Antinociceptive in vivo activity and chemical profiling by UHPLC-MS/MS of stem bark and leaves extracts of Ficus maxima Mill. (Moraceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Ficus maxima is a medicinal plant extensively used in traditional medicine by Indigenous peoples across Central and South America. It is a member of the family Moraceae, subgenus Pharmacosycea, employed in treating various conditions, including intestinal parasites, gingivitis, internal inflammations, and snake bites. Despite its significant pharmacological potential, the species remains underrepresented in scientific literature. AIM OF THE STUDY: This study aimed to evaluate the in vivo antinociceptive properties of leaf (ELFM) and stem bark (EBFM) extracts from Ficus maxima. Additionally, the chemical composition of these extracts was determined using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). MATERIALS AND METHODS: Plant material was collected in Abaetetuba, Pará, Brazil, in October 2013 and subjected to static maceration to obtain crude ELFM and EBFM. Bio-guided fractionation was performed by sequential liquid-liquid partitioning with hexane (Hex), dichloromethane (DCM), and ethyl acetate (EtOAc), yielding the following fractions: ELFM-Hex and EBFM-Hex, ELFM-DCM and EBFM-DCM, and ELFM-EtOAc and EBFM-EtOAc. The biological activity of EBFM, ELFM, and their respective fractions were evaluated using the formalin-induced pain test and the hot plate test, followed by an assessment of their mechanisms of action. The UHPLC-MS/MS analysis was conducted using electrospray ionization (ESI) in both positive and negative modes. Metabolite annotation was facilitated by MS/MS libraries and molecular networks constructed on the GNPS platform. RESULTS: The reactivity time to formalin in the neurogenic phase was reduced from 84.7 ± 7.6 s (100%) to 37.3 ± 4.7 s (44%), 33.1 ± 6.3 s (39%), 40.7 ± 7.4 s (48%), 57.2 ± 2.6 s (77%), 49.7 ± 4.1 s (58%), 46.8 ± 8.1 s (55%), and 52.4 ± 5.3 s (61%) after treatment with ASA, morphine, EBFM, ELFM, ELFM-Hex, ELFM-DCM, and ELFM-EtOAc at doses of 30 mg/kg, respectively. In the inflammatory phase, the reactivity time to formalin was reduced from 124.3 ± 25.9 s (100%) to 49.7 ± 4.7 s (40%), 9.8 ± 4.3 s (8%), 32.5 ± 8.5 s (26%), 59.8 ± 16.8 s (48%), and 54.4 ± 7.3 s (44%) after treatment with ASA, morphine, EBFM, ELFM, and ELFM-Hex at doses of 30 mg/kg, respectively. A reversal of the antinociceptive action of EBFM and ELFM was observed in the inflammatory phase after treatment with atropine, a muscarinic antagonist, and naloxone, an opioid antagonist, respectively. In the hot plate test, EBFM showed Antinociceptive Activity (AA) of 62.6 ± 9.2% after 90 min; however, there was a reversal of AA to 8.6 ± 2.8% when naloxone was used. The UHPLC-MS/MS metabolite analysis revealed the presence of loliolide (3), luteolin (13), lupeol (14), gallic acid (15), chlorogenic acid (16), pygenic acid A (17), and other metabolites from the alkaloids and fatty acids classes.

Relationship between Maternal Stress and Neurobehavioral Indicators of Preterm Infants in the Neonatal Intensive Care Unit.

BACKGROUND: Preterm birth and prolonged neonatal hospitalization are potential sources of stress for mothers of preterm and low birth weight infants. AIM: To evaluate maternal stress and its association with neurobehavioral indicators of preterm infants during hospitalization in the neonatal intensive care unit. METHODS: A cross-sectional study was conducted in a neonatal intensive care unit of a hospital in Goiânia, Brazil. The study included preterm and low birth weight infants of both genders and their mothers. The Parental Stressor Scale: Neonatal Intensive Care Unit and the Neurobehavioral Assessment of the Preterm Infant were respectively applied to mothers and infants in the neonatal intensive care unit. RESULTS: The study involved 165 premature infants and their mothers. The mean age of the mothers was 26.3 years and most had a high school education level (57.6%). Mothers perceived the experience of having an infant in the neonatal intensive care unit as moderately stressful (2.96 ± 0.81). The parental role alteration (4.11 ± 1.03) and sights and sounds (2.15 ± 0.90) subscales exhibited the highest and lowest stress levels, respectively. Significant correlations (rho < -0.3; p < 0.05) were found between maternal stress and neurobehavioral indicators of infants. In the multivariate analysis, low leg tone was a predictor of higher maternal stress. Low tone and limited arm movement were predictors of higher maternal stress in the maternal role item. CONCLUSIONS: The experience of having a preterm infant hospitalized was considered moderately stressful for mothers. Maternal stress levels were significantly correlated with low scores on neonatal neurobehavioral indicators.

Holistic assessment of dimethoate toxicity in Carcinus aestuarii's muscle tissues.

Dimethoate (DMT) is one of the most harmful and commonly used organophosphate pesticides in agricultural lands to control different groups of parasitic insects. However, this pesticide is considered a dangerous pollutant for aquatic organisms following its infiltration in coastal ecosystems through leaching. Yet, our investigation aimed to gain new insights into the toxicity mechanism of DMT in the muscles of the green crab Carcinus aestuarii, regarding oxidative stress, neurotransmission impairment, histological aspects, and changes in lipid composition, assessed for the first time on the green crab's muscle. Specimens of C. aestuarii were exposed to 50, 100, and 200 µg DMT L-1 for 24 h. Compared to the negative control group, the higher the DMT concentration, the lower the saturated fatty acids (SFA), and the higher the monounsaturated fatty acids (MUFA). The significant increase in polyunsaturated fatty acid n-6 (PUFA n-6) was related to the high release, mainly, of linoleic acid (LA, C18: 2n6) and arachidonic acid (ARA, C20: 4n6) levels. Biochemical biomarkers showed that DMT exposure promoted oxidative stress, highlighted by increased levels of hydrogen peroxide (H2O2), malondialdehyde (MDA), advanced oxidation protein product levels (AOPP), and protein carbonyl (PCO). Furthermore, the antioxidant defense system was activated, as demonstrated by the significant changes in the enzymatic activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and reduced glutathione (GSH) levels associated with an adaptation process of C. aestuarii to cope with the DMT exposure. This pesticide significantly impairs the neurotransmission process, as evidenced by the inhibition of acetylcholinesterase (AChE) activity. Finally, several histopathological changes were revealed in DMT-treated crabs, including vacuolation, and muscle bundle loss.This research offered new insights into the toxic mechanism of DMT, pointing to the usefulness of fatty acid (FA) composition as a sensitive biomarker in littoral crabs.

Approaches of marine compounds and relevant immune mediators in Autism Spectrum Disorder: Opportunities and challenges.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects social skills, language, communication, and behavioral skills, significantly impacting the individual's quality of life. Recently, numerous works have centered on the connections between the immune and central nervous systems and the influence of neuroinflammation on autism symptomatology. Marine natural products are considered as important alternative sources of different types of compounds, including polysaccharides, polyphenols, sterols, carotenoids, terpenoids and, alkaloids. These compounds present anti-inflammatory, neuroprotective and immunomodulatory activities, exhibiting a potential for the treatment of many diseases. Although many studies address the marine compounds in the modulation of inflammatory mediators, there is a gap regarding their use in the regulation of the immune system in ASD. Thus, this review aims to provide a better understanding regarding cytokines, chemokines, growth factors and immune responses in ASD, as well as the potential of bioactive marine compounds in the immune regulation in ASD. We expect that this review would contribute to the development of therapeutic alternatives for controlling immune mediators and inflammation in ASD.

Hand function outcomes following surgical treatment of complete neonatal brachial plexus palsy.

PURPOSE: Although re-innervation of the hand is considered a priority in the treatment of infants with complete brachial plexus injury, there is currently a paucity of publications investigating hand function outcomes following primary nerve reconstruction in infants with neonatal brachial plexus palsy (NBPP). This study therefore aimed to evaluate hand function outcomes in a series of patients with complete NBPP. METHODS: This retrospective case series included all patients who underwent primary nerve surgery for complete neonatal brachial plexus palsy over an 8-year period. Outcomes were assessed using the Raimond Hand Scale. Classification of grade 3 or higher indicates a functional hand (assistance in bimanual activity). RESULTS: Nineteen patients with a complete NBPP underwent primary nerve reconstruction at a mean age of 3.7 months. Periodic clinical evaluations were performed until at least 4 years of age. According to the Raimondi hand scale, one patient did not recover (grade 0), three patients attained grade 1, four grade 2, ten grade 3, and in one grade 4. Overall hand functional recovery was achieved in 57.8% (11/19) of patients. CONCLUSION: Sufficient recovery of hand function to perform bimanual activity tasks in patients with complete NBPP lesions is possible and should be a priority in the surgical treatment of these infants.

Plasmonic immunosensors based on spoon-shaped waveguides for fast and on-site ultra-low detection of ochratoxin A in coffee samples.

The high toxicity and occurrence of ochratoxin A (OTA) in grains and foods has been a growing concern due to the impacts on health and the economy in many countries. In this sense, simplified devices with high sensitivity and specificity for local monitoring are enthusiastically pursued. In this work, we report for the first time the detection of ochratoxin A in coffee samples using a spoon-shaped waveguide immunosensor. The biosensor was built with the surface of the spoon-shaped waveguide covered by a 60 nm layer of gold to enable the SPR phenomenon. The measurements indicated a linear relationship between the change in the SPR phenomenon values and the OTA concentration in the range from 0.2 ppt to 5 ppt. When analyzed in coffee samples, the biosensor was highly selective and did not suffer matrix interference. The developed biosensor represents a promising analytical device for coffee quality analyses, as it is portable, simple, and suitable for onsite detection of target analytes.

Alteration of redox status and fatty acid profile in gills from the green crab (Carcinus aestuarii) following dimethoate exposure.

Dimethoate is a broad-spectrum organophosphate insecticide and acaricide. Through various pathways, such as runoff and drift, dimethoate can reach marine environment, and easily impact common organisms in coastal areas, close to agriculture lands, namely crustaceans. The purpose of this study was to investigate the potential effects of dimethoate exposure (50, 100, and 200 µg/l), for 1 day, on a wide range of markers of oxidative stress and neurotransmission impairment, as well as fatty acids composition and histopathological aspect in the gills of the green crab Carcinus aestuarii. A significant increase in n-3 polyunsaturated fatty acids series, namely the eicosapentaenoic acid (C20: 5n3) and its precursor alpha-linolenic acid (C 18: 3n3) in dimethoate-treated crabs was recorded. Concerning n-6 polyunsaturated fatty acids, we noted a high reduction in arachidonic acid (C20:4n-6) levels. Dimethoate exposure increased the levels of hydrogen peroxide, malondialdehyde, lipid hydroperoxides, protein carbonyl, and caused the advanced oxidation of protein products along with enzymatic and non-enzymatic antioxidant-related markers. Acetylcholinesterase activity was highly inhibited following exposure to dimethoate in a concentration-dependent manner. Finally, deleterious histopathological changes with several abnormalities were noted in exposed animals confirming our biochemical findings. The present study offered unique insights to establish a relationship between redox status and alterations in fatty acid composition, allowing a better understanding of dimethoate-triggered toxicity.

Harmonizing nanomaterial exposure methodologies in ecotoxicology: the effects of two innovative nanoclays in the freshwater microalgae Raphidocelis subcapitata.

Layered double hydroxides (LDHs) are innovative nanomaterials (NMs) with a typical nanoclay structure (height <40 nm) consisting of layers of metallic cations and hydroxides stabilized by anions and water molecules. Upon specific triggers, anions can exchange by others in the surrounding environment. Due to this stimuli-responsive behavior, LDHs are used as carriers of active ingredients in the industrial or pharmaceutical sectors. Available technical guidelines to evaluate the ecotoxicity of conventional substances do not account for the specificities of NMs, leading to inaccuracies and uncertainty. The present study aimed to assess two different exposure methodologies (serial dilutions of the stock dispersion vs. direct addition of NM powder to each concentration) on the ecotoxicological profile of different powder grain sizes of Zn-Al LDH-NO3 and Cu-Al LDH-NO3 (bulk, <25, 25-63, 63-125, 125-250, and >250 µm) in the growth of the freshwater microalgae Raphidocelis subcapitata. Results revealed that the serial dilutions methodology was preferable for Zn-Al LDH-NO3, whereas for Cu-Al LDH-NO3 both methodologies were suitable. Thus, the serial dilutions methodology was selected to assess the ecotoxicity of different grain sizes for both LDHs. All Zn-Al LDH-NO3 grain sizes yielded similar toxicity, while Cu-Al LDH-NO3 powders with smaller grain sizes caused a higher effect on microalgae growth; thus, grain size separation might be advantageous for future applications of Cu-Al LDH-NO3s. Considering the differences between exposure methodologies for the Zn-Al LDH-NO3, further research involving other NMs and species must be carried out to achieve harmonization and validation for inter-laboratory comparison.

Characterization and Behaviour of Silica Engineered Nanocontainers in Low and High Ionic Strength Media.

Mesoporous silica engineered nanomaterials are of interest to the industry due to their drug-carrier ability. Advances in coating technology include using mesoporous silica nanocontainers (SiNC) loaded with organic molecules as additives in protective coatings. The SiNC loaded with the biocide 4,5-dichloro-2-octyl-4-isothiazolin-3-one (DCOIT), i.e., SiNC-DCOIT, is proposed as an additive for antifouling marine paints. As the instability of nanomaterials in ionic-rich media has been reported and related to shifting key properties and its environmental fate, this study aims at understanding the behaviour of SiNC and SiNC-DCOIT in aqueous media with distinct ionic strengths. Both nanomaterials were dispersed in (i) low- (ultrapure water-UP) and (ii) high- ionic strength media-artificial seawater (ASW) and f/2 medium enriched in ASW (f/2 medium). The morphology, size and zeta potential (ζP) of both engineering nanomaterials were evaluated at different timepoints and concentrations. Results showed that both nanomaterials were unstable in aqueous suspensions, with the initial ζP values in UP below -30 mV and the particle size varying from 148 to 235 nm and 153 to 173 nm for SiNC and SiNC-DCOIT, respectively. In UP, aggregation occurs over time, regardless of the concentration. Additionally, the formation of larger complexes was associated with modifications in the ζP values towards the threshold of stable nanoparticles. In ASW, SiNC and SiNC-DCOIT formed aggregates (<300 nm) independently of the time or concentration, while larger and heterogeneous nanostructures (>300 nm) were detected in the f/2 medium. The pattern of aggregation detected may increase engineering nanomaterial sedimentation rates and enhance the risks towards dwelling organisms.

Therapeutic hypothermia as a neuroprotective strategy in newborns with perinatal asphyxia-case report.

Background: Perinatal asphyxia is a public health problem and the third major cause of death among children under 5 years. Objective: Two clinical cases of newborns with perinatal asphyxia submitted to therapeutic hypothermia and the follow-up of their motor development after hospital discharge have been reported. Methods: This retrospective case report study included two newborns with hypoxic-ischemic encephalopathy due to perinatal asphyxia who received a hypothermia protocol at the neonatal intensive care unit (NICU). The two newborns and their families were followed up at the outpatient clinic and assessed using the Hammersmith Child Neurological Examination, Alberta Child Motor Scale, and Denver Developmental Screening Test-II. Results: The newborns were submitted to a 72-hour hypothermia protocol. One newborn remained for 13 days in the NICU, while the other remained for 22 days. According to the multidisciplinary team, both cases presented with typical motor development with no cerebral palsy during the follow-up. Conclusion: Both cases showed positive results and a good prognostic for motor development. Therapeutic hypothermia may be a strategy to prevent neurologic sequelae in newborns with perinatal asphyxia, including cerebral palsy.

Fibrolipomatous hamartoma of the median nerve: An unusual cause of carpal tunnel syndrome.

Fibrolipomatous hamartoma is a rare benign tumor-like condition that affects most commonly the median nerve. The diagnosis is usually confirmed through its typical appearance on magnetic resonance imaging (MRI) without the need for a nerve biopsy. There are divergent views regarding treatment of this entity, but open carpal tunnel release for nerve decompression currently constitutes the standard care for alleviation of compressive neuropathy of the median nerve. In this report, we describe a case of fibrolipomatous hamartoma that was diagnosed via MRI and underwent open carpal tunnel release, with alleviation of the patient's symptoms.

Picossulfato de sódio comparado ao Manitol no preparo intestinal para colonoscopia: uma revisão sistemática / Sodium picosulfate compared to mannitol for bowel preparation before colonoscopy: a systematic review

Introdução: A colonoscopia é considerada o exame padrão ouro para diagnóstico do câncer de intestino. Porém o sucesso do exame depende do preparo colônico eficaz. Objetivo: Avaliar a eficácia do picossulfato de sódio (PS) comparativamente ao manitol (MN) no preparo intestinal precedente ao exame de colonoscopia. Material e Métodos: Revisão sistemática de ensaios clínicos randomizados controlados (ECRs). A busca por evidências na literatura científica foi conduzida nas bases de dados PubMed, Embase, Cochrane Library e Biblioteca Virtual da Saúde por meio da combinação dos seguintes indexadores e operadores booleanos: "colonoscopy" AND "picosulfate sodium" AND "mannitol". O risco de viés foi avaliado pela ferramenta RoB 2.0. Resultados: O efeito do PS sobre a limpeza colônica foi similar ou até mesmo inferior àquele demonstrado pelo MN. Entretanto, observou-se maior tolerabilidade e palatabilidade e menor frequência de efeitos colaterais associados ao PS em comparação ao MN. Ressalta-se a carência de rigor metodológico dos estudos incluídos, visto que 33% destes foram classificados com "alto risco" de viés, enquanto 66,7% apresentaram "alguma preocupação". Conclusão: Em comparação ao MN, o uso de PS não promove uma maior qualidade de limpeza colônica, embora esteja relacionado à menor ocorrência de efeitos colaterais, maior tolerabilidade e palatabilidade. Assim, sugere-se que a inclusão do PS seja considerada apenas em pacientes com intolerância importante ou surgimento de efeitos adversos que inviabilizem o preparo com MN.

Introduction: Colonoscopy is considered the gold standard test for diagnosing bowel cancer. The success of the exam, however, depends on effective colonic preparation. Objective: To evaluate the effectiveness of Sodium Picosulfate (PS) compared to Mannitol (MN) in intestinal preparation before colonoscopy examination. Material and Methods: Systematic review of randomized controlled clinical trials (RCTs). The search for evidence in the scientific literature was conducted in the PubMed, Embase, Cochrane Library and Virtual Health Library databases by combining the following indexers and Boolean operators: "colonoscopy" AND "picosulfate sodium" AND "Mannitol". The risk of bias was assessed using the RoB 2.0 tool. Results: The effect of PS on colonic cleansing was similar or even lower than that demonstrated by MN. However, greater tolerability and palatability and a lower frequency of side effects associated with PS were observed compared to MN. The lack of methodological rigor of the included studies is highlighted, as 33% of these were classified as "high risk" of bias, while 66.7% presented "some concern". Conclusion: Compared to MN, the use of PS does not promote a higher quality of colon cleansing, although it is related to the lower occurrence of side effects, greater tolerability and palatability. Therefore, it is suggested that the inclusion of PS must be considered only in patients with significant intolerance or the emergence of adverse effects that make preparation with MN unfeasible.

Zn-Al layered double hydroxides induce embryo malformations and impair locomotion behavior in Danio rerio.

Layered double hydroxides (LDHs) are stimuli-responsive anionic nanoclays. The vast possibilities of using LDHs can lead to their existence in the ecosystem, raising a question of potential ecological concern. However, little is known about the effect of these nanomaterials on freshwater organisms. The present study aimed to assess the ecotoxicological effects of Zinc-Aluminium LDH-nitrate (ZnAl LDH-NO3) in zebrafish (Danio rerio) early life stages. The endpoints measured were mortality, malformations and hatching rate after exposure of D. rerio embryos and larvae to ZnAl LDH-NO3 following the OECD 236 guideline. The behavioral, biochemical (markers of oxidative stress and neurotoxicity), and molecular (at DNA level) alterations were also assessed using sub-lethal concentrations. No observable acute effects were detected up to 415.2 mg LDH/L while the 96 h-LC50 was estimated as 559.9 mg/L. Tested LDH caused malformations in D. rerio embryos, such as pericardial edema, incomplete yolk sac absorption and tail deformities (96 h-EC50 = 172.4 mg/L). During the dark periods, the locomotor behavior in zebrafish larvae was affected upon ZnAl LDH-NO3 exposure. However, no significant biochemical and molecular changes were recorded. The present findings suggest that ZnAl LDH-NO3 can be regarded as a non-toxic nanomaterial towards D. rerio (E/LC50 > > 100 mg/L) although impairment of the locomotion behavior on zebrafish embryos can be expected at concentrations below 100 mg/L.

Gentle Touch and Sucrose for Pain Relief during Suctioning in Preterm Newborns-A Randomized Clinical Trial.

Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning during hospitalization in the neonatal intensive care unit. PTNBs underwent three different suctioning procedures. The first was performed without intervention (baseline). Right after, PTNBs were randomly allocated (sucrose and gentle touch or vice versa) to the next two suctioning procedures. Two validated scales assessed pain: the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile-Revised (PIPP-R). We evaluated 50 PTNBs (mean of 28 weeks) with a mean low birth weight of 1050 g; most were under continuous positive airway pressure 37 (74%) and mechanical ventilation 41 (82%). Gentle touch was efficacious for pain relief since NIPS (p = 0.010) compared to baseline. Sucrose was also effective in reducing pain NIPS and PIPP-R (p < 0.001). Although the two interventions reduced pain, no difference was observed between gentle touch and sucrose.

High-Risk Preterm Infant Born to a Mother With COVID-19: A Case Report.

The COVID-19 pandemic raises concerns about risks for pregnant women and fetuses, considering factors such as vertical transmission and neonatal alterations caused by maternal infection. Despite this, neuropsychomotor and functional complications in infants delivered by mothers with COVID-19 are still little studied. Thus, we aimed to describe the health history and development based on ICF (International Classification of Functioning, Disability and Health) components of a high-risk preterm infant born to a mother hospitalized due to COVID-19 complications. This case report was based on medical records, developmental assessments, and maternal reports. The infant was born at 30 weeks and 3 days, weighing 1,300 g, measuring 40 cm, and with Apgar scores of 2, 5, 6, and 7. COVID-19 test was negative 1 and 72 h after birth. Moreover, the infant had cardiorespiratory complications and hyperechogenicity of the periventricular white matter. The infant presented speech and language delays during follow-up, but neuromotor development occurred according to age. The health care and follow-up provided helped the development of resilience mechanisms by the infant and family to overcome adversities in the prenatal, perinatal, and neonatal periods. The assessments based on ICF components can contribute to future studies on this topic.

Reliability and internal consistency in the assessment of neonatal pain in preterm infants during tracheal aspiration: prospective study / Confiabilidade e consistência interna na avaliação da dor neonatal de prematuros durante o procedimento de aspiração traqueal: estudo prospectivo

ABSTRACT BACKGROUND AND OBJECTIVES: Inadequate pain assessment in preterm infants (PI) is a persistent problem. Currently, a precise pain assessment is one of the main challenges for health professionals in the intensive care units (NICU). The objective of this study was to verify the correlation between the Neonatal Infant Pain Scale (NIPS) and Premature Infant Pain Prole - Revised (PIPP-R), internal consistency, and inter-evaluator reliability on pain assessment during aspiration in PI. METHODS: Prospective observational study with low birth weight PI (< 2500 g), hemodynamically stable, minimal or no sedation, under mechanical ventilation, continuous positive airway pressure, nasal cannula oxygen, or ambient air, and needing aspiration during hospitalization in the neonatal intensive care unit in the period from 2019 to 2020.. PI were evaluated during three different aspiration procedures: without intervention (1), using gentle touch (2), and using sucrose (3). NIPS and PIPP-R instruments were applied, while internal consistency was determined using Cronbach's alpha, reliability using the intraclass correlation coefficient, and concurrent validity using Spearman's correlation coefficient. RESULTS: Fifty PIs requiring tracheal aspiration were evaluated. NIPS and PIPP-R showed high (Cronbach α: 0.824) and moderate (Cronbach α: 0.655) internal consistency. Inter-e- valuation reliability was excellent in all aspiration procedures for NIPS (1: 0.991, 2: 0.987, and 3: 0.993) and PIPP-R (1: 0.997, 2: 0.986, and 3: 0.977). Concurrent validity was observed only for aspiration without intervention. CONCLUSION: Although NIPS may have better clinical utility than PIPP-R, both instruments presented good internal consistency and inter-evaluator reliability and may be used for assessing pain during aspiration in PI.

RESUMO JUSTIFICATIVA E OBJETIVOS: A avaliação inadequada da dor em recém-nascidos prematuros (RNPT) é um problema persistente. A avaliação precisa da dor é um dos principais desafios para profissionais de saúde nas Unidades de Terapia Intensiva Neonatais (UTIN). O objetivo deste estudo foi verificar a associação entre a Escala de Dor Neonatal (Neonatal Infant Pain Scale - NIPS) e o Perfil da Dor do Bebê Prematuro - Revisado (Premature Infant Pain Profile Revised - PIPP-R), assim como a consistência interna e a confiabilidade inter-avaliadores na aferição da dor durante a aspiração do RNPT. MÉTODOS: Estudo transversal prospectivo com RNPT de baixo peso ao nascer (<2500 g), hemodinamicamente estáveis, com mínima ou nenhuma sedação, sob ventilação mecânica, apresentando pressão positiva contínua nas vias aéreas, oxigênio na cânula nasal ou ar ambiente, e precisando de aspiração durante a internação na UTIN no período de 2019 a 2020. Os RNPT foram avaliados durante três diferentes procedimentos de aspiração: sem intervenção (1), toque gentil (2) e administração de sacarose (3). Os instrumentos NIPS e PIPP-R foram aplicados durante a avaliação. A consistência interna foi determinada pelo alfa de Cronbach, a confiabilidade pelo coeficiente de associação intraclasse e a validade concorrente pelo teste de associação de Spearman. RESULTADOS: Foram avaliados 50 RNPT que necessitaram de aspiração traqueal. A NIPS e a PIPP-R mostraram consistência interna alta (Cronbach α: 0,824) e moderada (Cronbach α: 0,655), respectivamente. A confiabilidade inter-avaliadores foi excelente em todos os procedimentos de aspiração para NIPS (1: 0,991, 2: 0,987 e 3: 0,993) e PIPP-R (1: 0,997, 2: 0,986, e 3: 0,977). A validade concorrente foi observada apenas para aspiração sem intervenção. CONCLUSÃO: Embora a NIPS possa ter melhor utilidade clínica do que o PIPP-R, ambos os instrumentos apresentaram boa consistência interna e confiabilidade inter-avaliadores, e podem ser usados para avaliar a dor durante a aspiração em RNPT.

Effects of mycogenic silver nanoparticles on organisms of different trophic levels.

Biogenic silver nanoparticles (AgNPs) are considered a promising alternative to their synthetic versions. However, the environmental impact of such nanomaterials is still scarcely understood. Thus, the present study aims at assessing the antimicrobial action and ecotoxicity of AgNPs biosynthesized by the fungus Aspergillus niger IBCLP20 towards three freshwater organisms: Chlorella vulgaris, Daphnia similis, and Danio rerio (zebrafish). AgNPs IBCLP20 showed antibacterial action against Klebsiella pneumoniae between 5 and 100 µg mL-1, and antifungal action against Trichophyton mentagrophytes in concentrations ranging from 20 to 100 µg mL-1. The cell density of the microalgae Chlorella vulgaris decreased 40% after 96 h of exposure to AgNPs IBCLP20, at the highest concentration analysed (100 µg L-1). The 48 h median lethal concentration for Daphnia similis was estimated as 4.06 µg L-1 (2.29-6.42 µg L-1). AgNPs IBCLP20 and silver nitrate (AgNO3) caused no acute toxicity on adult zebrafish, although they did induce several physiological changes. Mycosynthetized AgNPs caused a significant increase (p < 0.05) in oxygen consumption at the highest concentration studied (75 µg L-1) and an increase in the excretion of ammonia at the lower concentrations, followed by a reduction at the higher concentrations. Such findings are comparable with AgNO3, which increased the oxygen consumption on low exposure concentrations, followed by a decrease at the high tested concentrations, while impairing the excretion of ammonia in all tested concentrations. The present results show that AgNPs IBCLP20 have biocidal properties. Mycogenic AgNPs induce adverse effects on organisms of different trophic levels and understanding their impact is detrimental to developing countermeasures aimed at preventing any negative environmental effects of such novel materials.

True neurogenic thoracic outlet syndrome: late outcomes from a surgical series.

BACKGROUND: True neurogenic thoracic outlet syndrome (TNTOS) is rare, and evaluation of surgical treatment is limited to a few studies in the literature. The purpose of this study is to present the results from a surgical series of 21 patients with TNTOS. METHODS: Retrospective analysis on 21 patients diagnosed with TNTOS who underwent surgery. Demographic data and neurological status were characterized, and patients were classified in accordance with a pre-established scale for assessing the severity of hand impairment before and after surgery. Neuropathic pain was assessed using a visual analogue scale (VAS) and functional disability was quantified using the QuickDASH questionnaire. The results from before and after surgery were compared using the Wilcoxon test, and the significance level was taken to be 5%. RESULTS: There was a significant difference in VAS values from before to after the operation (Wilcoxon test: p = 0.0001; r = 0.86). Most patients (90%) improved after surgery, and in 85% of these patients, the VAS improvement was greater than 50%. Improvement in hand function occurred in seven patients (33.3%), and in most of these cases (28.6%), this improvement was classified as mild. Most patients (93.3%) showed moderate to very severe functional disability at the end of the follow-up. CONCLUSION: After surgery, only one-third of the cases showed improvement in motor function and most patients had significant functional disability. However, the improvement regarding pain was significant. Surgery to control this symptom should be recommended, even in cases of late presentation and severe motor impairment.

Self-biting behavior in patients with neonatal brachial plexus palsy.

PURPOSE: Self-biting behavior in patients with neonatal brachial plexus palsy (NBPP) has been associated with finger amputation. Our objective is to describe the incidence of this complication, risk factors, and clinical management. METHODS: We retrospectively analyzed 612 patients with NBPP. There were 303 males and 309 females. 51.8% of patients had C5-C6 lesions, 28.9% had C5-C7, 18.9% had C5-T1, and 0.3 had C7-T1 involvement. RESULTS: We identified 15 patients with self-biting behavior (2.5%). Ten patients had C5-T1 lesions, and five had C5-C7 lesions. Eight patents were submitted to brachial plexus surgery and seven were not. This behavior appeared between 8 and 46 months of life (mean 23.5), and it was always temporary. There was no difference between operated and non-operated patients (p > 0.05), and no correlation between age at surgery and age of appearance of self-biting behavior (p > 0.05). Physical restriction was effective in treating this complication and we had no case of finger amputation. CONCLUSION: Self-biting behavior is a rare complication of NBPP, and it is usually associated with severe motor involvement. The behavior duration is limited to a few months. This condition can be effectively treated with physical restriction to prevent hand biting.

Structural Elucidation of an Atropisomeric Entcassiflavan-(4ß→8)-Epicatechin Isolated from Dalbergia monetaria L.f. Based on NMR and ECD Calculations in Comparison to Experimental Data.

A rare dihydoxyflavan-epicatechin proanthocyanidin, entcassiflavan-(4ß→8)-epicatechin, was isolated from Dalbergia monetaria, a plant widely used by traditional people from the Amazon to treat urinary tract infections. The constitution and relative configuration of the compound were elucidated by HR-MS and detailed 1D- and 2D-NMR measurements. By comparing the experimental electronic circular dichroism (ECD) spectrum with the calculated ECD spectra of all 16 possible isomers, the absolute configuration, the interflavan linkage, and the atropisomers could be determined.