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Cryptococcus neoformans is a lethal fungus that primarily affects the respiratory system and the central nervous system. One of the main virulence factors is the capsule, constituted by the polysaccharides glucuronoxylomannan (GXM) and glucuronoxylomanogalactan (GXMGal). Polysaccharides are immunomodulators. One of the target cell populations for modulation are macrophages, which are part of the first line of defense and important for innate and adaptive immunity. It has been reported that macrophages can be modulated to act as a "Trojan horse," taking phagocytosed yeasts to strategic sites or having their machinery activation compromised. The scarcity of information on canine cryptococcosis led us to assess whether the purified capsular polysaccharides from C. neoformans would be able to modulate the microbicidal action of macrophages. In the present study, we observed that the capsular polysaccharides, GXM, GXMGal, or capsule total did not induce apoptosis in the DH82 macrophage cell line. However, it was possible to demonstrate that the phagocytic activity was decreased after treatment with polysaccharides. In addition, recovered yeasts from macrophages treated with polysaccharides after phagocytosis could be cultured, showing that their viability was not altered. The polysaccharides led to a reduction in ROS production and the mRNA expression of IL-12 and IL-6. We observed that GXMGal inhibits MHC class II expression and GXM reduces ERK phosphorylation. In contrast, GXMGal and GXM were able to increase the PPAR-γ expression. Furthermore, our data suggest that capsular polysaccharides can reduce the microbicidal activity of canine macrophages DH82.

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Although clean energy generation utilizing the Oxygen Reduction Reaction (ORR) can be considered a promising strategy, this approach remains challenging by the dependence on high loadings of noble metals, mainly Platinum (Pt). Therefore, efforts have been directed to develop new and efficient electrocatalysts that could decrease the Pt content (e.g., by nanotechnology tools or alloying) or replace them completely in these systems. The present investigation shows that high catalytic activity can be reached towards the ORR by employing 1.8 ± 0.7 nm Ir nanoparticles (NPs) deposited onto MnO2 nanowires surface under low Ir loadings (1.2 wt.%). Interestingly, we observed that the MnO2-Ir nanohybrid presented high catalytic activity for the ORR close to commercial Pt/C (20.0 wt.% of Pt), indicating that it could obtain efficient performance using a simple synthetic procedure. The MnO2-Ir electrocatalyst also showed improved stability relative to commercial Pt/C, in which only a slight activity loss was observed after 50 reaction cycles. Considering our findings, the superior performance delivered by the MnO2-Ir nanohybrid may be related to (i) the significant concentration of reduced Mn3+ species, leading to increased concentration of oxygen vacancies at its surface; (ii) the presence of strong metal-support interactions (SMSI), in which the electronic effect between MnOx and Ir may enhance the ORR process; and (iii) the unique structure comprised by Ir ultrasmall sizes at the nanowire surface that enable the exposure of high energy surface/facets, high surface-to-volume ratios, and their uniform dispersion.

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Ao longo dos anos o câncer infanto-juvenil evoluiu de uma doença inevitavelmente fatal para uma condição crônica de saúde com risco de vida. A redução da taxa de mortalidade em decorrência da doença, se deu devido ao avanço contínuo da medicina e da eficácia dos tratamentos disponíveis. Os tipos de câncer mais prevalentes na infância são a leucemia e o linfoma, que podem levar até 3 anos de quimioterapia, variando entre fases mais e menos intensas. O extenso período do tratamento pode ser desgastante para o paciente e para o núcleo familiar, levando em consideração o número de consultas, internações, os sintomas que a própria doença pode causar e os efeitos colaterais advindos das medicações. Para avaliar o impacto que esses agravantes podem ter na qualidade de vida relacionada à saúde (QVRS) do paciente e da família, são necessárias pesquisas focadas na percepção e relato do próprio indivíduo (PROs). Desta forma, o objetivo do presente estudo foi identificar o impacto que a leucemia/linfoma e seu tratamento nas crianças/adolescentes podem causar na qualidade de vida dos pais/responsáveis e na família. Foi realizado um estudo transversal com amostra não probabilística de 52 famílias com crianças/adolescentes em tratamento para leucemia ou linfoma no Hospital das Clínicas da UFMG, Belo Horizonte, Brasil. Os responsáveis responderam sobre questões socioeconômicas e demográficas, e perguntas específicas da doença e do tratamento. O instrumento escolhido para mensurar o impacto da leucemia ou linfoma na QVRS dos familiares, foi a versão brasileira do PedsQLTM Family Impact Module. Foram realizadas análise descritiva dos dados e regressão logística bivariada e múltipla (IC 95%, P<0,05), usando o programa SPSS. As mães foram as principais respondentes responsáveis pelo paciente em tratamento (78,8%), a renda familiar mensal de 51,9% dos participantes era de até 1 salário mínimo e 65,4% compartilhavam a moradia com até 4 pessoas. Das crianças/adolescentes 88,5% estavam em tratamento para leucemia e 42,3% eram do sexo feminino. A análise múltipla revelou que a mãe, quando responsável pelo paciente em tratamento, possuía 13,9 vezes mais chances de apresentar maior impacto negativo na QVRS do que quando o responsável era representado por outra pessoa (OR=13,89 95%IC: 1,39-138,92; p=0,025). Outras variáveis independentes não estiveram associadas com impacto na QVRS das famílias. Considerando o autorrelato dos pais/responsáveis sobre o funcionamento parental, o maior impacto negativo foi relacionado com a preocupação (média=46,2; DP±25,56). Os domínios sobre funcionamento familiar "Atividades Cotidianas" e "Relacionamentos Familiares" apresentaram médias 64,4 (DP±36,60) e 84,4 (DP±25,25) respectivamente, representando maior comprometimento relacionado às atividades desenvolvidas no dia-a-dia, do que nos relacionamentos. Conclui-se que o câncer infantil e seu tratamento repercutem na QVRS da família. A mãe quando principal responsável pela criança/adolescente com câncer, apresenta mais chances de perceber o impacto negativo que a doença e o tratamento podem trazer ao núcleo familiar.

Throughout the years, pediatric cancer has evolved from a fatal disease to a chronic health condition with life threat. The reduction in the disease's mortality rate is due to the continuous advances in the field of medicine and the efficiency of available treatments. The most prevalent types of children's cancer are leukemia and lymphoma, each require until 3 years of chemotherapy varying in intensity throughout different phases. The lengthy treatment can be wearing to the patient and their families, considering the number of medical appointments, hospitalizations, and symptoms: adverse from the medication, and from the disease itself. To evaluate the impact that the aggravating factors can have on the patient's and related families' Health-Related Quality of Live (HRQoL) research focused on self-report is required. As so this study's objective is to identify the psychosocial impact that leukemia/lymphoma and its treatment in children/adolescents can cause in the parents/guardians and family's lives. A cross-sectional study was conducted with a non-probability sample of 52 families with children/adolescents under treatment for leukemia or lymphoma at a reference hospital in Belo Horizonte, Brazil. The parents/guardians answered questions about their socioeconomical and demographical status and questions related to the disease, and its treatments. The Brazilian version of PedsQLTM Family Impact Module was also used to measure the possible impact of leukemia and lymphoma on the HRQoL of families. The descriptive data analysis, bivariate logistics regression, and multiple logistics regression was made with the SPSS software (IC 95%, p<0,05). In most of the studied subjects the mother was the main guardian of the patient (78.8%), the monthly income of 51.9% of the families was 1 minimum wage salary and 65,4% shared their home with up to 4 people. From the children/adolescents 88,5% were being treated for leukemia and 42,3% were female. The multiple analysis that when the mother was the person responsible for the patient there was a chance 13,9 times higher of a greater negative impact to the HRQoL when compared to when the guardian was a different person (OR=13,89; 95%IC: 1,39-138,92; p=0,025). Other independent variables where not associated with the impact on the HRQoL of families. Considering the parents/guardians proxy-report on the parental function, the biggest negative impact was related to worry (mean=46,2; SD±25,56). The family function domains "Daily Activities" and "Family Relationships" had means of 64,4 (SD±36,60) and 84,4 (SD±25,25) respectively, exhibiting a greater impairment in the daily activities than in relationships. It is concluded that childhood cancer and its treatment affect the family's HRQoL. When the mother is primarily responsible for the child/adolescent with cancer, she is more likely to perceive the negative impact that the disease and its treatment can bring to the family nucleus.

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BACKGROUND: Coexistence of cancer and COVID-19 is associated with worse outcomes. However, the studies on cancer-related characteristics associated with worse COVID-19 outcomes have shown controversial results. The objective of the study was to evaluate cancer-related characteristics associated with invasive mechanical ventilation use or in-hospital mortality in patients with COVID-19 admitted to intensive care unit (ICU). METHODS: We designed a cohort multicenter study including adults with active cancer admitted to ICU due to COVID-19. Seven cancer-related characteristics (cancer status, type of cancer, metastasis occurrence, recent chemotherapy, recent immunotherapy, lung tumor, and performance status) were introduced in a multilevel logistic regression model as first-level variables and hospital was introduced as second-level variable (random effect). Confounders were identified using directed acyclic graphs. RESULTS: We included 274 patients. Required to undergo invasive mechanical ventilation were 176 patients (64.2%) and none of the cancer-related characteristics were associated with mechanical ventilation use. Approximately 155 patients died in hospital (56.6%) and poor performance status, measured with the Eastern Cooperative Oncology Group (ECOG) score was associated with increased in-hospital mortality, with odds ratio = 3.54 (1.60-7.88, 95% CI) for ECOG =2 and odds ratio = 3.40 (1.60-7.22, 95% CI) for ECOG = 3 to 4. Cancer status, cancer type, metastatic tumor, lung cancer, and recent chemotherapy or immunotherapy were not associated with in-hospital mortality. CONCLUSIONS: In patients with active cancer and COVID-19 admitted to ICU, poor performance status was associated with in-hospital mortality but not with mechanical ventilation use. Cancer status, cancer type, metastatic tumor, lung cancer, and recent chemotherapy or immunotherapy were not associated with invasive mechanical ventilation use or in-hospital mortality.

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Introdução: O cisto radicular é o cisto odontogênico mais comum, com uma prevalência aproximada de 60%. Esta lesão é geralmente observada por radiografias de rotina ou a partir de uma tumefação local, mas basicamente é assintomática, com crescimento lento e se encontra vinculada à um dente desvitalizado, possuindo predileção por indivíduos do sexo masculino com faixa etária se enquadrando entre a terceira e quarta décadas de vida. Seu tratamento pode ser cirúrgico ou não, variando de acordo com a dimensão e localização da lesão. Relato de caso: Paciente feminino, 66 anos, com presença de cisto radicular em região anterior de maxila, vinculada ao elemento dentário 22. A mesma foi submetida à enucleação cirúrgica associada à curetagem local para remoção e diagnóstico adequado da lesão, a partir da análise anatomopatológica do espécime. Considerações finais: Por ser uma patologia muito comum nos maxilares, é pertinente que o profissional conheça suas características essenciais para o correto diagnóstico, bem como os tratamentos mais adequados para cada paciente e que, apesar de somente a realização do tratamento endodôntico ser uma opção, a ausência da avaliação histológica da lesão restringe o correto diagnóstico desta patologia... (AU)

Introduction: Radicular cysts are the most common odontogenic cyst, with a prevalence of approximately 60%. This lesion is usually observed by routine radiographs or presence of local swelling, but it is basically asymptomatic, with slow growth and it is associated with the root apex of a nonvital tooth, with a predilection for male individuals with ages ranging between the third and fourth decades of life. Its treatment can be surgical or not, varying according to the size and location of the lesion. Case report: A 66 year old female, with the presence of a radicular cyst in the anterior region of the maxilla, associated to the dental element 22 was evaluated. She was underwent surgical enucleation associated with local curettage for removal and proper diagnosis of the lesion, based on the anatomopathological analysis of the specimen. Final considerations: As it is a very common pathology in the jaws, it is pertinent that the professional knows its essential characteristics for the correct diagnosis, as well as the most appropriate treatments for each patient and that, although only endodontic treatment is an option, the absence of histological evaluation of the lesion restricts the correct diagnosis of this pathology... (AU)

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Introdução: A comunicação buco-sinusal é tida como uma comunicação entre a cavidade bucal e o seio maxilar, cuja qual possui variadas etiologias, sendo a mais comum a extração de dentes posteriores superiores, pela proximidade de seus ápices radiculares com o assoalho do seio maxilar. O diagnóstico é obtido a partir da combinação de anamnese, exame físico e exames imaginológicos, podendo ser por meio de radiografias ou tomografia. Há diversas abordagens para o tratamento, incluindo o uso de membranas de Fibrina Rica em Plaqueta e Leucócitos para obstrução local da comunicação. O objetivo deste trabalho é relatar e discutir o emprego de membrana de Fibrina Rica em Plaqueta e Leucócitos para manejo de uma comunicação buco-sinusal associado à reconstrução de tábua óssea vestibular com Stick Bone. Relato de caso: Mulher, 61 anos, compareceu ao atendimento odontológico relatando incômodo na região do dente 16 e história de extração do mesmo há cerca de 8 meses. Ao exame intra-oral, observou-se a presença área hiperemiada no alvéolo da região da extração e, ao exame tomográfico, foi observada solução de continuidade no assoalho do seio maxilar, sugerindo comunicação buco-sinusal associado à perda de tábua óssea vestibular local. Considerações Finais: Portanto, o uso destas membranas são adequados para obstrução destas comunicações, sendo um plugue adequado devido às suas propriedades adesivas na área de perfuração, não estar vinculado a nenhuma reação imunológica, preparação fácil e rápida, altamente biocompatível, baixo custo, prevenção da profundidade do sulco vestibular e não apresentar nenhum risco de infecção... (AU)

Introduction: The oroantral communication is a communication between the oral cavity and the maxillary sinus, which has different etiologies, being the most common the extraction of upper posterior teeth, due to the proximity of their root apexes to the floor of the maxillary sinus. Diagnosis is obtained from a combination of anamnesis, physical examination and imaging exams, which may be through radiographs or tomography. There are several approaches to treatment, including the use of Leukocyte- and Platelet-RichFibrin membranes for local obstruction of communication. The aim of this work is to report and discuss the use of a Leukocyte- and Platelet-Rich Fibrin membrane for the management of oroantral communication associated with the reconstruction of the buccal bone plate with Stick Bone. Case report: A 61-year-old woman reported discomfort in the region of right maxillary first molar and a history of extraction of the same for about 8 months. The intraoral evaluation revealed the presence of a hyperemic area in the alveolus of the extraction region, and the tomographic examination revealed an oroantral communication associated with loss of local vestibular bone plate. Final considerations: Therefore, the use of these membranes are suitable for obstructing these communications, being a propper plug due to its adhesive properties in the perforation area, not being associated to any immunological reaction, easy and fast preparation, highly biocompatible, low cost, prevention of the depth of the vestibular sulcus and do not present any risk of infection... (AU)

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AIM: To estimate the incidence rates of surgical site infection and identify the independent effect of perioperative hypothermia on the incidence of this type of infection in patients undergoing abdominal surgery. BACKGROUND: Around the world, surgical site infection is a frequent complication in surgical patients, mainly causing increased morbidity and mortality rates and health service costs. DESIGN: A prospective cohort study. METHODS: The 484 patients were recruited from a large private philanthropic hospital in the state of São Paulo, Brazil, from July 2016 to May 2017. Crude and adjusted models were constructed for the hypothermia indicators to assess the effect of this exposure on surgical site infection. RESULTS: The incidence rate of surgical site infection was 20.25% (n = 98). The attributable fraction to exposed to hypothermia was >40%. A greater probability of developing surgical site infection (relative risk = 1.89) was found for patients who experienced body temperatures <36.0°C (from entry time into the operating room until the end of the surgery) for more than five hypothermic episodes or longer than 75 min. CONCLUSION: Perioperative hypothermia was an independent risk factor for surgical site infection. SUMMARY STATEMENT: What is already known about this topic? Around the world, surgical site infection is a complication that leads to damage to the patient and increased costs for the health services. Despite recent advances in surgical techniques, surgical site infection remains one of the most frequent complications in abdominal surgery. Perioperative hypothermia can increase the incidence rates of surgical site infection. There is evidence that perioperative hypothermia is associated with surgical site infection in abdominal surgery, but most studies were conducted in developed countries using retrospective designs. What this paper adds? Perioperative hypothermia was identified as an independent risk factor for surgical site infection in patients undergoing abdominal surgery. The attributable fraction to the exposed indicated that, if the main exposure of interest (perioperative hypothermia) could be prevented during surgical anaesthetic procedures, more than 40% of surgical site infection cases would be avoided. The classification of the American Society of Anaesthesiologists was independently associated with the surgical site infection and presented a dose-response effect among its categories. Spinal anaesthesia served as an independent protective factor for surgical site infection. The implications of this paper: The health service managers need to be aware of potential cost-savings associated with perioperative hypothermia prevention as a measure to reduce the incidence of surgical site infection. During the perioperative period, health professionals need to implement effective measures to maintain patients' normothermia, promoting improved care and surgical patient safety. In this context, the nurse's role is fundamental. Future research projects using a prospective design and developed to address the reality of developing countries can contribute to the strengthening and consistency of the findings with a view to a global understanding of the surgical site infection problem.

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A obesidade é uma doença crônica e multifatorial com sérias repercussões na saúde. O excesso de peso na infância aumenta o risco de obesidade na adolescência e na vida adulta. A obesidade é uma das principais causas de hipertensão arterial em crianças e adolescentes. No sexo feminino, os problemas ginecológicos relacionados com a obesidade incluem as desordens menstruais e a diminuição da fertilidade na adolescência e na vida adulta. O controle dessa patologia evita a sua evolução para formas crônicas e graves, que acarretaria novos transtornos e consequências para essas jovens. A mudança de hábitos alimentares e a realização de atividade física são a principal linha de tratamento. O tratamento medicamentoso é reservado para portadoras de obesidade grave que apresentam comorbidades associadas e que não respondem às mudanças do estilo de vida. (AU)

Obesity is a chronic and multifactorial disease with serious repercussions on health. Overweight in childhood increases the risk of obesity in adolescence and adulthood. Obesity is one of the main causes of high blood pressure in children and adolescents, among others. In women, gynecological problems related to obesity include menstrual disorders and decreased fertility in adolescence and adulthood. The control of this pathology prevents its evolution to chronic and severe forms that would cause new disorders and consequences for these young women. The main line of treatment is to change eating habits and encourage physical activity. Drug treatment is reserved for patients with severe obesity, who have associated comorbidities and who do not respond to changes in lifestyle.(AU)

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OBJECTIVE: To depict the clinical presentation and outcomes of a cohort of critically ill patients with esophageal cancer. METHODS: We carried out a multicenter retrospective study that included patients with esophageal cancer admitted to intensive care units with acute illness between September 2009 and December 2017. We collected the demographic and clinical characteristics of all included patients, as well as organ-support measures and hospital outcomes. We performed logistic regression analysis to identify independent factors associated with in-hospital mortality. RESULTS: Of 226 patients included in the study, 131 (58.0%) patients died before hospital discharge. Squamous cell carcinoma was more frequent than adenocarcinoma, and 124 (54.9%) patients had metastatic cancer. The main reasons for admission were sepsis/septic shock and acute respiratory failure. Mechanical ventilation (OR = 6.18; 95%CI 2.86 - 13.35) and metastatic disease (OR = 7.10; 95%CI 3.35 - 15.05) were independently associated with in-hospital mortality. CONCLUSION: In this cohort of patients with esophageal cancer admitted to intensive care units with acute illness, the in-hospital mortality rate was very high. The requirement for invasive mechanical ventilation and metastatic disease were independent prognostic factors and should be considered in discussions about the short-term outcomes of these patients.

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Leishmaniasis is an anthropozoonotic disease, and dogs are considered the main urban reservoir of the parasite. Macrophages, the target cells of Leishmania sp., play an important role during infection. Although dogs have a major importance in the epidemiology of the disease, the majority of the current knowledge about Leishmania-macrophage interaction comes from murine experimental models. To assess whether the canine macrophage strain DH82 is an accurate model for the study of Leishmania interaction, we compared its infection by two species of Leishmania (Leishmania infantum and L. amazonensis) with the murine macrophage cell line (RAW264.7). Our results demonstrated that L. amazonensis survival was around 40% at 24 h of infection inside both macrophage cell lines; however, a reduction of 4.3 times in L. amazonensis infection at 48 h post-infection in RAW 264.7 macrophages was observed. The survival index of L. infantum in DH82 canine macrophages was around 3 times higher than that in RAW264.7 murine cells at 24 and 48 h post-infection; however, at 48 h a reduction in both macrophages was observed. Surprisingly at 24 h post-infection, NO and ROS production by DH82 canine cells stimulated with LPS or menadione or during Leishmania infection was minor compared to murine RAW264.7. However, basal arginase activity was higher in DH82 cells when compared to murine RAW264.7 cells. Analysis of the cytokines showed that these macrophages present a different response profile. L. infantum induced IL-12, and L. amazonensis induced IL-10 in both cell lines. However, L. infantum and L. amazonensis also induced TGF-ß in RAW 264.7. CD86 and MHC expression showed that L. amazonensis modulated them in both cell lines. Conversely, the parasite load profile did not show significant difference between both macrophage cell lines after 48 h of infection, which suggests that other mechanisms of Leishmania control could be involved in DH82 cells.

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RESUMO Objetivo: Mostrar o quadro clínico e os desfechos de uma coorte de pacientes críticos com câncer esofágico. Métodos: Conduzimos um estudo multicêntrico retrospectivo que incluiu pacientes com câncer esofágico admitidos a unidades de terapia intensiva em razão de doença aguda entre setembro de 2009 e dezembro de 2017. Colhemos os dados demográficos e as características clínicas de todos os pacientes incluídos, assim como as medidas de suporte a órgãos e os desfechos no hospital. Realizamos uma análise de regressão logística para identificar os fatores associados de forma independente com mortalidade hospitalar. Resultados: Dentre os 226 pacientes incluídos no estudo, 131 (58,0%) faleceram antes de receber alta hospitalar. O carcinoma espinocelular foi mais frequente do que o adenocarcinoma, e 124 (54,9%) pacientes tinham câncer metastático. As principais razões para admissão foram sepse/choque séptico e insuficiência respiratória aguda. Uso de ventilação mecânica (RC = 6,18; IC95% 2,86 - 13,35) e doença metastática (RC = 7,10; IC95% 3,35 - 15,05) tiveram associação independente com mortalidade hospitalar. Conclusão: Nesta coorte de pacientes com câncer esofágico admitidos à unidades de terapia intensiva em razão de doença aguda, a taxa de mortalidade hospitalar foi muito elevada. A necessidade de utilizar ventilação mecânica invasiva e a presença de doença metastática foram fatores independentes de prognóstico e devem ser levados em conta nas discussões a respeito dos desfechos destes pacientes em curto prazo.

ABSTRACT Objective: To depict the clinical presentation and outcomes of a cohort of critically ill patients with esophageal cancer. Methods: We carried out a multicenter retrospective study that included patients with esophageal cancer admitted to intensive care units with acute illness between September 2009 and December 2017. We collected the demographic and clinical characteristics of all included patients, as well as organ-support measures and hospital outcomes. We performed logistic regression analysis to identify independent factors associated with in-hospital mortality. Results: Of 226 patients included in the study, 131 (58.0%) patients died before hospital discharge. Squamous cell carcinoma was more frequent than adenocarcinoma, and 124 (54.9%) patients had metastatic cancer. The main reasons for admission were sepsis/septic shock and acute respiratory failure. Mechanical ventilation (OR = 6.18; 95%CI 2.86 - 13.35) and metastatic disease (OR = 7.10; 95%CI 3.35 - 15.05) were independently associated with in-hospital mortality. Conclusion: In this cohort of patients with esophageal cancer admitted to intensive care units with acute illness, the in-hospital mortality rate was very high. The requirement for invasive mechanical ventilation and metastatic disease were independent prognostic factors and should be considered in discussions about the short-term outcomes of these patients.

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We develop herein plasmonic-catalytic Au-IrO2 nanostructures with a morphology optimized for efficient light harvesting and catalytic surface area; the nanoparticles have a nanoflower morphology, with closely spaced Au branches all partially covered by an ultrathin (1 nm) IrO2 shell. This nanoparticle architecture optimizes optical features due to the interactions of closely spaced plasmonic branches forming electromagnetic hot spots, and the ultra-thin IrO2 layer maximizes efficient use of this expensive catalyst. This concept was evaluated towards the enhancement of the electrocatalytic performances towards the oxygen evolution reaction (OER) as a model transformation. The OER can play a central role in meeting future energy demands but the performance of conventional electrocatalysts in this reaction is limited by the sluggish OER kinetics. We demonstrate an improvement of the OER performance for one of the most active OER catalysts, IrO2, by harvesting plasmonic effects from visible light illumination in multimetallic nanoparticles. We find that the OER activity for the Au-IrO2 nanoflowers can be improved under LSPR excitation, matching best properties reported in the literature. Our simulations and electrocatalytic data demonstrate that the enhancement in OER activities can be attributed to an electronic interaction between Au and IrO2 and to the activation of Ir-O bonds by LSPR excited hot holes, leading to a change in the reaction mechanism (rate-determinant step) under visible light illumination.

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BACKGROUND: Surgical site infection (SSI) remains one of the most frequent complications in abdominal surgery, and hyperglycemia prevention is recommended as a measure to reduce this type of infection. The aims of this study were to estimate the incidence of SSI and to identify the effect of perioperative hyperglycemia on the incidence of this type of infection in patients undergoing abdominal surgery. METHODS: We enrolled 484 abdominal surgery patients ≥ 18 years of age, recruited between July 2016 and May 2017. Data were collected through structured interviews and patient assessments in the perioperative period and at the surgical outpatient clinic (30th day after surgery). Crude and adjusted models were built to identify the effect of hyperglycemia on SSI. RESULTS: The incidence rate of SSI was 20.25%. The attributable fraction for patients exposed to hyperglycemia was >60%. In the multivariable analysis, patients with hyperglycemia, at the end of the surgery and 12 hours later, were more likely to develop this type of infection (relative risk = 1.89 and 2.17, respectively). CONCLUSIONS: Perioperative hyperglycemia was identified as an independent risk factor for SSI. The evidence generated reinforces the importance of proper glycemic control management in the perioperative period for the prevention of SSI.

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Human African trypanosomiasis (HAT) caused by the protozoan Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, and transmitted by the tsetse fly (genus Glossina), affects 36 Sub-Saharan African countries with considerable public health impact. Despite approximately 15,000 infected individuals and 70 million at risk, in recent years the World Health Organization has mentioned removal of HAT from the list of Neglected Tropical Diseases by 2020, due to the decrease in cases over the last two decades. When untreated, the disease presents high lethality rates and the available treatments are complicated to administer, highly toxic, and do not guarantee cure, especially in the advanced stages of the disease. Further, there is no prospect for vaccine development in the near future. The present review compiles information on the history of the clinical aspects of HAT, as well as its epidemiology, diagnosis, therapy, and prophylaxis, as well as updating information on the current panorama and perspectives regarding the disease.

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Cryptococcosis is a systemic fungal infection caused by Cryptococcus neoformans. In immunocompetent patients, cryptococcal infection is often confined to the lungs. In immunocompromised individuals, C. neoformans may cause life-threatening illness, either from novel exposure or through reactivation of a previously acquired latent infection. For example, cryptococcal meningitis is a severe clinical disease that can manifest in people that are immunocompromised due to AIDS. The major constituents of the Cryptococcus polysaccharide capsule, glucuronoxylomannan (GXM), and galactoxylomannan (GalXM), also known as glucuronoxylomanogalactan (GXMGal), are considered the primary virulence factors of Cryptococcus. Despite the predominance of GXM in the polysaccharide capsule, GalXM has more robust immunomodulatory effects on host cellular immunity. This review summarizes current knowledge regarding host-Crytococcus neoformans interactions and the role of capsular polysaccharides in host immunomodulation. Future studies will likely facilitate a better understanding of the mechanisms involved in antigenic recognition and host immune response to C. neoformans and lead to the development of new therapeutic pathways for cryptococcal infection.

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Minthostachys verticillata essential oil (EO) is a natural product that reports immunomodulatory effects on human T cells as well as anti-inflammatory activity. Bovine mastitis is a worldwide disease, mainly caused by bacteria, affecting milk quality and yield, leading to high economic losses. Environmental pathogens, as Enterococcus faecium, are implicated in the disease. Antibiotic therapy is adequate, although it can leave residues in milk, causing problems in human health. The search of immunomodulatory substances for bovine mastitis treatment is a promising alternative strategy. The aim of this study was to characterize the effect of M. verticillata EO on macrophage phagocytosis and evaluate its immunomodulatory and protective effects in mice challenged with E. faecium. The results showed that EO activated macrophage phagocytosis mechanisms inducing reactive oxygen species production. Moreover, EO modulated the innate immune response in mammary glands of female Balb/c mice challenged with E. faecium decreasing the infiltration of polymorphonuclear neutrophils and IL-1ß and TNF-α mRNA expression. In addition, EO increased the expression of IL-10 in the last hours of infection. Treatment with EO did not increase the number of activated CD4+ or CD8+ T cells or the production of specific antibodies. These results suggest that EO play an important role in helping to resolve the infection in the first hours without activating adaptive immunity. In addition, a marked decrease of the bacterial count in the glands of mice treated with EO was observed. A natural product such as M. verticillata EO could have a potential use to control bovine mastitis.

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B-1 cells can directly and indirectly influence the immune response. These cells are known to be excellent producers of natural antibodies and can secrete a variety of immunomodulatory molecules. They are also able to differentiate into B-1 cell-derived phagocytes (B-1CDP). B-1 cells can modulate macrophages to become less effective, and B-1CDP cells are more susceptible in infection models. In this work, we investigated the microbicidal ability of these cells in Trypanosoma cruzi infection in vitro. The results show that macrophages from BALB/c mice are more susceptible to infection than macrophages from XID mice. The resistance observed in macrophages from XID mice was abolished in the presence of B-1 cells, and this event seems to be associated with IL-10 production by B-1 cells, which may have contributed to the decrease of NO production. Additionally, B-1CDP cells were more permissive to intracellular T. cruzi infection than peritoneal macrophages. These findings strongly suggest that B-1 cells and B-1CDP cells have a potential role in the persistence of the parasite in host cells.

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Cryptococcus neoformans is an opportunistic fungus that can cause lethal brain infections in immunosuppressed individuals. Infection usually occurs via the inhalation of a spore or desiccated yeast which can then disseminate from the lung to the brain and other tissues. Dissemination and disease is largely influence by the production of copious amounts of cryptococcal polysaccharides, both which are secreted to the extracellular environment or assembled into a thick capsule surrounding the cell body. There are two important polysaccharides: glucuronoxylomannan (GXM) and galactoxylomannan, also called as glucuronoxylomanogalactan (GXMGal or GalXM). Although GXM is more abundant, GalXM has a more potent modulatory effect. In the present study, we show that GalXM is a potent activator of murine dendritic cells, and when co-cultured with T cells, induces a Th17 cytokine response. We also demonstrated that treating mice with GalXM prior to infection with C. neoformans protects from infection, and this phenomenon is dependent on IL-6 and IL-17. These findings help us understand the immune biology of capsular polysaccharides in fungal pathogenesis.

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Among the several classes of chemical reactions, the green oxidation of organic compounds has emerged as an important topic in nanocatalysis. Nonetheless, examples of truly green oxidations remain scarce due to the low activity and selectivity of reported catalysts. In this paper, we present an approach based on the optimization of both the support material and the active phase to achieve superior catalytic performances towards green oxidations. Specifically, our catalysts consisted of ultrasmall Au NPs deposited onto MnO2 nanoflowers. They displayed hierarchical morphology, large specific surface areas, ultrasmall and uniform Au NPs sizes, no agglomeration, strong metal-support interactions, oxygen vacancies, and Auδ+ species at their surface. These features led to improved performances towards the green oxidations of CO, benzene, toluene, o-xylene, glucose, and fructose relative to the pristine MnO2 nanoflowers, commercial MnO2 decorated with Au NPs, and other reported catalysts. We believe that the catalytic activities, stabilities, and mild/green reaction conditions described herein for both gas and liquid phase oxidations due to the optimization of both the support and active phase may inspire the development of novel catalytic systems for a wealth of sustainable transformations.

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ntrodução: O câncer é responsável por mais de 12% de todas as causas de morte no mundo. No Brasil, mais de 15% dos pacientes admitidos em unidade de terapia intensiva (UTI) tem um diagnóstico de base de câncer. O câncer de esôfago possui um prognóstico ruim, com taxa de sobrevivência menor que 20% após cinco anos. Entretanto, as características e a evolução de pacientes com câncer de esôfago admitidos em UTI ainda não foi adequadamente estudada. Objetivo: Descrever o perfil dos pacientes com câncer de esôfago admitidos na UTI do A.C.Camargo Cancer Center em um período de 6 anos e identificar fatores de risco relacionados à mortalidade hospitalar destes pacientes, bem como dos subgrupos de pacientes admitidos por causas clínicas ou cirúrgicas de urgência e em pós-operatório (PO) de esofagectomia. Métodos: Estudo de coorte retrospectiva, onde foram coletados dados demográficos, motivos de admissão, estádio do câncer, gravidade à admissão da UTI, complicações relacionadas ao tumor (massa tumoral, fistula, obstrução e sangramento) e não relacionadas (disfunções orgânicas, infecções e complicações cardiovasculares) e mortalidade hospitalar. Uma análise multivariada por regressão logística incluindo variáveis pré-determinadas identificou os fatores independentemente associados à mortalidade hospitalar Resultados: Foram incluídos 272 pacientes, dos quais 100 (36,8%) faleceram à internação hospitalar. Tumores metastáticos (OR = 8,64; IC 95% 3,93-18,96), SAPS 3 (OR = 1,04; IC 95% 1,01-1,06), fibrilação atrial (FA) (OR = 2,95; IC 95% 1,11-7,85) e uso de vasopressor (OR = 2,31; IC 95% 1,03-5,16) foram fatores independentemente associados à mortalidade hospitalar. Dos 119 pacientes admitidos por causas clínicas ou cirurgia de urgência, 71 (59,7%) morreram à internação hospitalar. Os fatores independentemente associados à maior mortalidade hospitalar foram tumores metastáticos (OR = 9,26; IC 95% 2,84-30,21), ventilação mecânica (OR = 3,34; IC 95% 1,04-10,76), e SAPS 3 (OR = 1,03; IC 95% 0,85-1,24). Cento e seis pacientes foram admitidos no PO de esofagectomia, dos quais 17 (16%) não sobreviveram à internação. Deiscência de ferida, pneumonia, infecção de cateter, síndrome coronariana aguda, FA, delirium, uso de vasopressor e terapias de substituição renal foram mais comuns nos pacientes que faleceram. Conclusão: Pacientes com câncer de esôfago admitidos na UTI têm uma alta mortalidade. A presença de metástases, a gravidade inicial, FA e a necessidade de suporte às disfunções orgânicas associam-se à maior mortalidade hospitalar (AU)

Introduction: Cancer is the cause of 12% of deaths worldwide. More than 15% of patients admitted in intensive care units (ICU) in Brazil have a cancer diagnosis. Esophageal cancer has a dismal prognosis, with an overall survival of less than 20% in five years. However, the characteristics and outcomes of esophageal cancer patients admitted in ICU have not been adequately addressed. Objectives: To describe characteristics of esophageal patients admitted at A.C. Camargo Cancer Center during a six-year period, and to identify risk factors associated with hospital mortality in these patients, as well as in patients admitted for medical or urgent surgical reasons, and after esophagectomy. Methods: Retrospective cohort study. We collected demopgraphic data, reasons for admission, cancer status, severity at admission, tumor-related complications (tumor mass, fistula, obstruction and bleeding) and non-related complications (organ dysfunctions, infections and cardiovascular complications). A multivariate logistic regression analysis with a priori included variables identified independent factors associated with hospital mortality. Results: We included 272 patients, 100 (36,8%) of whom died during hospital stay. Metastatic tumors (OR = 8.64, CI 95% 3.93-18.96), SAPS 3 (OR = 1.04, CI 95% 1.01-1.06), atrial fibrillation (AF) (OR = 2.95, CI 95% 1.11-7.85) and vasopressor (OR = 2.31, CI 95% 1.03-5.16) were independently associated with hospital mortality. We included 119 patients admitted for medical or urgent surgical reasons, 71 (59,7%) of whom died. Metastatic tumors (OR = 9.26, CI 95% 2.84-30.21), mechanical ventilation (OR = 3.34, CI 95% 1.04-10.76) and SAPS 3 (OR = 1.03, CI 95% 1.07-1.12) were associated with hospital mortality. We included 106 patients after esophagectomy, 17 (16%) of whom died. Dehiscence, pneumonia, acute coronary syndrome, AF, delirium, vasopressor and renal replacement therapy were more common in patients who died. Conclusion: Esophahgeal cancer patients admitted in ICU have a high hospital mortality rate. Metastasis, initial severity, AF and organ-dysfunction support measures are associated with hospital mortality (AU)

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