Equal Maintenance of Anti-SARS-CoV-2 Antibody Levels Induced by Heterologous and Homologous Regimens of the BNT162b2, ChAdOx1, CoronaVac and Ad26.COV2.S Vaccines: A Longitudinal Study Up to the 4th Dose of Booster.

Several technological approaches have been used to develop vaccines against COVID-19, including those based on inactivated viruses, viral vectors, and mRNA. This study aimed to monitor the maintenance of anti-SARS-CoV-2 antibodies in individuals from Brazil according to the primary vaccination regimen, as follows: BNT162b2 (group 1; 22) and ChAdOx1 (group 2; 18). Everyone received BNT162b2 in the first booster while in the second booster CoronaVac, Ad26.COV2.S, or BNT162b2. Blood samples were collected from 2021 to 2023 to analyze specific RBD (ELISA) and neutralizing antibodies (PRNT50). We observed a progressive increase in anti-RBD and neutralizing antibodies in each subsequent dose, remaining at high titers until the end of follow-up. Group 1 had higher anti-RBD antibody titers than group 2 after beginning the primary regimen, with significant differences after the 2nd and 3rd doses. Group 2 showed a more expressive increase after the first booster with BNT162B2 (heterologous booster). Group 2 also presented high levels of neutralizing antibodies against the Gamma and Delta variants until five months after the second booster. In conclusion, the circulating levels of anti-RBD and neutralizing antibodies against the two variants of SARS-CoV-2 were durable even five months after the 4th dose, suggesting that periodic booster vaccinations (homologous or heterologous) induced long-lasting immunity.

Ladder-based resistance training with the progression of training load altered the tibial nerve ultrastructure and muscle fiber area without altering the morphology of the postsynaptic compartment.

Scientific evidence regarding the effect of different ladder-based resistance training (LRT) protocols on the morphology of the neuromuscular system is scarce. Therefore, the present study aimed to compare the morphological response induced by different LRT protocols in the ultrastructure of the tibial nerve and morphology of the motor endplate and muscle fibers of the soleus and plantaris muscles of young adult Wistar rats. Rats were divided into groups: sedentary control (control, n = 9), a predetermined number of climbs and progressive submaximal intensity (fixed, n = 9), high-intensity and high-volume pyramidal system with a predetermined number of climbs (Pyramid, n = 9) and lrt with a high-intensity pyramidal system to exhaustion (failure, n = 9). myelinated fibers and myelin sheath thickness were statistically larger in pyramid, fixed, and failure. myelinated axons were statistically larger in pyramid than in control. schwann cell nuclei were statistically larger in pyramid, fixed, and failure. microtubules and neurofilaments were greater in pyramid than in control. morphological analysis of the postsynaptic component of the plantar and soleus muscles did not indicate any significant difference. for plantaris, the type i myofibers were statistically larger in the pyramid and fixed compared to control. the pyramid, fixed, and failure groups for type ii myofibers had larger csa than control. for soleus, the type i myofibers were statistically larger in the pyramid than in control. pyramid and fixed had larger csa for type ii myofibers than control and failure. the pyramid and fixed groups showed greater mass progression delta than the failure. We concluded that the LRT protocols with greater volume and progression of accumulated mass elicit more significant changes in the ultrastructure of the tibial nerve and muscle hypertrophy without endplate changes.

Strength training improves heart function, collagen and strength in rats with heart failure.

BACKGROUND/OBJECTIVES: Myocardial infarction (MI) frequently leads to cardiac remodeling and failure with impaired life quality, playing an important role in cardiovascular deaths. Although physical exercise is a well-recognized effective non-pharmacological therapy for cardiovascular diseases, the effects of strength training (ST) on the structural and functional aspects of cardiac remodeling need to be further documented. In this study, we aimed to investigate the role of a linear block ST protocol in the rat model of MI. METHODS AND RESULTS: After 6 weeks of MI induction or sham surgery, male adult rats performed ST for the following 12 weeks. The ladder-based ST program was organized in three mesocycles of 4 weeks, with one load increment for each block according to the maximal carrying load test. After 12 weeks, the infarcted-trained rats exhibited an increase in performance, associated with reduced cardiac hypertrophy and pulmonary congestion compared with the untrained group. Despite not changing MI size, the ST program partially prevented cardiac dilatation and ventricular dysfunction assessed by echocardiography and hemodynamics, and interstitial fibrosis evaluated by histology. In addition, isolated cardiac muscles from infarcted-trained rats had improved contractility parameters in a steady state, and in response to calcium or stimuli pauses. CONCLUSIONS: The ST in infarcted rats increased the capacity to carry mass, associated with attenuation of cardiac remodeling and pulmonary congestion with improving cardiac function that could be attributed, at least in part, to the improvement of myocardial contractility.

Níveis de estresse e fatores relacionados em profissionais de saúde da atenção primária: revisão integrativa / Stress levels and related factors in primary care health professionals: an integrative review

Objetivo: Identificar, a partir das evidências da literatura, os níveis de estresse e fatores relacionados em profissionais de saúde atuantes na Atenção Primária à Saúde. Métodos: Foi realizada uma revisão integrativa, tendo como questão norteadora "Quais os níveisde estresse e fatores relacionados em profissionais de saúde atuantes na Atenção Primária à Saúde?''. A pesquisa ocorreu em dezembro de 2022, nas bases de dados Lilacs, MEDLINE, CINAHL e Scopus. Foram incluídos estudos primários disponíveis na íntegra em inglês, português e espanhol.Resultados: Das 1.358 produções inicialmente encontradas, 14 textos foram incluídos como amostra. Observou-se que os profissionais enfrentam diferentes níveis de estresse em seu cotidiano de trabalho. O estresse pode ser relacionado à exaustão física e emocional, insatisfação, sobrecarga e menor engajamento no trabalho, maior tempo de atuação, sexo feminino, atuação na pandemia da COVID-19, problemas organizacionais e de comunicação. Conclusões: As evidências permitem a reflexão crítica acerca da necessidade de maior preocupação e envolvimento por parte das autoridades e órgãos competentes com a saúde dos trabalhadores, a fim de direcionar ações que possam intervir sobre os fatores de risco no ambiente de trabalho e minimizar as vulnerabilidades ocasionadas pelo estresse

Objective: To identify, based on the evidence in the literature, stress levels and related factors in health professionals working in Primary Health Care. Methods: An integrative review was carried out, with the guiding question, "What are the stress levels and related factors in health professionals working in Primary Health Care?''. The search occurred in December 2022 in the Lilacs, MEDLINE, CINAHL, and Scopus databases. Primary studies available in full in English, Portuguese, and Spanish were included. Results: Of the 1,358 productions initially found, 14 texts were included as a sample. It was observed that professionals face different stress levels in their daily work. Stress can be related to physical and emotional exhaustion, dissatisfaction, overload, and less engagement at work, longer working hours, female sex, work in the COVID-19 pandemic, and organizational and communication problems. Conclusions: The evidence allows critical reflection on the need for more concern and involvement on the part of the authorities and competent bodies with the health of workers to direct actions that can intervene on risk factors in the work environment and minimize vulnerabilities caused by stress

Rehabilitation and release of confiscated songbirds into the wild: A pilot study.

Songbirds are currently the most prevalent animals in illegal trafficking in Brazil and other countries, so they are often confiscated, and this poses legal, ethical, and conservation challenges. Returning them to nature requires complex and expensive management, a topic that is sparingly addressed in the literature. Here, we described the processes and costs associated with an attempt to rehabilitate and release confiscated songbirds into the wild. A total of 1,721 songbirds of several species were quarantined, rehabilitated, and released, primarily on two farms located within their typical geographical distribution. Health assessments were performed on samples from 370 birds. Serology revealed no antibodies against Newcastle disease, and Salmonella spp. cultures were negative. Real-time polymerase chain reactions detected M. gallisepticum in samples from seven birds. Atoxoplasma spp. and Acuaria spp. infections, sepsis, and trauma were the top causes of bird death. About 6% of the released birds were recaptured, within an average period of 249 days after release, and at a mean distance of 2,397 meters from the release sites. The majority of these birds were found with free-living mates within or close to fragments of transitional ecoregions with native or cultivated grasslands, and native groves/forests, and shrublands. However, eucalyptus plantations with rich understory regeneration provided a suitable environment for the released forest species to settle, since they were recaptured during the defense of these sites. Over half of the recaptured birds presented behavioral profiles with both dominant and tame traits. Birds with dominant traits are more likely to settle in habitats and face the live decoys during fieldwork, whereas birds with tame characteristics tend to accept close contact with humans. Ultramarine grosbeak (Cyanoloxia brissonii), the least common species among those released, at the release sites showed an almost 2-fold recapture rate in the shortest mean distances from the release sites. This suggests less territory competition, perhaps a major factor of bird re-establishment here. The total per-bird cost was USD 57. Our findings suggested suitable survival and re-establishment of confiscated songbirds in the wild, when managed as we describe.

In vitro inflammatory modulation of bioceramic endodontic sealer in macrophages stimulated by bacterial lipopolysaccharide.

AIM: To evaluate the effects of AH Plus (Dentsply), Sealer 26 (Dentsply), and Sealer Plus BC (Produtos Médicos e Odontológicos) on cytotoxicity and inflammation in macrophage cultures exposed to bacterial lipopolysaccharide (LPS). METHODOLOGY: After initial setting, the sealers were conditioned with serum-free culture medium for 24 h (1 ml/cm2 ). Macrophages from the RAW 264.7 strain were exposed to sealer extracts in a 1:16 ratio in a culture medium with or without LPS. Cell morphology, viability, mitochondrial activity, oxidative stress and gene expression of interleukin 1ß (IL-1ß) and tumour necrosis factor-alpha (TNF-α) were evaluated. Data on mitochondrial activity, oxidative stress and TNF-α were analysed using a two-way analysis of variance (anova) test, followed by the Student-Newman-Keuls post-test. IL-1ß data were analysed using one-way anova, followed by SNK, and the t-test was used for intragroup comparison. The significance level was set at 5%. RESULTS: In the absence of LPS, only AH Plus and Sealer 26 showed a reduction in cell density, while in the presence of LPS, Sealer 26 had the lowest density compared to the other groups. In terms of mitochondrial activity, at 24 and 48 h, Sealer Plus BC had significantly higher mean values than Sealer 26 and AH Plus (p < .05). Sealer 26 exhibited the lowest levels of oxidative stress and IL-1ß and TNF-α expression, regardless of the presence of LPS (p < .05). CONCLUSIONS: Although all sealers interfere with the response of macrophages to LPS, contact with epoxy resin-based sealers can impair cell activity in vitro, while bioceramic sealer seems to favour the inflammatory functions of these cells.

Thoracolombar burst fractures: short fixation, without arthrodesis and without removal of the implant / Fratura toracolombar explosão: fixação curta, sem artrodese e sem a retirada do implante

ABSTRACT Objectives: To present the functional outcomes, through the first case series in our country, of patients with thoracolumbar burst fractures (A3,A4), submitted to short posterior fixation, without arthrodesis and without removal of the implants, until the end of the minimum follow-up of one year. Methods: Fifty five patients consecutively treated between January/2010 and January/2019 were evaluated through medical records and imaging exams. Radiographic analysis was performed by mea suring local and segmental kyphosis using the Cobb method. Functional assessment was analyzed using the non-specific SF-36 questionnaire and the 1983 Denis pain and work-specific questionnaire, applied after 12 months of follow-up. Results: With a loss of five patients (9%), 22 (44%) patients reported having minimal and occasional pain and 8 (16%) patients reported having no pain. Three (6%) patients responded that they were completely incapacitated. Patients had a mean score of 73.16 points in the SF-36 domains. There was a significant reduction in kyphosis in 12 months (9.1±5.2 [min-max 0-22]) compared to the preoperative period (14.9±7.8 [min-max 0-32]) ( p≤0.01). One patient required implant removal due to the symptomatic prominence of the implant. Conclusion: This case series suggests that the technique leads to satisfactory functional results, without implant failure or significant kyphosis after a minimum follow-up of 12 months of treatment. Evidence Level IV; Case series.

RESUMO Objetivo: Apresentar os desfechos funcionais, mediante primeira série de casos no nosso meio, de pacientes com fratura toracolombar do tipo explosão (A3, A4), submetidos a fixação posterior curta, sem artrodese e sem retirada dos implantes, até o final do acompanhamento mínimo de um ano. Métodos: Foram avaliados, por meio de prontuários e exames de imagem, 55 pacientes consecutivamente tratados entre Janeiro/2010 e Janeiro/2019. A análise radiográfica foi realizada medindo a cifose local e segmentar, pelo método de Cobb. A avaliação funcional analisada por meio do questionário inespecífico SF-36 e questionário específico de dor e trabalho de Denis de 1983, aplicados após os 12 meses de seguimento. Resultados: Com perda de cinco pacientes (9%), 22 (44%) pacientes relataram ter dor mínima e ocasional e 8 (16%) pacientes responderam não ter dor. Três (6%) pacientes responderam que estavam completamente incapacitados. Os pacientes tiveram uma pontuação média de 73,16 pontos nos domínios do SF-36. Houve redução significativa da cifose em 12 meses (9,1±5,2 [min-máx 0-22]) na comparação com o pré-operatório (14,9±7,8 [min-máx 0-32]) (p≤0,01). Um paciente necessitou de retirada do implante em razão da proeminência sintomática do implante. Conclusão: Esta série de casos sugere que a técnica leva a resultados funcionais satisfatórios, sem falha do implante ou cifose pós-traumática após acompanhamento mínimo de 12 meses de tratamento. Nível de Evidência IV; Série de casos.

Deceptive intensities: An exploratory strategy for overcoming early central fatigue in resistance training.

Neuropsychological stress induced by misleading information can limit human performance, possibly by early central fatigue mechanisms. In this study, we investigated the impact caused by prescribing misleading intensities of resistance exercise on acute electroencephalogram (EEG) and electromyogram (EMG) responses and the total number of repetitions to exhaustion. Collegiate female students performed three sets of biceps curls to exhaustion. The actual intensity for all sets was set at 65% 1-Repetition Maximum (1-RM). However, participants were deceptively informed that the intensities were 60%, 65%, or 70% 1-RM. The number of repetitions to fatigue and the magnitude of EEG and EMG signals were analyzed. The number of repetitions to exhaustion was significantly lower in greater announced intensities (18.11 ± 8.44) compared to lower (29.76 ± 16.28; p = 0.017) and correctly (27.82 ± 11.01; p = 0.001) announced intensity. The correlation between frontal and motor-cortex signals was significant in lower (r = 0.72, p = 0.001) and higher (r = 0.64, p = 0.005) announced intensities. The median and mean frequencies of EMG signal and Root Mean Square (RMS) did not show any significant difference between sets, but the peak-to-peak range (PPR) of biceps EMG signals was significantly higher in lower intensity (0.145 ± 0.042) when compared with higher (0.104 ± 0.044; p = 0.028) or correctly (0.126 ± 0.048; p = 0.037) announced intensity. It seems that deceptive information regarding the mass of an object could affect the number of repetitions to exhaustion and PPR to cover muscle capacity in endurance-type strength training.

Absence of Anti-RBD Antibodies in SARS-CoV-2 Infected or Naive Individuals Prior to Vaccination with CoronaVac Leads to Short Protection of Only Four Months Duration.

The COVID-19 pandemic is the biggest public health threat facing the world today. Multiple vaccines have been approved; however, the emergence of viral variants such as the recent Omicron raises the possibility of booster doses to achieve adequate protection. In Brazil, the CoronaVac (Sinovac, Beijing, China) vaccine was used; however, it is important to assess the immune response to this vaccine over time. This study aimed to monitor the anti-SARS-CoV-2 antibody responses in those immunized with CoronaVac and SARS-CoV-2 infected individuals. Samples were collected between August 2020 and August 2021. Within the vaccinated cohort, some individuals had a history of infection by SARS-CoV-2 prior to immunization, while others did not. We analyzed RBD-specific and neutralizing-antibodies. Anti-RBD antibodies were detected in both cohorts, with a peak between 45-90 days post infection or vaccination, followed by a steady decline over time. In those with a previous history of COVID-19, a higher, longer, more persistent response was observed. This trend was mirrored in the neutralization assays, where infection, followed by immunization, resulted in higher, longer lasting responses which were conditioned on the presence of levels of RBD antibodies right before the vaccination. This supports the necessity of booster doses of CoronaVac in due course to prevent serious disease.

Muscle hypertrophy is correlated with load progression delta, climb volume, and total load volume in rodents undergoing different ladder-based resistance training protocols.

We compared the effects of two ladder-based resistance training (LRT) protocols on the skeletal muscle morphology (biceps brachialis and plantaris) of Wistar rats. Also, we correlated the training parameters with the muscle fiber cross-sectional area (fCSA). After maximum load tests (ML), twenty-nine young adult Wistar rats were divided into: CONTROL (n = 9), LIMITED (n = 10, 6-8 climb [2 × 50 %ML, 2 × 75 %ML, 2 × 100 %ML, and 2 × 100 %ML+30 g]) and UNLIMITED (n = 10, ≥4 climbs [50 %ML, 75 %ML, 90 %ML, 100 %ML + 30 g until failure) LRT. After eight weeks, the main results were: 1) For biceps brachialis, the type I, IIa, and mean fCSA was statistically larger in the LIMITED than CONTROL. The nuclei/fiber ratio was statistically higher in the LIMITED and UNLIMITED. The correlations found between total load, absolute delta load, and relative load and fCSA were moderate. 2) For plantaris, the type I, IIa, IIx/b, and mean fCSA was statistically larger in the LIMITED than CONTROL. The type IIa, IIx/b, and mean fCSA was statistically larger in the UNLIMITED than CONTROL. The nuclei/fiber ratio was statistically higher in both trained groups than CONTROL. The correlation between the climbing number, total load, and the fCSA was moderate. The correlation between delta absolute load and fCSA was strong. We concluded that rodents submitted to high-intensity, high-volume LRT, but limited climbing volume per session, presented more significant type I, IIa, IIx/b, and mean fCSA, higher nuclei/fiber ratio, and greater maximum carrying capacity. Also, muscle hypertrophy correlated positively with the load progression, training volume, and total load.

The sciatic and radial nerves seem to adapt similarly to different ladder-based resistance training protocols.

The present study aimed to compare the morphological response induced by different ladder-based resistance training (LRT) protocols on the peripheral nerve ultrastructure of young adult Wistar rats. Twenty-nine rodents were distributed into groups: control (CON), submaximal (SUBMAX [6 climbs/session, moderate intensity, 3x/week]) and maximum (MAX [> 4 climbs/session, maximum intensity, 3x/week]) LRT. After 8 weeks, the radial and sciatic nerves were removed and prepared for transmission electron microscopy. In the radial nerve, the myelinated fibers and axons, myelin sheath thickness, and unmyelinated axons were statistically greater in the SUBMAX and MAX. The MAX group had greater unmyelinated fibers than SUBMAX. The Schwann cell (SC) nuclei diameter was statistically larger in the SUBMAX than the CON. The number of microtubules and neurofilaments was statistically higher in the SUBMAX and MAX. In the sciatic nerve, the myelinated fibers, myelinated and unmyelinated axons, and myelin sheath thickness were statistically greater in the SUBMAX and MAX. The SUBMAX and MAX had more SC at the nuclei level than CON. The SC nuclei were statistically larger in the SUBMAX and MAX. The number of microtubules and neurofilaments was statistically higher in the SUBMAX and MAX. Total training load and total load per climb were not different between groups. The SUBMAX and MAX statistically increased maximum carried load (ML). In conclusion, the different LRT protocols induced similar morphological responses in radial and sciatic nerves, probably due to load progression and equal total load volume.

Previous short-term use of testosterone propionate enhances muscle hypertrophy in Wistar rats submitted to ladder-based resistance training.

To investigate the effects of the previous administration of testosterone propionate (TP) on the morphology of the gastrocnemius muscle of Wistar rats submitted to ladder-based resistance training (LRT). Twenty-eight rats were divided equally into groups: initial control (CI), 4-week TP (CT4), 4-week TP + LRT (TRT), and placebo + LRT (RT). The rats from the CT4 and TRT groups were treated with TP for four weeks (10 mg/kg/week). TRT and RT trained for ten weeks. The rodents were euthanized at the end of the experiment, and gastrocnemius muscle, prostate, and left and right testicles were collected. There was no statistical difference between the RT and TRT for final volume load. The prostate mass of the TRT and RT groups was statistically heavier than the CT4 group (P < 0.01). The TRT group's prostate/body mass ratio was statistically different from the CT4 group (P < 0.05). The TRT group was shown to have larger type I, type II, and mean fCSA fibers than all other groups (P < 0.001). Regarding the nuclei/fiber ratio (N/f), the CT4, RT, and TRT groups had higher values than CI (P < 0.01). In addition, the RT group showed a higher N/f ratio than CT4 (P < 0.001) but lower than TRT (P < 0.001). In conclusion, short-term TP administration before resistance training can elicit a greater N/f ratio and size of the mean fCSA of the Gastrocnemius muscle of young adult Wistar rats than resistance training alone.

Journey of the Probiotic Bacteria: Survival of the Fittest.

This review aims to bring a more general view of the technological and biological challenges regarding production and use of probiotic bacteria in promoting human health. After a brief description of the current concepts, the challenges for the production at an industrial level are presented from the physiology of the central metabolism to the ability to face the main forms of stress in the industrial process. Once produced, these cells are processed to be commercialized in suspension or dried forms or added to food matrices. At this stage, the maintenance of cell viability and vitality is of paramount for the quality of the product. Powder products requires the development of strategies that ensure the integrity of components and cellular functions that allow complete recovery of cells at the time of consumption. Finally, once consumed, probiotic cells must face a very powerful set of physicochemical mechanisms within the body, which include enzymes, antibacterial molecules and sudden changes in pH. Understanding the action of these agents and the induction of cellular tolerance mechanisms is fundamental for the selection of increasingly efficient strains in order to survive from production to colonization of the intestinal tract and to promote the desired health benefits.

Knowledge, Perception, and Experience of Dentists About Teledentistry.

OBJECTIVES: This study aimed to evaluate the level of knowledge, perception, and experience of teledentistry amongst Brazilian dentists with the ongoing COVID-19 pandemic. METHODS: Between June and July 2020, an online questionnaire was used to collect information on the demographic and professional profiles of dentists and their levels of knowledge, perception, and attitudes towards teledentistry. Descriptive statistics were reported as percentages, and Chi-squared test was used to compare responses amongst general practitioners, specialists, and those with varying levels of professional experience. RESULTS: This study included 575 dentists, the majority of whom were from the southeast region of Brazil (73.4%) and had a specialist degree (70.4%). Approximately 42.4% of the study sample had graduated more than 10 years ago, 39.3% between 2 and 10 years ago, and 18.3% up to 2 years ago. In general, the majority of dentists exhibited only a superficial awareness of the resolution that regulates teledentistry in Brazil. A greater number of specialists were aware of the resolution (P = .007) and felt confident performing teledentistry (P = .000) compared to general practitioners, whilst those with more experience (graduated more than 10 years ago) exhibited greater knowledge (P = .012) and preparation (P = .000). More than 60% of the dentists, regardless of dental specialty and clinical experience, had no knowledge of providing prescriptions via teledentistry. The majority of general practitioners (89.5%) and specialists (81.4%) had no previous experience using teledentistry. CONCLUSIONS: The findings of this study suggest that Brazilian dentists are inadequately prepared for the implementation of teledentistry.

[Factors associated with timing of lepra reactions in a cohort from 2008 to 2016 in Rondônia, Amazon Region, Brazil]. / Fatores associados ao tempo de ocorrência das reações hansênicas numa coorte de 2008 a 2016 em Rondônia, Região Amazônica, Brasil.

The clinical management of leprosy patients poses a specific challenge, namely lepra reactions. This non-concurrent cohort study aimed to analyze the timing of the first lepra reaction during and after polychemotherapy (PCT) and associated factors. A total of 1,621 patients were assessed (PB = 8.9% and MB = 91.1%) from 2008 to 2016, reported to the System of Reaction States in Leprosy (SisReação/RO) database. Reactions occurred predominantly during PCT (997; 61.5%) and less frequently only after PCT (624; 38.5%). Earliness of the reaction after diagnosis was analyzed with Kaplan-Meier survival curves, with comparison between the PB and MB groups using the Mantel-Cox log-rank test. Univariate and multivariate Cox regression models were constructed to identify factors associated with occurrence of lepra reactions (hazard ratio) and the corresponding 95%CI. The multivariate model included variables with p-values < 0.20 in the univariate analysis. PB patients developed reactions earlier than MB patients. Other characteristics were associated with earlier reactions: female gender and negative smear microscopy. In the aggregate period (during and after PCT), PB presented 24% higher risk of lepra reaction than MB patients, and negative smear microscopy increased this risk by 40% compared to positive smear microscopy. During and after PCT, PB presented 1.3 and 1.6 times the risk, respectively, of reactions when compared to MB patients. We thus recommend prioritizing surveillance of lepra reactions during and after PCT as measures to prevent physical disabilities and to improve quality of life for persons with leprosy.

O manejo clínico de pacientes com hanseníase apresenta um desafio particular que são as reações. O objetivo deste estudo de coorte não concorrente foi analisar o tempo e fatores associados à ocorrência da primeira reação durante e após o tratamento da poliquimioterapia (PQT). Avaliou-se 1.621 pacientes paucibacilares (PB = 8,9%) e multibacilares (MB = 91,1%) de 2008 a 2016 notificados no Sistema de Estados Reacionais em Hanseníase/Rondônia (SisReação/RO). Prevaleceu a ocorrência durante o tratamento da PQT = 997 (61,5%), e 624 (38,5%) somente após o PQT. A precocidade da reação, a partir do diagnóstico, foi analisada por meio de curvas de sobrevida de Kaplan-Meier e comparadas entre os grupos PB e MB, usando o teste de log-rank de Mantel-Cox; e foram construídos modelos de regressão de Cox univariada e multivariada para identificar os fatores associados à ocorrência da reação (hazard ratio) e os correspondentes IC95%. No modelo multivariado foram incluídas variáveis com valores de p < 0,2 na análise univariada. Os PB desenvolveram reação de forma mais precoce do que os MB. Outras características associaram-se à reação em menor tempo: sexo feminino e baciloscopia negativa. No período agregado (durante e após a PQT), os pacientes PB apresentaram risco 24% maior de reação do que os MB e aqueles com baciloscopia negativa aumentaram este risco em 40% comparado à baciloscopia positiva. Durante e após a PQT, os PB apresentaram 1,3 e 1,6 vezes maior risco de ocorrência da reação dos pacientes MB. Dessa forma, recomendamos priorizar ações de vigilância para reações hansênicas durante e após a PQT como medidas de prevenção de incapacidades físicas e de melhoria na qualidade de vida das pessoas acometidas pela hanseníase.

La gestión clínica de pacientes con hanseniasis presenta un desafío particular que son las reacciones. El objetivo de este estudio de cohorte no concurrente fue analizar el tiempo y factores asociados a la ocurrencia de la primera reacción durante y tras el tratamiento de la poliquimioterapia (PQT). Se evaluó a 1621 pacientes (PB = 8,9% y MB = 91,1%) de 2008 a 2016, notificados en el Sistema de Estados Reaccionarios en Lepra (SisReação/RO). Prevaleció la ocurrencia durante la PQT = 997 (61,5%), y 624 (38,5%) solamente tras la PQT. La precocidad de la reacción a partir del diagnóstico se analizó mediante curvas de supervivencia de Kaplan-Meier y se compararon entre los grupos PB y MB, usando el test de log-rank de Mantel-Cox; asimismo, se construyeron modelos de regresión univariada y multivariada de Cox para identificar los factores asociados con la ocurrencia de la reacción (cociente de riesgos) y los correspondientes IC95%. En el modelo multivariado se incluyeron las variables con valores de p < 0,2 en el análisis univariado. Los PB desarrollaron una reacción de forma más precoz que los MB. Otras características se asociaron a la reacción en menor tiempo: sexo femenino y baciloscopia negativa. En el período agregado (durante y tras PQT), los PB presentaron un riesgo un 24% mayor de reacción que los multibacilares y la baciloscopia negativa aumentó este riesgo en un 40%, comparado con la baciloscopia positiva. Durante y tras el tratamiento PQT, los PB presentaron 1,3 y 1,6 veces el riesgo de ocurrencia de la reacción de los pacientes MB. De esa forma, recomendamos priorizar acciones de vigilancia para reacciones hansénicas durante y tras PQT, como medidas de prevención de discapacidades físicas, así como de mejoría en la calidad de vida de personas afectadas por la hanseniasis.

Training Intensity, Not Duration, May Be Key to Upregulating Presynaptic Proteins of Calcium Dynamics and Calcium-Dependent Exocytosis in Fast- and Slow-Twitch Skeletal Muscles, in Addition to Maintaining Performance After Detraining.

Neuromuscular adaptations are essential for improving athletic performance. However, little is known about the effect of different endurance training protocols and their subsequent detraining on the gene expression of critical factors for neuromuscular synaptic transmission. Therefore, this study investigated the effects of endurance training (high-intensity interval training [HIIT], continuous [cEND], mixed interval [Mix], and all protocols combined [Comb]) and detraining on performance and gene expression (GE) of the alpha-1a, synaptotagmin II (Syt-II), synaptobrevin II (Vamp2), and acetylcholinesterase (AChE) in the gastrocnemius and soleus of Wistar rats. Eighty rodents were randomly divided into control, HIIT, cEND, Mix, Comb, and detraining groups. The rodents trained for 6 weeks (5 × /week), followed by 2 weeks of detraining. Performance improved in all training groups and decreased following detraining (p < 0.05), except HIIT. In the gastrocnemius, alpha-1a GE was upregulated in the Mix. Syt-II and AChE GE were upregulated in HIIT, Mix, and Comb. Vamp2 GE was upregulated in all groups. In the soleus, alpha-1a GE was upregulated in HIIT, Mix, and Comb. Syt-II and Vamp2 GE were upregulated in all groups. AChE GE was upregulated in cEND, Mix, and Comb. Detraining downregulated mostly the gene expression in the skeletal muscles. We conclude that training intensity appears to be a key factor for the upregulation of molecules involved in neuromuscular synaptic transmission. Such changes occur to be involved in improving running performance. On the other hand, detraining negatively affects synaptic transmission and performance.

DOES THE DROP IN PORTAL PRESSURE AFTER ESOPHAGOGASTRIC DEVASCULARIZATION AND SPLENECTOMY INFLUENCE THE VARIATION OF VARICEAL CALIBERS AND THE REBLEEDING RATES IN SCHISTOSOMIASIS IN LATE FOLLOW-UP?

BACKGROUND: The treatment of choice for patients with schistosomiasis with previous episode of varices is bleeding esophagogastric devascularization and splenectomy (EGDS) in association with postoperative endoscopic therapy. However, studies have shown varices recurrence especially after long-term follow-up. AIM: To assess the impact on behavior of esophageal varices and bleeding recurrence after post-operative endoscopic treatment of patients submitted to EGDS. METHODS: Thirty-six patients submitted to EGDS were followed for more than five years. They were divided into two groups, according to the portal pressure drop, more or less than 30%, and compared with the behavior of esophageal varices and the rate of bleeding recurrence. RESULTS: A significant reduction on the early and late post-operative varices caliber when compared the pre-operative data was observed despite an increase in diameter during follow-up that was controlled by endoscopic therapy. CONCLUSION: The drop in portal pressure did not significantly influence the variation of variceal calibers when comparing pre-operative and early or late post-operative diameters. The comparison between the portal pressure drop and the rebleeding rates was also not significant.

Effects of different lengths of high-intensity interval training microcycles on the systemic and hippocampal inflammatory state and antioxidant balance of immature rats.

There is a lack of evidence on the effects of high-intensity interval training (HIIT) microcycle duration on the antioxidant capacity and hippocampal inflammatory response of young (immature) samples. This study compared two HIIT microcycles lengths on adaptation to training, antioxidant balance, and systemic and hippocampal inflammation in immature rats. Twenty-four immature Wistar rats (27 days) were equally divided into groups: control; 4-day HIIT (3 training days + 1 rest day); and 7-day HIIT (6 training days + 1 rest day). Both microcycles of 4 and 7 days were 28 days of training (37-38 m min-1). Running performance improved in all training groups compared to controls (P < 0.05). However, the 7-day HIIT group statistically increased serum interleukin-6 (IL-6) compared to the control and 4-day HIIT groups (P < 0.05). The total serum antioxidant capacity in the 7-day HIIT group was statistically lower than in the control group (P < 0.05). There was no statistical difference for the analysis of serum malondialdehyde between the groups. The hippocampal gene expression of IL-6, IL-1ß, IL-10, and tumor necrosis factor-alpha in the training groups was statistically higher than in the control group (P = 0.01), with no significant difference between the 4-day HIIT and 7-day HIIT groups. We concluded that HIIT microcycles with a longer duration decrease the antioxidant capacity and increase the systematic and hippocampal inflammation. Thus, we suggest using short HIIT microcycles for young (immature) groups due to improved running performance with less inflammatory and antioxidant changes.

Ladder-based resistance training elicited similar ultrastructural adjustments in forelimb and hindlimb peripheral nerves of young adult Wistar rats.

To analyze the morphological response induced by high-volume, high-intensity ladder-based resistance training (LRT) on the ultrastructure of the radial (forelimb) and sciatic (hindlimb) nerves of adults Wistar rats. Twenty rats were equally distributed into groups: sedentary (SED) and LRT. After the rodents were subjected to the maximum load (ML) carrying test, the LRT group performed 6-8 progressive climbs (2 × 50% ML, 2 × 75% ML, 2 × 100% ML, and 2 × 100% ML + 30 g) three times per week. After 8 weeks, the radial and sciatic nerves were removed and prepared for transmission electron microscopy. In the radial nerve, myelinated axons cross-sectional area (CSA), unmyelinated axons CSA, myelin sheath thickness, and Schwann cells nuclei area were statistically larger in the LRT group than SED (p < 0.05). Also, the number of microtubules and neurofilaments per field were statistically higher in the LRT group than in SED (p < 0.01). For sciatic nerve, myelinated fibers CSA, unmyelinated axons CSA, myelin sheath thickness, Schwann cells nuclei area, and the number of neurofilaments per field were statistically larger in the LRT group compared to the SED group (p < 0.05). LRT with high-volume and high-intensity effectively induce similar changes in adult Wistar rats' radial and sciatic nerves' ultrastructure.