The osteogenic and mineralogenic potential of the microalgae Skeletonema costatum and Tetraselmis striata CTP4 in fish models.

Skeletal disorders are problematic aspects for the aquaculture industry as skeletal deformities, which affect most species of farmed fish, increase production costs and affect fish welfare. Following recent findings that show the presence of osteoactive compounds in marine organisms, we evaluated the osteogenic and mineralogenic potential of commercially available microalgae strains Skeletonema costatum and Tetraselmis striata CTP4 in several fish systems. Ethanolic extracts increased extracellular matrix mineralization in gilthead seabream (Sparus aurata) bone-derived cell cultures and promoted osteoblastic differentiation in zebrafish (Danio rerio) larvae. Long-term dietary exposure to both extracts increased bone mineralization in zebrafish and upregulated the expression of genes involved in bone formation (sp7, col1a1a, oc1, and oc2), bone remodeling (acp5a), and antioxidant defenses (cat, sod1). Extracts also improved the skeletal status of zebrafish juveniles by reducing the incidence of skeletal anomalies. Our results indicate that both strains of microalgae contain osteogenic and mineralogenic compounds, and that ethanolic extracts have the potential for an application in the aquaculture sector as dietary supplements to support fish bone health. Future studies should also identify osteoactive compounds and establish whether they can be used in human health to broaden the therapeutic options for bone erosive disorders such as osteoporosis.

Ultra-processed food consumption and metabolic syndrome: a cross-sectional study in Quilombola communities of Alagoas, Brazil.

BACKGROUND: The processing of food can cause changes that turn them into risk factors for chronic diseases. A higher degree of food processing is associated with the development of chronic non-communicable diseases (NCDs), including the metabolic syndrome (MetS). The objective of this study was to analyze the relationship between ultra-processed food (UPF) consumption and the prevalence of MetS and its risk factors, focusing on a population group especially subjected to precarious living conditions and food insecurity. METHOD: Cross-sectional population-based study with women (19 to 59 years) from Quilombola communities of Alagoas. The socioeconomic, demographic, anthropometric, health status, lifestyle, and food intake (24-h recall) variables were analyzed. The dependent variable was the MetS, defined using the harmonization criteria of the Joint Interim Statement, and its components. The foods consumed were categorized according to the Nova Classification, assuming the highest UPF consumption as risk exposure. The measure of association was the prevalence ratio (PR) and respective 95%CI, calculated by Poisson regression with robust variance. We also analyzed the association with the Nova score of UPF consumption. RESULTS: We investigated 895 women (38.9 ± 11.0 years), of whom 48.3% had MetS. On average, 15.9% of the total energy intake came from UPF. Lower Nova scores were associated with a lower prevalence of diabetes and low HDL. Higher UPF consumption was associated with a 30% higher prevalence of hypertension (PR = 1.30; 95%CI: 1.06-1.61). CONCLUSION: The highest UPF consumption was positively associated with the prevalence of hypertension, while a lower Nova score was a protective factor against diabetes and low HDL. UPF consumption in Quilombola communities is important but lower than that observed in the Brazilian population in general. It is suggested that public health programs be implemented to promote healthy eating while valuing the existing eating habits and traditions among the remaining Brazilian Quilombola people.

RESUMO: INTRODUçãO: O processamento de alimentos pode causar alterações que os transformam em fatores de risco para doenças crônicas. Um maior grau de processamento de alimentos está associado ao desenvolvimento de doenças crônicas não transmissíveis (DCNT), incluindo a síndrome metabólica (SM). O objetivo deste estudo foi analisar a relação entre o consumo de alimentos ultraprocessados (AUP) e a prevalência de SM e seus fatores de risco, com foco em um grupo populacional especialmente submetido a precárias condições de vida e insegurança alimentar. MéTODO: Estudo transversal de base populacional com mulheres (19 a 59 anos) de comunidades Quilombolas de Alagoas. Foram analisadas as variáveis socioeconômicas, demográficas, antropométricas, estado de saúde, estilo de vida e ingestão alimentar (recordatório de 24 horas). A variável dependente foi a SM, definida a partir dos critérios de harmonização do Joint Interim Statement, e seus componentes. Os alimentos consumidos foram categorizados de acordo com a Classificação Nova, assumindo como exposição de risco o maior consumo de AUP. A medida de associação foi a razão de prevalência (RP) e respectivo IC 95%, calculado por regressão de Poisson com variância robusta. Também analisou-se a associação com o Escore Nova de consumo de AUP. RESULTADOS: Foram investigadas 895 mulheres (38,9 ± 11,0 anos), das quais 48,3% tinham SM. Em média, 15,9% da ingestão total de energia provinham de AUP. Escores Nova mais baixos foram associados a uma menor prevalência de diabetes e HDL baixo. O maior consumo de AUP se associou a uma prevalência 30% maior de hipertensão arterial (RP = 1,30; IC95%: 1,06-1,61). CONCLUSãO: O maior consumo de AUP se associou positivamente à prevalência de hipertensão, enquanto o menor escore Nova foi fator de proteção contra diabetes e baixo HDL. O consumo de AUP nas comunidades Quilombolas é relevante, mas inferior ao observado na população brasileira em geral. Sugere-se a implementação de programas de saúde pública que promovam a alimentação saudável, valorizando os hábitos e tradições alimentares existentes entre os remanescentes Quilombolas brasileiros.

The Induction of Hypothyroidism during Gestation Decreases Outer Hair Cell Motility in Rat Offspring

Abstract Introduction Perinatal hypothyroidism has a negative repercussion on the development and maturation of auditory system function. However, its long-term effect on auditory function remains unsettled. Objective To evaluate the effect of prenatal hypothyroidism on the auditory function of adult offspring in rats. Methods Pregnant Wistar rats were given the antithyroid drug methimazole (0.02%-1-methylimidazole-2-thiol- MMI) in drinking water, ad libitum, from gestational day (GD) 9 to postnatal day 15 (PND15). Anesthetized offspring from MMI-treated dams (OMTD) and control rats were evaluated by tympanometry, distortion product otoacoustic emission (DPOAE), and auditory brainstem response (ABR) at PNDs 30, 60, 90, and 120. Results Our data demonstrated no middle ear dysfunction, with the OMTD compliance lower than that of the control group. The DPOAE revealed the absence of outer hair cells function, and the ABR showed normal integrity of neural auditory pathways up to brainstem level in the central nervous system. Furthermore, in the OMTD group, hearing loss was characterized by a higher electrophysiological threshold. Conclusion Our data suggest that perinatal hypothyroidism leads to irreversible damage to cochlear function in offspring.

The Induction of Hypothyroidism during Gestation Decreases Outer Hair Cell Motility in Rat Offspring.

Introduction Perinatal hypothyroidism has a negative repercussion on the development and maturation of auditory system function. However, its long-term effect on auditory function remains unsettled. Objective To evaluate the effect of prenatal hypothyroidism on the auditory function of adult offspring in rats. Methods Pregnant Wistar rats were given the antithyroid drug methimazole (0.02% -1-methylimidazole-2-thiol- MMI) in drinking water, ad libitum, from gestational day (GD) 9 to postnatal day 15 (PND15). Anesthetized offspring from MMI-treated dams (OMTD) and control rats were evaluated by tympanometry, distortion product otoacoustic emission (DPOAE), and auditory brainstem response (ABR) at PNDs 30, 60, 90, and 120. Results Our data demonstrated no middle ear dysfunction, with the OMTD compliance lower than that of the control group. The DPOAE revealed the absence of outer hair cells function, and the ABR showed normal integrity of neural auditory pathways up to brainstem level in the central nervous system. Furthermore, in the OMTD group, hearing loss was characterized by a higher electrophysiological threshold. Conclusion Our data suggest that perinatal hypothyroidism leads to irreversible damage to cochlear function in offspring.

Effects of pristine or contaminated polyethylene microplastics on zebrafish development.

The presence of microplastics in the aquatic ecosystem represents a major issue for the environment and human health. The capacity of organic pollutants to adsorb onto microplastic particles raises additional concerns, as it creates a new route for toxic compounds to enter the food web. Current knowledge on the impact of pristine and/or contaminated microplastics on aquatic organisms remains insufficient, and we provide here new insights by evaluating their biological effects in zebrafish (Danio rerio). Zebrafish larvae were raised in ZEB316 stand-alone housing systems and chronically exposed throughout their development to polyethylene particles of 20-27 µm, pristine (MP) or spiked with benzo[α]pyrene (MP-BaP), supplemented at 1% w/w in the fish diet. While they had no effect at 30 days post-fertilization (dpf), MP and MP-BaP affected growth parameters at 90 and 360 dpf. Relative fecundity, egg morphology, and yolk area were also impaired in zebrafish fed MP-BaP. Zebrafish exposed to experimental diets exhibited an increased incidence of skeletal deformities at 30 dpf as well as an impaired development of caudal fin/scales, and a decreased bone quality at 90 dpf. An intergenerational bone formation impairment was also observed in the offspring of parents exposed to MP or MP-BaP through a reduction of the opercular bone in 6 dpf larvae. Beside a clear effect on bone development, histological analysis of the gut revealed a reduced number of goblet cells in zebrafish fed MP-BaP diet, a sign of intestinal inflammation. Finally, exposure of larvae to MP-BaP up-regulated the expression of genes associated with the BaP response pathway, while negatively impacting the expression of genes involved in oxidative stress. Altogether, these data suggest that long-term exposure to pristine/contaminated microplastics not only jeopardizes fish growth, reproduction performance, and skeletal health, but also causes intergenerational effects.

Phyto-genotoxicity assessment of different associations between sludges from Water and Sewage Treatment Plants, before and after the bioremediation process.

Water Treatment Plants (WTP) and Sewage Treatment Plants (STP) generate residues known as sludge (WS and SS, respectively). SS and WS present some positive characteristics for reuse in agriculture. The aim of the present study was to evaluate, using the Allium cepa test, the effectiveness of the bioremediation process in the detoxification of SS and WS sludges. In this study, the phytotoxic, cytotoxic, genotoxic, and mutagenic potentials of pure sludge samples (WS and SS) were evaluated, as well as the association of these two sludges with soil (S), before and after the bioremediation process. In the T0 period (before undergoing bioremediation), the SS, SS + S, and SS + WS samples totally inhibited the germination of A. cepa, proving the high phytotoxic potential of these samples. For the T1 period (after 6 months of bioremediation), phytotoxicity was observed for the SS, SS + S, SS + WS, and SS + WS + S samples, but there was not a complete inhibition of germination and radicles growth, allowing the evaluation of the other parameters (cytogenotoxic and mutagenic potential). No cytotoxicity was observed for any sample, both in T0 and T1. As for the genotoxicity parameter, a significant result was observed for the pure WS sample in T0 and for all samples in T1, when compared to NC. The genotoxic alteration most found in meristematic cells exposed to treatments was of binucleated cells. Mutagenic potential was also observed for samples of WS and WS + S in T0. From this study, we can conclude that, after six months of bioremediation, despite the SS phytotoxicity being reduced, all samples were genotoxic to the A. cepa organism test.

What is the best anthropometric predictor for identifying higher risk for cardiovascular diseases in afro-descendant Brazilian women? A cross-sectional population-based study.

OBJECTIVES: Excessive adiposity is associated with cardiovascular disease (CVD). Anthropometric indices are useful in screening individuals at higher risk for these diseases. However, there are no studies that show which of these indices has the best discriminatory power among Afro-descendant Brazilian women. The objective of this study was to assess the accuracy of anthropometric indices in identifying risk factors for CVD in Afro-descendant Brazilian women and define the one most suitable for use under the operating conditions prevailing in Quilombola communities. METHODS: A household random sample of 1661 women descendants of African slaves were analyzed. The anthropometric predictors analyzed were waist circumference (WC), body mass index, waist-to-height ratio, conicity index (C-index), body shape index, and percentage of body fat (%BF; estimated by bioimpedance). The assessed risk factors for CVD were arterial hypertension, diabetes mellitus, and dyslipidemias (hypertriglyceridemia; hypercholesterolemia; low high-density lipoprotein). To identify the statistical significance between the differences in the areas under the ROC curves (AUC) obtained with the different predictors and outcomes, was used the Bonferroni test adjusted for multiple analyses by the Sidak method. RESULTS: The AUC obtained with WC was higher (p < .05) or similar (p > .05) to those obtained with the other predictors 29 times out of 30 possibilities (six predictors x five outcomes). Only the AUC obtained with C-index in identifying hypercholesterolemia was significantly higher than that with WC. CONCLUSION: Due to its accuracy and greater operational simplicity, WC was the most adequate predictor for identifying Afro-descendant women at greatest risk for CVD.

Nutritional and Functional Evaluation of Inula crithmoides and Mesembryanthemum nodiflorum Grown in Different Salinities for Human Consumption.

The nutritional composition and productivity of halophytes is strongly related to the biotic/abiotic stress to which these extremophile salt tolerant plants are subjected during their cultivation cycle. In this study, two commercial halophyte species (Inula crithmoides and Mesembryanthemum nodiflorum) were cultivated at six levels of salinity using a soilless cultivation system. In this way, it was possible to understand the response mechanisms of these halophytes to salt stress. The relative productivity decreased from the salinities of 110 and 200 mmol L-1 upwards for I. crithmoides and M. nodiflorum, respectively. Nonetheless, the nutritional profile for human consumption remained balanced. In general, I. crithmoides vitamin (B1 and B6) contents were significantly higher than those of M. nodiflorum. For both species, ß-carotene and lutein were induced by salinity, possibly as a response to oxidative stress. Phenolic compounds were more abundant in plants cultivated at lower salinities, while the antioxidant activity increased as a response to salt stress. Sensory characteristics were evaluated by a panel of culinary chefs showing a preference for plants grown at the salt concentration of 350 mmol L-1. In summary, salinity stress was effective in boosting important nutritional components in these species, and the soilless system promotes the sustainable and safe production of halophyte plants for human consumption.

In situ monitoring of chlorophyll a fluorescence in Nannochloropsis oceanica cultures to assess photochemical changes and the onset of lipid accumulation during nitrogen deprivation.

In situ chlorophyll a fluorescence measurements were applied to monitor changes in the photochemical variables of Nannochloropsis oceanica cultures under nitrogen-deplete and nitrogen-replete (control) conditions. In addition, growth, lipid, fatty acid, and pigment contents were also followed. In the control culture, growth was promoted along with pigment content, electron transport rate (ETR), and polyunsaturated fatty acids, while total lipid content and fatty acid saturation level diminished. Under nitrogen-deplete conditions, the culture showed a higher de-epoxidation state of the xanthophyll cycle pigments. Fast transients revealed a poor processing efficiency for electron transfer beyond QA , which was in line with the low ETR due to nitrogen depletion. Lipid content and the de-epoxidation state were the first biochemical variables triggered by the change in nutrient status, which coincided with a 20% drop in the in situ effective quantum yield of PSII (ΔF'/Fm '), and a raise in the Vj measurements. A good correlation was found between the changes in ΔF'/Fm ' and lipid content (r = -0.96, p < 0.01). The results confirm the reliability and applicability of in situ fluorescence measurements to monitor lipid induction in N. oceanica.

Carotenoid biosynthetic gene expression, pigment and n-3 fatty acid contents in carotenoid-rich Tetraselmis striata CTP4 strains under heat stress combined with high light.

In this study, two carotenoid-rich strains of the euryhaline microalga Tetraselmis striata CTP4 were isolated by random mutagenesis combined with selection via fluorescence activated cell sorting and growth on norflurazon. Both strains, ED5 and B11, showed an up to 1.5-fold increase in carotenoid contents as compared with the wildtype, independent of the growth conditions. More specifically, violaxanthin, ß-carotene and lutein contents reached as high as 1.63, 4.20 and 3.81 mg g-1 DW, respectively. Genes coding for phytoene synthase, phytoene desaturase, lycopene-ß-cyclase and ε-ring hydroxylase involved in carotenoid biosynthesis were found to be upregulated in ED5 and B11 cells as compared to the wildtype. Both strains showed higher contents of eicosapentaenoic acid as compared with those of the wildtype, reaching up to 4.41 and 2.88 mg g-1 DW, respectively. Overall, these results highlight the complexity of changes in carotenoid biosynthesis regulation that are required to improve pigment contents in microalgae.

Common Mental Disorder and early interruption of exclusive maternal breastfeeding in Quilombola women: a population-based study / Transtorno mental comum e interrupção precoce do aleitamento materno exclusivo em mulheres quilombolas: estudo de base populacional

Abstract Objectives: to investigate the prevalence of exclusive maternal breastfeeding (EMBF) and evaluate whether common mental disorder (CMD) and other predictors promote its early interruption (EI-EMBF4). Methods: a cross-sectional study involving all children <24 months (n=252) residing in 50% (n=34) of the Quilombola communities in Alagoas. The EI-EMBF4 was established when EMBF was ≤4 months. The Self-Reporting Questionnaire was used to identify the occurrence of CMD. Other predictors were obtained through interviews. The measure of association was the prevalence ratio calculated by the Poisson regression, following a hierarchical theoretical model. The prevalence of EMBF for 4 and 6 months, and its median duration (survival analysis) were calculated. Results: the prevalence of EI-EMBF4 and CMD was 57.6% and 42.9%, respectively. The risk factors independently associated with EI-EMBF4 were: living in a mud house, maternal age ≤18 years, low birth weight and the use of a pacifier or baby bottle. There was no association with CMD. The prevalence of EMBF for four and six months was 42.4% and 25.4%, respectively, and the median duration was 106 days. Conclusion: EMBF indicators are below the established recommendations, justifying the implementation of measures that prioritize women subjected to risk factors identified here. CMD is not configured among these.

Resumo Objetivos: investigar a prevalência do aleitamento materno exclusivo (AME) e se o transtorno mental comum (TMC) e outros preditores promovem sua interrupção precoce (IP- AME4). Métodos: estudo transversal envolvendo todas as crianças <24 meses (n=252) residentes em 50% (n=34) das comunidades quilombolas de Alagoas. A IP-AME4 foi definida quando o AME foi ≤ 4 meses. Utilizou-se o Self-Reporting Questionnaire para identificar o TMC. Outros preditores foram obtidos por meio de entrevista. A medida de associação foi a razão de prevalência calculada por regressão de Poisson, seguindo modelo teórico hierárquico. Foram calculadas as prevalências de AME por 4 e 6 meses e sua duração mediana (análise de sobrevivência). Resultados: as prevalências de IP-AME4 e do TMC foram 57,6% e 42,9%, respectivamente. Os fatores de risco independentemente associados à IP-AME4 foram: residir em casa de taipa, idade materna ≤18 anos, baixo peso ao nascer e uso de chupeta ou de mamadeira. Não houve associação com TMC. As prevalências do AME por quatro e por seis meses foram 42,4% e 25,4%, nessa ordem, e a duração mediana foi de 106 dias. Conclusão: os indicadores de AME estão aquém das metas estabelecidas, justificando a implementação de medidas que atuem sobre os fatores de risco aqui identificados, sendo que o TMC não se configura entre esses.

Prevalence of IGFBP3, NOS3 and TCF7L2 polymorphisms and their association with hypertension: a population-based study with Brazilian women of African descent.

OBJECTIVE: African ancestry seems to be a risk factor for hypertension; however, few genetic studies have addressed this issue. This study aimed to investigate the prevalence of polymorphisms NOS3; rs1799983, IGFBP3; rs11977526 and TCF7L2; rs7903146 in Brazilian women of African descent and their association with hypertension. RESULTS: The prevalences of the less frequent genotypes were 26.5% TT genotype of NOS3; rs1799983, 16.7% AA genotype of IGFBP3; rs11977526, and 18.3% TT genotype of TCF7L2; rs7903146. For these conditions, the prevalence of hypertension and PR (adjusted) relatively to the ancestral genotype were, respectively: 52.0% vs 24.5% (PR = 1.54; p < 0.001), 62.0% vs 24.1% (PR = 1.59; p < 0.001), and 38.9% vs 27.9% (PR = 0.86; p = 0.166). Associations with hypertension were statistically significant, except for the TCF7L2; rs7903146 polymorphism, after adjusted analysis. Brazilian Afro-descendant women with the TT genotype for the NOS3 gene and the AA genotype for the IGFBP3 gene are more susceptible to hypertension. The understanding of underlying mechanisms involving the pathogenesis of hypertension can motivate research for the development of new therapeutic targets related to nitric oxide metabolism and the management of oxidative stress.

Factors associated with childhood anaemia in Afro-descendant communities in Alagoas, Brazil.

OBJECTIVE: To investigate factors associated with anaemia in preschool children. DESIGN: A home survey was conducted in 2018. Anaemia in children (capillary blood Hb level < 110 g/l) was the outcome, and socio-economic, demographic and health factors of the mother and child were the independent variables. The measure of association was the prevalence ratio, and its 95 % CI was calculated using Poisson's regression with robust variance and hierarchical selection of independent variables. SETTING: Afro-descendants communities living in the state of Alagoas, northeast Brazil. PARTICIPANTS: Children aged 6-59 months and their mothers (n 428 pairs). RESULTS: The prevalence of child anaemia was 38·1 % (95 % CI 33·5, 42·7). The associated factors with child anaemia were male sex, age < 24 months, larger number of residents at home (> 4), relatively taller mothers (highest tertile) and higher z-score of BMI for age, after further adjustment for wealth index, vitamin A supplementation in the past 6 months and clinical visit in the last 30 d. CONCLUSIONS: The high prevalence of anaemia observed reveals a relevant public health problem amongst children under five from the quilombola communities of Alagoas. Considering the damage caused to health and multiplicity of risk factors associated with anaemia, the adoption of intersectoral strategies that act on modifiable risk factors and increase vigilance concerning those that are not modifiable becomes urgent.

Flashing light emitting diodes (LEDs) induce proteins, polyunsaturated fatty acids and pigments in three microalgae.

As the periodic emission of light pulses by light emitting diodes (LEDs) is known to stimulate growth or induce high value biocompounds in microalgae, this flashing light regime was tested on growth and biochemical composition of the microalgae Nannochloropsis gaditana, Koliella antarctica and Tetraselmis chui. At low flashing light frequencies (e.g., 5 and 50 Hz, Duty cycle = 0.05), a strain-dependent growth inhibition and an accumulation of protein, polyunsaturated fatty acids, chlorophyll or carotenoids (lutein, ß-carotene, violaxanthin and neoxanthin) was observed. In addition, a 4-day application of low-frequency flashing light to concentrated cultures increased productivities of eicosapentaenoic acid (EPA) and specific carotenoids up to three-fold compared to continuous or high frequency flashing light (500 Hz, Duty cycle = 0.05). Therefore, applying low-frequency flashing light as finishing step in industrial production can increase protein, polyunsaturated fatty acids or pigment contents in biomass, leading to high-value algal products.

Wild vs cultivated halophytes: Nutritional and functional differences.

Some halophyte plants are currently used in gourmet cuisine due to their unique organoleptic properties. Moreover, they exhibit excellent nutritional and functional properties, being rich in polyphenolics and vitamins. These compounds are associated to strong antioxidant activity and enhanced health benefits. This work compared the nutritional properties and antioxidant potential of three species (Mesembryanthemum nodiflorum, Suaeda maritima and Sarcocornia fruticosa) collected in saltmarshes from Portugal and Spain with those of cultivated plants. The latter were generally more succulent and had higher contents of minerals than plants obtained from the wild and contained less fibre. All species assayed are a good source of proteins, fibres and minerals. Additionally, they are good sources of carotenoids and vitamins A, C and B6 and showed good antioxidant potential particularly S. maritima. Chromatographic analysis of the phenolic profile revealed that ferulic and caffeic acids as the most relevant phenolic compounds detected in the halophytes tested.

Influence of cultivation salinity in the nutritional composition, antioxidant capacity and microbial quality of Salicornia ramosissima commercially produced in soilless systems.

The consumption of halophytes as healthy gourmet food has increased considerably in the past few years. However, knowledge on the nutritional profile of domesticated halophytes is scarce and little is known on which cultivation conditions can produce plants with the best nutritional and functional properties. In this context, Salicornia ramosissima J. Woods was cultivated in six different salt concentrations, ranging from 35 to 465 mM of NaCl. Both the nutritional profile, the antioxidant capacity, and microbial quality of the produced plants were evaluated including minerals and vitamins. Salt has a marked effect on growth, which decreases for salinities higher than 110 mM. Nonetheless, plants cultivated with intermediate levels of salinity (110 and 200 mM) revealed better antioxidant status with higher amounts of phenolic compounds. Overall, results from this paper indicated that soilless culture systems using low-intermediate salinities produces S. ramosissima plants fit for commercialization and human consumption.

Prevalence of clinically manifested drug interactions in hospitalized patients: A systematic review and meta-analysis.

AIMS: This review aims to determine the prevalence of clinically manifested drug-drug interactions (DDIs) in hospitalized patients. METHODS: PubMed, Scopus, Embase, Web of Science, and Lilacs databases were used to identify articles published before June 2019 that met specific inclusion criteria. The search strategy was developed using both controlled and uncontrolled vocabulary related to the following domains: "drug interactions," "clinically relevant," and "hospital." In this review, we discuss original observational studies that detected DDIs in the hospital setting, studies that provided enough data to allow us to calculate the prevalence of clinically manifested DDIs, and studies that described the drugs prescribed or provided DDI adverse reaction reports, published in either English, Portuguese, or Spanish. RESULTS: From the initial 5,999 articles identified, 10 met the inclusion criteria. The pooled prevalence of clinically manifested DDIs was 9.2% (CI 95% 4.0-19.7). The mean number of medications per patient reported in six studies ranged from 4.0 to 9.0, with an overall average of 5.47 ± 1.77 drugs per patient. The quality of the included studies was moderate. The main methods used to identify clinically manifested DDIs were evaluating medical records and ward visits (n = 7). Micromedex® (27.7%) and Lexi-Comp® (27.7%) online reference databases were commonly used to detect DDIs and none of the studies evaluated used more than one database for this purpose. CONCLUSIONS: This systematic review showed that, despite the significant prevalence of potential DDIs reported in the literature, less than one in ten patients were exposed to a clinically manifested drug interaction. The use of causality tools to identify clinically manifested DDIs as well as clinical adoption of DDI lists based on actual adverse outcomes that can be identified through the implementation of real DDI notification systems is recommended to reduce the incidence of alert fatigue, enhance decision-making for DDI prevention or resolution, and, consequently, contribute to patient safety.

Synthesis, molecular structure and antioxidant activity of bis [L(µ2-chloro)copper(II)] supported by phenoxy/naphthoxy-imine ligands.

A new series of Cu(II) complexes [bis[{(µ2-chloro)-2-MeO-Ph-CH2-(N=CH)-2,4-tert-butyl-2-OC6H2)}Cu(II)] (Cu1); bis[{(µ2-chloro)-2-MeS-Ph-CH2-(N=CH)-2,4-tert-butyl-2-(OC6H2)}Cu(II)] (Cu2); bis[{(µ2-chloro)-2-MeO-Ph-CH2-(N=CH)-2-(OC10H6)} Cu(II)] (Cu3); bis[{(µ2-chloro)-2-MeS-Ph-CH2-(N=CH)-2-(OC10H6)}Cu(II)] complex (Cu4); bis[{2-MeS-Ph-CH2-(N=CH)-2,4-tert-butyl-2-(OC6H2)}Cu(II)] (Cu5)] have been synthesized and characterized by elemental analysis, IR, UV-Visible and by X-ray crystallography for Cu1, Cu4 and Cu5. In the solid state, Cu1 features of a chloro-bridged dimer complex with κ2 coordination of the monoanionic phenoxy-imine ligand onto the copper center. On the other hand, the molecular structure of Cu4 reveals the naphthoxy-imine ligand with pendant S-group coordinated to the copper atom in tridentate meridional fashion. Treatment of [Cu(OAc)2·H2O] with two equiv. of [2-MeS-Ph-CH2-(N=CH)-2,4-tert-butyl-2-(HOC6H2)] led to a monomeric complex Cu5, with the ONS-donor Schiff base acting as a bidentate ligand. The redox behavior was explored by cyclic voltammetry. The reduction/oxidation potential of Cu(II) complexes depends on the structure and conformation of the central atom in the coordination compounds. Antioxidant activities of the complexes, Cu1 - Cu5, were determined by in vitro assays such as 1,1-diphenyl-2-picryl-hydrazyl free radicals (DPPH) and 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) radicals (ABTS+). The dinuclear compounds Cu1-Cu4, from the concentration of 5 µM, presented a good activity in scavenging DPPH radical. In addition, most of the Cu(II) complexes showed ABTS.+ radical-scavenging activity. The monomeric complex Cu5 at all concentrations tested showed antioxidant inability. The cytotoxicity of the Cu1 and Cu3 was determined in V79 cell line by reduction of 3(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay.

Endophytic fungi isolated from Brazilian medicinal plants as potential producers of antioxidants and their relations with anti-inflammatory activity.

In this study, 19 endophytic fungi were isolated from Lafoensia pacari, Guazuma ulmifolia, Campomanesia xanthocarpa and Siparuna guianensis. Seventeen strains were molecularly identified as belonging to the genera Colletotrichum, Diaporthe, Bjerkandera, Talaromyces, Cochliobolus, Phaeophlebiopsis, Curvularia, and Xylaraceae. Assays for detecting antioxidant activity were performed by free radical scavenging activity using the DDPH and ABTS + methods. Based on the results with DPPH, two strains were selected to evaluate the presence of flavonoids and anti-inflammatory activity. A strong positive correlation was found between these activities and the presence of flavonoids. The anti-inflammatory activity of endophytic fungi is under explored; however, the Talaromyces obtained the best result of 87.33% protection of erythrocytes and Colletotrichium of 60.71%. This study demonstrated that endophytic fungi associated with selected plants are potential sources of novel antioxidant products.

Stunting and overweight among children in Northeast Brazil: prevalence, trends (1992-2005-2015) and associated risk factors from repeated cross-sectional surveys.

BACKGROUND: A study involving children from Alagoas (Northeast Brazil) revealed that, as a consequence of a drastic reduction in the prevalence of stunting between 1992 to 2005, (22.5 to 11.4%) combined with an increase in overweight prevalence (6.7 to 9.3%), the prevalence of these two conditions in 2005 was very close. If these trends were maintained, it is very likely that, at this time, the childhood overweight prevalence has already exceeded that of the stunting. However, no study is available to confirm this hypothesis. The identification of these changes is relevant to the planning and evaluation of public policies. This study aimed to investigate the prevalence, time trends and associated factors with stunting and overweight in children from Alagoas. METHODS: Independent cross-sectional household surveys were conducted in 1992 (n = 1231), 2005 (n = 1381) and 2015 (n = 988). Data were collected from probabilistic samples of children aged 0-60 months. Stunting was defined by stature-for-age < - 2 sd and overweight by weight-for-stature > 2 sd. RESULTS: Between 1992, 2005 and 2015, the stunting prevalence was 22.6, 11.2 and 3.2% (reduction of 85.8%), while the overweight prevalence was 6.9, 7.5 and 14.9% (increase of 115.9%), respectively. After multivariate analysis, the following positive associations with stunting were observed in 1992: age group > 24 months (28.3% vs 14.5%), mother with ≥2 children (28.8% vs 12.8%), low birth weight (28.3% vs 15.7%) and mother with low schooling (29.3% vs 7.2%). In 2015 there was a higher prevalence of stunting in males (4.2% vs 2.2%), in children < 24 months (4.6% vs 2.2%), with low birth weight (8.6% vs 3.0%) and in those who had mothers with low schooling (7.0% vs 2.6%). Regarding overweight, in 1992 there was higher prevalence for male (9.1% vs 4.7%) and in children whose mothers had ≤2 children (8.9% vs 5.8%), while in 2015 only birth weight >  4 kg was associated to overweight (27.3% vs 14.2%). CONCLUSIONS: During the analyzed period, there was a significant decrease in stunting prevalence. At the same time, a substantial increase was observed in the overweight prevalence. Currently, stunting is a problem of low magnitude, while overweight has become a worrying public health problem.