Francisella salimarina infection in farmed cobia (Rachycentron canadum) and dusky grouper (Epinephelus marginatus) in Brazil: A case report.

This study aimed to identify and characterize isolates of Francisella salimarina associated with an outbreak on a marine fish farm in Brazil and to analyse their genetic variability and antimicrobial susceptibility. In 2021, diseased cobias (Rachycentron canadum, n = 10) and dusky groupers (Epinephelus marginatus, n = 10) were sampled and subjected to bacteriological and pathological examinations. The isolates obtained were morphologically and biochemically characterized and identified by matrix-assisted laser desorption/ionization-time of flight (MALDI-ToF) and 16S rRNA gene sequencing. The genetic diversity of these isolates was analysed using repetitive extragenic palindromic-polymerase chain reaction (REP-PCR). Antimicrobial susceptibility was assessed using the disk diffusion technique. Macroscopically, the fish presented skin ulcerations, ocular lesions, hepatomegaly and splenomegaly. A pleomorphic, gram-negative, catalase- and oxidase-positive bacterium was isolated from seven cobias and two groupers. The 16S rRNA gene sequences showed >99% coverage and identity with other deposited sequences of F. salimarina. The results of the biochemical analysis corresponded to these bacterial species. Histologically, granulomas were observed in the spleen, liver and heart of the cobias (n = 6), and necrotizing and fibrinous dermatitis and myositis were identified in some groupers (n = 2). The isolates exhibited the same banding pattern when REP-PCR was performed, indicating that they were clonally related. Finally, the antibiogram test, no inhibition halo was observed for amoxicillin and trimethoprim-sulfamethoxazole. To our knowledge, this is the first report of F. salimarina infection in cobias and dusky groupers.

Lentil protein isolate (Lens culinaris) subjected to ultrasound treatment combined or not with heat-treatment: structural characterization and ability to stabilize high internal phase emulsions.

This study evaluated the effect of ultrasound treatment combined or not with heat treatment applied to lentil protein isolate (LPI) aiming to enhance its ability to stabilize high internal phase emulsions (HIPE). LPI dispersion (2%, w/w) was ultrasound-treated at 60% (UA) and 70% (UB) amplitude for 7 min; these samples were subjected to and then heat treatments at 70 °C (UAT70 and UBT70, respectively) or 80 °C (UAT80 and UBT80, respectively) for 20 min. HIPEs were produced with 25% untreated and treated LPI dispersions and 75% soybean oil using a rotor-stator (15,500 rpm/1 min). The LPI dispersions were evaluated for particle size, solubility, differential scanning calorimetry, electrophoresis, secondary structure estimation (circular dichroism and FT-IR), intrinsic fluorescence, surface hydrophobicity, and free sulfhydryl groups content. The HIPEs were evaluated for droplet size, morphology, rheology, centrifugal stability, and the Turbiscan test. Ultrasound treatment decreased LPI dispersions' particle size (∼80%) and increased solubility (∼90%). Intrinsic fluorescence and surface hydrophobicity confirmed LPI modification due to the exposure to hydrophobic patches. The combination of ultrasound and heat treatments resulted in a reduction in the free sulfhydryl group content of LPI. HIPEs produced with ultrasound-heat-treated LPI had a lower droplet size distribution mode, greater oil retention values in the HIPE structure (> 98%), lower Turbiscan stability index (< 2), and a firmer and more homogeneous appearance compared to HIPE produced with untreated LPI, indicating higher stability for the HIPEs stabilized by treated LPI. Therefore, combining ultrasound and heat treatments could be an effective method for the functional modification of lentil proteins, allowing their application as HIPE emulsifiers.

Can Salvinia auriculata bioremediate the toxic effects of Fipronil 800wg on the tadpoles of Dendropsophus minutus?

Worldwide, the indiscriminate and escalating application of pesticides has led to extensive impacts on both the environment and non-target organisms. Phytoremediation, which employs plants to decontaminate environments, is a potential strategy for the mitigation of this damage. The present study assessed the phytoremedial potential of Salvinia auriculata, an aquatic macrophyte known to be effective for the removal of environmental contaminants. In the laboratory, Dendropsophus minutus tadpoles were exposed to different concentrations (0.035, 0.1, 1.0, and 1.5 mg/l) of the commercial insecticide Fipronil 800wg in two treatments - (i) simple exposure for 96 h, and (ii) exposure for 168 h in aquariums containing S. auriculata. In the first experiment, a mortality rate of 33.3 % was recorded at the highest Fipronil concentration (1.5 mg/l), and genotoxic parameters increased at all concentrations except 0.035 mg/L, in comparison with the control. In the second experiment, phytoremediation occurred at all the concentrations tested, with lower frequencies of cells with micronuclei, and binucleated, anucleated, and pyknotic nuclei being observed, in comparison with the first experiment. These findings highlight the potential effectiveness of S. auriculata for the phytoremediation of environments contaminated by pesticides and contribute to the understanding of the benefits of this approach for the protection and preservation of aquatic biodiversity.

Exploring the antifungal potential of Annona muricata leaf extract-loaded hydrogel in treating vulvovaginal candidiasis.

Vulvovaginal candidiasis, mostly caused by Candida albicans, remains a prevalent concern in women's health. Annona muricata L. (Annonaceae), a plant native from Brazil, is well-known for its therapeutic potential, including antitumor, anti-inflammatory, and antimicrobial properties. This study presents an innovative hydrogel formulation containing the ethanolic extract from A. muricata leaves designed to control C. albicans in an in vivo model of vulvovaginal candidiasis. Here, we report the development, thermal, physicochemical and rheological characterization of a Carbopol®-based hydrogel containing A. muricata extract. Furthermore, we evaluated its activity in a vulvovaginal candidiasis in vivo model. Thermal analyses indicated that the addition of the extract increased the polymer-polymer and polymer-solvent interactions.Rheological analysis showed a decrease in the viscosity and elasticity of the formulation as the A. muricata extract concentration increased, suggesting a liquid-like behavior. After treatment with the Carbopol®-based hydrogel with A. muricata, our in vivo results showed a significant reduction in vulvovaginal fungal burden and infection, as well as a reduction in mucosal inflammation. The current research opens up possibilities for the application of the Carbopol®-based hydrogel with A. muricata as a natural therapeutic option for the treatment of vulvovaginal candidiasis.

Assessment of Gastroenteric Viruses in Marketed Bivalve Mollusks in the Tourist Cities of Rio de Janeiro, Brazil, 2022.

This study investigated the prevalence and genetic diversity of gastroenteric viruses in mussels and oysters in Rio de Janeiro, Brazil. One hundred and thirty-four marketed bivalve samples were obtained between January and December 2022. The viral analysis was performed according to ISO/TS 15216, and the screening revealed the detection of norovirus GII/GI (40.3%), sapovirus (SaV; 12.7%), human mastadenovirus (7.5%), and rotavirus A (RVA; 5.9%). In total, 44.8% (60) of shellfish samples tested positive for one or more viruses, 46.7% (28/60) of the positive samples tested positive for a single viral agent, 26.7% (16) tested positive for two viral agents, 8.3% (5) for three viral agents, and 13.3% (8) for four viral agents. Additionally, three mussel samples were contaminated with the five investigated viruses (5%, 3/60). Norovirus GII showed the highest mean viral load (3.4 × 105 GC/g), followed by SaV (1.4 × 104 GC/g), RVA (1.1 × 104 GC/g), human mastadenovirus (3.9 × 103 GC/g), and norovirus GI (6.7 × 102 GC/g). Molecular characterization revealed that the recovered norovirus strains belonged to genotypes GII.2, GII.6, GII.9, GII.17, and GII.27; SaV belonged to genotypes GI.1 and GIV.1; RVA to genotypes G6, G8, P[8]-III, and human mastadenovirus to types F40 and F41. The GII.27 norovirus characterized in this study is the only strain of this genotype reported in Brazil. This study highlights the dissemination and diversity of gastroenteric viruses present in commercialized bivalves in a touristic area, indicating the potential risk to human health and the contribution of bivalves in the propagation of emerging pathogens.

CHARACTERIZATION OF THE FUNGAL MICROBIOTA IN THE NOSTRILS AND RECTUM OF AMAZONIAN MANATEES (TRICHECHUS INUNGUIS) FROM A REHABILITATION PROGRAM IN BRAZIL.

The present study characterized the filamentous and yeast-like fungal microbiota of the nasal cavity and rectum of Amazonian manatees (Trichechus inunguis) undergoing rehabilitation at the Laboratory of Aquatic Mammals, National Institute of Amazonian Research, Manaus, Amazonas, and determined the antifungal susceptibility of these organisms. Nasal and rectal swabs were collected from 22 calves and three juveniles. The samples were seeded in Sabouraud agar supplemented with chloramphenicol 10%, incubated at 26°C, and observed daily for up to 7 d. The growth of different filamentous and yeast-like fungi was observed among the two anatomical sites. Filamentous fungi were categorized by macro- and microscopic characteristics of the colonies. Representatives of each group were selected for molecular identification based on the internal transcribed spacer region. Yeast identification was performed using MALDI-TOF MS and molecular analyses. Thirteen genera of filamentous fungi and six genera of yeasts were isolated and identified. The dominant filamentous species were Fusarium spp., Aspergillus spp., and Cochliobolus lunatus in the nostril samples and Aspergillus melleus in the rectal samples. Candida was the dominant genus among the identified yeasts at both anatomical sites. In the antifungal susceptibility test, 28 isolates showed resistance to fluconazole (78%), itraconazole (39%), and nystatin (42%). The knowledge of fungal microbiota composition of Amazonian manatees provides information that assists in monitoring the health status of individuals maintained in captivity, as these organisms can behave either as opportunists or as primary pathogens. Moreover, the composition and resistance of these organisms may vary among different rehabilitation institutions or different time frames of search, reinforcing the importance of constant in loco surveillance of these microorganisms. This study provides new perspectives on the fungal diversity in the microbiota of manatees and supports future studies concerning the clinical and epidemiological aspects and the impacts of these agents on the health of Amazonian manatees undergoing rehabilitation.

Evaluation of Extraction Methods to Detect Noroviruses in Ready-to-Eat Raw Milk Minas Artisanal Cheese.

This study aimed to assess two homogenization methods to recover norovirus from Minas artisanal cheese (MAC) made with raw bovine milk obtained from four microregions of the Minas Gerais state, Brazil, with different ripening times and geographical and abiotic characteristics. For this purpose, 33 fiscal samples were artificially contaminated with norovirus GI and GII, and Mengovirus (MgV), used as an internal process control (IPC). TRIzol® reagent and Proteinase K homogenization methods were evaluated for all samples were then subjected to RNA extraction using viral magnetic beads and RT-qPCR Taqman® for viral detection/quantification. Proteinase K method showed better efficiency results for both norovirus GI and GII, with means recovery efficiency of 45.7% (95% CI 34.3-57.2%) and 41.4% (95% CI 29.1-53.6%), respectively, when compared to TRIzol method (16.6% GI, 95% CI 8.4-24.9%, and 12.3% GII, 95% CI 7.0-17.6%). The limits of detection for norovirus GI and GII for this method were 101GC/g and 103GC/g, respectively, independent of cheese origin. MgV was detected and revealed in 100% success rate in all types of cheese, with mean recovery efficiency of 25.6% for Proteinase K, and 3.8% for the TRIzol method. According to cheese origin, Triangulo Mineiro MAC had the highest mean recovery rates for the three viral targets surveyed (89% GI, 87% GII, and 51% MgV), while Serro MAC showed the lowest rates (p < 0.001). Those results indicate that the proteinase K adapted method is suitable for norovirus GI and GII detection in MAC and corroborated MgV as an applicable IPC to be used during the process.

Does protein deamidation enhance rice protein concentrate's ability to produce and stabilize high internal phase emulsions?

Rice is one of the most consumed grains in the world. Rice protein has great nutritional value as a hypoallergenic protein and due to its high lysine content, a limiting amino acid in several other plant protein sources. However, rice protein has low solubility, hampering its use in many applications in the food industry. In this context, alkaline deamidation (0.5 h, 343 K, and pH 11) was applied to modify the protein structure of rice protein concentrate (RPC). After deamidation, two protein powders were produced: (i) one containing the whole protein fraction recovered after RPC deamidation (DT) and (ii) another containing only the soluble fraction recovered after RPC deamidation (DS). Protein dispersions were characterized by SDS-PAGE, zeta potential, solubility, surface hydrophobicity, and capacity to hold water and oil. RPC could not structure canola oil into a high internal phase emulsion (HIPE) due to its low solubility. DT and DS dispersions displayed solubility much higher than RPC and enabled the structuration of HIPEs with 75 % (w/w) canola oil and 25 % of DT or DS dispersions (2, 4, and 6 % w/w). HIPEs were characterized regarding particle size, microstructure, Turbiscan and oil loss stabilities, and rheological behavior for 60 days. Turbiscan analysis and oil loss measurements showed high stability, and the thixotropy tests showed high recovery in all HIPEs. Higher protein concentrations and DS dispersions produced HIPEs with smaller particle sizes. However, rheological measurements indicate that HIPEs produced with DT dispersions had better results, maintaining their structure over the 60 days. Furthermore, DT is cheaper to produce; therefore, DT 4 and 6 % w/w were the most promising for producing HIPEs. The HIPEs produced in this study displayed great potential as fat replacers.

Outcomes of Chylothorax Nonoperative Management After Cardiothoracic Surgery: A Systematic Review and Meta-Analysis.

INTRODUCTION: Chylothorax after thoracic surgery is a severe complication with high morbidity and mortality rate of 0.10 (95% confidence interval [CI] 0.06 - 0.02). There is no agreement on whether nonoperative treatment or early reoperation should be the initial intervention. This systematic review and meta-analysis aimed to evaluate the outcomes of the conservative approach to treat chyle leakage after cardiothoracic surgeries. METHODS: A systematic review was conducted in PubMed®, Embase, Cochrane Library Central, and LILACS (Biblioteca Virtual em Saúde) databases; a manual search of references was also done. The inclusion criteria were patients who underwent cardiothoracic surgery, patients who received any nonoperative treatment (e.g., total parenteral nutrition, low-fat diet, medium chain triglycerides), and studies that evaluated chylothorax resolution, length of hospital stay, postoperative complications, infection, morbidity, and mortality. CENTRAL MESSAGE: Nonoperative treatment for chylothorax after cardiothoracic procedures has significant hospital stay, morbidity, mortality, and reoperation rates. RESULTS: Twenty-two articles were selected. Pulmonary complications, infections, and arrhythmia were the most common complications after surgical procedures. The incidence of chylothorax in cardiothoracic surgery was 1.8% (95% CI 1.7 - 2%). The mean time of maintenance of the chest tube was 16.08 days (95% CI 12.54 - 19.63), and the length of hospital stay was 23.74 days (95% CI 16.08 - 31.42) in patients with chylothorax receiving nonoperative treatment. Among patients that received conservative treatment, the morbidity event was 0.40 (95% CI 0.23 - 0.59), and reoperation rate was 0.37 (95% CI 0.27 - 0.49). Mortality rate was 0.10 (95% CI 0.06 - 0.02). CONCLUSION: Nonoperative treatment for chylothorax after cardiothoracic procedures has significant hospital stay, morbidity, mortality, and reoperation rates.

Compartmentalization of lutein in simple and double emulsions containing protein nanoparticles: Effects on stability and bioaccessibility.

Delivery systems designed through protein stabilized emulsions are promising for incorporating carotenoids in different products. Nevertheless, the versatility in structures of such systems raises questions regarding the effect of the bioactive compound localization on their bio-efficacy, in particular for double emulsions. In this context, the aims of this study were to determine the impact of the localization of lutein in different water/oil/water double emulsions versus a single oil/water emulsion on the stability and in vitro bioaccessibility of lutein, a lipophilic carotenoid. The inner aqueous phase, which contained whey protein isolate (WPI) nanoparticles obtained by desolvation, was emulsified in sunflower oil stabilized by polyglycerol polyricinoleate (PGPR). The primary emulsion was then emulsified in a continuous aqueous phase containing whey protein isolate (WPI) and xanthan gum, the latter to increase the viscosity of the outer phase and delay creaming. Lutein was incorporated using different strategies: (1) lutein entrapped by WPI nanoparticles within the inner water phase of a double emulsion (W-L/O/W); (2) lutein incorporated into the oil phase of the double emulsion (W/O-L/W); (3) lutein incorporated in the oil phase of a single emulsion (O-L/W). All systems contained similar whey protein concentrations, as well as all other stabilizers. W-L/O/W sample showed the lowest lutein stability against light exposure during storage, and the highest lutein bioaccessibility after in vitro digestion, for freshly made samples. Furthermore, the in vitro bioaccessibility of lutein incorporated into the single emulsion was considerably lower than those observed for the double emulsions. The results reinforce the importance of designing appropriate structures for delivering improved stability and bioaccessibility of bioactive compounds.

Thermo-induced changes in the structure of lentil protein isolate (Lens culinaris) to stabilize high internal phase emulsions.

This study aims to assess the impact of heat treatment on the emulsifying properties of lentil protein isolate (LPI) dispersion to produce high internal phase emulsions (HIPEs). The heat-treated LPI dispersion was characterized by size, turbidity, solubility, zeta potential, free sulfhydryl group, electrophoresis, differential scanning calorimetry, circular dichroism, Fourier transforms infrared spectroscopy and intrinsic fluorescence. HIPEs were produced with 25% of LPI dispersion (2%, w/w) and soybean oil (75%) using a rotor-stator (15,500 rpm/1 min). HIPEs were evaluated for their droplet size, zeta potential, centrifugal stability, microscopy, appearance, Turbiscan stability, and rheology over 60 days (25 °C). Heat treatment reduced the size of LPI, resulting in increased turbidity, solubility, and exposure of hydrophobic groups. HIPEs produced with heat-treated LPI at 70 °C (HIPE70) and 80 °C (HIPE80) for 20 min exhibited lower droplet sizes, increased stability, reduced oil loss, and a homogeneous appearance compared to HIPE produced with untreated LPI (HIPEc). In addition, HIPE70 and HIPE80 displayed resistance to shear stress, higher apparent viscosity, and increased storage modulus than HIPEc. HIPEs produced with heat-treated LPI were stable, suggesting that the treatment was efficient for improving the functional properties of the protein and the possibility of future research focusing on fat substitutes in food applications.

Effects of processing technologies on the antioxidant properties of common bean (Phaseolus vulgaris L.) and lentil (Lens culinaris) proteins and their hydrolysates.

The effects of ultrasound (280 W, 5 min), heat treatment (75 °C and 90 °C for 10 min) and microfluidization (125 MPa, 4 cycles) as pre or post treatments and their combination with enzymatic hydrolysis on the antioxidant properties of common bean and lentil protein hydrolysates were investigated. In general, hydrolysis resulted in increases of antioxidant activity, both in the presence and absence of processing technologies. The increases reached maximum values of 158% (ABTS), 105% (DPPH), 279% (FRAP) and 107% (TAC) for the bean protein hydrolysates submitted to post-treatment with ultrasound (ABTS, FRAP and TAC) and pre-treatment with microfluidization (DPPH), compared to their respective controls (untreated samples). For lentil proteins, the increases reached 197% (ABTS), 170% (DPPH), 690% (FRAP) and 213% (TAC) for samples submitted to ultrasound post-treatment (ABTS), microfluidization pre-treatment (DPPH) and post-treatment (FRAP), and 75 °C pre-treatment (TAC) compared to their respective controls. Surface hydrophobicity and molecular weight profile by SEC-HPLC analysis indicated modifications in the structures of proteins in function of the different processing technologies. For both proteins, electrophoresis indicated a similar profile for all hydrolysates, regardless of the process applied as pre or post treatment. Solubility of bean and lentil protein concentrates was also improved. These results indicated that different processing technologies can be successfully used in association with enzymatic hydrolysis to improve the antioxidant properties of lentil and bean proteins.

Edwardsiella tarda in Tambaqui (Colossoma macropomum): A Pathogenicity, Antimicrobial Susceptibility, and Genetic Analysis of Brazilian Isolates.

Edwardsiella tarda is a crucial pathogenic bacterium in tropical aquaculture. This bacterium was recently isolated from tambaqui (Colossoma macropomum), a commercially important fish species in Brazil. This study assessed the antimicrobial susceptibility, pathogenicity, and genetic diversity of the tambaqui-derived E. tarda isolates. Fourteen bacterial isolates isolated from tambaqui were identified as E. tarda by using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and dnaJ gene sequencing. Antimicrobial susceptibility tests were conducted against seven drugs using the disc diffusion assay. The pathogenicity test conducted by intraperitoneal injection of 2.4 × 107 colony-forming units (CFU) fish-1 of E. tarda (ED38-17) into tambaqui juveniles eventually revealed that neither clinical signs nor death were present. However, splenomegaly and whitish areas in the spleen and kidneys were observed. The histological investigation also revealed granulomatous splenitis, nephritis, and hepatitis occurring internally. Repetitive extragenic palindromic-PCR fingerprinting separated the 14 isolates into three genetic groups. The antibiogram revealed that all E. tarda isolates were wild-type (WT) to florfenicol (FLO), norfloxacin (NOR), neomycin (NEO), erythromycin (ERY), and oxytetracycline (OXY); however, some were non-wild-type to sulfamethoxazole/trimethoprim (7.1%) and amoxicillin (21.4%). Therefore, through experimental infection, E. tarda ED38-17 could induce pathogenic effects in C. macropomum. Additionally, three distinct genetic types were found, and the E. tarda isolates were WT to FLO, NOR, NEO, ERY, and OXY. These findings raise awareness of a bacteria causing unseen lesions, a pathogen that will potentially impact tambaqui aquaculture in the future.

Advancements in Chitosan-Based Nanoparticles for Pulmonary Drug Delivery.

The evolution of respiratory diseases represents a considerable public health challenge, as they are among the leading causes of death worldwide. In this sense, in addition to the high prevalence of diseases such as asthma, chronic obstructive pulmonary disease, pneumonia, cystic fibrosis, and lung cancer, emerging respiratory diseases, particularly those caused by members of the coronavirus family, have contributed to a significant number of deaths on a global scale over the last two decades. Therefore, several studies have been conducted to optimize the efficacy of treatments against these diseases, focusing on pulmonary drug delivery using nanomedicine. Thus, the development of nanocarriers has emerged as a promising alternative to overcome the limitations of conventional therapy, by increasing drug bioavailability at the target site and reducing unwanted side effects. In this context, nanoparticles composed of chitosan (CS) show advantages over other nanocarriers because chitosan possesses intrinsic biological properties, such as anti-inflammatory, antimicrobial, and mucoadhesive capacity. Moreover, CS nanoparticles have the potential to enhance drug stability, prolong the duration of action, improve drug targeting, control drug release, optimize dissolution of poorly soluble drugs, and increase cell membrane permeability of hydrophobic drugs. These properties could optimize the performance of the drug after its pulmonary administration. Therefore, this review aims to discuss the potential of chitosan nanoparticles for pulmonary drug delivery, highlighting how their biological properties can improve the treatment of pulmonary diseases, including their synergistic action with the encapsulated drug.

In vitro activity of the novel Fe-cyclam complex against clinical multidrug-resistant bacterial isolates from Brazil.

Aim: To evaluate the effect of a new Fe-cyclam complex on pathogenic bacterial species, including multidrug-resistant clinical specimens. Materials & methods: The complex [Fe(cyclam)ox]PF6 (D2) was tested in cytotoxicity and MIC tests. Clinical and reference strains of Gram-negative and Gram-positive bacteria were used. Considering Staphylococcus aureus strains, the profile of antimicrobial susceptibility and time-kill kinetics for D2 was performed. An in silico analysis for D2 was also performed. Results: D2 showed broad bacterial activity, mainly against specimens of Cutibacterium acnes, S. aureus, Pseudomonas aeruginosa and Acinetobacter baumannii. Low cytotoxicity in human cells was demonstrated. Conclusion: The tested compound proved to be a promising agent against resistant bacterial infections.

Stability of milk proteins subjected to UHT treatments: challenges and future perspectives.

Ultra-high temperature (UHT) treatments are of high economic relevance for food industries because they contribute to extending the shelf life of food products and facilitating their distribution. In the dairy segment, UHT treatments are applied to a wide range of products containing variable protein amounts. In this sense, the changes in the molecular structure of milk proteins induced by the severity of UHT treatments may lead to fouling in equipment during processing or sedimentation and/or gelation during storage. Nowadays, these concerns are even more relevant due to the increasing demand for UHT-treated high-protein beverages. This review will discuss the two main strategies used by industries to increase the stability of milk proteins during and/or after UHT treatments: (i) addition of chelating agents and (ii) use of polysaccharides. Moreover, the challenges and opportunities associated with promising strategies to improve the stability of milk proteins during and/or after UHT treatments will be covered in this review. The information compiled will be useful to guide researchers and industries in developing more stable UHT dairy products in harmony with consumers' demands.

Co-aggregation between whey proteins and carotenoids from yellow mombin (Spondias mombin): Impact of carotenoids' self-aggregation.

The interaction between whey proteins and carotenoid is reported to improve carotenoid solubility and stability, however, the strong trend of carotenoids to aggregate when in polar systems is often neglected in papers addressing their molecular interaction. Therefore, this study focused on characterizing the aggregative behavior of the carotenoids from yellow mombin (Spondias mombin) and to understand how these carotenoids behave when added to aqueous dispersions of whey proteins. Carotenoids-rich extract, containing mainly ß-cryptoxanthin and lutein, was obtained from freeze-dried yellow mombin pulp and its aggregative behavior in ethanol/water medium was studied. By increasing the medium polarity, carotenoids trend to form J-aggregation, causing a drop in the color intensity of the solution. When added to whey protein aqueous dispersions, rather than a protein-carotenoid bimolecular interaction, the formation of co-aggregates between carotenoids and whey proteins was evidenced by preparative size exclusion chromatography. These results may contribute to the developing functional food products.

Evaluation of disk diffusion method for testing the rifampicin, erythromycin, and tetracycline susceptibility of Clostridioides (prev. Clostridium) difficile.

INTRODUCTION: Antimicrobial resistance (AMR) is one of the greatest threats to animal and public health. Clostridioides (prev. Clostridium) difficile is a major burden to healthcare and a relevant AMR gene reservoir. Despite the known importance of AMR in C. difficile epidemiology and treatment, antimicrobial susceptibility testing for this pathogen is still based on the determination of the minimal inhibitory concentration (MIC) by the agar dilution method, which is technically demanding and labor-intensive. In this study, the disk diffusion method was used to evaluate the susceptibility of C. difficile to erythromycin, rifampicin, and tetracycline. MATERIAL AND METHODS: A total of 155 isolates isolated between 2011 and 2022 from humans and animals in Brazil were simultaneously tested using the disk diffusion method and the epsilometer test (Etest) for these three antimicrobials on Brucella blood agar supplemented with vitamin K and hemin. RESULTS: The results suggest that disk diffusion can be an interesting routine tool to identify erythromycin- and rifampicin-resistant C. difficile isolates (≥20 mm cut-off) and wild type (WT) strains (≥28 mm). However, the disk diffusion protocol tested in this study does not seem suitable for tetracycline because of the common misclassification of resistant strains.

Telemedicine for Diabetes Mellitus Management in Older Adults: A Systematic Review.

BACKGROUND: Diabetes mellitus affects almost 20% of the world's population between 65 and 99 years old. The care for this disease urges a complex, multidisciplinary, and stepwise approach. Telemedicine has been evaluated, and clinical trials as well as systematic reviews have been performed, and most have shown the benefits of its use in DM management. However, as the prevalence of diabetes mellitus increases, as well as the population ages, considerations regarding access and compliance of older patients to such technologies arise. OBJECTIVE: The study aimed to determine the efficacy of telemedicine medical consultations in comparison to standard face-to-face consultations. METHODS: A systematic literature search to identify trials investigating the effect of telemedicine medical consultations in clinical-laboratory aspects of DM management was conducted. The search was carried out in electronic databases: Medline, EMBASE, LILACS, ClinicalTrials.gov, and the CENTRAL Cochrane. Two authors independently assessed the included studies using the proper bias assessment tool for each study design. RESULTS: In agreement with the eligibility criteria, three studies were included. In terms of the main outcome, HbA1c, only one out of three articles showed a significant difference between the groups, favoring patients in the telemedicine group. With respect to blood pressure, Sood A reported that the usual care group exhibited a greater improvement in systolic blood pressure with statistical differences. All other results displayed no significant statistical difference between the groups. Also, no statistical difference was found in most of the lipid profile results. CONCLUSION: Our review shows that teleconsultations do not provide a clear benefit to elderly people with diabetes, but they may be non-inferior.

Outcomes of Chylothorax Nonoperative Management After Cardiothoracic Surgery: A Systematic Review and Meta-Analysis

ABSTRACT Introduction: Chylothorax after thoracic surgery is a severe complication with high morbidity and mortality rate of 0.10 (95% confidence interval [CI] 0.06 - 0.02). There is no agreement on whether nonoperative treatment or early reoperation should be the initial intervention. This systematic review and meta-analysis aimed to evaluate the outcomes of the conservative approach to treat chyle leakage after cardiothoracic surgeries. Methods: A systematic review was conducted in PubMed®, Embase, Cochrane Library Central, and LILACS (Biblioteca Virtual em Saúde) databases; a manual search of references was also done. The inclusion criteria were patients who underwent cardiothoracic surgery, patients who received any nonoperative treatment (e.g., total parenteral nutrition, low-fat diet, medium chain triglycerides), and studies that evaluated chylothorax resolution, length of hospital stay, postoperative complications, infection, morbidity, and mortality. Central Message Nonoperative treatment for chylothorax after cardiothoracic procedures has significant hospital stay, morbidity, mortality, and reoperation rates. Results: Twenty-two articles were selected. Pulmonary complications, infections, and arrhythmia were the most common complications after surgical procedures. The incidence of chylothorax in cardiothoracic surgery was 1.8% (95% CI 1.7 - 2%). The mean time of maintenance of the chest tube was 16.08 days (95% CI 12.54 - 19.63), and the length of hospital stay was 23.74 days (95% CI 16.08 - 31.42) in patients with chylothorax receiving nonoperative treatment. Among patients that received conservative treatment, the morbidity event was 0.40 (95% CI 0.23 - 0.59), and reoperation rate was 0.37 (95% CI 0.27 - 0.49). Mortality rate was 0.10 (95% CI 0.06 - 0.02). Conclusion: Nonoperative treatment for chylothorax after cardiothoracic procedures has significant hospital stay, morbidity, mortality, and reoperation rates.