Tacrolimus impairs airway mucociliary clearance of rats.

OBJECTIVES: Tacrolimus (TAC) is the most widely used immunosuppressive agent after lung transplantation. Considering that the ciliary beat frequency (CBF) mainly depends on the cytoplasmic calcium concentration and that TAC can affect this due to its binding with the intracellular immunophilin FKBP12, we hypothesized that TAC could also impair the airway mucociliary clearance of rats. METHODS: Sixty rats were divided into two groups (n = 30 each): Control = water; TAC = tacrolimus. After 7, 15 or 30 days of treatment, ten animals from each group were euthanized and the following parameters were studied: mucus transportability, CBF, mucociliary transport velocity (MCTV), and neutral and acid mucus production. RESULTS: There was a significant decrease in CBF (Control vs TAC: 7 days, p = 0.008; 15 days, p = 0.007; 30 days, p = 0.001) and MCTV (Control vs TAC: 7 days, p = 0.004; 15 days, p < 0.001; 30 days, p < 0.001) in all immunosuppressed animals. TAC therapy also caused an increase in acid mucus production at all treatment times (Control vs TAC: 7 days, p = 0.001; 15 days, p = 0.043; 30 days, p = 0.001). CONCLUSIONS: TAC impairs airway mucociliary clearance of rats.

Ecological importance of lepidopteran defoliators on eucalyptus plantations based in faunistic and natural enemy analyses.

Areas planted with Eucalyptus urophylla S.T. Blake variety platyphylla F. Muell. (Myrtaceae) expand annually in most regions of Brazil. Many lepidopteran species defoliate this plant, but with damage varying per species. The objective of this study was to identify the pest status of lepidopteran defoliators based in the faunistic analysis of these insects and of their natural enemies on E. urophylla variety platyphylla plantations in a representative producing region of Brazil. Adult moths of lepidopterans and of their natural enemies were captured using a light trap, installed every two weeks, from September 2016 to August 2018. A total of 183, 10, three and 139 lepidopteran species was captured and classified as primary, secondary, without defined importance to eucalypt plants and non-identified with 1,419, seven, 465 and 876 individuals, respectively. Two primary pest species were constants, two accessories and six accidentals and all secondary ones were accidentals. Six primary pest species were common and dominant and four non-dominants. Faunistic indices indicated the main lepidopteran species that should be monitored in pest management programs. Seven hymenopteran species (65 individuals), three dipterans (49 individuals) and two hemipterans (four individuals) were the natural enemies collected using light traps. The monitoring of lepidopteran pests with light traps can contribute to the management and to reduce damage and control costs for these species, besides identifying natural enemies for biological control programs in Eucalyptus plantations.

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients / Validación multicéntrica de Sistemas de Alerta Temprana para la detección precoz de deterioro clínico en pacientes hospitalizados por COVID-19

Objective Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24h. Design Retrospective multicenter study. Setting Two third-level hospitals in Argentina. Patients All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders. Interventions Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization. Variables We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48h, and at hospital admission. Result We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68–0.78) 24h before ICU admission, and 0.52 (95%CI 0.47–0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68–0.78) and 0.52 (95%CI 0.47–0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77–0.84) and 0.61 (95%CI 0.58–0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C. Conclusion COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization (AU)

Objetivo Investigar el valor predictivo de los scores NEWS2, NEWS-C y COVID-19 Severity Index para predecir la transferencia de urgencia a la unidad de cuidados intensivos (UCI) en las próximas 24horas. Diseño Estudio multicéntrico retrospectivo. Ámbito Dos hospitales de tercer nivel en Argentina. Pacientes Pacientes adultos con COVID-19, ingresados en salas generales, excluyendo pacientes con órdenes de no intubar. Intervenciones Se dividió a los pacientes entre los que ingresaron en la UCI y los que no ingresaron. Calculamos las tres puntuaciones para cada día de hospitalización. Variables Evaluamos la calibración y discriminación de las tres puntuaciones para predecir el traslado de urgencia a UCI en las 24, 48h previas al pase a UCI y al ingreso hospitalario. Resultados Evaluamos 13.768 días de hospitalización en internación general de 1.318 pacientes, de los cuales 126 (9,5%) fueron trasladados a UCI. El AUROC del NEWS2 fue de 0,73 (IC 95% 0,68-0,78) 24h antes del ingreso en UCI y de 0,52 (IC 95% 0,47-0,57) al ingreso hospitalario. El AUROC de NEWS-C fue de 0,73 (IC 95% 0,68-0,78) y 0,52 (IC 95% 0,47-0,57) respectivamente, y el AUROC del COVID-19 Severity Index fue de 0,80 (IC 95% 0,77-0,84) y 0,61 (IC 95% 0,58-0,66) respectivamente. El COVID-19 Severity Index presentó una mejor calibración que NEWS2 y NEWS-C. Conclusión El COVID-19 Severity Index presentó una mejor calibración y discriminación que NEWS2 y NEWS-C para predecir la transferencia de la UCI durante la hospitalización (AU)

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients.

OBJECTIVE: Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24h. DESIGN: Retrospective multicenter study. SETTING: Two third-level hospitals in Argentina. PATIENTS: All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders. INTERVENTIONS: Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization. VARIABLES: We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48h, and at hospital admission. RESULTS: We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24h before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C. CONCLUSION: COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.

Multicenter validation of Early Warning Scores for detection of clinical deterioration in COVID-19 hospitalized patients.

Objective: Investigate the predictive value of NEWS2, NEWS-C, and COVID-19 Severity Index for predicting intensive care unit (ICU) transfer in the next 24 h. Design: Retrospective multicenter study. Setting: Two third-level hospitals in Argentina. Patients: All adult patients with confirmed COVID-19, admitted on general wards, excluding patients with non-intubated orders. Interventions: Patients were divided between those who were admitted to ICU and non-admitted. We calculated the three scores for each day of hospitalization. Variables: We evaluate the calibration and discrimination of the three scores for the outcome ICU admission within 24, 48 h, and at hospital admission. Results: We evaluate 13,768 days of hospitalizations on general medical wards of 1318 patients. Among these, 126 (9.5%) were transferred to ICU. The AUROC of NEWS2 was 0.73 (95%CI 0.68-0.78) 24 h before ICU admission, and 0.52 (95%CI 0.47-0.57) at hospital admission. The AUROC of NEWS-C was 0.73 (95%CI 0.68-0.78) and 0.52 (95%CI 0.47-0.57) respectively, and the AUROC of COVID-19 Severity Index was 0.80 (95%CI 0.77-0.84) and 0.61 (95%CI 0.58-0.66) respectively. COVID-19 Severity Index presented better calibration than NEWS2 and NEWS-C. Conclusion: COVID-19 Severity index has better calibration and discrimination than NEWS2 and NEWS-C to predict ICU transfer during hospitalization.

Objetivo: Investigar el valor predictivo de los scores NEWS2, NEWS-C y COVID-19 Severity Index para predecir la transferencia de urgencia a la unidad de cuidados intensivos (UCI) en las próximas 24 horas. Diseño: Estudio multicéntrico retrospectivo. Ámbito: Dos hospitales de tercer nivel en Argentina. Pacientes: Pacientes adultos con COVID-19, ingresados en salas generales, excluyendo pacientes con órdenes de no intubar. Intervenciones: Se dividió a los pacientes entre los que ingresaron en la UCI y los que no ingresaron. Calculamos las tres puntuaciones para cada día de hospitalización. Variables: Evaluamos la calibración y discriminación de las tres puntuaciones para predecir el traslado de urgencia a UCI en las 24, 48 h previas al pase a UCI y al ingreso hospitalario. Resultados: Evaluamos 13.768 días de hospitalización en internación general de 1.318 pacientes, de los cuales 126 (9,5%) fueron trasladados a UCI. El AUROC del NEWS2 fue de 0,73 (IC 95% 0,68-0,78) 24 h antes del ingreso en UCI y de 0,52 (IC 95% 0,47-0,57) al ingreso hospitalario. El AUROC de NEWS-C fue de 0,73 (IC 95% 0,68-0,78) y 0,52 (IC 95% 0,47-0,57) respectivamente, y el AUROC del COVID-19 Severity Index fue de 0,80 (IC 95% 0,77-0,84) y 0,61 (IC 95% 0,58-0,66) respectivamente. El COVID-19 Severity Index presentó una mejor calibración que NEWS2 y NEWS-C. Conclusión: El COVID-19 Severity Index presentó una mejor calibración y discriminación que NEWS2 y NEWS-C para predecir la transferencia de la UCI durante la hospitalización.

Theoretical and experimental approach of fuel gas and carbon black production from coal tar pitch by thermal plasma process.

The processing of coal tar pitch (CTP) to produce clean fuel gas and carbon black (CB) is studied in a plasma reactor equipped with a direct-current plasma torch. The composition of the gas produced and energy costs were estimated theoretically for the CTP pyrolysis and gasification processes by two oxidants, namely oxygen and water vapor. We have found that the main gaseous compounds obtained in the pyrolysis and gasification processes are hydrogen (H2), carbon monoxide (CO), and very often carbon dioxide (CO2). For the pyrolysis case, the mean value of the synthesis gas concentration reaches a major value of 98 vol.% (H2 - 81 vol.%, CO - 17. vol.%). However, only 23% of the initial CTP is transformed into gas phase at 1100 K and its content increases up to 37.4% at a temperature of 3000 K. For oxygen gasification, the syngas quantity is little less compared to the pyrolysis case and attains 96.6 vol.% (H2 - 26.5 vol.%, CO - 70.1 vol.%) for T > 1100 K. An intermediate syngas content for the water steam gasification is 97.8 vol.% (with H2 - 55.8 vol.% and CO - 42.0 vol.%). The CB produced was composed of well-defined spherical particles of 30-nm size. Furthermore, it is composed of carbon (98.2%), and followed by oxygen (1.8%) with a surface area of 97 m2 g-1. The thermal plasma system shows high efficiency in conversion of CTP into high-value-added products.

Size does matter: intraspecific geometric morphometric analysis of wings of the blowfly Chrysomya albiceps (Diptera: Calliphoridae).

Blowflies have forensic, sanitary and veterinary importance, as well as being pollinators, parasitoids and ecological bioindicators. There is still little work with real data and from experiments assessing the relationship between blowflies' morphologic features and environmental and demographic factors. The present work tests whether the variation, in the shape and size, of Chrysomya albiceps (Wiedemann, 1819) wings is influenced by the following factors: 1) time; 2) temperature; 3) sex and; 4) different types of carcasses (pig, dog/cat and whale). Male and female wings from four different sites collected in six different years were used to obtain wing size and shape of C. albiceps. Analyses between wing shape and the variables tested had low explanatory power, even though they had statistical support. However, it was possible to identify differences in wing shape between males and females, with good returns in sex identification. The comparison between wing size and the variables tested showed that wing size has a negative relationship with temperature, significant differences between sexes, slight variation over time and no influence by carcass types. Furthermore, wing size influenced wing shape. Understanding population-specific characteristics of C. albiceps provide important insights about how the species reacts under specific conditions.

Prevalência de queixas de incontinência urinária em músicos do instrumento de sopro / Prevalence of complaints of urinary incontinence in blow instrument musicians

Introdução: Para tocar o instrumento de sopro, o instrumentista, com os lábios semicerrados, faz uma expiração forçada para produzir a intensidade e a frequência desejada do som. Esta ação, ao tocar o instrumento se relaciona a manobra de valsalva, pois da mesma forma impõe pressão ao músculo do assoalho pélvico. Objetivo: Avaliar se o músico de sopro pode desencadear incontinência urinária pela pressão intra-abdominal exercida durante a execução de seu instrumento. Métodos: Foi realizado um questionário com perguntas relacionadas a incontinência urinária para dois grupos musicais, a Orquestra Sinfônica Jovem do Estado de Mato Grosso e a banda do Corpo de Bombeiros Militar de Mato Grosso localizada na cidade de Cuiabá, capital do estado de Mato Grosso. Foram estudados 36 músicos (30 homens e 6 mulheres). Resultados: Foram encontrados dois músicos do sexo masculino com incontinência urinária há menos de um ano e queixas relacionadas à incontinência urinária, assim como alguns músicos possuem desconforto ao tocar afirmando sentir vontade de defecar. Conclusão: Esse tipo de sintoma pode estar relacionado a outra patologia, a incontinência fecal, deixando espaço para estudos futuros.

Proficiency of 38 HID-INDELS in kinship analysis and forensic parameters in a Mexican population / Eficiencia de 38 HID-INDELS en análisis de parentesco y parámetros forenses en una población mexicana

Introduction: Insertion–deletions for human identification (HID-INDELs) allow solving peculiar forensic situations when autosomal STRs are insufficient. Although limitations were predicted since the forensic implementation of biallelic markers, formal evaluation of these restrictions is scarce. Particularly, to define the informativity provided by HID-INDELs in kinship analysis is useful to avoid wasting work, resources, and –finally– disappointments.Material and methods: For this reason, we analyzed the 38-plex HID-INDEL system in 25 Mexican families including father, daughter, and mother, whose kinship was previously established with 22 autosomal STRs.Results and discussion: From genotypes of unrelated individuals, we updated allele frequencies and forensic parameters of the Jalisco state (West, Mexico), by increasing the population sample size from 62 to 112. Among the forensic a priori parameters, the Typical paternity index (PI) of the 38plex HID-INDEL system showed important differences regarding the PI and probability of paternity (W) estimated herein from real paternity cases, generally undervaluing the observed informativity of these 38-plex HID-INDEL system. Conversely, the studied HID-INDEL loci offered confident kinship conclusions based on the paternity index (PI ≥10,000) and probability of paternity (W ≥ 99.99%) in 68% of the standard trio cases (18/25), and only 12% of duo paternity cases (6/50) (motherless and fatherless). In fact, 14% of duo paternity cases (7/50) did not reach minimum requirements to stablish paternity (IP < 100; W < 99%).Conclusions: We updated a Mexican population database for 38 HID-INDEL loci, and we described their proficiency from real paternity cases, detailing some limitations non-previously specified. (AU)

Introducción: Las inserciones-deleciones para identificación humana (HID-INDEL), permiten resolver situaciones forenses peculiares cuando los STR autosómicos son insuficientes. Aunque se predijeron sus limitaciones desde la implementación forense de marcadores bialélicos, la evaluación formal de estas restricciones es escasa. Particularmente es útil definir su informatividad en el análisis de parentesco, para evitar desperdiciar trabajo, recursos y –finalmente– decepciones.Material y Métodos: Por este motivo, analizamos el sistema de 38plex HID-INDELs en 25 familias mexicanas entre padre, hija y madre, cuyo parentesco se estableció previamente con 22 STR autosómicos. A partir de los individuos no emparentados, actualizamos las frecuencias alélicas y los parámetros forenses del estado de Jalisco (Oeste, México), aumentando el tamaño de la muestra poblacional de 62 a 112.Resultados y discusión: Entre los parámetros forenses a priori, el índice de paternidad típico (IPT) del sistema 38plex HID-INDEL mostró diferencias importantes con respecto al IP y la probabilidad de paternidad (W) derivados de casos reales de paternidad, generalmente subestimando la informatividad observada de ese sistema. Sin embargo, los 38 HID-INDELs ofrecieron conclusiones de parentesco confiables basadas en el índice de paternidad (IP ≥ 10,000) y la probabilidad de paternidad (W ≥ 99,99%) sólo en el 68% de los casos tríos estándar (18/25), y el 12% de casos de paternidad dúo (6/50) (sin madre y sin padre). De hecho, el 14% de los casos de paternidad dúo (7/50) no alcanzó los requisitos mínimos para establecer la paternidad (IP <100; W < 99%).Conclusiones: En este trabajo actualizamos una base de datos de población mexicana para 38 HID-INDELs y describimos su eficiencia en casos reales de paternidad, detallando algunas limitaciones no especificadas previamente. (AU)

Prediction of fatty acids composition in the rainbow trout Oncorhynchus mykiss by using Raman micro-spectroscopy.

The importance of poly-unsaturated fatty acids (PUFAs) in food is crucial for the animal and human development and health. As a complementary strategy to nutrition approaches, genetic selection has been suggested to improve fatty acids (FAs) composition in farmed fish. Gas chromatography (GC) is used as a reference method for the quantification of FAs; nevertheless, the high cost prevents large scale phenotyping as needed in breeding programs. Therefore, a calibration by means of Raman scattering spectrometry has been established in order to predict FA composition of visceral adipose tissue in rainbow trout Onchorhynchus mykiss. FA composition was analyzed by both GC and Raman micro-spectrometry techniques on 268 individuals fed with three different feeds, which have different FA compositions. Among the possible regression methods, the ridge regression method, was found to be efficient to establish calibration models from the GC and spectral data. The best cross-validated R2 values were obtained for total PUFAs, omega-6 (Ω-6) and omega-3 (Ω-3) PUFA (0.79, 0.83 and 0.66, respectively). For individual Ω-3 PUFAs, α-linolenic acid (ALA, C18:3), eicosapentaenoic acid (EPA, C20:5) and docosahexenoic acid (DHA, C22:6) were found to have the best R2 values (0.82, 0.76 and 0.81, respectively). This study demonstrates that Raman spectroscopy could be used to predict PUFAs with good correlation coefficients on adipocytes, for future on adipocytes physiology or for large scale and high throughput phenotyping in rainbow trout.

Toxicity of innovative antifouling additives on an early life stage of the oyster Crassostrea gigas: short- and long-term exposure effects.

Recent advances in nanotechnology have allowed the encapsulation of hazardous antifouling (AF) biocides in silica mesoporous nanocapsules (SiNC) reducing their short-term toxicity. However, the chronic effects of such novel nanoadditives remain understudied. The present study aimed to assess short- and long-term sub-lethal effects of soluble forms (DCOIT and Ag) and nanostructured forms (SiNC-DCOIT and SiNC-DCOIT-Ag) of two AF biocides and the "empty" nanocapsule (SiNC) on juveniles of Crassostrea gigas after 96 h and 14 days of exposure. Juvenile oysters exposed for a short period to free DCOIT and AgNO3 presented worse physiological status comparing with those exposed to the nanostructured forms. The long-term exposure to DCOIT and Ag+ caused an extensive biochemical impairment comparing with the tested nanomaterials, which included oxidative damage, activation of the antioxidant defense system, and neurotransmission impairment. Despite the negative effects mostly observed on the health condition index and AChE, the encapsulation of the abovementioned AF biocides into SiNC seems to be a technological advantage towards the development of AF nanoadditives with lower long-term toxicity comparing with the soluble forms of such biocides.

Melanoma Awareness Among Medical Students.

Melanoma is the most aggressive skin cancer. Since diagnosis is visual, it is critical to evaluate if students acquire enough knowledge for early detection during medical school. To assess the melanoma knowledge of first-year (freshman) and sixth-year (senior) medical students, in a Brazilian Institution. It was a transversal and quantitative study. A questionnaire with sociodemographic data, knowledge about melanoma, and the habit of skin self-exam was filled out by medical students. A total of 128 first-year and 122 seniors students were included. All the sixth-year students knew melanoma as a skin cancer compared with 46.09% of the first-year students. Melanoma clinical characteristics were known by 30.51% of the freshman and 97.54% of seniors. However, they did not know the most usual site of melanoma occurrence (79.66% of first-year students and 24.59% of senior). About the skin self-exam, only 50% of first-year students and 53.28% of senior had the habit of doing it sometimes. Medical school was effective in providing knowledge about melanoma and its features. However, this was not reflected in an increase in the number of students that did the skin self-exam, which indicates the need for new approaches in teaching.

Clinical safety of zafirlukast treatment during acute inflammatory reaction in nile tilapia (Oreochromis Niloticus)

Little is known about the toxicity of immune modulators in fish. Zafirlukast is an anti-inflammatory that antagonizes cysteine leukotriene receptors (CysLTR1). Aiming to study immunomodulatory treatments on fish health, this study evaluated the clinical safety of oral zafirlukast treatment, through biochemical and hematological analyzes during acute inflammatory reaction in Nile tilapia (Oreochromis niloticus), induced by Aeromonas hydrophilabacterins. 72 young tilapias were randomly divided in 9 aquariums (100 L each, n=8) to compose the following treatments: T0 (control), T1 (Treatment with 250 μg zafirlukast) and T2 (Treatment with 500 μg zafirlukast). Eight animals were evaluated per treatment in three periods: six, 24 and 48 hours post-inoculation (HPI), blood collection was performed for hematological and serum biochemical evaluation. The study of hepatic and renal functionality revealed that treatment with both doses of zafirlukast did not result in changes in the circulating values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, creatinine, triglycerides, cholesterol, and total protein, suggesting that the drug has not presented hepatotoxicity, as well as compromised liver and kidney functions. Tilapia submitted to treatment with 500 μg showed adverse hematological effects characterizedby polycythemia associated with microcytosis. Therefore, oral treatment with zafirlukast has demonstrated clinical safety at a therapeutic dose of 250 μg in tilapia during acute aerocystitis, although hematological changes were observed in tilapia treatedwith overdose of this leukotriene blocker.

Pouco se sabe sobre a toxicidade de imunomoduladores em peixes. Zafirlukast é um anti-inflamatório que antagoniza os receptores de leucotrienos cisteínicos (CysLTR1). Com o objetivo de estudar o efeito de tratamentos imunomoduladores sobre a saúde dos peixes, este estudo avaliou a segurança clínica do tratamento com zafirlucaste oral, por meio de análises bioquímicas e hematológicas durante reação inflamatória aguda em tilápia do Nilo (Oreochromis niloticus), induzida por bacterinas de Aeromonas hydrophila.Para tal, 72 tilápias jovens foram divididas aleatoriamente em 9 aquários (100 L cada, n=8) para compor os seguintes tratamentos: T0 (controle), T1 (Tratamento com 250 μg de zafirlucaste) e T2 (Tratamento com 500 μg de zafirlucaste). Oito animais foram avaliados por tratamento em três períodos: seis, 24 e 48 horas pós-inoculação (HPI), foi realizada coleta de sangue para avaliação hematológica e bioquímica sérica. O estudo da funcionalidade hepática e renal revelou que o tratamento com ambas as doses de zafirlucaste não resultou em alterações nos valores circulantes de aspartato aminotransferase (AST), alanina aminotransferase (ALT), fosfatase alcalina, creatinina, triglicerídeos, colesterol e proteína total, sugerindo que a droga não comprometeu as funçõeshepáticas e renais. As tilápias tratadas com 500 μg apresentaram efeitos hematológicos adversos caracterizados por policitemia associada a microcitose. Portanto, o tratamento oral com zafirlucaste demonstrou segurança clínica nadose de 250 μg em tilápiasdurante aerocistite aguda, embora alterações hematológicas tenham sido observadas em tilápias tratadas com sobredosagem deste bloqueador de leucotrieno.

Cirurgia de revascularização do miocárdio melhora a qualidade de vida relacionada a saúde, ansiedade e depressão: um estudo de coorte prospectivo / Coronary artery bypass surgery improves health-related quality of life, anxiety and depression: a prospective cohort study

Introdução: As doenças cardiovasculares somam 1/3 de todas as mortes na América Latina e no Brasil, representando a 2ª causa de morte no país. Objetivos: Mensurar e acompanhar a qualidade de vida relacionada a saúde (QVRS) durante 180 dias e correlacionar os resultados com ansiedade, depressão em pacientes submetidos a cirurgia de revascularização do miocárdio (CRM). Métodos: 63 pacientes foram submetidos a CRM eletiva, no pré-operatório foram coletados os dados sociodemográficos e clínicos depois os pacientes preencheram questionários: MacNew QLMI para avaliação de QVRS, IDATE Traço-Estado para avaliação de ansiedade e Beck Depression Inventory (BDI) para avaliação de depressão. Após a alta hospitalar, em seus domicílios, os pacientes responderam novamente os questionários e foram acompanhados por 6 meses. Resultados: Foi observada melhora significativa da QVRS após 60 dias, que se manteve estável entre 120-180 dias após CRM. Houve uma correlação negativa significante entre QVRS e depressão e QVRS e ansiedade. Quanto aos domínios do QLMI, observou-se melhora significante no físico e social após 120 e 180 dias da cirurgia. Não foi observada diferença significativa nos escores de depressão e ansiedade em relação ao tempo de CRM. Porém, observou-se redução significativa nos níveis de depressão 180 dias após CRM. Conclusão: Pacientes submetidos a CRM apresentam uma melhora espontânea significativa em sua QVRS após 60 dias e que se estabiliza até 180 dias. Fatores como ansiedade e depressão podem afetar o curso de sua completa recuperação emocional, física e social. (AU)

Introduction: Cardiovascular diseases account for 1/3 of all deaths in Latin America and Brazil is the second leading cause of death in the country. Objectives: The aim of the present study was to measure and to follow health-related quality of life (HRQL) up to 180 days after coronary artery bypass graft (CABG) and to correlate the results with presence of anxiety, depression. Methods: A cohort of 63 patients who had undergone to elective CABG were followed for 180 days. Patients were asked to answer questionnaires: HRQL (MacNew QLMI); IDATE with two distinct scales for evaluation of draw and anxiety state; and Beck Depression Inventory (BDI) for evaluation of attitudes and depression symptoms. Results: Results obtained demonstrated significant inverse correlation between HRQL and depression, and between HRQL and anxiety. A significant increase of HRQL after 60 days post-CABG was observed, which stabilizes after 120-180 days. A significant increase in the physical and social QLMI domains after 120-180 days post-CABG was also observed. The analysis of depression and anxiety scores did not show significant difference regarding time. However, the distribution of levels (normal, light/moderated and moderated/severe) of depression showed a significant reduction of depression. No correlation between the presence of postoperative complications and HRQL scores were detected. Conclusion: Concluding these results demonstrated a spontaneous improvement of HRQL after 60 days post-CABG, which stabilizes in 180 days. Factors as anxiety and depression can affect social, physical and emotional recuperation. (AU)

Attitudes and Personal Attributes Regarding Patient Receptivity towards the Participation of Medical Students in Gynecological Consultations: A Cross-Sectional Study.

OBJECTIVE: To evaluate the association between the acceptance on the part of the patients and their reasons to consent to or refuse medical student attendance during gynecological outpatient care, considering the participants' demographic characteristics, consultation experience, and gender bias or lack thereof. METHODS: Face-to-face interviews with patients waiting for gynecological consultations that had been scheduled in advance at Hospital Universitário de Brasília. Contingency analyses were used to determine the levels of association among the patient variables. The accepted significance level was values of p < 0.05. RESULTS: We interviewed 469 patients. The comfort level with the presence of a student was strongly related to the number of students present during the consultation (Cramér V = 0.671). The inclination to grant consent (a series of reasons to consent to or refuse student attendance) was significantly related (p < 0.001) to the overall receptivity to student participation (ρ = 0.482), the positive appraisal of student-doctor demeanor in previous consultations (ρ = 0.253, N = 408), and to greater levels of schooling (ρ = 0.158). The patients' receptivity was significantly related (p < 0.001) to the lack of bias regarding the gender of the physician (Cramér V = 0.388), previous experience with students (Cramér V = 0.235) and awareness of the fact that they would be present (Cramér V = 0.217), older age (ρ = 0.136, p = 0.003), and multiparity (ρ = 0.102, p = 0.027). CONCLUSION: Greater receptivity to student participation related significantly to five conditions in decreasing order of strength of association: lack of bias regarding the gender of the Ob-Gyn, previous experience with student involvement, awareness of the presence of students, older age, and multiparity. We also found that a more positive inclination to consent to student attendance correlated positively with a greater receptivity to student participation and to a suitable student-doctor demeanor.

OBJETIVO: Avaliar a associação entre as razões das pacientes para consentir ou recusar a presença de estudantes de medicina no ambulatório de Ginecologia, considerando seus fatores demográficos, experiência prévia com alunos, e sensibilidade com relação ao gênero. MéTODOS: Entrevistas com as pacientes que aguardavam consultas ginecológicas previamente agendadas no Hospital Universitário de Brasília. Análises de contingência foram utilizadas para determinar os níveis de associação entre as variáveis das pacientes. Valores de p < 0.05 foram considerados estatisticamente significativos. RESULTADOS: Foram entrevistadas 469 pacientes. Observou-se forte associação entre o conforto com a presença do estudante e o número destes presentes à consulta (V de Cramér = 0.671). A tendência ao consentimento (relação de motivos para consentir ou discordar da presença do estudante) relacionou-se significativamente (p < 0.001) à maior receptividade à participação dos alunos (ρ = 0.482), a uma avaliação positiva do comportamento aluno-médico em consultas anteriores (ρ =0.253, N = 408), e a maior escolaridade das pacientes (ρ =0.158). Observou-se associação significativa entre receptividade das pacientes (p < 0.001) e ausência de discriminação quanto ao gênero do médico (V de Cramér = 0.388), experiência prévia com estudantes (V de Cramér = 0.235), ciência de que estariam presentes à consulta (V Cramér = 0.217), idade mais avançada (ρ = 0.136; p = 0.003), e multiparidade (ρ = 0.102; p = 0.027). CONCLUSãO: Maior receptividade à participação dos estudantes relacionou-se a cinco condições em ordem decrescente de força de associação: ausência de discriminação quanto ao gênero do médico ginecologista-obstetra, experiência prévia com estudantes, conhecimento antecipado sobre a presença deles, idade mais avançada, e multiparidade. Também foi observada correlação positiva entre maior tendência ao consentimento e maior receptividade à participação dos alunos e comportamento adequado médico-estudante.

Attitudes and personal attributes regarding patient receptivity towards the participation of medical students in gynecological consultations: A cross-sectional study / Atitudes e atributos pessoais relativos à receptividade das pacientes à participação de estudantes de medicina em consultas ginecológicas: Um estudo de corte transversal

Abstract Objective To evaluate the association between the acceptance on the part of the patients and their reasons to consent to or refuse medical student attendance during gynecological outpatient care, considering the participants' demographic characteristics, consultation experience, and gender bias or lack thereof. Methods Face-to-face interviews with patients waiting for gynecological consultations that had been scheduled in advance at Hospital Universitário de Brasília. Contingency analyses were used to determine the levels of association among the patient variables. The accepted significance level was values of p<0.05. Results We interviewed 469 patients. The comfort level with the presence of a student was strongly related to the number of students present during the consultation (Cramér V=0.671). The inclination to grant consent (a series of reasons to consent to or refuse student attendance) was significantly related (p<0.001) to the overall receptivity to student participation (ρ=0.482), the positive appraisal of student-doctor demeanor in previous consultations (ρ=0.253, N=408), and to greater levels of schooling (ρ=0.158). The patients' receptivity was significantly related (p<0.001) to the lack of bias regarding the gender of the physician (CramérV=0.388), previous experience with students (Cramér V=0.235) and awareness of the fact that they would be present (Cramér V=0.217), older age (ρ=0.136, p=0.003), and multiparity (ρ=0.102, p=0.027). Conclusion Greater receptivity to student participation related significantly to five conditions in decreasing order of strength of association: lack of bias regarding the gender of the Ob-Gyn, previous experience with student involvement, awareness of the presence of students, older age, and multiparity. We also found that a more positive inclination to consent to student attendance correlated positively with a greater receptivity to student participation and to a suitable student-doctor demeanor.

Resumo Objetivo Avaliar a associação entre as razões das pacientes para consentir ou recusar a presença de estudantes de medicina no ambulatório de Ginecologia, considerando seus fatores demográficos, experiência prévia com alunos, e sensibilidade com relação ao gênero. Métodos Entrevistas com as pacientes que aguardavam consultas ginecológicas previamente agendadas no Hospital Universitário de Brasília. Análises de contingência foram utilizadas para determinar os níveis de associação entre as variáveis das pacientes. Valores de p<0.05 foram considerados estatisticamente significativos. Resultados Foram entrevistadas 469 pacientes. Observou-se forte associação entre o conforto com a presença do estudante e o número destes presentes à consulta (V de Cramér=0.671). A tendência ao consentimento (relação de motivos para consentir ou discordar da presença do estudante) relacionou-se significativamente (p<0.001) à maior receptividade à participação dos alunos (ρ=0.482), a uma avaliação positiva do comportamento aluno-médico em consultas anteriores (ρ =0.253, N=408), e a maior escolaridade das pacientes (ρ =0.158). Observou-se associação significativa entre receptividade das pacientes (p<0.001) e ausência de discriminação quanto ao gênero do médico (V de Cramér=0.388), experiência prévia com estudantes (V de Cramér =0.235), ciência de que estariam presentes à consulta (V Cramér=0.217), idade mais avançada (ρ=0.136; p=0.003), e multiparidade (ρ=0.102; p=0.027). Conclusão Maior receptividade à participação dos estudantes relacionou-se a cinco condições em ordem decrescente de força de associação: ausência de discriminação quanto ao gênero do médico ginecologista-obstetra, experiência prévia com estudantes, conhecimento antecipado sobre a presença deles, idade mais avançada, e multiparidade. Também foi observada correlação positiva entre maior tendência ao consentimento e maior receptividade à participação dos alunos e comportamento adequado médico-estudante.

Physiotherapy in the Prevention of Falls in Elderly People / Atuação da Fisioterapia na Prevenção de Quedas em Idosos

Brazil has around 14 million elderly and, in a certain area of the big cities, this population already exceeds the mark of 20%. As the person ages the risk of falls increases. One in every three people above 65 years of age suffer from some type of fall at least once a year. The objective of this study was to identify the aging factor in humanity, the risk factors in falling in the elderly and consider information about the physiotherapy role in the senior patients treatment who suffer with injuries caused by falls. A bibliographic survey was held with the use of databases of the virtual library SciELO, Pubmed and Redalic from 2007 to 2017. Among the changes resulting from aging, the ones that generate postural instability are the locomotor, sensory and nervous changes, limiting the coordination and control of postural balance, called intrinsic factors. In this sense, physical therapy has been acting in the prevention, promotion, maintenance, and rehabilitation of pathologies affecting the elderly, extending the functional independence of this group. Based on these definitions it was possible to pinpoint prospects for the health performance in the mitigation of the effects of this event, as well as reduce the high hospital expenditures of the elderly to the public health. (AU)

O Brasil tem cerca de 14 milhões de idosos e, em determinada área das grandes cidades, esta população já ultrapassa a marca dos 20%. À medida que a pessoa envelhece o risco de quedas aumenta. Uma em cada três pessoas acima de 65 anos de idade sofrem algum tipo de queda pelo menos uma vez por ano. O objetivo desse estudo foi identificar o fator de envelhecimento na humanidade, os fatores de risco na queda em idosos e considerar informações sobre o papel desempenhado da fisioterapia no tratamento de pacientes sênior que sofrem com lesões causadas por quedas. Realizou-se um levantamento bibliográfico com a utilização dos bancos de dados da biblioteca virtual SciELO, Pubmed e Redalic de 2007 a 2017. Dentre as alterações decorrentes do envelhecimento, as que mais geram instabilidade postural são as alterações no aparelho locomotor, sensorial e nervoso, limitando a coordenação e o controle do equilíbrio postural, chamados de fatores intrínsecos. Nesse sentido, a fisioterapia vem atuando na prevenção, promoção, manutenção e reabilitação de patologias que acometem o idoso, prolongando a independência funcional deste grupo. Com base nessas definições foi possível apontar perspectivas para a atuação da saúde na mitigação dos efeitos deste evento, bem como reduzir o alto gasto hospitalar destes idosos para a saúde pública. (AU)

Notch3 signaling activation in smooth muscle cells promotes extrauterine growth restriction-induced pulmonary hypertension.

BACKGROUND AND AIMS: Early postnatal life is a critical developmental period that affects health of the whole life. Extrauterine growth restriction (EUGR) causes cardiovascular development problems and diseases, including pulmonary arterial hypertension (PAH). PAH is characterized by proliferation, migration, and anti-apoptosis of pulmonary artery smooth muscle cells (PASMCs). However, the role of PASMCs in EUGR has not been studied. Thus, we hypothesized that PASMCs dysfunction played a role in EUGR-induced pulmonary hypertension. METHODS AND RESULTS: Here we identified that postnatal nutritional restriction-induced EUGR rats exhibited an elevated mean pulmonary arterial pressure and vascular remodeling at 12 weeks old. PASMCs of EUGR rats showed increased cell proliferation and migration features. In EUGR-induced PAH rats, Notch3 signaling was activated. Relative mRNA and protein expression levels of Notch3 intracellular domain (Notch3 ICD), and Notch target gene Hey1 in PASMCs were upregulated. We further demonstrated that pharmacological inhibition of Notch3 activity by using a γ-secretase inhibitor DAPT, which blocked the cleavage of Notch proteins to ICD peptides, could effectively inhibit PASMC proliferation. Specifically knocked down of Notch3 in rat PASMCs by shRNA restored the abnormal PASMC phenotype in vitro. We found that administration of Notch signaling inhibitor DAPT could successfully reduce mean pulmonary arterial pressure in EUGR rats. CONCLUSIONS: The present study demonstrated that upregulation of Notch3 signaling in PASMCs was crucial for the development of EUGR-induced PAH. Blocking Notch3-Hey1 signaling pathway in PASMCs provides a potential therapeutic target for PAH.

A Preliminary Study of Carrion Insects and Their Succession in Luanda, Angola.

The study of the arthropod fauna involved in carcass decomposition is crucial for medicolegal forensic purposes. This knowledge is especially needed in countries with high levels of criminality and where the arthropod fauna is still under-recorded and not well known, such as Angola. We present data from the first survey on sarcosaprophagous flies and beetles in Angola, conducted in Luanda over a 17-d period, in the wet summer season. In total, 881 adult and immature specimens, belonging to 18 species, were collected from three pig carcasses that were sampled daily. Three species were not previously known from Angola. The dominant flies were Chrysomya albiceps (Wiedemann, 1819) (Diptera: Calliphoridae) and Chrysomya megacephala (Fabricius, 1794), but Chrysomya marginalis (Wiedemann, 1830), Chrysomya putoria (Wiedemann, 1830), and Liosarcophaga emmrichiana (Lehrer, 2002) (Diptera: Sarcophagidae) also bred on the carcasses. The dominant beetles were Dermestes maculatus De Geer, 1774 (Coleoptera: Dermestidae), Saprinus splendens (Paykull 1811) (Coleoptera: Histeridae), and Necrobia rufipes (De Geer, 1775) (Coleoptera: Cleridae). Because of the hot weather during the experimental period (~27°C), decomposition was extremely fast. Periods of insect activity on carcasses are presented and comparisons are made with other carrion communities reported from the Afrotropical region.

Combined genetic and epigenetic alterations of the TERT promoter affect clinical and biological behavior of bladder cancer.

In urothelial bladder cancer (UBC), risk stratification remains an important unmet need. Limitless self-renewal, governed by TERT expression and telomerase activation, is crucial for cancer progression. Thus, telomerase activation through the interplay of mutations (TERTpMut ) and epigenetic alterations in the TERT promoter may provide further insight into UBC behavior. Here, we investigated the combined effect of TERTpMut and the TERT Hypermethylated Oncological Region (THOR) status on telomerase activation and patient outcome in a UBC international cohort (n = 237). We verified that TERTpMut were frequent (76.8%) and present in all stages and grades of UBC. Hypermethylation of THOR was associated with higher TERT expression and higher-risk disease in nonmuscle invasive bladder cancers (NMIBC). TERTpMut alone predicted disease recurrence (HR: 3.18, 95%CI 1.84 to 5.51, p < 0.0001) but not progression in NMIBC. Combined THORhigh /TERTpMut increased the risk of disease recurrence (HR 5.12, p < 0.0001) and progression (HR 3.92, p = 0.025). Increased THOR hypermethylation doubled the risk of stage progression of both TERTpwt and TERTpMut NMIBC. These results highlight that both mechanisms are common and coexist in bladder cancer and while TERTpMut is an early event in bladder carcinogenesis THOR hypermethylation is a dynamic process that contributes to disease progression. While the absence of alterations comprises an extremely indolent phenotype, the combined genetic and epigenetic alterations of TERT bring additional prognostic value in NMIBC and provide a novel insight into telomere biology in cancer.