A phase 3, randomised, double-blind, placebo-controlled clinical trial evaluation of the efficacy and safety of a SARS-CoV-2 recombinant spike RBD protein vaccine in adults (ABDALA-3 study).

Background: The pandemic of COVID-19 raised the urgent need for safe and efficacious vaccines against SARS-CoV-2. We evaluated the efficacy and safety of a new SARS-CoV-2 virus receptor-binding domain (RBD) vaccine. Methods: A phase 3, multicentre, randomised, double-blind, placebo-controlled trial was carried out at 18 clinical sites in three provinces of the south-eastern region of Cuba. Subjects (healthy or those with controlled chronic diseases) aged between 19 and 80 years, who gave written informed consent were eligible. Subjects were randomly assigned (1:1, in blocks) to two groups: placebo, and 50 µg RBD vaccine (Abdala). The product was administered intramuscularly, 0.5 mL in the deltoid region, in a three-dose immunization schedule at 0-14-28 days. The organoleptic characteristics and presentations of the vaccine and placebo were identical. All participants (subjects, clinical researchers, statisticians, laboratory technicians, and monitors) remained blinded during the study period. The main endpoint was to evaluate the efficacy of the Abdala vaccine in the prevention of symptomatic COVID-19. The trial is registered with the Cuban Public Registry of Clinical Trials, RPCEC00000359. Findings: Between March 22 to April 03, 2021, 48,290 subjects were included (24,144 and 24,146 in the placebo and Abdala groups, respectively) in the context of predominant D614G variant circulation. The evaluation of the main efficacy outcomes occurred during May-June 2021, starting at May 3rd, in the context of high circulation of mutant viruses, predominantly VOC Beta. The incidence of adverse reactions for individuals in the placebo and Abdala vaccine groups were 1227/24,144 (5.1%) and 1621/24,146 (6.7%), respectively. Adverse reactions were mostly mild, and from the injection site, which resolved in the first 24-48 h. No severe adverse events with demonstrated cause-effect relationship attributable to the vaccine were reported. Symptomatic COVID-19 disease was confirmed in 142 participants in the placebo group (78.44 incidence per 1000 person-years, 95% confidence interval [CI], 66.07-92.46) and in 11 participants in Abdala vaccine group (6.05 incidence per 1000 person years; 95% CI 3.02-10.82). The Abdala vaccine efficacy against symptomatic COVID-19 was 92.28% (95% CI 85.74-95.82). Moderate/serious forms of COVID-19 occurred in 30 participants (28 in the placebo group and only 2 in the Abdala vaccine group) for a vaccine efficacy of 92.88% (95% CI 70.12-98.31). There were five critical patients (of which four died), all in the placebo group. Interpretation: The Abdala vaccine was safe, well tolerated, and highly effective, fulfilling the WHO target product profile for COVID-19 vaccines. Those results, along with its immunization schedule and the advantage of easy storage and handling conditions at 2-8 °C, make this vaccine an option for the use in immunization strategies as a key tool for the control of the pandemic. Funding: Centre for Genetic Engineering and Biotechnology (CIGB), Havana, Cuba.

Safety, tolerability, and immunogenicity of a SARS-CoV-2 recombinant spike RBD protein vaccine: A randomised, double-blind, placebo-controlled, phase 1-2 clinical trial (ABDALA Study).

Background: Multiple vaccine candidates against COVID-19 are currently being evaluated. We evaluate the safety and immunogenicity protein of a novel SARS-CoV-2 virus receptor-binding domain (RBD) vaccine. Methods: A phase 1-2, randomised, double-blind, placebo-controlled trial was carried out in "Saturnino Lora" Hospital, Santiago de Cuba, Cuba. Subjects (healthy or those with controlled chronic diseases) aged between 19 and 80 years, who gave written informed consent were eligible. Subjects were randomly assigned (1:1:1, in blocks) to three groups: placebo, 25 µg and 50 µg RBD vaccine (Abdala). The product was administered intramuscularly, 0·5 mL in the deltoid region. During the first phase, two immunization schedules were studied: 0-14-28 days (short) and 0-28-56 days (long). In phase 2, only the short schedule was evaluated. The organoleptic characteristics and presentations of vaccine and placebo were identical. All participants (subjects, clinical researchers, statisticians, laboratory technicians, and monitors) remained masked during the study period. The main endpoints were safety and the proportion of subjects with seroconversion of anti-RBD IgG antibodies, analysed by intention to treat and per protocol, respectively. The trial is registered with the Cuban Public Registry of Clinical Trials, RPCEC00000346. Findings: Between Dec 7, 2020, and Feb 9, 2021, 792 subjects were included; 132 (66 in each vaccination schedule, divided into 22 for each group) in phase 1, and 660 (220 in each group plus 66 from the short scheme of phase 1) in phase 2. The product was well tolerated. No severe adverse events were reported. During phase 1, the incidence of adverse events in the 25 µg, 50 µg, and placebo arms for the short schedule were 6/22 (27·3%), 6/22 (27·3%), 3/22 (13·6%), respectively, and for the long schedule were 8/22 (36·4%), 9/22 (40·9%), 4/22 (18·2%), respectively. In phase 2, adverse reactions were reported by 53/242 (21·9%), 75/242 (31·0%) and 41/242 (16·9%) participants in the 25 µg, 50 µg, and placebo group, respectively. Adverse reactions were minimal, mostly mild, and from the injection site, which resolved in the first 24-48 hours. In phase 1, seroconversion at day 56 was seen in 95·2% of the participants (20/21) in the 50 µg group, 81% (17/21) in the 25 µg group, and none in the placebo group (0/22). For the long schedule, seroconversion at day 70 was seen in 100% of the participants (21/21) in the 50 µg group, 94·7% (18/19) in the 25 µg group, and none in the placebo group (0/22). In phase 2, seroconversion of anti-RBD IgG antibodies at day 56 was seen in 89·2% of the participants in the 50 µg group (214/240; 95% CI 84·5-92·82), 77·7% in the 25 µg group (185/238; 72·0-82·9) and 4·6% in the placebo group (11/239; 2·3-8·1). Compared with the placebo arm, the differences in the proportion of participants with seroconversion were 73·1% (95% CI 66·8-79·5) and 84·6% (79·4-89·7) in the 25 µg and 50 µg groups, respectively. The seroconversion rate in the 50 µg group was significantly higher than in the 25 µg group (p=0·0012). Interpretation: The Abdala vaccine was safe, well tolerated, and induced humoral immune responses against SARS-CoV-2. These results, in the context of the emergency COVID-19 pandemic, support the 50 µg dose, applied in a 0-14-28 days schedule, for further clinical trials to confirm vaccine efficacy. Funding: Centre for Genetic Engineering and Biotechnology (CIGB), Havana, Cuba.

Incidência de Streptococcus ß-Hemolítico em Gestantes do Município de Campinas, São Paulo / ß-hemolytic Streptococcus incidence in pregnant women of Campinas Municipality, São Paulo

Objetivo: O objetivo deste estudo foi avaliar a incidência de Streptococcus ß-hemolítico em gestantes e a suscetibilidade aos antimicrobianos das pacientes colonizadas. Métodos: Para isso, foram analisadas 4.380 amostras de secreções vaginais e anais de gestantes, a partir de 35 semanas de gestação, atendidas em laboratório particular na cidade de Campinas, para detecção da presença de Streptococcus ß-hemolítico. Resultados: Foi encontrada uma prevalência de colonização nas gestantes analisadas de 12% (504/4380), sendo 293 (13%) vaginais e 211 (10%) anais. Das positivas, foi realizado o perfil de resistência bacteriana em 60 amostras, sendo 20% das amostras anais resistentes à clindamicina e 22% à eritromicina e das amostras vaginais 25% resistentes à clindamicina e 33% à eritromicina, não havendo resistência à penicilina e ampicilina. Conclusão: Diante da incidência apresentada, ressalta-se a importância da realização do rastreio da colonização transitória de estreptococos ß-hemolíticos em gestantes durante o pré-natal, associado à adequada profilaxia intraparto, para minimizar os riscos de ocorrência de sepse nos neonatos.

Objective: The aim of this study was evaluate the incidence of ß-hemolytic Streptococcus in pregnant women and antimicrobial susceptibility of colonized patients. Methods: For this, a cohort of 4,380 of pregnant women, from 35 weeks of gestation, were analyzed, samples of vaginal and anal secretion were collected in a private laboratory in the city of Campinas. Result: The prevalence of colonization was of 12% (504/4380) in pregnant women was evidenced, being 293 (13%) vaginal and 211 (10%) anal. From the positives, the bacterial resistance profile was performed in 60 samples, 20% of the clinical samples resistant to Clindamycin and 22% of Erythromycin and 25% of the vaginal samples resistant to Clindamycin and 33% to Erythromycin, without resistance to Penicillin and Ampicillin. Conclusion: We conclude that the emphasize the importance of performing the screening of ß-hemolytic Streptococcus in pregnant women during the prenatal period, associated with adequate intrapartum prophylaxis is needed.

Antioxidant Properties of Lyophilized Rosemary and Sage Extracts and its Effect to Prevent Lipid Oxidation in Poultry Pátê.

This study aimed to evaluate the antioxidant activities (AA) of lyophilized rosemary extract and lyophilized sage extract, and their effects on the oxidative stability of poultry pátê. For this purpose, four poultry pátê formulations with rosemary, sage, sodium erythorbate and a control (without antioxidants) were produced. The rosemary and sage were characterized according to total phenolic compounds (TPC) and AA by several methods. The poultry pátês stored at 4 °C were evaluated by the lipid oxidation. High concentrations of TPC were detected in the rosemary extract and sage extract (46.48 and 41.61 mg GAE/g (Gallic acid equivalent), respectively). The AA of the rosemary and sage extracts determined by free radical-scavenging were 4745.72 and 2462.82 µmol TE/g (Trolox equivalents), respectively. The high concentrations of catechin, rutin, myricetin and p-coumaric acids in these extracts may be responsible for the strong inhibitory action against food pathogens. Besides this, these compounds can be responsible for the best performance in inhibiting lipid oxidation in poultry pátês during storage. This study suggests that rosemary and sage extracts may be used as a natural antioxidant in meat products.

The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire

Objective: The ICD-11 Trauma Questionnaire (ITQ) was developed as a joint effort by researchers from several countries to evaluate post-traumatic stress (PTSD) and complex-PTSD (C-PTSD) symptoms. This study is part of a multi-center international collaborative research project that aims to provide psychometric support for this initial instrument in different languages, considering the specific contexts related to complex traumatization. This study verified the psychometric characteristics of the Portuguese version of the ITQ, evaluating symptoms beyond those described the existing literature. Methods: We examined the results of a convenience sample totaling 268 Portuguese and Angolan participants. Two instruments were applied: the ITQ, which evaluates symptoms resulting from a traumatic life event, and the Life Events Checklist (LEC), which evaluates stressful life events. The general characteristics of the scales are described, and reliability analysis and validity studies were performed. Results: Cronbach's alpha varied between 0.84 and 0.88, and the exploratory factorial analysis results were consistent with the concept of C-PTSD, with five components explaining 61.58% of scale variance. Conclusion: The results suggest good psychometric characteristics for the Portuguese version of the ITQ, and thus it can be included in protocols intended evaluating complex traumatic symptoms.

Epstein-Barr virus induces morphological and molecular changes in thyroid neoplastic cells.

Although the evolution of differentiated thyroid cancer (DTC) is usually indolent, some tumors grow fast, metastasize, and may be fatal. Viruses have been associated with many human tumors, especially the Epstein-Barr virus (EBV), which shows a high viral load in DTC. In order to evaluate the ability of the virus to cause morphological and molecular changes in neoplastic thyroid cell lines TPC-1, BCPAP, and 8505C, a viral adaptation was performed for the analysis of EBV cytopathic effect (CPE), viral kinetics and gene expression analysis of oncogenes KRAS, NRAS, HRAS, and TP53. Comparison of inoculated cells with non-inoculated control cells showed that all tumor cell lines were permissive to the virus. The virus caused CPE in the TPC-1 and 8505C, but not in BCPAP cells. Viral kinetic was similar in both BCPAP and 8505C with a point of eclipse at 24 h post infection. TPC-1 cell line displayed a decreasing growth curve, with highest viral load right after inoculation, which decreased over time. There was hyperexpression of TP53 and NRAS in BCPAP cell (p = 0.012 and p = 0.0344, respectively). The 8505C cell line presented NRAS hyperexpression (p = 0.0255), but lower TP53 expression (p = 0.0274). We concluded that neoplastic thyroid cell lines are permissive to EBV that the virus presents different viral kinetic patterns in different cell lines and produces a CPE on both well-differentiated and undifferentiated thyroid cell lines. We also demonstrated that EBV interferes in oncogene expression in thyroid neoplastic cell lines, suggesting that these effects could be related to different tumor progression patterns.

The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire.

OBJECTIVE: The ICD-11 Trauma Questionnaire (ITQ) was developed as a joint effort by researchers from several countries to evaluate post-traumatic stress (PTSD) and complex-PTSD (C-PTSD) symptoms. This study is part of a multi-center international collaborative research project that aims to provide psychometric support for this initial instrument in different languages, considering the specific contexts related to complex traumatization. This study verified the psychometric characteristics of the Portuguese version of the ITQ, evaluating symptoms beyond those described the existing literature. METHODS: We examined the results of a convenience sample totaling 268 Portuguese and Angolan participants. Two instruments were applied: the ITQ, which evaluates symptoms resulting from a traumatic life event, and the Life Events Checklist (LEC), which evaluates stressful life events. The general characteristics of the scales are described, and reliability analysis and validity studies were performed. RESULTS: Cronbach's alpha varied between 0.84 and 0.88, and the exploratory factorial analysis results were consistent with the concept of C-PTSD, with five components explaining 61.58% of scale variance. CONCLUSION: The results suggest good psychometric characteristics for the Portuguese version of the ITQ, and thus it can be included in protocols intended evaluating complex traumatic symptoms.

Perfil epidemiológico da hanseníase no período de 2011 a 2018 no município de Campinas - SP / Epidemiological profile of leprosy in the period from 2011 to 2018 in the municipality of Campinas - SP

Objetivo ­ Descrever o perfil epidemiológico da hanseníase em Campinas através do levantamento do número de casos da doença, registrados de 2011 a agosto de 2018 no município. Métodos ­ Tratou-se de uma pesquisa com abordagem transversal retrospectiva, quantitativa do tipo descritiva com a coleta de dados registrados no Sistema de Informação de Agravos de Notificação (Sinan) a respeito dos casos de hanseníase notificados no período de agosto de 2011 a agosto de 2018. Resultados ­ Foram encontrados 213 novos casos de hanseníase em Campinas no período estudado, com uma taxa de incidência de 2,47 casos para cada 100 mil habitantes. A população masculina apresentou-se com 57% dos casos registrados e a população feminina com 43%. A hanseníase mostrou-se prevalente em populações com idade acima de 14 anos com 96% das notificações. As formas clínicas iniciais mais encontradas foram a Virchowiana e a Dimorfa, com 31% e 26% respectivamente. O distrito residencial com o maior número de casos foi o Sul, com 28% dos casos registrados e o grau de incapacidade mais prevalente no momento do diagnóstico, foi o grau 0 da patologia com 59% dos casos notificados. Quanto a classificação operacional da notificação, notou-se que a classificação multibacilar apresentou 69% dos casos. Conclusão ­ Conclui-se que apesar da taxa de incidência da hanseníase no município de Campinas estar em declínio nas últimas décadas, é necessário manter o afinco dos órgãos de saúde do município na luta contra a doença, pois esta, ainda é considerada como um grave problema de saúde pública

Objective ­ To describe the epidemiological profile of leprosy in Campinas by surveying the number of cases of disease, recorded from 2011 to August 2018 in the city. Methods ­ This is a cross-sectional, quantitative, descriptive retrospective research with data collection recorded in the Notification Recording Information System (Sinan) and respect for unreported leprosy cases from August 2011 to August 2018. Results ­ A total of 213 new leprosy cases were found in Campinas during the study period, with an incidence rate of 2.47 cases per 100,000 inhabitants. The male population shows up with 57% of registered cases and the female population with 43%. Leprosy was prevalent at ages over 14 years with 96% of notifications. The most recent clinical forms found were Virchowiana and Dimorfa, with 31% and 26%, respectively. The residential district with the largest number of cases was the South, with 28% of the cases registered and the most prevalent degree of disability at the time of diagnosis, was the degree 0 pathology with 59% of the reported cases. Regarding the operational classification of the notification, there is no multibacillary classification Displaying 69% of cases. Conclusion ­ It was concluded that, although leprosy incidence rates in the city of Campinas have been declining in the last decades, it is necessary to maintain the commitment of public agencies of the city in the fight against the disease, since it is still considered as a serious public health problem.

Thyroid autoimmune diseases and thyroid tumors: Would EBV infection be the link?

The role of EBV in thyroid cancer development and the patient's outcome is still unclear. Using nested-PCR, Moghoofei et al. reported a high incidence of a virus in thyroid tumor samples, different from our results, obtained by quantitative real-time PCR and confirmed by in situ hybridization. Because lymphocytes are the main reservoir of the virus and tumor-infiltrating lymphocytes are commonly observed in thyroid cancer, it is important to distinguish follicular cells infection from lymphoid tissue infection. The association between autoimmune diseases and thyroid cancer raises the importance of continuing to investigate the role of ubiquitous pathogens in thyroid tumorigenesis.

Epstein-Barr Virus and Thyroid Cancer.

Epstein-Barr virus (EBV) seroprevalence is extremely high worldwide. This member of the herpesvirus family is considered to be a human carcinogen, implicated in lymphoid and epithelial malignancies. Because of its characteristics, EBV has been investigated in thyroid specimens, especially in autoimmune and neoplastic lesions. However, the role of EBV in thyroid diseases is still unclear. Reports on its presence in thyroid cancer (TC) vary drastically according to population and applied methodology. This review presents the history of EBV and TC, aiming to better understand the role of this oncogenic virus in thyroid tumorigenesis. We hope to assist researchers, and we discuss possible approaches to better understand the role of EBV in TC.

Análise da percepção de jogadores de futebol amador sobre mulheres que praticam o futebol / Analysis of football players of perception on amateur women practicing the football / Análisis de los futbolistas de percepción sobre la mujer de aficionados que practican el fútbol

O futebol feminino é uma modalidade esportiva marcada, desde a sua origem, pelo preconceito, desvalorizando as mulheres que o praticam. Sob essa ótica o presente estudo teve como principal objetivo analisar qual a percepção de jogadores de futebol amador da cidade de Aragarças - GO a respeito de mulheres que praticam o futebol. A metodologia utilizada foi uma pesquisa quali-quantitativa, baseada em um questionário aplicado e contando com material bibliográfico, por meio do qual os resultados desvelaram que, apesar da fala dos entrevistados, ainda existe um grande preconceito da sociedade contra mulheres que praticam tal esporte, como também a ausência de incentivos por parte da mídia e das entidades governamentais, fato que não acontece no futebol masculino.

Women's football is a sport marked from the outset by prejudice, devaluing women who practice it. Under this view the present study aimed to analyze the perception of amateur footballers City Aragarças - GO about women who play football. The methodology used was a qualitative and quantitative research, bibliographic and documentary evidence, by means of which the results unveiled that despite the talk of respondents, there is still a lot of prejudice in society against women playing football, but also the lack of incentives for the media, and government entities, which did not happen in men's soccer.

El fútbol femenino es un deporte marcado desde el principio por el prejuicio, la devaluación de las mujeres que lo practican. Bajo este punto de vista el presente estudio tuvo como objetivo analizar la percepción de los futbolistas amateurs Ciudad Aragarcas - GO acerca de las mujeres que juegan al fútbol. La metodología utilizada fue una evidencia cualitativa y la investigación cuantitativa, bibliográfico y documental, mediante el cual los resultados revelaron que a pesar de la charla de los encuestados, todavía hay muchos prejuicios en la sociedad contra las mujeres jugando al fútbol, sino también la falta de incentivos para los medios de comunicación y entidades de gobierno, lo que no ocurrió en el fútbol masculino.

Polymorphism in LEP and LEPR May Modify Leptin Levels and Represent Risk Factors for Thyroid Cancer.

Purpose. To understand the role of polymorphisms in the LEP (rs7799039 and rs2167270) and LEPR (rs1137101 and rs1137100) genes in DTC susceptibility and their effect on leptin levels. Methods. We studied 153 patients with DTC and 234 controls through TaqMan SNP Genotyping and ELISA, comparing these data to the clinicopathological data of patients with DTC. Results. Patients with AA genotype of rs7799039 had higher levels of serum leptin (9.22 ± 0.98 ng/mL) than those with AG genotype (10.07 ± 0.60 ng/mL; P = 0.005). Individuals with AG genotype of rs2167270 also produced higher serum leptin levels (10.05 ± 0.59 ng/mL) than the subjects with GG genotype (9.52 ± 0.79 ng/mL; P < 0.05). A multivariate logistic regression adjusted for gender, age, and BMI showed that the AG genotype of rs7799039 was an independent risk for DTC (OR, 11.689; P = 0.0183; 95% CI, 1.516-90.119). Similarly, AG and GG genotypes of rs1137101 increased the susceptibility to DTC (OR, 3.747; P = 0.027; 95% CI, 1.161-12.092 and OR, 5.437; P = 0.013; 95% CI, 1.426-20.729). Conclusions. We demonstrated that rs7799039 and rs2167270 polymorphisms modify the serum leptin concentrations in patients with DTC. Furthermore, polymorphisms rs7799039 and rs1137101 increase the risk of DTC development, although they do not correlate with tumor aggressiveness.

The effects of cyclosporin A and Heteropterys tomentosa on the rat liver.

Cyclosporin A (CsA) is a widely employed immunosuppressive drug that is associated with several side effects, among then hepatotoxicity. Heteropterys tomentosa is a Brazilian plant efficient in reducing damage caused by CsA on the rat testis and prostate. The aim of this study was to evaluate the effect of CsA and H. tomentosa (administered isolated or simultaneously) on the liver of Wistar rats. The animals were treated daily with water (control), CsA (15 mg/kg/day), H. tomentosa infusion or CsA+H. tomentosa, for 21 or 56 days. The treatments did not alter liver morphology or cause fibrosis. H. tomentosa administered for 21 days increased the number of hepatocyte nuclei and Kupffer cell volumetric proportion. After 56 days of treatment, H. tomentosa administration did not alter the parameters analyzed. Biochemical plasma dosages and liver stereology showed impairment caused by CsA-treatment after 21 days; these results were not observed after 56 days of treatment. The simultaneous treatment with CsA and H. tomentosa for 21 or 56 days did not alleviate nor accentuate CsA hepatic effects. The present study showed that the 21 days treatment with CsA caused more alteration to the liver than the 56 days treatment; this could be related to hepatic recovery after the long term treatment.

Clinical physiology grand rounds.

BACKGROUND: Clinical Physiology Grand Rounds (CPGR) is an interactive, case-based conference for medical students designed to: (1) integrate preclinical and clinical learning; (2) promote inductive clinical reasoning; and (3) emphasise students as peer teachers. CPGR specifically encourages mixed learning level student interactions and emphasises the use of concept mapping. We describe the theoretical basis and logistical considerations for an interactive, integrative, mixed-learner environment such as CPGR. In addition, we report qualitative data regarding students' attitudes towards and perceptions of CPGR. CONTEXT: Medical students from first to fourth year participate in a monthly, interactive conference. PROGRAMME DESCRIPTION: The CPGR was designed to bridge gaps and reinforce linkages between basic science and clinical concepts, and to incorporate interactive vertical integration between preclinical and clinical students. Medical education and content experts use Socratic, interactive teaching methods to develop real-time concept maps to emphasise the presence and importance of linkages across curricula. PROGRAMME EVALUATION: Student focus groups were held to assess attitudes towards and perceptions of the mixed-learner environment and concept maps in CPGR. Qualitative analyses of focus group transcripts were performed to develop themes and codes describing the students' impressions of CPGR. DISCUSSION: CPGR is a case-based, interactive conference designed to help students gain an increased appreciation of linkages between basic science and clinical medicine concepts, and an increased awareness of clinical reasoning thought processes. Success is dependent upon explicit attention being given to goals for students' integrated learning.

A comparative study of pentoxifylline effects in adult and aged rats submitted to lung dysfunction by thermal injury.

PURPOSE: To investigate the protective effects of pentoxifylline against lung injury observed after dorsal scald in aged animals. METHODS: Adult (eight months old) and aged (20 months old) rats were subjected to thermal injury or sham procedure. The six hours post-trauma animals received pentoxifylline and after 24 hours were euthanatized and lung tissue samples collected. The bronchoalveolar lavage fluid was evaluated for total protein content and tumor necrosis factor-alpha cytokine. Malondialdehyde and myeloperoxidase activity in the lung homogenate were measured and a histological lung examination was undertaken. RESULTS: Burn injury induced oxidative stress in lung homogenate was higher in elderly-burned rats compared to adult-burned rats (p<0.001). Total protein and cytokine in bronchoalveolar lavage increased in the elderly-burned group when compared to the adult-burned group (p<0.001). All parameters decreased in both groups treated with pentoxifylline (p<0.05). CONCLUSIONS: The injury was augmented in elderly rats when compared to adult rats. Damage was reduced with the use of pentoxifylline, however further studies are needed to evaluate the dose-response of the drug.

A comparative study of pentoxifylline effects in adult and aged rats submitted to lung dysfunction by thermal injury

PURPOSE: To investigate the protective effects of pentoxifylline against lung injury observed after dorsal scald in aged animals. METHODS: Adult (eight months old) and aged (20 months old) rats were subjected to thermal injury or sham procedure. The six hours post-trauma animals received pentoxifylline and after 24 hours were euthanatized and lung tissue samples collectedted. The bronchoalveolar lavage fluid was evaluated for total protein content and tumor necrosis factor-alpha cytokine. Malondialdehyde and myeloperoxidase activety in the lung homogenate were measured and a histological lung examination was undertaken. RESULTS: Burn injury induced oxidative stress in lung homogenate was higher in elderly-burned rats compared to adult-burned rats (p<0.001). Total protein and cytokine in bronchoalveolar lavage increased in the elderly-burned group when compared to the adult-burned group (p<0.001). All parameters decreased in bolth groups treated with pentoxifylline (p<0.05). CONCLUSIONS: The injury was augmented in elderly rats when compared to adult rats. Damage was reduced with the use of pentoxifylline, however further studies are needed to evaluate the dose-response of the drug.

Reaching the limits of mandated self-reporting: clinical logbooks do not predict clerkship performance.

BACKGROUND: Logbooks are used by US medical schools to evaluate curricular objectives and meet accreditation requirements, but research supporting their utility is conflicting. AIMS: The goal of our study was to examine the relationship between volume of clinical rotation experiences as reported in a logbook and clerkship grades within a longitudinal integrated clerkship. METHODS: We conducted a retrospective cohort study of third-year (clinical) medical students during academic year 2008-2009. We tracked student entries in a pocket-sized logbook (number of clinical encounters per clerkship, total number of exams, and procedures over the academic year). We performed correlation analyses between logbook entries and clerkship grades. RESULTS: We enrolled 36 students, who reported a total of 2992 encounters, 2262 exams, and 2342 procedures. Correlation coefficients between volume of clinical experience and clerkship grades were less than 0.4, indicating low correlation. We found borderline statistical significance for the Neurology, OB/Gyn, and Surgery clerkships. Sensitivity analyses showed little correlation between low-reporting activity and clerkship grades. CONCLUSIONS: Even within an integrated longitudinal clerkship framework, our findings are consistent with previous studies showing a negligible relationship between logbooks as an educational process measure and how they relate to educational outcomes.

Teaching medical students about obesity: a pilot program to address an unmet need through longitudinal relationships with bariatric surgery patients.

BACKGROUND: Despite obesity's relevance and impact, curricula addressing obesity are underrepresented in clinical medical education. A novel pilot program to begin teaching medical students about care of the obese patient was developed and student attitudes toward obesity and bariatric surgery were assessed. METHODS: The authors paired third-year students with obese patients undergoing bariatric surgery. Students established a longitudinal patient relationship, received faculty mentorship, and kept a reflections journal. An attitude assessment survey was administered before and after third year. Reflections were analyzed for common themes. RESULTS: Baseline student responses differed from those previously reported for practicing physicians on many survey statements, including more strongly agreeing with the relationship between obesity and serious medical conditions (P < .001), the need to educate patients about obesity risks (P < .001), and willingness to recommend bariatric surgery evaluation (P = .004). These differences were maintained after clinical clerkships. Reflection themes included recognition of obesity stereotypes, improved estimation of body mass index, and awareness of physicians' attitudes about obesity. CONCLUSION: Development and assessment of a novel pilot program to teach third-year medical students about obesity and bariatric surgery suggests a potential impact on student attitudes and understanding of obesity and obesity surgery. Students today may have different attitudes toward obesity than those reflected in prior data for physicians in practice, and programs such as this may help maintain positive attitudes.

Indução de brotações em explantes de segmentos de folhas de plântulas de urucueiro em diferentes citocininas / Induction of shoot buds in leaf explants of annatto seedlings in differents cytokinins

Segmentos de folhas de plântulas de urucum (Bixa orellana L), foram cultivados in vitro, em um meio básico idealizado por Murashige & Skoog (1962), suplementado com 0,5mg/l dos reguladores do crescimento, benzilaminopurina (BAP), cinetina (KN) e isopentenil-adenina (2iP), isolados ou combinados entre si, com o objetivo de avaliar qual a melhor citocinina ou combinação destas para indução de brotações de boa qualidade visando à micropropagação. Após 60 dias de cultivo, as gemas obtidas foram transferidas para um meio MS modificado, contendo a metade da formulação de sais minerais, sem a suplementação de reguladores do crescimento. Gemas de melhor qualidade foram obtidas nos tratamentos onde a KN e o BAP estavam em combinação. A KN sozinha não foi eficiente na indução de brotações. O maior número de gemas por explante foi obtido com KN, BAP e 2iP e no tratamento com apenas BAP.

Excised leaf explants of annatto (Bixa orellana L.) seedlings were cultivated on a Murashige & Skoog basal medium containing benzylaminopurine (BAP), kinetin (KN) and isopentenyl-adenine (2iP) individually or in combination, each at concentration of 0.5mg/l, with the purpose of evaluated the best cytokinins or cytokinins combination for shoot bud formation. After 60 days, regenerated shoots were transferred to half strenght MS medium without growth regulators. Best shoots were observed where KN and BAP were added in combination. Isolated KN was ineffective for shoot bud formation. The maximum average number of shoot buds per leaf explant was obtained on medium with BAP, KN and 2iP in combination and on medium supplied of isolated BAP.