Effects of dietary compounds on nuclear factor erythroid 2-related factor 2 (Nrf2) modulation in chronic kidney disease: a systematic review of clinical trials.

Nuclear factor-erythroid 2-related factor 2 (Nrf2) is an important transcription factor that activates antioxidant genes and increases detoxifying enzymes. Studies have shown that dietary compounds can activate the Nrf2 expression and improve the antioxidant response in patients with exacerbated oxidative stress, such as chronic kidney disease (CKD). We aimed to evaluate the efficacy of nutritional interventions on Nrf2 expression and phase II antioxidant enzymes in clinical trials in CKD. We searched PubMed, Lilacs, Embase, Scopus, and Cochrane Library databases of published clinical trials and the Cochrane tool was used for the quality assessment of the studies included. We reported this review according to the PRISMA and it was registered in PROSPERO (42023389619). Thirty-nine studies were included in this review; nine evaluated the Nrf2 expression and three showed an increase in its expression. Twenty-three studies found an increase in the antioxidant enzyme levels, including superoxide dismutase, catalase, and glutathione peroxidase. Moreover, a high risk of bias was found in most of the studies and high heterogeneity in the designs, type, and duration of supplementation administered. These results suggest that dietary supplementations have a promising effect on the antioxidant enzyme response, however, it is recommended that further studies should be carried out.

Bisphenol S exposure induces cardiac remodeling and aggravates high-fat diet-induced cardiac hypertrophy in mice.

Bisphenol S (BPS) is widely used in the manufacture products and increase the risk of cardiovascular diseases. The effect of the association between obesity and BPS on cardiac outcomes is still unknown. Male C57BL/6 mice were divided into standard chow diet (SC; 15 kJ/g), standard chow diet + BPS (SCB), high-fat diet (HF; 21 kJ/g), and high-fat diet + BPS (HFB). Over 12 weeks, the groups were exposed to BPS through drinking water (dose: 25 µg/Kg/day) and/or a HF diet. We evaluated: body mass (BM), total cholesterol, systolic blood pressure (SBP), left ventricle (LV) mass, and cardiac remodeling. In the SCB group, BM, total cholesterol, and SBP increase were augmented in relation to the SC group. In the HF and HFB groups, these parameters were higher than in the SC and SCB groups. Cardiac hypertrophy was evidenced by augmented LV mass and wall thickness, and ANP protein expression in all groups in comparison to the SC group. Only the HFB group had a thicker LV wall than SCB and HF groups, and increased cardiomyocyte area when compared with SC and SCB groups. Concerning cardiac fibrosis, SCB, HF, and HFB groups presented higher interstitial collagen area, TGFß, and α-SMA protein expression than the SC group. Perivascular collagen area was increased only in the HF and HFB groups than SC group. Higher IL-6, TNFα, and CD11c protein expression in all groups than the SC group evidenced inflammation. All groups had elevated CD36 and PPARα protein expression in relation to the SC group, but only HF and HFB groups promoted cardiac steatosis with increased perilipin 5 protein expression than the SC group. BPS exposure alone promoted cardiac remodeling with pathological concentric hypertrophy, fibrosis, and inflammation. Diet-induced remodeling is aggravated when associated with BPS, with marked hypertrophy, alongside fibrosis, inflammation, and lipid accumulation.

LoRaCELL-Driven IoT Smart Lighting Systems: Sustainability in Urban Infrastructure.

In recent years, the rate of urbanization has increased enormously, precipitating an escalating demand for improved services and applications in urban areas to improve the quality of life. In the Internet of Things (IoT)era, cities are transforming into smart urban centers. These cities incorporate connected devices, such as intelligent public lighting systems, to enhance their urban infrastructure. Therefore, this work explores the transformative potential of an IoT-enabled smart lighting system in urban environments, emphasizing its essential role in enhancing safety, economy, and sustainability. In this sense, LoRaCELL (Long-Range Cell) is introduced. LoRaCELL is an innovative system that utilizes edge devices for data collection, such as light intensity, humidity, temperature, air quality, solar ultraviolet radiation, ammeter, and voltmeter. It stands as a pioneering solution for intelligent public lighting systems, contributing to advancing IoT-driven urban development. The outcomes showed that the proposed system could successfully synchronize the devices with each other and send IoT sensing data at a low cost compared to traditional technologies such as LoRaWAN.

mitoTALEN reduces the mutant mtDNA load in neurons.

Mutations within mtDNA frequently give rise to severe encephalopathies. Given that a majority of these mtDNA defects exist in a heteroplasmic state, we harnessed the precision of mitochondrial-targeted TALEN (mitoTALEN) to selectively eliminate mutant mtDNA within the CNS of a murine model harboring a heteroplasmic mutation in the mitochondrial tRNA alanine gene (m.5024C>T). This targeted approach was accomplished by the use of AAV-PHP.eB and a neuron-specific synapsin promoter for effective neuronal delivery and expression of mitoTALEN. We found that most CNS regions were effectively transduced and showed a significant reduction in mutant mtDNA. This reduction was accompanied by an increase in mitochondrial tRNA alanine levels, which are drastically reduced by the m.5024C>T mutation. These results showed that mitochondrial-targeted gene editing can be effective in reducing CNS-mutant mtDNA in vivo, paving the way for clinical trials in patients with mitochondrial encephalopathies.

Is the enteric nervous system a lost piece of the gut-kidney axis puzzle linked to chronic kidney disease?

The enteric nervous system (ENS) regulates numerous functional and immunological attributes of the gastrointestinal tract. Alterations in ENS cell function have been linked to intestinal outcomes in various metabolic, intestinal, and neurological disorders. Chronic kidney disease (CKD) is associated with a challenging intestinal environment due to gut dysbiosis, which further affects patient quality of life. Although the gut-related repercussions of CKD have been thoroughly investigated, the involvement of the ENS in this puzzle remains unclear. ENS cell dysfunction, such as glial reactivity and alterations in cholinergic signaling in the small intestine and colon, in CKD are associated with a wide range of intestinal pathways and responses in affected patients. This review discusses how the ENS is affected in CKD and how it is involved in gut-related outcomes, including intestinal permeability, inflammation, oxidative stress, and dysmotility.

Brazil nut-enriched diet modulates bone mineral density and body composition in an experimental model of chronic kidney disease.

OBJECTIVE: This study investigates the effects of a Brazil nut-enriched diet on body composition and bone parameters in CKD animal model. METHODS: Male Wistar rats were assigned to the following groups: Sham (n=8), Nx (n=6), nephrectomized rats, and NxBN (n=6), nephrectomized rats and an enricheddiet with 5% Brazil nut. Body composition parameters were obtained by dual-energy X- ray absorptiometry (DXA). Bioclin kits determined plasmatic calcium. The femurs werecollected to determine absolute mass and length, bone mineral density, and biomechanical tests. RESULTS: The NxBN group exhibited a higher total body bone mineral density (BMD) value than the Nx group (0.177±0.004g/cm2vs 0,169±0.003g/cm2; p=0.0397). No significant differences were observed regarding absolute mass, length, BMD, and biomechanical parameters in the femurs of the groups. Moreover, no significant differences were found in plasmatic calcium levels among the groups. CONCLUSIONS: Brazil-nut enriched diet modulated BMD in CKD experimental model, and further studies are demanded to understand the pathways involved in this finding.

Brazil nuts potential: effects on lipid peroxidation and heart health in nephrectomized rats.

OBJECTIVES: To investigate the effects of a Brazil nut-enriched diet on the wall thickness and the left ventricular chamber diameter of the heart, and lipid peroxidation in a CKD-induced model. METHODS: Male Wistar rats at 12 weeks of age were divided into two groups (n=16/group): the Nx group, which underwent 5/6 nephrectomy, and the Sham group, as a control. After 5 weeks, the groups were subdivided according to diet (n=8/group): the Nx and Sham groups received a control diet; the Nx5% and Sham5% groups received a diet enriched with 5 % Brazil nuts for 8 weeks. The left ventricular thickening and chamber diameter were determined. Plasma biochemical parameters were evaluated. Analysis of thiobarbituric acid reactive substances (TBARS) and antioxidant enzyme activity was performed in the plasma and the left ventricle (LV). LV mRNA expression of nuclear factor-kappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2) was evaluated by reverse transcription-polymerase chain reaction. RESULTS: The Nx5% group showed a remodeled LV wall with decreased thickness compared to the Nx group (p=0.016). Furthermore, LV TBARS concentration was reduced in the Nx5% group (p=0.0064). In addition, the Nx5% group showed an increase in plasma GPx activity (p=0.0431). No significant results were found concerning the LV mRNA expression of NF-κB and Nrf2 genes. CONCLUSIONS: A Brazil nut-enriched diet decreased LV thickness and LV TBARS concentration and increased GPx activity in a 5/6 nephrectomy experimental model, making it a promising adjuvant therapy to improve antioxidant status and cardiovascular outcomes in chronic kidney disease.

Is Trimethylamine N-oxide (TMAO) Associated with NF-κB mRNA Expression in Patients with Coronary Artery Disease?

Abstract Background: Trimethylamine N-oxide (TMAO), a gut microbiota metabolite, is associated with cardiovascular disease (CVD) development. TMAO can trigger an inflammatory response by inducing the nuclear factor-kappa B (NF-κB) signaling cascade and increasing the expression of pro-inflammatory cytokines, contributing to the worsening of CVD. This study aimed to evaluate the association between TMAO plasma levels and inflammation in patients with coronary artery disease (CAD). Methods: A cross-sectional study was carried out including 29 patients with CAD. Peripheral blood mononuclear cells (PBMC) were isolated from fasting blood samples, and NF-κB and vascular cell adhesion protein 1 (VCAM1) mRNA expression were estimated using real-time quantitative PCR. We determined TMAO plasma levels by LC-MS/MS and TNF-α by ELISA. Routine biochemical parameters were evaluated using an automatic biochemical analyzer. Correlations were estimated by Spearman or Pearson test. Statistical significance was set at the level of p < 0.05. Results: All patients presented TMAO levels within the normal range according to EUTox (normal range: 2.83 ± 1.53 mg/L; CAD patients: 0.2 [0.1 to 0.2] ng/μL). TMAO plasma levels were positively correlated with NF-κB mRNA expression (0.555; p = 0.002). Conclusion: TMAO plasma levels may be associated with NF-κB mRNA expression in patients with CAD and may contribute to the pathogenesis of this disease.

Consumo de Castanha-do-Brasil reduz o N-óxido de trimetilamina (TMAO) e a inflamação em um paciente com síndrome cardiorrenal: uma comunicação breve / Brazil nut consumption reduces trimethylamine-n-oxide (TMAO) and inflammation in a patient with cardiorenal syndrome: a brief communication

Introdução: A disbiose intestinal é uma característica comum na síndrome cardiorrenal e está associada ao aumento de toxinas urêmicas, como o N-óxido de trimetilamina (TMAO), que estão envolvidas com a inflamação e mortalidade cardiovascular. A castanha-do-Brasil (semente típica brasileira) possui propriedades anti-inflamatórias e antioxidantes, mas não há evidências dos seus efeitos na modulação da microbiota intestinal e redução de toxinas urêmicas. Objetivo: Avaliar o impacto do consumo de castanha-do-Brasil nos níveis de TMAO e marcadores de inflamação em um paciente com síndrome cardiorrenal. Métodos: Um paciente com doença arterial coronariana (66 anos e IMC, 26 kg/m2), estágio 3 da DRC (TFGe 36 mL/min), recebeu uma castanha-do-Brasil por dia durante três meses. Resultados: Os níveis plasmáticos de TMAO e a expressão de mRNA de NF-κB foram reduzidos e a atividade da glutationa peroxidase (GPx) aumentou após esta intervenção. Conclusão: A prescrição de castanha-do-Brasil pode ser uma estratégia promissora para mitigar as complicações relacionadas à síndrome cardiorrenal. Este caso apoia o conceito de "alimento como remédio" visando o fenótipo urêmico na síndrome cardiorrenal.

Introduction: Gut dysbiosis is a common feature in cardiorenal syndrome, and it is linked to increased uremic toxins, like trimethylamine-n-oxide (TMAO), which are involved with inflammation and cardiovascular mortality. Brazil nut (typical Brazilian seed) has anti-inflammatory and antioxidant properties, but there is no evidence of the effects of gut microbiota modulation and reduction of uremic toxins. Objective: To assess the impact of Brazil nut consumption on TMAO levels and inflammation markers in a patient with cardiorenal syndrome. Methods: Acoronary artery disease patient(66 years and BMI, 26 kg/m2),stage-3 of CKD (eGFR 36 mL/min), receivedone Brazil nut per day for three months. Results: TMAO plasma levels and NF-κB mRNA expression were reduced, and glutathione peroxidase (GPx) activity increased after this intervention. Conclusion: Brazil nut prescription may be a promising strategy to mitigate complications related tothe cardiorenal syndrome. This case supports the concept of "Food as medicine" targeting the uremic phenotype in cardiorenal syndrome.

Escolarização de Pessoas com Paralisia Cerebral: uma Revisão Sistemática na Literatura Nacional / Schooling of People with Cerebral Palsy: A Systematic Review in the National Literature

RESUMO: A perspectiva inclusiva ampliou discussões sobre a educação do público-alvo da Educação Especial relacionadas à efetividade do ensino, ao uso de recursos, de planejamento e de práticas pedagógicas. Estudos sobre a paralisia cerebral tendem a dar enfoque na perspectiva clínica, de reabilitação e de cuidados, distanciando-se de atividades escolares. Assim sendo, este estudo teve como objetivo caracterizar produções sobre a escolarização de alunos com paralisia cerebral. Para isso, foi realizada uma revisão sistemática na literatura nas bases de dados da Scientific Electronic Library Online (SciELO), no Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e na Revista Educação Especial, de 2000 a 2020. Foram selecionados 31 artigos de acordo com os critérios de inclusão e exclusão, categorizados em Acessibilidade, Desenvolvimento Motor, Tecnologia Assistiva, Comunicação Alternativa, Inclusão escolar e Ensino. Os resultados indicam que o contexto escolar nacional narrado nos estudos se mostra despreparado para atender às especificidades de alunos com paralisia cerebral, considerando discussões sobre formação inicial e equipe profissional, recursos físicos e pedagógicos ofertados, o que requer maior produção de conhecimento teórico e prático no país que responda a garantia de educação de qualidade a esse alunado.

ABSTRACT: The inclusive perspective has broadened discussions about the education of the target audience of Special Education, related to the efectiveness of teaching, the use of resources, planning and pedagogical practices. Studies on cerebral palsy tend to focus on the clinical perspective, rehabilitation and care, distancing themselves from school activities. Thus, this study aimed to characterize productions about the schooling of students with cerebral palsy. For this, a systematic literature review was carried out in the Scientific Electronic Library Online (SciELO), in the Journal database of the Coordination for the Improvement of Higher Education Personnel (CAPES), and in the Revista Educação Especial [Special Education Journal], from 2000 to 2020. Thirty-one articles were selected according to the inclusion and exclusion criteria, categorized as Accessibility, Motor Development, Assistive Technology, Alternative Communication, School Inclusion, and Teaching. The results indicate that the national school context described in the studies is unprepared to meet the specificities of students with cerebral palsy, considering discussions on initial training and professional staf, physical and pedagogical resources ofered, which requires greater production of theoretical and practical knowledge in the country that responds to the guarantee of quality education to this student.

Behavior of pulmonary function after discharge in patients submitted to myocardial revascularization / Comportamento da função pulmonar após a alta em pacientes submetidos à revascularização do miocárdio

Background: Coronary artery bypass grafting (CABG) is a type of surgery where there is a compromise in one or more coronary arteries, with the objective of restoring function to the areas that have been compromised in the heart, possibly leading to respiratory compromise and postoperative complications. The return time of the pulmonary function to the preoperative condition is still indeterminate in the literature. Objective: To describe the behavior of pulmonary function after hospital discharge in patients submitted to CABG. Methods: This is a prospective cohort study. Only patients undergoing MRI, whose lung function was evaluated preoperatively, at hospital discharge and 30 days after surgery, were evaluated. This evaluation consisted of maximum inspiratory pressure (MIP) and expiratory (MEP), vital capacity (VC) and expiratory flow peak (EFP). Results: A total of 30 patients were evaluated, of which 18 (60%) were males, mean age 62 ± 9 years. A reduction in lung function from preoperative time to hospital discharge was observed in all variables. There was improvement in MIP (88 ± 9 vs 109 ± 5, p < 0.001), MEP (67 ± 10 for 90 ± 8, p < 0.001) and EFP (310 ± 59 for 390 ± 32, p < 0.001), high for review. At the time of the review, no variables returned to their preoperative value: MIP (116 ± 5 for 109 ± 5, p = 0.43), MEP (111 ± 8 for 90 ± 8, p < 0.001), VC (45 ± 12 for 39 ± 7, p = 0.33) and EFP (430 ± 40 for 390 ± 32, p < 0.001). Conclusion: It is concluded that MRI surgery reduces lung function and is not reestablished after 30 days of the procedure. Being the expiratory muscular force and the peak of expiratory flow the most affected

Nuts and Cardiovascular Diseases: Focus on Brazil Nuts

Cardiovascular diseases (CVD) are the main cause of death globally and most CVD can be prevented by addressing their risk factors, such as an unhealthy diet. Many authors have studied the benefits of nut consumption on CVD. Nuts contain high amounts of vegetable protein, unsaturated fatty acids, dietary fibers, vitamins, minerals and many other bioactive compounds, like phytosterols and phenolic compounds, which are able to reduce cholesterol levels and promote antioxidant and anti-inflammatory effects, thereby reducing cardiovascular risks. This review aims to describe studies involving the consumption of nuts, including Brazil nuts and CVD risk factors with positive results in the improvement of lipid profile, glucose metabolism, vascular function, and inflammatory and oxidative stress biomarkers

Nrf2, NF-κB and PPARβ/δ mRNA Expression Profile in Patients with Coronary Artery Disease / Perfil da Expressão do mRNA do Nrf2, NF-κB e PPARβ/δ em Pacientes com Doença Arterial Coronariana

Abstract Background: Oxidative stress and inflammation are present in coronary artery disease (CAD) and are linked to the activation of the transcription nuclear factor kappa B (NF-κB). To attenuate these complications, transcription factors like nuclear factor erythroid 2-related factor 2 (Nrf2) and peroxisome proliferator-activated receptor-β/δ (PPARβ/δ) can be activated to inhibit NF-κB. However, the available data on expression of NF-κB, Nrf2 and PPARβ/δ in CAD patients are limited. Objective: To evaluate the expression of the transcription factors NF-κB and Nrf2 and PPAR��/�� in CAD patients. Methods: Thirty-five patients (17 men, mean age 62.4 ? 7.55 years) with CAD and twelve patients (5 men, mean age 63.50 ? 11.46 years) without CAD were enrolled. Peripheral blood mononuclear cells (PBMCs) were isolated and processed for mRNA expression of Nrf2, NF-κB, NADPH: quinone oxidoreductase 1 (NQO1) and PPARβ/δ mRNAs using quantitative real-time polymerase chain reaction (qPCR). p < 0.05 was considered statistically significant. Results: There was no difference in the mRNA expressions of Nrf2 (1.35 ? 0.57), NF-κB (1.08 ? 0.50) or in the antioxidant enzyme NQO1 (1.05 ? 0.88) in the CAD group compared to the group without CAD (1.16 ? 0.76, 0.95 ? 0.33, 0.81 ? 0.55, respectively). However, PPARβ/δ was highest expressed in the CAD group (1.17 ? 0.86 vs. 0.56 ? 0.34, p = 0.008). Conclusion: The main finding of this study was the PPARβ/δ being more expressed in the PBMC of patients with CAD compared to the control group, whereas no differences were observed in Nrf2 or NF-κB mRNA expressions.

Resumo Fundamentos: O estresse oxidativo e a inflamação estão presentes na doença arterial coronariana (DAC) e estão ligados à ativação do fator de transcrição nuclear kappa B (NF-κB). Para atenuar essas complicações, fatores de transcrição como o fator nuclear eritroide 2-relacionado ao fator 2 (Nrf2) e o receptor ativado por proliferador de peroxissoma β/δ (PPARβ/δ) podem ser ativados para inibir o NF-κB. No entanto, os dados disponíveis sobre a expressão de NF-κB, Nrf2 e PPARβ/δ em pacientes com DAC são limitados. Objetivo: Avaliar a expressão dos fatores transcricionais NF-κB e Nrf2 e o PPARβ/δ em pacientes com DAC. Métodos: Trinta e cinco pacientes (17 homens, idade média de 62,4 ± 7,55 anos) com DAC e doze pacientes (5 homens, com idade média de 63,50 ± 11,46 anos) sem DAC foram incluídos. Células mononucleares do sangue periférico (PBMCs) foram isoladas e processadas para a expressão de mRNA do Nrf2, NF-κB, NADPH: quinona oxidoredutase 1 (NQO1) e mRNAs do PPARβ/δ por meio de reação em cadeia da polimerase quantitativa em tempo real (qPCR). Valores de p < 0,05 foram considerados como estatisticamente significativos. Resultados: Não houve diferença nas expressões de mRNA do Nrf2 (1,35 ± 0,57), NF-κB (1,08 ± 0,50) ou na enzima antioxidante NQO1 (1,05 ± 0,88) no grupo DAC em comparação com o grupo sem DAC (1,16 ± 0,76, 0,95 ± 0,33, 0,81 ± 0,55, respectivamente). Entretanto, o PPARβ/δ apresentou maior expressão no grupo com DAC (1,17 ± 0,86 vs. 0,56 ± 0,34, p = 0,008). Conclusão: O principal achado do presente estudo foi o PPARβ/δ apresentar maior expressão nas PBMCs de pacientes com DAC comparados ao grupo controle, ao passo que não foram observadas diferenças nas expressões de mRNA do Nrf2 ou NF-κB.

Qualidade microbiológica de refrescos armazenados em garrafas pet e refresqueiras comercializados em um munícipio do recôncavo da Bahia / Microbiological quality of soft drinks stored in pet bottles marketed in a municipality of the Bahia state

Este trabalho teve por objetivo avaliar as características higienicossanitárias dos refrescos armazenados em garrafas tipo PET e em refresqueiras comercializados em estabelecimentos de um município do Recôncavo da Bahia. Foram analisadas, quanto à presença de bolores, leveduras e coliformes termotolerantes, 10 amostras de refrescos, acondicionadas em garrafas PET e refresqueiras. Das cinco amostras analisadas, duas (40%) armazenadas em garrafas PET, e uma (20%) armazenada em refresqueiras, apresentou-se em desacordo com os padrões estabelecidos pela legislação vigente. Na análise de bolores e leveduras, encontrou-se elevado crescimento destes micro- -organismos em quatro amostras (80%) armazenadas em garrafas PET e em cinco amostras (100%) armazenadas em refresqueiras. As informações obtidas nessa pesquisa demonstraram que os refrescos coletados estavam em condições higienicossanitárias insatisfatórias, podendo representar causas de infecções de origem alimentar aos consumidores.(AU)

The objective of this study was to evaluate the hygienic-sanitary characteristics of refreshment stored in PET bottles and in refreshments marketed in establishments in a municipality in the Recôncavo da Bahia. For the presence of molds, yeasts and thermotolerant coliforms, 10 samples of refreshment, packed in PET bottles and coolers, were analyzed. Of the five samples analyzed, two (40%) stored in PET bottles, and one (20%) stored in refrigerators, were in disagreement with the standards established by current legislation. When analyzing molds and yeasts, a high growth of these microorganisms was found in four samples (80%) stored in PET bottles and in five samples (100%) stored in coolants. The information obtained in this research showed that the refreshments collected were in unsatisfactory hygienic-sanitary conditions, and may represent causes of food-borne infections to consumers.

Does high intensity exercise affects irisin plasma levels in hemodialysis patients? A pilot study / O exercício físico de alta intensidade afeta os níveis plasmáticos de irisina em pacientes em hemodiálise? Um estudo piloto

ABSTRACT Background: Irisin is a recently identified exercise-induced hormone that stimulates the "browning" of the white adipose tissue, at least in mice. In chronic kidney disease (CKD) patients, irisin regulation is not fully understood, and little attention has been given to the effects of exercise on irisin levels in these patients. The purpose of this study was to assess the effects of high intensity exercise on irisin plasma levels in CKD patients under hemodialysis (HD). Methods: Fifteen HD patients (5 men, 44.4 ± 15.1 years old) were studied and served as their own controls. High intensity (single session) intradialytic strength exercises consisted of three sets of ten repetitions with four different movements in both lower limbs during 30 minutes. Blood samples were collected on different days (exercise and non-exercise day) at exactly the same time (30 and 60 minutes after the start of dialysis session). Plasma irisin levels were measured by ELISA assay and anthropometric and biochemical parameters were evaluated. Results: Irisin plasma levels were significantly reduced in both exercise day (125.0 ± 18.5 to 117.4 ± 15.0 ng/mL, p=0.02) and non-exercise day (121.5 ± 13.7 to 115.4 ± 17.2 ng/mL, p=0.02) after 60 minutes of dialysis. Conclusion: These data suggest that intense intradialytic strength exercise was unable to increase the circulating concentration of irisin in HD patients. Moreover, our data show that after one hour of dialysis session, irisin plasma levels may be reduced.

RESUMO História: A irisina é um hormônio induzido pelo exercício recentemente identificado que estimula o "escurecimento" do tecido adiposo branco, pelo menos em camundongos. Nos pacientes com doença renal crônica (DRC), a regulação da irisina não é totalmente compreendida, e pouca atenção tem sido dada aos efeitos do exercício sobre os níveis de irisina nesses pacientes. O objetivo deste estudo foi avaliar os efeitos do exercício de alta intensidade sobre os níveis plasmáticos de irisina em pacientes com DRC em hemodiálise (HD). Métodos: 15 pacientes em HD (5 homens, 44,4 ± 15,1 anos) foram estudados e serviram como os próprios controles. Os exercícios de resistência intradialítica de alta intensidade (sessão única) consistiram em três séries de dez repetições com quatro movimentos diferentes em ambos os membros inferiores durante 30 minutos. As amostras de sangue foram coletadas em dias diferentes (dia de exercício e dia sem exercício) exatamente no mesmo horário (30 e 60 minutos após o início da sessão de diálise). Os níveis de irisina plasmática foram medidos por ensaio ELISA e os parâmetros antropométricos e bioquímicos foram avaliados. Resultados: Os níveis plasmáticos de irisina foram significativamente reduzidos tanto nos dias de exercício (125,0 ± 18,5 a 117,4 ± 15,0 ng/mL, p=0,02) quanto nos dias sem exercício (121,5 ± 13,7 a 115,4 ± 17,2 ng / mL, p=0,02), após 60 minutos de diálise. Conclusão: esses dados sugerem que o exercício intenso de resistência intradialítica não aumentou a concentração circulante de irisina em pacientes sob HD. Além disso, nossos dados mostram que após uma hora de sessão de diálise, os níveis plasmáticos de irisina podem ser reduzidos.

Crown lengthening surgery and transurgical restoration

Introduction: The crown lengthening surgery and the transurgical restoration are alternative procedures to enable the restoration of teeth inaccessible to the conventional techniques and restore the lost biological space. Objective: This study aimed to present clinically the reconstruction of a right maxillary second molar through crown lengthening surgery associated with transurgical restoration with composite resin in a patient treated in the Integrated Clinics of the University of Ribeirão Preto. Case report: Patient E.H.C.V., female, aged 51 years, attended the dental clinic of the University of Ribeirão Preto. The anamnesis showed a favorable health history and the clinical examination showed great tooth crown destruction of tooth #17. The treatment planning included the crown lengthening periodontal surgery with regularization of alveolar bone on the buccal surface of tooth #17, rubber dam isolation, the restauration of the compromised area with composite resin, and suture in the same session. After 7 days, the sutures were removed and the restoration polished. Conclusion: It can be concluded that the use of this technique is a viable, fast, and satisfactory solution, with good results, favoring the health and aesthetics, returning function and better social life to the patient.

Concordance between the zinc sulphate flotation and centrifugal sedimentation methods for the diagnosis of intestinal parasites / Concordancia entre los métodos de flotación con sulfato de zinc y sedimentación centrífuga para el diagnóstico de parásitos intestinales

Resumen Introduction: The diagnosis of intestinal parasitic infections depends on the parasite load, the specific gravity density of the parasite eggs, oocysts or cysts, and the density and viscosity of flotation or sedimentation medium where faeces are processed. Objective: To evaluate the concordance between zinc sulphate flotation and centrifugal sedimentation in the recovery of parasites in faecal samples of children. Materials and methods: Faecal samples of 330 children from day care centers were evaluated by zinc sulphate flotation and centrifugal sedimentation techniques. The frequencies of detection of parasites by each method were determined and the agreement between the diagnostic techniques was evaluated using the kappa index, with 95% confidence intervals. Results: The faecal flotation in zinc sulphate diagnosed significantly more cases of Trichuris trichiura infection when compared to centrifugal sedimentation (39/330; 11.8% vs. 13/330; 3.9%, p<0.001), with low diagnostic concordance between methods (kappa=0.264; 95% CI: 0.102-0.427). Moreover, all positive samples for Enterobius vermicularis eggs (n=5) and Strongyloides stercoralis larvae (n=3) were diagnosed only by zinc sulphate. No statistical differences were observed between methods for protozoa identification. Conclusions: The results showed that centrifugal flotation in zinc sulphate solution was significantly more likely to detect light helminths eggs such as those of T. trichiura and E. vermicularis in faeces than the centrifugal sedimentation process.

Abstract Introducción. El diagnóstico de infecciones parasitarias intestinales depende de la carga de parásitos, la densidad de la gravedad específica de los huevos, ooquistes o quistes de parásitos, y de la densidad y viscosidad de los reactivos de flotación o sedimentación usados para procesar las heces. Objetivo. Evaluar la concordancia entre el método de flotación de sulfato de zinc y la sedimentación por centrifugación en la recuperación de parásitos en muestras fecales de niños. Materiales y métodos. Se evaluaron las muestras fecales de 330 niños de guarderías mediante las técnicas de flotación con sulfato de zinc y de sedimentación por centrifugación. Se determinó la frecuencia de detección de parásitos con cada método y se evaluó la concordancia entre las técnicas de diagnóstico mediante el índice kappa, con intervalos de confianza del 95 %. Resultados. Mediante la flotación fecal con sulfato de zinc, se diagnosticó un número significativamente mayor de casos de infección por Trichuris trichiura que con la sedimentación por centrifugación (39/330; 11,8 % Vs. 13/330; 3,9 %) (p<0,001), con poco acuerdo entre los métodos (kappa=0,264; IC95% 0,102-0,427). Además, todas las muestras positivas para huevos de Enterobius vermicularis (n=5) y larvas de Strongyloides stercoralis (n=3) se diagnosticaron solamente por sulfato de zinc. No se observaron diferencias estadísticamente significativas entre los métodos para la identificación de protozoos. Conclusiones. La flotación centrífuga en una solución de sulfato de zinc presentó una probabilidad significativamente mayor de detectar los huevos livianos de helmintos como T. trichiura y E. vermicularis en heces, que el proceso de sedimentación por centrifugación.

Associação entre níveis de ferritina e peroxidação lipídica em pacientes em hemodiálise / Association between serum ferritin and lipid peroxidation in hemodialysis patients

Resumo Introdução: A suplementação de ferro é uma das importantes recomendações em pacientes com doença renal crônica (DRC), contudo, uma sobrecarga desse mineral pode contribuir para o estresse oxidativo, condição essa bastante relacionada com o risco cardiovascular nesses pacientes. Objetivo: O objetivo desse trabalho foi investigar se os níveis de ferritina estão associados ao estresse oxidativo avaliado pelo malondialdeído (MDA) em pacientes em hemodiálise (HD). Métodos: Vinte pacientes em tratamento de HD (55,0 ± 15,2 anos, tempo de diálise de 76,5 ± 46,3 meses, IMC 23,6 ± 3,0 kg/m2) foram comparados com 11 indivíduos saudáveis (50,9 ± 8,0 anos, IMC 23,8 ± 1,9 kg/m2). O nível de MDA foi medido pela reação com o ácido tiobarbitúrico e os dados bioquímicos de rotina foram obtidos por meio do prontuário médico. Resultados: Os pacientes em HD apresentaram elevados níveis de MDA (13,2 ± 5,3 nmol/mL) quando comparados aos indivíduos saudáveis (5,1 ± 2,7 nmol/mL; p < 0,01). Doze pacientes (60%) apresentaram valores de ferritina superiores a 500 ng/mL e houve correlação positiva entre ferritina e MDA nos pacientes HD (r = 0,66; p = 0,005; n = 17). Conclusão: O excesso dos estoques de ferro em pacientes em HD resulta em um aumento da peroxidação lipídica e, consequentemente, contribui para um maior estresse oxidativo nesses pacientes. .

Abstract Introduction: Iron supplementation is one of the recommendations found in patients with chronic kidney disease (CKD), however, an overload of this mineral can contribute to oxidative stress, a condition closely related to the cardiovascular risk in these patients, as well as disease progression. Objective: The objective of this study was to investigate whether ferritin levels are associated with oxidative stress marker MDA in patients on hemodialysis (HD). Methods: Twenty HD patients (55.0 ± 15.2 years, time of dialysis 76.5 ± 46.3 months, BMI 23.6 ± 3.0 kg/m2) were compared with 11 healthy subjects (50.9 ± 8.0 years, BMI 23.8 ± 1.9 kg/m2). Malondialdehyde (MDA) was measured by reaction with thiobarbituric acid and routine biochemical data were obtained from medical records. Results: MDA levels were significantly higher in HD patients compared to the control group (13.2 ± 5.3 nmol/mL vs. 5.1 ± 2.7nmol/mL, p < 0.01). Twelve patients (60%) had ferritin values greater than the 500 ng/mL and there was a positive correlation between ferritin and MDA in HD (r = 0.66, p = 0.005, n = 17) patients. Conclusion: The excess iron stores in HD patients results in increased lipid peroxidation, and consequently contributes to increased oxidative stress in these patients. .

Effects of grape powder supplementation on inflammatory and antioxidant markers in hemodialysis patients: A randomized double-blind study / Efeitos da suplementação de farinha de uva sobre marcadores inflamatórios e antioxidantes em pacientes em hemodiálise: Estudo duplo-cego randomizado

Introduction: Polyphenols contained in natural sources such as grapes, have been considered pharmacological agents to combat oxidative stress and inflammation, common features in Chronic Kidney Disease patients. Objective: To evaluate the effects of grape powder supplementation on inflammatory and antioxidant biomarkers in hemodialysis (HD) patients. Methods: The double-blind placebo-controlled randomized clinical trial evaluated non-diabetic HD patients that received grape powder (500 mg of polyphenols/day) (n = 16, 9 men, 53.0 ± 9.8 years of age, 111.6 ± 58.2 HD months) or placebo (n = 16, 9 men, 52.7 ± 13.7 years of age, 110.4 ± 93.1 HD months) for five weeks. The glutathione peroxidase (GSH-Px) activity and C-reactive protein (CRP) levels were evaluated by ELISA method. Results: After the intervention period, the patients receiving grape powder showed an increase in the GSH-Px activity (16.5 (41.0) to 42.0 (43.3) nmol/min/ml) (p < 0.05) and they did not have the CRP levels increased as seen in placebo group (2.6 (0.28) to 2.8 (0.23 mg/L) (p < 0.05). Conclusion: The use of grape powder as phenolic source could play an important role as an antioxidant and anti-inflammatory agent in non-diabetic HD patients. .

Introdução: Polifenóis contidos em fontes naturais, como as uvas, têm sido considerados agentes farmacológicos no combate ao estresse oxidativo e inflamação, condições comuns na Doença Renal Crônica. Objetivo: Avaliar os efeitos da suplementação de farinha de uva sobre marcadores inflamatórios e antioxidantes em pacientes submetidos à hemodiálise (HD). Métodos: Estudo randomizado, duplo-cego, placebocontrolado, no qual foram avaliados pacientes não diabéticos em HD que receberam farinha de uva (500 mg de polifenóis/dia) (n = 16, 9 homens, 53,0 ± 9,8 anos, 111,6 ± 58,2 meses em HD) ou placebo (n = 16, 9 homens, 52,7 ± 13,7 anos, 110,4 ± 93,1 meses em HD) por cinco semanas. A atividade da glutationa peroxidase (GSH-Px) e os níveis plasmáticos de proteína C-reativa (PCR) foram mensurados por meio do método ELISA. Resultados: Após o período de intervenção, os pacientes que receberam farinha de uva apresentaram elevação na atividade da GSH-Px (16,5 (41,0) para 42,0 (43,3) nmol/min/ml) (p < 0,05) e não foi observada elevação nos níveis de PCR, como visto no grupo placebo (2,6 (0,28) para 2,8 (0,23) mg/L) (p < 0,05). Conclusão: O uso da farinha de uva como fonte de polifenóis pode desempenhar um importante papel anti-inflamatório e antioxidante em pacientes não diabéticos submetidos à HD. .