Retrospective survival analysis of the use of uncemented modular tapered stems for revision in periprosthetic Vancouver B-type fractures. Is instability a threat to survival?

INTRODUCTION AND OBJECTIVES: Periprosthetic hip fractures show increasing incidence and complexity, representing a challenge for the surgeon. We aimed to evaluate the survival of uncemented modular tapered stems in the treatment of periprosthetic Vancouver B2 and B3 type fractures and review the main complications and factors associated with decreased survival. MATERIALS AND METHODS: We performed a retrospective study of patients submitted to revision arthroplasty for treatment of periprosthetic femoral stem Vancouver B2 and B3 type fractures with an uncemented modular fluted tapered stem (MRP-Titan). Demographic and radiographic parameters were analyzed. The survival rate (free of reoperation) was calculated at 2- and 5-years using the Kaplan-Meier survivorship analysis. RESULTS: Thirty-nine patients were included with a mean age of 73.5 years and a mean follow-up of 5 years. Arthroplasty survivorship at 2 years was 73.7% and at 5 years was 67.5% (mean 8.4 years; range 6.7-10.2). Survivorship was inferior in the patients with episodes of instability (mean 2.5 years; range 0-5.42) (p<0.001). At least one episode of instability occurred in 26.3% of patients and 60% of these patients had a femoral head size 32mm or lower. At least one episode of instability occurred in 71.4% of patients with a greater trochanter fracture (p=0.008). The consolidation rate was 90.6% and the mortality rate was 23.7%. In the group of patients that died, 55.6% were submitted to at least one revision surgery (p=0.044). CONCLUSION: Survivorship of an uncemented modular stem (MRP-Titan) in revision for PHF is significantly reduced by episodes of instability.

Effects of a music-based intervention on psychophysiological outcomes of patients undergoing medical imaging procedures: A systematic review and meta-analysis.

INTRODUCTION: Musical intervention (MI) is a valuable strategy for addressing the psychological and emotional challenges faced by patients undergoing imaging procedures. This study explores MI's impact on psychophysiological outcomes during imaging procedures, detailing the sound repertoire and technical characteristics employed in MI. METHODS: A systematic review (SR) and meta-analysis (MA) were conducted. Electronic database searches of PubMed, Web-of-Science, and Scopus were performed encompassing original randomised research and quasi-experimental articles published until June 2023. RESULTS: Thirteen articles were included in this SR, scoring between 23 and 68 on the Joanna Briggs Institute (JBI) Checklist. Four articles were included to perform a MA concerning anxiety and heart rate (HR) outcomes. Most studies utilised digital playlists as the medium for MI. Headphones were commonly used, with an average volume of 50-60 dB and a musical frequency of 60-80 beats/min. While authors generally preferred selecting musical genres for the repertoire, two articles specifically chose Johann Pachelbel's "Canon in D major" as their musical theme. In terms of psychological parameters, the experimental groups exhibited lower anxiety values than the control groups, with further reductions after MI. However, MA shows that this trend is only marginally significant. Patient comfort and overall examination experience showed improvement with MI. Regarding physiological parameters, HR, especially in the final phase of the examination, was significantly lower in the experimental group compared to the control group. CONCLUSION: Across multiple studies, MI demonstrated the ability to reduce anxiety and HR. However, no specific music repertoire emerged as the most effective. IMPLICATIONS FOR PRACTICE: MI arises as a painless, reliable, low-cost, and side-effect-free strategy, presenting imaging departments with a practical means to enhance patient comfort and mitigate anxiety and stress during medical procedures.

Characterizing functional morphology and trophic niches in a neotropical Characiforms (Actinopterygii: Teleostei) assemblage in middle Munim River basin, Maranhão, Brazil.

Understanding how functionally similar species segregate resources to minimize competition is vital for predicting evolutionary factors and patterns of coexistence. We conducted a study in Mata de Itamacaoca, in the middle Munim River basin, Maranhão, northeastern Brazil, to characterize the functional morphology and trophic niches of five coexisting Characiform species in this area - including a recently described species, and to investigate whether their functional morphology is a key determinant of their trophic niches. Our analysis of functional morphology and diet, employing linear measurements to predict dietary specializations, showed that these species are predominantly generalist insectivores with a significant morphological overlap. This study underscores the influence of species' natural history on their ecological characteristics, contributing to more effective conservation strategies.

Guarana propagation strategies: a review.

Guarana [Paullinia cupana var. sorbilis (Mart.) Ducke] is a species of great economic and social important in Brazil, as it is the only commercial guarana producer in the world. The vegetative propagation method indicated for the culture is stem cuttings, which aims at productivity, tolerance, and uniformity of clonal cultivars, because reproduction by seeds has slow germination and high genetic variability, which in traditional varieties is an undesirable factor. Genetic factors can interfere with the rooting capacity of the crop. Studies seek alternatives that can improve this condition and enhance the production system. Use of growth regulators, microorganisms that promote plant growth, variation of substrates and fertilization, have been strategies used. Preliminary tests on the rate of stem rooting and seed germination with the use of exogenous phytohormone did not demonstrate in relation to the non-application of these inducers. The use of rhizobacteria, which presents itself as a promising activity in many cultures, has not yet been demonstrated in the culture of guarana. On the other hand, the influence of different substrates on rooting has already shown consistent results as a function of rooting rate. Fertilizing the mother plants as recommended by the production system for the crop has proven to be an efficient procedure. There are still few studies aimed at improving the spread of guarana, demonstrating that new protocols need to be explored, or that the protocols already used are reviewed from another perspective.

The ultimate technique for posterior rib fractures: The parascapular sub-iliocostalis plane block – A series of cases / Una técnica fundamental para las fracturas costales posteriores: el bloqueo paraescapular del plano subiliocostal. Una serie de casos

We report retrospectively a series of four cases involving the successful use of the recently described parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures. The efficacy of the PSIP block may potentially depend on different mechanisms of action: (1) direct action in the fracture site by craniocaudal myofascial spread underneath the erector spinae muscle (ESM); (2) spread to deep layers through tissue disruption caused by trauma, to reach the proximal intercostal nerves; (3) medial spread below the ESM, to reach the posterior spinal nerves; and (4) lateral spread in the sub-serratus (SS) plane to reach the lateral cutaneous branches of the intercostal nerves; while avoiding significant negative hemodynamic effects and other possible complications associated to other techniques leading that the PSIP may be considered an alternative in some clinical scenarios to the erector spinae plane block or the paravertebral block. (AU)

Presentamos retrospectivamente una serie de 4 casos en los que se utilizó con éxito el bloqueo paraescapular del plano subiliocostal (PSIP), descrito recientemente, para fracturas costales laterales-posteriores. La eficacia del bloqueo PSIP puede depender potencialmente de diferentes mecanismos de acción: (1) acción directa en las fractura por la extensión miofascial craneocaudal por debajo del músculo erector de la columna, (2) diseminación a capas profundas a través de la disrupción tisular causada por el traumatismo, para alcanzar los nervios intercostales proximales, (3) extensión medial por debajo del músculo erector de la columna, para alcanzar los nervios espinales posteriores y (4) extensión lateral en el plano subserrato para alcanzar las ramas cutáneas laterales de los nervios intercostales, evitando al mismo tiempo efectos hemodinámicos negativos y otras posibles complicaciones asociados a otras técnicas, lo que hace que el bloqueo PSIP pueda considerarse en algunos escenarios clínicos una alternativa al bloqueo del plano erector de la columna vertebral o al bloqueo paravertebral. (AU)

The ultimate technique for posterior rib fractures: the parascapular sub-iliocostalis plane block - A series of cases.

We report retrospectively a series of four cases involving the successful use of the recently described parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures. The efficacy of the PSIP block may potentially depend on different mechanisms of action: (1) direct action in the fracture site by craniocaudal myofascial spread underneath the erector spinae muscle (ESM); (2) spread to deep layers through tissue disruption caused by trauma, to reach the proximal intercostal nerves; (3) medial spread below the ESM, to reach the posterior spinal nerves; and (4) lateral spread in the sub-serratus (SS) plane to reach the lateral cutaneous branches of the intercostal nerves; while avoiding significant negative hemodynamic effects and other possible complications associated to other techniques leading that the PSIP may be considered an alternative in some clinical scenarios to the Erector Spinae Plane block or the Paravertebral block.

Development, implementation and evaluation of a multinational FLS mentorship programme in Latin America.

Realising the benefits of systematic secondary fracture prevention requires supporting local sites to get started and becoming effective. We here describe the development, implementation and impact of a regional fracture liaison service (FLS) mentorship programme in Latin America that led to 64 FLS getting started and coverage of 17,205 patients. INTRODUCTION: Despite treatments and service models to deliver effective secondary fracture prevention, most patients are left untreated after a fragility fracture. To improve the capability to get FLS started and more effective, we describe the development, implementation and evaluation of an international programme to develop national communities of FLS mentors as part of the Capture the Fracture Partnership in Latin America. METHODS: The IOF regional team and the University of Oxford developed the curriculum and associated resources for training mentors in setting up FLS, service improvement and mentorship. Mentors were selected during a preparatory meeting, trained using live online sessions followed by regular mentor-led post-training meetings. The programme was evaluated using a pre-training needs assessment and post-training evaluation based on Moore's outcomes. RESULTS: The mentorship programme was initiated in Mexico, Brazil, Colombia and Argentina. The mentors were multidisciplinary, including orthopaedic surgery, rehabilitation, rheumatology, endocrinology, geriatrics, gynaecology and internal medicine. There was 100% participation in training sessions and reported satisfaction with the training. Since the initiation of the training programme, 22 FLS have been set up in Mexico, 30 in Brazil, 3 in Colombia and 9 in Argentina, in comparison with two in Chile and none in any other LATAM countries that were not involved in the mentorship programme. This equates to approximately 17,025 additional patients identified from 2019 to 2021 after initiation of mentorship. The mentors have engaged with 58 FLS for service development. Post-training activities include two published national best practice guidelines and other country-specific resources for FLS in the local language. CONCLUSION: Despite the COVID pandemic, the mentorship pillar of the Capture the Fracture Partnership has developed a community of FLS mentors with measurable improvement in national FLS provision. The programme is a potentially scalable platform to develop communities of mentors in other countries.

Socio-economic factors affecting the distribution of marine litter: The Portuguese case study.

Marine litter is a growing global problem with serious environmental, economic, social, and health threats. Understanding the socio-economic factors that influence the types and amounts of litter is of utmost importance. In this study, an integrative analysis of the socio-economic factors that characterize the beach litter distribution in continental Portugal and the Azores archipelago was conducted via a cluster analysis, implementing a novel technique to support the difficult task of marine litter characterization. The results highlighted that the most abundant beach litter material is plastic (92.9 %), followed by paper (2.2 %), wood (1.5 %), and metal (1.3 %). The majority of the items could not be attributed to a specific source (46.5 %). The remaining were attributed to public litter (34.5 % of total aggregated items), fishing (9.8 %), sewage-related debris (6.4 %) and shipping (2.2 %). The top-three beach litter categories were small plastic pieces (0-2.5 cm, 43.5 %), cigarette butts (30.1 %), and medium plastic pieces (2.5-50 cm, 26.4 %). A positive relation between both municipality environment expenditures and population density and the quantity and typology of litter was found. Beach litter quantity and categories were also associated with specific economic sectors, as well as with geographical/hydrodynamic conditions, demonstrating the utility of the technique and its applicability to other regions.

Water, sanitation, and hygiene vulnerability in child stunting in developing countries: a systematic review with meta-analysis.

OBJECTIVES: This study aimed to perform a systematic review and meta-analysis to assess the scientific evidence of the relationship between vulnerability to access to safe drinking water, sanitation, and hygiene (WASH) practices on stunting in children aged <5 years in developing countries. STUDY DESIGN: This is a systematic review and meta-analysis article to assess the relationship between under-five stunting and WASH vulnerability in developing countries. METHODS: The systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol methodology. The following databases were used: LILACS, MEDLINE (via PubMed), SciELO, Web of Science, ScienceDirect, SCOPUS, and Embase. All original studies identified that related WASH vulnerability to stunting in children aged <5 years in developing countries was included. Three authors performed independently the selection and extraction of data from the articles. The statistical software STATA version 11 was used. Cochran's Q test and Chi-square test (I2) with 95% significance were used to assess the heterogeneity of the studies. RESULTS: The search resulted in the initial identification of 2047 articles; after reading the abstracts, followed by the full articles, 14 articles were included in the systematic review and eight articles were included in the meta-analysis. The studies selected for the systematic review were published between the years 1992 and 2021 and conducted in eight countries, namely, Ethiopia, India, Indonesia, Bangladesh, Tanzania, Peru, China, and Lesotho. The studies assessed vulnerability to access to WASH on the growth of children aged <5 years. There was a significant difference when relating WASH vulnerability to children's height. The meta-analysis of this study showed that the impact of WASH on child stunting is significant when it comes to lack of sanitation in 72% of the studies. CONCLUSIONS: The study found that WASH vulnerability contributes to stunting in children aged <5 years in developing countries. Based on our findings, we recommend incorporating WASH strategies, especially sanitation, into the formulation of interventions integrating with health promotion policies for healthy early childhood development.

Lactobacillus delbrueckii UFV-H2b20 increases IFN-γ production and CD39+CD73+ Treg cell numbers in lungs, and protects mice against experimental allergic asthma.

Asthma is a disorder characterized by airflow obstruction, inflammation, declining airway function, bronchial hyperresponsiveness and tissue remodelling. Probiotics are defined as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host". The use of probiotics is becoming increasingly studied and recent evidence has suggested that it may provide therapeutic benefits in asthma and other diseases. Lactobacillus delbrueckii UFV-H2b20 fulfils all the requirements to be classified as probiotic. Previous studies have already shown the ability of L. delbrueckii UFV-H2b20 to stimulate the immune system. Our objective was to evaluate the protective effects of L. delbrueckii UFV-H2b20 in experimental allergic asthma. We used a murine model of ovalbumin-induced allergic airway inflammation to mimic allergic asthma. Oral treatment with L. delbrueckii UFV-H2b20 improves respiratory parameters and inhibits the inflammatory response in the lungs by decreasing the numbers of inflammatory monocytes, eosinophils and alveolar macrophages, as well as IgE levels. Treatment increased the IFN-γ/IL-4 cytokine ratio. Levels of IL-10 in the lungs were also increased in treated animals. Our results also showed that the probiotic administration increases the number of CD39+CD73+ T regulatory lymphocytes in the lung, suggesting a role for purinergic signals in the regulation of inflammation promoted by the treatment. Understanding the mechanisms of modulation of the immune system by probiotics could allow the development of probiotic preparations that are safe and have a direct action. Our results suggest that oral administration of L. delbrueckii UFV-H2b20 could be helpful to treat chronic inflammatory airway diseases, such as asthma.

DIAGNOSTIC REFERENCE LEVELS BASED ON PATIENT BODY MASS INDEX FOR SELECT INTERVENTIONAL PROCEDURES IN MINAS GERAIS/BRAZIL.

This work establishes local diagnostic reference levels (DRLs) in interventional radiology based on adult patient body mass index (BMI). The monitoring was carried out from 23 institutions and patient data from 3015 procedures were collected, being 907 Catheterism (CAT), 921 Percutaneous transluminal coronary angioplasty (PTCA) and 1187 CAT/PTCA and 6 BMI ranges were taken, going from under 18 up to 40 kg·m-2. It is presented that 18 initial DRL values to be used in the county of Minas Gerais. The overall 75th kerma-area product (KAP), commonly considered DRL, in Gy·cm2, is 94.6(SD 119)-CAT, 88.6(SD 121)-PTCA and 33.0(SD 47.6)-CAT/PTCA. In considering KAP-BMI individual values, one obtain the min-max ranges, in Gy·cm2, 3.2-BMI A to 101-BMI B for CAT, 65-BMI A to 102-BMI F for PTCA and 10.4-BMI A to 59.2-BMI E for CAT/PTCA. The KAP-BMI approach has shown to be feasible as a DRL optimization process.

Epidemiology And Outcome Assessment Of Hand Burns: A 3-Year Retrospective Analysis In A Burn Unit.

A great number of burns affect the hands, either as part of a more extensive burn or as an isolated injury. These injuries can lead to physical, social and psychological consequences that may reduce quality of life and make difficult the return to work. The goal of this study was to investigate the main epidemiologic characteristics of adult patients with hand burns admitted to a dedicated burn centre, evaluate the outcomes of the treatment, and identify the predictors associated with the worst outcomes. This study found that a considerable amount of burn victims admitted had hand burns (41.5%). Males are more likely to be injured in general, but females are more prevalent in burns by hot liquids. The most common comorbidity was hypertension, followed by dyslipidemia and type II diabetes. Cooking is the activity associated with more accidental victims. Most injuries did not require surgical intervention. Approximately two-thirds of the patients did not have any important sequelae. The most common complications were scar disturbances (26%) and scar contractures (14%). The need for surgery, a higher number of surgeries and higher surface area burn were associated with the worst outcomes. It is imperative to establish a burn prevention education program nationwide, encompassing water temperature control in households, the use of anti-burn equipment, and the replacement of old electrical/ heating equipment.

Bon nombre de brûlures touchent les mains, isolément ou dans le cadre de brûlures plus étendues. Elles peuvent entraîner des conséquences physiques, psychologiques et sociales susceptibles d'obérer la qualité de vie et rendre difficile la reprise de l'activité professionnelle. Le but de cette étude était d'évaluer les principales caractéristiques épidémiologiques des brûlures de main chez des adultes admis dans notre CTB, leur évolution et les facteurs prédictifs de mauvaise évolution. Nous avons constaté que 41,5% de nos patients avaient une atteinte de main. Si les hommes étaient plus à risque de brûlures, les brûlures des femmes étaient plus souvent dues à un ébouillantement. Les comorbidités les plus fréquentes étaient l'hypertension artérielle, les dyslipidémies et le diabète de type 2. La cuisine était une activité particulièrement à risque. La plupart des lésions ont cicatrisé spontanément et les 2/3 des patients n'avaient pas de séquelle majeure, les plus fréquentes étant les anomalies cicatricielles (26%) et les brides rétractiles (14%). Les critères de mauvaise évolution étaient la nécessité d'intervention chirurgicale (et leur nombre) ainsi que l'augmentation de la surface brûlée. Il est impératif d'établir un plan national de prévention comprenant la régulation de la température de l'eau aux points de puisage, l'utilisation d'équipements sécurisés et le remplacement des systèmes de chauffage comme des circuits électriques anciens.

Will extreme weather events influence the toxic impacts of caffeine in coastal systems? Comparison between two widely used bioindicator species.

In the recent years, marine heatwaves (MHWs) have caused devastating impacts on marine life. The understanding of the combined effects of these extreme events and anthropogenic pollution is a vital challenge. In particular, the combined effect of MHWs on the toxicity of pharmaceuticals to aquatic life remains unclear. To contribute to these issues, the main goal of the present investigation was to evaluate how MHWs may increase caffeine (CAF) toxicity on the clam Ruditapes philippinarum and the mussel Mytilus galloprovincialis. Bioaccumulation levels and changes on oxidative stress, metabolic capacity and neurotoxic status related biomarkers were investigated. The obtained results revealed the absence of CAF accumulation in both species. However, the used contaminant generated in both bivalve species alteration on neurotransmission, detoxification mechanisms induction as well as cellular damage. The increase of antioxidant defence mechanisms was complemented by an increase of metabolic activity and decrease of energy reserves. The obtained results seemed magnified under a simulated MHWs, suggesting to a climate-induced toxicant sensitivities' response. On this perspective, understanding of how toxicological mechanisms interact with climate-induced stressors will provide a solid platform to improve effect assessments for both humans and wildlife.

In vitro cytotoxic effects of 5-Fluorouracil on isolated murine ovarian preantral follicles.

5 fluorouracil (5FU), an antineoplastic drug, is often utilized in the therapeutic regimen for several types of cancer, including the hepatoblastoma in children. The effects of 5FU on the population of ovarian preantral follicles, which is the largest oocyte reservoir, is still poorly understood. The integrity of the ovarian preantral follicle pool is important for lifelong fertility. The better understanding of such effects may favor intervention strategies to protect fertility in 5FU-treated children and women coping with cancer. To analyze the effects of 5FU on isolated murine secondary follicles in vitro, ovaries were collected from young mice (28-30 days old), and secondary follicles were isolated and cultured for 12 days in basic culture medium, with or without 5FU at concentrations of 0.3 mM, 1 mM, 3 mM, 10 mM, and 30 mM. In the in vitro study, we analyzed the percentage of morphologically normal follicles, antrum formation, follicular diameter, and hormone production. On day 12, oocytes were recovered for in vitro maturation. 5FU treatment did not alter the percentage of morphologically normal follicles. On day 12, only 1, 10, and 30 mM 5FU significantly reduced the percentage of antrum. From day 4 onwards, 5FU treatments significantly reduced follicle diameter. The meiosis resumption rate was significantly lower in all 5FU treatments. 5FU concentrations ≥3 mM reduced estradiol levels. In conclusion, 5FU does not affect follicular morphology. However, 5FU deleteriously affects follicular growth, estradiol production, and oocyte maturation in isolated ovarian follicles.

Patients with resolution of low-lying placenta and placenta previa remain at increased risk of postpartum hemorrhage.

OBJECTIVE: To determine whether women who experience resolution of low placentation (low-lying placenta or placenta previa) are at increased risk of postpartum hemorrhage compared to those with normal placentation throughout pregnancy. METHODS: This was a retrospective cohort study of women who delivered at Mount Sinai Hospital between 2015 and 2019, and who were diagnosed with low-lying placenta or placenta previa on transvaginal ultrasound at the time of the second-trimester anatomical survey, with resolution of low placentation on subsequent ultrasound examination. Women undergoing second-trimester anatomical survey who had normal placentation on transvaginal ultrasound 3 days before or after the cases were randomly identified for comparison. The primary outcome was the rate of postpartum hemorrhage. Secondary outcomes included the need for a blood transfusion, use of additional uterotonic medication, the need for additional procedures to control bleeding, and maternal admission to the intensive care unit. Outcomes were assessed using a multivariable logistic regression model. RESULTS: A total of 1256 women were identified for analysis, of whom 628 had resolved low placentation and 628 had normal placentation. Women with resolved low placentation, compared to those with normal placentation throughout pregnancy, had significantly higher mean age (33.0 ± 5.4 years vs 31.9 ± 5.5 years; P < 0.01) and lower mean body mass index at delivery (27.9 ± 5.5 kg/m2 vs 30.2 ± 5.7 kg/m2 ; P < 0.01), and were more likely to have undergone in-vitro fertilization, be of non-Hispanic white race, have posterior placental location (all P < 0.01) and have private/commercial health insurance (P = 0.04). Patients with resolved low placentation vs normal placentation had greater odds of postpartum hemorrhage (adjusted odds ratio (aOR), 3.5 (95% CI, 2.0-6.0); P < 0.01), use of additional uterotonic medication (aOR, 2.2 (95% CI, 1.5-3.1); P < 0.01) and increased rates of additional procedures to control bleeding (aOR, 4.0 (95% CI, 1.3-11.9); P = 0.01). CONCLUSION: Despite high rates of resolution of low-lying placenta and placenta previa by term, women with resolved low placentation remain at increased risk of postpartum hemorrhage compared to those with normal placentation throughout pregnancy. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Caffeine as a contaminant of concern: A review on concentrations and impacts in marine coastal systems.

Caffeine has been identified as emerging contaminant of concern due to its widespread occurrence in the aquatic environment and potential to be biologically active. Recently, these concerns have been translated in an increasing research on its occurrence and effects on biota. However, there is still a limited knowledge on seawater matrices and the implications of caffeine presence in coastal and marine ecosystems are not fully known. The present review aims to fill these knowledge gaps, analysing the existing literature regarding the occurrence, effects and potential risks of caffeine residues to coastal ecosystems, contributing to the risk assessment of this psychoactive drug in the aquatic environment. The analysed literature reported caffeine concentrations in the coastal ecosystems, raising high concerns about the potential adverse impacts on the ecological safety and human health. Caffeine has been found in tissues from coastal and marine biota including microalgae, coral reefs, bivalves and fish due to bioaccumulation after chronic, long-term exposures in a contaminated environment. Additionally, caffeine residues had been demonstrated to have adverse impacts on aquatic organisms, at environmentally realistic concentrations, inducing oxidative stress and lipid peroxidation, neurotoxicity, changing energy reserves and metabolic activity, affecting reproduction and development and, in some cases, causing mortality. Considering the increasing adverse impacts of caffeine pollution in the coastal environment, this review highlights the urgent need to minimize the increasing load of caffeine to the aquatic ecosystems; being imperative the implementation of scientific programs and projects to classify effectively the caffeine as a high-priority environmentally hazardous emerging pollutant.

Is resveratrol a prospective therapeutic strategy in the co-association of glucose metabolism disorders and neurodegenerative diseases?

Objectives: The mechanism behind the progression of Mild Cognitive Impairment (MCI) to Alzheimer's disease (AD) remains poorly understood. However some evidence pointed out that the co-occurrence of metabolic conditions affecting glucose homeostasis, as type 2 diabetes mellitus (T2DM), may be an important catalyst in this context. Notably, candidate drugs which modulate common pathways in the development of MCI-to-AD mediated by T2DM may offer likely therapy for AD. Nonetheless, limited pharmacological alternatives that modulate common pathways in T2DM, MCI, and AD are available. In the recent decades, studies have shown that resveratrol may act as a neuroprotective compound, but little is known about its potential in improving cognitive and metabolic aspects associated with AD progression mediated by the co-association between TDM2-MCI.Methods: In this review, we discuss possible protective mechanisms of resveratrol on shared pathways associated with AD progression mediated by T2DM-MCI co-occurrence.Results: Some studies indicated that insulin resistance and hyperglycemia may be also a T2DM risk factor for the progression of MCI-to-AD, promoting alterations in metabolic pathways associated with neuronal plasticity, and increasing pro-inflammatory environment. Interestingly, basic research and clinical trials indicate that resveratrol may modulate those pathways, showing a potential neuroprotective effect of this polyphenol.Conclusion: Therefore, there is not enough clinical data supporting the translational therapeutic use of resveratrol in this scenario.