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BACKGROUND: Prostate cancer exhibits a very diverse behaviour, with some patients dying from the disease and others never needing treatment. Active surveillance (AS) consists of periodic PSA assessment (prostate-specific antigen), DRE (digital rectal examination) and periodic prostate biopsies. According to the main guidelines, AS is the preferred strategy for low-risk patients, to avoid or delay definitive treatment. However, concerns remain regarding its applicability in certain patient subgroups, such as African American men, who were underrepresented in the main cohorts. Brazil has a very racially diverse population, with 56.1% self-reporting as brown or black. The aim of this study is to evaluate and validate the AS strategy in low-risk prostate cancer patients following an AS protocol in the Brazilian public health system. METHODS: This is a multicentre AS prospective cohort study that will include 200 patients from all regions of Brazil in the public health system. Patients with prostate adenocarcinoma and low-risk criteria, defined as clinical staging T1-T2a, Gleason score ≤ 6, and PSA < 10 ng/ml, will be enrolled. Archival prostate cancer tissue will be centrally reviewed. Patients enrolled in the study will follow the AS strategy, which involves PSA and physical examination every 6 months as well as multiparametric MRI (mpMRI) every two years and prostate biopsy at month 12 and then every two years. The primary objective is to evaluate the reclassification rate at 12 months, and secondary objectives include determining the treatment-free survival rate, metastasis-free survival, and specific and overall survival. Exploratory objectives include the evaluation of quality of life and anxiety, the impact of PTEN loss and the economic impact of AS on the Brazilian public health system. DISCUSSION: This is the first Brazilian prospective study of patients with low-risk prostate cancer under AS. To our knowledge, this is one of the largest AS study cohort with a majority of nonwhite patients. We believe that this study is an opportunity to better understand the outcomes of AS in populations underrepresented in studies. Based on these data, an AS national clinical guideline will be developed, which may have a beneficial impact on the quality of life of patients and on public health. TRIAL REGISTRATION: Clinicaltrials registration is NCT05343936.
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Antígeno Prostático Específico , Neoplasias da Próstata , Masculino , Humanos , Estudos Prospectivos , Brasil/epidemiologia , Conduta Expectante/métodos , Qualidade de Vida , Saúde Pública , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapiaRESUMO
Background: Rootstocks less vigorous are among the most crucial management techniques to modernize fruit cultivation. Replanting with fallow land has become necessary due to a lack of land to establish new orchards. Objective: The aim of this study is to determine the effect of various rootstocks of the American Geneva® series on the yield performance of the apple (Malus domestica Borkh) cultivars 'Gala Select' and 'Fuji Suprema' under replanting conditions in southern Brazil. Methods: After two years of fallow land, the experiments were initiated in 2017 and conducted during the 2018, 2019, 2020, and 2021 growing seasons in Painel and Caxias do Sul municipalities at the Santa Catarina and the Rio Grande do Sul State, respectively. The 'Gala Select' and 'Fuji Suprema' were grafted onto the G.202, G.814, G.210, and G.213 Geneva series rootstocks in a tall spindle training system using a randomized complete block design with four replicates. Principal component analysis (PCA) was used to assess the interrelationship among the variable's vigor, productivity, and fruit quality. Results: The PCA result showed significant differences in vigor, productivity, and fruit quality when the G.210 and G.213 and G.814 and G.213 Geneva series rootstocks were used in combination with Gala Select and Fuji Suprema cultivars, respectively. The PCA analysis clustered all cultivar/rootstock combinations into two groups, based on their vigor and productivity and the yield performance and fruit quality data, that differed significantly among combinations and regions. The 'Gala Select'/G.202 and 'Fuji Suprema'/G.213 combinations were less vigorous than the 'Gala Select'/G.210 and 'Fuji Suprema'/G.814 combinations. However, 'Gala Select'/G.210 (semi-dwarfing) and G.213 (dwarfing) are the combinations with high yield performance, productive efficiency and fruit quality, being more reliable to the producer, and less vigorous, resulting in lower labor costs under replating conditions, with two years of fallow land, from 2018 until 2021 growing seasons.
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The aim of this study is to demonstrate the stability-indicating capacity of an analytical method for Eugenia uniflora, enhance understanding of the stability of myricitrin, and assess the effect of degradation of spray-dried extract (SDE) on antioxidant and antifungal activities. Validation of the stability-indicating method was carried out through a forced degradation study of SDE and standard myricitrin. The antioxidant and antifungal activities of SDE were evaluated both before and after degradation. The quantification method described was found to be both accurate and precise in measuring myricitrin levels in SDE from E. uniflora, with excellent selectivity that confirmed its stability-indicating capability. The forced degradation study revealed that the marker myricitrin is sensitive to hydrolysis, but generally stable under other stress conditions. By contrast, the standard myricitrin displayed greater susceptibility to degradation under forced degradation conditions. Analysis of the antioxidant activity of SDE before and after degradation showed a negative impact in this activity due to degradation, while no significant effect was observed on antifungal activity. The method described can be a valuable tool in the quality control of E. uniflora, and the findings can assist in determining the optimal conditions and storage of products derived from this species.
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The continuous interest in discovering new bioactive molecules derived from natural products (NP) has stimulated the development of improved screening assays to help overcome challenges in NP-based drug discovery. Here, we describe a unique platform for the online screening of acetylcholinesterase inhibitors without the need for pre-treating the sample. In the current study, we have demonstrated the ability to combine reversed-phase separation with a capillary immobilized enzyme reactor (cIMER) in two-dimensional liquid chromatography system coupled with mass spectrometry detection. We systematically investigated the effects of method parameters that are of practical significance and are known to affect the enzyme assay and interfere in the analysis such as: bioreactor dimensions, loop sizes, amount of immobilized enzyme, second dimension flow rates, reaction time, substrate concentration, presence of organic modifier, limit of detection and signal suppression. The performance of this new platform was evaluated using a mixture containing three known AChE inhibitors (tacrine, galanthamine and donepezil) and an ethanolic extract obtained from the dry bulbs of Hippeastrum calyptratum (Amaryllidaceae) was investigated to provide a proof of concept of the applicability of the platform for the analysis of complex mixtures such as those derived from NPs.
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Leishmaniasis are endemic diseases caused by different species of intracellular parasites of the genus Leishmania. Due to the high toxicity and drug resistance of current antileishmanial drugs, it is necessary to identify new and more effective drugs. Previously, we investigated the immunomodulatory and anti-Trypanosoma cruzi action of BA5, a derivative of betulinic acid. In the present study, we investigated the in vitro activity of BA5 against different species of Leishmania and their action mechanism. BA5 exhibited low cytotoxicity against macrophages and inhibited the proliferation of promastigote forms of Leishmania amazonensis (IC50 = 4.5 ± 1.1 µM), Leishmania major (IC50 = 3.0 ± 0.8 µM), Leishmania braziliensis (IC50 = 0.9 ± 1.1 µM) and Leishmania infantum (IC50 = 0.15 ± 0.05 µM). Incubation with BA5 reduced the percentage of Leishmania amazonensis-infected macrophages and the number of intracellular parasites (IC50 = 4.1 ± 0.7 µM). To understand the mechanism of action underlying BA5 antileishmanial activity (incubation at IC50/2, IC50 or 2xIC50 values of the drug), we investigated ultrastructural changes by scanning electron microscopy and evaluated cell cycle, membrane mitochondrial potential, and cell death against promastigote forms of Leishmania amazonensis by flow cytometry. Promastigotes incubated with BA5 presented membrane blebbing, flagella damage, increased size, and body deformation. Flow cytometry analysis showed that parasite death is mainly caused by apoptosis-like death, arrested cell cycle in G0/G1 phase and did not alter the membrane mitochondrial potential of Leishmania amazonensis. Surprisingly, the combination of BA5 and amphotericin B, an assay used to determine the degree of drug interaction, revealed synergistic effects (CI = 0.15 ± 0.09) on promastigotes forms of Leishmania amazonensis. In conclusion, BA5 compound is an effective and selective antileishmanial agent.
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Acute gastroenteritis is one of the main causes of mortality and morbidity worldwide, affecting mainly children, the immunocompromised and elderly people. Enteric viruses, especially rotavirus A, are considered important etiological agents, while long-term care facilities are considered favorable environments for the occurrence of sporadic cases and outbreaks of acute gastroenteritis. Therefore, it is important to monitor the viral agents present in nursing homes, especially because studies involving the elderly population in Brazil are scarce, resulting in a lack of available virological data. As a result, the causative agent remains unidentified in a large number of reported acute gastroenteritis cases. However, the advent of next-generation sequencing provides new opportunities for viral detection and discovery. The aim of this study was to identify the viruses that circulate among elderly people with and without acute gastroenteritis, living in residential care homes in Belém, Pará, Brazil, between 2017 and 2019. Ninety-three samples were collected and screened by immunochromatography and qPCR. After, the samples were analyzed individually or in pools by next generation sequencing to identify the viruses circulating in this population. In 26 sequenced samples, members of 13 eukaryotic virus families were identified. The most abundantly present virus families were Parvoviridae, Genomoviridae and Smacoviridae. Contigs displaying similarity to pegiviruses were also detected. Furthermore, a near-complete rotavirus A genome was obtained and could be classified as G3P[8] genotype with the equine DS-1-like genetic background. Complete sequences of the VP4 and VP7 genes of a rotavirus C were also detected, belonging to G4P[2]. This study demonstrates the first characterization of the gastrointestinal virome in elderly in Northern Brazil. A diversity of viruses was found to be present in patients with and without diarrhea, reinforcing the need to monitor elderly people residing in long-term care facilities, especially in cases of acute gastroenteritis.
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Gastroenterite , Infecções por Rotavirus , Rotavirus , Vírus , Idoso , Animais , Brasil/epidemiologia , Eucariotos , Fezes , Gastroenterite/epidemiologia , Genótipo , Cavalos , Humanos , Filogenia , Rotavirus/genética , ViromaRESUMO
Bryophyllum pinnatum (Crassulaceae) is used in traditional medicine for treating skin wounds. In our previous study, a topical gel containing B. pinnatum aqueous leaf extract showed a preclinical anti-inflammatory effect in in vivo acute edema models. In continuation, the present study aims to evaluate the phytochemical content and the stability of a formulation in gel containing B. pinnatum aqueous leaf extract and its healing properties and mechanism of action through an experimental model of induction of skin wounds in rats and in vitro assays. The animals were treated topically for 7 or 14 days with a formulation in gel containing extract at 5% or a placebo or Fibrinase® in cream. In addition, to establish some quality control parameters, the total phenolic content (TPC), total flavonoid content (TFC), and a study focusing on the phytochemical and biological stability of a gel for 30 days at two different conditions (room temperature and 40°C/75% RH) were performed. Gel formulation containing extract showed a TPC and TFC of 2.77 ± 0.06 mg of gallic acid/g and 1.58 ± 0.03 mg of quercetin/g, respectively. Regarding the stability study, the formulation in gel showed no significant change in the following parameters: pH, water activity, chromatographic profile, and the content of the major compound identified in the extract. The gel formulation containing extract stimulated skin wound healing while reducing the wound area, as well as decreasing the inflammatory infiltrate, reducing the levels of IL-1ß and TNF-α, and stimulating angiogenesis with increased expression of VEGF, an effect similar to Fibrinase. In conclusion, the gel formulation containing extract exhibited relevant skin wound healing properties and, therefore, has the potential to be applied as a novel active ingredient for developing wound healing pharmaceuticals.
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Social isolation is necessary during the COVID-19 pandemic but can be harmful to mental health, especially in people with neurocognitive disorders. Although physical exercise can alleviate neuropsychiatric symptoms and improve quality of life (QoL), sedentary behavior increased during the pandemic. Online interventions can contribute to improving physical activity and mental health. Objective: The objective of this study was to compare the neuropsychiatric symptoms and QoL of older adults with neurocognitive disorders who participated in an online physical exercise program with sedentary patients during the COVID-19 pandemic. Methods: In this cross-sectional study, 25 older patients with neurocognitive disorders (control group=11; online exercise group=14) were evaluated based on Neuropsychiatric Inventory (NPI) and the Quality of Life in Alzheimer's Disease (QoL-AD) scale. Results: There were differences between the two groups in the total NPI (U=36.50, p=0.025) and the nighttime behavior disturbances item (U=38.00, p=0.033), both with large effect sizes (ES=-1.03, 95% confidence interval [CI]:-1.83 to -0.16 and ES=-1.06, 95%CI -1.86 to -0.19, respectively). In terms of QoL-AD, a difference was identified only in the memory subitem (U=20.00, p=0.005), with a large ES (1.59, 95%CI 0.59-2.48). Conclusions: Older adults with neurocognitive disorders who participated in an online physical exercise program, during the COVID-19 pandemic, showed fewer neuropsychiatric total symptoms, fewer nighttime disturbances episodes, and better subjective memory, compared to their physically inactive counterparts. Randomized controlled trials should be performed to better understand the effect of physical exercise in neuropsychiatric symptoms in dementia patients during periods of social isolation.
O isolamento social é necessário na pandemia de COVID-19, mas pode impactar a saúde mental, especialmente em idosos com demência, dada a alta prevalência de sintomas neuropsiquiátricos. Apesar da prática de exercícios físicos contribuir para a redução desses sintomas e a melhora da qualidade de vida, houve um aumento de comportamento sedentário durante a pandemia. Objetivo: Comparar os sintomas neuropsiquiátricos e a qualidade de vida de idosos com distúrbios neurocognitivos que participaram de um programa de exercícios físicos online voltado a pacientes sedentários durante a pandemia de COVID-19. Métodos: Neste estudo de corte transversal, 25 idosos diagnosticados com transtorno neurocognitivo (controle=11; exercícios online=14) foram avaliados por meio do inventário neuropsiquiátrico (INP) e da escala de qualidade de vida na doença de Alzheimer (QV-DA). Resultados: Observou-se diferença entre os grupos no INP total (U=36,50, p=0,025), com tamanho de efeito grande (effect size [ES]=-1,03, intervalo de confiança - IC95% -1,83 a -0,16), e no subdomínio sono (U=38,00, p=0,033), com tamanho de efeito grande (ES=-1,06, IC95% -1,86 a -0,19), favoráveis ao grupo fisicamente ativo. Na QV-DA, houve diferença entre os grupos apenas no subitem memória (U=20,00, p=0,005), com tamanho de efeito grande (ES=1,59, IC95% 0,59 a 2,48), não houve diferença na pontuação total (U=45,5, p=0,277). Conclusões: Idosos submetidos a rotina de exercícios físicos com supervisão online na pandemia de COVID-19 apresentam menos sintomas neuropsiquiátricos, melhor qualidade de sono e memória quando comparados aos fisicamente inativos. Estudos randomizados controlados devem ser feitos para a melhor compreensão dos efeitos do exercício físico nos sintomas neuropsiquiátricos de pacientes com demência durante períodos de isolamento social.
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The synthesis of three coordination polymers of cerium(III) and the ligand pyridine-2,4,6-tricarboxylate (PTC) is reported. Two of the materials crystallise under hydrothermal conditions at 180 °C, with [Ce(PTC)(H2O)2]·1.5H2O, (1), being formed on extended periods of reaction time, 3 days or longer, and Ce(PTC)(H2O)3, (2), crystallising after 1 day. Both phases contain Ce(III) but are prepared using the Ce(IV) salt Ce(SO4)2·4H2O as reagent. Under solvothermal conditions (mixed water-N,N-dimethylformamide (DMF)), the phase [Ce(PTC)(H2O)(DMF)]·H2O (3) is crystallised. The structures of the three materials are resolved by single crystal X-ray diffraction, with the phase purity of the samples determined by powder X-ray diffraction and thermogravimetric analysis. (1) is constructed from helical chains cross-linked by the PTC linkers to give a three-dimensional structure that contains clusters of water molecules in channels that are hydrogen-bonded to each other and to additional waters that are coordinated to cerium. (2) also contains nine-coordinate cerium but these are linked to give a dense framework, in which water is directly coordinated to cerium. (3) contains corner-shared nine-coordinate cerium centres, linked to give a framework in which Ce-coordinated DMF fills space. Upon heating the material (1) in air all water is irreversibly lost to give a poorly crystalline anhydrous phase Ce(PTC), as deduced from X-ray thermodiffractometry and thermogravimetric analysis. The material (1), however, is hydrothermally stable, and is also stable under oxidising conditions, where immersion in 30% H2O2 gives no loss in crystallinity. Oxidation of around 50% of surface Ce to the +4 oxidation state is thus possible, as evidenced by X-ray photoelectron spectroscopy, which is accompanied by a colour change from yellow to orange. Photocatalytic activity of (1) is screened and the material shows effective degradation of methyl orange.
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2A is an oligopeptide sequence that mediates a ribosome "skipping" effect and can mediate a co-translation cleavage of polyproteins. These sequences are widely distributed from insect to mammalian viruses and could act by accelerating adaptive capacity. These sequences have been used in many heterologous co-expression systems because they are versatile tools for cleaving proteins of biotechnological interest. In this work, we review and update the occurrence of 2A/2A-like sequences in different groups of viruses by screening the sequences available in the National Center for Biotechnology Information database. Interestingly, we reported the occurrence of 2A-like for the first time in 69 sequences. Among these, 62 corresponded to positive single-stranded RNA species, six to double stranded RNA viruses, and one to a negative-sense single-stranded RNA virus. The importance of these sequences for viral evolution and their potential in biotechnological applications are also discussed.
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Biotecnologia , Vírus de RNA , Proteínas Virais , Animais , Cisteína Endopeptidases/metabolismo , Evolução Molecular , Picornaviridae/genética , Poliproteínas , Totiviridae/genética , Proteínas Virais/genéticaRESUMO
BACKGROUND AND AIMS: This study sought (i) to adapt cross-culturally the Brazilian Portuguese-translated version of the MSRA questionnaire, (ii) to estimate the prevalence of risk of sarcopenia, and (iii) to correlate the MSRA Portuguese version with CC in hospitalized cancer patients. METHODS: This was a cross-sectional study developed at the hospital in the year 2018. After being translated and adapted to the Portuguese language, the questionnaire was applied and associated with the measurement of calf circumference (CC) to verify its validity. RESULTS: Of the 45 patients, 71.1% presented significant or severe body weight loss, and 55.5% indicated muscle mass loss (CC < 31 cm). From the MSRA of seven and five items, 91.1 and 84.5% of the patients, respectively, presented risk for sarcopenia. Among those at risk for sarcopenia, more than 60% were aged <70 years, >80% were hospitalized in the last year, more than 40% could not walk > 1000 m, >40% did not eat regularly, and >80% lost >2 kg in the last year. CC was correlated with MSRA of five items (r = 0.46, p = 0.001) and seven items (r = 0.53, p = 0.0002). Furthermore, both versions of the MSRA (seven and five items) presented strong agreement and high reliability. CONCLUSIONS: The MSRA full and short version was adapted for a Brazilian Portuguese-translated version and showed strong agreement and high reliability to identify the risk for sarcopenia in hospitalized cancer patients. Therefore, this questionnaire can be used as part of nutritional assessment protocols in order to enable early screening of the risk for sarcopenia.
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BACKGROUND: Measuring the patient safety climate of a health service provides important information about the safety status at a given time. This study aimed to determine the factors influencing the patient safety climate in Intensive Care Units. METHODS: An analytical and cross-sectional study conducted in 2017 and 2018 in two adult Intensive Care Units of a Brazilian Teaching Hospital. The Safety Attitudes Questionnaire instrument was applied with the multidisciplinary teams to determine the factors influencing the patient safety climate. Data were double entered into a database and processed using the R (version 3.5.0) statistical software. Position, central tendency and dispersion measures were taken and absolute and relative frequencies, mean and confidence intervals were calculated for the quantitative variables. Linear regression was performed to verify the effect of variables on the SAQ domains. Variables with a p-value of less than 0.25 were selected for multivariate analysis. RESULTS: A total of 84 healthcare providers participated in the study. The mean Safety Attitudes Questionnaire score was 59.5, evidencing a negative climate. The following factors influenced the safety climate: time since course completion, professional category, type of employment contract, complementary professional training, and weekly workload. CONCLUSIONS: The factors identified indicate items for planning improvements in communication, teamwork, work processes, and management involvement, aiming to ensure care safety and construct a supportive safety climate.
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OBJECTIVES: We compared physical activity levels before the outbreak and quarantine measures with COVID-19-associated hospitalization prevalence in surviving patients infected with SARS-CoV-2. Additionally, we investigated the association of physical activity levels with symptoms of the disease, length of hospital stay, and mechanical ventilation. DESIGN: Observational, cross-sectional. METHODS: Between June 2020 and August 2020, we invited Brazilian survivors and fully recovered patients infected with SARS-CoV-2 to respond to an online questionnaire. We shared the electronic link to the questionnaire on the internet. We collected data about clinical outcomes (symptoms, medications, hospitalization, and length of hospital stay) and cofactors, such as age, sex, ethnicity, preexisting diseases, socioeconomic and educational, and physical activity levels using the International Physical Activity Questionnaire (IPAQ short version). RESULTS: Out of 938 patients, 91 (9.7%) were hospitalized due to COVID-19. In a univariate analysis, sex, age, and BMI were all associated with hospitalizations due to COVID-19. Men had a higher prevalence of hospitalization (66.6%, pâ¯=â¯0.013). Patients older than 65â¯years, obese, and with preexisting disease had a higher prevalence of COVID-19-related hospitalizations. In a multivariate regression model, performance of at least 150â¯min/wk (moderate) and/or 75â¯min/wk (vigorous) physical activity was associated with a lower prevalence of hospitalizations after adjustment for age, sex, BMI, and preexisting diseases (PRâ¯=â¯0.657; pâ¯=â¯0.046). CONCLUSIONS: Sufficient physical activity levels were associated with a lower prevalence of COVID-19-related hospitalizations. Performing at least 150â¯min a week of moderate-intensity, or 75â¯min a week of vigorous-intensity physical activity was associated with 34.3% reduction in prevalence.
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COVID-19/epidemiologia , Exercício Físico , Comportamentos Relacionados com a Saúde , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , COVID-19/diagnóstico , COVID-19/etiologia , COVID-19/terapia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Quarentena , Respiração Artificial/estatística & dados numéricos , Fatores de Risco , Índice de Gravidade de Doença , Sobreviventes , Adulto JovemRESUMO
OBJECTIVE: Propose a standard, fast and accurate protocol for the processing of the temporomandibular joint (TMJ) of adults' rats for histology and immunohistochemistry reactions. DESIGN: Wistar male rats were perfused with paraformaldehyde (4 %). The heads were fixed in formaldehyde 10 % solution for 48 h. After that, the heads were sectioned in a sagittal plane and fixed for plus 48 h. Decalcification was performed using 20 % formic acid for 96 h and delimitation of TMJ area was done. Detailed methodology to a standard extraction and processing of TMJ to histological sections is described. Different buffers, equipment, temperature and time were tested to optimize immunostaining. Morphological preservation and antigenicity were evaluated by hematoxylin and eosin staining and immunohistochemistry reaction. RESULTS: The current findings demonstrated that TMJ fixed in 10 % formaldehyde and decalcified in 20 % formic acid optimized decalcification processing time with preservation of cell morphology. Antigen retrieval with citrate buffer in pressure cooker (2 min at 100 °C and 5 min at room temperature) demonstrated the best protocol to preservation of the structures of TMJ. CONCLUSIONS: This work demonstrates in detail a methodology of a fast and accurate TMJ processing for histology and immunohistochemistry reactions that guarantee tissue integrity and quality of staining.
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Articulação Temporomandibular , Animais , Imuno-Histoquímica , Masculino , Ratos , Ratos Wistar , Coloração e RotulagemRESUMO
Introdução: hidradenite supurativa (HS) é uma condição inflamatória, crônica, recorrente e debilitante. Há uma falta de consenso sobre o seu tratamento. Objetivo: foi realizada revisão da literatura nacional e internacional, buscando-se artigos que abordassem o uso da toxina botulínica na HS, além de descrever as doses e técnicas utilizadas. Métodos: foi realizada busca bibliográfica nas bases LILACS, Medline e SciELO. Resultados: considera-se que a toxina botulínica pode ser eficaz em pacientes com HS, principalmente se houver hiperidrose concomitante e quando as terapias tradicionais falham. Oferece a possibilidade de realizar um tratamento com efeitos colaterais mínimos, repetíveis ao longo do tempo sem perda de eficácia, além de diminuir a dor. Conclusões: é provável que os pacientes precisem de mais de um tratamento com o tempo, pois as lesões tendem a se repetir após uma média de seis a 10 meses. Utiliza-se a técnica padrão para hiperidrose. Mais pesquisas são necessárias para entender o seu papel no gerenciamento da HS, incluindo dosagem e frequência ideais de administração.
Introduction: Hidradenitis suppurativa (HS) is an inflamatory, chronic, recurrent, and debilitating condition. There is a lack of consensus about its treatment. Objective: We conducted a review of the national and international literature, searching for articles that addressed the use of botulinum toxin in HS, in addition to describing the doses and techniques used. Methods: A bibliographic search was performed in LILACS, Medline, and SciELO. Results: Botulinum toxin can be an effective therapy in patients with HS, especially in cases of concomitant hyperhidrosis and traditional therapies fail. It offers the possibility of conducting treatment with minimal adverse events, reproducible over time without loss of effectiveness, in addition to reducing pain. Conclusions: Patients will likely need more than one treatment over time, as the lesions tend to recur after 6 to 10 months. The technique used has been the standard for hyperhidrosis. Further research is needed to understand its role in the management of HS, including the ideal dosage and frequency of administration
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BACKGROUND: The microbiome is now known for its important role in whole-body homeostasis. A dysbiosis of the normal microbiota is correlated with metabolic disorders. In this sense, the search for compounds able to modulate the microbiome is needed. Resveratrol, a natural compound found in grapes seems to be a promising candidate. OBJECTIVE: In this study, our motivation was to evaluate the effects of the association between Resveratrol and Lactococcus lactis, a probiotic, on the composition of the gastrointestinal microbiota and body weight of mice. METHODS: Twenty female mice were divided into 4 groups: (1) standard diet, (2) standard diet plus Lactococcus lactis, (3) standard diet plus resveratrol, and (4) standard diet plus Lactococcus lactis and resveratrol. At the end of the treatment period, samples of blood, mucus, stomach, and small and large intestines were collected for analysis. Total levels of Immunoglobulin A and Immunoglobulin E, Lac+ and Lac- bacteria and Lactobacillus were measured. RESULTS: The main results indicate that the association between resveratrol and probiotics was able to decrease mice body weight, as compared to the other groups, in addition to decrease the number of Lac- bacteria and increasing the number of Lac+ bacteria. The levels of secretory IgA were also decreased, compared to the animals treated with only probiotics or resveratrol. CONCLUSION: We observed potential synergism between Resveratrol and Lactococcus lactis mainly in modulating the stomach and intestinal microbiota.
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Peso Corporal/efeitos dos fármacos , Enterobacteriaceae/efeitos dos fármacos , Microbioma Gastrointestinal/efeitos dos fármacos , Lactococcus lactis/imunologia , Probióticos/administração & dosagem , Resveratrol/administração & dosagem , Animais , Peso Corporal/imunologia , Dieta/métodos , Enterobacteriaceae/crescimento & desenvolvimento , Enterobacteriaceae/imunologia , Feminino , Microbioma Gastrointestinal/imunologia , Imunoglobulina A/biossíntese , Imunoglobulina E/sangue , Intestino Grosso/efeitos dos fármacos , Intestino Grosso/imunologia , Intestino Grosso/microbiologia , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/imunologia , Intestino Delgado/microbiologia , Camundongos , Camundongos Endogâmicos C57BL , Estômago/efeitos dos fármacos , Estômago/imunologia , Estômago/microbiologiaRESUMO
BACKGROUND: Mental disorders increase the risk factor for developing physical comorbidity conditions, such as cardiometabolic diseases. There is a high prevalence of multimorbidity and polypharmacy in the elderly population which hampers clinical response. Studies have shown that this positive correlation between the aging process and enhancement of physical comorbidities is especially high among older adults who live in low or middle income countries. OBJECTIVE: To investigate the association between physical disease comorbidities and polypharmacy in older adults with a clinical diagnosis of Alzheimer's disease (AD), mild cognitive impairment (MCI) or major depressive disorder (MDD), living in a middle income country. METHODS: Cross-sectional study of community-dwelling elderly individuals who are cognitively healthy and those with AD, MCI, or MDD. The severity scale of the Charlson Comorbidity Index (CCI) was calculated to classify the severity of comorbidity condition. Logistic regression model (unadjusted and adjusted for age) were used to calculate odds ratios (OR) and 95 % confidence intervals (CI) for cardiometabolic comorbidity (hypertension, diabetes, dyslipidemia and overweight), and polypharmacy. RESULTS: Although there was not an increased risk of hypertension, diabetes, and obesity among the groups, elderly people with mental disorders presented higher odds for polypharmacy condition. Polypharmacy was significantly higher for all groups in comparison with cognitively healthy participants: AD (OR 22.00, 95 % CI 6.11-79.11), MDD (OR 14.73, 95 % CI 3.69-58.75) and MCI (OR 10.31, 95 % CI 2.44-43.59). Elderly patients with AD presented more severe comorbidities and higher risks for dyslipidemia. CONCLUSION: Elderly patients with depression, dementia and mild cognitive impairment have considerably higher odds for polypharmacy. People with dementia also have greater comorbidity severity than those who are cognitively healthy. In middle income countries, there is an urgent need to focus on promoting age-appropriate health approaches for the elderly with mental illness to prevent the development of aggravated cardiometabolic conditions and polypharmacy.
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INTRODUCTION: Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients. METHODS AND ANALYSIS: We will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository. ETHICS AND DISSEMINATION: Given the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020191192.
Assuntos
Transplante de Coração , Qualidade de Vida , Adulto , Exercício Físico , Terapia por Exercício , Humanos , Metanálise como Assunto , Metanálise em Rede , Revisões Sistemáticas como AssuntoRESUMO
Functionalized micro- and nano-sized magnetic beads (MBs) have been widely used as versatile supports for proteins, enzymes, and drugs. Immobilized protein on MB surfaces has been successfully applied for ligand fishing assays allowing for direct identification of active ligands from complex mixtures, such as natural products and synthetic libraries. MBs with different properties such as different core compositions, sizes, coatings, and surface modifications are available commercially. Studies have been conducted to understand the role of these properties for ligand fishing assays. Here we evaluated, for the first time, the effect of MB size on the ligand fishing assay for acetylcholinesterase from Electrophorus electricus (AChE). For this purpose, four commercially available amine-terminated magnetic particles with diameters ranging from 4.5 nm to 106 µm were evaluated to fish out galantamine, a well-known AChE inhibitor, from an aqueous solution. All MBs were efficient at using glutaraldehyde to covalently immobilize AChE. The particles with diameters of about 1 µm (small microparticles) presented a higher protein mass capacity per milligram of particle than did those with diameters of about 4.5 nm (nanoparticles) and those with diameters of about 106 µm (large microparticles). The influence of these supports on the produced AChE-MBs with regards to hydrolysis turnover and ligand fishing was evaluated and is fully discussed.
Assuntos
Aminas , Enzimas Imobilizadas , Acetilcolinesterase , Animais , Ligantes , Fenômenos MagnéticosRESUMO
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a prevalent syndrome, with exercise intolerance being one of its hallmarks, contributing to worse quality of life and mortality. High-intensity interval training is an emerging training option, but its efficacy in HFpEF patients is still unknown. DESIGN: Single-blinded randomized clinical trial. METHODS: Single-blinded randomized clinical trial with exercise training 3 days per week for 12 weeks. HFpEF patients were randomly assigned to high-intensity interval training or moderate continuous training. At baseline and after 12 week follow-up, patients underwent clinical assessment, echocardiography and cardiopulmonary exercise testing (CPET). RESULTS: Mean age was 60 ± 9 years and 63% were women. Both groups (N = 19) showed improved peak oxygen consumption (VO2), but high-intensity interval training patients (n = 10) had a significantly higher increase, of 22%, compared with 11% in the moderate continuous training (n = 9) individuals (3.5 (3.1 to 4.0) vs. 1.9 (1.2 to 2.5) mL·kg-1·min-1, p < 0.001). Ventilatory efficiency and other CPET measures, as well as quality of life score, increased equally in the two groups. Left ventricular diastolic function also improved with training, reflected by a significant reduction in E/e' ratio by echocardiography (-2.6 (-4.3 to -1.0) vs. -2.2 (-3.6 to -0.9) for high-intensity interval training and moderate continuous training, respectively; p < 0.01). There were no exercise-related adverse events. CONCLUSIONS: This randomized clinical trial provided evidence that high-intensity interval training is a potential exercise modality for HFpEF patients, being more effective than moderate continuous training in improving peak VO2. However, the two strategies were equally effective in improving ventilatory efficiency and other CPET parameters, quality of life score and diastolic function after 3 months of training.