Discovering New Natural Products Using Metabolomics-Based Approaches.

The incessant search for new natural molecules with biological activities has forced researchers in the field of chemistry of natural products to seek different approaches for their prospection studies. In particular, researchers around the world are turning to approaches in metabolomics to avoid high rates of re-isolation of certain compounds, something recurrent in this branch of science. Thanks to the development of new technologies in the analytical instrumentation of spectroscopic and spectrometric techniques, as well as the advance in the computational processing modes of the results, metabolomics has been gaining more and more space in studies that involve the prospection of natural products. Thus, this chapter summarizes the precepts and good practices in the metabolomics of microbial natural products using mass spectrometry and nuclear magnetic resonance spectroscopy, and also summarizes several examples where this approach has been applied in the discovery of bioactive molecules.

Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Although the cornerstone treatment for deep vein thrombosis (DVT) remains anticoagulation, clinicians perform stenting or angioplasty (SA) in particular patients. To assess the effects of SA in this setting, we performed a systematic review of randomized controlled trials. METHODS: Based on the Cochrane standards, we searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, LILACS and IBECS databases, and trial registries. Our primary outcomes were post-thrombotic syndrome (PTS), venous thromboembolism (VTE) and all-cause mortality. RESULTS: We included 7 randomized controlled trial (1485 participants). There was no clinically significant difference between SA and best medical practice (BMP) for the additional treatment of acute DVT regarding PTS (standardized mean difference -7.87, 95% confidence interval [CI] -12.13 to -3.61; very low-certainty) and VTE (risk ratio [RR] 1.19, 95% CI 0.28-5.07, very low-certainty), and no deaths. Compared to BMP, the SA plus BMP and thrombolysis results in little to no difference in PTS (mean difference [MD] -1.07, 95% CI -1.12 to -1.02, moderate-certainty), VTE (RR 1.48, 95% CI 0.95-2.31, low-certainty), and mortality (RR 0.92, 95% CI 0.34-2.52, low-certainty). There was no clinical difference between stenting and BMP for chronic DVT regarding PTS (MD 2.73, 95% CI -2.10 to 7.56, very low certainty) and no VTE and death events. CONCLUSIONS: SA results in little to no difference in PTS, VTE and mortality in acute DVT compared to BMP. The evidence regarding SA in chronic DVT and whether SA, compared to BMP and thrombolysis, decreases PTS and VTE in acute DVT is uncertain. Open Science Framework (osf.io/f2dm6).

Factors affecting the in vitro embryo production in buffalo (Bubalus bubalis): A review.

Under natural and well-managed conditions, the buffalo has good reproductive and productive indices. However, in vitro embryo production (IVEP) has been used commercially to maximise the number of elite animals. In this species, several factors (donor management, in vitro culture medium, semen, in vitro conditions, embryo transfer) still affect the IVEP results. In addition, the cost of this technique is very high for this purpose. Therefore, more studies, as well as adequate plans, are needed to achieve this objective efficiently. In this review, we discussed the current commercial status, influencing factors (in vivo and in vitro), and the progress and future challenges of IVEP in buffalo. A total of 81 references were used from 1979 to 2022. The relevant data or literature were searched using the following databases: Google, ResearchGate, Science Alert, Science Direct and PubMed, using the following keywords: buffalo oocytes/COCs, buffalo embryos, pregnancy and calving or live birth rate after embryo transfer. The best maturation, cleavage and blastocyst rates in the in vitro production of buffalo embryos were 95.8, 75.2 and 33.4%, respectively. The pregnancy and live birth rates ranged from 22.2% to 43.5% and from 15.3% to 36.5%, respectively, after the transfer of fresh embryos produced in vitro to the recipients. This review will help to contextualise IVEP in buffaloes, as well as create an adequate plan for implementing IVEP in buffaloes.

Comparison of theoretical approaches for epidemic processes with waning immunity in complex networks.

The role of waning immunity in basic epidemic models on networks has been undervalued while being noticeably fundamental for real epidemic outbreaks. One central question is which mean-field approach is more accurate in describing the epidemic dynamics. We tackled this problem considering the susceptible-infected-recovered-susceptible (SIRS) epidemic model on networks. Two pairwise mean-field theories, one based on recurrent dynamical message-passing (rDMP) theory and the other on the pair quenched mean-field (PQMF) theory, are compared with extensive stochastic simulations on large networks of different levels of heterogeneity. For waning immunity times longer than or comparable with the recovering time, rDMP outperforms PQMF theory on power-law networks with degree distribution P(k)∼k^{-γ}. In particular, for γ>3, the epidemic threshold observed in simulations is finite, in qualitative agreement with rDMP, while PQMF leads to an asymptotically null threshold. The critical epidemic prevalence for γ>3 is localized in a finite set of vertices in the case of the PQMF theory. In contrast, the localization happens in a subextensive fraction of the network in rDMP theory. Simulations, however, indicate that localization patterns of the actual epidemic lay between the two mean-field theories, and improved theoretical approaches are necessary to understanding the SIRS dynamics.

Use of logistic models to evaluate the response of superovulation treatment and embryo production in Santa Inês ewes.

The study aimed to verify the influence of the FecGE mutation in superovulated ewes and to evaluate the probability of logistic models to determine the response capacity of these ewes to superovulatory treatment. Santa Inês ewes (n = 29) were genotyped for the FecGE mutation and separated for their genotype group in carriers of the mutant E allele (FecGE/E, FecG+/E) and non-carrier (FecG+/+) alleles. The ewes underwent hormonal treatment for superovulation. Aside from the genotypes, variables included in the statistical model were reproductive status (empty, early lactation, or late lactation), age (> or < 6 years), and number of births (nulliparous, primiparous, multiparous). The carriers of the mutation could be discriminated from the non-carriers based on the number of corpora lutea, rate of frozen embryos, and fecundity. Recovery rate was significantly higher (P < 0.05) in FecGE/E (94.31%) compared to FecG+/E (63.15%) and FecG+/+ (61.90%) (P < 0.05), whereas fecundity rate of FecG+/+ ewes (50.76%) was significantly higher than FecG+/E (18.96%) and FecGE/E (32.53%) (P < 0.05). We determined in this study that the response to superovulation and embryo production can be discriminated between FecGE/E and FecG+/E ewes in relation to the FecG+/+ genotype. Logistic models that included reproductive status and mutation, or reproductive status and age, or reproductive status and number of births were effective in predicting the response to superovulatory treatment.

First titanosaur dinosaur nesting site from the Late Cretaceous of Brazil.

Titanosaurs were successful herbivorous dinosaurs widely distributed in all continents during the Cretaceous, with the major diversity in South America. The success of titanosaurs was probably due to several physiological and ecological factors, in addition to a series of morphological traits they achieved during their evolutionary history. However, the generalist nesting behaviour using different palaeoenvironments and strategies was key to accomplish that success. Titanosaur nesting sites have been found extensively around the world, with notable records in Spain, France, Romania, India, and, especially, Argentina. Here, we describe the first titanosaur nesting site from the Late Cretaceous of Brazil that represents the most boreal nesting site for South America. Several egg-clutches, partially preserved, isolated eggs and many eggshell fragments were discovered in an Inceptisol palaeosol profile of the mining Lafarge Quarry, at the Ponte Alta District (Uberaba Municipality, Minas Gerais State), corresponding to the Serra da Galga Formation (Bauru Group, Bauru Basin). Although classical mechanical preparation and CT scans have not revealed embryonic remains in ovo, the eggs and eggshell features match those eggs containing titanosaurian embryos found worldwide. The morphology of the egg-clutches and observations of the sedimentary characteristics bolster the hypothesis that these sauropods were burrow-nester dinosaurs, as was already suggested for the group based on other nesting sites. The egg-clutches distributed in two levels along the Lafarge outcrops, together with the geopalaeontological data collected, provide clear evidence for the first colonial nesting and breeding area of titanosaur dinosaurs in Brazil.

What do Cochrane systematic reviews say about congenital vascular anomalies and hemangiomas? A narrative review.

BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients' lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.

What do Cochrane systematic reviews say about congenital vascular anomalies and hemangiomas? A narrative review

ABSTRACT BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients' lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.

Delayed left main coronary obstruction following transfemoral inovare transcatheter aortic valve replacement: A challenging case.

Coronary obstruction is an uncommon and severe complication after a transcatheter aortic valve replacement (TAVR), that occurs during the procedure in the vast majority of patients. In the present case even in the absence of classic risk factors, an acute coronary syndrome occurred one day after TAVR. Selective angiography revealed a severe left main ostium obstruction by the bulky native leaflet calcification. This is the first case of delayed presentation of coronary obstruction with a transfemoral balloon-expandable valve using the Inovare bioprosthesis (Braile Biomedica, Brazil). In addition, after drug-eluting stent placement in the left main coronary, intravascular ultrasound revealed severe stent underexpansion, so that a second layer of a bare-metal stent and high-pressure balloon post-dilatation was necessary to improve the final result. The patient was discharged after 7 days, and at the 6-month follow-up remained asymptomatic. .

Reabilitação Psicossocial: o Relato de um Caso na Amazônia / Mental Psychosocial Rehabilitation: a Case Report in Amazon Region

Objetivo: relatar o acompanhamento de reabilitação psicossocial de um usuário da Rede de Atenção Psicossocial (RAPS) de um município da região Amazônica, em função de seu Projeto Terapêutico Singular (PTS). Método: utilizamos o relato de experiência como método de trabalho para narrar o acompanhamento e a intervenção em relação ao caso estudado. Resultados: os resultados demonstraram que pela articulação e implementação de projeto de reabilitação, por meio da integração entre profissionais da RAPS e família, foi possível diminuir o número de internações psiquiátricas, promover a autonomia, favorecer o exercício da cidadania, garantir a defesa dos direitos sociais e humanos ao paciente em estudo. Dessa forma, as etapas necessárias para realizar um projeto de reabilitação, à luz do caso estudado, foram registradas, apresentadas e discutidas no presente trabalho. Conclusão: a intervenção relatada mostrou ser viável, por meio de um projeto de reabilitação psicossocial - construído e articulado através do trabalho em equipe e integração da rede de saúde mental - promover o bem-estar, a funcionalidade e certo grau de autonomia ao paciente do estudo, proporcionando-lhe o exercício da cidadania e dignidade humana.

Sexual diversity: a perspective on the impact of stigma and discrimination on adolescence. / Diversidade sexual: uma leitura do impacto do estigma e discriminação na adolescência.

The objective of this article is to analyze the impact of stigma and discrimination against the LGBT adolescents' psychic suffering. Qualitative study conducted in a specialized outpatient service of Child and Adolescent Mental Health Secondary Care of the Federal District's Health Secretariat. Nine adolescents participated. In-depth interviews facilitated data collection, and data were analyzed with Iramuteq software and Bardin's Content Analysis. Gender identity and sexual orientation intolerance based on heteronormativity violate human rights and are relevant social determinants in health, and overcoming the psychological distress problems identified, combined with respect for human rights of the LGBT community, is an essential vector for facing adolescent health inequalities. Discrimination against LGBT adolescents is a social determinant that health services must address since its leads to harmful consequences, such as school dropouts, lack of opportunities, family bond losses, and suicidal behavior.

O objetivo deste artigo é analisar o impacto do estigma e da discriminação diante do sofrimento psíquico de adolescentes LGBT. Estudo qualitativo em serviço ambulatorial especializado de Saúde Mental Infantojuvenil, da Atenção Secundária da Secretaria de Saúde do Distrito Federal. Participaram do estudo nove adolescentes. Entrevista em profundidade viabilizou a coleta de dados, cuja análise ocorreu com utilização do software Iramuteq e da Análise de Conteúdo de Bardin. Intolerância à identidade de gênero e orientação sexual, fundamentada na heteronormatividade, viola direitos humanos e constitui relevante determinante social em saúde, e a superação dos sofrimentos psíquicos apresentados, articulada com o respeito aos direitos humanos da comunidade LGBT, constitui importante vetor para enfrentamento das iniquidades em saúde na adolescência. A discriminação de adolescentes LGBT é um determinante social que também deve ser enfrentado pelos serviços em saúde, pois ocasiona prejuízos, como a evasão escolar, falta de oportunidades, perda do vínculo familiar e comportamento suicida.

The Impact of Education on All-cause Mortality Following St-Segment Elevation Myocardial Infarction (STEMI): Results from the Brazilian Heart Study. / O Impacto da Educação na Mortalidade por Todas as Causas após Infarto do Miocárdio com Supradesnivelamento do Segmento ST (IAMCSST): Resultados do Brasília Heart Study.

BACKGROUND: Low schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood. OBJECTIVE: To investigate whether schooling stands as an independent risk factor for mortality in STEMI patients. METHODS: STEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and >10 years). Groups were compared by student's t test for continuous variables and qui-square for categorical. Incidence of all-cause mortality was compared with Kaplan-Meyer with Cox regression adjusted by age, gender, and GRACE score. Values of p < 0.05 were considered significant. SPSS21.0 was used for all analysis. RESULTS: The mean schooling duration was 6.63±4.94 years. During the follow-up period (mean: 21 months; up to 6.8 years), 83 patients died (cumulative mortality of 15%). Mortality rate was higher among the lowest quartile compared to those in the highest quartile [18.5 vs 6.8%; HR 2.725 (95% CI: 1.27-5.83; p=0.01)]. In multivariate analysis, low schooling has lost statistical significance for all-cause mortality after adjustment for age and gender, with HR of 1.305 (95% CI: 0.538-3.16; p=0.556), and after adjustment by GRACE score with an HR of 1.767 (95% CI: .797-3.91; p=0.161). CONCLUSION: Low schooling was not an independent risk factor for mortality in STEMI patients.

FUNDAMENTO: A baixa escolaridade tem sido considerada um fator de risco modificável significativo para o desenvolvimento de doenças cardiovasculares há bastante tempo. Apesar disso, ainda não se sabe muito sobre esse fator impactar ou não os desfechos após infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). OBJETIVO: Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST. MÉTODOS: Os pacientes com diagnóstico de IAMCSST foram consecutivamente incluídos em uma coorte prospectiva (Brasília Heart Study) e categorizados de acordo com os anos dos quartis de estudo (0-3, 4-5, 6-10 e >10 anos). Os grupos foram comparados pelo teste t de Student para variáveis contínuas e qui-quadrado para categóricas. A incidência de mortalidade por todas as causas foi comparada com Kaplan-Meyer com regressão de Cox ajustada por idade, sexo e escore GRACE. Valores de p < 0,05 foram considerados significativos. SPSS21.0 foi utilizado para todas as análises. RESULTADOS: A média de escolaridade foi de 6,63±4,94 anos. Durante o período de acompanhamento (média: 21 meses; até 6,8 anos), 83 pacientes vieram à óbito (mortalidade cumulativa de 15%). A taxa de mortalidade foi maior entre o quartil inferior em comparação com aqueles do quartil superior [18,5 vs. 6,8%; RR 2,725 (IC 95%: 1,27-5,83; p=0,01)]. Na análise multivariada, a baixa escolaridade perdeu significância estatística para mortalidade por todas as causas após ajuste para idade e sexo, com RR 1,305 (IC 95%: 0,538-3,16; p=0,556), e após ajuste pelo escore GRACE com RR 1,767 (IC 95%: 0,797-3,91; p=0,161). CONCLUSÃO: Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST.

O impacto da educação na mortalidade por todas as causas após infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST): resultados do brasília heart study / The impact of education on all-cause mortality following St-segment elevation myocardial infarction (STEMI): results from the brazilian Heart study

Resumo Fundamento A baixa escolaridade tem sido considerada um fator de risco modificável significativo para o desenvolvimento de doenças cardiovasculares há bastante tempo. Apesar disso, ainda não se sabe muito sobre esse fator impactar ou não os desfechos após infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). Objetivo Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST. Métodos Os pacientes com diagnóstico de IAMCSST foram consecutivamente incluídos em uma coorte prospectiva (Brasília Heart Study) e categorizados de acordo com os anos dos quartis de estudo (0-3, 4-5, 6-10 e >10 anos). Os grupos foram comparados pelo teste t de Student para variáveis contínuas e qui-quadrado para categóricas. A incidência de mortalidade por todas as causas foi comparada com Kaplan-Meyer com regressão de Cox ajustada por idade, sexo e escore GRACE. Valores de p < 0,05 foram considerados significativos. SPSS21.0 foi utilizado para todas as análises. Resultados A média de escolaridade foi de 6,63±4,94 anos. Durante o período de acompanhamento (média: 21 meses; até 6,8 anos), 83 pacientes vieram à óbito (mortalidade cumulativa de 15%). A taxa de mortalidade foi maior entre o quartil inferior em comparação com aqueles do quartil superior [18,5 vs. 6,8%; RR 2,725 (IC 95%: 1,27-5,83; p=0,01)]. Na análise multivariada, a baixa escolaridade perdeu significância estatística para mortalidade por todas as causas após ajuste para idade e sexo, com RR 1,305 (IC 95%: 0,538-3,16; p=0,556), e após ajuste pelo escore GRACE com RR 1,767 (IC 95%: 0,797-3,91; p=0,161). Conclusão Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST.

Abstract Background Low schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood. Objective To investigate whether schooling stands as an independent risk factor for mortality in STEMI patients. Methods STEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and >10 years). Groups were compared by student's t test for continuous variables and qui-square for categorical. Incidence of all-cause mortality was compared with Kaplan-Meyer with Cox regression adjusted by age, gender, and GRACE score. Values of p < 0.05 were considered significant. SPSS21.0 was used for all analysis. Results The mean schooling duration was 6.63±4.94 years. During the follow-up period (mean: 21 months; up to 6.8 years), 83 patients died (cumulative mortality of 15%). Mortality rate was higher among the lowest quartile compared to those in the highest quartile [18.5 vs 6.8%; HR 2.725 (95% CI: 1.27-5.83; p=0.01)]. In multivariate analysis, low schooling has lost statistical significance for all-cause mortality after adjustment for age and gender, with HR of 1.305 (95% CI: 0.538-3.16; p=0.556), and after adjustment by GRACE score with an HR of 1.767 (95% CI: .797-3.91; p=0.161). Conclusion Low schooling was not an independent risk factor for mortality in STEMI patients.

Diversidade sexual: uma leitura do impacto do estigma e discriminação na adolescência / Sexual diversity: a perspective on the impact of stigma and discrimination on adolescence

Resumo O objetivo deste artigo é analisar o impacto do estigma e da discriminação diante do sofrimento psíquico de adolescentes LGBT. Estudo qualitativo em serviço ambulatorial especializado de Saúde Mental Infantojuvenil, da Atenção Secundária da Secretaria de Saúde do Distrito Federal. Participaram do estudo nove adolescentes. Entrevista em profundidade viabilizou a coleta de dados, cuja análise ocorreu com utilização do software Iramuteq e da Análise de Conteúdo de Bardin. Intolerância à identidade de gênero e orientação sexual, fundamentada na heteronormatividade, viola direitos humanos e constitui relevante determinante social em saúde, e a superação dos sofrimentos psíquicos apresentados, articulada com o respeito aos direitos humanos da comunidade LGBT, constitui importante vetor para enfrentamento das iniquidades em saúde na adolescência. A discriminação de adolescentes LGBT é um determinante social que também deve ser enfrentado pelos serviços em saúde, pois ocasiona prejuízos, como a evasão escolar, falta de oportunidades, perda do vínculo familiar e comportamento suicida.

Abstract The objective of this article is to analyze the impact of stigma and discrimination against the LGBT adolescents' psychic suffering. Qualitative study conducted in a specialized outpatient service of Child and Adolescent Mental Health Secondary Care of the Federal District's Health Secretariat. Nine adolescents participated. In-depth interviews facilitated data collection, and data were analyzed with Iramuteq software and Bardin's Content Analysis. Gender identity and sexual orientation intolerance based on heteronormativity violate human rights and are relevant social determinants in health, and overcoming the psychological distress problems identified, combined with respect for human rights of the LGBT community, is an essential vector for facing adolescent health inequalities. Discrimination against LGBT adolescents is a social determinant that health services must address since its leads to harmful consequences, such as school dropouts, lack of opportunities, family bond losses, and suicidal behavior.

Evaluation of quality and gene expression of goat embryos produced in vivo and in vitro after cryopreservation.

In the present study, we aimed to identify morphological and molecular changes of in vivo and in vitro-produced goat embryos submitted to cryopreservation. In vivo embryos were recovered by transcervical technique from superovulated goats, whereas in vitro produced embryos were produced from ovaries collected at a slaughterhouse. Embryos were frozen by two-steps slow freezing method, which is defined as freezing to -32 °C followed by transfer to liquid nitrogen. Morphological evaluation of embryos was carried out by assessing blastocoel re-expansion rate and the total number of blastomeres. The expression profile of candidate genes related to thermal and oxidative stress, apoptosis, epigenetic, and implantation control was measured using RT-qPCR based SYBR Green system. In silico analyses were performed to identify conserved genes in goat species and protein-protein interaction networks were created. In vivo-produced embryos showed greater blastocoel re-expansion and more blastomere cells (P < 0.05). The expression level of CTP2 and HSP90 genes from in vitro cryopreserved embryos was higher than their in vivo counterparts. Unlikely, no significant difference was observed in the transcription level of SOD gene between groups. The high similarity of CPT2 and HSP90 proteins to their orthologs among mammals indicates that they share conserved functions. In summary, cryopreservation negatively affects the morphology and viability of goat embryos produced in vitro and changes the CPT2 and HSP90 gene expression likely in response to the in vitro production process.

Correlations of corpus luteum blood flow with fertility and progesterone in embryo recipient mares.

The aim of this study was to evaluate the correlation between the corpus luteum vascularization with the concentration of progesterone and the fertility of embryo recipient mares. Mangalarga Marchador mares (n = 33) were distributed into groups according to the days (D) after ovulation, as follows: D3 (n = 8), D4 (n = 8), D5 (n = 9), and D6 (n = 8). The evaluations of the corpus luteum, endometrium, and blood collection to quantify the progesterone concentration were carried out on D3, D4, D5, and D6. Among the parameters evaluated, only progesterone concentration on D6 differed from the other groups (P <0.05). A positive correlation (P <0.05) between the diameter and the area of the corpus luteum, and the objective and subjective methods of the corpus luteum vascular perfusion, was identified. Likewise, a positive correlation (P <0.05) was observed between the objective and subjective methods of the vascular perfusion in the corpus luteum and the progesterone concentration. The pregnancy rate obtained in this study (54.54%) was not affected (P> 0.05) by the day of embryo transfer, whose percentages were 37.50% (3/8) on D3, 50% (4/8) on D4, 66.70% (6/9) on D5, and 62.50% (5/8) on D6. It was estimated that with each increase on the day of embryo transfer, the pregnancy rate increases. The results allow to conclude that the corpus luteum vascularization in mares, evaluated by Doppler ultrasound, correlates with progesterone concentration and the embryo transfer day.

Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction. / O Escore Gensini e a Carga Trombótica Adicionam Valor Preditivo ao Escore SYNTAX na Detecção de No-Reflow após Infarto do Miocárdio.

BACKGROUND: No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow. OBJECTIVE: We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow. METHODS: In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5). RESULTS: A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001). CONCLUSIONS: Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).

FUNDAMENTO: O fenômeno de no-reflow após a intervenção coronária percutânea está associado a um pior prognóstico em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). O escore SYNTAX é um bom preditor de no-reflow. OBJETIVO: Nosso objetivo foi avaliar se a carga aterosclerótica (escore Gensini) e a carga trombótica na artéria coronária culpada melhorariam a capacidade do escore SYNTAX para detectar o no-reflow. MÉTODOS: Neste estudo coorte prospectivo, foram estudados pacientes com IAMCSST consecutivos que se apresentaram dentro de 12 horas a partir do início dos sintomas. O no-reflow foi definido como fluxo TIMI < 3 ou fluxo TIMI =3 mas grau de blush miocárdico (myocardial blush grade) < 2. A carga trombótica foi quantificada de acordo com o grau TIMI de trombo (0 a 5). RESULTADOS: Foram incluídos 481 pacientes no estudo, com idade média de 61±11 anos. O fenômeno de no-reflow ocorreu em 32,8% dos pacientes. O escore SYNTAX (OR=1,05, IC95% 1,01­1,08, p<0,01), a carga trombótica (OR=1,17, IC95% 1,06­1,31, p<0,01), e o escore Gensini (OR=1,37, IC95% 1,13­1,65, p<0,01) foram preditores independentes do no-reflow. Os escores combinados apresentaram uma maior área sob a curva quando comparados ao escore SYNTAX isolado (0,78 [0,73­0,82] vs 0,73 [0,68­0,78], p=0,03). A análise da melhora da reclassificação líquida (NRI) categórica (0,11 [0,01­0,22], p=0,02) e contínua (NRI>0) (0,54 [0,035­0,73], p<0.001) mostrou melhora na capacidade preditiva do no-reflow no modelo combinado, com melhora da discriminação integrada (IDI) de 0,07 (0,04­0,09, p<0,001). CONCLUSÕES: Nossos achados sugerem que, em pacientes com IAMCSST submetidos à intervenção coronária percutânea, a carga aterosclerótica e a carga trombótica na artéria culpada adicionam valor preditivo ao escore SYNTAX na detecção do fenômeno no-reflow. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0).

O Escore Gensini e a Carga Trombótica Adicionam Valor Preditivo ao Escore SYNTAX na Detecção de No-Reflow após Infarto do Miocárdio / Gensini Score and Thrombus Burden Add Predictive Value to the SYNTAX Score in Detecting No-Reflow after Myocardial Infarction

Resumo Fundamento O fenômeno de no-reflow após a intervenção coronária percutânea está associado a um pior prognóstico em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). O escore SYNTAX é um bom preditor de no-reflow. Objetivo Nosso objetivo foi avaliar se a carga aterosclerótica (escore Gensini) e a carga trombótica na artéria coronária culpada melhorariam a capacidade do escore SYNTAX para detectar o no-reflow. Métodos Neste estudo coorte prospectivo, foram estudados pacientes com IAMCSST consecutivos que se apresentaram dentro de 12 horas a partir do início dos sintomas. O no-reflow foi definido como fluxo TIMI < 3 ou fluxo TIMI =3 mas grau de blush miocárdico (myocardial blush grade) < 2. A carga trombótica foi quantificada de acordo com o grau TIMI de trombo (0 a 5). Resultados Foram incluídos 481 pacientes no estudo, com idade média de 61±11 anos. O fenômeno de no-reflow ocorreu em 32,8% dos pacientes. O escore SYNTAX (OR=1,05, IC95% 1,01-1,08, p<0,01), a carga trombótica (OR=1,17, IC95% 1,06-1,31, p<0,01), e o escore Gensini (OR=1,37, IC95% 1,13-1,65, p<0,01) foram preditores independentes do no-reflow. Os escores combinados apresentaram uma maior área sob a curva quando comparados ao escore SYNTAX isolado (0,78 [0,73-0,82] vs 0,73 [0,68-0,78], p=0,03). A análise da melhora da reclassificação líquida (NRI) categórica (0,11 [0,01-0,22], p=0,02) e contínua (NRI>0) (0,54 [0,035-0,73], p<0.001) mostrou melhora na capacidade preditiva do no-reflow no modelo combinado, com melhora da discriminação integrada (IDI) de 0,07 (0,04-0,09, p<0,001). Conclusões Nossos achados sugerem que, em pacientes com IAMCSST submetidos à intervenção coronária percutânea, a carga aterosclerótica e a carga trombótica na artéria culpada adicionam valor preditivo ao escore SYNTAX na detecção do fenômeno no-reflow. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)

Abstract Background No-reflow after percutaneous coronary intervention is associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). SYNTAX score is a good predictor of no-reflow. Objective We aimed to evaluate whether atherosclerotic burden (Gensini score) and thrombus burden in the culprit coronary artery would improve the ability of the SYNTAX score to detect no-reflow. Methods In this prospective cohort study, consecutive patients with STEMI who presented within 12 h of onset of symptoms were selected for this study. No-reflow was defined as TIMI flow < 3 o r TIMI flow = 3 but myocardial blush grade <2. Thrombus burden was quantified according to the TIMI thrombus grade scale (0 to 5). Results A total of 481 patients were included (mean age 61±11 years). No-reflow occurred in 32.8%. SYNTAX score (OR=1.05, 95%CI 1.01-1.08, p<0.01), thrombus burden (OR=1.17, 95%CI 1.06-1.31, p<0.01), and Gensini score (OR=1.37, 95%CI 1.13-1.65, p<0.01) were independent predictors of no-reflow. Combined scores had a larger area under the curve than the SYNTAX score alone (0.78 [0.73-0.82] vs 0.73 [0.68-0.78], p=0.03). Analyses of both categorical (0.11 [0.01-0.22], p=0.02), and continuous net reclassification improvement (NRI>0) (0.54 [0.035-0.73], p<0.001) showed improvement in the predictive ability of no-reflow in the combined model, with integrated discrimination improvement (IDI) of 0.07 (0.04-0.09, p<0.001). Conclusions Our findings suggest that, in patients with STEMI undergoing percutaneous coronary intervention, atherosclerotic burden and thrombus burden in the culprit artery add predictive value to the SYNTAX score in detecting the no-reflow phenomenon. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)

Doping esportivo e consumo de suplementos alimentares: uma relação delicada / Sports doping and dietary supplements consumption: a delicate relationship / Dopaje desportivo y consumo de suplementos alimenticios: uma relación delicada

Objetivo: neste estudo, procura-se saber se os suplementos alimentares tão consumidos são aptos a causarem doping, já que os atletas buscam recursos ergogênicos visando à melhora da sua performance e, no campo nutricional, os suplementos aparecem como os mais consumidos. Metodologia: pesquisa bibliográfica descritiva, de abordagem exploratória; foram utilizadas informações oficiais de órgãos afetos ao controle de competições esportivas mundiais, bem como normas da Anvisa, agência reguladora brasileira. Resultados: verificou-se que a opção pelo alto consumo de suplementos alimentares se deve tanto à influência massiva da publicidade, que promete resultados miraculosos, quanto à facilidade de aquisição desses produtos. A eficácia de muitos deles carece de comprovação científica, enquanto outros podem causar efeitos colaterais graves pouco divulgados, além de conter substâncias de uso proibido e aptas a causar doping. No Brasil, a indústria de suplementos alimentares ganhou marco regulatório apenas em 2018, razão pela qual ainda não foi possível uma avaliação rigorosa dos seus efeitos. Conclusão: constatou-se que a multidisciplinariedade que envolve a relação entre dopagem e consumo de suplementos alimentares é a responsável pela dificuldade de controle do setor, reveladora ainda de quão movediça é a abordagem do problema no qual, frequentemente, se imiscuem novas áreas de conhecimento, exigindo profundo saber interdisciplinar. Daí a necessidade da interferência de profissionais habilitados para a prescrição de tais suplementos somente nos casos em que eles se mostrem necessários.

Objective: this study seeks to know if the massive consumed dietary supplements can cause doping, since, unable to accept their limits, athletes search ergogenic methods aiming for the increase of their performance and, in the nutritional field, dietary supplements appear as the most prominent choice. Methods: the present paper is a descriptive bibliographic research, with an exploratory approach, in which were used official information of organs related to the control of world sports competitions, as well as Brazilian regulatory agency rules. Results: It was found that the option for the huge consumption of dietary supplements is due to the influence of massive publicity ­ that promises miraculous results ­ and to the ease of the purchase of these products. The effectiveness of many of them lack scientific proof; many others may cause serious side effects that are not disclosed, containing substances of prohibited use and able to characterize doping. In Brazil, the sector has reached a regulation mark only in 2018, the reason why a rigorous evaluation of its effects was not possible to be done. Conclusions: it was found that the multidisciplinarity that concerns the relationship between doping and consumption of dietary supplements is responsible for the difficulty of controlling the sector, revealing how unstable is the approach to the problem, in which new areas of knowledge are often inserted, requiring deep interdisciplinary knowledge. Hence the need for the intervention of qualified professionals to prescribe such supplements only in cases where they are necessary.

Objetivo: en este estudio se busca conocer si los complementos alimenticios que se consumen ampliamente son susceptibles de provocar dopaje, ya que los deportistas buscan recursos ergogénicos con el objetivo de mejorar su rendimiento y, en el ámbito nutricional, los complementos aparecen como los más consumidos. Metodología: investigación bibliográfica descriptiva, con enfoque exploratorio; Se utilizó información oficial de agencias relacionadas con el control de las competiciones deportivas mundiales, así como normas de Anvisa, la agencia reguladora brasileña. Resultados: se encontró que la opción por un alto consumo de complementos dietéticos se debe tanto a la influencia masiva de la publicidad, que promete resultados milagrosos, como a la facilidad de compra de estos productos. La eficacia de muchos de ellos carece de pruebas científicas, mientras que otros pueden provocar efectos secundarios graves y poco conocidos, además de contener sustancias de uso prohibido y aptas para causar dopaje. En Brasil, la industria de complementos alimenticios obtuvo un marco regulatorio recién en 2018, por lo que aún no ha sido posible evaluar rigurosamente sus efectos. Conclusión: se constató que la multidisciplinariedad que implica la relación entre el dopaje y el consumo de complementos alimenticios es responsable de la dificultad para controlar el sector, revelando además lo rápido que es el abordaje del problema, en el que muchas veces se imbuyen nuevas áreas de conocimiento. lo que requiere un profundo conocimiento interdisciplinario. De ahí la necesidad de la intervención de profesionales cualificados para prescribir dichos suplementos solo en los casos en que sean necesarios.

Occurrence, morphology, and morphometry of follicles containing multiple oocytes in FecGE mutant Santa Inês ewes.

This study was conducted to characterize the morphology and morphometry of follicles containing multiple oocytes (MOFs) and determine the association with the FecGE mutation in Santa Inês ewes. Based on the genotypes, 65 ewes were characterized as being homozygous wild-type (n = 25; FecG+/+), heterozygous mutant (n = 27, FecG+/E), and homozygous mutant (n = 13, FecGE/E). The variables evaluated were follicle developmental stage, number of oocytes per follicle, morphology, and morphometry of MOFs. The FecGE mutation did not affect the frequency of MOFs (P > 0.05) (3.0 % in FecG+/+; 3.3 % in FecG+/E; and 3.5 % in FecGE/E). The greater viability (P < 0.05) of MOFs was identified in transitory stage of the FecGE/E (95.0 %) and FecG+/E (90.9 %) when compared to the FecG+/+ genotype (73.3 %). Furthermore, the morphology of transitory follicles with two oocytes was the variable and when evaluated was the most reliable determinant for predicting which ewes had an FecGE mutation. In conclusion, the FecGE mutation did not affect the frequency of MOFs. The ewes with FecGE mutation had a greater frequency of morphologically normal MOFs in the transitory stage. Furthermore, the ewes with the FecGE mutation had a greater likelihood of having MOFs containing two morphologically normal oocytes.