Functional aggregation of cell-free proteins enables fungal ice nucleation.

Biological ice nucleation plays a key role in the survival of cold-adapted organisms. Several species of bacteria, fungi, and insects produce ice nucleators (INs) that enable ice formation at temperatures above -10 °C. Bacteria and fungi produce particularly potent INs that can promote water crystallization above -5 °C. Bacterial INs consist of extended protein units that aggregate to achieve superior functionality. Despite decades of research, the nature and identity of fungal INs remain elusive. Here, we combine ice nucleation measurements, physicochemical characterization, numerical modeling, and nucleation theory to shed light on the size and nature of the INs from the fungus Fusarium acuminatum. We find ice-binding and ice-shaping activity of Fusarium IN, suggesting a potential connection between ice growth promotion and inhibition. We demonstrate that fungal INs are composed of small 5.3 kDa protein subunits that assemble into ice-nucleating complexes that can contain more than 100 subunits. Fusarium INs retain high ice-nucleation activity even when only the ~12 kDa fraction of size-excluded proteins are initially present, suggesting robust pathways for their functional aggregation in cell-free aqueous environments. We conclude that the use of small proteins to build large assemblies is a common strategy among organisms to create potent biological INs.

Lichen species across Alaska produce highly active and stable ice nucleators.

Forty years ago, lichens were identified as extraordinary biological ice nucleators (INs) that enable ice formation at temperatures close to 0°C. By employing INs, lichens thrive in freezing environments that surpass the physiological limits of other vegetation, thus making them the majority of vegetative biomass in northern ecosystems. Aerosolized lichen INs might further impact cloud glaciation and have the potential to alter atmospheric processes in a warming Arctic. Despite the ecological importance and formidable ice nucleation activities, the abundance, diversity, sources, and role of ice nucleation in lichens remain poorly understood. Here, we investigate the ice nucleation capabilities of lichens collected from various ecosystems across Alaska. We find ice-nucleating activity in lichen to be widespread, particularly in the coastal rainforest of Southeast Alaska. Across 29 investigated lichen, all species show ice nucleation temperatures above -15 °C and ~30% initiate freezing at temperatures above -6 °C. Concentration series of lichen ice nucleation assays in combination with statistical analysis reveal that the lichens contain two subpopulations of INs, similar to previous observations in bacteria. However, unlike the bacterial INs, the lichen INs appear as independent subpopulations resistant to freeze-thaw cycles and against temperature treatment. The ubiquity and high stability of the lichen INs suggest that they can impact local atmospheric processes and that ice nucleation activity is an essential trait for their survival in cold environments.

Modulation of hypothalamic AMPK and hypothalamic neuropeptides in the control of eating behavior: A systematic review.

Eating behavior is regulated by central and peripheral signals, which interact to modulate the response to nutrient intake. Central control is mediated by the hypothalamus through neuropeptides that activate the orexigenic and anorexigenic pathways. Energy homeostasis depends on the efficiency of these regulatory mechanisms. This neuroendocrine regulation of hunger and appetite can be modulated by nutritional sensors such as adenosine monophosphate-activated protein kinase (AMPK). Thus, this systematic review discusses the literature on correlations between AMPK and hypothalamic neuropeptides regarding control of eating behavior. Lilacs, PubMed/Medline, ScienceDirect, and Web of Science were searched for articles published from 2009 to 2021 containing combinations of the following descriptors: "eating behavior," "hypothalamus," "neuropeptide," and "AMPK." Of the 1330 articles found initially, 27 were selected after application of the inclusion and exclusion criteria. Of the selected articles, 15 reported decreased AMPK activity, due to interventions using angiotensin II infusion, fructose, glucose, cholecystokinin, leptin, or lipopolysaccharide (LPS) injection; dietary control through a low-protein diet or a high-fat diet (60 % fat); induction of hyperthyroidism; or injection of AMPK inhibitors. Seven studies showed a decrease in neuropeptide Y (NPY) through CV4 AICAR administration; fructose, glucose, leptin, or angiotensin II injections; or infusion of LPS from Escherichia coli and liver kinase B1 (LKB1) overexpression. Eleven studies reported a decrease in food consumption due to a decrease in AMPK activity and/or hypothalamic neuropeptides such as NPY. The results indicate that there is a relationship between AMPK and the control of eating behavior: a decrease in AMPK activity due to a dietary or non-dietary stimulus is associated with a consequent decrease in food intake. Furthermore, AMPK activity can be modulated by glucose, thyroid hormones, estradiol, leptin, and ghrelin.

REPERCUSSIONS OF BARIATRIC SURGERY ON METABOLIC PARAMETERS: EXPERIENCE OF 15-YEAR FOLLOW-UP IN A HOSPITAL IN MACEIÓ, BRAZIL. / REPERCUSSÕES DA CIRURGIA BARIÁTRICA SOBRE PARÂMETROS METABÓLICOS. EXPERIÊNCIA DE 15 ANOS EM HOSPITAL DE MACEIÓ - BRASIL.

OBJECTIVE: Obesity is a disease characterized by an excessive accumulation of body fat, which is harmful to health, and it has grown significantly in the past years in the majority of countries. The surgery should be recommended to those patients with obesity who did not succeed in conservative clinical therapy after a rigorous analysis by a multidisciplinary team. The aim of this study was to compare metabolic results, weight loss, and parameters associated with obesity in the preoperative and postoperative periods of patients treated with bariatric surgery. METHODS: This was a retrospective, descriptive, cross-sectional, and quantitative study through consultation medical records. Data were collected from May to September 2020 from individuals treated with bariatric surgery in a period of 15 years (from 2003 to 2018). A comparative and descriptive statistical analysis of anthropometric, metabolic, biochemical, and associated morbidities was performed. RESULTS: The majority of patients were female (68.50%). In both sexes, the highest prevalence was found in the age group of 30-39 years and more than half had grade III obesity. The surgical technique used was gastroplasty with Roux-en-Y gastric bypass. After 4 months, there was a significant reduction in the lipid profile, anthropometric parameters, and liver enzymes in both sexes, which remained decreasing till the end of the first year, with marked improvement in the metabolic syndrome (MS). CONCLUSIONS: The positive impact resulted from gastroplasty in terms of weight loss, reduction of body mass index, and lipid profile is quite relevant after 4 months and it is maintained until 1 year after the procedure, showing benefits in reducing the risk factors of the MS.

OBJETIVO: A obesidade é caracterizada pelo acúmulo excessivo de gordura corporal prejudicial à saúde e nos últimos anos tem crescido significativamente na maioria dos países. A cirurgia bariátrica deverá ser recomendada para pacientes obesos que não obtiveram êxito no tratamento clínico e após análise da equipe multiprofissional. comparar os resultados metabólicos, perda ponderal e parâmetros associados à obesidade no pré e pós-operatório dos pacientes submetidos à cirurgia bariátrica. MÉTODOS: estudo retrospectivo, descritivo, transversal, de abordagem quantitativa através da consulta a prontuários. Os dados foram coletados no período de maio a setembro de 2020, de indivíduos submetidos à cirurgia bariátrica no período de 15 anos (2003 a 2018). Foi realizada análise estatística comparativa e descritiva das variáveis antropométricas, metabólicas, bioquímicas e morbidades associadas. RESULTADOS: a maioria era do sexo feminino (68,50%). Em ambos os sexos a maior prevalência se encontravam na faixa etária de 30 a 39 anos e mais da metade tinha obesidade grau III. A técnica cirúrgica utilizada foi o gastroplastia em Y de Roux. Após 4 meses houve uma redução significativa do perfil lipídico, dos parâmetros antropométricos e enzimas hepáticas em ambos os sexos, os quais permaneceram em declínio no final do primeiro ano, com melhora acentuada da síndrome metabólica. CONCLUSÕES: O impacto positivo determinado pela gastroplastia na perda de peso, na redução do IMC e perfil lipídico é bastante relevante já após quatro meses, e se mantém após um ano da realização do procedimento, demonstrando benefícios na redução dos fatores de risco da síndrome metabólica.

Is It Possible to Follow the Structural Evolution of Water in "No-Man's Land" Using a Pulsed-Heating Procedure?

The anomalous increase in compressibility and heat capacity of supercooled water has been attributed to its structural transformation of into a four-coordinated liquid. Experiments revealed that κT and Cp peak at TWthermo ≈ 229 K [Kim et al. Science 2017, 358, 1589; Pathak et al. Proc. Natl. Acad. Sci. 2021, 118, e2018379118]. Recently, a pulsed heating procedure (PHP) was employed to interrogate the structure of water, reporting a steep increase in tetrahedrality around TWPHP = 210 ± 3 K [Kringle et al. Science 2020, 369, 1490]. This discrepancy questions whether water structure and thermodynamics are decoupled, or if the shift in TW is an artifact of PHP. Here we implement PHP in molecular simulations. We find that the stationary states captured at the bottom of the pulse are not representative of the thermalized liquid or its inherent structure. Our analysis reveals a temperature-dependent distortion that shifts TWPHP to ∼20 K below TWthermo. We conclude that 2 orders of magnitude faster rates are required to sample water's inherent structure with PHP.

Perinatal and post-weaning exposure to an obesogenic diet promotes greater expression of nuclear factor-κB and tumor necrosis factor-α in white adipose tissue and hypothalamus of adult rats.

Aim: To analyze the effects of exposure to a high-fat diet during the perinatal period and after weaning on white adipose tissue accumulation and gene expression of TNF- α and NF- κB.Method: Wistar female rats were fed with high-fat (H) or control (C) diet during pregnancy and lactation. The offspring were allocated into four groups: Control Control (CC), offspring of mothers GC, fed a control diet after weaning; Control High-fat (CH), offspring of mothers GC, fed a hight-fat diet after weaning; High-fat Control (HC), offspring of mothers GH, fed with control diet after weaning; and High-fat High-fat (HH), offspring of mothers GH, fed a H diet after weaning.Results: HH and HC groups showed increased body weight compared to CC group and increases in caloric intake, larger amount of white adipose tissue and adipocyte size compared to CC and CH groups. The HH and CH groups showed higher NF-kB expression in white adipose tissue compared to the CC and HC groups, and the HH group also showed higher TNF- α expression. In the hypothalamus, the HH and HC groups exhibited higher TNF- α expression compared to the CC and CH groups.Conclusion: Perinatal and post-weaning exposure to the high-fat diet increases the amount of white adipose tissue, adipocyte size, and expression of the inflammatory genes TNF-α and NF-kB.

Hemodynamic Effects of Different Combinations of Midazolam and Opioids in Healthy Dogs.

The purpose of this study was to compare the hemodynamic effects of four different combinations of midazolam and opioids in healthy dogs. Twenty-four healthy dogs were divided in four groups (n = 6) using intramuscular midazolam 0.3 mg/kg and morphine 0.3 mg/kg (GMOR), methadone 0.3 mg/kg (GMET), butorphanol 0.2 mg/kg (GBUT) or fentanyl 5 ug/kg (GFEN). Cardiovascular variables were recorded before (TB) and 20 minutes following drug administration (T20) and comprised arterial blood pressure, heart rate and cardiac index. Subsequently, left ventricular work index and total peripheral resistance index were calculated using the previous variables. At the end of the study, data were compared using analysis of variance followed by Tukey test and Friedman followed by Dunn test, all under 5% significance. No differences were found on cardiovascular variables at all times among the groups, which indicates that all combinations provide hemodynamic stability for clinical sedation of healthy dogs. However, a few animals showed paradoxical excitation in GBUT. In conclusion, the association of midazolam with morphine, methadone, butorphanol or fentanyl provides cardiovascular stability and can be used to sedate dogs undergoing cardiovascular examination, although caution is warranted with the use of midazolam with butorphanol due to possible paradoxical excitation.

Advances in the study of supercooled water.

In this review, we report recent progress in the field of supercooled water. Due to its uniqueness, water presents numerous anomalies with respect to most simple liquids, showing polyamorphism both in the liquid and in the glassy state. We first describe the thermodynamic scenarios hypothesized for the supercooled region and in particular among them the liquid-liquid critical point scenario that has so far received more experimental evidence. We then review the most recent structural indicators, the two-state model picture of water, and the importance of cooperative effects related to the fact that water is a hydrogen-bonded network liquid. We show throughout the review that water's peculiar properties come into play also when water is in solution, confined, and close to biological molecules. Concerning dynamics, upon mild supercooling water behaves as a fragile glass former following the mode coupling theory, and it turns into a strong glass former upon further cooling. Connections between the slow dynamics and the thermodynamics are discussed. The translational relaxation times of density fluctuations show in fact the fragile-to-strong crossover connected to the thermodynamics arising from the existence of two liquids. When considering also rotations, additional crossovers come to play. Mobility-viscosity decoupling is also discussed in supercooled water and aqueous solutions. Finally, the polyamorphism of glassy water is considered through experimental and simulation results both in bulk and in salty aqueous solutions. Grains and grain boundaries are also discussed.

Correlation between pain, anthropometric measurements, stress and biochemical markers in women with low back pain.

Aim: To analyze the associations between pain duration, pain levels, anthropometric measures, perceived stress and biochemical markers in women with low back pain. Materials & methods: Forty-two participants were submitted to body mass, height, abdominal circumference, cortisol and creatine kinase (CK) collections. Pain duration, pain levels and stress were analyzed through specific questionnaires. Results: There were positive correlations between abdominal circumference and body mass, duration of pain and age, abdominal circumference, CK and age, CK and BMI, CK and abdominal circumference, and CK and duration of pain (p < 0.05). Conclusion: The higher the level of tissue damage over the years, the greater the tendency for higher levels of low back pain perception. Central fat was related to greater load on the spine.

Lay abstract Low back pain (LBP) is one of the factors that hinders the routine and productivity of women. LBP can cause functional disability and negatively interfere with work activities. The increase in pain can be caused by mechanical postural factors (such as behavioral habits), traumatic (such as accidents), and psychosocial factors (such as physical inactivity). Chronic LBP can influence behavioral aspects due to adaptations of pain feedback, such as postures to avoid pain and sedentary lifestyle. In this study, we observed that duration of LBP was related to higher levels of creatine kinase, which is an enzyme of our body that can be related to tissue damage. Moreover, the abdominal circumference, due to the accumulation of fat in this region, presented correlation with higher levels of tissue damage by creatine kinase and longer exposure time with LBP.

Repercussões da cirurgia bariátrica sobre parâmetros metabólicos. experiência de 15 anos em hospital de maceió - brasil / Repercussions of bariatric surgery on metabolic parameters: experience of 15-year follow-up in a hospital in maceió, brazil

RESUMO - RACIONAL: A obesidade é caracterizada pelo acúmulo excessivo de gordura corporal prejudicial à saúde e nos últimos anos tem crescido significativamente na maioria dos países. A cirurgia bariátrica deverá ser recomendada para pacientes obesos que não obtiveram êxito no tratamento clínico e após análise da equipe multiprofissional. Objetivo: comparar os resultados metabólicos, perda ponderal e parâmetros associados à obesidade no pré e pós-operatório dos pacientes submetidos à cirurgia bariátrica. Métodos: estudo retrospectivo, descritivo, transversal, de abordagem quantitativa através da consulta a prontuários. Os dados foram coletados no período de maio a setembro de 2020, de indivíduos submetidos à cirurgia bariátrica no período de 15 anos (2003 a 2018). Foi realizada análise estatística comparativa e descritiva das variáveis antropométricas, metabólicas, bioquímicas e morbidades associadas. Resultados: a maioria era do sexo feminino (68,50%). Em ambos os sexos a maior prevalência se encontravam na faixa etária de 30 a 39 anos e mais da metade tinha obesidade grau III. A técnica cirúrgica utilizada foi o gastroplastia em Y de Roux. Após 4 meses houve uma redução significativa do perfil lipídico, dos parâmetros antropométricos e enzimas hepáticas em ambos os sexos, os quais permaneceram em declínio no final do primeiro ano, com melhora acentuada da síndrome metabólica. Conclusões: O impacto positivo determinado pela gastroplastia na perda de peso, na redução do IMC e perfil lipídico é bastante relevante já após quatro meses, e se mantém após um ano da realização do procedimento, demonstrando benefícios na redução dos fatores de risco da síndrome metabólica.

ABSTRACT - BACKGROUND: Obesity is a disease characterized by an excessive accumulation of body fat, which is harmful to health, and it has grown significantly in the past years in the majority of countries. The surgery should be recommended to those patients with obesity who did not succeed in conservative clinical therapy after a rigorous analysis by a multidisciplinary team. Objective: The aim of this study was to compare metabolic results, weight loss, and parameters associated with obesity in the preoperative and postoperative periods of patients treated with bariatric surgery. Methods: This was a retrospective, descriptive, cross-sectional, and quantitative study through consultation medical records. Data were collected from May to September 2020 from individuals treated with bariatric surgery in a period of 15 years (from 2003 to 2018). A comparative and descriptive statistical analysis of anthropometric, metabolic, biochemical, and associated morbidities was performed. Results: The majority of patients were female (68.50%). In both sexes, the highest prevalence was found in the age group of 30-39 years and more than half had grade III obesity. The surgical technique used was gastroplasty with Roux-en-Y gastric bypass. After 4 months, there was a significant reduction in the lipid profile, anthropometric parameters, and liver enzymes in both sexes, which remained decreasing till the end of the first year, with marked improvement in the metabolic syndrome (MS). Conclusions: The positive impact resulted from gastroplasty in terms of weight loss, reduction of body mass index, and lipid profile is quite relevant after 4 months and it is maintained until 1 year after the procedure, showing benefits in reducing the risk factors of the MS.

FcγR2B B2.4 haplotype predicts increased risk of red blood cell alloimmunization in sickle cell disease patients.

BACKGROUND: Red blood cell (RBC) alloimmunization is an important transfusion complication which is prevalent among sickle cell disease (SCD) patients. Autoimmune diseases are a known risk factor for RBC alloimmunization, suggesting that autoimmunity and post-transfusion alloantibody development occur through similar physiopathological pathways. Polymorphisms in the FcγR2B gene have already been associated with several autoimmune disorders and hypothetically could be associated with RBC alloimmunization. Our goal was to evaluate if important polymorphisms of FcγR2B have an impact on the risk of RBC alloimmunization among SCD patients. STUDY DESIGN AND METHODS: This was a case-control study in which alloimmunized and non-alloimmunized SCD patients were compared in terms of the genotype frequency of the FcγR2B polymorphisms -386G/C, -120 T/A, and 695C/T, genotyped through direct Sanger sequencing. RESULTS: A total of 237 patients met the eligibility criteria, 120 cases (alloimmunized) and 117 controls (non-alloimmunized). RBC alloimmunization was associated with female sex (p < 0.001), lifetime number of RBC units transfused (p = 0.002) and 120 T/A FcγR2B genotype (p = 0.031). The FcγR2B promoter region haplotype 2B.4 (386C120A) was positively associated with RBC alloimunization (p = 0.045). The logistic regression (LR) model identified female sex (OR 10.03, CI 95% 5.16-19.49; p < 0.001) and FcγR2B 2B.4 haplotype (OR 4.55, CI95% 1.1118.65; p = 0.035) as independent predictors of RBC alloimmunization in SCD patients. CONCLUSION: SCD patients with the FcγR2B 2B.4 haplotype had over a fourfold higher risk for RBC alloimmunization. This highlights the role played by FcγR2B on RBC alloimmunization and may be helpful in identifying the immune responders.

Diversity of RH and transfusion support in Brazilian sickle cell disease patients with unexplained Rh antibodies.

BACKGROUND: Genetic diversity in the RH genes among sickle cell disease (SCD) patients is well described but not yet extensively explored in populations of racially diverse origin. Transfusion support is complicated in patients who develop unexpected Rh antibodies. Our goal was to describe RH variation in a large cohort of Brazilian SCD patients exhibiting unexpected Rh antibodies (antibodies against RH antigens to which the patient is phenotypically positive) and to evaluate the impact of using the patient's RH genotype to guide transfusion support. STUDY DESIGN AND METHODS: Patients within the Recipient Epidemiology and Evaluation Donor Study (REDS)-III Brazil SCD cohort with unexpected Rh antibodies were selected for study. RHD and RHCE exons and flanking introns were sequenced by targeted next-generation sequencing. RESULTS: Fifty-four patients with 64 unexplained Rh antibodies were studied. The majority could not be definitively classified as auto- or alloantibodies using serologic methods. The most common altered RH were RHD*DIIIa and RHD*DAR (RHD locus) and RHCE*ce48C, RHCE*ce733G, and RHCE*ceS (RHCE locus). In 53.1% of the cases (34/64), patients demonstrated only conventional alleles encoding the target antigen: five of 12 anti-D (41.7%), 10 of 12 anti-C (83.3%), 18 of 38 anti-e (47.4%), and one of one anti-E (100%). CONCLUSION: RHD variation in this SCD cohort differs from that reported for African Americans, with increased prevalence of RHD*DAR and underrepresentation of the DAU cluster. Many unexplained Rh antibodies were found in patients with conventional RH allele(s) only. RH genotyping was useful to guide transfusion to determine which patients could potentially benefit from receiving RH genotyped donor units.

Frailty syndrome in the elderly in elderly with chronic diseases in Primary Care.

OBJECTIVE: To evaluate the frailty syndrome in the elderly nursing diagnosis in elderly with chronic diseases of a health district of the Federal District. METHOD: A quantitative, descriptive, cross-sectional study was conducted with elderly patients served at the Basic Health Units, who presented arterial hypertension and/or diabetes mellitus. The following were used: a sociodemographic questionnaire, the Mini-Mental State Examination, anthropometric data, evaluation of sarcopenia (measured by body composition), muscle strength and functional capacity, and the identification of NANDA-I nursing diagnosis. A statistical software was used for data analysis. RESULTS: Participation of 78 elderly people, of which 93.6% of had Impaired memory, 93.6% had Impaired physical mobility, 82.1% had Fatigue, 76.9% had Impaired ambulation, 53.8% had Dressing self-care deficit, 43.6% had Activity Intolerance, 35.9% had Social Isolation, 30.8% had Hopelessness, 29.5% had Feeding self-care deficit, 29.5% had Bathing self-care deficit, 12.8% had Toileting self-care deficit, and 10.3% had Decreased cardiac output. CONCLUSION: The nursing diagnosis Frailty Syndrome in the Elderly allows a multidimensional view of the elderly. Since one factor can cause health problems in several health fields, nurses must intervene early, plan and implement actions in the short and long term.

SMIM1 intron 2 gene variations leading to variability in Vel antigen expression among Brazilian blood donors.

BACKGROUND: There is a significant inter-individual heterogeneity of Vel antigen expression which can lead to inaccuracies on Vel phenotyping of blood donors and, potentially, to hemolytic post-transfusion reactions. Our aim was to evaluate the impact of genetic variants in the SMIM1 intron 2 on the expression of Vel antigen among Brazilian blood donors harboring the c.64_80del17 deletion in heterozygosity. METHODS: Donors presenting the SMIM1 c.64_80del17 in heterozygosity were included in the study and subjected to SMIM1 intron 2 direct sequencing aiming to genotype the following polymorphisms: rs143702418, rs1181893, rs191041962, rs6673829, rs1175550 and rs9424296. RESULTS: SMIM1 intron 2 sequencing was performed on two hundred donors presenting one c.64_80del17 allele. The rs1175550 polymorphism significantly impacted on Vel antigen expression. Variations in the strength of agglutination on Vel phenotyping were also observed according to the rs6673829 genotype, but this difference did not persist with statistical relevance after multivariate analysis. CONCLUSION: The presence of the rs1175550A allele of SMIM1 is significantly and independently associated with a decrease in Vel antigen expression. Even though the population in Brazil is intensely mixed, the allele frequencies obtained in the current study were very similar to that reported for Europeans.

Randomized controlled trial of the effect of periodontal treatment on cardiovascular risk biomarkers in patients with stable coronary artery disease: Preliminary findings of 3 months.

AIM: To assess the effect of periodontal therapy (PT) on cardiovascular blood biomarkers. MATERIALS AND METHODS: This single-blind, parallel-design, randomized controlled trial included patients with stable coronary artery disease and periodontitis. The test group (TG) received non-surgical PT, whereas the control group (CG) received one session of plaque removal. Plasma levels of C-reactive protein (CRP), glycated haemoglobin, lipids and cytokines (IL-1ß, IL-6, IL-8, IL-10, IFN-γ and TNF-α) were measured at baseline and after 3 months. RESULTS: Eighty-two patients (74.4% women, mean age 59.6 years) were analysed. TG had significantly better periodontal parameters than CG after 3 months, but no significant differences in blood markers were observed between them. In a post hoc subgroup analysis in patients with baseline CRP <3 mg/L, a significant increase in CRP was observed in CG (1.44 ± 0.82 mg/L to 4.35 ± 7.85 mg/L, p = 0.01), whereas CRP remained unchanged in TG (1.40 ± 0.96 mg/L to 1.33 ± 1.26 mg/L, p = 0.85), resulting in a significant difference between groups at 3 months. In patients with CRP ≥3 mg/L, a significant reduction in CRP was observed only in TG (11.3 ± 12.8 mg/L to 5.7 ± 4.1 mg/L, p = 0.04). Levels of IL-6 and IL-8 were significantly lower in TG than CG at 3 months. CONCLUSIONS: PT leads to lower levels of CRP, IL-6 and IL-8 in cardiovascular patients with high CRP levels.

Frailty syndrome in the elderly in elderly with chronic diseases in Primary Care / Síndrome del anciano frágil en personas mayores con enfermedades crónicas en la Atención Primaria / Síndrome do idoso frágil em idosos com doenças crônicas na Atenção Primária

ABSTRACT Objective: To evaluate the frailty syndrome in the elderly nursing diagnosis in elderly with chronic diseases of a health district of the Federal District. Method: A quantitative, descriptive, cross-sectional study was conducted with elderly patients served at the Basic Health Units, who presented arterial hypertension and/or diabetes mellitus. The following were used: a sociodemographic questionnaire, the Mini-Mental State Examination, anthropometric data, evaluation of sarcopenia (measured by body composition), muscle strength and functional capacity, and the identification of NANDA-I nursing diagnosis. A statistical software was used for data analysis. Results: Participation of 78 elderly people, of which 93.6% of had Impaired memory, 93.6% had Impaired physical mobility, 82.1% had Fatigue, 76.9% had Impaired ambulation, 53.8% had Dressing self-care deficit, 43.6% had Activity Intolerance, 35.9% had Social Isolation, 30.8% had Hopelessness, 29.5% had Feeding self-care deficit, 29.5% had Bathing self-care deficit, 12.8% had Toileting self-care deficit, and 10.3% had Decreased cardiac output. Conclusion: The nursing diagnosis Frailty Syndrome in the Elderly allows a multidimensional view of the elderly. Since one factor can cause health problems in several health fields, nurses must intervene early, plan and implement actions in the short and long term.

RESUMEN Objetivo: Evaluar el diagnóstico enfermero Síndrome del Anciano Frágil en personas mayores con enfermedades crónicas de un centro regional de salud del Distrito Federal. Método: Estudio cuantitativo, descriptivo y transversal, llevado a cabo con ancianos que presentaban hipertensión arterial y/o diabetes mellitus atendidos en Unidades Básicas de Salud. Se utilizó un Cuestionario sociodemográfico, Miniexamen del Estado Mental, datos antropométricos, evaluación de la sarcopenia (medida por la composición corporal), fuerza muscular y capacidad funcional e identificación de diagnóstico de enfermería de la NANDA-I. Los datos fueron analizados en software estadístico. Resultados: Participaron 78 personas mayores. Fueron identificados el 93% de ancianos con Memoria perjudicada, el 93,6% con Movilidad física perjudicada, el 82,1% con Fatiga, el 76,9% con Deambulación perjudicada, el 53,8% con Déficit en el autocuidado para vestirse, el 43,6% con Intolerancia a la actividad, el 35,9% con Aislamiento Social, el 30,8% con Desesperanza, el 29,5% con Déficit en el autocuidado para alimentación, el 29,5% con Déficit para baño, el 12,8% con Déficit para higiene íntima, el 10,3% con Gasto cardiaco disminuido. Conclusión: El diagnóstico enfermero Síndrome del Anciano Frágil permite tener una visión multidimensional de la persona mayor. Considerándose que un factor puede traer agravamientos a distintos campos de la salud, se hace esencial que el enfermero intervenga precozmente, planifique e implante acciones a corto y largo plazo.

RESUMO Objetivo: Avaliar o diagnóstico de enfermagem Síndrome do Idoso Frágil em idosos com doenças crônicas de uma regional de saúde do Distrito Federal. Método: Estudo quantitativo, descritivo e transversal, realizado com idosos que apresentavam hipertensão arterial e/ou diabetes mellitus atendidos Unidades Básicas de Saúde. Utilizou-se de Questionário sociodemográfico, Miniexame do Estado Mental, dados antropométricos, avaliação da sarcopenia (medida pela composição corporal), força muscular e capacidade funcional e identificação do diagnóstico de enfermagem da NANDA-I. Os dados foram analisados em software estatístico. Resultados: Participaram 78 idosos. Foram identificados 93,6% idosos com Memória prejudicada, 93,6% com Mobilidade física prejudicada, 82,1% com Fadiga, 76,9% com Deambulação prejudicada, 53,8% com Deficit no autocuidado para vestir-se, 43,6% com Intolerância à atividade, 35,9% com Isolamento Social, 30,8% com Desesperança, 29,5% com Deficit no autocuidado para alimentação, 29,5% com Deficit para banho, 12,8% com Deficit para higiene íntima, e 10,3% com Débito cardíaco diminuído. Conclusão: O diagnóstico de enfermagem Síndrome do Idoso Frágil permite ter uma visão multidimensional do idoso. Considerando que um fator pode acarretar agravos a vários campos da saúde, torna-se essencial que o enfermeiro intervenha precocemente, planeje e implemente ações em curto e em longo prazo.

Periodontal therapy and endothelial function in coronary artery disease: A randomized controlled trial.

OBJECTIVE: To assess the effects of periodontal treatment on endothelial function in patients with coronary artery disease. MATERIALS AND METHODS: A randomized controlled trial was conducted with 69 patients with stable coronary disease and severe periodontitis. The test group received nonsurgical periodontal therapy consisting of personalized oral hygiene instructions, subgingival scaling, and root planing per quadrant, whereas the control group received equal treatment after the study period. Endothelial function was assessed by measurement of brachial artery flow-mediated dilation, concentrations of sVCAM-1, sICAM-1, and P-selectin in serum before and 3 months after periodontal therapy. RESULTS: The test group exhibited statistically better periodontal parameters-plaque, probing depth, periodontal attachment loss, and bleeding on probing. No significant improvements were observed in the control (1.37%) and test (1.39%) groups in flow-mediated dilation, with no significant between-group difference. sVCAM-1 concentration increased in the control group (997.6 ± 384.4-1201.8 ± 412.5; p = 0.03), whereas in the test group, no significant changes were observed (915.1 ± 303.8-1050.3 ± 492.3; p = 0.17), resulting in a significant difference between the two groups (p = 0.04). The same pattern was observed for concentrations of sICAM-1. CONCLUSION: Periodontal treatment did not provide better vasodilation in patients with coronary disease in a short-term follow-up period, although it maintained blood concentrations of markers of vascular inflammation.

Anomalous diffusion of water molecules at grain boundaries in ice Ih.

Using ab initio and classical molecular dynamics simulations, we study pre-melting phenomena in pristine coincident-site-lattice grain boundaries (GBs) in proton-disordered hexagonal ice Ih at temperatures just below the melting point Tm. Concerning pre-melt-layer thicknesses, the results are consistent with the available experimental estimates for low-disorder impurity-free GBs. With regard to molecular mobility, the simulations provide a key new insight: the translational motion of the water molecules is found to be subdiffusive for time scales from ∼10 ns up to at least 0.1 µs. Moreover, the fact that the anomalous diffusion occurs even at temperatures just below Tm where the bulk supercooled liquid still diffuses normally suggests that it is related to the confinement of the GB pre-melt layers by the surrounding crystalline environment. Furthermore, we show that this behavior can be characterized by continuous-time random walk models in which the waiting-time distributions decay according to power-laws that are very similar to those describing dynamics in glass-forming systems.

Defining the clinical relevance of red blood cell autoantibodies by Monocyte Monolayer Assay.

BACKGROUND: The Monocyte Monolayer Assay (MMA) is an in vitro simulation of red blood cell (RBC) alloantibody behavior. It has been classically applied to predict the risks of post-transfusion hemolytic reactions when transfusing incompatible RBC units. Quantifying erythrophagocytosis by MMA may be an interesting option for situations where there is doubt whether a RBC autoantibody is mediating significant hemolysis. Here, we present three situations involving RBC autoantibodies in which the MMA was decisive for clarifying the diagnosis and choosing the best clinical treatment. CASE REPORT: Case 1. Pregnant patient with severely anemic fetus exhibited warm autoantibody without signs of hemolysis. MMA revealed 30% of monocyte index (MI) highlighting that fetal hemolysis was caused by maternal autoantibody. Prednisone was prescribed with fetal clinical improvement. Cases 2 and 3. Two patients with the diagnosis of mixed auto-immune hemolytic anemia and poor response to corticosteroids were evaluated using MMA. The resulting MI was less than 10% in both cases, suggesting that the cold-agglutinin rather than the warm auto-IgG was responsible for overt hemolysis. Treatment with rituximab was begun, with good clinical response. CONCLUSION: MMA can be used to evaluate the ability of RBC autoantibodies to mediate overt hemolysis. It can be especially useful to determine the role played by cold and warm auto-antibodies in mixed auto-immune hemolytic disease, helping to define the best treatment option.

Evaluation of the applicability and effectiveness of a molecular strategy for identifying weak D and DEL phenotype among D- blood donors of mixed origin exhibiting high frequency of RHD*Ψ.

BACKGROUND: Molecular tests designed to detect the presence of active RHD gene among D- donors have been successfully applied in people of European ancestry, but not in admixed populations with a considerable frequency of RHD*Ψ. Our goal was to evaluate the performance of a molecular screening tool for identifying active RHD alleles among Brazilian blood donors classified as D- C+ and/or E+. STUDY DESIGN AND METHODS: Pools of five DNA samples of serologically D- C+ and/or E+ donors were checked by a RHD polymerase chain reaction (PCR) assay specific for RHD Intron 4 and Exon 7. When a pool result was positive, samples were genotyped individually for RHD Intron 4 and Exon 7, RHD*Ψ, RHCE*Cc, and RHD zygosity. Donors suspected of active RHD gene were further evaluated by whole-coding region and flanking intron direct sequencing. RESULTS: A total of 405 donors were included. Two percent exhibited active RHD gene, codifying D-weak (38 and 45) or DEL phenotype. The most prevalent DEL allele was RHD*DEL1 (c.1227G>A), which is proven to be immunogenic. A high frequency of RHD*Ψ was detected in the donors with nondeleted RHD alleles (31%), far superior to the frequency of RHD variant alleles (15.5%). The proposed approach presented sensitivity of 100% and specificity of 85.7% for identifying active RHD gene. CONCLUSION: The strategy of checking D- donors with RHD PCR followed by exclusion of RHD*Ψ allele has proved efficient in identifying weak-D and DEL phenotype in the Brazilian population.