Gestão do trabalho e o cuidado na Atenção Primária à Saúde durante pandemia de Covid-19 no município de São Paulo (SP), Brasil / Work management and care in Primary Health Care during the COVID-19 pandemic in the city of São Paulo (SP), Brazil

O município de São Paulo historicamente foi marcado pela heterogeneidade da implementação pela coexistência de modelos conflitivos de gestão do SUS e de atenção na Atenção Primária à Saúde (APS). Consolidou-se a administração via contratos de gestão dos serviços de saúde, associada a uma lógica produtivista. Durante a pandemia de COVID-19, as fragilidades de uma APS seletiva tendem a ser pronunciadas. Assim, o presente artigo tem como objetivo analisar a gestão do trabalho e o cuidado na APS durante a pandemia de COVID-19 no município de São Paulo, em pesquisa qualitativa multicêntrica, ancorada no referencial teórico Paideia. Foram realizadas 31 entrevistas em profundidade com usuários e trabalhadores da APS e observação participante. Observou-se postura autoritária e gerencialista da gestão municipal na condução das respostas, com pouco espaço para escuta e diálogo. Notou-se enfraquecimento dos espaços coletivos e do vínculo entre serviço e comunidade; burocratização e precarização dos processos de trabalho e desmantelamento do NASF. Neste cenário, o cuidado caracterizou-se pela redução expressiva da clínica ampliada, compartilhada e pelo distanciamento das diretrizes da APS de base territorial e comunitária.

Gestão do trabalho e o cuidado na Atenção Primária à Saúde durante pandemia de COVID-19 no município de São Paulo (SP), Brasil / Work management and care in Primary Health Care during the COVID-19 pandemic in the city of São Paulo (SP), Brazil

Resumo O município de São Paulo historicamente foi marcado pela heterogeneidade da implementação pela coexistência de modelos conflitivos de gestão do SUS e de atenção na Atenção Primária à Saúde (APS). Consolidou-se a administração via contratos de gestão dos serviços de saúde, associada a uma lógica produtivista. Durante a pandemia de COVID-19, as fragilidades de uma APS seletiva tendem a ser pronunciadas. Assim, o presente artigo tem como objetivo analisar a gestão do trabalho e o cuidado na APS durante a pandemia de COVID-19 no município de São Paulo, em pesquisa qualitativa multicêntrica, ancorada no referencial teórico Paideia. Foram realizadas 31 entrevistas em profundidade com usuários e trabalhadores da APS e observação participante. Observou-se postura autoritária e gerencialista da gestão municipal na condução das respostas, com pouco espaço para escuta e diálogo. Notou-se enfraquecimento dos espaços coletivos e do vínculo entre serviço e comunidade; burocratização e precarização dos processos de trabalho e desmantelamento do NASF. Neste cenário, o cuidado caracterizou-se pela redução expressiva da clínica ampliada, compartilhada e pelo distanciamento das diretrizes da APS de base territorial e comunitária.

Abstract The municipality of São Paulo has historically been marked by a heterogeneous implementation and coexistence of conflicting models of SUS management and Primary Health Care (PHC). The administration of health services management contracts was consolidated and associated with a productivist rationale. The selective PHC weaknesses tend to be pronounced during the COVID-19 pandemic. Thus, the present article aims to analyze work management and care in PHC during the COVID-19 pandemic in the municipality of São Paulo through a multicenter qualitative research anchored in the Paideia theoretical framework. We conducted 31 in-depth interviews with PHC clients and workers, along with participant observation. We noted the municipal management's authoritarian and managerialist stance when conducting the responses, with little room for listening and dialogue. We identified weakened collective spaces and service-community bond, bureaucratization and precariousness of work processes, and NASF's dismantling. In this setting, care was characterized by significantly reducing the expanded and shared clinical practice and the distancing from the territorial and community-based PHC guidelines.

Orange thyme: Phytochemical profiling, in vitro bioactivities of extracts and potential health benefits.

Orange thyme (Thymus fragrantissimus) is becoming widely used in food as a condiment and herbal tea, nevertheless its chemical composition and potential bioactivities are largely unknown. Thus the objective of this work is to obtain a detailed phytochemical profile of T. fragrantissimus by exhaustive ethanolic extraction and by aqueous decoction mimicking its consumption. Extracts showed high content in rosmarinic acid, luteolin-O-hexuronide and eriodictyol-O-hexuronide; these were the main phenolic compounds present in orange thyme accounting for 85% of the total phenolic compounds. Orange thyme extracts presented high scavenging activity against nitric oxide and superoxide radicals. Both extracts presented significant inhibitory effect of tyrosinase activity and moderate anti-acetylcholinesterase activity. Both extracts showed a good in vitro anti-inflammatory activity and a weak anti-proliferative/cytotoxic activity against Caco-2 and HepG2 cell lines supporting its safe use. Orange thyme is a very good source of bioactive compounds with potential use in different food and nutraceutical industries.

Programa de ejercicios de fuerza de los isquiosurales en pacientes con lesión del ligamento cruzado anterior, realizados en domicilio con mínima supervisión, compatibles con el confinamiento / Hamstring strength exercise program in patients with anterior cruciate ligament injury, performed at home with minimal supervision, compatible with confinement

Objetivo: Reportar los resultados del programa de ejercicios domiciliarios incrementales con mínima supervisión (PEDIMS), compatibles con el confinamiento, en el preoperatorio de lesiones de LCA, enfatizando la activación excéntrica de los isquiosurales agonistas del LCA. Materiales y métodos: se estudiaron seis hombres con lesiones del LCA en el preoperatorio para su reconstrucción. Se registraron las medidas de fuerza de los isquiosurales antes y después de realizar el PEDIMS, utilizamos el instrumento original DINABANG para obtener dichas mediciones. Este programa se implementó durante cuatro semanas; solamente se hicieron cinco consultas presenciales, el resto lo realizaron los pacientes en su domicilio. Resultados: comparando la rodilla sana contralateral, fuerza de 2.17 N/kg, con la lesionada, preentrenamiento y postentrenamiento, se observa el aumento de la fuerza de los isquiosurales en la rodilla con lesión del LCA, de 1.63 N/kg a 1.92 N/kg, respectivamente. Partiendo de una satisfacción subjetiva del 67% según el score de Lysholm, el entrenamiento logra un 87% de satisfacción; estos resultados son estadísticamente significativos.Conclusiones: para su aplicación en etapa preoperatoria del LCA, el PEDIMS es un programa clínico de fortalecimiento muscular flexor de la rodilla que reduce el número de sesiones presenciales, lo que le confiere al método una clara vigencia en épocas de pandemia o reducción presupuestaria. Nivel de Evidencia: V

Objective: To report the results of this lockdown-compliant, minimally supervised incremental home exercise program (PEDIMS, by its acronym in Spanish) in the preoperative stage of ACL injuries emphasizing the eccentric activation of the ACL agonist hamstrings. Materials and methods: six men with ACL injuries were studied in the preoperative ACL reconstruction stage. Hamstring strength measurements were recorded before and after performing the PEDIMS. We used the original DINABANG instrument to obtain these measurements. This program was carried out for four weeks, with only five face-to-face sessions and the rest at home by the patients.Results: comparing the healthy contralateral knee, strength of 2.17 N/kg, with the injured one pre-training and post-training, we obtained an increase in the strength of the hamstrings with ACL injury, of 1.63 N/kg to 1.92 N/kg, respectively. Starting from a subjective satisfaction of 67% according to the Lysholm score, the training achieves 87% satisfaction, these results are statistically significant. Conclusions: PEDIMS is a clinical program for knee flexor muscle strengthening for its application in the pre-operative stage of the ACL that reduces the number of face-to-face sessions, which gives the method a clear validity in times of pandemic or budget reduction. Level of Evidence: V

Descripción del movimiento de la rodilla en un deportista con lesión completa bilateral del ligamento cruzado anterior. Nota técnica / Description of the dynamic function of the knee in athlete with bilateral anterior cruciate ligament injury. Technical note

La rotación tibial y la migración del punto de contacto tibiofemoral a lo largo del platillo tibial, y durante la tarea motora de subir un escalón de 17 cm de altura, difieren entre las medidas tomadas en un individuo con lesión bilateral de ligamento cruzado anterior y las de un voluntario saludable. Al subir el escalón, la rotación promedio de la tibia de ambos miembros inferiores cambia de 25 a 14°, y para el caso del voluntario sano, de 20 a 5°. La migración del punto de contacto, en cambio, está muy alterada ya que cambia de 30% a 45%, mientras que para el voluntario cambia de 45 a 80%. Esta metodología cuantitativa denominada CINARTRO permite evaluar objetivamente la función dinámica de la rodilla, realizar el diagnóstico funcional y orientar la rehabilitación con mayor exactitud y eficiencia. Nivel de evidencia: V

Tibial rotation and migration of the tibiofemoral contact point along the tibial plateau during the motor task of climbing a step of 17 cm of height differ between measurements taken in an individual with bilateral anterior cruciate ligament full injury and those of a healthy volunteer. During step negotiation the mean rotation of both lower limbs changes from 25 to 14° and the healthy volunteer 20° to 5°. The contact point migration changes from (bilateral injury) 30 to 45% and (healthy) 45 to 80%. These measurements of 3D stereophotogrammetry and videofluoroscopy (CINARTRO) allow to performance an evaluation of the dynamic function of the knee for a functional diagnosis and follow up and rehabilitation with greater accuracy and efficiency than in the absence of this objective evaluation. Level of evidence: V

CINAR-XLS: Herramienta de consolidación de datos de la biomecánica de la rodilla para su análisis poblacional / CINAR-XLS: Merging Tool for Knee Biomechanics Data Analysis

Introducción: CINARTRO es un instrumento original que permite determinar los parámetros biomecánicos de la rodilla en movimiento durante la rehabilitación, al realizar tareas motoras. Se calculan el punto de contacto tibio-femoral y el brazo de palanca a partir de la videofluorscopía, lo que permite definir el estado funcional dinámico de la rodilla. Objetivo: Diseñar e implementar CINAR-XLS que consolide los datos generados por CINARTRO para realizar análisis poblacionales. Método: Se desarrolla una plataforma Java que reúne archivos de resultados de varios pacientes y los unifica en un archivo XLS. Compatible Linux y Windows, CINAR-XLS tiene una interfaz de usuario amigable. Resultados: Se obtiene una herramienta de informática médica que aporta el eslabón faltante entre la producción clínica de datos de la biomecánica de la rodilla y la capacidad de realizar fácilmente estudios epidemiológicos y de caracterización fisiológica de la rodilla en movimiento. Conclusión: Esta realización interdisciplinaria es una contribución al aprovechamiento inmediato de datos clínicos (datamining) a cargo del personal asistencial y de investigación médica(AU)

Introduction: CINARTRO is an original instrument to calculate mechanical parameters of the moving knee during rehabilitation motor tasks. The interactive software calculates the tibio-femoral contact point and the moment arm from videofluoroscopic images, which allows to define the knee functional behavior. Objective: Design and implement CINAR-XLS to merge data created by CINARTRO for subsequent population analyses. Method: Development of a Java platform to join several patient results files into an XLS file. CINAR-XLS is compatible with Linux and Windows through a friendly user interface. Results: We have obtained a medical informatics tool to fill in the missing link between knee clinical biomechanics data production and epidemiological data analysis. The tool is also useful to characterize the physiology of the moving knee. Conclusion: This interdisciplinary achievement is a contribution to easy clinical data processing (datamining) by health personnel and medical research staff(AU)

Possible ways for Public Health Surveillance practices evaluation. / Caminhos possíveis para a avaliação das práticas da Vigilância em Saúde.

This is an evaluative and qualitative study that proposes to investigate self-assessment evaluation as a device to analyze Health Surveillance practices through a questionnaire built by researchers, adapted from the Self-Assessment of Improved Access and Primary Care Quality (AMAQ) and available on the FORMSUS platform. Forty-one Health Surveillance workers and managers of a large municipality from São Paulo State evaluated the realms of "management", "teamwork" and their respective sub-realms. Two categories were created to analyze the results: "Management" and "Team" in dialogue with references from Management, Evaluation and Health Surveillance. Most "management" and "teamwork" sub-realms were deemed satisfactory. Self-assessment evaluation through an applied evaluation tool was shown to be a powerful resource for the analysis of Health Surveillance practices in combination with other devices adopted by the Unified Health System (SUS). Unlike usual evaluation processes guided by quantitative markers, this self-assessable evaluative process included subjects and enabled the possibility of incorporating a new look at itself to the way Health Surveillance is carried out and support future management contracts between workers and managers.

Resumo Trata-se de pesquisa avaliativa, qualitativa que se propôs investigar a autoavaliação como dispositivo de análise das práticas da Vigilância em Saúde, valendo-se de questionário construído pelos pesquisadores, adaptado da Autovaliação da Melhoria do Acesso e da Qualidade da Atenção Básica (AMAQ) e disponibilizado na plataforma FORMSUS. Quarenta e um trabalhadores e gestores da Vigilância em Saúde de um município de grande porte do estado de São Paulo avaliaram as dimensões da "gestão" e "trabalho da equipe" e suas respectivas subdimensões. Criaram-se duas categorias de análise dos resultados: "Gestão" e "Equipe", em diálogo com referenciais da Gestão, Avaliação e Vigilância em Saúde. A maior parte das subdimensões da "gestão" e "trabalho da equipe" foram avaliadas como satisfatórias. A autoavaliação, mediante o instrumento aplicado, mostrou-se potente para a análise das práticas da Vigilância em Saúde, em conjunto com outros dispositivos adotados no SUS. Diferentemente dos processos habituais de avaliação, pautados em indicadores quantitativos, este processo autoavaliativo incluiu os sujeitos e trouxe a possibilidade de incorporar aos modos de fazer da Vigilância em Saúde o olhar para si e sustentar futuros contratos de gestão entre trabalhadores e gestores.

Caminhos possíveis para a avaliação das práticas da Vigilância em Saúde / Possible ways for Public Health Surveillance practices evaluation

Resumo Trata-se de pesquisa avaliativa, qualitativa que se propôs investigar a autoavaliação como dispositivo de análise das práticas da Vigilância em Saúde, valendo-se de questionário construído pelos pesquisadores, adaptado da Autovaliação da Melhoria do Acesso e da Qualidade da Atenção Básica (AMAQ) e disponibilizado na plataforma FORMSUS. Quarenta e um trabalhadores e gestores da Vigilância em Saúde de um município de grande porte do estado de São Paulo avaliaram as dimensões da "gestão" e "trabalho da equipe" e suas respectivas subdimensões. Criaram-se duas categorias de análise dos resultados: "Gestão" e "Equipe", em diálogo com referenciais da Gestão, Avaliação e Vigilância em Saúde. A maior parte das subdimensões da "gestão" e "trabalho da equipe" foram avaliadas como satisfatórias. A autoavaliação, mediante o instrumento aplicado, mostrou-se potente para a análise das práticas da Vigilância em Saúde, em conjunto com outros dispositivos adotados no SUS. Diferentemente dos processos habituais de avaliação, pautados em indicadores quantitativos, este processo autoavaliativo incluiu os sujeitos e trouxe a possibilidade de incorporar aos modos de fazer da Vigilância em Saúde o olhar para si e sustentar futuros contratos de gestão entre trabalhadores e gestores.

Abstract This is an evaluative and qualitative study that proposes to investigate self-assessment evaluation as a device to analyze Health Surveillance practices through a questionnaire built by researchers, adapted from the Self-Assessment of Improved Access and Primary Care Quality (AMAQ) and available on the FORMSUS platform. Forty-one Health Surveillance workers and managers of a large municipality from São Paulo State evaluated the realms of "management", "teamwork" and their respective sub-realms. Two categories were created to analyze the results: "Management" and "Team" in dialogue with references from Management, Evaluation and Health Surveillance. Most "management" and "teamwork" sub-realms were deemed satisfactory. Self-assessment evaluation through an applied evaluation tool was shown to be a powerful resource for the analysis of Health Surveillance practices in combination with other devices adopted by the Unified Health System (SUS). Unlike usual evaluation processes guided by quantitative markers, this self-assessable evaluative process included subjects and enabled the possibility of incorporating a new look at itself to the way Health Surveillance is carried out and support future management contracts between workers and managers.

Mercury Amalgam Diffusion in Human Teeth Probed Using Femtosecond LIBS.

In this work the diffusion of mercury and other elements from amalgam tooth restorations through the surrounding dental tissue (dentin) was evaluated using femtosecond laser-induced breakdown spectroscopy (fs-LIBS). To achieve this, seven deciduous and eight permanent extracted human molar teeth with occlusal amalgam restorations were half-sectioned and analyzed using pulses from a femtosecond laser. The measurements were performed from the amalgam restoration along the amalgam/dentin interface to the apical direction. It was possible to observe the presence of metallic elements (silver, mercury, copper and tin) emission lines, as well as dental constituent ones, providing fingerprints of each material and comparable data for checking the consistence of the results. It was also shown that the elements penetration depth values in each tooth are usually similar and consistent, for both deciduous and permanent teeth, indicating that all the metals diffuse into the dentin by the same mechanism. We propose that this diffusion mechanism is mainly through liquid dragging inside the dentin tubules. The mercury diffused further in permanent teeth than in deciduous teeth, probably due to the longer diffusion times due to the age of the restorations. It was possible to conclude that the proposed femtosecond-LIBS system can detect the presence of metals in the dental tissue, among the tooth constituent elements, and map the distribution of endogenous and exogenous chemical elements, with a spatial resolution that can be brought under 100 µm.

Distribution of superoxide dismutase 1 and glutathione peroxidase 1 in the cyclic canine endometrium.

Superoxide dismutase (SOD) and glutathione peroxidase (GPx) are two important antioxidant enzymes involved in tissue homeostasis by protecting cells and tissues from an accumulation of reactive oxygen species. Information concerning antioxidant enzymes in the canine uterus is almost inexistent. This work intends to establish the pattern of distribution of SOD1 and GPx1 immunoreaction in canine endometrium throughout the estrous cycle, using 46 endometrium samples of healthy dogs representing different cycle stages (anestrus-10, proestrus-10, estrus-10, early diestrus-7, and diestrus-9). SOD1 distribution in canine endometrium showed cyclic variations (P ≤ 0.001), with higher immunoscores in the progesterone-associated stages. Changing immunoreaction also concerned the different epithelial structures considered (surface epithelium, superficial glandular epithelium, and deep glandular epithelium) (P ≤ 0.001), but it was always higher than in the stroma (P ≤ 0.001). Deep glandular epithelial cells usually showed higher scores of immunoreaction compared with the other epithelial cells. Interestingly, in epithelial cells, distinct subcellular patterns for SOD1 were seen: the nuclear labeling was observed in estrus and early diestrus (P ≤ 0.001), whereas an apical reinforcement was observed in estrus (P = 0.011) in the glandular epithelia but not in the surface epithelia. In general, GPx1 distribution in canine endometrium remained relatively unchanged throughout the estrous cycle (P = 0.169) despite the slight decrease observed from proestrus to early diestrus. The highest scores were found in anestrus and diestrus (P < 0.05), varying with of the structure considered. An apical reinforcement pattern was also found for this molecule, which peaked in proestrus and estrus (P < 0.005). In summary, the present study showed that SOD1 and GPx1 are consistently distributed in the canine endometrium. The cyclic changes registered for both molecules suggest that they may play important roles in endometrial physiology, probably in apoptosis and proliferation.

Measuring Mitochondrial Membrane Potential with a Tetraphenylphosphonium-Selective Electrode.

Mitochondrial bioenergetics is based on the generation of the protonmotive force by the electron transport chain. The protonmotive force is used by mitochondria for different critical aspects of its normal function, ranging from calcium accumulation to the synthesis of ATP. The transmembrane electric potential (ΔΨ) is the major component of the protonmotive force and is also the main responsible for ATP synthesis by mitochondrial ATP synthase. Although several methods can be used to measure the ΔΨ, the use of the tetraphenylphosphonium cation (TPP(+))-selective electrode is still a method of election due to its sensitivity. The method is based on the accumulation of TPP(+) by energized mitochondria, which develop a negative charge in the matrix due to the ejection of protons. This unit describes how to build a custom-made TPP(+)-selective electrode and how to establish the necessary set-up to follow ΔΨ fluctuations in isolated mitochondrial fractions.

Direct determination of the nutrient profile in plant materials by femtosecond laser-induced breakdown spectroscopy.

Femtosecond laser-induced breakdown spectroscopy (fs-LIBS) has been used for the first time for quantitative determination of nutrients in plant materials from different crops. A highly heterogeneous population of 31 samples, previously analyzed by inductively coupled plasma optical emission spectroscopy, covering a wide range of matrices was interrogated. To tackle the analysis, laser-induced plasmas under argon atmosphere of pellets prepared from sieved cryogenically ground leaves were studied. Predictive functions based on univariate and multivariate modeling of optical emissions associated to macro- (Ca, Mg, and P) and micronutrients (Cu, Fe, Mn and Zn) were designed. Hierarchical cluster analysis was performed to select representative calibration (n(cal)=17) and validation (n(val)=14) datasets. The predictive performance of calibration functions over fs-LIBS data was compared with that attained on spectral information from nanosecond LIBS (ns-LIBS) operating at different wavelengths (1064 nm, 532 nm, and 266 nm). Findings established higher accuracy and less uncertainty on mass fractions quantification from fs-LIBS, whatever the modeling approach. Quality coefficients below 20% for the accuracy error on mass fractions' prediction in unknown samples, and residual predictive deviations in general above 5, were obtained. In contrast, only multivariate modeling satisfactorily handled the non-linear variations of emissions in ns-LIBS, leading to 2-fold decrease in the root mean square error of prediction (RMSEP) of Ca, Mg, P, Cu, Fe, Mn and Zn in comparison with the univariate approach. But still, an averaged quality coefficient about 35% and residual predictive deviations below 3 were found. Similar predictive capabilities were observed when changing the laser wavelength. Although predicted values by ns-LIBS multivariate modeling exhibit better agreement with reference mass fractions as compared to univariate functions, fs-LIBS conducts better quantification of nutrients in plant materials since it is less dependent on the chemical composition of the matrices.

Surface engineering of silica nanoparticles for oral insulin delivery: characterization and cell toxicity studies.

The present work aimed at studying the interaction between insulin and SiNP surfaced with mucoadhesive polymers (chitosan, sodium alginate or polyethylene glycol) and the evaluation of their biocompatibility with HepG2 and Caco-2 cell lines, which mimic in vivo the target of insulin-loaded nanoparticles upon oral administration. Thus, a systematic physicochemical study of the surface-modified insulin-silica nanoparticles (Ins-SiNP) using mucoadhesive polymers has been described. The surfacing of nanoparticle involved the coating of silica nanoparticles (SiNP) with different mucoadhesive polymers, to achieve high contact between the systems and the gut mucosa to enhance the oral insulin bioavailability. SiNP were prepared by a modified Stöber method at room temperature via hydrolysis and condensation of tetraethyl orthosilicate (TEOS). Interaction between insulin and nanoparticles was assessed by differential scanning calorimetry (DSC), X-ray and Fourier-transform infrared (FTIR) studies. The high efficiency of nanoparticles' coating resulted in more stable system. FTIR spectra of insulin-loaded nanoparticles showed amide absorption bands which are characteristic of α-helix content. In general, all developed nanoparticles demonstrated high biocompatible, at the tested concentrations (50-500 µg/mL), revealing no or low toxicity in the two human cancer cell lines (HepG2 and Caco-2). In conclusion, the developed insulin-loaded SiNP surfaced with mucoadhesive polymers demonstrated its added value for oral administration of proteins.

Cationic solid lipid nanoparticles interfere with the activity of antioxidant enzymes in hepatocellular carcinoma cells.

Solid lipid nanoparticles (SLN) are colloidal drug and/or gene carriers developed from solid lipids and surfactants that are considered safe. Cationic SLN, usually used for formulating poorly water-soluble drugs and for gene delivery purposes, as positively charged particles may attach to cellular surfaces and be internalized more easily than negatively charged SLN, but they can also cause damage. The main aim of this work was to test a set of cationic SLN and investigate its influence on the amount of reactive oxygen species (ROS), on antioxidant enzymes activities and on possible oxidative damage to membrane lipids in HepG2 cells. The Dichlorofluorescein assay revealed great increase in ROS presence after cell exposure to SLN. While the exposure to SLN increased the activities of superoxide dismutase and glutathione peroxidase it decreased glutathione reductase activity. Although no significant increase in thiobarbituric reactive species was found, a decrease in sulfhydryl groups was detected. These results indicate that cationic SLN caused oxidative stress in HepG2 cells, but under reported exposure conditions HepG2 cells could attenuate the stress and thus the damage to cellular components was minimal.

Endopolysaccharides from Ganoderma resinaceum, Phlebia rufa, and Trametes versicolor affect differently the proliferation rate of HepG2 cells.

Fungi have been used for medicinal purposes for long time by Asian countries, being a putative source of powerful new phytopharmaceuticals such as polysaccharides. The aim of this study was to extract endopolysaccharides (IPS) from Ganoderma resinaceum, Phlebia rufa, and Trametes versicolor, grown under submerged culture, to compare crude IPS production, total carbohydrate, and protein yield, and to study the effect of these IPS on HepG2 cells proliferation rate. Total biomass produced by G. resinaceum, P. rufa, and T. versicolor was (in gram per liter) 3.32 ± 0.80, 5.42 ± 0.58, and 4.2 ± 1.29 and the IPS yield (as the biomass percent) was 9.9 ± 0.05, 29.0 ± 6.3, and 9.1 ± 3.1 %, respectively. Characterization of IPS has shown different proportion between total sugar and protein being, on average 6.04, 10.74, and 22.62, for G. resinaceum, T. versicolor, and P. rufa, respectively. The IPS effect, at 50, 100, and 200 µg mL(-1) on HepG2 cell growth and viability was negligible for G. resinaceum and P. rufa but, in the case of T. versicolor, 200 µg mL(-1) of IPS evoked 40 % reduction on cell growth. The results suggest that the intracellular polysaccharides from T. versicolor are a potential source for bioactive molecules with anti-proliferative properties.

Nerolidol effects on mitochondrial and cellular energetics.

In the present work, we evaluated the potential toxic effects of nerolidol, a sesquiterpenoid common in plants essential oils, both on mitochondrial and cellular energetics. Samples of enriched natural extracts of nerolidol (a racemic mixture of cis and trans isomers) were tested on rat liver mitochondria and a decrease in phosphorylative system was observed but not in the mitochondrial respiratory chain activity, which reflects a direct effect on F1-ATPase. Hence, respiratory control ratio was also decreased. Cellular ATP/ADP levels were significantly decreased in a concentration-dependent manner, possibly due to the direct effect of nerolidol on F(0)F(1)-ATPsynthase. Nerolidol stimulates respiratory activity probably due to an unspecific effect, since it does not show any protonophoric effect. Furthermore, we observed that mitochondrial permeability transition was delayed in the presence of nerolidol, possibly due to its antioxidant activity and because this compound decreases mitochondrial transmembrane electric potential. Our results also show that, in human hepatocellular liver carcinoma cell line (HepG2), nerolidol both induces cell death and arrests cell growth, probably related with the observed lower bioenergetic efficiency.

Evaluacion del equilibrio durante la marcha a velocidad autoseleccionada en jovenes saludables, adultos mayores no caedores y adultos mayores con alto riesgo de caidas / Assessment of balance during gait at a self-elected speed in healthy youngsters, elderly persons who do not fall and elderly persons with a high risk of falls

Introduccion: el equilibrio depende de mantener la proyeccion del centro de masa corporal dentro de los limites de la base de sustentacion, pero su valoracion se realiza habitualmente en forma indirecta a traves de la variabilidad cinematica. Objetivos: analizar el equilibrio durante la marcha a velocidad autoseleccionada en tres poblaciones de sujetos utilizando diferentes abordajes. Material y metodo: los grupos analizados fueron: jovenes saludables, adultos mayores no caedores y adultos mayores caedores. Mediante analisis cinematico tridimensional se calculo: velocidad, variabilidad temporal, variabilidad angular de rodilla y el equilibrio duranteciclos de marcha. Para el calculo directo del equilibrio se definio una variable considerando la proyeccion del centro de masa corporal y la base de sustentacion. Los resultados de las variables cinematicas fueron comparados entre los grupos mediante ANOVA (alfa=0,05). Deigual forma se procedio con los valores medio, maximo y minimo de la estimacion directa del equilibrio entre grupos para las fases de apoyo simple y doble del ciclo. Resultados: la velocidad de ciclo fue similar entre los adultos mayores. En los jovenes saludables la variabilidad temporal del ciclo fue baja y la variabilidad angular de rodilla alta y estas variables no mostraron diferencias entre los grupos de adultos mayores. Durante tamla fase de apoyo simple los valores medio y minimo de equilibrio para el grupo de caedores fueron significativamente diferentes respecto a los demas grupos. Conclusiones: la estimacion directa del equilibrio durante la fase de apoyo simple surge como una potencial herramienta para la identificacion de individuos con riesgo de caida.

Introduction: balance depends on keeping the projection of the center of body mass within the limits of the support basis, although its assessment is usually performed by means of cinematic variability. Objectives: to analyse balance during gait at a selfelected speed in three populations using different approaches. Method: the groups analysed were: healthy youngsters, elderly who do not fall and elderly who fall. We calculated speed, time variability, angle variability of knee and balance during gait cycles through a tridimensional cinematic analysis. To directly calculate balance we defineda variable considering the projection of the center of body mass. Results of the cinematic variables were compared between groups using ANOVA (a=0,05). Similarly we compared average, maximum and minimum values ofthe direct balance estimation between groups for simple support and double cycle stages. Results: cycle speed was similar in elderly persons. Time variability of cycle was low and angle variability was high in healthy youngsters, while these variables evidenced no difference between the elderly persons groups. During the simple support stage average and minimum balance values for the group of people who fall were significantly different if compared to the other groups. Conclusions: direct estimation of balance during the simple support stage appears as a potential tool to identify individuals with a risk of falls.

Introdução: o equilibrio depende da manutenção da projeção do centro de massa corporea dentro dos limitesda base de apoio, mas sua avaliação é feita habitualmente de maneira indireta utilizando variabilidade cinematica. Objetivos: analisar o equilibrio durante a marcha em velocidade auto-selecionada em tres populações de pessoas utilizando diferentes abordagens. Material e metodo: os grupos analisados foram: jovens saudaveis, adultos idosos não caidores e adultos idosos caidores. Utilizando analise cinematica tridimensional foram calculadas a velocidade, a variabilidade temporal, avariabilidade angular do joelho e o equilibro durante os ciclos da marcha. Para fazer o calculo direto do equilibrio definiu-se uma variavel considerando a projeção do centro de massa corporea e a base de apoio. A comparação entre os resultados das variaveis sistematicas entre os grupos foi feita usando ANOVA (a=0,05) e tambem para comparar os valores minimo, medio e maximo da estimativa direta para as fases de apoio simples e duplo do ciclo. Resultados: a velocidade de ciclo foi similar entre os dois grupos de idosos. No grupo de jovens saudaveis a variabilidade temporal do ciclo foi baixa e a variabilidade angular do joelho alta e não se encontraram diferenças nessas variaveis entre os dois grupos de idosos. Durante a fase de apoio simples os valores medio e minimo de equilibrio para o grupo de caidores foram significativamente diferentes quando comparados com os outros grupos. Conclusões: a estimativa direta do equilibrio durante a fase de apoio simples pode ser uma ferramenta potencial para a identificação de individuos com risco de queda.

Evaluation of grinding methods for pellets preparation aiming at the analysis of plant materials by laser induced breakdown spectrometry.

It has been demonstrated that laser induced breakdown spectrometry (LIBS) can be used as an alternative method for the determination of macro (P, K, Ca, Mg) and micronutrients (B, Fe, Cu, Mn, Zn) in pellets of plant materials. However, information is required regarding the sample preparation for plant analysis by LIBS. In this work, methods involving cryogenic grinding and planetary ball milling were evaluated for leaves comminution before pellets preparation. The particle sizes were associated to chemical sample properties such as fiber and cellulose contents, as well as to pellets porosity and density. The pellets were ablated at 30 different sites by applying 25 laser pulses per site (Nd:YAG@1064 nm, 5 ns, 10 Hz, 25J cm(-2)). The plasma emission collected by lenses was directed through an optical fiber towards a high resolution echelle spectrometer equipped with an ICCD. Delay time and integration time gate were fixed at 2.0 and 4.5 µs, respectively. Experiments carried out with pellets of sugarcane, orange tree and soy leaves showed a significant effect of the plant species for choosing the most appropriate grinding conditions. By using ball milling with agate materials, 20 min grinding for orange tree and soy, and 60 min for sugarcane leaves led to particle size distributions generally lower than 75 µm. Cryogenic grinding yielded similar particle size distributions after 10 min for orange tree, 20 min for soy and 30 min for sugarcane leaves. There was up to 50% emission signal enhancement on LIBS measurements for most elements by improving particle size distribution and consequently the pellet porosity.

Are fentanyl and remifentanil safe opioids for rat brain mitochondrial bioenergetics?

Fentanyl and remifentanil are potent opioid widely used in routine anesthesia procedures. This study evaluates and compares the effects of fentanyl/remifentanil in isolated brain mitochondria bioenergetic status. Fentanyl and remifentanil in clinical concentrations does not interfere with rat brain isolated mitochondria. Do not withstand, fentanyl concentrations >4 microg/mL, induces an impairment of the respiratory chain characterized by a decrease in respiratory control ratio, state 3 and uncoupled respiration. Additionally, membrane potential collapses and ADP/O were reduced. Remifentanil follows the same profile but with effects at higher concentrations (>10 microg/mL). High concentrations of fentanyl and remifentanil interfere with mitochondrial electron chain (complexes III, IV) and on mitochondrial phosphorylation unit (complex V). Mitochondrial permeability transition pore was not induced by both fentanyl and remifentanil in tested concentrations. These data provide the first indication that fentanyl and remifentanil (microg/mL range) alters mitochondrial metabolism. Fentanyl showed a stronger inhibitory effect on mitochondrial bioenergetics.