Exercise-induced muscle vasodilatation and treadmill exercise test responses in individuals without overt heart disease.

BACKGROUND: The beneficial effects of exercise on cardiovascular health may be related to the improvement in several physiologic pathways, including peripheral vascular function. The aim of this study was to evaluate the relationship between cardiovascular responses during the treadmill exercise test and exercise-induced muscle vasodilatation in individuals without overt heart disease. METHODS: The study included 796 asymptomatic subjects (431 females and 365 males) without overt heart disease. We evaluated the heart rate (chronotropic reserve and heart rate recovery), blood pressure (maximum systolic and diastolic blood pressure as well as systolic blood pressure recovery) and exercise capacity during symptom-limited treadmill exercise testing. Exercise-induced muscle vasodilatation was studied with venous occlusion plethysmography and estimated by forearm blood flow and vascular conductance responses during a 3-min handgrip maneuver. RESULTS: Forearm blood flow increase during the handgrip exercise was positively associated with heart rate recovery during treadmill exercise testing (p < 0.001). Forearm vascular conductance increase during the handgrip exercise was inversely associated with exercise diastolic blood pressure during exercise treadmill testing (p = 0.038). No significant association was found between exercise capacity and exercise-induced muscle vasodilation. CONCLUSION: In a sample of individuals without overt heart disease, exercise-induced muscle vasodilatation was associated with heart rate and blood pressure responses during treadmill exercise testing, but was not associated with exercise capacity. These findings suggest that favorable hemodynamic and chronotropic responses are associated with better vasodilator capacity, but exercise capacity does not predict muscle vasodilatation.

Antifungal activity of lectins against yeast of vaginal secretion.

Lectins are carbohydrate-binding proteins of non-imune origin. This group of proteins is distributed widely in nature and they have been found in viruses, microorganisms, plants and animals. Lectins of plants have been isolated and characterized according to their chemical, physical-chemical, structural and biological properties. Among their biological activities, we can stress its fungicidal action. It has been previously described the effect of the lectins Dviol, DRL, ConBr and LSL obtained from the seeds of leguminous plants on the growth of yeasts isolated from vaginal secretions. In the present work the experiments were carried out in microtiter plates and the results interpreted by both methods: visual observations and a microplate reader at 530nm. The lectin concentrations varied from 0.5 to 256µg/mL, and the inoculum was established between 65-70% of trammitance. All yeast samples isolated from vaginal secretion were evaluated taxonomically, where were observed macroscopic and microscopic characteristics to each species. The LSL lectin did not demonstrate any antifungal activity to any isolate studied. The other lectins DRL, ConBr and DvioL, showed antifungal potential against yeast isolated from vaginal secretion. These findings offering offer a promising field of investigation to develop new therapeutic strategies against vaginal yeast infections, collaborating to improve women's health.

Decentralized COVID-19 measures in Brazil were ineffective to protect people with diabetes.

BACKGROUND AND AIMS: COVID-19 severity and mortality are elevated in individuals with diabetes. During the pandemic, interventions recommended globally for people with diabetes were to keep blood glucose on target whilst staying at home to curb the spread of the virus. In Brazil, similar measures were proposed. The aim of our observational study was to assess whether these measures achieved their objectives. METHODS: An anonymous and untraceable survey was shared from April 22nd to May 4th. States with more than 30 respondents were included in the analysis and Fisher's exact test was performed to identify associations, with p < 0.05 considered significant. RESULTS: Type 1 diabetes and female participants were prevalent, 60.76% and 76.12% respectively. 10 out of 26 states were included, in addition to the Federal District (1562 responses). Only in three states (Bahia, Goiás and Pernambuco) less than 50% of the respondents experienced higher glycemia or higher variability during the pandemic. Goiás state, where almost half of the respondents (49.12%) have private insurance, presented the highest percentage of individuals receiving medicines for three months (35.48%) and one of the lowest percentages of blood glucose deterioration (47.17%). In the large states of Minas Gerais, Rio de Janeiro and São Paulo, consultations and/or lab exams were postponed by 37.14%, 34.33% and 40.88%, respectively. CONCLUSIONS: The decentralized measures implemented by states in Brazil left most people with diabetes unprotected. Many were forced to venture outside to collect or to purchase their medical supplies monthly and reported increased glycemic levels and/or variability.

COVID-19 impact on people with diabetes in South and Central America (SACA region).

AIMS: The present observational study aims to describe political actions in place to combat COVID-19 in the South and Central America region (SACA) while protecting individuals with diabetes. METHODS: A survey with 12 questions was shared with all IDF-SACA member organizations, in 18 countries. A descriptive analysis was performed and a multivariate cluster analysis technique pam (partitioning around medoids) was applied. RESULTS: Two groups of countries were identified. The first group, mostly countries with stricter measures to contain the spread of the virus, reported more difficulties (limitations in accessing basic or health needs) and fears (concerns regarding the impact of the pandemic); whereas most of the second group consisted of countries with less restrictive measures, and reported fewer difficulties. Only 37% responded that a policy was put into place to protect individuals with diabetes, either delivering their medicines and supplies at home (16%) or providing them at once enough for 2-3 months (21%). All respondents reported that one of the main fear was to "be infected and not to receive adequate treatment" and/or "getting infected if going to the hospital or medical appointments". CONCLUSION: Most of the SACA countries failed to implement timely measures to protect individuals with diabetes, which may severely impact individuals, health systems and economies.

The impact of COVID-19 on people with diabetes in Brazil.

The present study aims at identifying main barriers faced by people living with diabetes in Brazil during the COVID-19 pandemic. METHODS: In a convenience sampling study, data were collected from 1701 individuals, aged 18 or above; 75.54% female participants; 60.73% T1D and 30.75% T2D, between April 22nd and May 4th, using an anonymous and untraceable survey containing 20 multiple choice questions (socio-demographic; health status and habits of life during COVID-19 pandemic). Relationship between variables was established using the multiple correspondence analysis technique. RESULTS: 95.1% of respondents reduced their frequency of going outside of their homes; among those who monitored blood glucose at home during the pandemic (91.5%), the majority (59.4%) experienced an increase, a decrease or a higher variability in glucose levels; 38.4% postponed their medical appointments and/or routine examinations; and 59.5% reduced their physical activity. T1D, the youngest group, was more susceptible to presenting COVID-19 symptoms despite not being testing; whilst the T2D group had higher frequency of comorbidities that are additional risk factors for COVID-19 severity. CONCLUSIONS: This study provides a first hand revelation of the severity of COVID-19 on individuals with diabetes in Brazil. Their habits were altered, which impacted their glycemia, potentially increasing the risk of poor outcomes and mortality if infected by SARS-CoV-2, and of acute and chronic diabetes complications.

Cardiovascular disease parameters in periodontitis.

BACKGROUND: Recently, there has been an increasing in the impact of oral health on atherosclerosis and subsequent cardiovascular disease. The aim of this study is to investigate the association between chronic periodontitis and cardiovascular risk markers. METHODS: Forty patients with periodontitis and 40 healthy gender-, body mass index-, and age-matched individuals were compared by measuring total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, levels of cytokines, antibodies against oxidized low-density lipoprotein, thiobarbituric acid reactive substances, total and differential white blood cell counts, and the non-linear index of refraction. RESULTS: The levels of triglycerides and high-density lipoprotein in periodontitis patients were significantly higher and lower, respectively (P = 0.002 and P = 0.0126), compared to controls. Total cholesterol, low-density lipoprotein, and lipid peroxide levels were the same in both groups (P = 0.2943, P = 0.1284, and P = 0.067, respectively). Interleukin (IL)-6 and -8, antibodies against oxidized low-density lipoprotein, and leukocyte and neutrophil counts were significantly higher in periodontitis patients (P <0.05). The value of the non-linear index of refraction of low-density lipoprotein solutions was higher in the controls (P = 0.015) compared to individuals with periodontitis. CONCLUSION: Our results confirmed and further strengthened the suggested association between coronary artery disease and periodontitis.

A model for the functional assessment of elderly with myeloid neoplasms.

OBJECTIVE: Myeloid neoplasms are heterogeneous diseases that are more incident in the elderly. The goals of this study were to aggregate a geriatric approach to the patient assessment, to show the impact of gender, age, hemoglobin concentration and comorbidities on the functionality of elderly with myeloid neoplasms and to better understand how the instruments of functional assessment work according to the aggressiveness of the disease. METHODS: Elderly patients (≥60 years old) with myeloid neoplasms were assessed using the Karnofsky scale, Eastern Cooperative Oncologic Group scale, and basic and instrumental activities of daily living scales. The hematopoietic cell transplantation-comorbidity index assessed the comorbidities. A mixed logistical regression model was fitted to estimate the impact of gender, age, hemoglobin concentration and the hematopoietic cell transplantation-comorbidity index on patients' functionality. RESULTS: Eighty-two patients with a mean age of 72.8 years (range: 60-92 years) were evaluated. Eighty percent had good Karnofsky and Eastern Cooperative Oncologic Group scales and 39% were independent according to the daily living activity scales. All of the patients with poor Karnofsky and Eastern Cooperative Oncologic Group scales were classified as dependent by the daily living activity scales. The mixed logistic regression models showed that age, gender, hemoglobin concentration and the comorbidity index impacted on the daily living activity scales. Karnofsky and Eastern Cooperative Oncologic Group scales were affected by hemoglobin and the comorbidity index. The model hypothesized the hemoglobin concentration at which there was a higher risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales. This hemoglobin concentration depended on comorbidities and on the aggressiveness of the myeloid neoplasm. CONCLUSION: The geriatric approach improved the sensitivity and specificity of the patients' assessment. Hemoglobin concentration associated to the risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales depended on the comorbidity score and on the disease aggressiveness. The Karnofsky and Eastern Cooperative Oncologic Group scales had higher sensitivity in patients with more aggressive diseases.

Stem cells labeled with superparamagnetic iron oxide nanoparticles in a preclinical model of cerebral ischemia: a systematic review with meta-analysis.

INTRODUCTION: Although there is an increase in clinical trials assessing the efficacy of cell therapy in structural and functional regeneration after stroke, there are not enough data in the literature describing the best cell type to be used, the best route, and also the best nanoparticle to analyze these stem cells in vivo. This review analyzed published data on superparamagnetic iron oxide nanoparticle (SPION)-labeled stem cells used for ischemic stroke therapy. METHOD: We performed a systematic review and meta-analysis of data from experiments testing the efficacy of cellular treatment with SPION versus no treatment to improve behavioral or modified neural scale outcomes in animal models of stroke by the Cochrane Collaboration and indexed in EMBASE, PubMed, and Web of Science since 2000. To test the impact of study quality and design characteristics, we used random-effects meta-regression. In addition, trim and fill were used to assess publication bias. RESULTS: The search retrieved 258 articles. After application of the inclusion criteria, 24 reports published between January 2000 and October 2014 were selected. These 24 articles were analyzed for nanoparticle characteristics, stem cell types, and efficacy in animal models. CONCLUSION: This study highlights the therapeutic role of stem cells in stroke and emphasizes nanotechnology as an important tool for monitoring stem cell migration to the affected neurological locus.

Influence of dyslipidemia and diabetes mellitus on chronic periodontal disease.

BACKGROUND: Periodontal disease is closely related to certain systemic conditions, such as type 2 diabetes mellitus (DM2), and, as recently described, dyslipidemia, a condition with alterations in blood lipids levels. However, more than acting as disease modifiers, these conditions commonly occur as comorbidities, possibly synergically affecting periodontal tissues. The aim of the current study is to identify whether DM2 and dyslipidemia are related to the occurrence and severity of chronic periodontitis. METHODS: A total of 254 individuals participated: 56 were patients with DM2, 67 had dyslipidemia, 74 had DM2 and dyslipidemia, and 57 were systemically healthy individuals. The clinical examination included a full-mouth evaluation of periodontal probing depth, plaque score, bleeding on probing, and clinical attachment level (CAL). Blood samples were taken to assess fasting plasma glucose, low-density lipoprotein, high-density lipoprotein, and triglyceride levels. These parameters, as well as other medical conditions (i.e., smoking habits and body mass index), were considered in multiple regression analyses for data analyses (α = 5%). RESULTS: Dyslipidemia was not related to periodontal disease (P >0.05). At the same time, DM2, age, and smoking showed a statistical and positive association, an increase in percentage of sites with CAL ≥3 and ≥5 mm. Regarding the percentage of sites presenting severe destruction (CAL ≥7 mm), only DM2 remained a significant risk factor (P <0.05). CONCLUSIONS: It could be concluded that dyslipidemia did not influence periodontal conditions in participants with normal health or those with DM2. However, age, smoking habits, and especially DM2 were significantly associated with loss of CAL.

Measurement of the nonlinear optical response of low-density lipoprotein solutions from patients with periodontitis before and after periodontal treatment: evaluation of cardiovascular risk markers.

The Z-Scan (ZS) technique in the thermal regime has been used to measure the nonlinear optical response of low-density lipoprotein (LDL). The ZS technique is carried out in LDL from 40 patients with chronic periodontitis before and after three, six, and 12 months of periodontal treatment. Clinical parameters such as probing depths, bleeding on probing, total and differential white blood cells counts, lipid profiles, cytokine levels, and antibodies against oxidized LDL are also determined and compared over time. Before the treatment, the ZS experimental results reveal that the LDL particles of these patients are heavily modified. Only after 12 months of the periodontal treatment, the ZS results obtained reveal behavioral characteristics of healthy particles. This conclusion is also supported by complementary laboratorial analysis showing that the periodontal treatment induces systemic changes in several inflammatory markers.

A model for the functional assessment of elderly with myeloid neoplasms

Objective: Myeloid neoplasms are heterogeneous diseases that are more incident in the elderly. The goals of this study were to aggregate a geriatric approach to the patient assessment, to show the impact of gender, age, hemoglobin concentration and comorbidities on the functionality of elderly with myeloid neoplasms and to better understand how the instruments of functional assessment work according to the aggressiveness of the disease. Methods: Elderly patients (≥60 years old) with myeloid neoplasms were assessed using the Karnofsky scale, Eastern Cooperative Oncologic Group scale, and basic and instru- mental activities of daily living scales. The hematopoietic cell transplantation-comorbidity index assessed the comorbidities. A mixed logistical regression model was fitted to estimate the impact of gender, age, hemoglobin concentration and the hematopoietic cell transplantation-comorbidity index on patients' functionality. Results: Eighty-two patients with a mean age of 72.8 years (range: 60-92 years) were evaluated. Eighty percent had good Karnofsky and Eastern Cooperative Oncologic Group scales and 39% were independent according to the daily living activity scales. All of the patients with poor Karnofsky and Eastern Cooperative Oncologic Group scales were classified as dependent by the daily living activity scales. The mixed logistic regression models showed that age, gender, hemoglobin concentration and the comorbidity index impacted on the daily living activity scales. Karnofsky and Eastern Cooperative Oncologic Group scales were affected by hemoglobin and the comorbidity index. The model hypothesized the hemoglobin concentration at which there was a higher risk of poor Karnofsky and Eastern Cooperative Oncologic Group scales. This hemoglobin concentration depended on comorbidities and on the aggressiveness of the myeloid neoplasm. Conclusion: The geriatric approach improved the sensitivity and specificity ...

Semantic Verbal Fluency test in dementia: Preliminary retrospective analysis.

The Semantic Verbal Fluency (SVF) test entails the generation of words from a given category within a pre-set time of 60 seconds. OBJECTIVES: To verify whether socio-demographic and clinical data of individuals with dementia correlate with the performance on the SVF test and to ascertain whether differences among the criteria of number of answers, clusters and data spread over the intervals, predict clinical results. METHODS: This was a retrospective study of 49 charts of demented patients classified according to the Clinical Dementia Rating (CDR) scale. We correlated education, age and gender, as well as CDR and Mini-Mental State Exam (MMSE) scores with the number of answers, clustering and switching distributed over four 15-second intervals on the SVF test. RESULTS: The correlation between number of answers and quartiles was weak (r=0.407, p=0.004; r=0.484, p< 0.001) but correlation between the number of clusters and responses was strong (r=0.883, p< 0.001). The number of items on the SVF was statistically significant with MMSE score (p=0.01) and there was a tendency for significance on the CDR (p=0.06). The results indicated little activity regarding what we propose to call cluster recalling in the two groups. DISCUSSION: The SVF test, using number of items generated, was found to be more effective than classic screening tests in terms of speed and ease of application in patients with CDR 2 and 3.

A Fluência Verbal Semântica (FVS) requer a geração de palavras de determinada categoria, num tempo pré-fixado de 60 segundos. OBJETIVOS: Verificar se os dados sociodemográficos e clínicos de indivíduos com demências se correlacionam com a FVS; apontar possíveis diferenças entre critérios de número de respostas, agrupamentos e dados distribuídos nos intervalos predizem resultados clínicos. MÉTODOS: Este é um estudo retrospectivo de 49 prontuários de pacientes com demência, classificados de acordo com a escala de estadiamento de demência (Clinical Dementia Rating-CDR). Foram correlacionados os dados de educação, idade e gênero e CDR e Mini-Exame do Estado Mental (MEEM) ao número de respostas, agrupamentos e mudanças de critério (switchings) gerados, em quatro intervalos de 15 segundos. RESULTADOS: As correlações entre número de respostas, quartis e entre número de respostas e de quartis foram baixas (r=0.407, p=0.004; r=0.484, p< 0.001); porém, a correlação foi alta entre número de agrupamentos e de respostas (r=0.883, p< 0.001). O número de itens gerados na SVF foi estatisticamente significante com o MMSE (p=0.01) e houve tendência à significância no CDR (p=0.06). Os resultados indicaram pouca atividade daquilo que chamamos de cluster recalling nos dois grupos. DISCUSSÃO: A FVS com o critério de itens gerados pode ser considerado instrumento clínico vantajoso em relação às varreduras clássicas, em pacientes com CDR 2 e 3, pela rapidez e facilidade de aplicação.

Antifungal activity of lectins against yeast of vaginal secretion

Lectins are carbohydrate-binding proteins of non-imune origin. This group of proteins is distributed widely in nature and they have been found in viruses, microorganisms, plants and animals. Lectins of plants have been isolated and characterized according to their chemical, physical-chemical, structural and biological properties. Among their biological activities, we can stress its fungicidal action. It has been previously described the effect of the lectins Dviol, DRL, ConBr and LSL obtained from the seeds of leguminous plants on the growth of yeasts isolated from vaginal secretions. In the present work the experiments were carried out in microtiter plates and the results interpreted by both methods: visual observations and a microplate reader at 530nm. The lectin concentrations varied from 0.5 to 256µg/mL, and the inoculum was established between 65-70% of trammitance. All yeast samples isolated from vaginal secretion were evaluated taxonomically, where were observed macroscopic and microscopic characteristics to each species. The LSL lectin did not demonstrate any antifungal activity to any isolate studied. The other lectins DRL, ConBr and DvioL, showed antifungal potential against yeast isolated from vaginal secretion. These findings offering offer a promising field of investigation to develop new therapeutic strategies against vaginal yeast infections, collaborating to improve women's health.

Whistle variability in South Atlantic spinner dolphins from the Fernando de Noronha archipelago off Brazil.

A series of quali- and quantitative analyses were conducted to evaluate the variability of spinner dolphin whistles from the Fernando de Noronha Archipelago off Brazil. Nine variables were extracted from each whistle contour, and the whistle contours shapes were classified into the seven categories described in Driscoll (1995). The analysis showed mean beginning and ending frequencies values of 10.78 and 12.74 kHz, respectively. On average, whistle duration was relatively short, with mean values around 0.495 s (N=702). Comparative analyses were also conducted to investigate the relationship between the obtained results and those presented in previous studies. When comparing averages, the results of the study of Oswald et al.(2003) in the Tropical Eastern Pacific (TEP) presented less significant differences in relation to this study; only whistle duration differed significantly between both works. The results of multivariate classification tests also pointed TEP population as the closest related to the population studied here. The similarities between such disjunct populations might be attributed to a more recent isolation event (the closing of the Panama Isthmus) than the divergence that has driven North and South Atlantic populations apart.

Prospecção de leveduras em secreção vaginal e correlação com hemograma e dosagem de glicose / Prospection of yeasts in vaginal secretion and correlation with hemograma and dosage of glucose

No período compreendido entre outubro de 2003 e agosto de 2004 foram realizadas coletas de secreção vaginal para exame micológico em 146 mulheres: 12 grávidas, 11 com sintomas e 1 sem sintomas; 134 não grávidas, 117 com sintomas e 17 sem sintomas de levedurose vaginal, atendidas no laboratório de ginecologia do Centro de Saúde Manuel Caldas de Araújo, Cidade do PAulista - PE. Em 60% das amostras de secreção vaginal foram detectadas leveduras ao exame direto e foi obtida cultura. Em 27% não foram observadas estruturas fúngicas ao exame direto e cultura não foi obtida. Em 13% foram observadas estruturas fúngicas ao exame direto e cultura não foi obtida. Foram isoladas leveduras pertencentes aos gêneros Candida (82%), Trichosporon (9%), Rhodotorula (8%) e Kloeckera (1%). Através da análise estatística o número de hemácias foi a única variável no hemograma que demonstrou correlação com a presença de leveduras na secreção vaginal.

Semantic Verbal Fluency test in dementia: preliminary retrospective analysis / Teste de Fluência Verbal Semântica nas demências: análise preliminar retrospectiva

Abstract ­ TheSemantic Verbal Fluency (SVF) test entails the generation of words from a given category within a pre-set time of 60 seconds. Objectives: To verify whether socio-demographic and clinical data of individuals with dementia correlate with the performance on the SVF test and to ascertain whether differences among the criteria of number of answers, clusters and data spread over the intervals, predict clinical results. Methods: This was a retrospective study of 49 charts of demented patients classified according to the Clinical Dementia Rating (CDR) scale. We correlated education, age and gender, as well as CDR and Mini-Mental State Exam (MMSE) scores with the number of answers, clustering and switching distributed over four 15-second intervals on the SVF test. Results: The correlation between number of answers and quartiles was weak (r=0.407, p=0.004; r=0.484, p<0.001) but correlation between the number of clusters and responses was strong (r=0.883, p<0.001). The number of items on the SVF was statistically significant with MMSE score (p=0.01) and there was a tendency for significance on the CDR (p=0.06). The results indicated little activity regarding what we propose to call cluster recalling in the two groups. Discussion: The SVF test, using number of items generated, was found to be more effective than classic screening tests in terms of speed and ease of application in patients with CDR 2 and 3.

Resumo ­ A Fluência Verbal Semântica (FVS) requer a geração de palavras de determinada categoria, num tempo pré-fixado de 60 segundos. Objetivos: Verificar se os dados sociodemográficos e clínicos de indivíduos com demências se correlacionam com a FVS; apontar possíveis diferenças entre critérios de número de respostas, agrupamentos e dados distribuídos nos intervalos predizem resultados clínicos. Métodos: Este é um estudo retrospectivo de 49 prontuários de pacientes com demência, classificados de acordo com a escala de estadiamento de demência (Clinical Dementia Rating-CDR). Foram correlacionados os dados de educação, idade e gênero e CDR e Mini-Exame do Estado Mental (MEEM) ao número de respostas, agrupamentos e mudanças de critério (switchings) gerados, em quatro intervalos de 15 segundos. Resultados: As correlações entre número de respostas, quartis e entre número de respostas e de quartis foram baixas (r=0.407, p=0.004; r=0.484, p<0.001); porém, a correlação foi alta entre número de agrupamentos e de respostas (r=0.883, p<0.001). O número de itens gerados na SVF foi estatisticamente significante com o MMSE (p=0.01) e houve tendência à significância no CDR (p=0.06). Os resultados indicaram pouca atividade daquilo que chamamos de cluster recalling nos dois grupos. Discussão: A FVS com o critério de itens gerados pode ser considerado instrumento clínico vantajoso em relação às varreduras clássicas, em pacientes com CDR 2 e 3, pela rapidez e facilidade de aplicação.

Dermatomicoses e enteroparasitoses em escolares da comunidade de Brasília Teimosa, Recife-PE, Brasil / Dermatomycosis and enteroparasitosis in students of the Brasília Teimosa community, Recife-PE, Brasil

A detecção de dermatomicoses e de enteroparasitoses foi verificada em escolares da Comunidade de Brasília Teimosa,Recife-PE, Brasil, no período de janeiro a dezembro de 2000. Foram avaliados 1063 escolares dos quais 100 foram selecionados por apresentarem lesões sugestivas de dermatomicoses e desses foram solicitadas amostras coprológicas. Entre os escolares selecionado, 61% são do sexo masculino com faixa etária entre 3 a 14 anos e 39%...