Imaging Assessment of Nontraumatic Pathologic Conditions at the Craniovertebral Junction: A Comprehensive Review.

Nontraumatic pathologic conditions of the craniovertebral junction encompass a range of conditions affecting the complex anatomy of this region without direct physical injury. These conditions include congenital syndromes that predispose individuals to ligamentous laxity, potentially leading to instability. Additionally, rare but noteworthy cases such as Grisel syndrome, a cause of pediatric torticollis, may arise without a traumatic trigger. Inflammatory diseases, including rheumatoid arthritis, ankylosing spondylitis, and crystal deposition, can lead to cervical instability and spinal cord compression. Infections at the upper cervical spine are dominated by tuberculosis, typically transmitted through hematologic or lymphatic routes with characteristic imaging findings. On the other hand, purulent bacterial infections in this area are rare. Furthermore, although tumors involving the structures of the craniovertebral junction are infrequent, they can lead to significant complications, albeit less frequently through cord compression and more commonly via pathologic fractures or subluxation. The craniocervical junction is a complex anatomic region comprising ligaments, bones, joints, and muscles that support the head's weight and enable its wide range of motion. Accurate recognition and understanding of the complex anatomy and the various nontraumatic pathologic conditions at the craniovertebral junction are pivotal for initiating timely and appropriate treatment strategies. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.

Application of a Dermal Regeneration Matrix for the Surgical Treatment of an Oromaxillary Defect in Medication-Related Osteonecrosis of the Jaw.

Surgical options for managing patients with medication-related osteonecrosis of the jaw are multiple and may range from superficial debridement to vascularized osteocutaneous free flaps. However, some protocols may not be an option in specific cases, and alternative techniques for patients who are not likely candidates for more invasive procedures may represent a suitable solution to treat these patients. Here, we report the case of a 69-year-old man who presented to the Stomatology Department with dysphagia, exposed bone, and mild mandibular pain for the past three months. The patient was diagnosed with stage III medication-related osteonecrosis of the jaw. Surgical debridement with sequestrum removal was performed and the remaining intraoral defect, which was unsuitable for primary closure, was addressed with a dermal regeneration matrix. This system allowed full coverage of the surgical wound. At 10 weeks of follow-up, the intraoral defect had healed completely with no need for active intervention. Dermal regeneration matrixes may represent a surgical approach to cover oromaxillary defects in select patients.

Seaweed Extracts to Control Postharvest Phytopathogenic Fungi in Rocha Pear.

Fungal infections cause losses amounting to between 20 and 25% of the fruit industry's total outcome, with an escalating impact on agriculture in the last decades. As seaweeds have long demonstrated relevant antimicrobial properties against a wide variety of microorganisms, extracts from Asparagopsis armata, Codium sp., Fucus vesiculosus, and Sargassum muticum were used to find sustainable, ecofriendly, and safe solutions against Rocha pear postharvest fungal infections. Alternaria alternata, Botrytis cinerea, Fusarium oxysporum, and Penicillium expansum mycelial growth and spore germination inhibition activities were tested in vitro with five different extracts of each seaweed (n-hexane, ethyl acetate, aqueous, ethanolic, and hydroethanolic). An in vivo assay was then performed using the aqueous extracts against B. cinerea and F. oxysporum in Rocha pear. The n-hexane, ethyl acetate, and ethanolic extracts from A. armata showed the best in vitro inhibitory activity against B. cinerea, F. oxysporum, and P. expansum, and promising in vivo results against B. cinerea using S. muticum aqueous extract were also found. The present work highlights the contribution of seaweeds to tackle agricultural problems, namely postharvest phytopathogenic fungal diseases, contributing to a greener and more sustainable bioeconomy from the sea to the farm.

Relationship between depressive symptoms, social isolation, visual complaints and hearing loss in middle-aged and older adults.

The prevalence of chronic diseases, especially depression, has been increasing worldwide. Health professionals have an important role in screening and early detection of the disorder, to prevent possible damage such as disability and dependence. With aging, sensory impairments can occur, such as visual and hearing losses, which can lead to isolation contributing to the development of depressive symptoms. The objective of this study was to analyze the relationship between depressive symptoms, social isolation, and self-perception of visual complaints and hearing loss in middle-aged and older adults. It was a cross-sectional quantitative study, in Três Lagoas, state of Mato Grosso do Sul, Brazil, with 300 participants of both sexes, aged 45 years and over, registered in the Primary Health Care network. Data were collected using a structured questionnaire with sociodemographic data and the questions "Do you consider yourself socially isolated?", "Do you have a vision and/or a hearing problem capable of stopping you from performing a daily life activity?" and "If yes, do you use a hearing aid and/or glasses or contact lenses?". Depressive symptoms were assessed using the Center for Epidemiological Studies - Depression (CES-D) scale with a cut-off score adapted for age. Data were analyzed with binary logistic regression, with the presence of depressive symptoms being the dependent variable. Values of p≤0.05 were considered significant. The majority of the sample were women (65.7%), with an average age of 60.9 years, 56.7% were classified with depressive symptoms, 27.0% considered themselves socially isolated, 84.7% reported visual acuity loss (70.7% used glasses) and 17.3% reported hearing loss (2.3% used hearing aids). Social isolation (OR = 6.0), visual complaints (OR = 3.85), and hearing loss (OR = 4.67) were related to the presence of depressive symptoms. Moreover, being married (OR = 0.51) was a protective factor in these participants. The results showed the importance of early diagnosis of depressive symptoms. The correction of visual and hearing deficits is highlighted, as these may be related to symptoms of depression. Health professionals in Primary Health Care should be able to monitor depressive symptoms, visual and hearing complaints, and to promote social interaction.

An insight into the mechanisms underpinning the anti-browning effect of Codium tomentosum on fresh-cut apples.

This work focuses on understanding the action of a novel seaweed extract with anti-browning functionality in fresh-cut apples. Organic fresh-cut apples were coated by immersion in an aqueous Codium tomentosum seaweed extract (0.5 % w/v), packaged under ambient atmospheric conditions in plastic bags, and stored at 4 ˚C for 15 days. Browning-related enzymatic activities, as well as targeted gene expression related to superficial browning, were monitored immediately after coating and followed at five-day intervals, until a final storage period of 15 days. Gene expression was particularly affected one hour after coating application (day 0), with no expression registered for peroxidase (mdPOD) and phenylalanine ammonia-lyase (mdPAL) genes in the coated samples. A reduction in polyphenol oxidase expression levels was also observed. After 15 days of storage, the coated samples developed lower browning levels and presented distinctly lower activities of polyphenol oxidase and peroxidase - the oxidative enzymes predominantly involved in enzymatic browning. The observed post-coating suppression of mdPAL and mdPOD expression, and reduction in mdPPO expression, suggest that the seaweed C. tomentosum extract delays the activation of these genes, and decreases enzymatic activity, which in turn accounts for the coating's anti-browning effect.

Electrospun Polycaprolactone (PCL) Degradation: An In Vitro and In Vivo Study.

Polycaprolactone (PCL) is widely used in tissue engineering due to its interesting properties, namely biocompatibility, biodegradability, elastic nature, availability, cost efficacy, and the approval of health authorities such as the American Food and Drug Administration (FDA). The PCL degradation rate is not the most adequate for specific applications such as skin regeneration due to the hydrophobic nature of bulk PCL. However, PCL electrospun fiber meshes, due to their low diameters resulting in high surface area, are expected to exhibit a fast degradation rate. In this work, in vitro and in vivo degradation studies were performed over 90 days to evaluate the potential of electrospun PCL as a wound dressing. Enzymatic and hydrolytic degradation studies in vitro, performed in a static medium, demonstrated the influence of lipase, which promoted a rate of degradation of 97% for PCL meshes. In an in vivo scenario, the degradation was slower, although the samples were not rejected, and were well-integrated in the surrounding tissues inside the subcutaneous pockets specifically created.

Imaging Review of Normal and Abnormal Skeletal Maturation.

The growing skeleton undergoes well-described and predictable normal developmental changes, which may be misinterpreted a as pathologic condition at imaging. Primary and secondary ossification centers (SOCs), which form the diaphysis and the epiphysis of long bones, respectively, are formed by endochondral and intramembranous ossification processes. During skeletal maturation, the SOCs may appear irregular and fragmented, which should not be confused with fractures, osteochondritis dissecans, and osteochondrosis. These normal irregularities are generally symmetric with a smooth, round, and sclerotic appearance, which are aspects that help in the differentiation. The metaphysis, epiphysis, and growth plates or physes are common sites of injuries and normal variants in the pediatric skeleton. The metaphysis contains the newly formed bone from endochondral ossification and is highly vascularized. It is predisposed to easy spread of infections and bone tumors. The physis is the weakest structure of the immature skeleton. Injuries to this location may disrupt endochondral ossification and lead to growth disturbances. Pathologic conditions of the epiphyses may extend into the articular surface and lead to articular damage. At MRI, small and localized foci of bone marrow changes within the epiphysis and metaphysis are also a common finding. These can be related to residual red marrow (especially in the metaphysis of long bones and hindfoot), focal periphyseal edema (associated with the process of physeal closure), and ultimately to a normal ossification process. The authors review the imaging appearance of normal skeletal maturation and discuss common maturation disorders on the basis of developmental stage and location. ©RSNA, 2022.

Argan Oil as a Rich Source of Linoleic Fatty Acid for Dietetic Structured Lipids Production.

Argan oil is rich in long-chain unsaturated fatty acids (FA), mostly oleic and linoleic, and natural antioxidants. This study addresses the production of low-calorie structured lipids by acidolysis reaction, in a solvent-free system, between caprylic (C8:0; system I) or capric (C10:0; system II) acids and argan oil, used as triacylglycerol (TAG) source. Three commercial immobilized lipases were tested: Novozym® 435, Lipozyme® TL IM, and Lipozyme® RM IM. Higher incorporation degree (ID) was achieved when C10:0 was used as acyl donor, for all the lipases tested. Lipozyme® RM IM yielded the highest ID for both systems (28.9 ± 0.05 mol.% C10:0, and 11.4 ± 2.2 mol.% C8:0), being the only catalyst able to incorporate C8:0 under the reaction conditions for biocatalyst screening (molar ratio 2:1 FA/TAG and 55 °C). The optimal conditions for Lipozyme® RM IM in system II were found by response surface methodology (66 °C; molar ratio FA/TAG of 4:1), enabling to reach an ID of 40.9 mol.% of C10:0. Operational stability of Lipozyme® RM IM in system II was also evaluated under optimal conditions, after eight consecutive 24 h-batches, with biocatalyst rehydration between cycles. The biocatalyst presented a half-life time of 103 h.

Inadequacy of gestational weight gain during high-risk pregnancies is not associated with household food insecurity.

BACKGROUND: Inadequate gestational weight gain (GWG) is associated with adverse outcomes in maternal and child health and can be enhanced by social inequalities, such as lower education and household food insecurity (HFI). Women are more vulnerable to HFI, which has been associated with negative health effects for pregnant women during the prenatal and puerperal periods, particularly in regard to the aggravation of pregnancy risks. This study investigated the association between sociodemographic characteristics and HFI with respect to adequacy of total GWG among women with high-risk pregnancies. METHODS: This was a prospective cohort study that evaluated the total GWG of 169 pregnant women. The women were seen at a public university hospital in the metropolitan region of Rio de Janeiro (Brazil). Their sociodemographic and gestational characteristics and the Brazilian Scale of Domestic Food Insecurity were investigated. To estimate the total GWG, the difference between the patient weight at the last prenatal visit and the initial patient weight was verified, with both collected from the medical records of the pregnant women. The classification of the total GWG considered the recommendations of the Institute of Medicine (IOM) (2009). A multinomial logistic regression model assessed the risk (odds ratio; OR) and confidence intervals (CI 95%)) of insufficient and excessive GWG with exposure to HFI and other covariates (p value <0.05). RESULTS: Insufficient and excessive GWG were observed in 27.8% and 47.9% of the pregnant women, respectively. More than half of the women (74.6%) had a high education level. Exposure to mild HFI occurred in 44.2% of the women. After adjustment, the HFI was not associated with insufficient or excessive GWG. The educational level of women was the only variable significantly associated with a lower risk of GWG insufficiency (OR: 0.10; 95% CI: 0.01-0.89). CONCLUSIONS: In this population, higher maternal education was a protective factor against insufficient GWG. We highlight the importance of additional health support and counseling for women in the most vulnerable social conditions, considering the importance of access to information for reducing health risks.

Household food insecurity associated with gestacional and neonatal outcomes: a systematic review.

BACKGROUND: Food insecurity (FI) occurs when people lack secure access to sufficient amounts of safe and nutritious food. FI has been associated with negative effects on human health, including during the prenatal and neonatal periods. The objective of this study is to evaluate the consequences of FI for pregnant women's and newborns' health. METHODS: A literature search was performed with three independent researchers based on the PRISMA guidelines; the search covered the period of November 2008 to July 2019 and was conducted in the following databases: the US National Library of Medicine at the National Institutes of Health (PubMed), Latin American and Caribbean Health Sciences (LILACS), Cochrane Library, Web of Science, Embase, Scopus and OpenGrey. The terms and descriptors were defined by consulting the Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS) platforms and mainly included "food security", "food insecurity", "pregnancy" and "newborn". The studies were selected through a title and abstract review and then a reading of the full text. The quality of the studies and the risk of bias were analysed based on the criteria defined in the "Joanna Briggs Institute Reviewers' Manual" and by Guyatt and colleagues for interventional studies. The population, study design, FI measurement instruments, FI proportions, outcomes, confounders and results were extracted from the 37 studies that were selected according to the eligibility and quality criteria. RESULTS: FI ​​proportions ranged from 5.2 to 87%. Most studies were conducted with African populations (42.2%) and applied globally used scales to assess FI (56.7%); 27% of the studies adapted scales. There were wide variations in the instruments used to estimate FI. The main outcomes related to FI included stress, anxiety and depression during pregnancy, followed by dietary quality and dietary diversity. Associations of FI with birth defects, neonatal mortality and the early introduction of animal milk to the infant's diet were also observed. CONCLUSIONS: It is necessary to pay attention to the diversity of FI measurement instruments before FI results are compared. FI can be a risk factor for depression and stress during pregnancy, as well as for neonatal mortality, newborn health problems and breastfeeding interruption. TRIAL REGISTRATION: This systematic review was registered on PROSPERO (CRD42018109478).

Oficina "MemorIdade": impactos na cognição e queixa de memória em idosos de um Centro de Convivência / Cognitive stimulation "MemorIdade": impacts on cognition and subjective memory complaint in the elderly of a Senior Center / Taller "MemorIdade": impactos en las quejas de cognición y memoria en personas mayores en un Centro Comunitario

Objetivou-se avaliar os efeitos promovidos por uma oficina de memória na cognição e queixa subjetiva de memória, em idosos de um Centro de Convivência. Dez idosos participaram da oficina, que constou de nove encontros semanais que abordaram diversos aspectos, com foco na memória episódica, operacional, e na linguagem. Foi observada melhora significativa nos domínios cognitivos memória e linguagem após a oficina, bem como aumento das queixas subjetivas de memória.

The purpose of this study was to evaluate the effects promoted by a cognitive stimulation program on cognition and subjective memory complaint in elderly people of a Senior Center. Ten elderly people participated in the program, which consisted of nine weekly meetings that addressed several aspects, focusing on episodic and operational memory, and language. Significant improvement in memory and language cognitive domains after the workshop was observed, as well as increased subjective complaints of memory.

El objetivo de este estudio fue evaluar los efectos promovidos por un taller de memoria sobre cognición y quejas de memoria subjetiva en personas mayores en un Centro Comunitario. Diez personas mayores participaron en el taller, que consistió en nueve reuniones semanales que abordaron diversos aspectos, centrándose en la memoria episódica, operativa y del lenguaje. Se observó una mejora significativa en los dominios cognitivos de memoria y lenguaje después del taller, así como un aumento en las quejas de memoria subjetiva.

Dental hypomineralization treatment: A systematic review.

INTRODUCTION: Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. OBJECTIVE: To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. MATERIALS AND METHODS: PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. RESULTS: From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. CONCLUSIONS: Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). CLINICAL SIGNIFICANCE: Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.

Measuring and mapping the effectiveness of the European Air Quality Directive in reducing N and S deposition at the ecosystem level.

To protect human health and the environment (namely ecosystems), international air quality protocols and guidelines, like the Gothenburg protocol (1999) and the 2001 EU Air Quality Directive (NECD), conveyed national emission ceilings for atmospheric pollutants (Directive 2001/81/EC), including the reduction of sulfur (S) and nitrogen (N) emissions by 2010. However, to what degree this expected reduction in emissions had reflections at the ecosystem level (i.e. pollutant levels reaching and impacting ecosystems and their organisms) remains unknown. Here, we used lichens as ecological indicators, together with reported air and precipitation pollutant concentrations, to determine and map the consequences of the S and N atmospheric emission's reduction, during the implementation of the 2001 Directive (in 2002 and 2011), due primarily to the industrial-sector. The study area is a mixed-land-use industrialized Mediterranean agroforest ecosystem, in southwest Europe. The reduction of S emissions (2002-2011) was reflected at the ecosystem level, as the same S-declining trend was observed in atmospheric measurement stations and lichens alike (-70%), indicating that most S deposited to the ecosystem had an industrial origin. However, this was not the case for N with a slight N-reduction near industrial facilities, but mostly N-deposition in lichens increased in areas dominated by agricultural land-uses. Taken together, these results highlight the importance of going beyond emissions estimation and modeling, to assess the success of the implementation of the NECD in lowering pollutant accumulation in living organisms and their environment. This can only be achieved by measuring pollutant deposition at the ecosystem level (e.g. living organisms). By doing so, we were able to show that the 2001 NECD was successful in reducing S concentrations from Industry, whereas N remains a challenge. Despite the small reduction in N-emissions, deposition into ecosystems did not reflect these changes as agriculture and transport sectors must reduce NH3 and NOx emissions.

Ângulos visuais: Artigo sobre a importância para o Implante de Lentes Intraoculares Multifocais / Visual angles: Article on the importance of Multifocal Intraocular Lenses Implantation

Resumo Objetivos: Medir o ângulo lâmbda (AL) em indivíduos no pré-operatório de facectomias, correlacionando a sua presença com o comprimento axial e o esférico dos olhos. Sugerir condutas para o implante de LIO multifocal de acordo com a presença do ângulo lâmbda. Métodos: Estudo transversal em 128 olhos de 74 indivíduos candidatos à cirurgia de catarata para registrar a equivalente presença do ângulo lâmbda. Resultados: Avaliando o ângulo lâmbda observou-se uma correlação positiva (r= 0,559 / p= 0,000) para o tamanho desse ângulo comparando-se os dois olhos. Não houve correlação entre o tamanho do ângulo lâmbda e o equivalente esférico no olho direito (r= -0,027 / p= 0,840), mas foi verificada correlação positiva para o olho esquerdo (r= 0,313 / p= 0,013). A presença da hipermetropia correlacionou com os comprimentos axiais pequenos, assim como a miopia com os grandes. Observou-se correlação negativa entre o tamanho do ângulo lâmbda e o comprimento axial para os dois olhos, sendo de r= -0,249 para o olho direito (p= 0,042) e r= -0,281 para o olho esquerdo (p= 0,018) Conclusões: Houve correlação entre a presença de ângulo lâmbda maior e comprimentos axiais menores para os dois olhos. Para o equivalente esférico hipermétrope houve correlação com a presença de um ângulo lâmbda maior apenas para o olho esquerdo. Esse trabalho sugere parcimônia nos implantes de LIO multifocal na presença de ângulo lâmbda significativo, baseado na teoria que a presença desse ângulo é reguladora do equilíbrio entre as aberrações da superfície corneana versus cristalineanas.

Abstract Objectives: To measure the labral angle (LA) in individuals in the preoperative period of facectomies, correlating their presence with axial length and spherical equivalent of the eyes. Suggest conduits for the implantation of multifocal IOL according to the presence of the lambda angle. Methods: A cross-sectional study of 128 eyes of 74 individuals who were candidates for cataract surgery to record the presence of the lambda angle. Results: A positive correlation (r = 0.559 / p = 0.000) was observed for the angle of this angle by comparing the two eyes. There was no correlation between the size of the lambda angle and the spherical equivalent in the right eye (r = -0.027 / p = 0.840), but a positive correlation was observed for the left eye (r = 0.313 / p = 0.013). The presence of hyperopia correlated with small axial lengths, as did myopia with large ones. There was a negative correlation between the angle of the tongue and the axial length of the two eyes, with r = -0.249 for the right eye (p = 0.042) and = 0.281 for the left eye (p = 0.018). Conclusions: There was a correlation between the presence of a larger lambda angle and smaller axial lengths for both eyes. For the spherical hypermétrope equivalent, there was a correlation with the presence of a larger blunt angle only for the left eye. This work suggests parsimony in multifocal IOL implants in the presence of a significant lamella angle, based on the theory that the presence of this angle regulates the balance between corneal versus crystaline surface aberrations.

The ROPScore as a Screening Algorithm for Predicting Retinopathy of Prematurity in a Brazilian Population.

OBJECTIVES: To evaluate the accuracy of the ROPScore algorithm as a predictor of retinopathy of prematurity (ROP). METHODS: A prospective cohort of 220 preterm infants with a birth weight ≤1500 g and/or gestational age ≤32 weeks was included. The ROPScore was determined in the sixth week of life in 181 infants who then survived until a corrected gestational age of 45 weeks. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of the algorithm were analyzed. RESULTS: ROP was found in 17.6% of the preterm infants. The sensitivity of this test for any stage of ROP was 87.5%, while that for severe ROP was 95.4% (21/22 cases). The PPV and NPV were 59.6% and 97%, respectively, for any stage of ROP and 44.7% and 99.25%, respectively, for severe ROP. The ROPScore could therefore hypothetically reduce the number of ophthalmologic examinations required to detect ROP by 71.8%. CONCLUSION: The ROPScore is a useful screening tool for ROP and may optimize examinations and especially the identification of severe ROP.

Síndrome de Bonnet na Oftalmologia: revisão de literatura / Bonnet's syndrome in ophthalmology: literature review

RESUMO Com o aumento da longevidade e da qualidade de vida da população, o número de pessoas com baixa visão pela senilidade tende a crescer. A síndrome de Charles Bonnet (SCB) foi citada no século XVIII por Bonnet, quando seu avô, psicologicamente saudável e cego por catarata, citava visões de homens, mulheres, pássaros e construções. O principal fator de risco é visão diminuída. Algumas doenças oftalmológicas podem estar envolvidas como catarata ou uso de algumas medicações. Apesar de ser conhecida, é pouco diagnosticada por neurologistas, oftalmologistas e psiquiatras. Até o momento não existe um consenso no tratamento da síndrome de Charles Bonnet.

ABSTRACT With the increase of longevity and the quality of life, the number of people with low vision due to senility tends to grow up. Charles Bonnet's syndrome (SCB) was cited in the XVIII century by Bonnet, when his grandfather blinded by cataracts and psychologically healthy cites visions of men, women, birds, and buildings. The main risk factor is low vision. Several ocular diseases may be involved as cataract or use of some medications. Although known, it is poorly diagnosed by neurologists, ophthalmologists and psychiatrists. To date there is no consensus on the treatment of Charles Bonnet's syndrome.

Influence of Codium tomentosum Extract in the Properties of Alginate and Chitosan Edible Films.

The growing search for natural alternatives to synthetic food packaging materials and additives has increased, and seaweed extracts' bioactivity has made them suitable candidates for incorporation in novel edible films. This study aims to investigate the effect of Codium tomentosum seaweed extract (SE) incorporation in alginate and chitosan edible films. Alginate- and chitosan-based films with and without the incorporation of 0.5% SE were characterized according to their physical, optical, mechanical, and thermal properties. Seaweed extract incorporation in chitosan films resulted in an increase of film solubility (50%), elasticity (18%), and decrease of puncture strength (27%) and energy at break (39%). In alginate films, the extract incorporation significantly decreased film solubility (6%), water vapour permeability (46%), and elasticity (24%), and had no effect on thermal properties. Depending on the type of application, the addition of SE in edible films can bring advantages for food conservation.

The Ropscore as a screening algorithm for predicting retinopathy of prematurity in a brazilian population

OBJECTIVES: To evaluate the accuracy of the ROPScore algorithm as a predictor of retinopathy of prematurity (ROP). METHODS: A prospective cohort of 220 preterm infants with a birth weight ≤1500 g and/or gestational age ≤32 weeks was included. The ROPScore was determined in the sixth week of life in 181 infants who then survived until a corrected gestational age of 45 weeks. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of the algorithm were analyzed. RESULTS: ROP was found in 17.6% of the preterm infants. The sensitivity of this test for any stage of ROP was 87.5%, while that for severe ROP was 95.4% (21/22 cases). The PPV and NPV were 59.6% and 97%, respectively, for any stage of ROP and 44.7% and 99.25%, respectively, for severe ROP. The ROPScore could therefore hypothetically reduce the number of ophthalmologic examinations required to detect ROP by 71.8%. CONCLUSION: The ROPScore is a useful screening tool for ROP and may optimize examinations and especially the identification of severe ROP.

Fatores associados ao aleitamento materno em crianças menores de 5 anos com doença do aparelho respiratório / Factors associated with breastfeeding in children under 5 years of age with respiratory disease

Objetivo: Avaliar fatores associados ao aleitamento materno em casos de doenças do aparelho respiratório (DAR) em crianças menores de 5 anos. Método: Coleta de dados clínico-antropométricos e de aleitamento materno de 45 crianças internadas na enfermaria de um hospital universitário com enfermidades respiratórias. As variáveis contínuas avaliadas foram expressas em termos de mediana e as categóricas foram apresentadas a partir da frequência absoluta e relativa. O teste do Qui-Quadrado foi usado para testar as diferenças entre as proporções das variáveis nos grupos com e sem aleitamento materno. Para avaliação da associação das diferentes variáveis com o aleitamento materno, foi estimado o odds ratio e a razão de prevalência. Resultados: Trinta crianças (69%) foram amamentadas por pelo menos 1 mês. Foi verificado que 56% (n=25) tiveram episódios anteriores de DAR. A prematuridade (31%; n=14), o baixo peso ao nascer (33%; n=13), a ausência do pré-natal (9%; n=13) e a presença de intercorrências na mãe durante a gestação (20%; n=9) foram fatores que se associaram a ausência do aleitamento materno (OR e RP, respectivamente, de 3,99 e 9,36; 2,8 e 3,17; 6,75 e 8,67; 1,77 e 2,08). O QuiQuadrado revelou diferenças significantes entre a ausência da amamentação entre prematuros e não prematuros e entre as mães que realizaram e não realizaram o pré-natal (p<0,05). Houve maior razão de chances (OR:2,25) e razão de prevalência (RP:1,91) para o excesso de peso para a altura dentre as crianças não amamentadas. Conclusão: O incentivo ao aleitamento materno em lactentes nascidos prematuramente ou com baixo peso, bem como em neonatos de mães com problemas clínicos na gestação, é de extrema relevância, assim como o pré-natal na promoção da amamentação em crianças com afecções respiratórias. Aponta-se, ainda, o aleitamento materno como fundamental para a prevenção de excesso de peso nestas condições, bem como a conscientização de mães e profissionais na atenção materno-infantil.(AU)

Objective: To evaluate factors associated with breastfeeding in cases of respiratory diseases (ARD) in children under 5 years of age. Methods: Clinical-anthropometric and breastfeeding data collection of 45 children admitted to the ward of a university hospital with respiratory diseases. The continuous variables evaluated were expressed in median terms and the categorical variables were presented from the absolute and relative frequency.The Chi-Square test was used to test differences between the proportions of the variables in the groups with without breast-feeding. To evaluate the association of the different variables with breastfeeding, the odds ration and the prevalence ratio were estimated. Results:Thirty children (69%) were breastfed for at least 1 month. It was verified that 56% (n=25) had previous episodes of ARD. Preterm birth (31%;n=14),low birth weight (33%, n=13), absence of prenatal care (9%, n=13) and presence of intercurrences in the mother during pregnancy (20%; n=9) were factors that were associated with absence of breastfeeding (OR and PR, respectively, of 3.99 and 9.36; 2.8 and 3.17; 6.75 and 8.67; 1.77 and 2.08). The chi-square test reveled significant differences between the absence of breastfeeding among premature and non-premature infants and among those mothers who did and did not perform prenatal care (p<0.05). There was a higher odds ratio (OR=2.25) and prevalence ratio (PR=1.91) for overweight for height among non-breastfed children. Conclusion: Encouraging breastfeeding in infants born prematurely or with low birth weight, as well as in neonates of mothers with clinical problems during pregnancy is extremely relevant, as is prenatal breastfeeding promotion in children with respiratory diseases. It is also pointed out that breastfeeding is essential for the prevention of overweight in these conditions, as well as the awareness of mothers and professionals in the maternal and child care.(AU)