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AIMS: To evaluate whether a strategy of double-dose influenza vaccination during hospitalization for an acute coronary syndrome (ACS) compared with standard-dose outpatient vaccination (as recommended by current guidelines) would further reduce the risk of major cardiopulmonary events. METHODS AND RESULTS: Vaccination against Influenza to Prevent cardiovascular events after Acute Coronary Syndromes (VIP-ACS) was a pragmatic, randomized, multicentre, active-comparator, open-label trial with blinded outcome adjudication comparing two strategies of influenza vaccination following an ACS: double-dose quadrivalent inactivated vaccine before hospital discharge vs. standard-dose quadrivalent inactivated vaccine administered in the outpatient setting 30 days after randomization. The primary outcome was a hierarchical composite of all-cause death, myocardial infarction, stroke, unstable angina, hospitalization for heart failure, urgent coronary revascularization, and hospitalization for respiratory causes, analysed by the win ratio method. Patients were followed for 12 months. During two influenza seasons, 1801 participants were included at 25 centres in Brazil. The primary outcome was not different between groups, with 12.7% wins in-hospital double-dose vaccine group and 12.3% wins in the standard-dose vaccine group {win ratio: 1.02 [95% confidence interval (CI): 0.79-1.32], P = 0.84}. Results were consistent for the key secondary outcome, a hierarchical composite of cardiovascular death, myocardial infarction and stroke [win ratio: 0.94 (95% CI: 0.66-1.33), P = 0.72]. Time-to-first event analysis for the primary outcome showed results similar to those of the main analysis [hazard ratio 0.97 (95% CI: 0.75-1.24), P = 0.79]. Adverse events were infrequent and did not differ between groups. CONCLUSION: Among patients hospitalized with an ACS, double-dose influenza vaccination before discharge did not reduce cardiopulmonary outcomes compared with standard-dose vaccination in the outpatient setting. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov number: NCT04001504.

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In2O3 and La3+-doped In2O3 nanostructures were synthesized through a facile and fast chemical route based on the microwave-assisted hydrothermal method combined with rapid thermal treatment in a microwave oven. The presence of the La3+ doping process modifies the size and morphology of the In2O3 nanostructures and also stabilizes the rhombohedral (rh) In2O3 phase with respect to the most stable cubic (bcc) polymorph. X-ray diffraction (XRD) patterns and Rietveld refinements, Raman, UV-vis, and energy dispersive X-ray (EDX) spectroscopies, transmission electron (TEM) and field-emission scanning electron (FE-SEM) microscopies, as well as PL emissions have been performed. To complement and rationalize the experimental results, first-principle calculations, based on density functional theory, are carried out to obtain the formation energies of the In2O3 and bcc- and rh-In2O3-doped phases, their geometry and electronic properties. Theoretical results are able to explain the relative stabilization of the rh-phase with respect to the bcc-phase based on the analysis geometry changes and the electronic redistribution induced by the La3+ doping process. In addition, Wulff construction is employed to match the theoretical and experimental morphologies of the cubic phase. The synthesized samples were applied for the O2 evolution reaction (OER). The La3+-doped In2O3 film presents superior electrocatalytic activity, with an onset potential lower than the undoped In2O3 film that can be associated with the increase in electron density caused by the La3+ doping process. This study provides a versatile strategy for obtaining In2O3 and La3+-doped In2O3 nanostructures for practical applications.

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Assessments of chromosomal integrity and structure enable the prevention of diseases associated with the work environment, with the frequencies of chromosomal aberrations and micronuclei often being used as markers in biomonitoring. Owing to their routine manipulation of potentially toxic chemicals, tannery workers as a group merit a more thorough evaluation and discussion. This study investigated chromosomal damage in 30 workers from a tannery in the city of Teresina, the state capital of Piauí, northeast Brazil, and a control group consisting of 30 employees from a nearby accounting firm. The frequencies of chromosomal aberrations (CAs) and binucleated cell micronuclei (MN) were assessed as a measure of damage. Means were compared using the Student t-test and ANOVA-Dunnett test. Our results indicated a higher number of CAs in exposed individuals compared to the control group, including dicentric (P < 0.0001) and tricentric chromosomes (P < 0.001), and those in ring (P < 0.0001) and acentric ring forms (P < 0.001). Assessment of MN frequency demonstrated a similar trend (exposed vs control, P < 0.0001). It was concluded that the tannery workers in this study exhibited a higher incidence of genetic damage than comparable unexposed individuals. However, further research on this subject is needed, particularly in regard to potentially clastogenic agents used in the tanning process.

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El Instituto Universitario de Ciencias de las Salud ha mostrado un particular compromiso con la formación de sus estudiantes en la estrategia de Atención Primaria de la Salud, con las prácticas asistenciales dedicadas al 1er nivel de atención ambulatoria y a las patologías prevalentes en ese ámbito. Del mismo modo se han desenvuelto las actividades de formación en investigación. Como exponente de esa orientación, la revista Ciencias de la Salud publicó en el Vol. 2, N°1, 2011:4-9, el artículo “Prevalencia de la Enfermedad de Chagas” de Érica G. Morais, que había obtenido el premio “Futuros Líderes”, otorgado por el Curso Anual Internacional de Investigación en Ciencias de la Salud (IUCS-AMA, Prof. Carlos Álvarez Bermúdez). Aquella investigación formaba parte de un proyecto más amplio realizado en el Hospital Teodoro Álvarez entre 2004 y 2012, en el que participaron un conjunto de investigadores, que compartieron la autoría de la actual publicación. El Dr. Jorge Mitelman, Prosecretario de Ciencia y Técnica del IUCS e integrante de ese equipo, preparó además una reseña sobre la jornada del INCOSUR, realizada en abril del presente año, describiendo asimismo el proceso de desarrollo de la Ciudad de Buenos Aires, como área no endémica, para encarar las consecuencias de la enfermedad de Chagas

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Type 2 diabetes mellitus is highly prevalent among the elderly. Age-associated changes in body composition, obesity and sedentary behavior are some of the main factors responsible for the increased prevalence of diabetes in this population. Elderly patients experience important and specific issues, including the association of comorbidities and geriatric syndromes, use of many medications, the presence of dependencies and frailty. Physical activity has been shown to be as effective for the treatment of diabetes in the elderly as in younger patients, so that its practice must be strongly encouraged. Resistive activities are preferable for the frail and vulnerable diabetic elderly. Aerobic activities should be prescribed whenever possible, and the association of both modalities is the best choice. Moderate- to high-intensity exercises are more effective for glycemic control and, unlike previously thought, are generally safe for the elderly population. The frequency of exercising should be at least 3 days/week for aerobic and 2 days/week for resistance activities. Balance exercises may be beneficial in special situations. In the elderly patient, special care must be taken for: the presence of contraindications for the practice of each exercise modality; the interactions and limitations imposed by medications, chronic comorbidities and geriatric syndromes; the higher possibility of developing hypoglycemia, especially if insulin is used for treatment, and the prevention of orthostatic hypotension that may be worsened by dehydration. The prescription of exercises tailored for each patient's preferences and limitations is highly effective not only for glycemic control, but also for improving independence, self-esteem and quality of life.

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The in vivo antifungal activity of the naphthoquinone beta-lapachone against disseminated infection by Cryptococcus neoformans was investigated. Swiss mice were immunosuppressed daily with dexamethasone (0.5 mg per mouse) intraperitoneally for 3 days, the procedure was repeated 4 days later, and the animals were then challenged intravenously with C. neoformans (10(6) CFU/mL) 1 week later. Seven days after infection, the mice were divided into groups and treated daily with beta-lapachone (10 mg/kg, iv) for 7 (N = 6) and 14 days (N = 10). Amphotericin B (0.5 mg/kg) was used as comparator drug and an additional group received PBS. Treatment with beta-lapachone cleared the yeast from the spleen and liver, and the fungal burden decreased approximately 10(4) times in the lungs and brain 14 days after infection when compared to the PBS group (P < 0.05). This result was similar to that of the amphotericin B-treated group. Protection was suggestively due to in vivo antifungal activity of this drug and apparently not influenced by activation of the immune response, due to similar leukocyte cell counts among all groups. This study highlights the prospective use of beta-lapachone for treatment of disseminated cryptococcosis.

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The in vivo antifungal activity of the naphthoquinone beta-lapachone against disseminated infection by Cryptococcus neoformans was investigated. Swiss mice were immunosuppressed daily with dexamethasone (0.5 mg per mouse) intraperitoneally for 3 days, the procedure was repeated 4 days later, and the animals were then challenged intravenously with C. neoformans (10(6) CFU/mL) 1 week later. Seven days after infection, the mice were divided into groups and treated daily with beta-lapachone (10 mg/kg, iv) for 7 (N = 6) and 14 days (N = 10). Amphotericin B (0.5 mg/kg) was used as comparator drug and an additional group received PBS. Treatment with beta-lapachone cleared the yeast from the spleen and liver, and the fungal burden decreased approximately 10(4) times in the lungs and brain 14 days after infection when compared to the PBS group (P < 0.05). This result was similar to that of the amphotericin B-treated group. Protection was suggestively due to in vivo antifungal activity of this drug and apparently not influenced by activation of the immune response, due to similar leukocyte cell counts among all groups. This study highlights the prospective use of beta-lapachone for treatment of disseminated cryptococcosis.

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In this work, the polymeric precursor method was used to prepare low-cost solid-state sensors for pH determination based on iridium oxide as the main pH sensitive material. The iridium content was reduced with addition of TiO(2), forming the binary system IrO(x)-TiO(2), whose electroanalytical properties were evaluated in comparison with a commercial glass pH electrode. The minimum iridium content which gave suitable results was 30mol%, and the electrode presented Nernstian and fast response in the pH range from 1 to 13, with no hysteresis effect observed. Besides, the electrode showed high selectivity in the presence of alkali ions as Li(+), Na(+) or K(+). The amount of iridium in the prepared electrodes was very small (<0.1mg), supporting the efficiency of this method on the simple preparation of functional low-cost pH electrodes.

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In this work Paspalum notatum root material was used to elucidate the influence of acid leaching pre-treatment and of sorption medium on metal adsorption. Ground P. notatum root was leached with 0.14M HNO(3). Leached root material (LRM) and non-leached root material (NLRM) were employed to flow sorption of Ni(II), Cu(II), Al(III) and Fe(III) in 0.5M CH(3)COONH(4) medium at pH 6.5. For LRM the sorption was also studied in 0.5M KNO(3) medium. The acid pre-treatment increased the sorption capacity (SC) for all ions studied. For the KNO(3) medium, Cu(II) and Fe(III) sorption was higher than in CH(3)COONH(4) and the type of the Ni(II) isotherm's model changed. The Freundlich model was the most representative isotherm model to describe metallic ions sorption. The (1)H NMR spectra showed differences between LRM and NLRM and the acid-basic potentiometric titration elucidated that acid-leaching procedure affected the root material sorption sites once only two predominant sorption sites were found for LRM (phenolic and amine, both able cations sorption) and five sorption sites (two carboxylic, amine and two phenolic) were founded for NLRM.

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Meningiomas in childhood are rare, and those located in the third ventricle are even rarer, with only 16 cases reported. A five-year-old girl was seen at our hospital with headache and bilateral papilledema. CT scan showed a large third ventricular mass and associated hydrocephalus. Transcallosal interfornical approach was performed with total removal of the tumor, that was attached to the choroid plexus of the anterior third ventricle. Histologically the lesion proved to be a transitional meningioma. The recovery was uneventful, a permanent shunt was not necessary. The diagnosis of these tumors can be done using CT scan or MRI, that usually are sufficient for surgical planning. Angiography usually is not required, unless a vascular lesion is concerned, or embolization is necessary. The treatment of these tumors is surgical, aiming the total removal of the lesion, usually curative once it is acomplished. We report this case, and add a brief review of the literature on third ventricle meningiomas.

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X-band (9.1 GHz) and S-band (3.4 GHz) electron paramagnetic resonance (EPR) spectra for particulate methane monooxygenase (pMMO) in whole cells from Methylococcus capsulatus (Bath) grown on (63)Cu and (15)N were obtained and compared with previously reported spectra for pMMO from Methylomicrobium album BG8. For both M. capsulatus (Bath) and M. album BG8, two nearly identical Cu(2+) EPR signals with resolved hyperfine coupling to four nitrogens are observed. The EPR parameters for pMMO from M. capsulatus (Bath) (g( parallel) = 2.244, A( parallel) = 185 G, and A(N) = 19 G for signal one; g( parallel) = 2.246, A( parallel) = 180 G, and A(N) = 19 G for signal two) and for pMMO from M. album BG8 (g( parallel) = 2.243, A( parallel) = 180 G, and A(N) = 18 G for signal one; g( parallel) = 2. 251, A( parallel) = 180 G, and A(N) = 18 G for signal two) are very similar and are characteristic of type 2 Cu(2+) in a square planar or square pyramidal geometry. In three-pulse electron spin echo envelope modulation (ESEEM) data for natural-abundance samples, nitrogen quadrupolar frequencies due to the distant nitrogens of coordinated histidine imidazoles were observed. The intensities of the quadrupolar combination bands indicate that there are three or four coordinated imidazoles, which implies that most, if not all, of the coordinated nitrogens detected in the continuous wave spectra are from histidine imidazoles.

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This study traces the nursing students' profile in order to have a prospective professional vision on the emotional intelligence of these workers. Considering that, nowadays, emotional intelligence is a basic requirement for any kind of profession, this research analysed patterns of cognitive, behavioral and emotional skills among the nursing workers. This is a descriptive exploratory study, accomplished in a public institution in the city of Fortaleza-CE, with 138 students enrolled in the first term of 1999. For this analyses an emotional intelligence questionnaire, available in internet, was applied. The subjects also answered questions related to their behavioral, cognitive and emotional skills. As a result, it was concluded that the majority of the students (78.26%) presented a satisfying level of emotional intelligence and only 16.67% would need improvement. In the classification of the three skills as sufficient, regular and insufficient, the cognitive skill exceeded the other two positively. The research showed that students have the basic characteristics of emotional intelligence. They can be in tune and understanding with patients, and also make themselves understood.

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Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = 2.17), pubertal development on stage G II, P II, and 4 cm3 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the referred syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

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The proteoglycans in the submandibular salivary glands of castrated male Wistar rats were studied before and after the daily administration of testosterone propionate (TP) for one month. Castration decreased the weight of the glands and their uronic acid content. The administration of TP reversed these effects. Chromatographic separation of the uronic acid fractions was performed on cellulose microcolumns. The principal fractions were hyaluronic acid, heparan sulfate and dermatan sulfate. There were also changes in the physical properties of the proteoglycans. Castration decreased the range of distribution of molecular weight and the density, while the lateral chains of smaller length disappeared. TP administration to castrated rats reversed these effects.

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Male Wistar rats were injected with 5 mg/kg/day of hydrocortisone during 21 days. Femur and mandible proteoglycans (PG) were isolated and their physico-chemical properties were compared with bone PG from a control and a starved group. The PG molecular weight decreased as a result of the hydrocortisone treatment but to a lower degree than in starvation, whereas the PG density seemed to be more affected by corticosteroid injection. These results allow us to conclude that bone alterations found after glucosteroid treatment may be due--at least partially--to changes in the PG physico-chemical properties of that tissue.

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In studies performed on male Wistar rats, castration induced atrophy of the prostate with a marked increase in the uronic acid content. The administration of testosterone propionate to castrated rats produced opposite effects. Fractionation of the glycosaminoglycans on cellulose microcolumns showed that the changes in uronic acid content in the dorsolateral lobes were due to variations in hyaluronic acid, chondroitin-4-sulfate, and dermatan sulfate, but in the ventral lobes, there were changes in all the chromatographic fractions. There were also changes in the physical properties of proteoglycans. In the ventral lobes, castration induced a wider distribution of molecular weight, increased density, and predominance of lateral chains of greater size. In the dorsolateral lobes, there was a decrease in molecular weight and density of proteoglycans and in the length of lateral chains. Opposite results were obtained when testosterone propionate was given to castrated rats. It is postulated that the effects of androgens upon prostatic growth would depend on an interrelationship between epithelium and stroma mediated by the proteoglycans.

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Male Wistar rats were injected with 5 mg/kg/day of hydrocortisone during 21 days. Femur and mandible proteoglycans (PG) were isolated and their physico-chemical properties were compared with bone PG from a control and a starved group. The PG molecular weight decreased as a result of the hydrocortisone treatment but to a lower degree than in starvation, whereas the PG density seemed to be more affected by corticosteroid injection. These results allow us to conclude that bone alterations found after glucosteroid treatment may be due--at least partially--to changes in the PG physico-chemical properties of that tissue.

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Male Wistar rats were injected with 5 mg/kg/day of hydrocortisone during 21 days. Femur and mandible proteoglycans (PG) were isolated and their physico-chemical properties were compared with bone PG from a control and a starved group. The PG molecular weight decreased as a result of the hydrocortisone treatment but to a lower degree than in starvation, whereas the PG density seemed to be more affected by corticosteroid injection. These results allow us to conclude that bone alterations found after glucosteroid treatment may be due--at least partially--to changes in the PG physico-chemical properties of that tissue.

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Existing hypotheses suggest that the effect of food deprivation on bone occurs via alterations in the synthesis of the organic matrix. Thus, this work was carried out to characterize the modifications of the physico-chemical properties of the proteoglycans (PG) of rat hyaline cartilage and femur. Male Wistar rats were assigned at random to a control group which was fed a standard pellet diet or to an experimental group which was given water "ad libitum" and starved over the experimental period. On day 4 or 8 the animals were administered a dose of 35S, weighed and killed. PG and glycosaminoglycans (GAG) were isolated from femurs and xyphoid cartilages. Uptake of 35S, GAG distribution patterns, PG molecular weight, molecular size of the side chains and the PG density gradient were determined. The aforementioned parameters decreased significantly after 4 and 8 days of total starvation. The GAG distribution pattern only exhibited a reduction of the Chondroitin-4-Sulphate fraction. These changes could alter the binding properties of PG to other macromolecules such as collagen which plays an important role in the ossification process.

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