo, Brazil.

BACKGROUND AND AIM: Gonorrhea is a bacterial infection in the urogenital tract, transmitted by sexual or perinatal contact, caused by Neisseria gonorrhoeae, a gram-negative diplococcus. The present study evaluates the frequency of N. gonorrhoeae in women treated at Hospital Wladimir Arruda in poor area of São Paulo and also verifies the presence of genetic resistance against three antimicrobials of different classes: Tetracycline, Azithromycin and Ciprofloxacin. METHODS: This is an observational and descriptive study with a quantitative approach. Samples were collected at Hospital Escola Wladimir Arruda. The volunteers are women from 16 to 65 years of age. Sociodemographic, gynecological, sexual and health data are collected through a questionnaire, their symptoms/clinical manifestation were requested by the medical records, and then the participant is referred for collection of samples of cervical vaginal smear. The samples were screened for N. gonorrhoeae (dcmH gene) and tested for resistance genes to Tetracycline, Azithromycin and Ciprofloxacin through PCR. RESULTS: In the total of 127 samples analyzed by Real-Time PCR, 23 were positive and correspond to a general prevalence of a gonococcal infection in the studied population of 17% (CI:95%), and the participants were married (43.4%), had active sexual life (56.5%) and did not use any type of condom during sexual intercourse (52.1%). The resistance to the tetM ribosomal gene was found in 14 samples, prevalence of 60% (CI= 95%). CONCLUSIONS: We have described a concerning frequency of N. gonorrhoeae infection in females attended in an outcare patient. Also, most of the strains detected presented resistance to one or more antimicrobials.

Clinical and Epidemiological Characteristics of Patients with COVID-19 Admitted to the Intensive Care Unit: A Two-Year Retrospective Analysis.

In March 2020, COVID-19 was characterized as a pandemic by the World Health Organization. Hospitalized patients affected by COVID-19 presented with severe respiratory and motor impairment, especially those who required intensive treatment and invasive mechanical ventilation, with sequelae that extended after the period of hospitalization. Thus, the aim of the current study was to verify the clinical and epidemiological characteristics of patients with COVID-19 admitted to the Intensive Care Unit in 2020 and 2021, according to age group. METHODS: A retrospective cohort study. Data were collected through the "ICUs Brasileiras" between March 2020 and November 2021 for severe acute respiratory syndrome (SARS) due to COVID-19. The following were analyzed: the number of hospital admissions, days in the ICU and hospital, clinical aspects (non-invasive or invasive ventilatory support, comorbidities, frailty, SAPS 3 and SOFA severity scales, use of amines and renal support), and ICU and hospital mortality rate. RESULTS: A total of 166,966 ICU hospital admissions were evaluated over the evaluated quarters. The main results showed a peak in the number of hospitalizations between March and May 2021, with a higher percentage of males. The peak of ICU admissions for 7 days was between March and May 2021 and 21 days between March and May 2020. In addition, higher deaths were observed in the age groups between 40 and 80 years between 2020 and 2021, with the group above 81 being the age group with the highest mortality. Mortality in the ICU of ventilated patients was higher in the age group above 70 years. Another observation was the predominance of SAPS 3 and the peak of mechanical ventilation for more than 7 days between June and August 2021. CONCLUSION: The clinical and epidemiological characteristics of patients with COVID-19 were influenced by age group, showing higher mortality over 81 years and over 70 years in the ICU supported by mechanical ventilation, maintained for 7 days from June to August 2021. The years 2020 and 2021 also showed differences for patients with COVID-19, with greater hospitalization between March and May 2021, especially in the ICU for 7 days, and between March and May 2020 for the 21-day period.

Monocyte chemokine receptors as therapeutic targets in cardiovascular diseases.

Chemokine receptors are fundamental in many processes related to cardiovascular diseases, such as monocyte migration to vessel walls, cell adhesion, and angiogenesis, among others. Even though many experimental studies have shown the utility of blocking these receptors or their ligands in the treatment of atherosclerosis, the findings in clinical research are still poor. Thus, in the current review we aimed to describe some promising results concerning the blockade of chemokine receptors as therapeutic targets in the treatment of cardiovascular diseases and also to discuss some challenges that need to be overcome before using these strategies in clinical practice.

Exercise behavior, practice, injury, and symptoms of respiratory tract infection of 502 Brazilian adults during lockdown oscillations in two years (2021-2022) of the COVID-19 pandemic.

BACKGROUND: In the period between 2020 and 2023, during the COVID-19 (coronavirus disease 2019) pandemic, many countries released their restriction measures so that individuals were able to begin practicing physical exercises and outdoor sports again. The purpose of the current study was to evaluate the physical exercise behavior, symptoms of respiratory tract infection, and training practice, as well as aspects of pain and injuries in the lower limbs of adults during periods of lockdown oscillations in the two years of the COVID-19 pandemic in Brazil. METHODS: Cross-sectional study. PARTICIPANTS: A total of 502 adults were evaluated during two consecutive years of the COVID-19 pandemic, corresponding to the years 2021 and 2022. A virtual questionnaire was applied using the Google Forms platform through a link, or a Quick Response Code available in social media environments. The variables collected were: anthropometric characteristics, presence of comorbidities, clinical history for the diagnosis of COVID-19, and behavior related to physical exercise practices, divided into five topics: (1) physical exercise habits; (2) symptoms and health care utilization; (3) habit of practicing physical exercise in relation to the prevention of COVID-19; (4) preventive measures for COVID-19; and (5) feelings and reasons for practicing exercises. RESULTS: A total 79.0% of the participants returned to the practice of physical exercise after a period of social isolation due to COVID-19, with running (30.0%) and muscle strength training (50.0%) being the most prevalent modalities, in which 62.0% of practitioners carried out the activity individually, without any professional or technical monitoring. With regard to physical preparation, 61.0% reported performing pre-training stretching, 64.0% associated with muscular resistance training. Of these, 89% did not report current injuries or pain symptoms when returning to exercise (69.0%). Total of 60.5% reported experiencing respiratory tract symptoms of COVID-19 and seeking a consultation with a doctor, and 61.0% performed diagnostic test, with RT-PCR (Real time-polymerase chain reaction) being the most common test. Of those tested, 55.0% were positive for COVID-19, without the need for hospitalization (95.0%). The most commonly used measures for the prevention of COVID-19 were the fabric or surgical mask. The predominant feeling in the pandemic was anxiety (50.5%) and the reasons for practicing sports were: physical conditioning (30.9%), a feeling of pleasure (21.3%), and weight loss (20.3%). CONCLUSION: After two years of the COVID-19 pandemic (2021-2022), with periods of lockdown, there were low reports of injuries and pain symptoms after exercising on the return to physical exercise practices of running and strength training. However, the restrictions negatively affected the exercise behavior due to respiratory tract symptoms of COVID-19 and a reduction in training intensity, performed without any professional or technical supervision. The participants reported the use of a fabric or surgical mask for the prevention of COVID-19, and an increased feeling of anxiety. The reasons given for practicing physical exercise were physical conditioning, a feeling of pleasure, and weight loss.

Persistence of a proinflammatory status after treatment of the acute myocardial infarction.

AIM: To evaluate the lipid-lowering and antiplatelet combined strategies on the expression of the receptors CCR2, CCR5, and CX3CR1 and the percentage of CCR2, CCR5, and CX3CR1 cells in monocyte subtypes after acute myocardial infarction. METHODS: Prospective, randomized, open-label study, with blinded analyses of endpoints (PROBE, ClinicalTrials.gov Identifier: NCT02428374, registration date: April 28, 2015). Participants were treated with rosuvastatin 20 mg or simvastatin 40 mg plus ezetimibe 10 mg, as well as ticagrelor 90 mg or clopidogrel 75 mg. The chemokine receptors CCR2, CCR5, and CX3CR1 were analyzed by real-time polymerase chain reaction as well as the percentages of CCR2, CCR5, and CX3CR1 cells in the monocyte subtypes (classical, intermediate, and non-classical), which were quantified by flow cytometry, at baseline, and after 1 and 6 months of treatment. RESULTS: After comparisons between the three visits, regardless of the treatment arm, there was an increase in CCR2 expression after treatment, as well as an increase in intermediate monocytes CCR2+ and a reduction in non-classical monocytes CCR2+ at the end of treatment. There was also a lower expression of CCR5 after treatment and an increase in classical and non-classical monocytes CCR5+. Concerning CX3CR1, there were no differences in the expression after treatment; however, there were reductions in the percentage of intermediate and non-classical monocytes CX3CR1+ at the end of treatment. CONCLUSIONS: The results suggest the persistence of the inflammatory phenotype, known as trained immunity, even with the highly-effective lipid-lowering and antiplatelet therapies. Geriatr Gerontol Int 2023; 23: 700-707.

Association among inflammaging, body composition, physical activity, and physical function tests in physically active women.

Background: Inflammaging is a phenomenon that has been associated with the development and progression of sarcopenia and frailty syndrome. According to the literature, on the one side, the increase in body fat is associated with a systemic pro-inflammatory status, which consequently favors inflammaging, and on the other side, the regular practice of physical exercise can mitigate the development of this scenario. Therefore, here, we aimed to evaluate the association between inflammaging and physical factors, both body and functional, in a group of physically active older women. Methods: Seventy older women (mean age 72.66 ± 6.17 years) participated in this observational cross-sectional and were separated into the eutrophic, overweight, and obese groups. It was assessed: by bioimpedance-body fat percentage (Fat%) and total (Fat kg), skeletal muscle mass (muscle), and free fat mass both in percentage (FFM%) and total (FFMkg); by the International Physical Activity Questionnaire (IPAQ)-the time of moderate-intensity physical activity per week; by physical tests-handgrip (HG), sit-up-stand-on-the-chair in 5 repetitions (Sit-up) and vertical squat jump test (SJ); in addition to the determination of serum cytokine concentration (IL-6, TNF-α, IL-10, and IL-8), and also body mass index (BMI) and calf circumference (Calf). Results: Higher FFM% and lower body fat (both kg and %) were found in the eutrophic group than in the other groups. The eutrophic group also performed more weekly physical activity, jumped higher, and presented not only higher serum IL-6 concentration but also an increased ratio of IL-10/IL-6, IL-10/TNF-α, IL-10/IL-8 as compared to the values found in the overweight group. The obese group presented higher body fat (kg and %) and lower FFM% than the other groups and also higher serum IL-6 concentration than the overweight group. Interestingly, several significant negative and positive correlations between body composition, physical tests, and serum cytokine concentrations were found in the eutrophic and obese groups. Conclusion: While the eutrophic older women group showed a remarkable regulation of the systemic inflammatory status with positive associations in the physical parameters assessed, the overweight and obese groups presented impairment regulations of the inflammaging, which could be related to less weekly physical activity and higher body fat.

Prevalence of associations among sarcopenia, obesity, and metabolic syndrome in Brazilian older adults.

Background: Although aging is a process associated with the development of obesity, metabolic syndrome (MetS), and sarcopenia, the prevalence of these conditions in older adults from São Paulo, Brazil, is unclear. Methods: Therefore, the current study aimed to investigate the prevalence of obesity, sarcopenia, and MetS, both separately and together, in a community-based sample of older adults from São Paulo, Brazil. Data from the medical records of 418 older adults of both genders, aged 60 years or older (mean age 69.3 ± 6.5 years), who were not physically active, were used to conduct this retrospective cross-sectional study. Anthropometric variables were used to determine both body mass index (BMI) and Conicity index (C index). Sarcopenia and MetS were defined according to the criteria of the European Working Group on Sarcopenia in Older People and by the Brazilian Society of Endocrinology and Metabolism, respectively. Results: Based on BMI, the group of older men (n = 91) showed a predominance of adequate weight (n = 49) and the group of older women (n = 327) showed a predominance of obesity (n = 181). In association with obesity, while only the group of older women presented with sarcopenia (n = 5), 52 older women and 9 older men presented with MetS, and two older women presented with sarcopenia + MetS [prevalence ratio = 0.0385, 95% CI (0.007;0.1924)]. Based on the C index, 58 older women and 11 older men presented with MetS, while the occurrence of sarcopenia or MetS + sarcopenia was found in 32 and 5 older women, respectively [prevalence ratio = 0.0910, 95% CI (0.037;0.2241)]. Discussion: Our results suggest that obesity, as measured by BMI or the C Index, was more closely associated with the occurrence of MetS than sarcopenia, regardless of gender, and also that sarcopenic obesity was only found in the group of older women. Additionally, the prevalence ratio of obesity, sarcopenia, and MetS evidenced using the C index was 2.3 times higher than the values found using the BMI classification.

Tap Water has No Influence on Microbial Colonization of Skin Wounds in Rats.

UNLABELLED:  The aim of this study was to investigate the influence of tap water on microbial colonization of skin wounds in rats. METHODS: A cir- cular wound 2.4 cm in diameter was created on the back of 40 Wistar rats, which were randomly assigned to the control (n = 20) or study (n = 20) group. The wounds were cleansed daily using a sterile 0.9% sodium chloride solution (control group) or tap water (study group) for 6 days, following a standardized protocol. Sequential samples were collected for microbiological analysis every other day. RESULTS: Microbial growth occurred in 49% of the samples from the control group and in 47% of the samples from the study group (P = 0.39). There was no significant difference in microbial growth between groups for the different culture media: thioglycolate (P = 0.20), mannitol salt agar (P = 0.53), blood agar (P = 0.61), eosin methylene blue agar (P = 0.51), and Sabouraud agar (P = 0.34). The following microorganisms were identified: Bacil- lus subtilis, Staphylococcus sp, Aureobasidium sp, Penicillium sp, and Cladosporium sp. CONCLUSION: The use of tap water for cleansing skin wounds in rats had no effect on microbial colonization compared with the use of a sterile saline solution. .

Effects of lidocaine with epinephrine or with buffer on wound healing in rat skin.

Lidocaine blocks nociceptive fibers, preventing initial wound signaling and mast cell degranulation. It is hypothesized that epinephrine and buffer affect the wound healing by potentiating lidocaine blockage. This double-blind, randomized, self-controlled study investigated this possibility using male Wistar rats, which were injected with 2 mL of different solutions into the left and right sides of the back. Then, each side was incised and sutured. Sixty rats were divided in three groups: saline solution (SS) and lidocaine; lidocaine and lidocaine with buffer; lidocaine with epinephrine and lidocaine with epinephrine and buffer. Half of each group was sacrificed 7 days after surgery and the remaining after 21 days. A sample of each wound was obtained and quantified for the level of collagen present using computer morphometry and for mast cell quantity. There were no differences between animals with regard to the collagen. However, mast cell levels in the same animal significantly differed between SS × lidocaine. Comparison of the same injected substance between animals with different healing dates showed a significant effect on collagen SS and on all mast cells, except SS. Lidocaine affected collagenization and decreased the initial quantity of mast cells at the wound site.

A prospective study of nutrition education and oral nutritional supplementation in patients with Alzheimer's disease.

BACKGROUND: Weight loss in patients with Alzheimer's disease (AD) is a common clinical manifestation that may have clinical significance. OBJECTIVES: To evaluate if there is a difference between nutrition education and oral nutritional supplementation on nutritional status in patients with AD. METHODS: A randomized, prospective 6-month study which enrolled 90 subjects with probable AD aged 65 years or older divided into 3 groups: Control Group (CG) [n = 27], Education Group (EG) [n = 25], which participated in an education program and Supplementation Group (SG) [n = 26], which received two daily servings of oral nutritional supplementation. Subjects were assessed for anthropometric data (weight, height, BMI, TSF, AC and AMC), biochemical data (total protein, albumin, and total lymphocyte count), CDR (Clinical Dementia Rating), MMSE (Mini-mental state examination), as well as dependence during meals. RESULTS: The SG showed a significant improvement in the following anthropometric measurements: weight (H calc = 22.12, p =< 0.001), BMI (H calc = 22.12, p =< 0.001), AC (H calc = 12.99, p =< 0.002), and AMC (H calc = 8.67, p =< 0.013) compared to the CG and EG. BMI of the EG was significantly greater compared to the CG. There were significant changes in total protein (H calc = 6.17, p =< 0.046), and total lymphocyte count in the SG compared to the other groups (H cal = 7.94, p = 0.019). CONCLUSION: Oral nutritional supplementation is more effective compared to nutrition education in improving nutritional status.

Components separation technique with limited subcutaneous undermining: a cadaver study.

The purpose of this study is to evaluate the influence of the undermining of the subcutaneous tissue on the tension of the abdominal wall, after the components separation of the abdominal muscles. Twenty adult cadavers were studied. The resistance of the medial advancement of both anterior and posterior recti sheaths was represented by the traction index and measured in 2 levels-3 cm above and 2 cm below the umbilicus. Traction indices were compared in the following 3 consecutive dissection situations: (1) after the subcutaneous tissue undermining laterally to the semilunaris line; (2) after the dissection of the rectus muscle from its posterior sheath associated with the release of the external oblique muscle; (3) after the subcutaneous tissue undermining laterally to the anterior axillary line. Friedman and Spearman tests were used to compare the results. There was no statistical significant difference between the subcutaneous tissue undermining laterally to the semilunaris line and that laterally to the anterior axillary line, when associated with the musculoaponeurotic dissections. In conclusion, limited subcutaneous undermining does not influence the tension of closure of the musculoaponeurotic layer after the components separation technique in cadavers.