Receptor-mediated endocytosis in kidney cells during physiological and pathological conditions.

Mammalian cell membranes are very dynamic where they respond to several environmental stimuli by rearranging the membrane composition by basic biological processes, including endocytosis. In this context, receptor-mediated endocytosis, either clathrin-dependent or caveolae-dependent, is involved in different physiological and pathological conditions. In the last years, an important amount of evidence has been reported that kidney function involves the modulation of different types of endocytosis, including renal protein handling. In addition, the dysfunction of the endocytic machinery is involved with the development of proteinuria as well as glomerular and tubular injuries observed in kidney diseases associated with hypertension, diabetes, and others. In this present review, we will discuss the mechanisms underlying the receptor-mediated endocytosis in different glomerular cells and proximal tubule epithelial cells as well as their modulation by different factors during physiological and pathological conditions. These findings could help to expand the current understanding regarding renal protein handling as well as identify possible new therapeutic targets to halt the progression of kidney disease.

Preconditioning by Moderate-Intensity Exercise Prevents Gentamicin-Induced Acute Kidney Injury.

A strict correlation among proximal tubule epithelial cell dysfunction, proteinuria, and modulation of the Renin-Angiotensin System and Kalikrein-Kinin System are crucial factors in the pathogenesis of Acute Kidney Injury (AKI). In this study, we investigated the potential protective effect of preconditioning by moderate-intensity aerobic exercise on gentamicin-induced AKI. Male Wistar rats were submitted to a moderate-intensity treadmill exercise protocol for 8 weeks, and then injected with 80 mg/kg/day s.c. gentamicin for 5 consecutive days. Four groups were generated: 1) NT+SAL (control); 2) NT+AKI (non-trained with AKI); 3) T+SAL (trained); and 4) T+AKI (trained with AKI). The NT+AKI group presented: 1) impairment in glomerular function parameters; 2) increased fractional excretion of Na + , K + , and water; 4) proteinuria and increased urinary γ-glutamyl transferase activity (a marker of tubular injury) accompanied by acute tubular necrosis; 5) an increased renal angiotensin-converting enzyme and bradykinin B1 receptor mRNA expression. Interestingly, the preconditioning by moderate-intensity aerobic exercise attenuated all alterations observed in gentamicin-induced AKI (T+AKI group). Taken together, our results show that the preconditioning by moderate-intensity aerobic exercise ameliorates the development of gentamicin-induced AKI. Our findings help to expand the current knowledge regarding the effect of physical exercise on kidneys during physiological and pathological conditions.

Akkermansia muciniphila and Parabacteroides distasonis as prognostic markers for relapse in ulcerative colitis patients.

Introduction: Ulcerative colitis is an inflammatory disorder characterized by chronic inflammation in the gastrointestinal tract, mainly in the colon and rectum. Although the precise etiology of ulcerative colitis remains unclear, recent research has underscored the significant role of the microbiome in its development and progression. Methods: The aim of this study was to establish a relationship between the levels of specific gut bacterial species and disease relapse in ulcerative colitis. For this study, we recruited 105 ulcerative colitis patients in remission and collected clinical data, blood, and stool samples. Akkermansia muciniphila and Parabacteroides distasonis levels were quantified in the stool samples of ulcerative colitis patients. Binary logistic regression was applied to collected data to predict disease remission. Results: The median time in remission in this cohort was four years. A predictive model incorporating demographic information, clinical data, and the levels of Akkermansia muciniphila and Parabacteroides distasonis was developed to understand remission patterns. Discussion: Our findings revealed a negative correlation between the levels of these two microorganisms and the duration of remission. These findings highlight the importance of the gut microbiota in ulcerative colitis for disease prognosis and for personalized treatments based on microbiome interventions.

Effect of cell therapy with adipose-derived stem cells in the treatment of acute rupture of the Achilles tendon in humans.

The aim of this study was to evaluate the effect of adipose-derived stem cells (ADSCs) in the treatment of acute rupture of the Achilles tendon. It was a cross-sectional study involving 15 patients. Patients were randomly divided: group 1-rupture; group 2-suture; group 3-rupture + ADSCs. In the AOFAS score, the score was higher in group 3 with a significant difference. In the ATRS score, the score was higher in groups 2 and 3, also with a significant difference. As for the ultrasound score, there was a significant difference between the experimental groups in relation to this score, however, in the multiple comparisons test, comparing two groups at a time, it was possible to observe a significant difference of the experimental groups. It can be concluded that cell therapy in this condition may be a treatment option due to tissue regeneration and significant recovery of function.

Interaction of Angiotensin-(1-7) with kinins in the kidney circulation: Role of B1 receptors.

Changes in renal hemodynamics impact renal function during physiological and pathological conditions. In this context, renal vascular resistance (RVR) is regulated by components of the Renin-Angiotensin System (RAS) and the Kallikrein-Kinin System (KKS). However, the interaction between these vasoactive peptides on RVR is still poorly understood. Here, we studied the crosstalk between angiotensin-(1-7) and kinins on RVR. The right kidneys of Wistar rats were isolated and perfused in a closed-circuit system. The perfusion pressure and renal perfusate flow were continuously monitored. Ang-(1-7) (1.0-25.0 nM) caused a sustained, dose-dependent reduction of relative RVR (rRVR). This phenomenon was sensitive to 10 nM A-779, a specific Mas receptor (MasR) antagonist. Bradykinin (BK) promoted a sustained and transient reduction in rRVR at 1.25 nM and 125 nM, respectively. The transient effect was abolished by 4 µM des-Arg9-Leu8-bradykinin (DALBK), a specific kinin B1 receptor (B1R) antagonist. Accordingly, des-Arg9-bradykinin (DABK) 1 µM (a B1R agonist) increased rRVR. Interestingly, pre-perfusion of Ang-(1-7) changed the sustained reduction of rRVR triggered by 1.25 nM BK into a transient effect. On the other hand, pre-perfusion of Ang-(1-7) primed and potentiated the DABK response, this mechanism being sensitive to A-779 and DALBK. Binding studies performed with CHO cells stably transfected with MasR, B1R, and kinin B2 receptor (B2R) showed no direct interaction between Ang-(1-7) with B1R or B2R. In conclusion, our findings suggest that Ang-(1-7) differentially modulates kinin's effect on RVR in isolated rat kidneys. These results help to expand the current knowledge regarding the crosstalk between the RAS and KKS complex network in RVR.

Unstable Angina Risk Stratification Using High-Sensitivity Cardiac Troponin and Coronary Angiography.

Patients formerly diagnosed with unstable angina (UA) are being reclassified as non-ST-elevation myocardial infarction with the widespread adoption of high-sensitivity troponin (hsTn) assays, leading to significant changes in the incidence and prognosis of UA. This study aimed to evaluate the value of hsTn and the presence of significant obstructive coronary artery disease (CAD) in the risk stratification of patients with UA. We conducted a retrospective, single-center study of 742 patients hospitalized for UA between 2016 and 2021. The primary end point of this study was all-cause mortality. The secondary outcome (major adverse cardiac events [MACEs]) was defined as a composite of nonfatal myocardial infarction (MI), hospitalization for heart failure (hHF), and repeated coronary angiography because of recurring UA (rUA) after the index event. The outcomes were assessed within 1 month, 1 year, and up to 5 years of follow-up. The average follow-up duration was 45 ± 24 months, and 37.2% (n = 276) of patients completed a 5-year follow-up. No in-hospital death was observed, and 6.9% of patients died during follow-up, which was more commonly a late event (>12 months). The composite secondary end point (MI+hHF+rUA) was observed in 16.7% of the patients. There were 3.2% nonfatal MI, 2.3% hHF, and 11.6% rUA during follow-up. We developed a risk model (UA mortality risk) using variables with the highest discriminatory power: age, hsTn, and ST-segment deviation. Our model performed well against the Global Registry of Acute Coronary Events and Thrombolysis in Myocardial Infarction risk scores in predicting death during follow-up. Obstructive CAD on coronary angiography was the only independent predictor of MACEs during follow-up. In conclusion, a contemporary cohort of patients with UA presented with favorable prognosis, particularly, within the first year after the index event. Nonsignificant increases in hsTn levels add to the risk stratification of patients with UA, and the presence of obstructive CAD was the only independent predictor of MACEs, highlighting the potential importance of assessing coronary anatomy.

Impact of the Pandemic Time on the Mental Health of People with Dementia and Their Family Caregivers in Brazil and Chile: One-Year Follow-Up.

Background: Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective: To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods: This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results: In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions: In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year.

First investigation into the genetic control of meiosis in sugarcane.

The sugarcane (Saccharum spp.) genome is one of the most complex of all. Modern varieties are highly polyploid and aneuploid as a result of hybridization between Saccharum officinarum and S. spontaneum. Little research has been done on meiotic control in polyploid species, with the exception of the wheat Ph1 locus harboring the ZIP4 gene (TaZIP4-B2) which promotes pairing between homologous chromosomes while suppressing crossover between homeologs. In sugarcane, despite its interspecific origin, bivalent association is favored, and multivalents, if any, are resolved at the end of prophase I. Thus, our aim herein was to investigate the purported genetic control of meiosis in the parental species and in sugarcane itself. We investigated the ZIP4 gene and immunolocalized meiotic proteins, namely synaptonemal complex proteins Zyp1 and Asy1. The sugarcane ZIP4 gene is located on chromosome 2 and expressed more abundantly in flowers, a similar profile to that found for TaZIP4-B2. ZIP4 expression is higher in S. spontaneum a neoautopolyploid, with lower expression in S. officinarum, a stable octoploid species. The sugarcane Zip4 protein contains a TPR domain, essential for scaffolding. Its 3D structure was also predicted, and it was found to be very similar to that of TaZIP4-B2, reflecting their functional relatedness. Immunolocalization of the Asy1 and Zyp1 proteins revealed that S. officinarum completes synapsis. However, in S. spontaneum and SP80-3280 (a modern variety), no nuclei with complete synapsis were observed. Importantly, our results have implications for sugarcane cytogenetics, genetic mapping, and genomics.

Real-World Effectiveness and Safety of Glecaprevir/Pibrentasvir for the Treatment of Chronic Hepatitis C: A Prospective Cohort Study in Portugal.

INTRODUCTION: Information about pan-genotypic treatments for hepatitis in Portugal is scarce. We aimed to evaluate the effectiveness and safety of glecaprevir plus pibrentasvir (GLE/PIB) treatment for hepatitis C virus (HCV) infection in real-world clinical practice. METHODS: An observational prospective study was implemented in six hospitals with 121 adult HCV patients who initiated treatment with GLE/PIB between October 2018 and April 2019, according to clinical practice. Eligible patients had confirmed HCV infection genotype (GT) 1 to 6 and were either treatment-naïve or had experience with interferon-, ribavirin- or sofosbuvir-based regimens, with or without compensated cirrhosis. Baseline sociodemographic and safety data are described for the total population (N = 115). Effectiveness [sustained virologic response 12 weeks after treatment (SVR12)] and patient-reported outcomes are presented for the core population with sufficient follow-up data (n = 97). RESULTS: Most patients were male (83.5%), aged < 65 years (94.8%), with current or former alcohol consumption (77.3%), illicit drug use (72.6%), and HCV acquisition through intravenous drug use (62.0%). HIV co-infection occurred in 22.6% of patients. The prevalence of each GT was: GT1 51.3%, GT2 1.7%, GT3 30.4%, GT4 16.5%, and GT5.6 0%. Most patients were non-cirrhotic (80.9%) and treatment-naïve (93.8%). The SVR12 rates were 97.9% (95% CI: 92.8 - 99.4), and > 95% across cirrhosis status, GT, illicit drug use, alcohol consumption, and HCV treatment experience. The adverse event rate was 2.6%, and no patient discontinued treatment due to adverse events related to GLE/PIB. CONCLUSION: Consistent with other real-world studies and clinical trials, treatment with GLE/PIB showed high effectiveness and tolerability overall and in difficult-to-treat subgroups (ClinicalTrials.gov: NCT03303599).

The Role of Flagellum and Flagellum-Based Motility on Salmonella Enteritidis and Escherichia coli Biofilm Formation.

Flagellum-mediated motility has been suggested to contribute to virulence by allowing bacteria to colonize and spread to new surfaces. In Salmonella enterica and Escherichia coli species, mutants affected by their flagellar motility have shown a reduced ability to form biofilms. While it is known that some species might act as co-aggregation factors for bacterial adhesion, studies of food-related biofilms have been limited to single-species biofilms and short biofilm formation periods. To assess the contribution of flagella and flagellum-based motility to adhesion and biofilm formation, two Salmonella and E. coli mutants with different flagellar phenotypes were produced: the fliC mutants, which do not produce flagella, and the motAB mutants, which are non-motile. The ability of wild-type and mutant strains to form biofilms was compared, and their relative fitness was determined in two-species biofilms with other foodborne pathogens. Our results showed a defective and significant behavior of E. coli in initial surface colonization (p < 0.05), which delayed single-species biofilm formation. Salmonella mutants were not affected by the ability to form biofilm (p > 0.05). Regarding the effect of motility/flagellum absence on bacterial fitness, none of the mutant strains seems to have their relative fitness affected in the presence of a competing species. Although the absence of motility may eventually delay initial colonization, this study suggests that motility is not essential for biofilm formation and does not have a strong impact on bacteria's fitness when a competing species is present.

Kidney Disease and Proteomics: A Recent Overview of a Useful Tool for Improving Early Diagnosis.

Kidney disease is a critical and potentially life-threatening degenerative condition that poses a significant global public health challenge due to its elevated rates of morbidity and mortality. It manifests primarily in two distinct clinical forms: acute kidney injury (AKI) and chronic kidney disease (CKD). The development of these conditions hinges on a multitude of factors, including the etiological agents and the presence of coexisting medical conditions. Despite disparities in their underlying pathogenic mechanisms, both AKI and CKD can progress to end-stage kidney disease (ESKD). This advanced stage is characterized by organ failure and its associated complications, greatly increasing the risk of mortality. There is an urgent need to delve into the pathogenic mechanisms underlying these diseases and to identify novel biomarkers that can facilitate earlier diagnosis. Such early detection is crucial for enhancing the efficacy of therapy and impeding disease progression. In this context, proteomic approaches have emerged as invaluable tools for uncovering potential new markers of different pathological conditions, including kidney diseases. In this chapter, we overview the recent discoveries achieved through diverse proteomic techniques aimed at identifying novel molecules that may play a pivotal role in kidney diseases such as diabetic kidney disease (DKD), IgA nephropathy (IgAN), CKD of unknown origin (CKDu), autosomal dominant polycystic kidney disease (ADPKD), lupus nephritis (LN), hypertensive nephropathy (HN), and COVID-19-associated acute kidney injury (COVID-AKI).

Predicting myopic changes in children wearing glasses using the Plusoptix photoscreener.

INTRODUCTION: With high increase in myopia prevalence, we aimed to assess whether Plusoptix_A09 can be used in myopic children over spectacles to predict visual acuity (VA) and myopic refraction changes. METHODS: Myopic children underwent a complete ophthalmological examination. Plusoptix_A09 was performed over spectacles. VA changes, refraction changes and time since previous glasses prescription, were determined. Age, current or past history of amblyopia, presence of strabismus and self-perception of VA changes were registered. RESULTS: In total, 199 patients were included. Spherical power (SP) and spherical equivalent (SE) measured by Plusoptix_A09 over spectacles predicted both VA changes (p < 0.001) and refraction changes (p < 0.001). Values of SP < - 0.06D or SE < - 0.22D indicated a VA decrease (AUC > 0.9, p < 0.01) for sensitivity and specificity of 85.1%, 82.1% and 82.6%, 83.3%, respectively. Age and ophthalmological comorbidities did not influence Plusoptix_A09 measurements (p > 0.05). Plusoptix_A09 over spectacles was a stronger predictor of VA changes when compared to children's self-perception, either in 4-9-year-old patients (p < 0.001 versus p = 0.628) and in 10-18-year-old children (OR < = 0.066 versus OR = 0.190). A decrease in SP and SE of - 0.10D in Plusoptix_A09 predicted a myopia progression of - 0.04D and - 0.05D, respectively. CONCLUSION/RELEVANCE: This study unveiled new features for the Plusoptix, a worldwide available photoscreener used in amblyopia screening. When Plusoptix is performed in children with their glasses on, it can rapidly predict myopia progression. For each decrease of - 0.10D in Plusoptix, a myopia progression of -0.05D is expected. Moreover, Plusoptix is more reliable than children's self-perception of visual acuity changes, making it a useful tool either in primary care or ophthalmology practice.

Unstable Angina: Risk Stratification for Significant Coronary Artery Disease in The Era of High-Sensitivity Cardiac Troponin.

Introduction: High-sensitivity troponin (hsTn) has a very high diagnostic accuracy for myocardial infarction (MI), and patients who were formerly diagnosed with unstable angina (UA) are being reclassified as having NSTEMI in the era of hsTn. This paradigm shift has changed the clinical features of UA, which remain poorly characterized, specifically the occurrence of obstructive coronary artery disease (CAD) and the need for myocardial revascularization. The main purpose of this study was to clinically characterize contemporary UA patients, assess predictors of obstructive CAD, and develop a risk model to predict significant CAD in this population. Methods: We conducted a retrospective cohort study of 742 patients admitted to the hospital with UA. All patients underwent coronary angiography. The endpoint of the study was the presence of obstructive CAD on angiography. The cohort was divided into two groups: patients with significant coronary artery disease (CAD+) and those without CAD (CAD-). We developed a score (UA CAD Risk) based on the multivariate model and compared it with the GRACE, ESC, and TIMI risk scores using ROC analysis. Results: Obstructive CAD was observed on angiography in 53% of the patients. Age, dyslipidemia, troponin level, male sex, ST-segment depression, and wall motion abnormalities on echocardiography were independent predictors of obstructive CAD. hsTn levels (undetectable vs. nonsignificant detection) had a negative predictive value of 81% to exclude obstructive CAD. We developed a prediction model with obstructive CAD as the outcome (AUC: 0.60). Conclusions: In a contemporary UA cohort, approximately 50% of the patients did not have obstructive CAD on angiography. Commonly available cardiac tests at hospital admission show limited discrimination power in identifying patients at risk of obstructive CAD. A revised diagnostic and etiology algorithm for patients with UA is warranted.

Prevalence and circulant genotypes of Chlamydia trachomatis in university women from cities in the Brazilian Amazon.

BACKGROUND: Approximately 80% of infected women infected by Chlamydia trachomatis are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection and genotypes are available in Amazonian communities. OBJECTIVES: To describe the prevalence of and associated factors and to identify the genotypes of sexual C. trachomatis infection in female university students in different urban centers (capital and interiors) in the Brazilian state of Pará, in the eastern Amazon region. METHODS: A cross-sectional study was performed among young women attending public universities in four different urban centers in the eastern Amazon region. They were invited to participate in the studt and cervical secretions were collected for molecular diagnosis of C. trachomatis. We utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by nucleotide sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Qui-square and Binominal regression test were used to evaluate the degree of association of these variables with the infection. RESULTS: A total of 686 female students was included in the study. The overall prevalence of C. trachomatis was 11.2% (77/686). The prevalence of this infection was higher in interiors (15.2% vs 9.5%/ p: 0.0443). Female university students who do not have a sexual partner (11.8%/p <0.008), who do not use a condom in their sexual relations (17.8%/p <0.0001) and who reported having suffered a miscarriage (32%/p <0.0001) have high chances of acquiring this sexual infection. The ompA gene was sequenced in only 33 (42.8%) samples, revealing the genotype J was the most frequent (27.2% [9/33]), followed by genotypes D (24.2% [8/33]), and then genotypes F (18.2% [6/33]), E (15.1% [5/33]) K (6.1% [2/33]), Ia (6.1% [2/33]), and G (3.1% [1/33]). CONCLUSIONS: The high prevalence of sexual infection by C. trachomatis in the female university students from the interior of the state of Pará, individuals with no fixed sexual partner, those that had had a miscarriage, the students that do not use condoms in their sexual relations. The genotype J of C. trachomatis genotypes was the most frequent. These data are important to help defining the epidemiological effects of chlamydial infections in Amazonian populations.

Competition through ritualized aggressive interactions between sympatric colonies in solitary foraging neotropical ants.

Understanding the structure of food competition between conspecifics in their natural settings is paramount to addressing more complex questions in ecology, evolution, and conservation. While much research on ants focuses on aggressive food competition between large and foraging trail-using societies, we lack a thorough understanding of inter-colony competition in socially less derived, solitarily foraging species. To fill this gap, we explored the activity of ten neighbouring colonies of the giant ant Dinoponera quadriceps, monitoring 2513 foraging trips of hundreds of workers and all its inter-individual interactions. We found that, on encountering, workers from different colonies rarely engaged in aggressive fights but instead avoided each other or performed ritualised agonistic bouts. We discovered that during foraging trips, a few workers within each colony repeatedly rubbed their gaster on the substrate, a behaviour not observed in the field before. We propose that workers use this behaviour to mark the foraging area and mark more frequently in its periphery. Only 25% of the individuals specialised in this behaviour, and we hypothesise that the specialisation results from the history of interactions and experience of individual foragers. Our study suggests that workers of contiguous D. quadriceps colonies engage in low-risk conflict, mainly displaying ritualised behaviours. As these small societies mainly rely on tiny, unpredictably scattered, albeit abundant in the environment, arthropod prey, and not on persistent food sources, they do not aggressively defend exclusive foraging territories. On the other hand, colonies rely on large overlapping foraging areas to sustain their survival and growth, most often tolerating foragers from nearby colonies. We discuss whether this type of competitive interaction is expected in all solitary foraging species.

Alamandine attenuates oxidative stress in the right carotid following transverse aortic constriction in mice.

OBJECTIVE: Pressure overload can result in significant changes to the structure of blood vessels, a process known as vascular remodeling. High levels of tension can cause vascular inflammation, fibrosis, and structural alterations to the vascular wall. Prior research from our team has demonstrated that the oral administration of alamandine can promote vasculoprotective effects in mice aorta that have undergone transverse aortic constriction (TAC). Furthermore, changes in local hemodynamics can affect the right and left carotid arteries differently after TAC. Thus, in this study, we aimed to assess the effects of alamandine treatment on right carotid remodeling and the expression of oxidative stress-related substances induced by TAC. METHODS AND RESULTS: Male C57BL/6 mice were categorized into three groups: Sham, TAC, and TAC treated with alamandine (TAC+ALA). Alamandine treatment was administered orally by gavage (30 µg/kg/day), starting three days before the surgery, and continuing for a period of fourteen days. Morphometric analysis of hematoxylin and eosin-stained sections revealed that TAC induced hypertrophic and positive remodeling in the right carotid artery. Picrosirius Red staining also demonstrated an increase in total collagen deposition in the right carotid artery due to TAC-induced vascular changes. Alamandine treatment effectively prevented the increase in reactive oxygen species production and depletion of nitric oxide levels, which were induced by TAC. Finally, alamandine treatment was also shown to prevent the increased expression of nuclear factor erythroid 2-related factor 2 and 3-nitrotyrosine that were induced by TAC. CONCLUSION: Our results suggest that alamandine can effectively attenuate pathophysiological stress in the right carotid artery of animals subjected to TAC.

Psychometric properties of the Providers Survey in the Brazilian context of mental health: a validation study

ABSTRACT BACKGROUND: Precisely determining the aspects related to an instrument's validity and reliability measures allows for greater assurance of the quality of the results. OBJECTIVES: To analyze the psychometric properties of The Providers Survey in the Brazilian context of mental health services. DESIGN AND SETTING: The instrument validation study was conducted in Montes Claros, Minas Gerais, Brazil. METHODS: The validation study was conducted using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist to analyze its validity and reliability. RESULTS: A committee of expert judges performed content validation after which the Content Validity Index was calculated. Construct validation took place through Exploratory Factor Analysis using the Kaiser-Meyer-Olkin Test criterion and Bartlett's Sphericity Test. Reliability was verified using test-retest reliability. The significance level adopted for the statistical tests was 5% (P < 0.05). The final instrument comprised 54 questions. The Content Validity Index was 97%. Exploratory Factor Analysis identified a Kaiser-Meyer-Olkin index of 0.901 and Bartlett's Sphericity Test with P < 0.001. We obtained a Cronbach's alpha coefficient of 0.95 and an intraclass correlation coefficient of 0.849. CONCLUSIONS: The Providers Survey, translated and adapted into Portuguese, was named the Work Assessment Instrument for the Recovery of Mental Health. It presented adequate psychometric properties for evaluating work-related practices for the recovery of psychosocial care network users.

Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care.

OBJECTIVE: to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care. METHODS: a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression. RESULTS: polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications. CONCLUSIONS: polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.

Differences in volume, density, electrolyte concentration, and total proteins in the fluid of the paranasal sinuses of freshwater and saltwater drowning victims: a systematic review and meta-analysis.

This study summarized the available evidence on the differences in volume, density, electrolyte concentration, and total proteins in paranasal sinus fluid between freshwater and saltwater drowning victims. A systematic search was conducted in electronic databases and gray literature, resulting in the inclusion of five studies with 234 drowning victims (92 saltwater incidents and 142 freshwater incidents). Meta-analyses using the inverse-of-variance method and a random-effects model were performed, reporting effect sizes as standardized mean differences (SMD) with 95% confidence intervals (CI). The findings showed a significantly higher sinus density in saltwater drowning cases compared to freshwater drowning cases (SMD 0.91, 95% CI 0.50 to 1.32). However, no significant differences were observed in sinus fluid volume. Saltwater drowning victims exhibited higher electrolyte concentrations (sodium: SMD 3.77, 95% CI 3.07 to 4.48; potassium: SMD 0.78, 95% CI 0.07 to 1.49; chloride: SMD 3.48, 95% CI 2.65 to 4.31; magnesium: SMD 4.01, 95% CI 3.00 to 5.03) and lower total protein concentrations (SMD - 1.20, 95% CI - 1.82 to - 0.58) in sinus fluid compared to freshwater drowning victims. This meta-analysis highlights the importance of analyzing the characteristics and composition of sinus fluid in forensic investigations of drowning cases. While no differences were found in sinus fluid volume, saltwater drowning victims exhibited higher sinus density, elevated electrolyte concentrations, and lower total protein concentrations compared to freshwater drowning victims.

Feline calicivirus and natural killer cells: A study of its relationship in chronic gingivostomatitis.

Background and Aims: Feline chronic gingivostomatitis (FCGS) is a frequent chronic inflammatory condition in the oral cavity with an etiopathogenesis not completely identified. This study aimed to contribute to the knowledge of FCGS by identifying the presence of feline calicivirus (FCV) antigens and natural killer (NK) cells and comparing them. Materials and Methods: Forty biopsies from the oral mucosa of cats diagnosed with chronic gingivostomatitis were subjected to immunohistochemical techniques to evaluate cells with FCV antigens and NK cells positive for CD56. Results: NK cells were identified in all samples, with an average of 725.3 ± 409.1 cells. Regarding FCV, it was identified in 18 out of 30 samples (60%), with a different number of cells with virus in between the analyzed cases. In all cases, the number of cells infected with FCV was lower than the number of NK cells present in the same samples, but there was no statistical association between them. Conclusion: This preliminary study shows that NK cells are present in gingivostomatitis lesions not exclusively caused by FCV-stimulus, as only 60% of all cases were positive for this virus, but other antigens should be considered in the etiology of FCGS.