Nutritional factors and pressure injury risk in hospitalised patients post-stroke.

OBJECTIVE: This study aimed to analyse the nutritional factors and pressure injury (PI) risk in hospitalised patients post-stroke. METHOD: The research employed a descriptive observational method in which patients ≥18 years of age were followed for six days. Nutritional evaluation was based on anthropometric and dietary factors. The nutritional risk was assessed via anthropometric measurements, Braden nutrition subscale and daily dietary intake. PI risk was evaluated through the Braden Scale. The Wilcoxon test, paired t-test, and Kruskal-Wallis test were applied and corrected with Bonferroni correction or analysis of variance, followed by the post hoc Tukey test. RESULTS: During their hospital stays, the participating 59 patients had an increase in sensory perception (p=0.02) and nutrition (p=0.005) scores. It was observed that patients at high risk of PI did not meet daily nutritional recommendations for calories, proteins, carbohydrates, lipids and micronutrients (zinc, selenium and copper) compared with patients at low-to-moderate risk. Weight (p<0.001), body mass index (p<0.001), calf (p=0.01) and arm (p=0.04) circumferences, and subscapular (p=0.003) and triceps (p<0.001) skinfolds decreased during the six days of hospitalisation. CONCLUSION: From the findings of this study, it was concluded that nutritional factors, such as unmet recommended daily nutritional requirements of macronutrients and micronutrients, and nutritional status are associated with a higher risk of developing a PI.

Overproduction, purification, and transcriptional activity of recombinant Acinetobacter baylyi ADP1 RNA polymerase holoenzyme.

Acinetobacter baylyi is an interesting model organism to investigate bacterial metabolism due to its vast repertoire of metabolic enzymes and ease of genetic manipulation. However, the study of gene expression in vitro is dependent on the availability of its RNA polymerase (RNAp), an essential enzyme in transcription. In this work, we developed a convenient method of producing the recombinant A. baylyi ADP1 RNA polymerase holoenzyme (RNApholo) in E. coli that yields 22 mg of a >96% purity protein from a 1-liter shake flask culture. We further characterized the A. baylyi ADP1 RNApholo kinetic profile using T7 Phage DNA as template and demonstrated that it is a highly transcriptionally active enzyme with an elongation rate of 24 nt/s and a termination efficiency of 94%. Moreover, the A. baylyi ADP1 RNApholo has a substantial sequence identity (∼95%) with the RNApholo from the human pathogen Acinetobacter baumannii. This protein can serve as a source of material for structural and biological studies towards advancing our understanding of genome expression and regulation in Acinetobacter species.

Vitamin D is associated with a low quality of life: a primary care study

Introduction: Some studies have described impairment in quality of life of vitamin-deficient subjects. However, little is known about this association in primary care. This study aimed to evaluate the association between vitamin D deficiency and quality of life in postmenopausal women attending primary care in the municipality of Santa Maria ­ Brazil. Methods: A cross-sectional study was carried out with postmenopausal women over 55 years of age, accompanied in primary care, from March to August 2014. These women were randomly selected among the participants of a cohort study in the municipality of Santa Maria ­ Brazil. Data were collected through a standardized questionnaire, quality of life was assessed using the Short Form-36 Health Survey (SF-36), and 25-hydroxyvitamin D were measured using the ALPCO® ELISA method. Results: Of the total of 78 studied women, 11.54% had vitamin D deficiency. Women with vitamin D deficiency had a poorer quality of life assessed by SF-36. In the regression analysis, both vitamin D deficiency and falls were independently associated with a lower physical component of the SF-36. Conclusion: Vitamin D deficiency is associated with poorer quality of life in the studied postmenopausal women.

Comportamento da variabilidade glicêmica em pacientes hospitalizados com Diabetes Mellitus 2 / Behavior of glycemic variability in hospitalized type 2 Diabetes Mellitus patients / Comportamiento de la variable glucémica en pacientes Hospitalizados con Diabetes Mellitus 2

Introdução: A hiperglicemia pode estar presente em até 38% dos pacientes hospitalizados.O controle glicêmico está associado a melhores desfechos clínicos. Objetivo: avaliar o comportamento da variabilidade glicêmica em pacientes hospitalizados com Diabetes Mellitus 2. Metodologia: Estudo transversal, composto por pacientes hospi-talizados com e sem diabetes, adultos e idosos, de ambos os gêneros, em terapia nutricional enteral. As glicemias foram medidas por testes de glicemia capilar e classificadas como normoglicemia, hiperglicemia e variabilidade glicêmica, avaliados a partir do desvio-padrão glicêmico e coeficiente de variação glicêmico. Foram avaliados dados bioquímicos como Proteína C-reativa. A análise de variância de duas vias (ANOVA) foi utilizada para comparar os grupos, além da correlação de Spearman. Resultados: Participaram 85 indivíduos, com diabetes mellitus 2 (20%; n= 17), e sem diabetes mellitus (80%; n = 68), sendo 34% (n = 29) adultos e 66% (n=56) idosos. Adultos e idosos com diabetes mellitus apresentaram hiperglicemia em relação aos pacientes não diabéticos (p<0,01), valores supe-riores de desvio-padrão glicêmico (p<0,01) e coeficiente de variação glicêmica em relação aos pacientes sem dia-betes (p= 0,03), no entanto, não foram classificados com variabilidade glicêmica. Os valores da Proteína C-reativa foram correlacionados com o desvio-padrão glicêmico (R= 0,29; p= 0,0065), no entanto, a quantidade de carboi-dratos infundida na dieta enteral não se correlacionou estatisticamente com as glicemias nem com a variabilidade glicêmica dos pacientes (p>0,05). Conclusão: pacientes hospitalizados com ou sem diabetes mellitus 2 não apre-sentaram variabilidade glicêmica, demonstrando um controle glicêmico na hospitalização. (AU)

Introduction: Hyperglycemia may be present in up to 38% of hospitalized patients. Glycemic control is associated with better clinical outcomes. Objective: assess the behavior of glycemic variability in hospitalized patients with Diabetes Mellitus 2. Methodology: Cross-sectional study composed of hospitalized patients with and without diabetes, adults and elderly, of both genders, undergoing enteral nutritional therapy. Blood glucose was measured by capillary blood glucose tests and classified as normoglycemia, hyperglycemia, and glycemic variability, assessed from the glycemic standard deviation and glycemic variation coefficient. Biochemical data such as C-reactive protein were assessed. Two-way analysis of variance (ANOVA) was used to compare the groups, in addition to Spearman's correlation. Results: Eighty-five individuals with diabetes mellitus 2 (20%; n=17) and without diabetes mellitus (80%; n=68) participated in the study; 34% (n=29) were adults, and 66% (n=56) were elderly. Adults and elderly people with diabetes mellitus presented hyperglycemia concerning non-diabetic patients (p<0.01), higher values of glycemic standard deviation (p<0.01), and glycemic variation coefficient concerning patients without diabetes (p= 0.03); however, they were not classified with glycemic variability. The C-reactive protein values were correlated with the glycemic standard deviation (R= 0.29; p= 0.0065); however, the amount of carbohydrates infused in the enteral diet was not statistically correlated with glycemia or with the glycemic variability of patients (p>0.05). Conclusion: hospitalized patients with or without diabetes mellitus 2 did not show glycemic variability, demonstrating glycemic control during hospitalization. (AU)

Introducción: La hiperglucemia puede estar presente hasta en un 38% de los pacientes hospitalizados. El con-trol glucémico se asocia con mejores resultados clínicos. Objetivo: evaluar el comportamiento de la variación glucémica en pacientes con Diabetes Mellitus 2. Metodología: Estudio transversal, compuesto por pacientes hos-pitalizados con y sin diabetes, adultos y ancianos, con terapia nutricional enteral. Las glucemias fueron medidas por exámenes de glucemia capilar y clasificadas como normo glucemia, hiperglucemia y variación glucémica, evaluados a partir de la desviación estándar y coeficiente de variación glucémico. Fueron evaluados datos bioquí-micos como Proteína C-reactiva. El análisis de la variación de las dos vías (ANOVA) fue utilizada para comparar los grupos, junto a la correlación de Spearman. Resultados: Participaron 85 individuos, con diabetes mellitus 2 (20%; n+17), y sin diabetes mellitus (80%; n = 68). Adultos 34% (n=29) y ancianos 66% (n=56). Pacientes con diabetes mellitus presentaron hiperglucemia en relación a los pacientes nodiabéticos (p< 0,01), valores superiores de desviación estándar glucémico (p< 0,01) y coeficiente de variación glucémica en relación a los pacientes sin dia-betes (p= 0,03), sin embargo, no fueron clasificados con variación glucémica. Los valores de la Proteína C-reactiva fueron correlacionados con la desviación estándar glucémica (R = 0,29; P= 0,0065), la cantidad de carbohidratos administrada, no se correlacionó estadísticamente con las glucemias ni con la variación glucémica de los pacientes (p>0,05). Conclusión: pacientes hospitalizados con o sin diabetes mellitus 2 no presentaron variación glucémica, demostrando control glucémico en la hospitalización. (AU)

Low Food Consumption Interferes with the Nutritional Status of Surgical Patients with Neoplasia of the Gastrointestinal Tract.

Nutritional support strongly influence the nutritional status of the surgical neoplastic patients. This study aimed to evaluate the influence of food consumption on the perioperative nutritional status of hospitalized patients with neoplasia of the upper (UGIT) and lower (LGIT) gastrointestinal tract. METHOD: Observational, longitudinal, and prospective study. Data collected: food consumption, Subjective Global Assessment, anthropometry, laboratory tests. RESULTS: Eighty patients were followed up: 43 (54%) in the UGIT and 37 (46%) in the LGIT. The consumption in the perioperative period was lower than the usual consumption in the UGIT and LGIT groups, respectively, of energy (14.2 ± 6.5; 22.8 ± 11.2 Kcal/kg/d, p < 0.001; 13.6 ± 1.2; 19.0 ± 2.0 Kcal/kg/d; p = 0.014), protein (1.1 ± 0.7; 0.6 ± 0.3 g/kg/d, p < 0.001; 0.8 ± 0.1; 0.5 ± 0.1 g/kg/d; p = 0.058), selenium, zinc and copper. Most patients presented in the UGIT and LGIT groups, respectively, worsening malnutrition and muscle depletion according to the Subjective Global Assessment (61.9%; 51.4%) and hypoalbuminemia, mainly in the UGIT in the postoperative. CONCLUSION: Low food consumption during the perioperative period associated with prolongation of the postoperative fasting period worsens the nutritional status of patients undergoing surgery of the gastrointestinal tract for neoplasia, especially in the UGIT group.

Relation of micronutrients with antioxidant properties in patients with chronic diseases and exclusive enteral nutrition

ABSTRACT Objective: To evaluate the intake of micronutrients with antioxidant properties through exclusive enteral nutrition therapy (ENT) in hospitalized patients with chronic diseases compared to the estimated average requirement (EAR). Methods: This prospective, longitudinal, descriptive, observational study was performed in a public hospital, with adult and elderly patients. The adequacy of the volume of ENT prescribed and offered was considered satisfactory when >80%. The adequacy of micronutrients with antioxidant properties was performed according to the estimated average need (EAR). Data were considered statistically significant when p<0.05. Results: Of the 53 included patients, 58.5% were male. Most of patients (45.3%) were in the neurology clinic, and the main cause was cerebral vascular accident (18.9%). The volume administered was less than the prescribed volume of ENT in both male and female patients. However, recommendations for micronutrients with antioxidant properties, such as vitamin A, vitamin C, vitamin E, zinc, selenium, copper and iron, are according to EAR and did not exceed the tolerable intake limit (upper limit, UL), (p<0.05). The present study shows a very large variability in the concentration of micronutrients in each enteral diet. It is necessary to consider the pathologies that affect the patient, as some health conditions may be able to require specific amounts of micronutrients. Conclusions: Patients received a lower volume of enteral nutrition therapy compared to the prescribed volume. The micronutrient concentrations were consistent with daily EAR recommendations and did not exceed the tolerable intake limit (UL) for healthy individuals.

RESUMEN Objetivo: Evaluar la ingesta de micronutrientes con propiedades antioxidantes a través de la terapia de nutrición enteral exclusiva (ENT) en pacientes hospitalizados con enfermedades crónicas en comparación con el requerimiento promedio estimado (RPE). Métodos: Prospectivo, longitudinal, descriptivo y de observación, se realizó en un hospital público con pacientes adultos y ancianos. La adecuación del volumen de ENT prescrito y ofrecido se consideró satisfactoria cuando fue >80%. La adecuación de micronutrientes con propiedades antioxidantes se realizó de acuerdo con la RPE. Se consideraron estadísticamente significativos p<0,05. Resultados: De los 53 pacientes incluidos, 58,5% eran hombres. La mayoría de los pacientes (45,3%) se encontraban en la consulta de neurología y la principal causa fue el accidente vascular cerebral (18,9%). El volumen administrado fue menor que el volumen prescrito de ENT tanto en pacientes masculinos como femeninos. Sin embargo, las recomendaciones de micronutrientes con propiedades antioxidantes, como vitamina A, vitamina C, vitamina E, zinc, selenio, cobre y hierro, están de acuerdo con la RPE y no superan el límite de ingesta tolerable (UL), (p<0,05). El presente estudio muestra una variabilidad muy grande en la concentración de micronutrientes en cada dieta enteral. Es necesario considerar las patologías que afectan al paciente, ya que algunas condiciones de salud pueden requerir cantidades específicas de micronutrientes. Conclusiones: Los pacientes recibieron un volumen menor de ENT en comparación con el volumen prescrito. Las concentraciones de micronutrientes fueron consistentes con las recomendaciones diarias de la RPE y no excedieron el límite de ingesta tolerable (UL) para individuos sanos.

Dysphagia, Immobility, and Diet Acceptance: Main Factors Associated with Increased Risk of Pressure Injury in Patients Hospitalized after Stroke.

OBJECTIVE: To determine the predisposing factors for PI in patients hospitalized after stroke. METHODS: This 7-day longitudinal study followed up with patients hospitalized after stroke. Assessments included mobility, nutrition, and the presence of dysphagia and anemia. The nutrition evaluation was based on anthropometric, biochemical, and dietary determinants. Pressure injury (PI) risk was assessed via the Braden Scale. Mann-Whitney and Kruskal-Wallis tests were applied. RESULTS: Patients who were bedridden showed a greater risk of PI development upon admission (P = .004) and 7 days later (P < .001) compared with patients who could ambulate. Patients who were not dysphagic presented a lower risk of PI development in relation to patients who were dysphagic on admission (P = .047) and 7 days later (P < .001). On admission, patients with good and average diet acceptance had a lower PI risk (P = .002; P = .034) compared with those with a low acceptance. Body mass index was lower in patients at a high risk of developing PI compared with those at moderate risk (P = .02). Hemoglobin and hematocrit were statistically lower among patients who were at high risk of PI compared with patients who were low risk. CONCLUSIONS: Predisposing factors such as immobility, dysphagia, low diet acceptance, nutrition risk, and anemia are associated with a greater risk of PI development.

Validation of the UNESP-Botucatu pig composite acute pain scale (UPAPS).

The creation of species-specific valid tools for pain assessment is essential to recognize pain and determine the requirement and efficacy of analgesic treatments. This study aimed to assess behaviour and investigate the validity and reliability of an acute pain scale in pigs undergoing orchiectomy. Forty-five pigs aged 38±3 days were castrated under local anaesthesia. Behaviour was video-recorded 30 minutes before and intermittently up to 24 hours after castration. Edited footage (before surgery, after surgery before and after rescue analgesia, and 24 hours postoperatively) was analysed twice (one month apart) by one observer who was present during video-recording (in-person researcher) and three blinded observers. Statistical analysis was performed using R software and differences were considered significant when p<0.05. Intra and inter-observer agreement, based on intra-class correlation coefficient, was good or very good between most observers (>0.60), except between observers 1 and 3 (moderate agreement 0.57). The scale was unidimensional according to principal component analysis. The scale showed acceptable item-total Spearman correlation, excellent predictive and concurrent criterion validity (Spearman correlation ≥ 0.85 between the proposed scale versus visual analogue, numerical rating, and simple descriptive scales), internal consistency (Cronbach's α coefficient >0.80 for all items), responsiveness (the pain scores of all items of the scale increased after castration and decreased after intervention analgesia according to Friedman test), and specificity (> 95%). Sensitivity was good or excellent for most of the items. The optimal cut-off point for rescue analgesia was ≥ 6 of 18. Discriminatory ability was excellent for all observers according to the area under the curve (>0.95). The proposed scale is a reliable and valid instrument and may be used clinically and experimentally to assess postoperative acute pain in pigs. The well-defined cut-off point supports the evaluator´s decision to provide or not analgesia.

Anti-inflammatory activity and identification of the Verbena litoralis Kunth crude extract constituents

Verbena litoralis is a plant popularly known as "gervãozinho-do-campo" in Portuguese. It is traditionally used for stomach, liver and gallbladder problems, and as an anti-inflammatory and anthelmintic. The goal of this study was to determine the chemical composition of the crude extract obtained from the aerial parts of V. litoralis by Ultra High Performance Liquid chromatography coupled with Mass Spectrometry in Tandem (UHPLC-MS/MS); assess the anti-inflammatory activity of ethyl acetate fraction and of crude extract; and verify liver, kidney and pancreas damage. In this study, the chemical composition of the extract was identified via UHPLC/MS/MS, assessing the anti-inflammatory activity of the crude extract and the acetate fraction in an induction model of the granulomatous tissue, as well as given liver, kidney and pancreas damage markers. Chlorogenic acid, luteolin, caffeic acid, apigenin, p-coumaric acid, vanillic acid, ferulic acid and quercetin were quantified in the extract. After the seven-day treatment, the granuloma of the animals treated with the plant extract and fraction presented values very close to the positive control (nimesulide). The V. litoralis crude extract and ethyl acetate fraction show anti-inflammatory activity similar to the nimesulide without evidence of liver, kidney and pancreas damage, which attributes the plant's pharmacological action to the flavonoids found.

Geometric morphometrics for the study of facial expressions in non-human animals, using the domestic cat as an exemplar.

Facial expression is a common channel for the communication of emotion. However, in the case of non-human animals, the analytical methods used to quantify facial expressions can be subjective, relying heavily on extrapolation from human-based systems. Here, we demonstrate how geometric morphometrics can be applied in order to overcome these problems. We used this approach to identify and quantify changes in facial shape associated with pain in a non-human animal species. Our method accommodates individual variability, species-specific facial anatomy, and postural effects. Facial images were captured at four different time points during ovariohysterectomy of domestic short haired cats (n = 29), with time points corresponding to varying intensities of pain. Images were annotated using landmarks specifically chosen for their relationship with underlying musculature, and relevance to cat-specific facial action units. Landmark data were subjected to normalisation before Principal Components (PCs) were extracted to identify key sources of facial shape variation, relative to pain intensity. A significant relationship between PC scores and a well-validated composite measure of post-operative pain in cats (UNESP-Botucatu MCPS tool) was evident, demonstrating good convergent validity between our geometric face model, and other metrics of pain detection. This study lays the foundation for the automatic, objective detection of emotional expressions in a range of non-human animal species.

Fruit and vegetable intake and bones: A systematic review and meta-analysis.

BACKGROUND: Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain. METHODS: A systematic review of randomized controlled trials (RCTs) and cohort studies (PROSPERO: CRD42016041462) was performed. RCTs and cohort studies that evaluated the combined intake of fruits and vegetables in men and women aged over 50 years were included. We considered fractures as a primary outcome measure. Changes in bone markers were considered as secondary outcomes. The search strategy included the following descriptors: fruit, vegetables, vegetable products, bone and bones, bone fractures, postmenopausal osteoporosis, and osteoporosis. PubMed, Embase, and Cochrane Library were the databases used. The appraisal of the studies was performed by two independent reviewers, and discussed and agreed upon by both examiners. The data extracted from the RCTs and cohort studies were summarized separately. The risks of fractures were combined across studies using random models. Bone resorption marker (CTx) was summarized with standardized mean differences. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate the strength of recommendations. RESULTS: Of the 1,192 studies screened, 13 articles were included in the systematic review and 10 were included in the pooled analysis (6 cohort studies and 4 RCTs). The six cohort studies included in the meta-analysis included a population of 225,062. The pooled hazard ratio (HR) (95% confidence interval (CI)) of the hip in five studies was 0.92 (0.87, 0.98). Its heterogeneity was moderate (I2 = 55.7%, p = 0.060), GRADE (⊕⊕⊕O). Two cohort studies evaluated the risk of any fracture; the HR was 0.90 (95% CI: 0.86-0.96), with aheterogeneity of 24.9% (p = 0.249, GRADE (⊕⊕⊕O)). There was no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by four RCTs, GRADE (⊕⊕O O). CONCLUSION: There was an association between the increase of at least one serving of fruits and vegetables per day and decreases in the risk of fractures. The level of evidence for this association is moderate.

Antidiabetic effects of Olea europaea L. leaves in diabetic rats induced by high-fat diet and low-dose streptozotocin.

ETHNOPHARMACOLOGICAL RELEVANCE: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia, insulin resistance, and dyslipidemia. It has broad occurrence worldwide, affecting millions of people, and can cause serious complications. The olive (Olea europaea L.) has important pharmacological functions, including anti-inflammatory, antioxidant, and hypoglycemic activities. Olive leaves are used in traditional medicine for diabetes and hypertension. AIM OF THE STUDY: To evaluate the effect of the ethanolic extract of olive leaves (EEOL) on the metabolism of rats with diabetes induced by a high-fat diet and low dose of streptozotocin (STZ). MATERIALS AND METHODS: Male Wistar rats were either given normal feed or a high-fat diet (70% standard laboratory feed, 15% sucrose, 10% lard and 5% yolk powder) for four weeks, followed by administration of STZ (35 mg/kg, via ip). Animals with fasting glucose levels above 200 mg/dL were considered diabetic. Animals were divided into 5 groups, which received ethanol (10 mL/kg), metformin (250 mg/kg), or EEOL at doses of 200 and 400 mg/kg during 10 weeks by oral gavage. Blood samples were used to measure hematological and biochemical parameters, and kidneys were removed for posterior analysis. Body weight was recorded weekly. RESULTS: A significant decrease in body weight was observed among diabetic animals treated with ethanol and EEOL compared to the control group. Moreover, animals treated with EEOL showed an improvement in glucose levels and in levels of inflammatory and metabolic markers when compared to diabetic animals. CONCLUSIONS: The results indicate a potential anti-diabetic activity of olive leaves, however more studies are needed to validate clinical effects.

Content validation of a Critical Appraisal Tool for Reviewing Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain.

INTRODUCTION: This article reports the content validation of a Critical Appraisal Tool designed to Review the quality of Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain and provide guidance as to the strengths and weakness of findings. The CATRAS quality items encompass 3 domains: level of evidence, methodological soundness, and grading of the pain assessment tool. OBJECTIVES: To validate a critical appraisal tool for reviewing analgesia studies involving subjects incapable of self-reporting pain. METHODS: Content validation was achieved using Delphi methodology through panel consensus. A panel of 6 experts reviewed the CATRAS in 3 rounds and quantitatively rated the relevance of the instrument and each of its quality items to their respective domains. RESULTS: Content validation was achieved for each item of the CATRAS and the tool as a whole. Item-level content validity index and kappa coefficient were at least greater than 0.83 and 0.81, respectively, for all items except for one item in domain 2 that was later removed. Scale-level content validity index was 97% (excellent content validity). CONCLUSIONS: This 67-item critical appraisal tool may enable critical and quantitative assessment of the quality of individual analgesia trials involving subjects incapable of self-reporting pain for use in systematic reviews and meta-analysis studies.

Validation of the Italian version of the UNESP-Botucatu multidimensional composite pain scale for the assessment of postoperative pain in cats.

The study described in this paper had the goal to validate the Italian version of the UNESP-Botucatu multidimensional composite pain scale (UNESP-Botucatu MCPS) to assess postoperative pain in cats using video analysis and psycometric testing. The English version of the scale was translated into Italian. Thirty videos of the perioperative period of ovariohysterectomy surgery were analysed by 5 Italian observers with the aim to determine the pain score using the Italian version of the scale and to verify the need for analgesic treatment for each cat. Obtained scores were submitted to psycometric validity, responsiveness, and reliability tests. Of the 3 domains identified by factor analysis, the internal consistency was excellent for 'Psychomotor changes' and 'Protection of the painful area and vocal expressions of pain', while 'Physiological variables' showed moderate internal consistency. Significant changes in pain scores in response to surgery and analgesics confirmed content and construct validity. The agreement between the 'gold standard' and the blinded observers supported the criterion validity. Inter- and intra-rater reliability ranged from good to very good for all scale items. The cut-off point for rescue analgesia was > 7. The study concluded that the Italian version of the UNESP-Botucatu MCPS is a valid and reliable instrument for assessing postoperative pain in cats. The cut-off point for rescue analgesia provides an additional tool for guiding analgesic therapy.

Validation of the Italian version of the UNESP-Botucatu unidimensional composite pain scale for the assessment of postoperative pain in cattle.

OBJECTIVE: The aim of this study was to validate the Italian version of the UNESP-Botucatu Unidimensional Composite Pain Scale (UCPS-IV) for assessing postoperative pain in cattle. STUDY DESIGN: Video analysis and psychometric testing. ANIMALS: A total of 40 Nellore cattle, age 2-3 years, weighing 365±51 kg. METHODS: An English version of the scale was translated to Italian and back translated to English to ensure semantic equivalence. A total of four Italian observers and the researcher who developed the original scale (considered as the gold standard) analysed videos of 40 cattle previously subjected to orchiectomy (recorded for each cattle at four predetermined timepoints during the perioperative period) unaware of the videos' timepoint. They assigned a pain score [ranging from no pain (0) to severe pain (10)] using the Italian version of the scale and verified the need for analgesic treatment for each animal. The obtained scores were subjected to psychometric validity, responsiveness and reliability tests. RESULTS: The factor analysis of the scale resulted in a one-factor solution. Significant changes in pain scores in response to surgery and analgesics confirmed not only the content and construct validity, but also responsiveness. The agreement between the researcher who developed the original scale and the blinded observers and the correlation between the pain scores determined by the scale and those determined by three classical unidimensional pain scales confirmed criterion and concurrent validity. Internal consistency of the scale was excellent. Inter- and intrarater reliability ranged from moderate to good and from moderate to very good for all scale items, respectively, supporting reproducibility and stability. The cut-off point for rescue analgesia calculated by the receiver operating characteristic curve was > 3. CONCLUSIONS AND CLINICAL RELEVANCE: The results confirm that the UNESP-Botucatu UCPS-IV appears to be a valid and reliable tool for the assessment of postorchiectomy pain in the bovine species. The determination of a cut-off point for rescue analgesia is also helpful for guiding analgesic therapy.

Evaluation of acute and subacute toxicity of hydroethanolic extract of Dolichandra unguis-cati L. leaves in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Dolichandra unguis-cati L. is a native climbing plant of Brazil, popularly known as "unha de gato". It has been traditionally used mainly as an antipyretic, anti-inflammatory and anti-tumor agent, yet little toxicological information is found in the literature. AIM OF THE STUDY: To identify the chemical composition of the hydroethanolic extract obtained from the leaves of Dolichandra uniguis-cati and to evaluate the acute and subacute toxicity in male and female rats, in order to assess the safety profile of this plant. MATERIALS AND METHODS: In the acute study, a single dose (2000mg/kg) of the extract was orally administered to male and female rats. In the subacute study, the extract was orally administered to male and female rats at doses 100, 200 and 400mg/kg for 28 days. Behavioral changes, catalase and tbars evaluations, biochemical, hematological and histopathological analysis were determined. The extract' chemical composition was accessed through UHPLC/MS. RESULTS: Chlorogenic acid, caffeic acid, ferulic acid, vanillinic acid, p-coumaric acid, rosmarinic acid, trans-cinnamic acid, luteolin, apigenin, quercitrin and quercetin were identified in the extract. In the acute treatment, the extract was classified as safe (category 5), according to the OECD guide. In relation to the subacute study, females showed a reduction in AST (100, 200 and 400mg/kg), ALT (200mg/kg) and BUN (100 and 200mg/kg) levels, while male rats 400mg/kg presented an increase in AST levels. The Chol dosage significantly decreased in female rats in a dose-dependent manner, whereas for male rats this parameter showed no statistically significant reductions. No behavioral and histopathological changes were recorded. CONCLUSIONS: Our results indicate that the hydroethanolic extract of Dolichandra unguis-cati leaves did not present relevant toxic effects when administered orally to male and female rats. The extract also showed a potential hypocholesterolemic activity.

Validation de la version francophone d'une échelle composite multidimensionnelle pour l'évaluation de la douleur postopératoire chez les chats.

Validation of the French version of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats. The aim of this study was to validate the French version of the UNESP-Botucatu multidimensional composite pain scale (MCPS-Fr) to assess postoperative pain in cats. Two veterinarians and one DVM student identified three domains of behavior based on video analyses: "psychomotor change", "protection of the painful area" and "physiological variables". Internal consistency was excellent (Cronbach's alpha coefficient of 0.94, 0.90 and 0.61, respectively). Criterion validity was good to very good when evaluations from the three observers were compared with a "gold standard". Inter- and intra-rater reliability for each scale item were good to very good. The optimal cut-off point identified with a ROC curve was > 7 (scale range 0-30 points), with a sensitivity of 97.8% and specificity of 99.1%. The MCPS-Fr is a valid, reliable and responsive instrument for assessing acute pain in cats undergoing ovariohysterectomy.(Translated by Dr. Beatriz Monteiro).

Nutrição e saúde óssea: a importância do cálcio, fósforo, magnésio e proteínas / Nutrition and bone health: the importance of calcium, phosphorus, magnesium and protein

A osteoporose é uma doença silenciosa que afeta, especialmente, as mulheres na pós-menopausa, e suas principais consequências são as fraturas. Medidas não farmacológicas, tais como uma nutrição adequada, podem ajudar a manter a massa óssea, retardando o aparecimento da osteoporose. Nessa revisão, será abordada a importância da nutrição adequada nesta fase da vida, com ênfase para o cálcio, fósforo, magnésio e proteínas. Tanto uma baixa ingestão desses nutrientes quanto um excesso de cálcio e fosforo parecem estar associados a um risco maior de fraturas. Uma dieta balanceada pode vir a diminuir o impacto do envelhecimento na saúde óssea(AU)

Osteoporosis is a silent disease that affects especially women after menopause, and its main consequences are the fractures. Non-pharmacological measures, such as proper nutrition, can help maintain bone mass delaying the onset of osteoporosis. Here the authors review the importance of proper nutrition at this stage of life, with emphasis on calcium, phosphorus, magnesium and protein. Both a low intake of these nutrients and an excess of calcium and phosphorus seem to be associated with an increased risk of fractures. A balanced diet can come to lessen the impact of aging on bone health(AU)

Traditional usages, botany, phytochemistry, biological activity and toxicology of tropaeolum majus L: a review / Usos tradicionales, botánica, fitoquímica, actividad biológica y toxicología de tropaeolum majus L: una revisión

Tropaeolum majus presents medicinal, nutritional and ornamental value. Plant extracts and fractions have been found to exhibit diuretic, antihypertensive, anti-inflammatory, antimicrobial and antioxidant activities. Moreover, protective effects on blood and liver, scurvy’s treatment, antithrombin activity and prevention against macular degeneration have also been observed. T. majus contains biologically active compounds such as flavonoids, glucosilonates, fatty acids, essential oil, chlorogenic acid, aminoacids, cucurbitacins, proteins and carotenoids. Acute and subchronic studies demonstrated a lack of toxic effects, but the extracts of this plant can have deleterious consequences during the pregnancy. The revised databases were SciELO, PubMed, ScienceDirect and Portal da Capes, considering studies between 1963 and 2014 and by searching for terms like Tropaeolum majus, Tropaeolaceae, Tropaeolum majus constituents, Tropaeolum majus use and Tropaeolum majus toxicity.

Tropaeolum majus presenta valor medicinal, alimenticio y ornamental. A partir del extracto y las fracciones de la planta se han encontrado actividades biológicas, que incluyen efecto diurético, antihipertensivo, anti-inflamatorio, antimicrobiano y antioxidante. Además, efectos protectores sobre la sangre y el hígado, tratamiento del escorbuto, actividad antitrombina y prevención contra la degeneración macular. T. majus contiene compuestos biológicamente activos como flavonoides, glucosilonates, ácidos grasos, aceite esencial, ácido clorogénico, aminoácidos, cucurbitacinas, proteínas y carotenoides. Estudios de toxicidad aguda y subcrónica demostraron una falta de efectos toxicológicos, pero los extractos de esta planta pueden tener consecuencias perjudiciales durante el embarazo. Las bases de datos revisadas fueron SciELO, PubMed, ScienceDirect y Portal da Capes, teniendo en cuenta los estudios entre 1963 y 2014 y mediante la búsqueda de términos como Tropaeolum majus, Tropaeolaceae, Tropaeolum majus constituyentes, Tropaeolum majus usos y Tropaeolum majus toxicidad.

Comparison of morphine, ketoprofen and Arnica montana 6x and 30x per oral transmucosal or subcutaneous route for control of postoperative pain in cats subjected to hysterectomy with bilateral salpingo-oophorectomy / Comparação de morfina, cetoprofeno e Arnica montana 6x e 30x por via transmucosa oral ou subcutânea para control e de dor pós-operatória em gatas submetidas à histerectomia e ooforectomia bilateral

ABSTRACT: The postoperative analgesic effect of Arnica montana (Arnica) was compared to morphine and ketoprofen in 50 cats following hysterectomy with bilateral salpingo-oophorectomy (HSO). Cats were randomly allocated to five groups (n=10) and were treated 30 minutes before surgery and over 72 hours with 1ml of Arnica 30x per subcutaneous (SC) route (GA30SC); Arnica 30x per oral transmucosal route (P.O.) (GA30PO); Arnica 6x P.O. (GA6PO); morphine 0.1mg kg-1 SC (GM) SID or ketoprofen 2mg kg-1 SC (GK) before and 1mg kg-1 after surgery. Sedation and postoperative pain were assessed by means of a dynamic and interactive visual analogue scale (DIVAS) and variable count scale (VCS) and hyperalgesia using an esthesiometer. Whenever the VAS and VCS scores attained 33% of the maximum value, rescue analgesia was performed with morphine 0.3mg kg-1 per the intramuscular (IM) route. Other variables assessed were vomiting, defecation, urination, body weight and wound healing. Vomiting only occurred in animals treated with morphine. The groups did not differ in defecation, urination, body weight or wound healing. Hyperalgesia was detected only on the occasions that the criterion for rescue analgesia was met. One animal in GK and one in GM required rescue analgesia, differing from groups GA30SC, GA30PO and GA6PO, in which 4, 4 and 5 animals, respectively, required rescue analgesia. It can be concluded that ketoprofen and morphine were more efficacious than Arnica and that there was no difference among the various potencies and routes of administration of Arnica for postoperative analgesia in cats undergoing HSO.

RESUMO: Comparou-se o efeito analgésico de Arnica em relação à morfina ou cetoprofeno, no período pós-operatório, de 50 gatas submetidas à ovariossalpingohisterectomia (OSH). As gatas foram divididas em cinco grupos (n=10) e tratadas aleatoriamente 30 minutos antes da cirurgia por 72 horas com 1ml de Arnica 30D por via subcutânea (SC) (GA30SC); Arnica 30D por via oral (VO) (GA30VO); Arnica 6D VO (GA6VO); 0,1mg kg-1 de morfina SC (GM) TID ou 2mg kg-1 de cetoprofeno SC (GC) antes e 1mg kg-1 após a cirurgia SID. Foram avaliadas a sedação e a dor pós-operatória, por meio de escala analógica visual (EAV), escala de contagem variável (ECV) e hiperalgesia, esta última pelo estesiômetro. Quando os escores da ECV e EAV atingiram 33% do valor máximo, realizou-se resgate analgésico com 0,3mg kg-1 de morfina por via intramuscular (IM). Observou-se ocorrência de vômito, defecação, micção, alteração de peso e a cicatrização. Exceto nos animais tratados com morfina, não houve vômito. Não houve diferença entre os grupos para defecação, micção, peso e cicatrização. A hiperalgesia foi observada apenas nos momentos do resgate analgésico. Um animal de GC e um de GM receberam resgate analgésico, o que diferiu dos grupos GA30SC, GA30VO e GA6VO, onde, respectivamente, 4, 4 e 5 animais necessitaram resgate analgésico. Conclui-se que o cetoprofeno e a morfina foram mais eficazes que a Arnica e que, quanto à Arnica, não houve diferença nem entre as dinamizações e entre as vias SC e oral para analgesia de gatas submetidas à OSH.