Effects of Pilates method on quality of life, fatigue and sleep quality among breast cancer women receiving hormone therapy - Two-arm randomized clinical trial.

OBJECTIVE: To analyze the effect of the Pilates method on the quality of life, fatigue, and sleep quality of patients undergoing adjuvant clinical treatment with hormone therapy for breast cancer. METHODS: A randomized two-arm clinical trial with 34 breast cancer women that were randomized into two groups: a) Intervention group, who performed 16 weeks of mat Pilates; b) Control group, who maintained their daily routine activities and received three educational sessions. The questionnaires for each variable were applied before the intervention, after the intervention, and six months after the end of the intervention. Quality of life was assessed by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30), fatigue by the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), and sleep quality by the Pittsburgh Sleep Quality Index. RESULTS: The fatigue variable presented a time effect (p = 0.034) regardless of the analyzed group, in which a difference was found between baseline and the post-intervention period (p = 0.037). The variable sleep showed an effect of time (p = 0.025), presenting a difference between the baseline period and six months, with improvement for all participants (p = 0.004). Global health also showed a positive change also for all participants, with an isolated effect of time (p = 0.024). CONCLUSION: Interventions based on the Pilates method may bring positive results in quality of life, fatigue, and sleep quality in patients undergoing adjuvant treatment for breast cancer, but further studies on the subject are needed to prove the results in a larger number of patients.

Synthesis of 6,8-diaminopurines via acid-induced cascade cyclization of 5-aminoimidazole precursors and preliminary anticancer evaluation.

Inspired by the pharmacological interest generated by 6-substituted purine roscovitine for cancer treatment, 5-aminoimidazole-4-carboxamidine precursors containing a cyanamide unit were prepared by condensation of 5-amino-N-cyanoimidazole-4-carbimidoyl cyanides with a wide range of primary amines. When these amidine precursors were combined with acids, a fast cascade cyclization occurred at room temperature, affording new 6,8-diaminopurines with the N-3 and N-6 substituents changed relatively to the original positions they occupied in the amidine and imidazole moieties of precursors. The efficacy and wide scope of this method was well demonstrated by an easy and affordable synthesis of 22 6,8-diaminopurines decorated with a wide diversity of substituents at the N-3 and N-6 positions of the purine ring. Preliminary in silico and in vitro assessments of these 22 compounds were carried out and the results showed that 13 of these tested compounds not only exhibited IC50 values between 1.4 and 7.5 µM against the colorectal cancer cell line HCT116 but also showed better binding energies than known inhibitors in docking studies with different cancer-related target proteins. In addition, good harmonization observed between in silico and in vitro results strengthens and validates this preliminary evaluation, suggesting that these novel entities are good candidates for further studies as new anticancer agents.

Elucidating the role played by bone marrow in visceral leishmaniasis.

Leishmaniasis is a widespread group of infectious diseases that significantly impact global health. Despite high prevalence, leishmaniasis often receives inadequate attention in the prioritization of measures targeting tropical diseases. The causative agents of leishmaniasis are protozoan parasites of the Leishmania genus, which give rise to a diverse range of clinical manifestations, including cutaneous and visceral forms. Visceral leishmaniasis (VL), the most severe form, can be life-threatening if left untreated. Parasites can spread systemically within the body, infecting a range of organs, such as the liver, spleen, bone marrow and lymph nodes. Natural reservoirs for these protozoa include rodents, dogs, foxes, jackals, and wolves, with dogs serving as the primary urban reservoir for Leishmania infantum. Dogs exhibit clinical and pathological similarities to human VL and are valuable models for studying disease progression. Both human and canine VL provoke clinical symptoms, such as organ enlargement, fever, weight loss and abnormal gamma globulin levels. Hematologic abnormalities have also been observed, including anemia, leukopenia with lymphocytosis, neutropenia, and thrombocytopenia. Studies in dogs have linked these hematologic changes in peripheral blood to alterations in the bone marrow. Mouse models of VL have also contributed significantly to our understanding of the mechanisms underlying these hematologic and bone marrow abnormalities. This review consolidates information on hematological and immunological changes in the bone marrow of humans, dogs, and mice infected with Leishmania species causing VL. It includes findings on the role of bone marrow as a source of parasite persistence in internal organs and VL development. Highlighting gaps in current knowledge, the review emphasizes the need for future research to enhance our understanding of VL and identify potential targets for novel diagnostic and therapeutic approaches.

Dogs Harbor Leishmania braziliensis and Participate in the Transmission Cycle of Human Tegumentary Leishmaniasis.

Dogs play an important role in transmission of Leishmania infantum, but epidemiologic and clinical studies of canine tegumentary leishmaniasis (CTL) are scarce. In an endemic area of human American tegumentary leishmaniasis (ATL) caused by Leishmania braziliensis, we determine the prevalence and incidence of both CTL and subclinical (SC) L. braziliensis infection in dogs and evaluated if the presence of dogs with CTL or SC L. braziliensis infection is associated with the occurrence of human ATL. SC infection in healthy animals and CTL in animals with ulcers were determined by PCR on biopsied healthy skin or on ulcers or by detecting antibodies against soluble leishmania antigen. We compared the occurrence of human ATL in homes with dogs with CTL or SC infection with control homes without dogs or with dogs without CTL or SC infection. The prevalence of SC infection was 35% and of CTL 31%. The incidence of SC infection in dogs was 4.6% and of CTL 9.3%. The frequency of ATL in humans was 50% in homes with infected dogs and 13% in homes without L. braziliensis infection in dogs. CTL and SC infection is highly prevalent, and dogs may participate in the transmission chain of L. braziliensis.

Tomato as a Natural Source of Dyes in the Food Industry: A Patent Data Analysis.

BACKGROUND: Foods that promote health benefits are being increasingly used. Innovative techniques, such as nanotechnology, have been used to improve functional properties, sensory characteristics, or the conservation of foods. OBJECTIVE: The objective of this study was to identify the technological domain of patents for tomato products with or without nanotechnology and elucidate the technological advances associated with the recent use of tomatoes as a natural food dye in the food industry by exploring patent documents. METHODS AND RESULTS: The search was conducted using the Espacenet and INPI databases. There was an increase in patent document applications employing nanotechnology in 2013, with a peak between 2017 and 2018. China is the lead country in the number of patent applications. In Brazil, the patent applications are variable, and the food industry is most involved in studies on tomatoes as a natural food dye. Most patent deposits using nanotechnology were from companies, and the main sources of the patent application were the food and pharmaceutical industries. CONCLUSION: There is an increasing trend for the use of tomatoes as natural food dyes, produced with or without nanotechnology, and number of patents filed yearly. New technologies are being developed in several application areas.

O pré natal psicológico como intervenção preventiva no período gravídico puerperal: uma revisão integrativa da literatura / Psychological prenatal care as a preventive intervention in the puerperal pregnancy: an integrative literature review / La atención psicológica prenatal como intervención preventiva en el embarazo puerperal: una revisión bibliográfica integradora

Ser mãe é um marco do desenvolvimento psicológico da mulher. Desse modo, a partir da confirmação da gravidez, há a necessidade de uma reestruturação e reajustamento de sua vida, com o intuito de tornar a experiência mais segura para mãe e filho. Sendo assim, a presente pesquisa tem como finalidade compreender os impactos emocionais no período gravídico puerperal, bem como investigar os efeitos do pré-natal psicológico na redução de possíveis psicopatologias que afetam mulheres no período reprodutivo. Em relação a metodologia, trata-se de uma Revisão Integrativa de literatura, sendo utilizadas as plataformas Biblioteca Virtual em Saúde (BVS), Scielo, Capes Periódicos (CAPES) e Periódicos e Eletrônicos em Psicologia (PePSIC), aos descritores foram: Gestação; Puerpério; Acompanhamento psicológico, Pre natal Psicológico. Como resultado, houve a síntese dos artigos com a realização de um quadro incluindo as seguintes informações: autor; ano da publicação; título; metodologia; resultados e conclusão, tais artigos foram organizados por números de forma crescente. Conclui-se, que o pré-natal psicológico é indispensável, pois têm como objetivo principal buscar formas de melhorar o momento do parto e a experiência dessa nova fase, por meio da oferta de programas parentais que incluam ações educativas e aspectos psicodinâmicos. PALAVRAS-CHAVE: Gestação; Puerpério; Acompanhamento Psicológico; Pre-natal Psicológico.

Being a mother is a milestone in a woman's psychological development. Thus, after the confirmation of pregnancy, there is the need for a restructuring and readjustment of her life in order to make the experience safer for mother and child. Thus, the present research aims to understand the emotional impacts of pregnancy and childbirth, as well as to investigate the effects of psychological prenatal care on the reduction of possible psychopathologies that affect women in the reproductive period. Regarding methodology, it is an Integrative Literature Review, being used the platforms Virtual Health Library (VHL), Scielo, Capes Periodicals (CAPES) and Periodicals and Electronic Psychology (PePSIC), the descriptors were: Pregnancy; Puerperium; Psychological monitoring, Psychological prenatal. As a result, there was the synthesis of the articles with the realization of a table including the following information: author; year of publication; title; methodology; results and conclusion, such articles were organized by numbers in an increasing form. It is concluded that prenatal psychology is indispensable, since its main objective is to seek ways to improve the moment of birth and the experience of this new phase, by offering parenting programs that include educational actions and psychodynamic aspects.

Ser madre es un hito en el desarrollo psicológico de la mujer. Por lo tanto, después de la confirmación del embarazo, hay la necesidad de una reestructuración y reajuste de su vida con el fin de hacer la experiencia más segura para la madre y el niño. Por lo tanto, la presente investigación tiene como objetivo comprender los impactos emocionales del embarazo y el parto, así como investigar los efectos de la atención psicológica prenatal en la reducción de posibles psicopatologías que afectan a las mujeres en el período reproductivo. En cuanto a la metodología, se trata de una Revisión Integrativa de Literatura, siendo utilizadas las plataformas Biblioteca Virtual en Salud (BVS), Scielo, Capes Publicaciones Periódicas (CAPES) y Publicaciones Periódicas y Electrónicas en Psicología (PePSIC), los descriptores fueron: Embarazo; Puerperio; Seguimiento Psicológico, Prenatal Psicológico. Como resultado, hubo la síntesis de los artículos con la realización de una tabla incluyendo las siguientes informaciones: autor; año de publicación; título; metodología; resultados y conclusión, tales artículos fueron organizados por números en forma creciente. Se concluye que la psicología prenatal es indispensable, ya que su principal objetivo es buscar formas de mejorar el momento del nacimiento y la vivencia de esta nueva etapa, ofreciendo programas de crianza que incluyan acciones educativas y aspectos psicodinámicos.

Red Tomato Products as an Alternative to Reduce Synthetic Dyes in the Food Industry: A Review.

Most dyes used in the food industry are synthetic and can be a health hazard. Red tomato may serve as a natural alternative dye to replace synthetic colorants. This study aimed to review the literature on the addition of red tomato products (powder tomato, paste, freeze-dried, tomato peel powder, tomato pomace) to reduce the usage of synthetic dyes in the food industry. Red tomato products have been used as coloring in pasta, bologna, sausages, cookies, crackers, macaroons, hamburgers, breads, muffins, cheeses, and nuggets. The trans-cis isomerization of lycopene by oxidative processes directly affects the color of the pigment. The lycopene contained in tomato has antioxidant activity and could reduce or eliminate other oxidants and/or synthetic preservatives in food. Moreover, tomatoes in foods have high sensory scores, nutritional appeal, and marketing potential. However, its use as a food colorant has been not extensively explored. Therefore, further studies are still required, especially on the stability of carotenoids in tomatoes used in processed foods.

Can belly dance and mat Pilates be effective for range of motion, self-esteem, and depressive symptoms of breast cancer women?

OBJECTIVE: This study aims to analyse the effect of an intervention with belly dance or mat Pilates on range of motion, self-esteem and depressive symptoms in women with breast cancer receiving hormone therapy. METHOD: A randomized clinical trial of 52 participants, diagnosed with breast cancer and undergoing adjuvant hormone therapy that were randomized and divided into three groups (1): Belly dance group, which received 16 weeks of Belly Dance classes 2) Mat Pilates group, that performed 16 weeks of Pilates intervention and (3) Control group, that received educational activities in the form of lectures and was invited to maintain its routine activities. The participants answered a questionnaire in which they contained the clinical and personal characteristics; quantification of the range of motion of the upper limbs using the Absolute Axis 360° digital goniometer; self-esteem by the Self-Esteem Scale (EAR) and depressive symptoms by the Beck Depression Inventory (BDI). All data was collected at two moments in the study, in the pre-intervention period (baseline) and at the end of the 16 weeks of intervention. RESULTS: Only the variable range of motion variable showed significant results in all study groups (p = 0.025), with the Mat Pilates group having the best scores. Although not significant, the other study variables also improved after the intervention period. CONCLUSION: Belly dance and the Mat Pilates can bring positive results in the range of movement of women undergoing adjuvant treatment of breast cancer, with the Pilates method being the one that most contributed to improvements in this variable.

Immune response dynamics and Lutzomyia longipalpis exposure characterize a biosignature of visceral leishmaniasis susceptibility in a canine cohort.

BACKGROUND: Reports have shown correlations between the immune response to vector saliva and Leishmaniasis outcome. We followed dogs in an endemic area for two years characterizing resistance or susceptibility to canine visceral leishmaniasis (CVL) according to Leishmania infantum diagnosis and clinical development criteria. Then, we aimed to identify a biosignature based on parasite load, serum biological mediators' interactions, and vector exposure intensity associated with CVL resistance and susceptibility. METHODOLOGY/PRINCIPAL FINDINGS: A prospective two-year study was conducted in an area endemic for CVL. Dogs were evaluated at 6-month intervals to determine infection, clinical manifestations, immune profile, and sandfly exposure. CVL resistance or susceptibility was determined upon the conclusion of the study. After two years, 78% of the dogs were infected with L. infantum (53% susceptible and 47% resistant to CVL). Susceptible dogs presented higher splenic parasite load as well as persistence of the parasite during the follow-up, compared to resistant ones. Susceptible dogs also displayed a higher number of correlations among the investigated biological mediators, before and after infection diagnosis. At baseline, anti-saliva antibodies, indicative of exposure to the vector, were detected in 62% of the dogs, reaching 100% in one year. Higher sandfly exposure increased the risk of susceptibility to CVL by 1.6 times (CI: 1.11-2.41). We identified a discriminatory biosignature between the resistant and susceptible dogs assessing splenic parasite load, interaction of biological mediators, PGE2 serum levels and intensity of exposure to sandfly. All these parameters were elevated in susceptible dogs compared to resistant animals. CONCLUSIONS/SIGNIFICANCE: The biosignature identified in our study reinforces the idea that CVL is a complex multifactorial disease that is affected by a set of factors which are correlated and, for a better understanding of CVL, should not be evaluated in an isolated way.

Characterization of chicken muscle disorders through metabolomics, pathway analysis, and water relaxometry: a pilot study.

Metabolite profiles of chicken breast extracts and water mobility in breasts were studied using proton nuclear magnetic resonance (1H-NMR) spectroscopy and time-domain NMR (TD-NMR) relaxometry, respectively, using normal breast (NB), and wooden breast (WB) and white striping (WS) myopathies in broilers. One thousand eight hundred sixty broilers were raised to commercial standards, receiving the same diets that were formulated as per the different growth stages. At 49 D of age, 200 animals were slaughtered following routine commercial procedures, and at 4 h postmortem, the whole breast (pectoralis major muscle) was removed and visually inspected by an experienced meat inspector who selected NB (without myopathies) and samples with the presence of WS and WB myopathies. Fifteen breasts (5 each of NB, WS, and WB) were analyzed through TD-NMR relaxometry, and samples of approximately 20 g were taken from each breast and frozen at -80°C for metabolite profiling through 1H-NMR spectroscopy. Multivariate statistical analysis was used to evaluate the effect on water relaxometry and metabolite profile in accordance with the presence and type of myopathy in the breast. 1H-NMR data showed that the metabolite profiles in WS and WB breasts were different from each other and from NB. This pilot study shows that myopathies appear to be related to hypoxia, connective tissue deposition, lower mitochondrial function, and greater oxidative stress compared with NB. The longitudinal and transverse relaxation time of the breasts determined by TD-NMR relaxometry was shorter for NB than that for WS and WB, indicating greater water mobility in breasts affected by myopathies. 1H-NMR spectroscopy can be used to differentiate the metabolism of WS, WB, and NB, and TD-NMR has the potential to be a fast, simple, and noninvasive method to distinguish NB from WB and WS. As a practical application, the metabolomic profile as per the occurrence of breast myopathies may be used for a better understanding of these issues, which opens a gap to mitigate the incidence and severity of WS and WB. In addition, the present study brings an opportunity for the development of a new and objective tool to classify the incidence of breast myopathies through TD-NMR relaxometry.

Effects of belly dancing on body image and self-esteem in women with breast cancer - pilot study / Efeito da dança do ventre na imagem corporal e autoestima de mulheres com câncer de mama - estudo piloto / Efectos de la danza del vientre en la imagen corporal y autoestima de mujeres con cáncer de mama - estudio piloto

ABSTRACT Introduction Breast cancer has innumerable consequences in women's lives and physical activity can be beneficial during this period. Objectives To analyze the influence of belly dancing on the body image and self-esteem of women during and after breast cancer treatment. Methods Nineteen women diagnosed with breast cancer, divided into a control group (8 women) and a study group (11 women), who were under treatment or post-treatment at the Center for Oncological Research (CEPON), participated in the study. A questionnaire was used for data collection, divided into three blocks as follows: a) general information - sociodemographic and clinical characterization; b) body image - Body Image After Breast Cancer; and c) self-esteem - Rosenberg Self-Esteem Scale. The study group underwent a belly dance intervention consisting of 60-minute classes, twice a week, for a total period of 12 weeks. Women in the control group only maintained their routine activities. Results Significant changes were observed in the improvement of body image in the belly dance group in the pre- and post-intervention periods in the body stigma (p = 0.017) and transparency (p = 0.021) scales. There were no changes in regards to self-esteem. The control group had no changes in either body image or self-esteem. Conclusion The influence of belly dancing on the improvement of women's body image was observed after 12 weeks of intervention. Thus, it is understood that physical activity may help these women after breast cancer, and should be encouraged by health professionals in this field. Level of evidence II; Therapeutic studies - Investigation of treatment results.

RESUMO Introdução O câncer de mama traz inúmeras consequências para a vida das mulheres e a atividade física pode ser benéfica neste período. Objetivos Analisar a influência da dança do ventre na imagem corporal e autoestima das mulheres durante e após o tratamento do câncer de mama. Métodos Participaram do estudo 19 mulheres, divididas em grupo controle (oito mulheres) e grupo experimental (11 mulheres), diagnosticadas com câncer de mama em tratamento ou após o-tratamento no Centro de Pesquisas Oncológicas (CEPON). Para a coleta de dados, utilizou-se um questionário dividido em três blocos: a) informações gerais - caracterização sociodemográfica e clínica; b) imagem corporal - Body Image After Breast Cancer; e c) autoestima - Escala de Autoestima de Rosenberg. O grupo experimental foi submetido a uma intervenção com aulas de 60 minutos de dança do ventre, duas vezes por semana, por um período total de 12 semanas. O grupo controle apenas manteve suas atividades de rotina. Resultados Houve mudanças significativas na melhora da imagem corporal no período pré- e pós-intervenção do grupo experimental, nas escalas de estigma corporal (p=0,017) e transparência (p=0,021). Não houve modificações em relação à autoestima. O grupo controle não apresentou mudanças tanto na imagem corporal quanto na autoestima. Conclusão Percebeu-se a influência da dança do ventre na melhora da imagem corporal das mulheres após 12 semanas de intervenção. Dessa maneira, entende-se que a prática de uma atividade física pode auxiliar essas mulheres após o câncer de mama e deve ser incentivada por profissionais de saúde desta área. Nível de evidência II; Estudos terapêuticos-Investigação dos resultados do tratamento.

RESUMEN Introducción El cáncer de mama trae innumerables consecuencias para la vida de las mujeres y la actividad física puede ser beneficiosa en este período. Objetivos Analizar la influencia de la danza del vientre en la imagen corporal y la autoestima de las mujeres durante y después del tratamiento del cáncer de mama. Métodos Participaron del estudio 19 mujeres, divididas en grupo control (ocho mujeres) y grupo experimental (11 mujeres), diagnosticadas con cáncer de mama en tratamiento o post tratamiento en el Centro de Investigaciones Oncológicas (CEPON). Para la recolección de los datos se utilizó un cuestionario dividido en tres bloques: a) informaciones generales - caracterización sociodemográfica y clínica; b) imagen corporal - Body Image After Breast Cancer; y c) autoestima - Escala de Autoestima de Rosenberg. El grupo experimental fue sometido a una intervención con clases de 60 minutos de danza del vientre, dos veces por semana, por un período total de 12 semanas. El grupo control sólo mantuvo sus actividades de rutina. Resultados Hubo cambios significativos en la mejora de la imagen corporal del período pre y post intervención del grupo experimental, en las escalas de estigma corporal (p = 0,017) y transparencia (p = 0,021). En la autoestima no se encontraron modificaciones. El grupo control no presentó cambios, tanto en la imagen corporal, como en la autoestima. Conclusión Se percibió la influencia de la danza del vientre en la mejora de la imagen corporal de las mujeres después de las 12 semanas de intervención. De esta manera, se entiende que la práctica de una actividad física puede ayudar a esas mujeres después del cáncer de mama, y debe ser incentivada por profesionales de salud de esta área. Nivel de evidencia II; Estudios terapéuticos-Investigación de los resultados del tratamiento.

Natural infection by Leishmania infantum in the Lutzomyia longipalpis population of an endemic coastal area to visceral leishmaniasis in Brazil is not associated with bioclimatic factors.

Visceral leishmaniasis (VL) is a zoonosis caused by the protozoan Leishmania infantum and in Brazil is transmitted mainly by the bite of Lutzomuyia longipalpis sand flies. Data about the presence, distribution, natural infection rate, seasonal and monthly dynamics of the vector population are important for optimizing the measures to control VL in endemic areas. This study aimed to identify sand fly fauna in an endemic area for VL to detect the prevalence of L. infantum infection in the Lu. longipalpis population and to elucidate the influence of bioclimatic factors on the monthly fluctuations of this vector. HP light traps were monthly set in the intradomicile and peridomicile of residences located in the central and beachfront areas of Camaçari, a VL endemic area. The sand fly collection was conducted in two periods: i) period 1-between December 2011 and November 2012 and ii) period 2-August 2014 and July 2015. Sand fly species were identified and detection of L. infantum infection by qPCR was performed in pools of female Lu. longipalpis. For the first time, the parasite load of positive pools was correlated with the number of Lu. longipalpis captured per month in both periods. Correlation analyses between the monthly fluctuation of the sand fly population and bioclimatic indices of the municipality in both collection periods were also performed. In both evaluated periods, more than 98% of the collected sand flies were Lu. longipalpis, confirming the predominance of this species in the region. It was captured mostly in the beachfront area in all months evaluated (99%). For the period 1, Leishmania DNA was detected in 81% of tested pools representing a minimal infection rate of 9.6%. In the period 2, 40% of the pools were positive with a minimal infection rate of 10.2%. Infected sand flies were only detected in the beachfront area in both periods. The parasite load was low and did not vary in the evaluated months despite the number of collected sand flies. No correlation was observed for climatic factors in both areas of Camaçari. These findings emphasize the high risk of Leishmania transmission in Camaçari regardless of the season and that other factors, aside from bioclimatic elements, are influencing the sand fly population monthly fluctuation.

Multimorbidity due to chronic noncommunicable diseases in older adults: a population-based study / Multimorbidade por doenças crônicas não transmissíveis em idosos: estudo de base populacional

Abstract Objective: To estimate the prevalence of multimorbidity arising from chronic noncommunicable diseases among older residents of the northeast of Brazil and to analyze its association with sociodemographic, behavioral and anthropometric factors. Method: A cross-sectional study was carried out with 3,141 older participants of the National Health Survey (2013). The dependent variable was multimorbidity, and the independent variables were sociodemographic, behavioral and anthropometric indicators. Descriptive, bivariate analyzes and logistic regression models were applied. Results: The prevalence of multimorbidity was 23.7%, with the state of Alagoas having the highest prevalence (27.2%). The occurrence of multimorbidity was associated with the female sex (OR=1.33; p=0.002), age over 80 years (OR=1.35; p=0.019) and being overweight (OR =1.37 p= 0.001). The protective factors were brown skin color (OR=0.79; p=0.013) and low weight (OR =0.71; p=0.017). Conclusion: The prevalence of multimorbidity in community-dwelling older adults in the northeast of Brazil was almost one quarter of the study population, with the state of Alagoas having the highest prevalence. Sex, age, skin color and being overweight were associated with the outcome. Knowledge of these factors can guide health care in the prevention, control and reduction of complications of these diseases, and support the strengthening of health education strategies and policies.

Resumo Objetivo: estimar a prevalência de multimorbidade por doenças crônicas não transmissíveis em idosos residentes no Nordeste brasileiro e analisar sua associação com fatores sociodemográficos, comportamentais e antropométricos. Método: estudo transversal, com 3.141 idosos, participantes da Pesquisa Nacional de Saúde, 2013. A variável dependente foi multimorbidade e as variáveis independentes foram indicadores sociodemográficos, comportamentais e antropométricos. Realizaram-se análises descritivas, bivariadas e modelos de regressão logística. Resultados: A prevalência de multimorbidade foi 23,7%, sendo o estado de Alagoas o que apresentou maior prevalência desse desfecho (27,2%). Associaram-se à ocorrência de multimorbidade: sexo feminino (OR=1,33; p=0,002), idade superior a 80 anos (OR=1,35; p=0,019) e excesso de peso (sobrepeso ou obesidade) (OR=1,37 p=0,001). Foram identificados como fatores de proteção a cor parda (OR=0,79; p=0,013) e o baixo peso (OR=0,71; p=0,017). Conclusão: A prevalência de multimorbidade em idosos que vivem em comunidade, na região Nordeste do Brasil, foi de quase um quarto da população do estudo, destacando-se o estado de Alagoas com maior prevalência. O sexo, a faixa etária, a cor de pele e o excesso de peso se associaram ao desfecho. O conhecimento desses fatores pode nortear o cuidado em saúde quanto à prevenção, controle e redução de complicações dessas doenças e agravos, além de sugerir o fortalecimento de estratégias e políticas de educação em saúde.

Eculizumab Modifies Outcomes in Adults with Atypical Hemolytic Uremic Syndrome with Acute Kidney Injury.

BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is a rare disease associated with congenital or acquired genetic abnormalities that result in uncontrolled complement activation, leading to thrombotic microangiopathy and kidney failure. Until recently, the only treatment was plasma exchange or plasma infusion (PE/PI), but 60% of patients died or had permanent kidney damage despite treatment. Eculizumab, a complement inhibitor, has shown promising results in aHUS. However, data are mainly extracted from case reports or studies of heterogeneous cohorts, and no direct comparison with PE/PI is available. METHODS: An observational retrospective study of adult, dialysis-dependent aHUS patients with acute kidney injury (AKI) who were treated with either PE/PI alone or with second-line eculizumab in our center. We compared the effect of PE/PI and eculizumab on kidney function, hypertension, proteinuria, hematologic values, relapse, and death. RESULTS: Thirty-one patients were included (females, 18; sporadic aHUS, 29; mean age, 46 ± 20 years). Twenty-six patients were treated with PE/PI alone, and 5 were deemed to be plasma-resistant and received eculizumab after stopping PE/PI. Among patients receiving eculizumab, 80% attained complete recovery of kidney function, 100% stopped dialysis, 20% had decreased proteinuria, and no patient relapsed (vs. 38.5, 50, 15.4, and 11.5%, respectively, of patients receiving only PE/PI). At 1-year of follow-up, no deaths had occurred in either group. CONCLUSION: Eculizumab shows greater efficacy than PE/PI alone for the treatment of adult aHUS patients with AKI. Prospective studies and meta-analyses are warranted to confirm our findings and set guidelines for treatment, monitoring, and maintenance.

The mass use of deltamethrin collars to control and prevent canine visceral leishmaniasis: A field effectiveness study in a highly endemic area.

BACKGROUND: Visceral leishmaniasis (VL) is a zoonosis of great importance. Limitations in current VL control measures compromise efficacy, indicating the need to implement new strategies. The aim of this study was to evaluate the effectiveness of the mass use of deltamethrin-impregnated collars in dogs as a public health measure to control and prevent canine visceral leishmaniasis (CVL). METHODOLOGY: An interventional study was implemented in two endemic areas in the district of Monte Gordo (Bahia-Brazil): an intervention area, in which VL seronegative dogs were collared, and a control area in which only conventional CVL control measures were applied. At baseline, seropositive dogs were removed and seronegative dogs were included. Dogs were then reevaluated every 7-8 months for almost two years. At each time point, dogs in the intervention area that remained seronegative received new collars and newly identified seronegative dogs were included and collared. The local zoonosis control authorities were notified of any dogs that tested seropositive in both areas, which were subsequently marked for euthanasia as mandated by the Brazilian Ministry of Health. PRINCIPAL FINDINGS: In the first serological survey, seroprevalence was similar in both areas. At the second evaluation, significant reductions in seroprevalence were seen in both areas, while seroprevalence in the intervention area reduced to 6.0% during the final evaluation versus an increase of 11.0% in the control area. This significant increase and the estimated relative risk (RR = 0.55) indicated protection against CVL in the intervention area. Although CVL incidence did not differ significantly between the areas, an increased tendency was observed in the control area, which could be due to low seroconversion rates throughout the study or a high loss to follow-up. CONCLUSIONS/SIGNIFICANCE: Although our evaluation of the effectiveness of deltamethrin-impregnated collars as a community-wide public health control measure was inconclusive, this measure likely provides protection over time. In endemic areas of Brazil, this strategy represents an operational challenge for local zoonosis control authorities, indicating the need for adjustments, including improved collar design.

Analysis of Brazilian publications on distance education in nursing: integrative review / Análisis de las publicaciones nacionales sobre educación a distancia en enfermería: revisión integradora / Análise das publicações nacionais sobre educação a distância em enfermagem: revisão integrativa

ABSTRACT Objective: To analyze the publications that focus on distance education in nursing in Brazil from 2010 to 2016. Method: Integrative review of the literature with data collection in June 2016 in the following databases: LILACS, MEDLINE via PUBMED, CINAHL and SCOPUS. For the data analysis and interpretation, the thematic categorization was chosen. Results: We selected 18 articles for discussion, whose textual analysis permitted the construction of three thematic categories: use of virtual technologies for distance education in nursing; construction of virtual learning environments with the aid of virtual technologies for distance education in nursing; and evaluation of the learning process through virtual technologies for distance education of nurses. Conclusion: Distance Education stands out as an effective teaching-learning strategy in this type of education in Brazilian nursing, focused mainly on the improvement and complement of traditional teaching.

RESUMEN Objetivo: analizar las publicaciones que enfocan la educación a distancia en Enfermería en Brasil de 2010 a 2016. Método: Revisión integradora de la literatura con colecta de datos en el mes de junio de 2016 en las siguientes bases de datos: LILACS, MEDLINE vía PUBMED, CINAHL y SCOPUS. Para análisis e interpretación de los datos se optó por la categorización temática. Resultados: Fueron seleccionados 18 artículos para discusión, cuyas análisis textuales permitieron la construcción de 3 categorías temáticas: uso de las tecnologías virtuales en educación a distancia en enfermería; construcción de ambientes virtuales de aprendizaje con auxilio de tecnologías virtuales en educación a distancia en enfermería; y evaluación del proceso de aprendizaje por intermedio de las tecnologías virtuales en educación a distancia de enfermeros. Conclusión: EAD se evidencia como una estrategia efectiva de enseñanza-aprendizaje en educación a distancia en enfermería brasileña, orientada principalmente para el perfeccionamiento y complemento de la enseñanza tradicional.

RESUMO Objetivo: analisar as publicações que enfocam a educação a distância na enfermagem no Brasil de 2010 a 2016. Método: Revisão integrativa da literatura com coleta de dados no mês de junho de 2016 nas seguintes bases de dados: LILACS, MEDLINE via PUBMED, CINAHL e SCOPUS. Para análise e interpretação dos dados, optou-se pela categorização temática. Resultados: Selecionados 18 artigos para discussão, cujas análises textuais permitiram a construção de três categorias temáticas: uso das tecnologias virtuais na educação a distância na enfermagem; construção de ambientes virtuais de aprendizagem com auxílio de tecnologias virtuais na educação a distância na enfermagem; e avaliação do processo de aprendizagem por intermédio das tecnologias virtuais na educação a distância de enfermeiros. Conclusão: a EAD evidencia-se como uma estratégia efetiva de ensino-aprendizagem nesta modalidade de educação na enfermagem brasileira, voltada principalmente para o aperfeiçoamento e complemento do ensino tradicional.

Analysis of Brazilian publications on distance education in nursing: integrative review.

OBJECTIVE: To analyze the publications that focus on distance education in nursing in Brazil from 2010 to 2016. METHOD: Integrative review of the literature with data collection in June 2016 in the following databases: LILACS, MEDLINE via PUBMED, CINAHL and SCOPUS. For the data analysis and interpretation, the thematic categorization was chosen. RESULTS: We selected 18 articles for discussion, whose textual analysis permitted the construction of three thematic categories: use of virtual technologies for distance education in nursing; construction of virtual learning environments with the aid of virtual technologies for distance education in nursing; and evaluation of the learning process through virtual technologies for distance education of nurses. CONCLUSION: Distance Education stands out as an effective teaching-learning strategy in this type of education in Brazilian nursing, focused mainly on the improvement and complement of traditional teaching.

Relação do perfil epidemiológico dos cuidadores de idosos com demência e a sobrecarga do cuidado* / Relationship between the epidemiological profile of caregivers of elderly people with dementia and overburden of care / Asociación entre el perfil epidemiológico de los cuidadores de ancianos con demencia y la sobrecarga del cuidado

Objetivou-se avaliar o perfil sociodemográfico e clínico dos cuidadores e sua relação com a sobrecarga proveniente do cuidado ao idoso com demência. Estudo descritivo transversal, amostra não probabilística com 94 cuidadores de idosos com demência, realizado num Centro de Atenção à Saúde do Idoso no estado do Rio de Janeiro. A coleta de dados ocorreu de fevereiro a junho de 2016, por meio de questionário sociodemográfico e escala de Zarit. Quarenta e seis (50%) cuidadores apresentaram sobrecarga moderada, 35 (38%) pouca sobrecarga e 11 (12%) sobrecarga moderada/severa; 71 (77%) cuidadores usavam de 1 a 5 medicamentos e 20 (22%) 6 a 11 medicamentos. Observou-se as tendências: indivíduos com rendas mais baixas evidenciaram maiores níveis de sobrecarga; cuidadores com menor tempo de experiência possuíam sobrecarga moderada; quanto maior a sobrecarga, menor a média da idade. Verificou-se que a sobrecarga do cuidado coloca o cuidador em condições de vulnerabilidade biológica e psicológica (AU).

The present study aimed to evaluate the sociodemographic and clinical profile of caregivers and their relationship with overburden of care of elderly people with dementia. Descriptive cross-sectional study, non-probability sample with 94 elderly people suffering with dementia, conducted at a Care Center for Elderly in the state of Rio de Janeiro. Data was collected from February to June 2016, through a questionnaire on sociodemographic aspects and Zarit Inventory. Forty-six (50%) caregivers had moderate overburden, 35 (38%) had little overburden and 11 (12%) moderate/severe overburden; 71 (77%) caregivers took 1 to 5 drugs and 20 (22%) took 6 to 11 drugs. The following trends were observed: individuals with lower income experienced higher levels of overburden; less experienced caregivers had moderate overburden; the greater the overburden of caregivers, the lower the average age of these individuals. Also, overburdened caregivers were in conditions of biological and psychological vulnerability (AU).

Fue objetivo del estudio evaluar el perfil sociodemográfico y clínico de los cuidadores y su relación con la sobrecarga del cuidado al anciano con demencia. Estudio descriptivo transversal, con muestra probabilística con 94 cuidadores de ancianos con demencia, realizado en un Centro de Atención a la Salud del Anciano en estado de Rio de Janeiro. Los datos fueron obtenidos de febrero a junio de 2016, por medio de cuestionario sociodemográfico y escala de Zarit. Cuarenta y seis (50%) cuidadores presentaron sobrecarga moderada, 35 (38%) poca sobrecarga y 11 (12%) sobrecarga moderada/severa; 71 (77%) cuidadores usaban de 1 a 5 medicamentos e 20 (22%) 6 a 11 medicamentos. Se observaron las siguientes tendencias: individuos con rentas más bajas evidenciaron mayores niveles de sobrecarga; cuidadores con menos tiempo de experiencia tenían sobrecarga moderada; cuanto mayor la sobrecarga, menor la media de edad. Se verificó que la sobrecarga del cuidado pone el cuidador en condiciones de vulnerabilidad biológica y psicológica (AU).

Integration host factor is important for biofilm formation by Salmonella enterica Enteritidis.

Salmonella enterica Enteritidis forms biofilms and survives in agricultural environments, infecting poultry and eggs. Bacteria in biofilms are difficult to eradicate compared to planktonic cells, causing serious problems in industry and public health. In this study, we evaluated the role of ihfA and ihfB in biofilm formation by S. enterica Enteritidis by employing different microbiology techniques. Our data indicate that ihf mutant strains are impaired in biofilm formation, showing a reduction in matrix formation and a decrease in viability and metabolic activity. Phenotypic analysis also showed that deletion of ihf causes a deficiency in curli fimbriae expression, cellulose production and pellicle formation. These results show that integration host factor has an important regulatory role in biofilm formation by S. enterica Enteritidis.

A vulnerabilidade dos cuidadores de idosos com demência: revisão integrativa / Vulnerabilidad de los cuidadores de personas mayores con demencia: revisión integradora / Vulnerability of caregivers for the elderly with dementia: integrative review

Objective: To analyze the vulnerability of caregivers of elderly with dementia. Method: This is an integrative review of quantitative and qualitative nature. The data collection period was from 01/09/14 to 10/30/14.Results: Of the articles analyzed, 26% point interventions to relieve overload; 20% analyze the depression load; 16% of studies address caregiver burden; 14% guided their discussions in physical and spiritual well-being, psychological and social well-being and damage to quality of life; 12% adress stress. Conclusion: Researchers from several countries show the care impact on the life of the caregiver, highlighting: the emotional overload, routine stress, and depressive symptoms. However, there are mitigation measures identified through the research that can contribute to the everyday stress relief, such as the daily practice of yoga meditation, religion, the positive relationship between the family, the elderly and the caregiver.

Objetivo: Analisar a vulnerabilidade dos cuidadores de idosos com demência. Método: Trata-se de uma revisão integrativa de natureza quanti-qualitativa. O período de coleta de dados ocorreu de 01/09/14 a 30/10/14. Resultados: Do total de artigos analisados, 26% apontam intervenções para alívio da sobrecarga; 20% analisam a carga de depressão; 16% dos estudos abordam a sobrecarga do cuidador; 14 % pautaram suas discussões no bem-estar físico e espiritual, bem-estar psicológico e social e nos prejuízos à qualidade devida; e 12% abordaram o estresse. Conclusão: Pesquisadores de diversos países apontam os impactos do cuidado na vida do cuidador destacando a sobrecarga emocional, estresse rotineiro e sintomas depressivos. Entretanto, existem medidas atenuantes, identificadas através das pesquisas, que podem contribuir para alívio do estresse cotidiano, por exemplo, a prática diária de meditação yogue, a religiosidade, o relacionamento positivo entre a família,o idoso e o cuidador.

Objetivo: Analizar la vulnerabilidad de los cuidadores de ancianos con demencia. Método: Se trata de una revisión integradora de la naturaleza cuantitativa y cualitativa. El período de recolección de datos fue de 09/01/14a 30/10/14. Resultados: De los artículos analizados, 26% puntuaron intervenciones para aliviar la sobrecarga; 20% analizaron la carga de la depresión; 16% de los estudios abordaron la carga del cuidador; 14% guió sus discusiones en buena salud física y espiritual, psicológico y social y dañar la calidad de vida; 12% se refirió al estrés. Conclusión: Investigadoresde varios países apuntan los impactos del cuidado en la vida del cuidador, destacando: la sobrecarga emocional, el estrés y la rutina de los síntomas depresivos. Sin embargo, hay medidas de mitigación identificadas a través de la investigación que pueden contribuir al alivio de la tensión diaria, tales como: la práctica diaria de la meditación del yoga, la religión, la relación positiva entre la familia, los ancianos y el cuidador.