Heparin-Bonded Expanded Polytetrafluoroethylene Is a Solution for Infrapopliteal Revascularization in the Absence of an Adequate Autologous Vein Graft.

BACKGROUND: To analyze the outcomes of heparin-bonded expanded polytetrafluoroethylene (HePTFE) graft as an alternative conduit in infrapopliteal revascularization of chronic limb-threatening ischemia (CLTI) in the absence of an autologous vein conduit. METHODS: A single-center retrospective analysis of patients with CLTI submitted to infrapopliteal bypasses with autologous vein graft (VEIN group) or HePTFE graft (HePTFE group) was implemented. Primary end points were freedom from CLTI at 12 months and recurrence of CLTI at 3 years. Secondary end points included freedom from major amputation, amputation-free survival (AFS), survival, and primary (PP) and secondary patency (SP) rates at 3 years of follow-up. RESULTS: A total of 348 limbs submitted to infrapopliteal bypasses, 214 with venous graft and 134 with HePTFE graft, were followed-up for a median of 25 months. Most patients of the HePTFE group were male (69%), with a median age of 76 years (interquartile range [IQR] 15). Fifty-nine percent of the limbs of the HePTFE group had Wound grade ≥2, being 46% of them infected. Eighty-eight percent were GLASS stage III. Freedom from CLTI was not significantly different between HePTFE and VEIN groups (75% vs. 84%, adjusted hazard ratio [aHR] 0.88, confidence interval [CI] 0.66-1.18, P = 0.401). Recurrence of CLTI was higher in the HePTFE group (42% vs.18% at 3 years; aHR 2.82, CI 1.59-5.00, P < 0.001). The VEIN group achieved higher rates of freedom from major amputation (87% vs.69% at 3 years; aHR 2.21, CI 1.31-3.75, P = 0.003) and AFS (59% vs. 37% at 3 years; aHR 1.39, CI 1.02-1.88, P = 0.036), but no significance in survival (aHR 1.10, CI 0.72-1.66, P = 0.667). Patency rates were inferior in the HePTFE group, with 2-year PP and SP rates of 52% vs. 74%, and 76% vs. 90%, respectively (PP: aHR 1.70, CI 1.11-2.59, P = 0.014; SP: aHR 2.51, CI 1.42-4.42, P = 0.001). CONCLUSIONS: Infrapopliteal bypass with autologous vein graft is the gold standard to treat CLTI limbs. HePTFE graft should be regarded as an alternative for complex infrapopliteal revascularization when lacking an autologous vein conduct.

IT-Related Barriers and Facilitators to the Implementation of a New European eHealth Solution, the Digital Survivorship Passport (SurPass Version 2.0): Semistructured Digital Survey.

BACKGROUND: To overcome knowledge gaps and optimize long-term follow-up (LTFU) care for childhood cancer survivors, the concept of the Survivorship Passport (SurPass) has been invented. Within the European PanCareSurPass project, the semiautomated and interoperable SurPass (version 2.0) will be optimized, implemented, and evaluated at 6 LTFU care centers representing 6 European countries and 3 distinct health system scenarios: (1) national electronic health information systems (EHISs) in Austria and Lithuania, (2) regional or local EHISs in Italy and Spain, and (3) cancer registries or hospital-based EHISs in Belgium and Germany. OBJECTIVE: We aimed to identify and describe barriers and facilitators for SurPass (version 2.0) implementation concerning semiautomation of data input, interoperability, data protection, privacy, and cybersecurity. METHODS: IT specialists from the 6 LTFU care centers participated in a semistructured digital survey focusing on IT-related barriers and facilitators to SurPass (version 2.0) implementation. We used the fit-viability model to assess the compatibility and feasibility of integrating SurPass into existing EHISs. RESULTS: In total, 13/20 (65%) invited IT specialists participated. The main barriers and facilitators in all 3 health system scenarios related to semiautomated data input and interoperability included unaligned EHIS infrastructure and the use of interoperability frameworks and international coding systems. The main barriers and facilitators related to data protection or privacy and cybersecurity included pseudonymization of personal health data and data retention. According to the fit-viability model, the first health system scenario provides the best fit for SurPass implementation, followed by the second and third scenarios. CONCLUSIONS: This study provides essential insights into the information and IT-related influencing factors that need to be considered when implementing the SurPass (version 2.0) in clinical practice. We recommend the adoption of Health Level Seven Fast Healthcare Interoperability Resources and data security measures such as encryption, pseudonymization, and multifactor authentication to protect personal health data where applicable. In sum, this study offers practical insights into integrating digital health solutions into existing EHISs.

A Rare Case of a Schwannoma on the Foot - Case Report.

A Schwannoma is an infrequent lesion. This tumor derives from the myelin sheath of the peripheral nerves; in most cases, it is benign and rarely presents in the foot and ankle region. Patients affected by this type of pathology are usually asymptomatic. Still, they sometimes have sensory or motor neurologic symptoms if the tumor is large enough to cause direct or indirect compression of the affected nerve. A 55-year-old male patient presented to our department with non-traumatic swelling and pain in the lateral aspect of the right foot and leg. A magnetic resonance imaging (MRI) scan of the right leg revealed a well-circumscribed lesion, measuring 2,5 by 1 cm, showing hypointensity on T1 sequences and hyperintensity on T2, compatible with a superficial peroneal nerve sheath cells tumor. Surgical excision of the lesion was performed, and the histopathological examination confirmed the initial suspicion-Schwannoma of the superficial peroneal nerve. The postoperative period was uneventful, with progressive improvement of pain and complete functional recovery without neurological deficits. Rigorous clinical examination associated to MRI scans allow adequate diagnosis as well as the exclusion of other pathologies with similar clinical presentation. Thus, the surgeon has to be aware of all the data for an effective diagnosis and treatment in this type of rare pathology that cannot be neglected.

Antimicrobial properties of hindered amine light stabilizers in polymer coating materials and their mechanism of action.

UV-stabilizers are a class of additives that provide extended polymer resistance to UV-degradation, but have also been suggested to have antimicrobial activity, potentially preventing the spread of pathogens, and inhibiting microbial-induced biodegradation. In this work, we incorporated different UV-stabilizers, a hindered amine light stabilizer (HALS), Tinuvin 770 DF and Tinuvin PA 123, or a hybrid HALS/UV-absorber, Tinuvin 5151, in polyurethane formulations to produce lacquer-films, and tested their antimicrobial activity against Staphylococcus aureus (methicillin-resistant and -sensitive strains), Escherichia coli and Candida albicans. Lacquer-films incorporated with Tinuvin 770 DF showed strong antimicrobial performance against bacteria and fungi, while maintaining cytocompatibility. The mechanism of action revealed a positive relationship between Tinuvin 770 DF concentration, microbial death, and reactive nitrogen species (RNS), suggesting that RNS produced during autoxidation of Tinuvin 770 DF is responsible for the antimicrobial properties of this UV-stabilizer. Conversely, lacquer-films incorporated with Tinuvin 5151 or Tinuvin PA 123 exhibited no antimicrobial properties. Collectively, these results highlight the commercial potential of Tinuvin 770 DF to prevent photo- and biodegradation of polymers, while also inhibiting the spread of potentially harmful pathogens. Furthermore, we provide a better understanding of the mechanism underlying the biocidal activity of HALS associated to autooxidation of the amine group.

Feasibility Study for a High-Frequency Flexible Ultrasonic Cuff for High-Precision Vagus Nerve Ultrasound Neuromodulation.

In the emerging research field of bioelectronic medicine, it has been indicated that neuromodulation of the vagus nerve (VN) has the potential to treat various conditions such as epilepsy, depression, and autoimmune diseases. In order to reduce side effects, as well as to increase the effectiveness of the delivered therapy, sub-fascicle stimulation specificity is required. In the electrical domain, increasing spatial selectivity can only be achieved using invasive and potentially damaging approaches like compressive forces or nerve penetration. To avoid these invasive methods while obtaining a high spatial selectivity, a 2-mm diameter extraneural cuff-shaped proof-of-concept design with integrated lead zirconate titanate (PZT) based ultrasound (US) transducers is proposed in this article. For the development of the proposed concept, wafer-level microfabrication techniques are employed. Moreover, acoustic measurements are performed on the device, in order to characterize the ultrasonic beam profiles of the integrated PZT-based US transducers. A focal spot size of around [Formula: see text] is measured for the proposed cuff. Moreover, the curvature of the device leads to constructive interference of the US waves originating from multiple PZT-based US transducers, which in turn leads to an increase of 45% in focal pressure compared to the focal pressure of a single PZT-based US transducer. Integrating PZT-based US transducers in an extraneural cuff-shaped design has the potential to achieve high-precision US neuromodulation of the VN without requiring intraneural implantation.

Modified Z-plasty of the Patellar Ligament with Reinforcement of the Quadriceps Tendon in the Treatment of Patella Baja.

Patella baja is an infrequent knee pathology, but it is limiting due to joint stiffness and localized pain in the anterior region of the knee. It may occur after trauma, prolonged immobilization or local surgical intervention. The striking pathological finding is the shortening and increase in thickness of the patellar ligament. Several surgical techniques have been described for its treatment, and there is no standardized treatment. We describe the case of a 73-year-old female patient who presented with knee stiffness, significant functional deficit, and patella baja after total knee arthroplasty. She underwent a recently described soft tissue surgical procedure, with excellent functional evolution, improving from a Lysholm Knee Score of 16 to 81 points, allowing early mobilization and return to daily life activities.

Infrapopliteal Bypass In Patients On Dialysis: Patency And Survival.

INTRODUCTION: Portugal has one of the highest prevalence of patients on a regular dialysis program. This population has a higher incidence of peripheral arterial disease with higher rates of postoperative morbidity and mortality. Our goal was to compare outcomes between dialysis and non-dialysis patients with chronic limb threatening ischemia (CLTI) submitted to infrapopliteal bypass. MATERIALS AND METHODS: A retrospective single-center study of infrapopliteal bypass for CLTI was performed between 2012 and 2019. Patients were divided in two groups based on dialysis status (group 1 incorporated patients on dialysis). Primary end point was 1-year freedom from CLTI. Secondary end points were limb-salvage, survival and primary (PP) and tertiary patency (TP) rates at 3 years of follow-up. RESULTS: A total of 352 infrapopliteal bypasses were performed in 310 patients with CLTI. Fourteen percent of the revascularizations were performed on dialysis patients (48/352). Median age was 73 years (interquartile range - IQR 15) and 74% (259/352) were male. Median follow-up was 26 months (IQR 42). Overall, 92% (325/352) had tissue loss and 44% (154/352) had some degree of infection. The majority of revascularization procedures were performed with vein grafts (61%, 214/352). The 30-day mortality was 4% (11/310), with no difference between groups (p = 0.627). Kaplan-Meier analysis showed no difference between groups regarding freedom from CLTI (76% vs. 79%; HR 0.96, CI 0.65-1.44, p=0.857), limb-salvage (70% vs. 82%; HR 1.40, CI 0.71-2.78, p=0.327) and survival (62% vs. 64%; HR 1.08, CI 0.60-1.94, p=0.799). PP rates were 39% in group 1 and 64% in group 2 (HR 1.71, CI 1.05-2.79, p=0.030). TP rates were not different between groups (57% and 78%; HR 1.79, CI 0.92-3.47, p=0.082). CONCLUSION: Infrapopliteal bypass for CLTI, on dialysis patients, resulted in lower PP rates. No differences were observed in freedom from CLTI, TP, limb salvage and survival.

Hydrothermal liquefaction aqueous phase mycoremediation to increase inorganic nitrogen availability.

Hydrothermal liquefaction aqueous phase (HTL-AP) is a waste product from a thermochemical process where wet biomass is converted into biocrude oil. This nutrient-rich wastewater may be repurposed to benefit society by assisting crop growth after adequate treatment to increase inorganic nitrogen, especially NO3 -. This study aims to increase HTL-AP inorganic nitrogen, specifically NH3/NH4 + and NO3 -, through fungal remediation for further use in hydroponic systems. Trametes versicolor, a white-rot fungus known for degrading a range of organic pollutants, was used to treat a diluted (5 %) HTL-AP for 9 days. No fungal growth was observed, but T. versicolor activity was suspected by laccase activity throughout cultivation time. NO3 --N and NH3/NH4 +-N increased by 17 and 8 times after three days of fungal treatment, which was chosen as the appropriate time for HTL-AP fungal treatment as it resulted in the highest concentration of NO3 --N. The addition of nitrifying bacteria to the fungal treatment resulted in a twofold increase in NO3 --N concentration compared to the fungal treatment alone, indicating an enhancement in treatment efficacy. COD decreased by 51.33 % after 24 h, which may be related to the fungus' capacity to reduce the concentration of organics in the wastewater; nonetheless, COD increased in the following days, which may be related to the release of fungal byproducts. T. versicolor shows promise as a potential candidate for increasing inorganic nitrogen in HTL-AP. However, future studies should primarily address HTL-AP toxicity, reducing NH3/NH4 +-N while increasing NO3 --N, and hydroponics crop production after fungal treatment.

Functionality of chimeric TssA proteins in the type VI secretion system reveals sheath docking specificity within their N-terminal domains.

The genome of Pseudomonas aeruginosa encodes three type VI secretion systems, each comprising a dozen distinct proteins, which deliver toxins upon T6SS sheath contraction. The least conserved T6SS component, TssA, has variations in size which influence domain organisation and structure. Here we show that the TssA Nt1 domain interacts directly with the sheath in a specific manner, while the C-terminus is essential for oligomerisation. We built chimeric TssA proteins by swapping C-termini and showed that these can be functional even when made of domains from different TssA sub-groups. Functional specificity requires the Nt1 domain, while the origin of the C-terminal domain is more permissive for T6SS function. We identify two regions in short TssA proteins, loop and hairpin, that contribute to sheath binding. We propose a docking mechanism of TssA proteins with the sheath, and a model for how sheath assembly is coordinated by TssA proteins from this position.

Vascular dysfunction occurs prior to the onset of amyloid pathology and Aß plaque deposits colocalize with endothelial cells in the hippocampus of female APPswe/PSEN1dE9 mice.

Increasing evidence shows that cardiovascular diseases (CVDs) are associated with an increased risk of cognitive impairment and Alzheimer's diseases (AD). It is unknown whether systemic vascular dysfunction occurs prior to the development of AD, if this occurs in a sex-dependent manner, and whether endothelial cells play a role in the deposition of amyloid beta (Aß) peptides. We hypothesized that vascular dysfunction occurs prior to the onset of amyloid pathology, thus escalating its progression. Furthermore, endothelial cells from female mice will present with an exacerbated formation of Aß peptides due to an exacerbated pressure pulsatility. To test this hypothesis, we used a double transgenic mouse model of early-onset AD (APPswe/PSEN1dE9). We evaluated hippocampus-dependent recognition memory and the cardiovascular function by echocardiography and direct measurements of blood pressure through carotid artery catheterization. Vascular function was evaluated in resistance arteries, morphometric parameters in the aortas, and immunofluorescence in the hippocampus and aortas. We observed that endothelial dysfunction occurred prior to the onset of amyloid pathology irrespective of sex. However, during the onset of amyloid pathology, only female APP/PS1 mice had vascular stiffness in the aorta. There was elevated Aß deposition which colocalized with endothelial cells in the hippocampus from female APP/PS1 mice. Overall, these data showed that vascular abnormalities may be an early marker, and potential mediator of AD, but exacerbated aortic stiffness and pressure pulsatility after the onset of amyloid pathology may be associated with a greater burden of Aß formation in hippocampal endothelial cells from female but not male APP/PS1 mice.

A Single-Short Partial Reprogramming of the Endothelial Cells decreases Blood Pressure via attenuation of EndMT in Hypertensive Mice.

Background: Small artery remodeling and endothelial dysfunction are hallmarks of hypertension. Growing evidence supports a likely causal association between cardiovascular diseases and the presence of endothelial-to-mesenchymal transition (EndMT), a cellular transdifferentiation process in which endothelial cells (ECs) partially lose their identity and acquire additional mesenchymal phenotypes. EC reprogramming represents an innovative strategy in regenerative medicine to prevent deleterious effects induced by cardiovascular diseases. Methods: Using a partial reprogramming of ECs, via overexpression of Oct-3/4, Sox-2, and Klf-4 (OSK) transcription factors, we aimed to bring ECs back to a youthful phenotype in hypertensive mice. Primary ECs were infected with lentiviral vectors (LV) containing the specific EC marker cadherin 5 (Cdh5) and the fluorescent reporter enhanced green fluorescence protein (EGFP) with empty vector (LVCO) or with OSK (LV-OSK). Confocal microscopy and western blotting analysis were used to confirm the OSK overexpression. Cellular migration, senescence, and apoptosis were evaluated. Human aortic ECs (HAoECs) from male and female normotensive and hypertensive patients were analyzed after OSK or control treatments for their endothelial nitric oxide synthase (eNOS) levels, nitric oxide (NO), and genetic profile. Male and female normotensive (BPN/3J) and hypertensive (BPH/2J) mice were treated with an intravenous (i.v.) injection of LVCO or LV-OSK and evaluated 10 days post-infection. The blood pressure, cardiac function, vascular reactivity of small arteries, in vivo EGFP signal and EndMT inhibition were analyzed. Results: OSK overexpression induced partial EC reprogramming in vitro , and these cells showed endothelial progenitor cell (EPC)-like features with lower migratory capability. OSK treatment of hypertensive BPH/2J mice normalized blood pressure and resistance arteries hypercontractility, via the attenuation of EndMT and elastin breaks. EGFP signal was detected in vivo in the prefrontal cortex of both BPN/3J and BPH/2J-treated mice, but OSK induced angiogenesis only in male BPN/3J mice. OSK-treated human ECs from hypertensive patients showed high eNOS activation and NO production, with low ROS formation. Single-cell RNA analysis showed that OSK alleviated EC senescence and EndMT, restoring their phenotypes in human ECs from hypertensive patients. Conclusion: Overall, these data indicate that OSK treatment and EC reprogramming can decrease blood pressure and reverse hypertension-induced vascular damage.

Mental health during ecological crisis: translating and validating the Hogg Eco-anxiety Scale for Argentinian and Spanish populations.

BACKGROUND: Eco-anxiety is increasingly recognized as a shared experience by many people internationally, encompassing fear of environmental catastrophe and anxiety about ecological crises. Despite its importance in the context of the changing climate, measures for this construct are still being developed in languages other than English. METHODS: To contribute to global eco-anxiety research, we translated the Hogg Eco-Anxiety Scale (HEAS) into Spanish, creating the HEAS-SP. We validated this measure in samples from both Argentina (n = 990) and Spain (n = 548), performing measurement invariance and confirmatory factor analyses. Internal consistency of the scale and score stability over time were investigated through reliability analyses. Differences in eco-anxiety across sociodemographic variables were explored through Student's t-tests and Pearson's r tests. RESULTS: The four-factor model of the HEAS-SP comprising affective and behavioural symptoms, rumination, and anxiety about personal impact demonstrated excellent model fit. We found good internal consistency for each subscale, and established measurement invariance between Spanish and Argentine samples, as well as across genders and participants' age. Spanish participants reported higher scores on the affective symptoms and personal impact anxiety factors compared to the Argentinian sample. Also, men reported lower levels than women on the subscales of affective symptoms, rumination, and personal impact anxiety. It was found that the relationship between both age and personal impact anxiety and age and affective symptoms varies significantly depending on the gender of the individuals. Younger participants tended to report higher scores on most dimensions of eco-anxiety. CONCLUSIONS: These findings enhance the global initiative to investigate, explore and therefore comprehend eco-anxiety by introducing the first valid and reliable Spanish-language version of this psychometric instrument for its use within Spanish and Argentinian populations. This study augments the body of evidence supporting the robust psychometric properties of the HEAS, as demonstrated in prior validations for Australian, Turkish, Portuguese, German, French, and Italian populations.

Exploring Suspected Diagnoses in Elderly Patients: A Case Study of Potential Necrotizing Otitis Externa.

Necrotizing otitis externa (NOE) is a rare invasive infection affecting the EAC and the base of the skull. This condition is more prevalent in the elderly, diabetics, and immunocompromised individuals, often attributed to the bacterium Pseudomonas aeruginosa. In this case report, we present the clinical scenario of a 90-year-old woman with a history of diabetes and epilepsy. Initially admitted with acute pyelonephritis, fever, and prostration, she subsequently developed left facial paralysis during treatment. Cranial computed tomography (CT) revealed inflammation in the middle ear and bone erosion of the facial nerve canal. The examination by the Department of Ear, Nose, and Throat (ENT) describes that NOE would be the most likely diagnosis. Given the patient's comorbidities and the severity of the disease, the treatment was initiated empirically and later adjusted based on the culture and sensitivity results with ceftazidime. NOE is a critical condition requiring early diagnosis and interdisciplinary collaboration due to the associated risk of complications. Adequate glycemic control is imperative, and the judicious use of antibiotics is crucial in light of escalating resistance.

Effect of two diets on the fecundity of ablated and non-ablated female of Macrobrachium amazonicum

Macrobrachium amazonicum is a species of freshwater shrimp of great importance for aquaculture and to know its reproductive potential, through the study of its fertility is necessary. Therefore, this study aimed to evaluate the effect of two different diets on the reproductive performance of the species, whether or not adopting the ablation procedure. The experiment was carried out in a completely randomized design in a 2 x 2 factorial arrangement, with two types of feed (inert and fresh) and two conditions (ablated and non-ablated females), using six replicates per treatment. After 10 days of spawning, the eggs were removed and counted in their entirety. For each female, three spawns were obtained, totaling 72 samples. The fertility rate, the interval between spawning and the weight gain of the females were analyzed. There was no interaction between the studied factors, except for weight gain, in which ablated females that received fresh feed gained up to three times more weight than non-ablated females. Females that received fresh feed obtained higher fertility (1,373.9 eggs) than those that received only inert feed (1,084.1 eggs). The interval between spawns was 1.6 days shorter in ablated females.(AU)

Sankofa: contribuições da Filosofia Africana para resgatar as relações afetivas e sexuais entre Africanos homens em diáspora

Este artigo busca dar subsídios teóricos e metodológicos ao processo de reontologização dos corpos africanos homens diaspóricos que se relacionam afetiva e sexualmente entre si. Parte-se do deslocamento do conceito de masculinidade e de sua relação estritacom as questões de gênero e sexualidades, situando esse processo em uma perspectiva afrocêntrica. Assim, a partir do conhecimento oriundo da matriz civilizatória africana, busca-se trazer novas contribuições no sentido de ampliar a compreensão sobre os modos de existir dos corpos africanos homens na diáspora, tomando a orixalidade como uma forma de repensar essas homenidades

Reproductive aspects of the dwarf cichlid Apistogramma agassizii under captive conditions / Aspectos reprodutivos do ciclídeo anão Apistograma agassizii em condições de cativeiro

Apistogramma agassizii is a native fish from the Amazon basin, which is of great interest for fishkeeping and is supplied to the retail trade from extractivism. Knowledge about the reproductive characteristics of this fish is fundamental to successful breeding. Objective: This work aimed to study the behavior and reproductive performance of this species in white and black aquariums. A total of 16 pairs were used, 8 in each treatment. The system had water recirculation, with fresh and inert food supply. Result: The fish demonstrated parental care, more accentuated by the female and partial spawning. The same coloration pattern was observed in both treatments, with coloration intensifying only during spawning. The eggs were adhesive and U-shaped/oval. The females followed the larvae, even after they left the nests, and attacked the males when they approached the offspring. Males exhibited territorial behavior. No significant differences were observed for the following parameters studied: largest and smallest egg size, spawning weight, absolute fecundity, number of hatched larvae, and hatchability rate. Conclusion: This study found that the fish are prolific and show good reproductive rates in conditions of captivity; thus, they are suitable to rear for the ornamental fish trade.

Apistograma agassizzi é um peixe nativo da bacia amazônica muito apreciado pela aquariofilia; seu comércio é oriundo do extrativismo. Conhecer os aspectos reprodutivos desse peixe é fundamental para o sucesso da criação. Este trabalho teve por objetivo estudar o comportamento e o desempenho reprodutivo dessa espécie, para isso utilizaram-se aquários brancos e pretos, nos quais foram aloja-dos 16 casais, oito em cada tratamento. O sistema adotado foi o de recirculação de água, com oferta de alimento inerte e fresco. Os peixes apresentaram cuidado parental acentuado pela fêmea e desova parcelada; o mesmo padrão de coloração para ambos os tratamentos pôde ser observado, intensificando-se na reprodução. Os ovos eram adesivos e em forma de U/ovais. As fêmeas acompanhavam as larvas, mesmo após a saída do ninho, chegando a agredir os machos quando estes se aproximavam da prole. Os machos apresentaram comportamento territorialista. Não foram observadas diferenças significativas para os seguintes parâmetros estudados: comprimento maior e menor do ovo, peso da desova, fecundidade absoluta, número de larvas eclodidas e taxa de eclodibilidade. Pôde-se ainda concluir que os peixes são prolíficos e apresentam bons índices reprodutivos em condições de cativeiro, portanto aptos para o cultivo visando ao comércio de peixes ornamentais.

Impact of SGLT2 inhibitors on renal function in elderly with type 2 diabetes in the firstyear of treatment / Impacto de los inhibidores de SGLT2 sobre la función renal en ancianos con diabetes tipo 2 durante el primer año de tratamiento

Objectives: This study aims to evaluate the effect of iSGLT2 on estimated glomerular filtration rate (eGFR) and albuminuria in elderly patients during the first year of treatment.Methods and Methodologies: Retrospective cohort study includingelderly patients (>65 years) with type 2 diabetes (T2D) treated withiSGLT2. Data were collected at the beginning of treatment, 3, 6, 9 and12 months after.Results: A total of 115 elderly patients were included, 48.7% male,mean age 72.4±5.2 years, median HbA1c 8.4±1.7% and medianT2D duration of 17±12 years. Dapagliflozin was initiated in 60.9%and empagliflozin in 39.1%. An eGFR of 30-60mL/min/1.73m2 wasobserved in 21.7%, with moderately increased albuminuria in 12.2%and severely increased albuminuria in 4.3%.Throughout the first year, there was a significant reduction in HbA1c(-0.32%±1,6%; p<0.038). Regarding eGFR, no significant differences at the beginning of treatment or after 1-year were observed,nonetheless, a non-significant reduction was observed in the firstsemester, followed by a significant increase in eGFR (71.4-84.9mL/min/1.73m2; p<0.006) in the second semester. As to the variation ofeGFR yearlong, there were no significant differences between dapagliflozin and empagliflozin, although in the first semester, empagliflozinpresented a greater variation in eGFR(p=0.021). There was no significant reduction in albuminuria(p=0,074).Conclusions: In our sample, iSGLT2 seems to preserve the glycemiceffects, without worsening renal function in an elderly population during the first-year treatment. It seems that the nephroprotective effectis also preserved in the elderly in real life. (AU)

Objetivos: Evaluar el efecto de iSGLT2 sobre la tasa de filtraciónglomerular estimada (TFGe) y la albuminuria en ancianos durante elprimer año de tratamiento.Métodos: Estudio coorte retrospectivo que incluyó a pacientes ancianos (>65 años) con diabetes tipo 2(DM2) tratados con iSGLT2.Los datos se recogieron al inicio del tratamiento, 3, 6, 9 y 12 mesesdespués.Resultados: Se incluyeron 115 ancianos, 48,7% varones, edad media 72,4±5,2 años, mediana de HbA1c 8,4±1,7% y de duración dela DM2 de 17±12 años. Se inició dapagliflozina en 60,9% y empagliflozina en 39,1%.Se observó una TFGe de 30-60 ml/min/1,73m2 en 21,7%, con unaumento moderado de la albuminuria en 12,2% y un aumento gravede la albuminuria en 4,3%.Durante el primer año, hubo una reducción significativa de la HbA1c(-0,32%±1,6%; p<0,038). En la TFGe no se observaron diferenciassignificativas al inicio del tratamiento ni al año, sin embargo, se observó una reducción no significativa en el primer semestre, seguida deun aumento significativo (71,4-84,9ml/min/1,73m2; p<0,006) en elsegundo semestre. La variación de la TFGe a lo largo del año no presentó diferencias significativas entre dapagliflozina y empagliflozina,aunque en el primer semestre la empagliflozina presentó una mayorvariación (p=0,021). No se ha demostrado una reducción significativade la albuminuria (p=0,074).Conclusiones: En nuestra muestra, iSGLT2 parece preservar losefectos glucémicos, sin empeorar la función renal en una poblaciónanciana durante el primer año de tratamiento. Por tanto, parece mantenerse el efecto nefroprotector en mayores de 65 años en vida real. (AU)

O uso de plantas medicinais para o tratamento do Diabetes Mellitus Tipo II ­ Revisão de literatura / The use of medicinal plants for treatment of type II Diabetes Mellitus ­ Literature review

O Diabetes mellitus tipo II (DM II) é uma síndrome metabólica com uma das maiores prevalências mundiais. A Organização Mundial da Saúde (OMS, 2019) estima que até 2045 teremos aproximadamente 629 milhões de diabéticos adultos no planeta. Além disso, a Federação Internacional de Diabetes (IDF, 2019) estima que o gasto anual global com tratamentos para diabetes adultos em 2017 foi de U$850 bilhões de dólares. Com números tão expressivos buscam-se tratamentos naturais efetivo, eficaz e baixo custo para tal distúrbio. Inúmeras plantas já estão sendo utilizadas como coadjuvante no tratamento do DM II por possuírem ação antidiabética. Porém, há uma incidência na procura de ampliar o acervo de plantas medicinais com compostos hipoglicemiantes. Portanto, este presente trabalho destaca plantas como Croton cajucara Benth, Licania rígida Benth e Morus nigra L. e seus compostos hipoglicemiantes como alternativa em potencial para tratamento desta síndrome metabólica. Os resultados demonstraram a importância das mesmas para a terapêutica do DM II com estudos que comprovem a ação, garantia da eficácia e segurança em sua utilização.

Diabetes mellitus type II (DM II) is a metabolic syndrome with one of the highest prevalence worldwide. The World Health Organization (WHO, 2019) estimates that by 2045 we will have approximately 629 milion adult diabetics on the planet. In addition, the International Diabetes Federation (IDF, 2019) estimates that the annual global expenditure on treatments for adult diabetes in 2017 was $ 850 bilion dollars. With such expressive numbers, effective, efficient and lowcost natural treatments are sought for such disorder. Numerous plants are already being used as an adjuvant in the treatment of DM II because they have an anti-diabetc action. However, there is an incidence in the search to expand the collection of medicinal plants with hypoglicemic compounds. Therefore, this present work highligths plants such as Croton cajucara Benth, Licania rigida Benth and Morus nigra L., and their hypoglycemic compounds as a potential alternative for the treatment of this metabolic syndrome. The results demonstrated the importance of the same for the treatment of DM II with studies that prove the action, guarantee of the efficacy and safety in its use.

Ecological aspects and molecular detection of Leishmania DNA (Kinetoplastida: Trypanosomatidae) in phlebotomine sand flies (Diptera: Psychodidae) from a rural settlement in the Eastern Amazon, Brazil

ABSTRACT Notifications concerning American tegumentary leishmaniasis (ATL) are increasing in the northern areas of Brazil, particularly due to the ongoing increase in human settlements inside the Amazon Forest. Notwithstanding the economical and sanitary importance of the ATL, the ecological aspects of its potential vectors, the Phlebotomine sand flies (Diptera: Psychodidae), remains largely neglected. This study aimed to investigate the diversity of the phlebotomine fauna as well as the detection of Leishmania DNA in these insects in the rural settlement Perimetral Norte, in the state of Amapá, eastern region of the Amazon, endemic region for tegumentary leishmaniasis. Sand flies were collected bimonthly from February 2018 to February 2019, using CDC light traps exposed for three consecutive nights in 10 houses of settlement residents. DNA extraction and multiplex PCR were performed to detect trypanosomatids. A total of 3,946 sandflies belonging to 37 species were collected. The most abundant species were Ty. trichopyga (Floch & Abonnenc, 1945) (21.9%) and Mi. rorotaensis (Floch & Abonnenc, 1944) (16.9%). A total of 36 positive pools were found with Leishmania DNA (Kinetoplastida: Trypanosomatidae), representing 17.9% of the total pools tested (201), those with the highest Minimum infection rates were Mg. migonei (França, 1920) and Lu. gomezi (Nitzulescu, 1931), Leishmania DNA was also detected in Bi. flaviscutellata (Mangabeira, 1942), Ny. umbratilis (Ward & Fraiha, 1977), Ny. anduzei (Roseboom, 1942) and Ny. antunesi (Coutinho, 1939). These data confirm the probable participation of these four species in the tegumentary leishmaniasis cycle in the eastern Amazon.

New records of dragonflies and damselflies (Insecta: Odonata) from Amapá state, Brazil / Libélulas e donzelinhas (Insecta: Odonata) novos registros para o estado do Amapá, Brasil

Abstract: The Odonata Order comprises one of the largest groups of aquatic insects, 7,000 species are described worldwide, with approximately 860 species registered in Brazil, around 14% of the global fauna known to date. However, there are still great gaps in the knowledge of Odonata fauna in many areas of Brazil. This study aims to present the results of the survey of Odonata species sampled in three counties in the state of Amapá. The state is located in the north of the country, inserted in the Amazon Biome. Odonata were caught between January and December 2018, with 472 specimens being sampled, belonging to seven families, 36 genera and 53 species. In total, 27 of the species found during the study correspond to new records for the state of Amapá. Due to the lack of information on the diversity of the Odonata order in Amapá, the list of species presented should serve as input for new studies contributing to the knowledge of the order in the state.

Resumo: A ordem Odonata compreende um dos maiores grupos de insetos aquáticos, mundialmente são descritas 7.000 espécies, sendo que, para o Brasil estão registradas aproximadamente 860 espécies, algo em torno de 14% da fauna global conhecida até o momento. No entanto, ainda existem grandes lacunas no conhecimento da odonatofauna em muitas áreas do Brasil. Este estudo tem como objetivo apresentar o resultado do levantamento de espécies de Odonata amostradas em três municípios do estado Amapá. O estado se encontra na região norte do país, inserido no Bioma amazônico. As capturas de Odonata foram realizadas entre os meses de janeiro e dezembro de 2018, sendo amostrados 472 espécimes pertencentes a sete famílias, 36 gêneros e 53 espécies. No total, 27 das espécies encontradas durante o estudo correspondem a novos registros para o estado do Amapá. Devido à falta de informação sobre a diversidade da ordem Odonata no Amapá, a lista de espécies apresentada deve servir de aporte para novos estudos contribuindo com o conhecimento da ordem no estado.