Pseudomonas aeruginosa Endocarditis With a Large Mitral Valve Vegetation Causing Severe Mitral Valve Regurgitation and Cardiogenic Shock.

Infective endocarditis (IE) is characterized by the inflammation of the inner layer of the heart that can be caused by different pathogens. Pseudomonas aeruginosa is an uncommon source of IE. The clinical presentation is highly dependent on the patient's medical history, societal factors, and valve involvement. This infection is associated with many unfavorable complications and high mortality rates. We present a case of P. aeruginosa endocarditis causing severe mitral valve regurgitation, leading to cardiogenic shock and an eventual replacement of the mitral valve. Prompt and sensitive antibiotics in combination with surgical consultation are vital to the survival of this condition.

Computational modelling of supramolecular metallopeptide assemblies.

Among the important questions in supramolecular peptide self-assemblies are their interactions with metallic compounds and ions. In the last decade, intensive efforts have been devoted to understanding the structural properties of these interactions including their dynamical and catalytic impact in natural and de novo systems. Since structural insights from experimental approaches could be particularly challenging, computational chemistry methods are interesting complementary tools. Here, we present the general multiscale strategies we developed and applied for the study of metallopeptide assemblies. These strategies include prediction of metal binding site, docking of metallic moieties, classical and accelerated molecular dynamics and finally QM/MM calculations. The systems of choice for this chapter are, on one side, peptides involved in neurodegenerative diseases and, on the other, de novo fibrillar systems with catalytic properties. Both successes and remaining challenges are highlighted so that the protocol could be apply to other system of this kind.

Genome resources for three modern cotton lines guide future breeding efforts.

Cotton (Gossypium hirsutum L.) is the key renewable fibre crop worldwide, yet its yield and fibre quality show high variability due to genotype-specific traits and complex interactions among cultivars, management practices and environmental factors. Modern breeding practices may limit future yield gains due to a narrow founding gene pool. Precision breeding and biotechnological approaches offer potential solutions, contingent on accurate cultivar-specific data. Here we address this need by generating high-quality reference genomes for three modern cotton cultivars ('UGA230', 'UA48' and 'CSX8308') and updating the 'TM-1' cotton genetic standard reference. Despite hypothesized genetic uniformity, considerable sequence and structural variation was observed among the four genomes, which overlap with ancient and ongoing genomic introgressions from 'Pima' cotton, gene regulatory mechanisms and phenotypic trait divergence. Differentially expressed genes across fibre development correlate with fibre production, potentially contributing to the distinctive fibre quality traits observed in modern cotton cultivars. These genomes and comparative analyses provide a valuable foundation for future genetic endeavours to enhance global cotton yield and sustainability.

Light-Chain (AL) Cardiac Amyloidosis Presenting as Heart Failure With Reduced Ejection Fraction.

Systemic amyloidosis is caused by the extracellular deposition of misfolded proteins in various organs and usually leads to organ dysfunction. The two common subtypes include light-chain amyloidosis and transthyretin amyloidosis. Deposition of these proteins in the heart can lead to infiltrative and restrictive cardiomyopathy, commonly manifesting as heart failure with preserved ejection fraction. However, systolic heart failure with reduced ejection fraction is mainly seen in the advanced stages of the disease. Here, we present the case of a 53-year-old female who presented with new-onset heart failure with reduced ejection fraction with no prior symptoms or diagnosis of amyloidosis and diastolic dysfunction.

A Rare Case of a 54-year-old Male with Vocal Cord Paralysis Secondary to Left Atrial Enlargement.

Ortner's syndrome, a rare condition characterized by hoarseness due to left recurrent laryngeal nerve palsy caused by cardiovascular structural compression, is typically associated with an enlarged left atrium secondary to conditions like mitral stenosis. However, recent studies propose additional causes, including compression between the dilated pulmonary artery and the aorta. We present a case of a 54-year-old male with Ortner's syndrome secondary to severe mitral regurgitation and pulmonary hypertension. Our patient presented with a one-month history of progressive dyspnea and hoarseness. Diagnostic imaging revealed cardiac enlargement, left vocal cord paralysis, and severe mitral valve pathology. A transesophageal echocardiogram revealed mitral valve prolapse and severe flail motion of the anterior leaflet. Further assessments through catheterizations confirmed severely elevated right ventricular systolic pressures and pulmonary hypertension. Attempts at mitral valve replacement were hindered by persistently elevated pulmonary pressures, necessitating transfer for specialized care. Our case highlights the broad differentials for hoarseness, emphasizing rare cardiovascular origins such as Ortner's syndrome, involving compression of the left recurrent laryngeal nerve. Early identification is essential, often necessitating comprehensive head and neck examination and radiological studies. While management depends on nerve injury duration, a timely intervention targeting the underlying cardiovascular pathology, including appropriate medical therapy and surgical approaches, can potentially alleviate or reverse nerve damage. Furthermore, our case underscores the significance of initiating guideline-directed medical therapy early in chronic cardiovascular conditions to mitigate cardiac remodeling and prevent complications like left recurrent laryngeal nerve palsy. Timely identification and targeted management of underlying cardiovascular etiologies are crucial in preventing Ortner's syndrome.

Benign Pneumoperitoneum Following Mitral Valve Replacement.

The pneumoperitoneum refers to the presence of free air inside the abdominal cavity. This finding is usually a sequela of a gastrointestinal tract perforation. Still, in rare instances, it can present after cardiac surgery due to the proximity of the peritoneal cavity and pericardium, allowing air to enter the peritoneal cavity. Our patient was a 63-year-old female who initially presented for revision of the mitral valve replacement. A chest X-ray on postoperative day 13 revealed a 6.6 cm lucency under the right diaphragm suggestive of pneumoperitoneum. She was discharged after serial chest X-rays revealed a decrease in the size of the pneumoperitoneum. Twelve days later, our patient was readmitted, as another chest X-ray revealed that the size of the pneumoperitoneum was again increasing. An endoscopy was performed, but it did not reveal any lesions or etiology that would lead to a leak from the gastrointestinal tract. Finally, due to the benign nature of the pneumoperitoneum and the decrease in its size over the following days, we opted for conservative management, and she was discharged again. This case emphasizes the rare occurrence of benign pneumoperitoneum post-mitral valve surgery. While surgery may not always be required for asymptomatic cases, careful vigilance post-cardiac surgery remains crucial to detect potential abdominal complications promptly.

Proceed with Caution: Social Acceptability of Forestry Practices in Puerto Rico among Members of Local Environmental Organizations, Academia and Professional Associations.

Social acceptability of forestry practices plays a key role in defining sustainable forestry policies and strategies. In this study an online survey was distributed among members of environmental, non-governmental, professional, and academic organizations to assess the acceptability of forestry practices in Puerto Rico among members of civic society interested in environmental management issues. Participants were asked about their perception of forest uses, their preference of tree harvesting technologies, methods that may apply in small scale wood production settings, and trust in organizations providing forest information. We also inquired about attitudes towards economic activity in forests and the impact of such activity on recreation and biodiversity. The results show that even though participants do not place a high priority on economic development through forestry activities, acceptance of forest management for wood harvesting will be possible by considering adherence to particular forestry technologies and methods to safeguard current recreation activities and biodiversity conservation. Social acceptability information would be worthwhile when seeking consensus among a broader group of local stakeholders. As a next step we suggest the creation of a council constituted by diverse forestry sector stakeholders that would engage in a strategic planning exercise to delineate a clear road map that can guide short and long-term sustainable forest management, including wood industry development.

Epilepsy and sudden unexpected death in epilepsy in a mouse model of human SCN1B-linked developmental and epileptic encephalopathy.

Voltage-gated sodium channel ß1 subunits are essential proteins that regulate excitability. They modulate sodium and potassium currents, function as cell adhesion molecules and regulate gene transcription following regulated intramembrane proteolysis. Biallelic pathogenic variants in SCN1B, encoding ß1, are linked to developmental and epileptic encephalopathy 52, with clinical features overlapping Dravet syndrome. A recessive variant, SCN1B-c.265C>T, predicting SCN1B-p.R89C, was homozygous in two children of a non-consanguineous family. One child was diagnosed with Dravet syndrome, while the other had a milder phenotype. We identified an unrelated biallelic SCN1B-c.265C>T patient with a clinically more severe phenotype than Dravet syndrome. We used CRISPR/Cas9 to knock-in SCN1B-p.R89C to the mouse Scn1b locus (Scn1bR89/C89). We then rederived the line on the C57BL/6J background to allow comparisons between Scn1bR89/R89 and Scn1bC89/C89 littermates with Scn1b+/+ and Scn1b-/- mice, which are congenic on C57BL/6J, to determine whether the SCN1B-c.265C>T variant results in loss-of-function. Scn1bC89/C89 mice have normal body weights and ∼20% premature mortality, compared with severely reduced body weight and 100% mortality in Scn1b-/- mice. ß1-p.R89C polypeptides are expressed in brain at comparable levels to wild type. In heterologous cells, ß1-p.R89C localizes to the plasma membrane and undergoes regulated intramembrane proteolysis similar to wild type. Heterologous expression of ß1-p.R89C results in sodium channel α subunit subtype specific effects on sodium current. mRNA abundance of Scn2a, Scn3a, Scn5a and Scn1b was increased in Scn1bC89/C89 somatosensory cortex, with no changes in Scn1a. In contrast, Scn1b-/- mouse somatosensory cortex is haploinsufficient for Scn1a, suggesting an additive mechanism for the severity of the null model via disrupted regulation of another Dravet syndrome gene. Scn1bC89/C89 mice are more susceptible to hyperthermia-induced seizures at post-natal Day 15 compared with Scn1bR89/R89 littermates. EEG recordings detected epileptic discharges in young adult Scn1bC89/C89 mice that coincided with convulsive seizures and myoclonic jerks. We compared seizure frequency and duration in a subset of adult Scn1bC89/C89 mice that had been exposed to hyperthermia at post-natal Day 15 versus a subset that were not hyperthermia exposed. No differences in spontaneous seizures were detected between groups. For both groups, the spontaneous seizure pattern was diurnal, occurring with higher frequency during the dark cycle. This work suggests that the SCN1B-c.265C>T variant does not result in complete loss-of-function. Scn1bC89/C89 mice more accurately model SCN1B-linked variants with incomplete loss-of-function compared with Scn1b-/- mice, which model complete loss-of-function, and thus add to our understanding of disease mechanisms as well as our ability to develop new therapeutic strategies.

Método simple para minimizar la discrepancia en la longitud de las extremidades y restaurar el offset en la artroplastia total de cadera / A Simple method to minimize limb length discrepancy and restore offset in total hip arthroplasty

Introducción: Existen más de 20 técnicas diferentes para corregir la discrepancia de miembros inferiores. El método que aquí se evalúa se basa en una clavija fija posicionada en el ala ilíaca asociada a un "calibre" móvil, con otra clavija con la que se marca la referencia en el trocánter mayor. Objetivo: Evaluar la confiabilidad de este dispositivo de medición usado durante la artroplastia total de cadera para restaurar la longitud del miembro inferior y el offset femoral. Materiales y Métodos: Se formaron dos grupos: grupo A con pacientes en quienes no se había usado el dispositivo y grupo B con pacientes en quienes sí se había usado el dispositivo. Se realizaron las mediciones en la radiografía panorámica de pelvis obtenida con el paciente de pie, antes de la cirugía y 3 meses después. Resultados: Se obtuvo una muestra de 80 pacientes (40 por grupo). Se logró corregir la discrepancia de la longitud de los miembros, pero no se hallaron diferencias estadísticamente significativas en la corrección promedio, entre ambos grupos (p = 0,07). Sin embargo, al analizar la varianza en la corrección de la discrepancia de la longitud de cada grupo se obtuvo una diferencia estadísticamente significativa (p <0,001). Conclusiones: Este dispositivo que permite una medición cuantificable más objetiva no asegura una corrección de la discrepancia de la longitud exacta a 0 mm, pero sí permite trabajar dentro de un rango más confiable y seguro. Nivel de Evidencia: III

Introduction: There are more than 20 different techniques to correct lower limb length discrepancy. The method evaluated in this study is based on a fixed pin in the iliac wing connected to a mobile gauge and another pin in the greater trochanter with which the reference is marked. The objective is to evaluate the reliability of this measurement device used during THA to restore lower limb length and femoral offset. Materials and Methods: Two groups were formed: Group A (patients who did not use the device) and Group B (patients who did use the device). Measurements were taken in the pre-surgery panoramic pelvic radiograph with the patient standing and three months later. Results: A sample of 80 patients was obtained, with 40 in each group. The difference in limb length could be corrected in each group, however the average correction achieved by both groups did not result in a statistically significant difference (p=0.07). However, when the variance in the correction of the difference in length of each group was examined, a statistically significant difference (p<0.001) was obtained. Conclusions: We can conclude that while this device, which serves as a more objective quantifiable measurement technique, does not guarantee a correction of the exact length discrepancy to 0 mm, it does allow us to work within a more dependable and safe range. Level of Evidence: III

Complications of Transcutaneous Protheses - A Systematic Review of Publications Over the Past 10 Years

Abstract Introduction Bone conduction implants, responsible for transmitting sound from an external processor to the inner ear, can be divided into active and passive, depending on the vibratory stimulus location. The use of transcutaneous device has increased, given its aesthetic appeal, the complications and limitations of percutaneous devices, and patient's treatment adherence, focusing mainly on efficacy. However, various complications are associated with the use of transcutaneous prosthesis, which can often be serious. Objective To approach the literature on complications involving transcutaneous bone-anchored prostheses through a systematic review of articles published in the past 10 years (2011-2021). Data Synthesis The MEDLINE, EMBASE, Scopus, and Cochrane Library databases were searched. All articles written in English reporting on currently available transcutaneous prosthesis implantation and its complications were selected. Studies on both children and adults were included. The data on complications were extracted, and complications were classified as minor or major and associated to each device used. Thirty-seven articles were included in the study, of which 14 were prospective cohort studies, 22 were retrospective case series, and 1 was a case report. Most studies (18) included both adults and children. Moreover, 901 implantations were performed, of which 552 implanted Baha Attract (Cochlear Ltd., Sydney, Australia), 244 implanted BoneBridge (MED-EL, Innsbruck, Austria), and 105 implanted Sophono (Sophono Inc., Boulder, CO, USA]). Furthermore, 192 adverse events were reported (total complication rate, 21.3%), with 161 minor complications (84.3%) and 31 major complications (16.1%). Conclusion Transcutaneous prosthesis is an audiological alternative with fewer complications than percutaneous prosthesis. However, its indication should be judicious because complications are common, and although most complications are minor, serious infections requiring explantation may develop.

Factores de riesgo de inestabilidad en el reemplazo total de cadera por fractura medial de cadera / Instability risk factors in total hip arthroplasty for femoral neck fracture

Introducción: Una de las complicaciones más importantes de la artroplastia total de cadera en el tratamiento de las fracturas es la luxación, con una tasa del 10%, cinco veces mayor que la de la artroplastia total de cadera por osteoartrosis. El objetivo de este estudio fue conocer nuestra incidencia de luxación en pacientes sometidos a artroplastia total de cadera por fractura del cuello femoral y evaluar la causa de la luxación. Materiales y Métodos: Estudio retrospectivo en 110 pacientes sometidos a artroplastia total de cadera por fractura medial de cadera (edad promedio 69 años; 71% mujeres). Se evaluaron el tipo de fijación de la prótesis, el tamaño de la cabeza, el offset y el abordaje quirúrgico. Se midieron los ángulos de inclinación y de anteversión acetabulares y se registraron las comorbilidades. Resultados: El 72% de las cirugías fueron por vía posterolateral. La vía anterolateral se asoció con una copa 7° más vertical (p = 0,001). El 65,4% de las cabezas eran de 32 mm. El 15% (3/20) de las cabezas chicas (22 y 28 mm) y el 1% (1/90) de las grandes se luxaron (p = 0,0027). No se luxó ninguna cabeza de 36 mm. Las comorbilidades neurológicas más frecuentes fueron depresión, Parkinson y Alzheimer. Conclusiones: Las cabezas de pequeño diámetro junto con el mal posicionamiento de la prótesis y las enfermedades neurocognitivas se asocian a una inestabilidad mayor. El uso de cabezas de 36 mm y la correcta orientación de los componentes son suficientes para asegurar la estabilidad. Nivel de Evidencia: III

Introduction: One of the most relevant complications of total hip arthroplasty (THA) in the treatment of fractures is a dislocation rate of 10%, which is 5 times higher than that of THA for osteoarthritis. Our objective was to determine the dislocation rate in patients treated with THA due to femoral neck fracture and to evaluate the cause of dislocation. Materials and Methods: We carried out a retrospective study on 110 THAs in patients with femoral neck fractures (the average age was 69 years, and 71% were women). The type of fixation of the prosthesis, the size of the head, the offset, and the surgical approach were evaluated. The angle of acetabular inclination and anteversion and the comorbidities were measured. Results: 72% of surgeries were performed through the posterolateral approach. The anterolateral approach is associated with a 7° more vertical cup (p=0.001). 65.4% of the heads were 32 mm. 15% of the small heads (22 and 28mm) (3/20) and only 1% of the large heads (1/90) dislocated (p=0.0027). No 36-mm heads were dislocated. Depression, Parkinson's, and Alzheimer's disease were the most frequent neurological comorbidities. Conclusions: Small-diameter heads, in combination with poor positioning of the prosthesis and neurocognitive diseases, are associated with greater instability. Using prosthetic heads with a diameter of 36 mm and a correct orientation of the components is sufficient to ensure stability. Level of Evidence: III

Prevalencia y resultados de cultivos positivos inesperados en revisiones de reemplazo total de cadera presumiblemente asépticas / Prevalence and outcomes of unexpected positive cultures in presumed aseptic revision total hip arthroplasty

Introducción: Las tasas de infección periprotésica, a veces, son subestimadas, ya que muchos casos de presunta falla aséptica pueden deberse a una infección no reconocida. Los objetivos de este estudio fueron: 1) estimar la prevalencia de cultivos positivos intraoperatorios inesperados, 2) determinar si las comorbilidades o los factores de riesgo de los pacientes tuvieron relación con la presencia de cultivos positivos inesperados, 3) determinar la supervivencia del implante en un seguimiento mínimo de 12 meses. Materiales y Métodos: Se realizó un estudio retrospectivo y observacional. En las historias clínicas electrónicas, se identificaron todas las revisiones de artroplastia total de cadera de una única institución entre 2014 y 2021. Resultados: De las 49 revisiones de artroplastia total de cadera en un tiempo, 9 pacientes (18,4%) tuvieron un resultado positivo inesperado. Los microorganismos aislados fueron: Staphylococcus aureus (3), Pseudomonas aeruginosa (1), Staphylococcus lugdunensis (1), Staphylococcus epidermidis (2), Staphylococcus haemolyticus (1), Streptococcus epidermidis (1). Ninguna comorbilidad tuvo significancia estadística para favorecer cultivos positivos inesperados en las revisiones asépticas. El 2% de la muestra, con un período de seguimiento de 49 meses, se reinfectó. Conclusiones: Nuestro estudio arrojó una prevalencia de cultivos positivos inesperados del 18,4%. Ninguno de los factores de riesgo reportados en la bibliografía se asoció con un mayor riesgo de cultivos positivos inesperados, excepto los niveles altos de velocidad de sedimentación glomerular. Nuestros hallazgos son compatibles con los publicados y sugieren que los cultivos positivos inesperados en revisiones presumiblemente asépticas no tienen consecuencias significativas en la supervivencia del implante. Nivel de Evidencia: III

Introduction: Periprosthetic infection rates are sometimes underestimated, given that many cases of presumed aseptic failure may be due to unrecognized infection. The objectives of this study were: (1) to estimate the prevalence of unexpected positive intraoperative cultures; (2) to determine if any of the patient's comorbidities or risk factors were related to the presence of unexpected positive cultures; (3) to determine the implant survival during a follow-up of at least 12 months. Materials and Methods: A retrospective and observational study was carried out where, through electronic medical records, all revision total hip arthroplasties (THAs) from a single institution between 2014 and 2021 were identified. Results: Out of 49 single-stage revision THAs, 9 patients (18.4%) had an unexpected positive culture. The isolated microorganisms were Staphylococcus aureus (3), Pseudomonas aeruginosa (1), Staphylococcus lugdunensis (1), Staphylococcus epidermidis (2), Staphylococcus haemolyticus (1), Streptococcus epidermidis (1). In addition, when we evaluated the comorbidities of the patients, none had statistical significance in favoring unexpected positive cultures in aseptic revisions. We discovered that 2% of our sample with a follow-up period of 49 months developed reinfection. Conclusion: Our study showed a prevalence of unexpected positive cultures of 18.4%. None of the risk factors reported in the literature was associated with a higher risk of unexpected positive cultures, except for high ESR values. Our findings in the analyzed sample suggest that unexpected positive cultures in presumably aseptic revisions do not have significant consequences on implant survival, as found in the literature. Level of Evidence: III

Osteosíntesis en fracturas femorales periprotésicas de cadera Vancouver tipos B1 y C. Análisis multicéntrico / Osteosynthesis in Vancouver type B1 and C periprosthetic hip fractures of the femur. A multicenter analysis

Introducción: Nuestro objetivo fue analizar los resultados del tratamiento con osteosíntesis en pacientes con fracturas Vancouver tipos B1 y C, evaluar las complicaciones, las reintervenciones y la tasa de mortalidad en este grupo. Materiales y métodos: Estudio multicéntrico, retrospectivo. Se estableció una base de datos que incluía a 53 pacientes con fracturas periprotésicas de fémur Vancouver tipos B1 y C tratadas con osteosíntesis, desde 2008 hasta 2021, en dos centros hospitalarios de alta complejidad. Resultados: La fijación proximal más utilizada fue con tornillos bicorticales más lazadas de alambre. El tipo de fractura según la clasificación de Vancouver se correlacionó con un valor significativo en el uso de tornillos de compresión interfragmentaria (p 0,001), con un total de 13 pacientes (24,52%), 9 en fracturas Vancouver tipo C. El tiempo de consolidación promedio fue de 4 meses, con un puntaje promedio del Harris Hip Score de 68. Doce pacientes (22,64%) tuvieron complicaciones: retraso de la consolidación (7 casos; 13,2%), falla de la osteosíntesis con trazo de fractura a nivel distal del tallo (un caso; 1,88%), una nueva osteosíntesis por falla a nivel del material de osteosíntesis (un caso; 1,88%) y tres fallecieron (5,66%). Conclusiones: El manejo de las fracturas femorales periprotésicas es un tema complejo y desafiante. El tratamiento con osteosíntesis constituye un método exitoso que requiere de la aplicación de principios actuales de técnicas mínimamente invasivas que, junto con una fijación proxi-mal estable, mejoran las posibilidades de éxito. Nivel de Evidencia: IV

Introduction: Our objective was to analyze the results of osteosynthesis treatment in patients with Vancouver type B1 and C fractures, evaluate complications, reinterventions and the mortality rate in this group. Materials and methods: Multicenter, retrospective study. A database was established that included 53 patients with Vancouver type B1 and C periprosthetic femoral fractures treated with osteosynthesis, from 2008 to 2021, who were evaluated in two high-complexity hospital centers. Results: The most used proximal fixation was bicortical screws and wire loops. The type of fracture according to the Vancouver classification correlated with a significant value in the use of interfragmentary compression screws (p 0.001), with a total of 13 patients (24.52%), 9 in Vancouver type C fractures. Mean consolidation was 4 months, with a mean Harris Hip Score of 68. Twelve patients (22.64%) had complications: delayed union (7 cases; 13.2%), failed osteosynthesis with fracture at the distal level of the stem (one case; 1.88%), one new osteosynthesis due to failure at the level of the osteosynthesis material (one case; 1.88%) and three patients died (5.66%). Conclusions: The management of periprosthetic femoral fractures is a complex and challenging issue. Osteosynthesis treatment is a successful method that requires the application of current principles of minimally invasive techniques that, together with stable proximal fixation, improve the chances of success. Level of Evidence: IV

Compounds isolated from Bixa orellana: evidence-based advances to treat infectious diseases / Compuestos aislados de Bixa orellana: avances basados en la evidencia para tratar enfermedades infecciosas

SUMMARY Bixa orellana L. is a native plant from Brazil, but it is also present in other tropical countries such as Peru, Colombia, Ecuador, Mexico, Indonesia, India and East Africa. It is popularly known as Urucum in Brazil. This review shows the potential of bioactive compounds derived from B. orellana to treat infectious diseases due their antimicrobial and antioxidant properties. This plant is also related as an antiinflammatory agent for treatment of pulmonary diseases, or even as eye drops for redness. Its leaves are used for treatment of snakebite, diarrhea, gonorrhea, hepatitis, gastritis, diuretic, antipyretic, and for skin disease. This popular knowledge has encouraged the identification of bioactive compounds in this plant. Compounds as β-cryptoxanthin, geranylgeraniol, lutein, procyanidin B2, procyanidin B3, ellagi tannin isomer and ellagic acid deoxyhexose have been described. These compounds inhibited pathogenic microorganisms such as bacteria, fungi, protozoan and viruses. In addition, some compounds with anti-inflammatory and antioxidant activities were also described. In this sense, B. orellana is a promising source of compounds that could be applied in antimicrobial therapy. This review work may help in the understanding and incentive of new research for antimicrobial discoveries using different B. orellana compounds.

RESUMEN Bixa orellana L. es una planta nativa de Brasil, pero también está presente en otros países tropicales como Perú, Colombia, Ecuador, México, Indonesia, India y África Oriental. Es conocida popularmente como Urucum en Brasil. Esta revisión expone el potencial de los compuestos bioactivos derivados de B. orellana para tratar enfermedades debido a sus propiedades antimicrobianas y antioxidantes. Esta planta también está relacionada como un agente antiinflamatorio para el tratamiento de enfermedades pulmonares e incluso como gotas para los ojos para el enrojecimiento. Sus hojas se utilizan para el tratamiento de la mordedura de serpiente, diarrea, gonorrea, hepatitis, gastritis, diuréticos, antipiréticos y para enfermedades de la piel. Ese conocimiento popular ha fomentado la identificación de compuestos bioactivos en esa planta. Los compuestos β-criptoxantina, geranilgeraniol, luteína, procianidina B2, procianidina B3, isómero elagitanino y ácido elágico desoxihexosa inhibieron microorganismos patógenos como bacterias, hongos, protozoos y virus. En ese sentido, B. orellana es una fuente prometedora de compuestos que podrían aplicarse en la terapia antimicrobiana. Este trabajo de revisión puede ayudar a comprender e incentivar nuevas investigaciones para los descubrimientos de antimicrobianos que utilizan diferentes compuestos de B. orellana.

Influence of creatine kinase on c-reactive protein in muscle adaptation / Influência da creatina quinase sobre a proteína c-reativa na adaptação muscular / Influencia de la creatina quinasa sobre la proteína c-reactiva en la adaptación muscular

ABSTRACT Introduction Aging is a natural process and marked by changes and adaptations of both a biological and physiological nature. As regards adaptations, there are numerous works that address these responses following various types of training programs. Resistance training (RT) can be assessed by biochemical parameters such as creatine kinase (CK), which is a major marker of stress in the skeletal muscles. C-reactive protein (CRP) is a biochemical marker used to assess damage to the cardiac muscles. Objective To evaluate the influence of CK on CRP in elderly female subjects undergoing RT. Methods An experimental study was carried out with 10 elderly women (61 ± 1.8 years). Peripheral venous blood was collected for the CK and CRP analysis both before and 24 hours after 8 weeks of RT. Anthropometric measurements involved BMI (Body Mass Index), WHR (waist-to-hip ratio) and body composition. The RT involved combined series - Bi-Set. For statistical analysis, the Shapiro-Wilk normality test was conducted first and presented p >0.05, confirming the use of parametric tests. Group variables were presented as mean and standard deviation. To compare the load-dependent samples, the repeated measures one-way ANOVA was performed first, followed by Tukey's post hoc test. For CK and CRP variables, we conducted the paired Student's t-test for the timepoints pre- and post-eight weeks of RT along with the one-way ANOVA test, also conducting Tukey's post-test when necessary. The level of significance was set at p ≤0.05. Results There was a statistically significant decrease in both serum CK and CRP, which indicated a reduction of 73.14% and 75%, respectively. Conclusion Long-term RT promoted influences among biomarkers assessed through skeletal muscle (CK) and cardiac muscle (CRP) damage, determining adaptation and muscle remodeling in any age group. Level of evidence II, Investigation of treatment results.

RESUMO Introdução O envelhecimento é um processo natural e marcado por mudanças e adaptações, tanto biológicas quanto fisiológicas. Com relação às adaptações, existem inúmeros trabalhos que abordam essas respostas decorrente a vários tipos de treinamento. O treinamento resistido (TR) pode ser avaliado por parâmetros bioquímicos, como a creatina quinase (CK), que é um grande marcador de estresse da musculatura esquelética. A proteína C-reativa (PCR) é um marcador bioquímico utilizado para avaliar o dano no sistema muscular cardíaco. Objetivo Avaliar a influência da CK sob a PCR em idosas em TR. Métodos Estudo do tipo experimental com dez idosas (61 ± 1,8 anos). As análises de CK e PCR foram coletadas em sangue venoso periférico antes e 24 horas após as 8 semanas de TR. Medidas antropométricas foram realizadas: índice de massa corporal (IMC), relação da cintura e o quadril (RCQ) e composição corporal. O TR foi realizado por série combinada (Bi-Set). Para análise estatística, primeiramente foi realizado o teste de normalidade de Shapiro-Wilk, apresentando p > 0,05) e comprovando a utilização de testes paramétricos. As variáveis do grupo foram apresentadas como média e desvio padrão. Para comparação das amostras dependentes de evolução das cargas foi realizado a ANOVA one-way pareada para medidas repetidas, seguida de pós-teste de Tukey. Para variáveis de CK e PCR, foi realizado teste t de Student pareado para os momentos pré e pós-8 semanas de TR, assim como o ANOVA one-way e, quando necessário, o pós-teste de Tukey. O nível de significância adotado foi de p ≤ 0,05. Resultados Houve diminuição estatisticamente significativa, tanto para as concentrações séricas de CK, quanto para PCR, o que indicou redução de 73,14% e 75%, respectivamente. Conclusão O TR de longa duração promoveu influências entre biomarcadores avaliados por meio do dano do músculo esquelético (CK) e dano do músculo cardíaco (PCR), determinando adaptação e remodelamento muscular em qualquer faixa etária. Nível de evidência II; Investigação dos resultados do tratamento.

RESUMEN Introducción El envejecimiento es un proceso natural y marcado por cambios y adaptaciones, tanto biológicas como fisiológicas. Con respecto a las adaptaciones, existen innumerables trabajos que abordan esas respuestas derivadas de varios tipos de entrenamiento. El Entrenamiento Resistido (ER) puede ser evaluado por parámetros bioquímicos, como la creatina quinasa (CK) que es un gran marcador de estrés de la musculatura esquelética. La proteína C-reactiva (PCR) es un marcador bioquímico utilizado para evaluar el daño en el sistema muscular cardíaco. Objetivo Evaluar la influencia de la CK bajo la PCR en ancianas en ER. Métodos Estudio de tipo experimental con 10 ancianas (61 ± 1,8 años). Los análisis de CK y PCR fueron recolectados en sangre venosa periférica antes y 24 horas después de las 8 semanas de ER. Se realizaron mediciones antropométricas: IMC (Índice de Masa Corporal), RCC (Relación Cintura / Cadera) y Composición Corporal. El ER fue realizado por Serie Combinada (Bi-Set). Para análisis estadístico, primero se realizó la prueba de normalidad de Shapiro-Wilk presentando p> 0,05 y comprobando el uso de pruebas paramétricas. Las variables del grupo se mostraron como promedio y desviación estándar. Para comparación de las muestras dependientes de evolución de las cargas se realizó el Test one-way ANOVA pareado para medidas repetidas, seguido de post-test de Tukey. Para variables de CK y PCR se realizó el Test t de Student pareado para los momentos pre y post ocho semanas de ER, así como el ANOVA one-way y cuando necesario, el post-test de Tukey. El nivel de significancia adoptado fue de p ≤ 0,05. Resultados Hubo disminución estadísticamente significativa, tanto para las concentraciones séricas de CK, como para PCR, lo que indicó reducción del 73,14% y el 75%, respectivamente. Conclusión El ER de larga duración promovió influencias entre biomarcadores evaluados a través del daño del músculo esquelético (CK) y daño del músculo cardíaco (PCR) determinando adaptación y remodelación muscular en cualquier grupo de edad. Nivel de evidencia II; Investigación de los resultados del tratamiento.

Efeitos de oito semanas de destreinamento sobre parâmetros cardiovasculares em mulheres idosas / Eight-week effects of detraining on cardiovascular parameters in elderly women / Efectos de 8 semanas de falta de entrenamiento sobre los parámetros cardiovasculares de mujeres mayores

Resumo Foram avaliados os efeitos do destreinamento sobre parâmetros cardiovasculares em idosas. Idosas foram submetidas a oito semanas de treinamento resistido seguidas de oito semanas de destreinamento. Foram avaliadas nove mulheres idosas (idade 62 ± 2,30). Foram feitas coletas de sangue venoso periférico e avaliação da composição corporal antes do início de treinamento, após o treinamento e após a fase de destreinamento. Não houve aumento significativo da PCR na fase de destreino, porém observamos alterações negativas para colesterol total e composição corporal, representada pelo peso gordo. Os resultados sugerem que oito semanas de destreinamento não aumentaram significativamente a PCR, porém influenciaram negativamente em outros parâmetros relacionados aos riscos cardiovasculares, como valores antropométricos e bioquímicos representados pelo colesterol total e massa gorda, respectivamente. De fato, a continuidade do treinamento físico é essencial para adquirir e manter uma boa saúde, caso contrário os benefícios alcançados regridem aos valores iniciais.

Abstract The detraining effects on cardiovascular parameters in the elderly women (EW) were evaluated. EW underwent 8 weeks of resistance training, followed by eight weeks of detraining. 9 EW were evaluated (age 62 ± 2.30). Peripheral venous blood collections and body composition evaluation were performed before training, after training and after the detraining phase. There was no significant increase in CRP in detraining phase, but we observed negative changes for total cholesterol and body composition, represented by fat weight. The results suggest that 8 weeks of detraining did not significantly increase CRP, but had a negative influence on other parameters related to cardiovascular risks, as anthropometric and biochemical values represented by total cholesterol and fat mass, respectively. In fact, continuity of physical training is essential to acquiring and maintaining good health, otherwise the beneficial adaptations achieved will return to initial values.

Resumen Se evaluaron los efectos de la falta de entrenamiento sobre los parámetros cardiovasculares de mujeres mayores. Estas siguieron un entrenamiento resistido durante 8 semanas, seguidas de 8 semanas de falta de entrenamiento. Se evaluó a 9 mujeres de edad avanzada (edad de 62 ± 2,30). Se realizaron extracciones de sangre venosa periférica y evaluación de la composición corporal antes del inicio del entrenamiento, después del entrenamiento y después de la fase de falta de entrenamiento. No hubo un aumento considerable de la PCR en la fase de falta de entrenamiento, pero observamos alteraciones negativas del colesterol total y composición corporal, representada por la grasa. Los resultados sugieren que 8 semanas de falta de entrenamiento no aumentaron considerablemente la PCR, pero influyeron negativamente en otros parámetros relacionados con los riesgos cardiovasculares, como valores antropométricos y bioquímicos representados por el colesterol total y la masa grasa, respectivamente. De hecho, la continuidad del entrenamiento físico es esencial para adquirir y mantener una buena salud; de lo contrario, las adaptaciones beneficiosas alcanzadas vuelven a los valores iniciales.

Retalho de Yu na reconstrução de defeitos labiais / Yu's flap for lip reconstruction

A reconstrução de defeitos que envolvam até 2/3 da extensão dos lábios é desafiadora, levando-se em consideração a importância funcional e estética desta estrutura. Existem diversas técnicas cirúrgicas descritas para esta finalidade, salientando-se o retalho de Abbe- Estlander, o retalho de Karapandzic e o retalho de Bernard-Burrow-Webster. A escolha da melhor abordagem deve levar em conta a dimensão e localização do defeito e as comorbidades do doente. O retalho de Yu constitui uma alternativa a ser considerada em relação a outros métodos, permitindo obter geralmente excelentes resultados cosmético- -funcionais.

The reconstruction of defects involving up to 2/3 of the lip extension is challenging, considering the functional and aesthetic importance of this structure. There are several surgical techniques described for this purpose, highlighting the Abbé-Estlander flap, the Karapandzic flap, and the Bernard-Burrow- Webster flap. The choice of the best approach should consider the size and location of the defect as well as the comorbidities of the patient. The reverse Yu flap is an alternative to be considered in relation to other methods, allowing obtaining excellent cosmetic-functional results in general.

Norma, integracion y desafio. Representaciones masculinas de varones con discapacidad física / Norma, integração e desafio. Representações masculinas de homens com deficiência física / Norm, integration, and challenge. Representations of men with physical disabilities

Resumen: El objetivo del presente artículo es preguntarnos sobre las representaciones masculinas presentes en los discursos que versan sobre varones con discapacidad física. Desde una metodología que abreva teóricamente en los estudios sobre discapacidad y de genero, se intenta abordar las representaciones como estrategias discursivas, con tres fines evidentes: instaurar una norma de masculinidad hegemónica, asociada a la normalidad funcional compulsiva vehiculizada mediante una retórica visual maravillosa; la adaptación de esa masculinidad con fines comerciales mediante una retórica realista; y el desafío a las normas antes citadas mediante la teoría queer.

Resumo: O presente artigo explora as representações masculinas presentes nos discursos que tratam de homens com deficiência física. A partir de uma metodologia que se baseia teoricamente nos estudos sobre deficiência e gênero, aborda representações como estratégias discursivas, com três objetivos: estabelecer uma norma de masculinidade hegemônica, associada à normalidade funcional compulsória transmitida por uma retórica visual maravilhosa; a adaptação dessa masculinidade para fins comerciais através de uma retórica realista; e o desafio às normas acima mencionadas apresentado pela teoria queer.

Abstract: The present work analyzes male representation in the discourse of men with physical disability. Using a methodology that draws theoretically on disability and gender studies, representations were approached as discursive strategies with three evident purposes: to establish a norm of hegemonic masculinity, associated with compulsory functional normality conveyed by a rhetoric of visual wonderfulness, the adaptation of that masculinity for commercial purposes through a realistic rhetoric; and the challenge to these processes presented by queer theory.