An acute bout of resistance exercise increases BDNF in hippocampus and restores the long-term memory of insulin-resistant rats.

A sedentary lifestyle, inadequate diet, and obesity are substantial risk factors for Type 2 diabetes mellitus (T2DM) development. A major picture of T2DM is insulin resistance (IR), which causes many impairments in brain physiology, such as increased proinflammatory state and decreased brain-derived neurotrophic factor (BDNF) concentration, hence reducing cognitive function. Physical exercise is a non-pharmacological tool for managing T2DM/IR and its complications. Thus, this study investigated the effects of IR induction and the acute effects of resistance exercise (RE) on memory, neurotrophic, and inflammatory responses in the hippocampus and prefrontal cortex of insulin-resistant rats. IR was induced by a high-fat diet and fructose-rich beverage. Insulin-resistant rats performed acute resistance exercise (IR.RE; vertical ladder climb at 50-100% of the maximum load) or rest (IR.REST; 20 min). Cognitive parameters were assessed by novel object recognition (NOR) tasks, and biochemical analyses were performed to assess BDNF concentrations and inflammatory profile in the hippocampus and prefrontal cortex. Insulin-resistant rats had 20% worse long-term memory (LTM) (p < 0.01) and lower BDNF concentration in the hippocampus (-14.6%; p < 0.05) when compared to non-insulin-resistant rats (CON). An acute bout of RE restored LTM (-9.7% pre vs. post; p > 0.05) and increased BDNF concentration in the hippocampus (9.1%; p < 0.05) of insulin-resistant rats compared to REST. Thus, an acute bout of RE can attenuate the adverse effects of IR on memory and neurotrophic factors in rats, representing a therapeutic tool to alleviate the IR impact on the brain.

Nanoparticles Loaded with a Carotenoid-Rich Extract from Cantaloupe Melon Improved Hepatic Retinol Levels in a Diet-Induced Obesity Preclinical Model.

The study evaluated the effect of the carotenoid-rich extract from cantaloupe melon (CE) nanoencapsulated in porcine gelatin (EPG) on hepatic retinol concentration and liver damage scores in Wistar rats with obesity induced by high glycemic index and high glycemic load diet (HGLI diet). For 17 days, animals were fed the HGLI diet. They were divided into three groups and treated for 10 days [HGLI diet + water, HGLI diet + CE (12.5 mg/kg), and HGLI diet + EPG (50 mg/kg)]. The groups were evaluated for dietary intake, retinol, weight variation, hematological parameters, fasting glucose, lipid profile, hepatic retinol concentration, AST/ALT ratio, FIB-4 (Fibrosis-4 Index for Liver Fibrosis), and APRI (AST to Platelet Ratio Index) scores to evaluate the effects on the liver. Animals treated with EPG showed a lower dietary intake (p < 0.05). No significant weight change was detected in the evaluated groups (p > 0.05). The EPG-treated group had significantly higher concentrations (p < 0.05) of hepatic retinol [266 (45) µg/g] than the untreated group [186 (23.8) µg/g] and the one treated with CE [175 (8.08) µg/g]. Liver damage assessment scores did not show significant differences, but the lowest means were observed in the group treated with EPG. The nanoencapsulation of the extract rich in beta-carotene promoted reduced food consumption and increased hepatic retinol without causing significant changes in liver damage scores. Thus, EPG is a candidate for future clinical studies to evaluate the beneficial effects of treating diseases involving vitamin A deficiencies.

Acute bouts of aerobic and resistance exercise similarly alter inhibitory control and response time while inversely modifying plasma BDNF concentrations in middle-aged and older adults with type 2 diabetes.

Impairments in several domains of cognitive functions are observed in people with Type 2 Diabetes Mellitus (T2DM), often accompanied by low Brain-derived neurotrophic factor (BDNF) concentrations. Although aerobic and resistance exercise enhances cognitive functions and raises BDNF concentrations in several populations, it remained uncertain in T2DM subjects. This study compared the effects of a single bout of aerobic (AER, 40 min of treadmill walk at 90-95% of the maximum walk speed) or resistance (RES, 3 × 10 repetitions in eight exercises at 70% of 10-RM) exercise on specific cognitive domain performance and plasma BDNF concentrations of physically active T2DM subjects. Eleven T2DM subjects (9 women/2 men; 63 ± 7 years) performed two counterbalanced trials on non-consecutive days. Stroop Color and Word (SCW) task [assessing the attention (congruent condition) and inhibitory control (incongruent condition)], Visual response time (assessing the response time), and blood collection (for plasma BDNF concentrations) were performed pre and post-exercise sessions. With distinct magnitude, both AER and RES improved the incongruent-SCW (d = - 0.26 vs. - 0.43 in AER and RES, respectively; p < 0.05), RT(best) (d = - 0.31 vs. - 0.52, p < 0.05), and RT(1-5) (d = - 0.64 vs. - 0.21, p < 0.05). The congruent-SCW and RT(6-10) were not statistically different. Plasma BDNF concentrations were elevated 11% in AER (d = 0.30) but decreased by 15% in RES (d = - 0.43). A single session of aerobic or resistance exercise similarly improved the inhibitory control and response time of physically active T2DM subjects. Nevertheless, aerobic and resistance exercise sessions induced an opposite clinical effect in plasma BDNF concentrations.

Retrospective Analysis of the SARS-CoV-2 Infection Profile in COVID-19 Positive Patients in Vitoria da Conquista, Northeast Brazil.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for causing Coronavirus Disease-2019 (COVID-19), a heterogeneous clinical condition that manifests varying symptom severity according to the demographic profile of the studied population. While many studies have focused on the spread of COVID-19 in large urban centers in Brazil, few have evaluated medium or small cities in the Northeast region. The aims of this study were: (i) to identify risk factors for mortality from SARS-CoV-2 infection, (ii) to evaluate the gene expression patterns of key immune response pathways using nasopharyngeal swabs of COVID-19 patients, and (iii) to identify the circulating SARS-CoV-2 variants in the residents of a medium-sized city in Northeast Brazil. A total of 783 patients infected with SARS-CoV-2 between May 2020 and August 2021 were included in this study. Clinical-epidemiological data from patients who died and those who survived were compared. Patients were also retrospectively divided into three groups based on disease severity: asymptomatic, mild, and moderate/severe. Samples were added to a qPCR array for analyses of 84 genes involved with immune response pathways and sequenced using the Oxford Nanopore MinION technology. Having pre-existing comorbidity; being male; having cardiovascular disease, diabetes, and/or chronic obstructive pulmonary disease; and PCR cycle threshold (Ct) values under 22 were identified as risk factors for mortality. Analysis of the expression profiles of inflammatory pathway genes showed that the greater the infection severity, the greater the activation of inflammatory pathways, triggering the cytokine storm and downregulating anti-inflammatory pathways. Viral genome analysis revealed the circulation of multiple lineages, such as B.1, B.1.1.28, Alpha, and Gamma, suggesting that multiple introduction events had occurred over time. This study's findings help identify the specific strains and increase our understanding of the true state of local health. In addition, our data demonstrate that epidemiological and genomic surveillance together can help formulate public health strategies to guide governmental actions.

Capacitação de cuidadores de crianças com autismo em intervenção via SUS / FORMACIÓN DE CUIDADORES DE NIÑOS CON AUTISMO EN INTERVENCIÓN VÍA SUS / TRAINING OF CAREGIVERS OF AUTISTIC CHILDREN IN INTERVENTION VIA SUS

Autism spectrum disorders are characterized by neurodevelopmental alterations with onset of symptoms in childhood. The literature has indicated that the models of intensive behavioral intervention can produce significant improvements in several areas of the development of people with this diagnosis. The offer of this type of therapy in Brazil is still scarce, especially in institutions financed by the Unified Health System. However, the training of caregivers has been pointed out as an alternative to promote access to this type of therapy to more autistic people. The aim of this study was to analyze the effects of caregiver training on the development of autistic children treated at an institution financed by the Unified Health System. Participants were assessed before and after the intervention, using an instrument that measured the children's development. The results indicated improvement in the development of six children out of a group of 17.

Os transtornos do espectro do autismo constituem-se por alterações do neurodesenvolvimento com início dos sintomas na infância. A literatura tem indicado que os modelos de intervenção comportamental in-tensiva podem produzir melhoras significativas em várias áreas do desenvolvimento de pessoas com esse diagnóstico. A oferta desse tipo de terapia no Brasil ainda é escassa, especialmente em instituições finan-ciadas pelo Sistema Único de Saúde. Contudo, a capacitação de cuidadores tem sido apontada como uma alternativa para promover o acesso a esse tipo de terapia a mais pessoas com autismo. O objetivo deste estudo foi analisar os efeitos da capacitação de cuidadores no desenvolvimento de crianças com autismo atendidas em uma instituição financiada pelo Sistema Único de Saúde. Os participantes foram avaliados antes e após a intervenção, por meio de instrumento que mediu o desenvolvimento das crianças. Os resul-tados indicaram melhora no desenvolvimento de seis crianças de um grupo de 17.

Los trastornos del espectro autista se caracterizan por alteraciones del neurodesarrollo con inicio de sín-tomas en la infancia. La literatura ha indicado que los modelos de intervención conductual intensiva pueden producir mejoras significativas en varias áreas del desarrollo de las personas con este diagnóstico. La oferta de este tipo de terapia en Brasil aún es escasa, especialmente en instituciones financiadas por el Sistema Único de Salud. Por otro lado, la formación de cuidadores se ha señalado como una alternativa para promover el acceso a este tipo de terapia a más personas con autismo. El objetivo de este estudio fue analizar los efectos de la formación de cuidadores en el desarrollo de niños con autismo atendidos en una institución financiada por el Sistema Único de Salud. Los participantes fueron evaluados antes y después de la intervención, utilizando un instrumento que midió el desarrollo de los niños. Los resultados indicaron una mejora en el desarrollo de seis niños en un grupo de 17.

Avaliação da sorção e solubilidade de água em cimentos de ionômero de vidro com e sem agente de proteção / Evaluation of water sorption and solubility in glass ionomer cements with and without protective agent

Objetivo: Avaliar o efeito de um protetor de superfície na sorção e solubilidade de cimentos de ionômero de vidro. Materiais e Métodos: Quatro materiais foram selecionados: ionômero modificado por resina encapsulado (Riva Light Cure); modificado por resina pó/líquido (Vitremer); convencional encapsulado (Equia Forte) e convencional pó/líquido (Fuji IX). Foram confeccionados 20 espécimes de cada, sendo metade com proteção superficial do Equia Forte Coat. As amostras foram mantidas em estufa a 37°C em repouso por 5 dias. Em seguida, esses foram pesados em intervalos de 24 horas. A espessura e o diâmetro foram medidos com um paquímetro digital para o cálculo do volume. Novas pesagens foram realizadas para a obtenção da massa intermediária. Em seguida, as amostras foram mantidas em repouso por 5 dias a 37°C e realizada nova pesagem. Resultados: Os dados obtidos de sorção e solubilidade foram submetidos à análise de variância (ANOVA dois fatores, material e protetor de superfície) e teste Tukey ( =0,05). Para sorção, houve diferença significativa apenas para o fator material (p<0,05), Vitremer > Equia Forte > Riva Light Cure > Fuji IX. O ionômero Fuji IX apresentou os menores valores de sorção, diferindo significativamente dos demais materiais, independentemente do uso do protetor superficial. Não houve diferença significativa para o fator proteção de superfície (p>0,05). Para solubilidade não houve diferença significativa no fator material, protetor de superfície ou interação material*protetor. Conclusão: O uso do protetor superficial não influenciou nos valores de sorção e solubilidade dos ionômeros avaliados e o ionômero convencional Fuji IX apresentou menores taxas de sorção.

Objective: evaluate the effect of a surface coating agents on the sorption and glass ionomer cements solubility. Materials and Methods: Four materials were selected: Encapsulated resin-modified ionomer (Riva Light Cure); Powder/liquid Encapsulated resin-modified (Vitremer); Encapsulated conventional (Equia Forte) and powder/ liquid conventional (Fuji IX). Twenty samples of each were made, half with surface protection of Equia Forte Coat. The samples were kept in an oven for 5 days. These were then weighed at 24-hour intervals. The thickness and diameter were measured using a digital caliper to calculate their volume. New weightings were performed to obtain the intermediate mass. Then, the samples were kept at rest for 5 days and weighed again. Results: The sorption and solubility data obtained were subjected to analysis of variance (two-way ANOVA, material and surface coating agents) and Tukey test ( =0.05). For sorption, there was a significant difference only for the material factor (p<0.05), Vitremer > Equia Forte > Riva Light Cure > Fuji IX. The Fuji IX ionomer showed the lowest sorption values, differing significantly from the other materials, regardless of the use of surface coating agents. There was no significant difference for the surface protection factor (p>0.05). For solubility there was no significant difference for the material factor, surface coating agents or material*surface coating agent interaction. Conclusion: The use of surface coating agents did not influence the sorption and solubility values of the evaluated ionomers and the conventional Fuji IX ionomer showed lower sorption rates.

Association between Palliative Performance Scale and nutritional aspects in individuals with cancer in exclusive palliative care.

BACKGROUND & AIMS: Palliative care in incurable cancer should be focused on symptom control, especially those impacting nutrition. This study aims to verify associations between functional performance using the Palliative Performance Scale Version 2 (PPS2) and nutritional and clinical aspects in cancer patients in exclusive palliative care (EPC). METHODS: Through a cross-sectional study, twenty-seven patients recently referred to the EPC outpatient clinic were evaluated. PPS2 was used to define functional performance, while nutritional aspects were obtained using the Patient-Generated Subjective Global Assessment (PG-SGA). Fisher's Exact test and correspondence analysis were used with a 5% level of significance. RESULTS: Of 27 eligible patients, a higher frequency of PPS2 levels 50% and 40% (70.3%) was observed, reflecting important functional impairments. The sample was mainly composed of severely malnourished patients (70.4%), polysymptomatic, and in critical need of nutritional intervention (96.3%). Regarding the primary diagnosis, gastrointestinal (37%) and lung (26%) cancer were the most prevalent. No associations between PPS2 and nutritional and clinical aspects were observed; however, the correspondence analysis demonstrated proximity between low PPS2 levels and worse nutritional markers. CONCLUSIONS: PG-SGA and PPS2 tools combined are suggested due to their importance in guiding assistance to cancer patients in EPC.

Mortality trend of cancer and main types according to macroregion in the state of Mato Grosso, Brazil, 2000 to 2015.

OBJECTIVE: To describe the mortality trend from all cancers and the five main ones in the state of Mato Grosso, Brazil, from 2000 to 2015. METHODS: This is a descriptive, ecological, time series study, with data referring to deaths of residents of Mato Grosso due to cancer (ICD-10 codes C00 to C97), from the Mortality Information System (SIM). Time trend analyses of the standardized mortality rate from all cancers and five specific cancers (lung, prostate, breast, colorectal and cervical) for the state and according to macroregion (South, West, North, East and Center-North) were performed using linear regression (p<0.05). RESULTS: From 2000 to 2015, 28,525 deaths from all cancers in residents of the state of Mato Grosso were recorded. An increasing trend was observed for all cancers, in addition to lung, breast and colorectal cancers. The South and North macroregions showed an increasing trend for all cancers, breast and colorectal, and Center-North for breast and colorectal. East showed an increasing trend for all cancers, prostate and colorectal, and decreasing for cervical. CONCLUSION: In the state of Mato Grosso, there was an increasing trend in mortality for all cancers and from specific ones, with emphasis on breast and colorectal cancer in most macroregions.

Heterologous Expression, Purification, and Immunomodulatory Effects of Recombinant Lipoprotein GUDIV-103 Isolated from Ureaplasma diversum.

Ureaplasma diversum is a bacterial pathogen that infects cattle and can cause severe inflammation of the genital and reproductive systems. Lipid-associated membrane proteins (LAMPs), including GUDIV-103, are the main virulence factors in this bacterium. In this study, we heterologously expressed recombinant GUDIV-103 (rGUDIV-103) in Escherichia coli, purified it, and evaluated its immunological reactivity and immunomodulatory effects in bovine peripheral blood mononuclear cells (PBMCs). Samples from rabbits inoculated with purified rGUDIV-103 were analysed using indirect enzyme-linked immunosorbent assay and dot blotting to confirm polyclonal antibody production and assess kinetics, respectively. The expression of this lipoprotein in field isolates was confirmed via Western blotting with anti-rGUDIV-103 serum and hydrophobic or hydrophilic proteins from 42 U. diversum strains. Moreover, the antibodies produced against the U. diversum ATCC 49783 strain recognised rGUDIV-103. The mitogenic potential of rGUDIV-103 was evaluated using a lymphoproliferation assay in 5(6)-carboxyfluorescein diacetate succinimidyl ester−labelled bovine PBMCs, where it induced lymphocyte proliferation. Quantitative polymerase chain reaction analysis revealed that the expression of interleukin-1ß, toll-like receptor (TLR)-α, TLR2, TLR4, inducible nitric oxide synthase, and caspase-3−encoding genes increased more in rGUDIV-103−treated PBMCs than in untreated cells (p < 0.05). Treating PBMCs with rGUDIV-103 increased nitric oxide and hydrogen peroxide levels. The antigenic and immunogenic properties of rGUDIV-103 suggested its suitability for immunobiological application.

Mortality trend of cancer and main types by macrorregions of the state of Mato Grosso, Brazil, 2000 to 2015 / Tendência da mortalidade por câncer e principais tipos, segundo macrorregiões do Estado de Mato Grosso, 2000 a 2015

Objective: To describe the mortality trend from all causes of cancer and the five main causes in the state of Mato Grosso, Brazil, from 2000 to 2015. Methods: This is a descriptive, ecological, time series study, with data referring to deaths of residents of Mato Grosso due to neoplasms (ICD-10 codes C00 to C97), from the Mortality Information System (SIM). Time trend analyzes of the standardized mortality rate from all causes of cancer and five specific causes of cancer (lung, prostate, breast, colorectal and cervix) for the state and according to macroregions (South, West, North, East and Center -North) were performed using linear regression (p-value<0.05). Results: From 2000 to 2015, 28,525 deaths from all causes of cancer in residents of the state of Mato Grosso were recorded. An increasing trend was observed for all causes of cancer, in addition to lung, breast and colorectal cancers. Southern and Northern macroregions showed an increasing trend for all causes, breast and colorectal; North-Central for breast and colorectal. East was increasing for all causes, prostate and colorectal, and decreasing for cervix. Conclusions: In the state of Mato Grosso, there was an increasing trend in mortality from all causes of cancer and from specific causes, with emphasis on breast and colorectal cancer in most macroregions.

Objetivo: Descrever a tendência da mortalidade por todas as causas de câncer e das cinco principais causas no Estado de Mato Grosso, Brasil, no período 2000 a 2015. Métodos: Trata-se de um estudo descritivo, ecológico, do tipo série temporal, com dados referentes aos óbitos de residentes de Mato Grosso por neoplasias (códigos C00 a C97 da CID-10), provenientes do Sistema de Informações sobre Mortalidade (SIM). A tendência temporal da taxa de mortalidade padronizada de todas as causas de câncer e cinco causas específicas de câncer (pulmão, próstata, mama feminina, colorretal e colo do útero) para o estado e segundo macrorregiões (Sul, Oeste, Norte, Leste e Centro-Norte) foi analisada por meio de regressão linear (p-valor<0,05). Resultados: De 2000 a 2015, ocorreram 28.525 óbitos por todas as causas de câncer em residentes no Estado de Mato Grosso. Tendência crescente foi observada para todas as causas de câncer, além dos cânceres de pulmão, mama e colorretal. Macrorregiões Sul e Norte apresentaram tendência crescente para todas as causas, mama e colorretal; Centro-Norte para mama e colorretal. Na Macrorregião Leste foi crescente para todas as causas, próstata e colorretal, e decrescente para colo do útero. Conclusões: No Estado de Mato Grosso, verificou-se tendência crescente da mortalidade por todas as causas de câncer e por causas específicas, com destaque para mama e colorretal na maioria das macrorregiões.

Symptomatic Recurrence and Survival Outcomes After Curative Treatment of Gastric Cancer: Does Intensive Follow-up Evaluation Improve Survival?

BACKGROUND: Intensive surveillance after treatment of gastric cancer patients with curative intent may lead to an earlier diagnosis of disease recurrence, but its impact on survival is uncertain. This study aimed to evaluate whether early diagnosis of disease recurrence among asymptomatic patients was associated with long-term survival. METHODS: This retrospective study analyzed patients with stages 1 to 3C gastric adenocarcinoma treated between 1999 and 2018. All recurrence events were classified as symptomatic or asymptomatic (detected by follow-up tests), and their clinicopathologic characteristics, patterns of recurrence, and survival were analyzed. RESULTS: The cohort consisted of 669 patients treated with a total gastrectomy in 48.6% and a D2-lymphadenectomy in 88.8% of the cases. Most of the tumors were pT3-4 (46.5%), with 45.5% involving lymph node metastases and 42.3% manifesting a diffuse histology. During a median follow-up period of 80.1 months (95% confidence interval [CI], 75.3-84.8 months), 166 patients had recurrences (24.8%), 65.7% of which were symptomatic. The peritoneum was the main site of recurrence (37.2%), and peritoneal recurrence was associated with worse overall survival (OS) (hazard ratio, 1.69; 95%CI, 1.2-2.37). The median disease-free, post-recurrence survival, and OS periods in the asymptomatic and symptomatic groups were respectively 13.4 versus 17.2 months (p = 0.04), 11.9 versus 4.7 months (p < 0.001), and 29.9 versus 26.4 months (p = 0.21). When OS was analyzed among the patients with non-peritoneal recurrence, no difference was observed between the two groups (31.3 vs 31.1 months; p = 0.46). CONCLUSION: Early diagnosis of asymptomatic disease recurrence did not affect the OS of the gastric cancer patients treated with curative intent. The use of intensive surveillance strategies in this scenario still requires further evidence.

Mortality trend of cancer and main types according to macroregion in the state of Mato Grosso, Brazil, 2000 to 2015 / Tendência da mortalidade por câncer e principais tipos segundo macrorregiões do Estado de Mato Grosso, 2000 a 2015

ABSTRACT: Objective: To describe the mortality trend from all cancers and the five main ones in the state of Mato Grosso, Brazil, from 2000 to 2015. Methods: This is a descriptive, ecological, time series study, with data referring to deaths of residents of Mato Grosso due to cancer (ICD-10 codes C00 to C97), from the Mortality Information System (SIM). Time trend analyses of the standardized mortality rate from all cancers and five specific cancers (lung, prostate, breast, colorectal and cervical) for the state and according to macroregion (South, West, North, East and Center-North) were performed using linear regression (p<0.05). Results: From 2000 to 2015, 28,525 deaths from all cancers in residents of the state of Mato Grosso were recorded. An increasing trend was observed for all cancers, in addition to lung, breast and colorectal cancers. The South and North macroregions showed an increasing trend for all cancers, breast and colorectal, and Center-North for breast and colorectal. East showed an increasing trend for all cancers, prostate and colorectal, and decreasing for cervical. Conclusion: In the state of Mato Grosso, there was an increasing trend in mortality for all cancers and from specific ones, with emphasis on breast and colorectal cancer in most macroregions.

RESUMO: Objetivo: Descrever a tendência da mortalidade por todas as causas de câncer e as cinco principais causas no Estado de Mato Grosso, Brasil, no período de 2000 a 2015. Métodos: Trata-se de um estudo descritivo, ecológico, do tipo série temporal, com dados referentes aos óbitos de residentes de Mato Grosso por neoplasias (códigos C00 a C97 da Classificação Internacional de Doenças — CID-10), provenientes do Sistema de Informações sobre Mortalidade. A tendência temporal da taxa de mortalidade padronizada de todas as causas de câncer e de cinco causas específicas (pulmão, próstata, mama feminina, colorretal e colo do útero) para o Estado e segundo macrorregiões (Sul, Oeste, Norte, Leste e Centro-Norte) foi analisada por meio de regressão linear (p<0,05). Resultados: De 2000 a 2015, ocorreram 28.525 óbitos por todas as causas de câncer em residentes do Estado de Mato Grosso. Tendência crescente foi observada para todas as causas de câncer, além dos cânceres de pulmão, mama e colorretal. As macrorregiões Sul e Norte apresentaram tendência crescente para todas as causas, mama e colorretal; Centro-Norte para mama e colorretal; Leste foi crescente para todas as causas, próstata e colorretal e decrescente para colo do útero. Conclusão: No Estado de Mato Grosso, verificou-se tendência crescente de mortalidade por todas as causas de câncer e por causas específicas, com destaque para mama e colorretal na maioria das macrorregiões.

Content Analysis of the Diagnostic Proposition Risk of Excessive Fluid Volume in Hemodialysis Patients.

OBJECTIVE: To analyze the content of the diagnostic proposition risk of excessive fluid volume in patients undergoing hemodialysis. METHOD: Content validity study, with 48 judges who assessed the content of the diagnostic proposition risk of excessive fluid volume, using an electronic data collection instrument. The judges' answers were analyzed through the calculation of the Content Validity Index and the T test. RESULTS: The risk of excessive fluid volume was considered adequate, containing 23 risk factors: increased sodium concentration in the dialysate; missing hemodialysis sessions; insufficient water; low self-efficacy for fluid restriction; deficient knowledge; altered body mass index; excessive intake of fluids, proteins and sodium; lower kt/v index; inadequate removal of fluids in hemodialysis; thirst; xerostomia; older people; comorbidities; renal function decline; decreased urinary volume; inflammatory status; hospitalization; low serum level of albumin and lymphocytes, and high level of phosphorus; and use of antihypertensive drugs. CONCLUSION: The content of the diagnostic proposition risk of excessive fluid volume was considered adequate by the judges.

Predictive Factors of Recurrence of Papillary Thyroid Microcarcinomas: Analysis of 2,538 Patients.

Introduction The incidence of papillary thyroid microcarcinoma (PTMC) has increased, and its treatment remains controversial. Objective To identify the clinical and pathological factors predictive of tumor recurrence. Methods We retrospectively analyzed 2,538 consecutive patients treated for PTMC, most submitted to total thyroidectomy (98%) followed by radioactive iodine (RAI) ablation (51.7%) at a cancer center from 1996 to 2015. The patients were stratified according to the American Thyroid Association (ATA) risk categories (low, intermediate, or high), and the clinicopathological features were evaluated by multivariate Cox regression analysis to identify independent prognostic factors for recurrence. Results After a mean follow-up of 58 months (range: 3 to 236.5 months), tumor recurrence was diagnosed in 63 (2.5%) patients, mostly in the lymph nodes. Distant metastasis occurred in 2 (0.1%) patients. There were no cancer-related deaths. The multivariate analysis showed that age < 55 years ( p = 0.049; hazard ratio [HR]: 2.54; 95% confidence interval [95%CI]: 0.95 to 0.99), multifocality ( p = 0.032; HR: 1.76; 95%CI: 1.05 to 2.96), and the presence of lymph-node metastasis ( p < 0.001; HR: 3.69; 95%CI: 2.07-6.57) were independent risk factors for recurrence. Recurrence was observed in 29 (1.5%) out of 1,940 low-risk patients, 32 (5.4%) out of 590 intermediate-risk patients, and in 2 (25%) out of 8 high-risk patients. Conclusions The prognosis of PTMC is excellent, favoring a conservative treatment for most patients. Age < 55 years, multifocality, and node metastasis at diagnosis, as well the ATA staging system effectively predict the risk of recurrence. The presence of these risk factors can help identify patients who should be considered for more aggressive management and more frequent follow-up.

Functional antibody and T-cell immunity following SARS-CoV-2 infection, including by variants of concern, in patients with cancer: the CAPTURE study.

Patients with cancer have higher COVID-19 morbidity and mortality. Here we present the prospective CAPTURE study (NCT03226886) integrating longitudinal immune profiling with clinical annotation. Of 357 patients with cancer, 118 were SARS-CoV-2-positive, 94 were symptomatic and 2 patients died of COVID-19. In this cohort, 83% patients had S1-reactive antibodies, 82% had neutralizing antibodies against WT, whereas neutralizing antibody titers (NAbT) against the Alpha, Beta, and Delta variants were substantially reduced. Whereas S1-reactive antibody levels decreased in 13% of patients, NAbT remained stable up to 329 days. Patients also had detectable SARS-CoV-2-specific T cells and CD4+ responses correlating with S1-reactive antibody levels, although patients with hematological malignancies had impaired immune responses that were disease and treatment-specific, but presented compensatory cellular responses, further supported by clinical. Overall, these findings advance the understanding of the nature and duration of immune response to SARS-CoV-2 in patients with cancer.

Risk Factors and Outcomes of Postoperative Neck Hematomas: An Analysis of 5,900 Thyroidectomies Performed at a Cancer Center.

Introduction Postoperative neck hematoma (PNH) is an uncommon but potentially-lethal complication of thyroid surgery. Objective To identify the risk factors for postthyroidectomy hematoma requiring reoperation, the timing, the source of the bleeding, the related respiratory distress requiring tracheotomy, and the late outcomes. Methods We retrospectively analyzed the records of 5,900 consecutive patients submitted to surgery for thyroid diseases at a single institution. Results In total, PNH occurred in 62 (1.1%) patients. Most cases of bleeding occurred within the first 6 hours after thyroidectomy, but 12.5% of the hematomas were observed after 24 hours. Obvious bleeding points were detected in 58.1% of the patients during the reoperation, with inferior thyroid artery branches and superior thyroid vessels being the most frequent bleeding sources. Only two patients required urgent tracheostomy. There were no hematoma-related deaths. Permanent hypoparathyroidism and recurrent laryngeal nerve injury are more frequent following reoperation for PNH. The factors significantly associated with PNH were: older age, concurrent lymph node dissection, and chronic lymphocytic thyroiditis. Gender, previous neck irradiation, presentation at diagnosis (symptomatic or incidental), substernal goiter, thyroidectomy for hyperthyroidism, prior thyroid surgery, malignant histology, the extent of the surgery (total versus non-total thyroidectomy), the use of energy-based vessel sealing devices, the use of the hemostatic agent Surgicel, and the placement of a surgical drain were not significantly associated with PNH. Conclusion Hematoma after thyroid surgery is an uncommon complication, but it is related to significant postoperative morbidity. A better understanding of the risk factors and of the time until hematoma formation can help target high-risk patients for preventive measures and closer postoperative observation.

Detection and Genetic Characterization of Hepatitis B and D Viruses: A Multi-Site Cross-Sectional Study of People Who Use Illicit Drugs in the Amazon Region.

Hepatitis B (HBV) and delta (HDV) viruses are endemic in the Amazon region, but vaccine coverage against HBV is still limited. People who use illicit drugs (PWUDs) represent a high-risk group due to common risk behavior and socioeconomic factors that facilitate the acquisition and transmission of pathogens. The present study assessed the presence of HBV and HBV-HDV co-infection, identified viral sub-genotypes, and verified the occurrence of mutations in coding regions for HBsAg and part of the polymerase in HBV-infected PWUDs in municipalities of the Brazilian states of Amapá and Pará, in the Amazon region. In total, 1074 PWUDs provided blood samples and personal data in 30 municipalities of the Brazilian Amazon. HBV and HDV were detected by enzyme-linked immunosorbent assay and polymerase chain reaction. Viral genotypes were identified by nucleotide sequencing followed by phylogenetic analysis, whereas viral mutations were analyzed by specialized software. High rates of serological (32.2%) and molecular (7.2%) markers for HBV were detected, including cases of occult HBV infection (2.5%). Sub-genotypes A1, A2, D4, and F2a were most frequently found. Escape mutations due to vaccine and antiviral resistance were identified. Among PWUDs with HBV DNA, serological (19.5%) and molecular (11.7%) HDV markers were detected, such as HDV genotypes 1 and 3. These are worrying findings, presenting clear implications for urgent prevention and treatment needs for the carriers of these viruses.

Predictive factors for recurrence of papillary thyroid carcinoma: analysis of 4,085 patients.

OBJECTIVE: The incidence of papillary thyroid carcinoma (PTC) has increased in recent years and its treatment remains controversial. The objective of this study is to identify clinicopathological predictive factors of tumour recurrence. METHODS: We retrospectively analysed 4,085 patients who underwent thyroidectomy for PTC from 1996 to 2015. Patients were stratified according to American Thyroid Association (ATA) risk categories and clinicopathological features were evaluated to identify independent factors for recurrence. RESULTS: After a mean follow-up of 58.7 (range 3-256.5) months, tumour recurrence was diagnosed in 176 (4.3%) patients, mostly in lymph nodes. Distant metastasis occurred in 18 patients (0.4%). There were 3 (0.1%) cancer-related deaths. Multivariate analysis showed that tumour size >10 mm, multifocality, extrathyroidal extension and lymph node metastasis (all, P < 0.001) were independent risk factors for recurrence. Further, recurrence was identified in 1.6% of the ATA low-risk, 7.4% of the intermediate-risk and 22.7% of the high-risk patients (P < 0.001). CONCLUSIONS: In PTC patients, tumour size >10 mm, multifocality, extrathyroidal extension and presence of lymph node metastasis as well as the ATA recurrence staging system effectively predict recurrence.

Optimized microwave-assisted extraction of polyphenols and tannins from Syzygium cumini (L.) Skeels leaves through an experimental design coupled to a desirability approach.

The present study consisted in optimizing the extractive method of polyphenols and total tannins of leaves of Syzygium cumini (L) Skeels assisted by microwaves to potentiate the antimicrobial activity of the dried extract of S. cumini against sensitive and resistant strains. A Box-Behnken design that consisted of 27 experimental runs coupled with a desirability function for multiple response optimization was employed to optimize the total polyphenols content and total tannins content. Antimicrobial sensitivity tests were evaluated by obtaining the minimum inhibitory concentration, minimum fungicidal concentration and minimum bactericidal concentration in 96-well petri dishes. The optimal extraction conditions were found to be 8 min of extraction, under 300 w of microwave power, using a 1:34 g/mL solid/solvent ratio and 38% of ethanol concentration as extraction solvent. The parameter with the greatest influence in the extraction was primarily the time, followed by the potency and proportion solid/solvent. This yielded a total polyphenol content of 87.37 ± 1.85 mg TAE g-1ext and a total tannin content of 79.68 ± 1.64 mg TAE g-1 ext. All tested microorganisms were sensitive to the extract, evidencing the effectiveness of the extraction method optimization.

Development of an analytical method for determination of polyphenols and total tannins from leaves of Syzygium cumini L. Skeels.

Syzygium cumini L. Skeels belongs to Myrtaceae family. This species has been recognized by its antidiabetic, anti-inflammatory, and antimicrobial activities. Despite ever-increasing scientific interest for this species there is no pharmacopeia method for characterization and standardization of S. cumini yet. So, toward this aim, the objective of this work was to develop an efficient analytical methodology able to determine polyphenols and tannins content from leaves hydroethanolic extract of S. cumini using Folin-Ciocalteu method by ultraviolet absorption spectrophotometry (UV-Vis). The analytical methodology was developed for the first time in the literature for leaves of this specie shown to be fast and low-cost with results expressed through tannic acid equivalent (TAE). Moreover, the methodology presented selectivity with maximum absorption at 706 nm wavelength, linearity with R2>0.99; limit of detection 0.275 µg TAE mL-1 and 0.102 µg TAE mL-1; limit of quantification 1.046 µg TAE mL-1 and 0.912 µg TAE mL-1 for total polyphenols and total tannins, respectively. Furthermore, the methodology was accurate with recover value greater than 98%, as well as exact, reproductive, and robust with coefficient of variation values less than 15% for both compounds. All the results are found within the fixed limits according to RDC 166/2017.