Effect of adjuvant probiotic therapy (Lactobacillus reuteri) in the treatment of periodontitis associated with diabetes mellitus: clinical, controlled, and randomized study.

OBJECTIVES: Subgingival instrumentation (SI) with probiotics may be a proposal for the treatment of periodontitis (P), for patients with type 2 diabetes mellitus (T2DM). The Lactobacillus reuteri probiotic as an adjunctive therapy in the treatment of P associated with T2DM was evaluated. MATERIALS AND METHODS: Forty diabetic participants diagnosed with P (stage III and IV, grade B) were randomized into SI + Placebo (n = 20): subgingival instrumentation plus placebo lozenges and SI + Probi (n = 20): subgingival instrumentation plus probiotics. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque index (PI), bleeding on probing (BoP), and PISA index were performed at baseline and 30, 90, and 180 days. Cytokine concentration in the gingival crevicular fluid, subgingival biofilm sample, and LDL and HDL subfractions were evaluated. RESULTS: In the deep pockets, PD in SI + Probi showed increased values (p = 0.02) compared to SI + Placebo at 90 days. For CAL, SI + Probi showed increased values compared to SI + Placebo, with a significant difference at 30 days (p = 0.03), 90 days (p = 0.02), and 180 days (p = 0.04). At #PD ≥ 7 mm, SI + Probi had a more frequent number of sites (p = 0.03) compared to SI + Placebo only at baseline. For the PISA, SI + Probi showed a significant difference (p = 0.04) compared to SI + Placebo at 90 days. For cytokines, SI + Probi showed higher quantification than SI + Placebo for IL-10 (p < 0.001) at 90 days, IL-12 (p = 0.010) at 90 days, IL-1ß (p = 0.035) at 90 days, and IL-8 (p = 0.003) at baseline. SI + Placebo showed higher quantification of IL-1ß (p = 0.041) compared to SI + Probi only at 30 days. There was a reduction in all microbial complexes. SI + Probi improved LDL size (246.7 nm vs 260.4 nm; p < 0.001), while large HDL subfractions were reduced aft 180 days of treatment (24.0% vs 20.3%; p = 0.022) when compared with SI + Placebo; this response was dependent of probiotics (1.0 mg/dL vs - 6.2 mg/dL; p = 0.002). CONCLUSION: Subgingival instrumentation improved the clinical periodontal parameters in patients with T2DM. The use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction. CLINICAL RELEVANCE: Scientific rationale for study: subgingival instrumentation with probiotics may be a proposal for the treatment of periodontitis (P), especially for patients with type 2 diabetes mellitus (T2DM). PRINCIPAL FINDINGS: the use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction.  Practical implications: L. reuteri as an adjunct to subgingival instrumentation may have significant therapeutic implications in dyslipidemia.

The Soret coefficient of human low-density lipoprotein in solution: a thermophilic behavior.

Thermodiffusion, or Soret effect, is the physical phenomenon of matter gradients originated by the migration of chemical species induced by thermal gradients. Thermodiffusion has been widely applied in the study of colloidal suspensions. In this study, we investigate the termodiffusion behavior of low-density lipoprotein (LDL) particles, by the Soret coefficient measurement. It is a new approach to studies of plasma lipoproteins. The experimental work was based on thermal- and Soret-lens effects. These effects were induced by laser irradiation of the samples, at two different time scales, in a Z-scan setup. LDL samples were analyzed under physiological conditions, notedly, ionic strength and pH, and at different temperatures. Temperature dependence of Soret coefficient showed a slight decrease in the absolute value of this coefficient, as a function of temperature increasing. However, its sign does not change at the temperatures investigated (15, 22.5 and 37.5 °C). The results show that LDL particles exhibit thermophilic behavior. The origin of this thermophilic behavior is not yet completely understood. We discuss some aspects that can be related with the Soret effect in LDL samples.

New Lyotropic Complex Fluid Structured in Sheets of Ellipsoidal Micelles Solubilizing Fragrance Oils.

New lyotropic, fragranced, viscoelastic fluid with a complex structure is obtained from fragranced microemulsions by the addition of a fatty acid. Nonhomogeneous mixing of an appropriate nonionic surfactant, a fatty acid, and a fragrance oil led to the formation of anisotropically shaped and highly oriented micelles in aqueous solution. The nano- and microstructures, and consequently the viscosity, are controlled by the balance of fatty acids used as a cosurfactant and fragrance molecules, which partly behave as a cosurfactant and partly segregate in the micelles of the hydrophilic nonionic surfactant. The transition from isotropic microemulsion to a more structured viscoelastic solution is characterized by X-ray scattering and rheological methods. Considering our X-ray scattering results, we propose a structure composed of planar sheets of ellipsoidal micelles arranged in a lamellar type of stacking. The complex structured, low viscous, transparent fluid is capable of solubilizing a fragrance inside the ellipsoidal micelles, as well as retaining microparticles containing fragrance, without the addition of a polymeric thickener or another gelator. These features allow the creation of a 2-in-1 fragrance-solubilizing liquid product compatible with all types of home and body care consumer products.

Molecular Dynamics Approach to Calculate the Thermodiffusion (Soret and Seebeck) Coefficients of Salts in Aqueous Solutions.

An approach to investigate the physical parameters related to ion thermodiffusion in aqueous solutions is proposed herein by calculating the equilibrium hydration free energy and the self-diffusion coefficient as a function of temperature, ranging from 293 to 353 K, using molecular dynamics simulations of infinitely diluted ions in aqueous solutions. Several ion force field parameters are used in the simulations, and new parameters are proposed for some ions to better describe their hydration free energy. Such a theoretical framework enables the calculation of some single-ion properties, such as heat of transport, Soret coefficient, and mass current density, as well as properties of salts, such as effective mass and thermal diffusion, Soret and Seebeck, coefficients. These calculated properties are compared with experimental data available from optical measurements and showed good agreement revealing an excellent theoretical predictability of salt thermodiffusion properties. Differences in single-ion Soret and self-diffusion coefficients of anions and cations give rise to a thermoelectric field, which affects the system response that is quantified by the Seebeck coefficient. The fast and slow Seebeck coefficients are calculated and discussed, resulting in values with mV/K order of magnitude, as observed in experiments involving several salts, such as K+Cl-, Na+Cl-, H+Cl-, Na+OH-, TMA+OH-, and TBA+OH-. The present approach can be adopted for any ion or charged particle dispersed in water with the aim of predicting the thermoelectric field induced through the fluid. It has potential applications in designing electrolytes for ionic thermoelectric devices in order to harvest energy and thermoelectricity in biological nanofluids.

Microcurrent electrotherapy improves palatal wound healing: Randomized clinical trial.

BACKGROUND: This study was conducted to assess the clinical, immunological, and patient-centered outcomes of microcurrent electrotherapy on palatal wound healing. METHODS: This was a parallel, double-masked randomized clinical trial, in which 53 patients with ridge preservation indications were selected and randomly assigned to one of two groups. In the control (sham) group (n = 27), palatal wounds, after free gingival grafts (FGG) harvest, received sham application of electrotherapy. In the test (electrotherapy treatment [EE]) group (n = 26), palatal wounds, after FGG harvest, received application of microcurrent electrotherapy protocol. Clinical parameters, patient-centered outcomes, and inflammatory markers were evaluated, up to 90 days postoperatively. RESULTS: The EE group achieved earlier wound closure (P <0.001) and epithelialization (P <0.05; P = 0.03) at 7 and 14 days after harvest when compared with the sham group. Painful symptomatology was reported less frequently in the EE group than in the sham group at 3-day follow-up (P = 0.008). Likewise, an improvement in Oral Health Impact Profile was reported 2 days after the procedure by the EE group (P = 0.04). In addition, favorable modulation of inflammatory wound healing markers occurred when electrotherapy was applied. CONCLUSION: Within the limits of the present study, it can be concluded that the use of a low-intensity electrotherapy protocol may accelerate palatal wound healing and decrease patient discomfort after FGG harvest.

Influence of Periodontal Disease on cardiovascular markers in Diabetes Mellitus patients.

The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.

Beneficial effects of green banana biomass consumption in patients with pre-diabetes and type 2 diabetes: a randomised controlled trial.

Diabetes mellitus is a global epidemic, characterised as a heterogeneous group of metabolic disorders associated with high risk of CVD. Green banana biomass, which is composed of resistant starches (RS) and cannot be hydrolysed by amylases, delays gastric emptying and modulates insulin sensitivity, thus contributing to improve metabolic disorders. The aim of the present study was to investigate the effects of consumption of RS from green banana biomass on body composition, fasting plasma glucose, glycated Hb (HbA1c) and homeostasis model assessment of insulin resistance in subjects with pre-diabetes or type 2 diabetes on top of treatment. Middle-aged subjects (n 113) of both sexes with pre-diabetes (HbA1c: 5·7-6·4 %) or diabetes (HbA1c ≥ 6·5 %) were randomised to receive nutritional support plus green banana biomass (40 g) (RS: approximately 4·5 g, G1, n 62) or diet alone (G2, n 51) for 24 weeks. Body composition, biochemical analyses and dietary intake were evaluated at the beginning and end of the study. In the experimental group (G1), consumption of RS was associated with reduction in HbA1c (P = 0·0001), fasting glucose (P = 0·021), diastolic blood pressure (P = 0·010), body weight (P = 0·002), BMI (P = 0·006), waist and hip circumferences (P < 0·01), fat mass percentage (P = 0·001) and increase in lean mass percentage (P = 0·011). In controls (G2), reductions were observed in waist and hip circumferences (P < 0·01), HbA1c (P = 0·002) and high-density lipoprotein-cholesterol (P = 0·020). In pre-diabetes or diabetes, non-significant differences were observed in the percentage reduction in HbA1c and fasting glucose in exploratory analyses. Our results indicate that the consumption of bioactive starches is a good dietary strategy to improve metabolic control and body composition.

Oxidized and electronegative low-density lipoprotein as potential biomarkers of cardiovascular risk in obese adolescents.

OBJECTIVES: To evaluate biomarkers associated with early cardiometabolic risk in obese adolescents. METHODS: This cross-sectional study included 137 adolescents of both sexes aged 10 to 19 years divided into a normal weight group (NW) (n=69) and an obese group (OB) (n=68). RESULTS: As expected, obesity showed positive associations with homeostatic model assessment for insulin resistance (HOMA-IR), triacylglycerol, insulin, plasma levels of non-esterified fatty acids, and cholesterol ester transfer protein activity and negative associations with plasma antioxidant levels. Plasma oxidized low-density lipoprotein (oxLDL) and electronegative low-density lipoprotein [LDL(-)] levels were significantly higher in the OB group. Higher tertiles of oxLDL were associated with increased values of body mass index; waist circumference; fatty mass percentage (%FM); and the atherogenic lipids non-high-density-lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B and triacylglycerol. Higher tertiles of LDL(-) were robustly associated with body mass index and waist circumference. Logistic regression models (odds ratios) confirmed that increased values of lipids and apolipoprotein B were associated with increased risk of oxLDL. For LDL(-), these associations were not significant, suggesting that another mechanism is involved in generating this particle in obese adolescents. CONCLUSIONS: Obese adolescents showed increased plasma LDL(-) and oxLDL, and obese girls had more LDL(-) than obese boys. Therefore, oxLDL is strongly and independently associated with classical cardiovascular risk factors, while increased levels of LDL(-) were influenced by body mass index, waist circumference and demographic parameters in obese adolescents.

Thermodiffusion of Monovalent Organic Salts in Water.

The ionic Soret effect induced by temperature gradients is investigated in organic electrolytes (tetramethylammonium and tetrabutylammonium hydroxides) dispersed in water using a holographic grating experiment. We report the influences of temperature and salt concentrations on the Soret, diffusion, and thermal diffusion coefficients. Experimental results to the thermal diffusion coefficient are compared with a theoretical description for thermodiffusion of Brownian particles in liquids based in the thermal expansion of the liquid solution. It is observed that the obtained thermal diffusion coefficients for the organic electrolytes present a similar temperature dependence as the theoretical prediction. Comparing the experimental results for the organic and common inorganic salts it is proposed an additional physical mechanism as the cause to the different thermal diffusion coefficients in both types of salt. We propose that the temperature dependence of hydration free energy gives rise to a force term that also leads to ion migration in a temperature gradient. We describe the thermal diffusion results as a competition between thermal expansion and hydration effects. The specific structure each type of ion cause in water molecules is considered in the heat of transport theory to describe thermal diffusion of electrolytes. A qualitative agreement is seen between our results and the classical heat of transport theory.

Oxidized and electronegative low-density lipoprotein as potential biomarkers of cardiovascular risk in obese adolescents

OBJECTIVES: To evaluate biomarkers associated with early cardiometabolic risk in obese adolescents. METHODS: This cross-sectional study included 137 adolescents of both sexes aged 10 to 19 years divided into a normal weight group (NW) (n=69) and an obese group (OB) (n=68). RESULTS: As expected, obesity showed positive associations with homeostatic model assessment for insulin resistance (HOMA-IR), triacylglycerol, insulin, plasma levels of non-esterified fatty acids, and cholesterol ester transfer protein activity and negative associations with plasma antioxidant levels. Plasma oxidized low-density lipoprotein (oxLDL) and electronegative low-density lipoprotein [LDL(-)] levels were significantly higher in the OB group. Higher tertiles of oxLDL were associated with increased values of body mass index; waist circumference; fatty mass percentage (%FM); and the atherogenic lipids non-high-density-lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B and triacylglycerol. Higher tertiles of LDL(-) were robustly associated with body mass index and waist circumference. Logistic regression models (odds ratios) confirmed that increased values of lipids and apolipoprotein B were associated with increased risk of oxLDL. For LDL(-), these associations were not significant, suggesting that another mechanism is involved in generating this particle in obese adolescents. CONCLUSIONS: Obese adolescents showed increased plasma LDL(-) and oxLDL, and obese girls had more LDL(-) than obese boys. Therefore, oxLDL is strongly and independently associated with classical cardiovascular risk factors, while increased levels of LDL(-) were influenced by body mass index, waist circumference and demographic parameters in obese adolescents.

Optical Properties of Europium Tetracycline Complexes in the Presence of High-Density Lipoproteins (HDL) Subfractions.

Standard lipoprotein measurements of triglycerides, total cholesterol, low-density lipoproteins (LDL), and high-density lipoproteins (HDL) fail to identify many lipoprotein abnormalities that contribute to cardiovascular heart diseases (CHD). Studies suggested that the presence of CHD is more strongly associated with the HDL subspecies than with total HDL cholesterol levels. The HDL particles can be collected in at least three subfractions, the HDL2b, HDL2a, and HDL3. More specifically, atherosclerosis is associated with low levels of HDL2. In this work, the optical spectroscopic properties of europium tetracycline (EuTc) complex in the presence of different HDL subspecies was studied. The results show that the europium spectroscopic properties in the EuTc complex are influenced by sizes and concentrations of subclasses. Eu3+ emission intensity and lifetime can discriminate the subfractions HDL3 and HDL2b.

Effect of classic ketogenic diet treatment on lipoprotein subfractions in children and adolescents with refractory epilepsy.

OBJECTIVE: The aim of this study was to evaluate the effects of the classic ketogenic diet (KD) on low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions in children and adolescents with refractory epilepsy. METHODS: This prospective study recruited children and adolescents of either sex, whose epilepsy was refractory to treatment with multiple drugs. To be included, the patient had to have an indication for treatment with the KD and be treated as an outpatient. At baseline and after 3 and 6 mo of the KD, lipid profile (total cholesterol [TC], triacylglycerols [TG], LDL cholesterol [LDL-C], and HDL cholesterol [HDL-C]), apolipoproteins (apoA-I and apoB), 10 subfractions of HDL, 7 subfractions of LDL, LDL phenotype, and LDL size were analyzed using the Lipoprint system. RESULTS: The lipid profile components (TC, TG, LDL-C, HDL-C, apoA-I, and apoB) increased during the 3-mo follow-up, and remained consistent after 6 mo of treatment. Similarly, non-HDL-C, TC/HDL-C, LDL-C/HDL-C, and apoB/apoA-I ratios, representing atherogenic particles, significantly increased. In contrast, qualitative lipoprotein characteristics progressively changed during the follow-up period. Small LDL subfractions increased, and this profile was related with reduced LDL size (27.3 nm to 26.7 nm). The LDL phenotype became worse; 52.1% of the patients had a non-A phenotype after 6 mo of the KD. Small HDL subfractions decreased only after 6 mo of the KD. CONCLUSIONS: KD treatment promotes negative changes in lipoprotein size and phenotype, contributing to atherogenic risk in these patients.

Common sources and composition of phytosterols and their estimated intake by the population in the city of São Paulo, Brazil.

OBJECTIVE: Phytosterols have been used alone, or combined with lipid-altering drugs, to reduce cholesterol levels and the burden of cardiovascular disease. Considerable variation in the composition of phytosterols exists and its consumption, in a regular diet, by the Brazilian population is still unknown. Thus, the aim of the present study was to determine the phytosterols content of the most consumed plant foods and to estimate the phytosterols intake by this population. METHODS: Intake of plant foods of a representative population of the city of São Paulo (n = 1609), randomly selected on the basis of the Brazilian Institute for Geography and Statistics census data (2010), was obtained by a food frequency questionnaire (FFQ). Foods were chosen on the basis of the Consume Expenditure Survey (2002-2003) and from answers to the FFQ. Phytosterols composition of most consumed greens, legumes, cereals, and seeds, fruits, and vegetable oils was determined by gas chromatography (flame ionization detection). Daily phytosterols intake was estimated in terms of mg per 100 g (mg/100 g(-1)) of edible portion. Underreporters and overreporters were excluded. RESULTS: Mean (SE) daily phytosterols intake in the diet of the study population was 100.6 (1.2) mg, with ß-sitosterol as the largest sterol component (65.4%), followed by campesterol (23.2%), and stigmasterol (10%). No significant changes in daily phytosterols intake were observed after exclusion of underreporters and overreporters. Considerable variation was observed in phytosterols content among the most consumed plant foods. CONCLUSIONS: Analysis of phytosterols composition in most consumed plant foods has shown that phytosterols content varied among food groups. Dietary intake of phytosterols in a large population of the city of São Paulo is in the same range of some countries.

Effect of alkyl chain length of alcohols on cholesteric uniaxial to cholesteric biaxial phase transitions in a potassium laurate/alcohol/potassium sulfate/water/brucine lyotropic mixture: evidence of a first-order phase transition.

Lyotropic cholesteric liquid crystalline phases were prepared by doping the quaternary mixture of potassium laurate (KL)/potassium sulfate (K(2)SO(4))/alcohol (n-OH)/water with the chiral agent brucine. Different long-chain alcohols whose alkyl chains (n) vary from 8 (1-octanol) to 16 (1-hexadecanol) were used. The cholesteric uniaxial to cholesteric biaxial phase transitions were investigated by measuring the birefringences via polarizing optical microscopy, and the phase diagram was constructed as a function of the alkyl chain length of the alcohols. Alcohols with 9 ≤ n ≤ 12 presented the three cholesteric phases (cholesteric discotic-Ch(D), cholesteric biaxial-Ch(B), and cholesteric calamitic-Ch(C)). The Ch(D)-to-Ch(B) transition was shown to be continuous, with a bare correlation length bigger than the typical micellar dimensions. Mixtures with n = 8 and n = 13 showed a first-order phase transition between the Ch(D) and the Ch(C) phases, without the presence of the Ch(B) phase in between. These results are interpreted in terms of the nanosegregation of the alcohol molecules in the micelles with respect to the main amphiphiles molecules.

Oxidative stress and modification of renal vascular permeability are associated with acute kidney injury during P. berghei ANKA infection.

Malaria associated-acute kidney injury (AKI) is associated with 45% of mortality in adult patients hospitalized with severe form of the disease. However, the causes that lead to a framework of malaria-associated AKI are still poorly characterized. Some clinical studies speculate that oxidative stress products, a characteristic of Plasmodium infection, as well as proinflammatory response induced by the parasite are involved in its pathophysiology. Therefore, we aimed to investigate the development of malaria-associated AKI during infection by P. berghei ANKA, with special attention to the role played by the inflammatory response and the involvement of oxidative stress. For that, we took advantage of an experimental model of severe malaria that showed significant changes in the renal pathophysiology to investigate the role of malaria infection in the renal microvascular permeability and tissue injury. Therefore, BALB/c mice were infected with P. berghei ANKA. To assess renal function, creatinine, blood urea nitrogen, and ratio of proteinuria and creatininuria were evaluated. The products of oxidative stress, as well as cytokine profile were quantified in plasma and renal tissue. The change of renal microvascular permeability, tissue hypoxia and cellular apoptosis were also evaluated. Parasite infection resulted in renal dysfunction. Furthermore, we observed increased expression of adhesion molecule, proinflammatory cytokines and products of oxidative stress, associated with a decrease mRNA expression of HO-1 in kidney tissue of infected mice. The measurement of lipoprotein oxidizability also showed a significant increase in plasma of infected animals. Together, our findings support the idea that products of oxidative stress, as well as the immune response against the parasite are crucial to changes in kidney architecture and microvascular endothelial permeability of BALB/c mice infected with P. berghei ANKA.

A história dos raios X e sua utilizaçäo de 1895 a 1912: reflexos na América Latina / X-rays history and their use from 1895 to 1912: influences upon Latin America

Procura identificar os elementos precursores da descoberta dos raios X; obter um panorama dos trabalhos desenvolvidos no final do século XIX em Astronomia, Optica, Eletricidade, Magnetismo e Química; analisar os artigos escritos por Röntgen sobre os raios X; estudar os experimentos mais significativos que foram realizados para verificar e determinar as propriedades dos raios X, assim como as teorias que surgiram para explicar estas propriedades; verificar as diferentes utilizaçöes e aplicaçöes dos raios X no período de 1895 a 1912 e sua utilizaçäo na América Latina.

A história dos raios X e sua utilizaçäo de 1895 a 1912: reflexos na América Latina / X-rays history and their use from 1895 to 1912: influences upon Latin America

Procura identificar os elementos precursores da descoberta dos raios X; obter um panorama dos trabalhos desenvolvidos no final do século XIX em Astronomia, Optica, Eletricidade, Magnetismo e Química; analisar os artigos escritos por Röntgen sobre os raios X; estudar os experimentos mais significativos que foram realizados para verificar e determinar as propriedades dos raios X, assim como as teorias que surgiram para explicar estas propriedades; verificar as diferentes utilizaçöes e aplicaçöes dos raios X no período de 1895 a 1912 e sua utilizaçäo na América Latina.(AU)