Multicenter Database of Patients with Germ-Cell Tumors: A Latin American Cooperative Oncology Group Registry (LACOG 0515).

INTRODUCTION: Germ-cell tumors (GCTs) are the most common malignancy in young men. There is a paucity of data on GCTs in developing countries. LACOG 0515 study aimed to evaluate clinical characteristics and treatment outcomes in patients with GCTs from Brazilian cancer centers. MATERIALS AND METHODS: This is a retrospective cohort study evaluating male patients diagnosed with GCTs from 2000 to 2018 in 13 Brazilian hospitals. We described baseline characteristics, progression-free survival (PFS), and overall survival (OS). RESULTS: A total of 1232 patients were included, with a median age of 30 years. Histology was seminoma in 47.1% and non-seminoma GCT (NSGCT) in 52.9%. The primary tumor site was testis in 96.5%. At diagnosis, clinical stage I was present in 68.1% and 34.7% and clinical stages IS/II/III in 31.9% and 65.2% of patients with seminoma and NSCGT, respectively. Following orchiectomy, 55.2% of patients with clinical stage I were managed with surveillance. The 5-year disease-free survival rates among patients with stage I were 98.0% in seminoma and 92.3% in NSGCT, with 5-year OS of 99.6% and 97.6%, respectively. Among patients with advanced disease (IS, II, and III), the 5-year PFS were 88.7% in seminoma and 68.7% in NSGCT, with 5y-OS of 97.6% and 82.8%, respectively. CONCLUSION: This is the largest Brazilian cohort of GCTs. Our results show a high rate of adjuvant chemotherapy in patients with clinical stage I. Although our data demonstrate slightly inferior PFS compared with the International Germ Cell Cancer Collaborative Group and other contemporary series, the OS rates were similar.

Non-Small-Cell Lung Cancer With CNS Metastasis: Disparities From a Real-World Analysis (GBOT-LACOG 0417).

PURPOSE: Despite the advances in the approach to non-small-cell lung cancer (NSCLC) with CNS metastasis, access to timely diagnosis and treatment may not be optimal in many instances. Our main objective was to describe a cohort of patients with NSCLC with brain metastases from public and private cancer centers, and the differences between patients' presentation, treatment, and outcomes. METHODS: GBOT-LACOG 0417 is a multi-institutional retrospective cohort study of patients diagnosed with NSCLC and CNS metastasis in Brazil. All patients had confirmed diagnosis of NSCLC between January 2010 and December 2015. CNS metastases were identified by imaging. RESULTS: A total of 273 patients were included. Patients treated at public institutions were more often Black or Brown (38.8% v 15.4%), current or former smoker (88.6% v 60.0%), of squamous cell histology (25.0% v 9.1%), EGFR- and ALK-negative (95.9% v 74.9%), and were less frequently assessed by using brain magnetic resonance imaging (38.8% v 83.6%). At public institutions, patients were more often symptomatic (78.1% v 44.6%) and had worse performance status (Eastern Cooperative Oncology Group 2 or higher 61.5% v 10.3%). CNS metastases were larger (median size 25 v 15 mm) and more often surrounded by edema (67.7% v 55.2%) at public institutions. Patients at public institutions were more frequently treated with whole-brain radiation therapy (72.9% v 45.4%) and less frequently with radiosurgery (6.3% v 24.1%). Among patients from private care, median overall survival was 24.2 months (95% CI, 20.0 to 30.6), significantly higher than in public care (median 12.1 months; 95% CI, 6.7 to 13.6; P < .001). CONCLUSION: Our results demonstrate the discrepancy between public and private health care system in the critical setting of patients with CNS metastasis from NSCLC.

Enfrentamento e estigmatização do obeso mórbido / Coping and stigmatization of the morbidly obese / Enfrentamiento y estigmatización del obeso mórbido

Objetivo: Compreender o enfrentamento do obeso mórbido em situações do cotidiano e estilo de vida. Métodos: Pesquisa de natureza qualitativa, com abordagem fenomenológica, realizada no setor de endocrinologia e cirurgia bariátrica de hospital terciário de referência no Ceará, com 22 obesos mórbidos, no período de dezembro de 2018 a fevereiro de 2019. Utilizou-se para a pesquisa pacientes maiores de 18 anos com IMC ≥40kg/m². A obtenção dos dados ocorreu por meio de entrevista com informações sociodemográficas, seguida de entrevista fenomenológica a partir da pergunta norteadora: como você se percebe na sociedade como obeso mórbido? Resultados: O grupo constituiu-se de 22 participantes, com média de idade de 44,1± 7,67 anos. Do total, 15 (68,1%) residiam no interior do estado, dez (45,4%) possuíam ensino médio completo, e 13 (59%) eram casados. As categorias que emergiram dos discursos deram-se enquanto: o preconceito da sociedade; dieta como modo de vida ou sacrifício?; a moda como um vilão para o obeso. Discutiram-se os relatos a partir do olhar fenomenológico de Merleau- Ponty. Conclusão: Ressalta-se a complexidade da intervenção sobre a obesidade diante de uma situação que envolve inúmerasquestões biológicas, psicológicas e sociais. As formas de enfretamento perpassaram por sentimentos de vergonha, desânimo,motivação para terapias e raiva.

Objective: To understand morbidly obese individuals' coping with everyday situations and lifestyle. Methods: A qualitative research was conducted using a phenomenological approach at the endocrinology and bariatric surgery sector of a reference tertiary hospital in Ceará with 22 morbidly obese individuals from December 2018 to February 2019. Research participants were over 18 years old and had a BMI ≥40kg/m². Data were collected through an interview to collect sociodemographic information, followed by a phenomenological interview based on the guiding question: how do you perceive yourself in society as morbidly obese? Results: The group consisted of 22 participants with a mean age of 44.1±7.67 years. Of the total, 15 (68.1%) lived in the countryside of the state, ten (45.4%) had completed secondary education, and 13 (59%) were married. The categories that emerged from the reports were: society's prejudice; diet as a way of life or sacrifice?; fashion as a villain for the obese. The reports were discussed from the phenomenological point of view of Merleau-Ponty. Conclusion: The complexity of intervention on obesity is highlighted in a situation that involves numerous biological, psychological and social issues. The ways of coping ranged from feelings of shame to discouragement to motivation for therapies and anger

Objetivo: Comprender el enfrentamiento del obeso mórbido en situaciones del cotidiano y su estilo de vida. Métodos: Investigación de naturaleza cualitativa y de abordaje fenomenológica realizada en el sector de endocrinología y cirugía bariátrica del hospital terciario de referencia de Ceará con 22 obesos mórbidos, en el período entre diciembre de 2018 y febrero de 2019. Para la investigación se utilizó los pacientes con más de 18 años y el IMC ≥40kg/m². La obtención de los datos se dio a través de entrevista con informaciones sociodemográficas, seguida de la entrevista fenomenológica a partir de la pregunta norteadora: ¿cómo te ves en la sociedad como una persona con obesidad mórbida? Resultados: El grupo tenía 22 participantes con media de edad de 44,1± 7,67 años. Del total de participantes, 15 (68,1%) vivían en el campo, diez (45,4%) tenían educación básica completa y 13 (59%) eran casados. Las categorías que emergieron de los discursos fueron: el prejuicio de la sociedad; ¿la dieta como modo de vida o sacrificio?; la moda como el villano para el obeso. Se ha discutido los relatos a partir de la mirada fenomenológica de Merleau-Ponty. Conclusión: Se destaca la complejidad de la intervención sobre la obesidad ante una situación que tiene inúmeras cuestiones biológicas, psicológicas y sociales. Las formas de enfrentamiento pasan por sentimientos de vergüenza, desanimo, la motivación para las terapias y la rabia.

Violência doméstica e sofrimento ético-político: redes de cuidados informais de usuárias do centro de atenção psicossocial e do centro de referência em assistência social no contexto brasileiro / Violencia intrafamiliar y apoyo ético-político: redes de atención informal de usuarios del centro de atención psicosocial y del centro de referencia de atención social en el contexto brasileño / Domestic Violence and Ethical-Political Support: Informal Care Networks of Users of the Psychosocial Care Center and the Social Care Referral Center in the Brazilian Context

O presente estudo objetivou identificar e discutir as redes de cuidados informais de mulheres em situação de violência doméstica, e que são usuárias de serviços de atenção especializada em saúde mental e assistência social de uma cidade do interior do Nordeste. A perspectiva teórico-metodológica adotada foi a Análise Institucional, com ênfase na pesquisa-intervenção, que permite visualizar as forças que tendem à reprodução (instituí-do), e as que tendem à transformação de determinado fenômeno (instituinte). Para tanto, foram realizadas, ao todo, seis rodas de conversa com os profissionais dos serviços acerca da temática da violência doméstica, e entrevistas com quatro mulheres escolhidas nas rodas de conversas. Além disso, outros instrumentos utilizados neste estudo foram o diário de pesquisa, os ecomapas e os prontuários dos serviços. Dessa maneira, a análise dos dados permitiu identificar três analisadores acerca do que tem permanecido e o que tem se transformado nas redes informais de cuidado de mulheres em situação de violência doméstica. O primeiro analisador se refere à configuração da rede informal das mulheres a partir da violência doméstica; o segundo consiste na relação entre a rede formal e informal; e o terceiro, nas redes quentes e vivas possivelmente construídas com a con-tribuição do processo de pesquisa. Destaca-se, ainda, o importante papel da rede informal como dispositivo de cuidado às mulheres em situação de violência doméstica e sofrimento ético-político, na medida em que se apre-senta como rede capaz de contribuir na participação e autonomia das usuárias no cuidado em saúde

Este estudio tuvo como objetivo identificar y discutir las redes de atención informal de mujeres en situación de violencia intrafamiliar, usuarias de servicios de atención especializada en salud mental y asistencia social en una ciudad del interior del nordeste de Brasil. La perspectiva teórico-metodológica adoptada fue el análisis institucional, con énfasis en la investigación intervencionista, que permite visualizar las fuerzas que tienden a la reproducción (establecidas) y las que tienden a transformar un fenómeno dado (instituyendo). Para ello, se realizaron un total de seis círculos de conversación sobre la violencia intrafamiliar con profesionales del servicio, y se realizaron entrevistas a cuatro mujeres elegidas en los círculos de conversación. Además, otros instrumentos utilizados en este estudio fueron el diario de investigación, los ecomapas y los registros de los servicios. Así, el análisis de los datos permitió identificar tres analizadores sobre lo que quedó y lo que se transformó en las redes informales de atención a mujeres en situación de violencia intrafamiliar. El primer analizador se refiere a la configuración de la red informal de mujeres basada en la violencia doméstica; el segundo consiste en la relación entre la red formal e informal; y el tercero, en las redes cálidas y vivas posiblemente construidas con el aporte del proceso de investigación. También se destaca el importante papel de la red informal como dispositivo de atención a las mujeres en situaciones de violencia intrafamiliar y sufrimiento ético-político, ya que se presenta como una red capaz de contribuir a la participación y autonomía de las usuarias en la atención de la salud

This study aimed to identify and discuss the informal care networks of women in situations of domestic vio-lence who are users of mental health and social assis-tance specialized care services in a city of the interior of Northeast Brazil. The theoretical and methodological perspectives adopted were the institutional analysis with an emphasis on intervention-research, which allowed to visualize the forces that tend to the reproduction (instituted) and those that tend to transform a certain phenomenon (instituting). To this end, six meetings were carried out with the professionals of the domestic violence services, plus interviews with four women from the meetings. Also, other instruments used in this study were the research diary, ecomaps, and medical records of the services. Thus, the data analysis allowed to iden-tify three analyzers about what has remained and what has been transformed in the informal networks of care for women in situations of domestic violence. The first analyzer refers to the women's informal network config-uration based on domestic violence. The second consists in the relationship between the formal and informal network, and the third consists in the warm and living networks possibly built with the contribution of the research process. It is also worth noting the important role of the informal network as a care device for women in situations of domestic violence and ethical-political suffering, as it appears as a network capable of con-tributing to the participation and autonomy of users within healthcare

How temperature variation affects white-rot fungi mycelial growth dynamics: a nonlinear mixed models approach.

This study aimed to model mycelial growth in a factorial experiment with two species of white rot fungi growing at five temperatures. The nonlinear models evaluated were logistic, Gompertz, Weibull and von Bertalanffy. The adjustments were performed first by evaluating the fixed and mixed-effects models with random effects, added to the fixed parameters. Then, the best adjusted model was improved by an adequated covariance structure, and dummy variables were added to the parameters asymptote (α) and abscissa of the inflection point (ß) in the model in order to verify the effect of the experiment factors, species and temperatures on the regression parameters. The criteria used to compare models were residual variance and Akaike information criterion. Gompertz and von Bertalanffy mixed-effects models were better adjusted. The parameters differed between species. Moreover, the linear and quadratic effects of temperature evaluated in each species were significant. The models were reparametrized in order to consider two parameters of interest: velocity (µ) at the inflection point and lag time (λ). The maximum growth velocity was obtained at 25.4 °C by S. ostrea, while T. villosa was achieved at 30.5 °C; both fungi suffered less lag time by increasing the temperature.

A seroprevalence survey of anti-SARS-CoV-2 antibodies among individuals 18 years of age or older living in a vulnerable region of the city of São Paulo, Brazil.

A second wave of COVID-19 has demonstrated how challenging it will be to achieve sustained control of the disease, even with vaccination underway in many countries. Therefore, it remains relevant to keep improving our understanding of the distribution of COVID-19, especially of asymptomatic individuals, among different populations, and particularly in vulnerable regions. Hence, this population-based serosurvey had the objective of estimating the prevalence of individuals 18 years of age or older infected by SARS-CoV-2, and the proportion of asymptomatic individuals, among a vulnerable population living in an urban setting. This was a cross-sectional single-stage cluster sampling serosurvey conducted between September and December of 2019, in a vulnerable region of the city of São Paulo, Brazil. Families covered by three public primary healthcare units represented the selected clusters. After study inclusion, participants were asked about signs and symptoms related to COVID-19, and had collected 10 mL of blood for serology testing. A total of 272 individuals from 185 families were included in the study, out of the 400 eligible individuals for inclusion, resulting in a non-response rate of 32%. The post stratified prevalence of individuals infected by SARS-CoV-2 was 45.2% (95% CI: 39.4-51.0%), with a proportion of asymptomatic cases of 30.2% (95% CI: 23.3-38.0%). This population-based serosurvey identified a greater prevalence of infected individuals by SARS-CoV-2 compared to data from the beginning of the pandemic, and from a recent citywide serosurvey, with a similar proportion of asymptomatic individuals. It demonstrated the value of primary healthcare services for disease surveillance activities, and the importance of more focused serosurveys, especially in vulnerable locations, and the need to evaluate new surveillance strategies to take into account asymptomatic cases.

Chemical structure of native and modified sulfated heterorhamnans from the green seaweed Gayralia brasiliensis and their cytotoxic effect on U87MG human glioma cells.

A water-soluble sulfated heterorhamnan (Gb1) was isolated from the green seaweed Gayralia brasiliensis and purified by ultrafiltration, yielding a homogeneous polysaccharide (Gb1r). Both fractions contained rhamnose, xylose, galacturonic and glucuronic acids, galactose, and glucose. Chemical and spectroscopic methods allowed the determination of Gb1 and Gb1r chemical structure. Their backbones were constituted by 3-, 2-, and 2,3-linked rhamnosyl units (1:0.49:0.13 and 1:0.58:0.17, respectively), which are unsulfated (13.5 and 14.6%), disulfated (16.6 and 17.8%) or monosulfated at C-2 (8 and 8.6%) and C-4 (24.5 and 23.4%). Gb1 was oversulfated giving rise to Gb1-OS, which presented ~2.5-fold higher content of disulfated rhamnosyl units than Gb1, as determined by methylation analyses and NMR spectroscopy. Gb1 and Gb1-OS potently reduced the viability of U87MG human glioblastoma cells. Gb1 caused cell cycle arrest in the G1 phase, increased annexin V-stained cells, and no DNA fragmentation, while Gb1-OS increased the percentage of cells in the S and G2 phases and the levels of fragmented DNA and cells double-stained with annexin V/propidium iodide, suggesting an apoptosis mechanism. The results suggest that the different effects of Gb1 and Gb1-OS were related to differences in the sulfate content and position of these groups along the polysaccharide chains.

Hydrometeorological conditions in the semiarid and east coast regions of Northeast Brazil in the 2012-2017 period.

Various studies have identified that between 2012 and 2017, Brazil's semiarid region suffered severe drought. However, few studies have analyzed whether this drought also affected the eastern coastal region of Northeast Brazil (ENEB). Therefore, the objective of this work is to identify rainfall anomalies in these regions and verify the hydrometeorological impact on reservoirs in the 2012-2017 interval. For this purpose, we used precipitation data and atmospheric variables in the period from 1981 to 2017 to investigate the rainy season and associated dynamic patterns, as well as the consequences of these mechanisms on the variation of the water parameters of important reservoirs. The results indicated that rain events in the ENEB during 2012-2017 presented similar climatological behavior, without the characteristic of a drought event as observed in the semiarid region. The meteorological analyses showed that the combination of convergence with moisture over the Atlantic Ocean possibly favored greater frequency of shallow convective rainfall in ENEB, an important factor to explain the absence of generalized negative anomalies in the region. As a consequence, the reservoirs did not suffer from water collapse, unlike in the semiarid region.

Untreated dental caries and visible plaque of mothers are not determinant for the incidence of caries in dentin among children: evidence from a 3-year prospective cohort study.

OBJECTIVES: To evaluate whether characteristics related to mother's oral health, trajectory of family income, and maternal education are associated with the incidence of caries in dentin in preschool children. MATERIALS AND METHODS: One hundred fifty-eight mothers and their children were evaluated at baseline and re-evaluated after 3 years. Sociodemographic variables, dental caries, and biofilm of the mothers and children and daily sugar intake of the children were evaluated. Poisson regression was used to evaluate what factor represents risk for the incidence of caries in dentin at four to 6 years of age. RESULTS: The risk of the incidence of caries in dentin was 54% higher in children whose mothers had a low level of education at both baseline and follow-up. Children from families with an income lower at baseline and follow-up (RR 2.49; 95% CI 1.62-3.83) and those whose families experienced a reduction in income in this period (RR 2.05; 95% CI 1.29-3.26) had a greater risk of the incidence of caries in dentin. Moreover, children who increased their daily sugar intake (RR 1.67; 95% CI 1.09-2.52), those that maintained high sugar intake (RR 1.81; 95% CI 1.14-2.87), and those with cavitated caries at baseline (RR 1.53; 95% CI 1.19-1.97) had a greater risk of the incidence of caries in dentin. CONCLUSIONS: Low mother's education, a lower family income, a reduction in family income, a high frequency of daily sugar intake, and a history of cavitated caries were risk factors for the incidence of caries in dentin. CLINICAL RELEVANCE: The results could help in the targeting of improved prevention and control strategies for dental caries.

Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study / Influência da duração da amamentação na incidência de cárie dentária em pré-escolares: um estudo de coorte

Abstract Objectives: investigate the association between breastfeeding duration and the incidence of severe caries in preschoolers. Methods: a cohort study was conducted with 132 pairs of mothers and children in the city of Diamantina, Brazil. Data collection was performed in 2 moments: when the children were between two and three years of age (baseline- 2013/2014) and after three years (T1-2016/2017). In both moments, children were evaluated for dental caries (International Caries Detection and Assessment System - ICDAS) and a questionnaire was administered to the mothers addressing socioeconomic aspects and thee habits of children. The outcome evaluated was the incidence of severe caries (Dentin caries - ICDAS Codes 5 and 6). Data analysis involved descriptive statistics, chi-squared test and Poisson hierarchical regression with robust variance. Results: children who breastfed for more than 24 months (RR = 2.24 CI95%= 1.23-4.08), those whose parents were separated (RR = 1.73 CI95%= 1.11-2.69), and those with estab-lished/severe caries (RR = 2.74 CI95%= 1.37-5.49) at baseline were at greater risk of incidence of severe caries after three years. Conclusion: breastfeeding for more than 24 months is a risk factor for incidence of severe caries. In addition, family structure and established or severe baseline caries were associated.

Resumo Objetivos: investigar a associação entre a duração da amamentação e a incidência de cárie grave em pré-escolares. Métodos: foi realizado um estudo de coorte com 132 pares de mães e crianças de Diamantina, Minas Gerais, Brasil. As crianças foram avaliadas em dois momentos: dois e três anos de idade (baseline-2013/2014) e após três anos (T1- 2016/2017). Dados socioeconómicos e relativos aos hábitos das criançasforam obtidos por meio de entrevistas com as mães e a presença de cárie dentária foi diagnosticada segundo o protocolo "International Caries Detection and Assessment System - ICDAS". O desfecho foi a incidência de cárie grave (cárie em dentina - códigos ICDAS 5 e 6). Para análise dos dados empregou-se regressão hierárquica de Poisson com variância robusta. Resultados: crianças que amamentaram por mais de 24 meses (RR = 2,24 IC95%= 1,234,08), cujos pais viviam separados no baseline (RR = 1,73 IC95%= 1,11-2,69) e aquelas com cárie estabelecida ou grave no baseline (RR = 2, 74 IC950%= 1,37-5,49) estavam em maior risco de incidência de cárie grave após 3 anos. Conclusão: a amamentação por mais de 24 meses foi um fator de risco para a incidência de cárie dentária grave em pré-escolares. Além disso, estrutura familiar e cárie estabelecida ou grave no baseline estiveram associados.

Comprehensive genomic profiling of Brazilian non-small cell lung cancer patients (GBOT 0118/LACOG0418).

BACKGROUND: The aim of this study was to carry out a descriptive analysis of the somatic genetic profile and co-occurring mutations of non-small cell lung cancer (NSCLC) samples from patients tested with comprehensive genomic profiling (CGP). METHODS: This was a retrospective cross-sectional study of patients diagnosed with NSCLC from 2013 to 2018 in Brazil and whose samples were submitted to CGP (FoundationOne or FoundationACT) using either tumor or circulating tumor DNA (ctDNA) from plasma. RESULTS: We recovered 513 CGP results from patients, 457 (89.1%) of which were from tumors and 56 (10.9%) from plasma. The median age of patients was 64 years old, of which 51.6% were males. TP53 mutations were identified in 53.6% of tumor samples, KRAS mutations in 24.2%, EGFR activating mutations were detected in 22.5%, STK11 mutations in 11.6%, PIK3CA mutations in 8.8%, ALK rearrangements in 5.4%, BRAF mutations in 5.2%, and ERBB2 alterations in 4.9%. The most commonly comutated gene was TP53. TP53 p.R337H was observed in 4.3% of samples and was associated with somatic mutations in EGFR and ERBB2 (P < 0.00001). Tumor mutational burden (TMB) analysis was available for 80.5% of samples tested, and 5.5% of samples had high TMB (≥ 20 mutations/Mb). In conclusion, this retrospective analysis of genomic data from NSCLC patients obtained by CGP showed that common abnormalities such as EGFR mutations and ALK rearrangements had similar frequency to those previously described by other groups using others strategies. Additionally, our data confirm an association between TP53 p.R337H, supposedly germline in nature, and somatic mutations in genes of the HER family. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This is the first report of the prevalence of driver mutations in Brazilian NSCLC patients using comprehensive genomic profiling (CGP). The frequency of the most common driver mutations in this population was similar to that previously described in Brazil. WHAT THIS STUDY ADDS: TP53 was the most commonly comutated gene across samples. TP53 p.R337H was associated with somatic mutations in EGFR and ERBB2. Most samples had low TMB; only 5.5% of samples had high TMB.

Efectos de un programa de entrenamiento multicomponente sobre indicadores de salud física y cognitiva de mujeres mayores / Effects of a multicomponent training program on physical and cognitive health indicators of older women

RESUMEN: Objetivo: Analizar el efecto de un programa de Entrenamiento MultiComponente (EMC) sobre autonomía funcional, fuerza muscular, composición corporal, capacidad cognitiva y perfil glucémico de mujeres mayores. Material y Métodos: 13 mujeres con edad 61,0 ± 6,0 años, participaron del estudio durante 12 semanas, siendo ­ Entrenamiento Resistido (ER); martes y viernes ­ Entrenamiento Funcional (EF) y Entrenamiento de Judo Adaptado (EJA), en la misma sesión; se utilizó el protocolo de autonomía funcional ­ GDLAM, Mini Examen del Estado Mental (MEEM), test de predicción de 1RM, índices: glicémico, masa corporal (IMC), relación cintura-cadera (IRCQ), relación cintura-estatura (RCE) y siete pliegues cutáneos. Resultados:Hubo mejora (p<0,05) para todos los test del GDLAM y el índice general (∆% = -21,31%; p-valor = 0,0006). Para el MEEM fue identificado mejoría en el puntaje general (∆%=8,98%; p-valor= 0,002), atención, cálculo y lenguaje. También hubo mejora (p<0,05) para todos los ejercicios de fuerza. Para composición corporal: porcentaje de grasa (%G) (∆%= -11,8%; p-valor= 0,001). Conclusión: El programa de EMC realizado cuatro veces en la semana, durante 12 semanas fue eficaz para mejorar la autonomía funcional, la fuerza muscular, la función cognitiva, para variables % G, masa magra y grasa de las mujeres estudiadas.

BSTRACT: Objective: To analyze the effect of a Multi-Component Training (CMT) program on functional autonomy, muscle strength, body composition, cognitive capacity and glycemic profile of older women. Material and Methods: 13 women aged 61.0 ± 6.0 years, participated in the study for 12 weeks, being -Resisted Training (ER); Tuesday and Friday - Functional Training (EF) and Adapted Judo Training (EJA), in the same session; The functional autonomy protocol was used - GDLAM, Mini Mental State Examination (MMSE), 1RM prediction test, glycemic index, body mass (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR) and seven skin folds. Results:There was improvement (p <0.05) for all GDLAM tests and the general index (Δ% = -21.31%; p-value = 0.0006). For the MMSE, an improvement was identified in the general score (Δ% = 8.98%; p-value = 0.002), attention, calculation and language. There was also improvement (p <0.05) for all resistance exercises. For body composition: fat percentage (% G) (Δ% = -11.8%; p-value = 0.001). Conclusion:The CME program performed four times a week for 12 weeks was effective in improving functional autonomy, muscle strength, cognitive function, for variables % F, lean mass and fat of the women studied.

Quinolone-N-acylhydrazone hybrids as potent Zika and Chikungunya virus inhibitors.

This work reports the synthesis of quinolone-N-acylhydrazone hybrids, namely 6-R-N'-(2-hydxoxybenzylidene)-4-oxo-1,4-dihydroquinoline-3-carbohydrazide (R = H: 5a, F: 5b, Cl: 5c and Br: 5d), which exhibited excellent activity against arbovirus Zika (ZIKV) and Chikungunya (CHIKV). In vitro screening towards ZIKV and CHIKV inhibition revealed that all substances have significant antiviral activity, most of them being more potent than standard Ribavirin (5a-d: EC50 = 0.75-0.81 µM, Ribavirin: EC50 = 3.95 µM for ZIKV and 5a-d: 1.16-2.85 µM, Ribavirin: EC50 = 2.42 µM for CHIKV). The quinolone-N-acylhydrazone hybrids were non-toxic against Vero cells, in which compounds 5c and 5d showed the best selectivities (SI = 1410 and 630 against ZIKV and CHIKV, respectively). Antiviral activity was identified by inhibition of viral RNA production in a dose-dependent manner. In the evaluation of the time of addition of the compounds, we observed that 5b and 5c remain with strong effect even in the addition for 12 h after infection. The above results indicate that quinolone-N-acylhydrazones represent a new and promising class to be further investigated as anti-ZIKV and anti-CHIKV agents.

Prolonged fasting followed by refeeding modifies proteome profile and parvalbumin expression in the fast-twitch muscle of pacu (Piaractus mesopotamicus).

Here, we analyzed the fast-twitch muscle of juvenile Piaractus mesopotamicus (pacu) submitted to prolonged fasting (30d) and refeeding (6h, 24h, 48h and 30d). We measured the relative rate of weight and length increase (RRIlength and RRIweight), performed shotgun proteomic analysis and did Western blotting for PVALB after 30d of fasting and 30d of refeeding. We assessed the gene expression of igf-1, mafbx and pvalb after 30d of fasting and after 6h, 24h, 48h and 30d of refeeding. We performed a bioinformatic analysis to predict miRNAs that possibly control parvalbumin expression. After fasting, RRIlength, RRIweight and igf-1 expression decreased, while the mafbx expression increased, which suggest that prolonged fasting caused muscle atrophy. After 6h and 24h of refeeding, mafbx was not changed and igf-1 was downregulated, while after 48h of refeeding mafbx was downregulated and igf-1 was not changed. After 30d of refeeding, RRIlength and RRIweight were increased and igf-1 and mafbx expression were not changed. Proteomic analysis identified 99 proteins after 30d of fasting and 71 proteins after 30d of refeeding, of which 23 and 17, respectively, were differentially expressed. Most of these differentially expressed proteins were related to cytoskeleton, muscle contraction, and metabolism. Among these, parvalbumin (PVALB) was selected for further validation. The analysis showed that pvalb mRNA was downregulated after 6h and 24h of refeeding, but was not changed after 30d of fasting or 48h and 30d of refeeding. The Western blotting confirmed that PVALB protein was downregulated after 30d of fasting and 30d of refeeding. The downregulation of the protein and the unchanged expression of the mRNA after 30d of fasting and 30d of refeeding suggest a post-transcriptional regulation of PVALB. Our miRNA analysis predicted 444 unique miRNAs that may target pvalb. In conclusion, muscle atrophy and partial compensatory growth caused by prolonged fasting followed by refeeding affected the muscle proteome and PVALB expression.

Cross-Cultural Validity Study of a Medical Education Leadership Competencies Instrument in Latin American Physicians: A Multinational Study.

PURPOSE: Physicians rarely receive formal training in leadership skills. Çitaku and colleagues have identified a set of leadership competencies (LCs) providing validity evidence in North American (NA) and European Union (EU) medical education institutions. We aim to apply this same survey to a sample of Latin American (LA) medical leaders from the oncology community and related areas, compare the results with those of the previous survey, and perform subgroup analyses within the LA cohort. METHODS: The survey was sent to nearly 8,000 physicians of participating professional organizations. In addition to the 63 questions, we also collected data on the type of institution, country, specialty, sex, age, years of experience in oncology, and leadership position. RESULTS: The 217 LA respondents placed the highest value on task management competencies (91.37% reported these as important or very important v 87.0% of NA/EU respondents; P < .0001), followed by self-management (87.45% of LA respondents v 87.55% of NA/EU respondents; P = not significant [NS]), social responsibility (86.83% of LA respondents v 87.48% of NA/EU respondents; P = NS), innovation (86.69% of LA respondents v 85.31% of NA/EU respondents; P = NS), and leading others (83.31% of LA respondents v 84.71% of NA/EU respondents; P = NS). Social responsibility, which was first in importance in the NA/EU survey, was only third in the LA survey. Subgroup analyses showed significant variations in the ratings of specific LCs within the LA population. CONCLUSION: LCs valued by LA leaders somewhat differ from those valued by their NA and EU counterparts, implying that cultural aspects might influence the perception of desired LCs. We also detected variations in the responses within the LA population. Our data indicate that current physician leadership training programs should be tailored to suit specific needs and cultural aspects of each region. Further validity studies of this instrument with other samples and cultures are warranted.

BCG vaccine and leprosy household contacts: Protective effect and probability to becoming sick during follow-up.

BACKGROUND: Immunoprophylaxis with Bacillus Calmette-Guérin (BCG) vaccine is still the most effective intervention in the prevention of leprosy among household contacts (HHCs) of leprosy patients. METHODS: A retrospective cohort study using data of 5.061 HHCs for a period of 16 years (follow-up of 7 years per leprosy HHCs), evaluating the occurrence of disease as the main outcome and the presence or absence of BCG scars verified at the first evaluation. Statistical analyzes were performed using the relative risk, hazard ratio and survival curves by Kaplan-Meier test. RESULTS: A total of 92 contacts sickened, of which 41.3% (38/92) in the first year and 58.7% (54/92) in the course of the other years of follow-up. Of those who became sick, 62% (57/92) developed borderline tuberculoid (BT). The additional protective effect occurred for those who had 2 BCG scars at the first follow-up assessment (Relative Risk: 0.41; p = 0.007) when compared to those not previously exposed to the vaccine. The number of BCG scars examined at the first assessment (t0 = time zero) affected the occurrence of the outcome evidenced by the difference in survival curves throughout the follow-up (Log Rank, p = 0.041; Breslow, p = 0.012; Tarone-Ware, p = 0.020). Leprosy HHCs with 0 BCG scar at time zero (t0) have a shorter survival time (average time of 22 months between t0 and outcome) when compared to those with 2 BCG scars (average time of 36 months between t0 and outcome). CONCLUSIONS: Vaccination of healthy individuals without signs and symptoms of leprosy is extremely important because BCG vaccine has an additional protective effect in those cases with 2 BCG scars throughout follow-up. Reducing the risk of leprosy HHCs becoming sick depends on preventive actions such as immunoprophylaxis and index cases treatment.

Proteomic analysis of the fast-twitch muscle of pacu (Piaractus mesopotamicus) after prolonged fasting and compensatory growth.

Protocols that improve growth performance in fish while assuring product quality are important for aquaculture. Fasting followed by refeeding may promote compensatory growth, thus optimizing growth performance. During fasting and refeeding, fast-twitch muscle, which comprises most of fish fillet, undergoes intense plasticity. In this work, we studied the proteome of pacu (Piaractus mesopotamicus) fast-twitch muscle after 30 days of fasting (D30), 30 days of refeeding (D60) and 60 days of refeeding (D90) with two-dimensional electrophoresis, mass spectrometry and bioinformatics. Body mass, growth rate and muscle histology were also assessed. At D30, fish presented muscle catabolism and decreased growth. Proteomic analysis showed that metabolism proteins were the most affected, up and downregulated. Cytoskeleton and amino acid biosynthesis proteins were downregulated, while nuclear and regulatory proteins were upregulated. At D60, fish showed accelerated growth, despite the body mass not completely recovering. Metabolism proteins were still the most affected. Amino acid biosynthesis proteins became upregulated, while cytoskeleton proteins remained downregulated. At D90, the fish presented total compensatory growth. Many metabolic proteins were up or downregulated. Few cytoskeleton proteins remained differentially expressed. Amino acid biosynthesis proteins were mostly upregulated, but less than at D60. Prolonged fasting followed by refeeding also led to the regulation of possible meat quality biomarkers, such as antioxidant enzymes. This fact suggests possible consequences of this protocol on fish meat quality. Our work also enriches our knowledge on proteomic changes during muscle plasticity that occur during fasting and refeeding diet protocols.

Avaliação do programa de Boas Práticas De Manipulação em açougues localizados na cidade de Aracaju/SE / Program evaluation of good practices in handling butchers located in the city of Aracaju/SE

Os açougues estão gradualmente se adequando às normas exigidas pela Vigilância Sanitária. O estudo teve como objetivo, avaliar a higiene das carnes através das Boas Práticas de Manipulação em açougues na cidade de Aracaju/SE, abrangendo a estrutura física dos locais, as condições de estoque da carne e a higiene e saúde dos manipuladores. No ano de 2015, foram visitados 10 açougues, sendo cinco da zona norte e os demais da zona sul na cidade de Aracaju/SE. Foi utilizado um guia de verificação ou check-list, baseado nas Resoluções RDC nº 275 de 21 de outubro de 2002 e RDC nº 216 de 15 de Setembro de 2004. Em geral, as lojas estudadas obtiveram em sua maioria, itens em Não Conformidades. Torna-se necessário que os órgãos fiscalizadores continuem atuando nas atividades da vigilância sanitária, a fim de evitar riscos à saúde dos consumidores.

Caracterização higiênico-sanitária de feiras livres do municipio de Aracaju com enfoque na comercialização dos produtos de origem animal / Hygienic-sanitary characterization of free fairs of the municipality of Aracaju with a focus on the marketing of products of animal origin

A boa condição do alimento é um fator de extrema importância para a conservação da saúde de quem o consome. Neste contexto, o presente estudo teve como objetivo caracterizar as condições higiênico-sanitárias de feiras livres do município de Aracaju, com enfoque na comercialização dos produtos de origem animal. Foram visitadas oito feiras livres, cada uma representando as regiões a qual o município é subdividido. Foi elaborado um questionário com perguntas direcionadas aos feirantes e consumidores. No geral, as feiras livres visitadas em sua maioria obtiveram itens em Não Conformidades. Sendo necessária para evitar riscos à saúde dos consumidores que os órgãos fiscalizadores continuem atuando nas atividades da vigilância sanitária.