Therapeutic dietary approach to children with autistic spectrum disorder / Abordaje dietético terapéutico de niños con trastorno del espectro autista

Autism spectrum disorder (ASD) is a neuropsychiatric disease, characterized by deficits in social communication, presence of restricted interests and repetitive behaviors. This review aims to address the different nutrients that can be included in the diet of patients with ASD in order to reduce the different signs and symptoms present in this disorder. Different bibliographic sources were reviewed, such as PubMed, MEDLINE, ScienceDirect, Embase, and SciELO, using the keywords "Probiotics", "Vitamin B", Vitamin C", "Gluten", "Omega-3" and "Autism Spectrum Disorder". It was found that probiotics and gluten improve gastrointestinal symptoms and, in addition, like vitamins B6, B9, B12 and C, as well as omega 3, help improve neurobehavioral symptoms, language and social behavior of children with ASD.

El trastorno del espectro autista (TEA) es una enfermedad neuropsiquiátrica, caracterizada por déficits en la comunicación social y la presencia de intereses restringidos y conductas repetitivas. La presente revisión tiene por objetivo abordar los diferentes nutrientes que pueden incluirse en la dieta de los pacientes con TEA con el fin de disminuir los diferentes signos y síntomas presentes en este trastorno. Se revisaron diferentes fuentes bibliográficas como PubMed, MEDLINE, ScienceDirect, Embase, y SciELO, empleando las palabras claves "Probióticos", "Vitamina B", Vitamina C", "Gluten", "Omega 3" y "Trastorno del Espectro Autista". Se encontró que los probióticos y el gluten mejoran los síntomas gastrointestinales y, además, al igual que las vitaminas B6, B9, B12 y C, así como el omega 3, ayudan al mejoramiento de síntomas neuroconductuales, lenguaje y conducta social del niño con TEA.

Exploring the microbiome, antibiotic resistance genes, mobile genetic element, and potential resistant pathogens in municipal wastewater treatment plants in Brazil.

Wastewater treatment plants (WWTPs) have been widely investigated in Europe, Asia and North America regarding the occurrence and fate of antibiotic resistance (AR) elements, such as antibiotic resistance genes (ARGs), mobile genetic elements (MGEs) and antibiotic resistant bacteria and pathogens. However, monitoring data about AR elements in municipal WWTPs in Brazil are scarce. This study investigated the abundance of intI1, five ARGs (sul1, tetA, blaTEM, ermB and qnrB) and 16S rRNA in raw and treated wastewater of three WWTPs, using different sewage treatments named CAS (Conventional activated sludge), UASB/BTF (UASB followed by biological trickling filter) and MAS/UV (modified activated sludge with UV disinfection stage). Bacterial diversity and the presence of potentially pathogenic groups were also evaluated, and associations between genetic markers and the bacterial populations were presented. All WWTPs decreased the loads of genetic markers finally discharged to receiving water bodies and showed no evidence of being hotspots for antimicrobial resistance amplification in wastewater, since the abundances of intI1 and ARGs within the bacterial population were not increased in the treated effluents. UASB/BTF showed a similar performance to that of the CAS and MAS/UV, reinforcing the sanitary and environmental advantages of this biological treatment, widely applied for wastewater treatment in warm climate regions. Bacterial diversity and richness increased after treatments, and bacterial communities in wastewater samples differed due to catchment areas and treatment typologies. Potential pathogenic population underwent considerable decrease after the treatments; however, strong significant correlations with intI1 and ARGs revealed potential multidrug-resistant pathogenic bacteria (Aeromonas, Arcobacter, Enterobacter, Escherichia-Shigella, Stenotrophomonas and Streptococcus) in the treated effluents, although in reduced relative abundances. These are contributive results for understanding the fate of ARGs, MGEs and potential pathogenic bacteria after wastewater treatments, which might support actions to mitigate their release into Brazilian aquatic environments in the near future.

Combined Subcutaneous-Intranasal Immunization With Epitope-Based Antigens Elicits Binding and Neutralizing Antibody Responses in Serum and Mucosae Against PRRSV-2 and SARS-CoV-2.

New vaccine design approaches, platforms, and immunization strategies might foster antiviral mucosal effector and memory responses to reduce asymptomatic infection and transmission in vaccinated individuals. Here, we investigated a combined parenteral and mucosal immunization scheme to induce local and serum antibody responses, employing the epitope-based antigens 3BT and NG19m. These antigens target the important emerging and re-emerging viruses PRRSV-2 and SARS-CoV-2, respectively. We assessed two versions of the 3BT protein, which contains conserved epitopes from the GP5 envelope protein of PRRSV-2: soluble and expressed by the recombinant baculovirus BacDual-3BT. On the other hand, NG19m, comprising the receptor-binding motif of the S protein of SARS-CoV-2, was evaluated as a soluble recombinant protein only. Vietnamese mini-pigs were immunized employing different inoculation routes: subcutaneous, intranasal, or a combination of both (s.c.-i.n.). Animals produced antigen-binding and neut1ralizing antibodies in serum and mucosal fluids, with varying patterns of concentration and activity, depending on the antigen and the immunization schedule. Soluble 3BT was a potent immunogen to elicit binding and neutralizing antibodies in serum, nasal mucus, and vaginal swabs. The vectored immunogen BacDual-3BT induced binding antibodies in serum and mucosae, but PRRSV-2 neutralizing activity was found in nasal mucus exclusively when administered intranasally. NG19m promoted serum and mucosal binding antibodies, which showed differing neutralizing activity. Only serum samples from subcutaneously immunized animals inhibited RBD-ACE2 interaction, while mini-pigs inoculated intranasally or via the combined s.c.-i.n. scheme produced subtle neutralizing humoral responses in the upper and lower respiratory mucosae. Our results show that intranasal immunization, alone or combined with subcutaneous delivery of epitope-based antigens, generates local and systemic binding and neutralizing antibodies. Further investigation is needed to evaluate the capability of the induced responses to prevent infection and reduce transmission.

Effect of digestate loading rates on microalgae-based treatment under low LED light intensity.

Low red-LED irradiances are an attractive alternative for enhancing microalgae photobioreactors treating digestate due to their potential contribution in decreasing area footprints with low energy consumptions. However, more information is required regarding the influence of digestate load on treatment performance and biomass valorisation when low-intensity red-LEDs are applied. Thus, this study assessed microalgae-based photobioreactors treating food waste digestate under different concentrations (5%, 25%, 50%, and 75%, v/v) at low red-LED irradiance (15 µmol·m-2·s-1). The removal efficiencies of soluble chemical oxygen demand (sCOD) at the end of the experiment ranged from 45% to 75% when treating influent loads between 5.3 and 79.1 g sCOD·m-3·d-1 (5% and 75%-digestate), respectively. Total ammonia nitrogen (TAN) was applied in loading rates between 3.2 and 48.5 g TAN·m-3·d-1 (5% and 75%, respectively) and removed with maximum efficiencies of 90%-100% in all trials. Nitrification-denitrification was proportionally more relevant when treating 5%-digestate, whereas volatilisation was the primary process in 25%, 50% and 75% concentrations. Microalgae presented adequate yields in all treatments, except in 75%-digestate, likely due to the blocking of light by the high solids concentrations. The assessment of the microalgae community and chlorophyll-a and carotenoids suggested that chlorophytes, mainly Dictyosphaerium pulchellum and Scenedesmus sp. grew autotrophically, whereas cyanobacteria Pseudanabaena sp. grew mixotrophically. Moreover, the sustainability of red LED lighting applications can be increased by anaerobic digestion or agricultural valorisation of the biomass, enabled by its high N and P contents. Low-intensity red-LEDs may have promissory applications in the treatment of high-strength wastewaters.

Recombinant Antigens Based on Non-Glycosylated Regions from RBD SARS-CoV-2 as Potential Vaccine Candidates against COVID-19.

The Receptor-Binding Domain (RBD) of the Spike (S) protein from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has glycosylation sites which can limit the production of reliable antigens expressed in prokaryotic platforms, due to glycan-mediated evasion of the host immune response. However, protein regions without glycosylated residues capable of inducing neutralizing antibodies could be useful for antigen production in systems that do not carry the glycosylation machinery. To test this hypothesis, the potential antigens NG06 and NG19, located within the non-glycosylated S-RBD region, were selected and expressed in Escherichia coli, purified by FPLC and employed to determine their immunogenic potential through detection of antibodies in serum from immunized rabbits, mice, and COVID-19 patients. IgG antibodies from sera of COVID-19-recovered patients detected the recombinant antigens NG06 and NG19 (A450 nm = 0.80 ± 0.33; 1.13 ± 0.33; and 0.11 ± 0.08 for and negatives controls, respectively). Also, the purified antigens were able to raise polyclonal antibodies in animal models evoking a strong immune response with neutralizing activity in mice model. This research highlights the usefulness of antigens based on the non-N-glycosylated region of RBD from SARS-CoV-2 for candidate vaccine development.

Viability of SARS-CoV-2 in river water and wastewater at different temperatures and solids content.

COVID-19 patients can excrete viable SARS-CoV-2 virus via urine and faeces, which has raised concerns over the possibility of COVID-19 transmission via aerosolized contaminated water or via the faecal-oral route. These concerns are especially exacerbated in many low- and middle-income countries, where untreated sewage is frequently discharged to surface waters. SARS-CoV-2 RNA has been detected in river water (RW) and raw wastewater (WW) samples. However, little is known about SARS-CoV-2 viability in these environmental matrices. Determining the persistence of SARS-CoV-2 in water under different environmental conditions is of great importance for basic assumptions in quantitative microbial risk assessment (QMRA). In this study, the persistence of SARS-CoV-2 was assessed using plaque assays following spiking of RW and WW samples with infectious SARS-CoV-2 that was previously isolated from a COVID-19 patient. These assays were carried out on autoclaved RW and WW samples, filtered (0.22 µm) and unfiltered, at 4 °C and 24 °C. Linear and nonlinear regression models were adjusted to the data. The Weibull regression model achieved the lowest root mean square error (RMSE) and was hence chosen to estimate T90 and T99 (time required for 1 log and 2 log reductions, respectively). SARS-CoV-2 remained viable longer in filtered compared with unfiltered samples. RW and WW showed T90 values of 1.9 and 1.2 day and T99 values of 6.4 and 4.0 days, respectively. When samples were filtered through 0.22 µm pore size membranes, T90 values increased to 3.3 and 1.5 days, and T99 increased to 8.5 and 4.5 days, for RW and WW samples, respectively. Remarkable increases in SARS-CoV-2 persistence were observed in assays at 4 °C, which showed T90 values of 7.7 and 5.5 days, and T99 values of 18.7 and 17.5 days for RW and WW, respectively. These results highlight the variability of SARS-CoV-2 persistence in water and wastewater matrices and can be highly relevant to efforts aimed at quantifying water-related risks, which could be valuable for understanding and controlling the pandemic.

Accuracy and interobserver agreement of retroareolar frozen sections in nipple-sparing mastectomies.

In the last decades, surgical treatment of breast cancer has enormously changed. As a result, nipple-sparing mastectomy (NSM) has evolved as an oncologically safe and cosmetic approach. NSM includes a subareolar frozen section to evaluate malignancy. We determined the accuracy of subareolar frozen section diagnosis, analyzed the discrepancy factor, and estimated the interobserver agreement of frozen section in NSM. A retrospective review of all NSMs at our institution from 2009 to 2015 was performed. Frozen sections were compared to the final diagnoses to analyze the accuracy of subareolar frozen sections. Discordant results were rigorously evaluated to identify discrepancy factors. Some cases were randomly chosen to assess the interobserver agreement (kappa) among pathologists. The agreement results were evaluated with and without knowledge of the tumor morphology. Among 34 NSMs, the frozen section false-negative and false-positive rate was 5.9% and 8.8%, respectively. The sensitivity and specificity was 77.8% and 88.0%, respectively. Sampling errors and diathermy artifacts explained our false-negative diagnoses. Freezing artifacts and an intraductal papilloma explained our false-positive diagnoses. The interobserver agreement between breast and general pathologists was 0.87 (p<0.0001) and 0.31 (p=0.0001), respectively. The interobserver agreement increased to 0.35 (p<0.0001) in general pathologists with knowledge of the tumor morphology. Subareolar frozen section showed to be a specific test with moderate sensitivity. Papillary lesions can mimic atypical cells and influence the frozen section interpretation. Frozen section in NSM had a better performance in breast pathologists (almost perfect) versus general pathologists (fair). Interobserver agreement may improve with knowledge of tumor morphology.

Avaliação da auto-percepção de mulheres portadoras de fissuras orais / Evaluation the perception of itself of the oral cleft women

As fissuras orais são as anomalias craniofaciais congênitas mais comuns nos seres humanos e acarretam diversas alterações funcionais e estéticas para os portadores dessa anomalia. Desta forma, o presente trabalho tem o objetivo de avaliar como mulheres portadoras de FL/P percebem sua estética facial, bem como analisar as variáveis envolvidas com essa percepção. Foi realizado um exame clínico e um questionário com 22 pacientes do gênero feminino que estavam em tratamento no Centro de Tratamento de Anomalias Craniofaciais do Rio de Janeiro. A maioria das pacientes demonstrou algum nível de insatisfação com a aparência do seu rosto, sendo o nariz (n=9) e os dentes (n=5) a maior queixa relatada pelas pacientes. Os profissionais da área da saúde devem reabilitar as alterações faciais proporcionando estética e qualidade de vida.

The oral clefts are the most common congenital craniofacial anomalies in humans and lead various alterations for individuals with this anomaly. Thus, this study aimed to evaluate oral cleft women perception regading their facial aesthetics, and analyze the variables involved with that perception. We conducted a clinical examination and a questionnaire with 22 female patients Who were in a treatment at the Center for Treatment of Craniofacial Anomalies of Rio de Janeiro. Most patients showed some level of satisfaction with the appearance of their faces. The nose (n=9) and teeth (n=5) were the main complaint reported by patients. The health Professional teams must rehabilitate the facial changes providing aesthetic and quality of life.

Tumor gigante cervical en paciente con neurofibromatosis (enfermedad de von recklinghausen): caso clínico / Cervix giant tumor (von recklinghausen): clinical case

La enfermedad de Von Recklinghausen o neurofibromatosis constituye una entidad clínica de poca frecuencia dentro del área quirúrgica, pero la misma presenta una serie de complicaciones propias de su evolución que ameritan su resolución quirúrgica y por ende la participación del anestesiólogo. Presentamos un caso de NF en una paciente sometida a cirugía para resección de neurofibromas gigantes maliginizados en la región cervical, su manejo anestésico y algunas consideraciones anestésicas pertinentes

Os jovens do ensino médio e suas representações sociais

O artigo relata os resultados de pesquisa sobre as representações sociais que estudantes do ensino médio desenvolvem acerca da escola e do trabalho. Constatou-se que estes jovens depositam na escola e na educação a única esperança de conseguir um status social mais reconhecido e empregos mais qualificados, desejando frequentemente continuar os estudos. As representações sobre o trabalho mostram-se bastante idealizadas, indicando o desconhecimento dos muitos determinantes estruturais e conjunturais nas relações de trabalho e sociais. Os resultados encontrados são analisados de forma a contribuir para as reflexões em torno da implantação da atual reforma curricular deste nível de escolaridade no Brasil(AU)

Mucocele orbitária / Orbital mucocele: a case report

Resumo: Objetivo: Relato de um caso de mucocele orbitária em um paciente de 50 anos de idade. Local: Instituto Penido Burnier, Campinas, Säo Paulo, Brasil. Método: Relato de caso. Resultado: O estudo radiológico da órbita revelou a presença de lesäo extraconal na órbita esquerda, sugerindo o diagnóstico de mucocele. Conclusäo: Mucocele é uma lesäo tumoral benigna, näo muito rara, que pode se estender à órbita causando manifestaçöes oculares. Seu diagnóstico se baseia na história; achados clínicos e radiológicos; e comprovaçäo anatomopatológica. O tratamento cirúrgico pode levar à cura desta enfermidade Recidivas näo säo raras (au)

Efeito imunossupressor da ciclosporina intra-muscular administrada em diferentes períodos pós-operatórios em um modelo de transplante penetrante de córnea em ratos / Immunosuppressive effect of intramuscular cyclosporine used at different post-operative period on a penetrating keratoplasty model in the rat

Obetivo: Avaliar o efeito imunossupressor da ciclosporina intramuscular (I.M.), administrada por tempo limitado em diferentes períodos do pós-operatório, no transplante penetrante de córnea em um modelo experimental em rato, por meio de avaliaçäo clínica e anátoma-patológica do enxerto corneano. Método: Foram utilizados ratos isogênicos Fischer cmo doadores e Lewis como receptopres, em um modelo ortotópico de transplante de córnea. A administraçäo de ciclosporina I.M. 10mg/kg/ dia foi iniciada em diferentes períodos nos grupos estudados: no pós-operatório. A ciclosporina quando iniciada foi administrada até o 30 dia pós-operatório. UM grupo controle näo recebeu a ciclosporina. I.M. Os enxertos corneanos foram avaliadas clínica e histologicamente. Resultado: Rejeiçäo foi observada nas primeiras três semanas dp pós-operatório em 100 (por cento) dos casos no grupo contole (n=5) que näo recebeu a ciclosporina. Os ratos tratados com ciclosporina (n=15) apresentaram rejeiçäo em apenas um caso, que teve curta evoluçäo e poucos sinais clínicos. Os estudos histológicos confirmaram as avaliaçöes clínicas. O grupo controle apresentou infiltrado no enxerto corneal com predomínio de linfócitos sobre neutrófilos com amsi neovasos, com mais fibrose e com infiltrado inflamatório mais intenso do que os grupos tratados com ciclosporina. Conclusäo: Os dados obtidos indicam que a ciclosporina I.M., pode ter efeito benéfico sobre o controle da rejeiçäo do transplante de córnea, mesmo na sua fase ativa

Empiema pleural postneumonia en el nino. / Pleural postpneumonic empyema in childhood

Se presentan 29 pacientes con diagnostico de empiema pleural, cuya edad vario de 5 meses a 10 anos. El estudio radiologico inicial revelo piotorax en 22 ninos y pioneumotorax en 7. El cultivo bacteriologico del liquido pleural resulto positivo en el 55.1% de los casos con predominio del estafilococo. Todos los pacientes recibieron terapia antimicrobiana especifica y simultaneamente les fue colocado drenaje cerrado de torax con un promedio de duracion de la sonda de 7 dias. En 7 pacientes en los que persistia supuracion y colapso pulmonar con mediastino fijo, se dejo tubo corto de drenaje, comunicado al exterior por un tiempo promedio de 22 dias. Todos los pacientes evolucionaron favorablemente y su seguimiento a los 6 meses demostro que todos se encontraban sanos, tanto clinica como radiologicamente. Ninguno de los pacientes amerito metodos quirurgicos mayores

Poliarteritis nodosa en el nino. / Polyarteritis nodosa in children

Se describen dos casos de poliarteritis nodosa del tipo clasico de Fink en dos ninos en edad escolar que presentaban sintomas generales, fiebre, mialgia y neuropatia periferica. Los hallazgos histopatologicos fueron los tipicos cambios arteriales descritos en esta enfermedad y los examenes del laboratorio estuvieron acordes a los informados en la literatura. Ambos pacientes presentaban elevacion de los titulos de antiestreptolisinas O, lo que sugiere que la infeccion estreptococica podria tener un papel importante en la genesis del problema. El tratamiento administrado fue prednisona en un paciente y prednisona asociada a ciclofosfamida en otro, con resultados satisfactorios. La sobrevida de los pacientes esta acorde a lo informado en la literatura sobre poliarteritis nodosa