Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil

There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.

Beta-hydroxy-beta-methylbutyrate associated with low-intensity exercise training improves skeletal muscle regeneration through the IGF-Akt pathway

The effect of beta-hydroxy-beta-methylbutyrate (HMB) supplementation associated with exercise training at different intensities and frequencies on skeletal muscle regeneration of muscle-injured rats was investigated. Male Wistar rats were divided into sedentary and trained groups. The sedentary groups were subdivided into non-injured (SED-Ct), non-injured supplemented with HMB (SED-Ct-HMB), injured (SED), and injured with HMB (SED-HMB), and the trained groups were injured, supplemented with HMB, and then divided into training three times a week without load (HT3) or with load (HT3L) and training five times a week without load (HT5) and with load (HT5L). The rats received a daily dose of HMB associated with 60 min of swimming with or without 5% body mass load for 14 days. On the 15th day, cryoinjury was performed in the right tibialis anterior muscle (TA), and 48 h later, supplementation and training continued for 15 days. After the last session, the TA was dissected and a cross-sectional area (CSA) of muscle fibers was used to determine the percentage of CSA fibers and connective tissue (%CT), as well as the total and phosphorylated protein contents. SED-HMB showed increased CSA and decreased %CT and TGF-β when compared to SED. HT3 showed increased CSA and reduced %CT accompanied by increased IGF-1/Akt, myogenin, and MuRF1, and decreased TGF-β. The CSA of HT5L also increased, but at the cost of a higher %CT compared to the other groups. Our results demonstrated that HMB associated with training without load and with lower frequency per week may be a valuable strategy for skeletal muscle regeneration.

Inflammatory and oxidative stress airway markers in premature newborns of hypertensive mothers

Although oxidative stress and inflammation are important mechanisms in the pathophysiology of preeclampsia and preterm diseases, their contribution to the respiratory prognosis of premature infants of hypertensive mothers is not known. Our objective was to determine the levels of oxidative stress and inflammation markers in the airways of premature infants born to hypertensive and normotensive mothers, in the first 72 h of life, and to investigate whether they are predictors of bronchopulmonary dysplasia (BPD)/death. This was a prospective study with premature infants less than 34 weeks’ gestation on respiratory support who were stratified into 2 groups: 32 premature infants of hypertensive mothers and 41 of normotensive women, with a mean gestational age of 29 weeks. Exclusion criteria were as follows: diabetes mellitus, chorioamnionitis, malformation, congenital infection, and death within 24 h after birth. The outcome of interest was BPD/death. Malondialdehyde (MDA), nitric oxide (NO), and interleukin 8 (IL-8) were measured in airway aspirates from the first and third days of life and did not differ between the groups. Univariate and multivariate statistical analyses were performed. The concentrations of MDA, NO, and IL-8 were not predictors of BPD/death. Premature infants who developed BPD/death had higher levels of IL-8 in the first days of life. The gestational age, mechanical ventilation, and a small size for gestational age were risk factors for BPD/death. In conclusion, the biomarkers evaluated were not increased in premature infants of hypertensive mothers and were not predictors of BPD/death.

Effect of dose and exposure to diatomaceous earth on different insects in stored corn / Efeito da dose e exposição à terra de diatomácea de diferentes insetos em milho armazenado

Sitophilus zeamais and Tribolium castaneum are important insect pests of stored grain and their damage corresponds to approximately 25% of post-harvest losses in Brazil. The methods used for the control of these pests notably include the use of post-harvest inert dusts. Therefore, the objective was to assess the mortality of adult S. zeamais and T. castaneum with the use of diatomaceous earth (DE) at different dosages and durations. The treatments with diatomaceous earth were 1,000 and 2,000 GT-1 and control (no application). Insects (10 each species) were placed in 300-ml plastic containers containing 100 g of corn kernels with different moisture contents (12, 14 and 16% wb). Infestations occurred 1 hour, 10 and 20 days after the application of TD. Mortality was evaluated at 30 and 60 days. There were five replicates per treatment. There was a higher mortality for the species S. zeamais than for T. castaneum, and this morality rate increased in direct relation to insect exposure time. It was concluded that T. castaneum has greater tolerance and that the more time the insects are in contact with treated grain the greater the mortality.

Sitophilus zeamais e Tribolium castaneum são importantes insetos-pragas de grãos armazenados e seus danos correspondem a aproximadamente 25% das perdas na pós-colheita do Brasil. Entre as formas de controle destaca-se o uso de pós-inertes. Sendo assim, o objetivo deste trabalho foi avaliar a mortalidade de adultos de S. zeamais e T. castaneum com uso de terra de diatomácea (TD) em diferentes dosagens e períodos de exposição. Os tratamentos com terra de diatomácea foram: 1.000 e 2.000 g.t-1 e controle (sem aplicação). Os insetos (10 de cada espécie) foram acondicionados em recipientes plásticos de 300 mL, contendo 100 g de grãos de milho com diferentes umidades (12, 14 e 16% b.u.). As infestações ocorreram 1 hora, 10 e 20 dias após a aplicação da TD. Avaliou-se a mortalidade aos 30 e 60 dias. Foram realizadas cinco repetições/tratamento. Obteve-se maior mortalidade para a espécie S. zeamais do que T. castaneum, sendo que ela aumenta conforme o tempo de exposição dos insetos. Conclui-se que a espécie T. castaneum apresenta maior tolerância e que quanto maior tempo os insetos estiverem em contato com grãos tratados maior será a mortalidade.

Effect of three exercise programs on patients with chronic obstructive pulmonary disease

We compared the effect of three different exercise programs on patients with chronic obstructive pulmonary disease including strength training at 50_80 percent of one-repetition maximum (1-RM) (ST; N = 11), low-intensity general training (LGT; N = 13), or combined training groups (CT; N = 11). Body composition, muscle strength, treadmill endurance test (TEnd), 6-min walk test (6MWT), Saint George's Respiratory Questionnaire (SGRQ), and baseline dyspnea (BDI) were assessed prior to and after the training programs (12 weeks). The training modalities showed similar improvements (P > 0.05) in SGRQ-total (ST = 13 ± 14 percent; CT = 12 ± 14 percent; LGT = 11 ± 10 percent), BDI (ST = 1.8 ± 4; CT = 1.8 ± 3; LGT = 1 ± 2), 6MWT (ST = 43 ± 51 m; CT = 48 ± 50 m; LGT = 31 ± 75 m), and TEnd (ST = 11 ± 20 min; CT = 11 ± 11 min; LGT = 7 ± 5 min). In the ST and CT groups, an additional improvement in 1-RM values was shown (P < 0.05) compared to the LGT group (ST = 10 ± 6 to 57 ± 36 kg; CT = 6 ± 2 to 38 ± 16 kg; LGT = 1 ± 2 to 16 ± 12 kg). The addition of strength training to our current training program increased muscle strength; however, it produced no additional improvement in walking endurance, dyspnea or quality of life. A simple combined training program provides benefits without increasing the duration of the training sessions.

Genotoxic effect of Physalis angulata L. (Solanaceae) extract on human lymphocytes treated in vitro

Physalis angulata L (Solanaceae) is a medicinal plant from North of Brazil, whose different extracts and infusions are commonly used in the popular medicine for the treatment of malaria, asthma, hepatitis, dermatitis and rheumatism. However, the genotoxic effects of P. angulata on human cells is not well known. The main purpose of the present study was to evaluate the in vitro genotoxic effects of aqueous extract of P. angulata using the comet assay and the micronucleus assay in human lymphocytes provided from 6 healthy donors. Treatments with P. angulata extracts were performed in vitro in order to access the extent of DNA damage. The comet assay has shown that treatments with P. angulata at 0.5, 1.0, 2.0, 3.0 and 6.0 microg/mL in culture medium were genotoxic. Lymphocytes treated with P. angulata at the concentrations of 3.0 and 6.0 microg/mL in culture medium showed a statistically significant increase in the frequency of micronucleus (p<0.05), however, the cytokinesis blocked proliferation index (CBPI) was not decreased after P. angulata treatment. In conclusion, the present work demonstrated the genotoxic effects of P. angulata extract on human lymphocytes in vitro.

Efeitos da fisioterapia respiratoria convencional versus aumento do fluxo expiratorio na saturacao de O2, frequencia cardiaca e frequencia respiratoria, em prematuros no periodo pos-extubacao / Effects of conventional chest physical therapy versus increased expiratory flow on oxygen saturation, heart rate and respiratory rate in premature infants following extubation

Recem-nascidos (RN) prematuros apresentam elevada morbidade respiratoria e necessiade de ventilacao mecanica, assim, a fisioterapia respiratoria e a parte integrante da assistencia neonatal. Objetivo: comparar os efeitos da fisioterapia respiratoria convencional (FRC) versus aumento do fluxo expiratorio (AFE), na saturacao de O2 (SPO2), frequencia cardiaca (FC) e na frequencia respiratoria (FR) em prematuros no periodo pos-extubacao. Metodo: ensaio clinico randomizado realizado na UTI Neonatal do Hospital das Ckinicas de Botucatu - UNESP, comparando duas tecnicas fisioterapeuticas, aplicadas em recem-nascidos prematuros, nas primeiras 48 horas pos-extubacao. Para a analise estatistica foram utilizadas o teste t Student, Mann-Whimey, Qui-quadrado e o teste exato de Fisher, com nivel de significancia em 5 por cento. Resultados: os dois grupos de estudo: Grupo FRC(n=20) e grupo AFE(n=20), nao diferiram quanto a idade gestacional (media de 28 semanas) e peso de nascimento (media de 1100 gramas). Em ambos os grupos a sindrome do desconforto respiratorio (SDR) foi o principal diagnostico. A mediana da idade no inicio da fisioterapia foi de sete dias no grupo AFE e 11 dias na FRC. Ambas as tecnicas produziram aumento significativo da SpO2 aos 10 e 30 minutos, sem alteracoes na FR. A FC aumentou significativamente apos a FRC e nao se alterou apos o AFE. Conclusao: os resultados sugerem que o AFE e menos estressante que a FRC e pode ser aplicado em prematuros no periodo pos-extubacao. Nestes recem-nascidos o AFE parece ser seguro e benefico a curto prazo

Opisthorchis felineus in cat: case report

Opisthorchis felineus foi encontrado em um gato admitido no Hospital Veterinário da Universidade de Trás-os-Montes e Alto Douro. No momento de admissão, o animal apresentava-se em estado de choque, com hipotermia, desidratação e mucosas pálidas. As análises hematológicas revelaram linfopenia, eosinofilia e anemia moderada. A necrópsia observou-se distensão da vesícula biliar e intensa infestação parasitária no fígado. O estudo morfológico do parasita revelou tratar-se de Opisthorchis felineus.

Spatial distribution of schistosomiasis foci on Itamaracá Island, Pernambuco, Brazil

Acute cases of schistosomiasis have been found on the coastal area of Pernambuco, Brazil, due to environmental disturbances and disorderly occupation of the urban areas. This study identifies and spatially marks the main foci of the snail host species, Biomphalaria glabrata on Itamaracá Island. The chaotic occupation of the beach resorts has favoured the emergence of transmission foci, thus exposing residents and tourists to the risk of infection. A database covering five years of epidemiological investigation on snails infected by Schistosoma mansoni in the island was produced with information from the geographic positioning of the foci, number of snails collected, number of snails tested positive, and their infection rate. The spatial position of the foci were recorded through the Global Positioning System (GPS), and the geographical coordinates were imported by AutoCad. The software packages ArcView and Spring were used for data processing and spatial analysis. AutoCad 2000 was used to plot the pairs of coordinates obtained from GPS. Between 1998 and 2002 5009 snails, of which 12.2 percent were positive for S. mansoni, were collected in Forte Beach. A total of 27 foci and areas of environmental risk were identified and spatially analyzed allowing the identification of the areas exposed to varying degrees of risk.

Estudo do comportamento dos linfocitos derivados do timo em pacientes com penfigo foliaceo na presenca de levamisol. / Behaviour of T - lymphocytes in patients with foliaceus pemphigus at the presence of levamisole

Foram estudados linfocitos T de pacientes portadores de penfigo foliaceo em relacao a sua capacidade de formar rosaceas "E", diante de concentracoes do imunopotenciador levamisol. O levamisol e uma substancia que estimula formacao de rosaceas de linfocitos T ativos em individuos normais: Os linfocitos de pacientes antes da corticoterapia sistemica nao responderam ao levamisol ja os linfocitos de pacientes em tratamento com corticoides tiveram inibida sua capacidade de formar rosaceas. Esses achados sugerem altecao no metabolismo celular dos linfocitos de pacientes penfigosos devido provavelmente a alguma falha no sistema enzimatico dessas celulas envolvendo a fosfodiesterase do AMPc