Mortality rates by gender and sexual orientation reveal a disproportionally high mortality among cisgender men of unknown sexual orientation and men who have sex with women in a cohort of people living with HIV in Rio de Janeiro, Brazil

ABSTRACT Background: Antiretroviral therapy use has led to a decline in HIV-related mortality yet disparities by gender and/or sexual orientation may exist. In this study, we estimated hazards of death in people living with HIV (PLWH) according to gender and sexual orientation. Methods: We included PLWH ≥ 18 years enrolled between 2000 and 2018 at INI/Fiocruz, Rio de Janeiro, Brazil. Participants were grouped as cisgender or transgender women, cisgender men who have sex with men (MSM) or men who have sex with women, or cisgender men with unknown sexual orientation. We assessed disparities in the hazard of death using Cox proportional hazards models. Results: Among 5,576 PLWH, median age at enrollment was 35 years, 39% were MSM, 28% cisgender women, 23% men who have sex with women, 5% transgender women, and 5% men with unknown sexual orientation. A total of 795 deaths occurred in 39,141 person-years of follow-up. Mortality rates per 1,000 person-years were: 82.4 for men with unknown sexual orientation, 24.5 for men who have sex with women, 18.3 for cisgender, 16.6 for transgender women, and 15.1 for MSM. Compared to MSM, men with unknown sexual orientation had the highest death hazard ratio (adjusted hazard ratio [aHR] 2.93, 95% confidence interval [CI] 2.35-3.81), followed by men who have sex with women (aHR 1.17, 95%CI 0.96, 1.43); death hazard ratios for cisgender and transgender women were not statistically different. Conclusion: We observed disparities in the hazard of death for men with unknown sexual orientation and men who have sex with women despite universal access to antiretroviral therapy in Brazil. Future work should characterize and assist men with unknown sexual orientation with tailored policies and interventions. Increased hazard of death was not observed for transgender women, which probably results from interventions implemented in our service to reach, engage, retain, and support this population.

Análise comparativa de dois volumes diferentes de agente de contraste oral para enterografia por tomografia computadorizada em pacientes com doença de Crohn / Comparative analysis of two oral contrast agent volumes for computed tomography enterography in crohn's disease patients

ABSTRACT BACKGROUND: Crohn's disease (CD) is an inflammatory bowel disease characterized by a chronic and recurrent inflammation of the gastrointestinal tract caused by an interaction of genetic and environmental factors. OBJECTIVE: To compare the quality and acceptance of two different oral contrast volumes for computed tomography enterography in Crohn's disease patients. METHODS: A cross-sectional study was conducted in 58 consecutive Crohn's disease patients who randomly received an oral contrast agent composed of 78.75 g polyethylene glycol diluted in either 1,000 mL or 2,000 mL of water. An examination was performed to evaluate the presence of inflammation or complications in the small bowel. The variables included the quality of intestinal segment filling and luminal distension, and oral contrast agent acceptance and tolerance in the patients. Statistical analysis included descriptive statistics and association tests. RESULTS: A total of 58 patients were assessed, in which 58.6% were female, 34.5% exhibited clinically-active disease, and 63.8% were receiving biologic therapy. As for comparative analysis between the two different volumes of oral contrast, no statistically significant difference was found regarding bowel loop filling (P=0.58) and adequate luminal distension (P=0.45). Patients who received a larger volume (2,000 mL) exhibited side-effects more frequently (51.7% vs 31.0%; P=0.06) and had greater difficulty ingesting the agent (65.5% vs 37.9%; P=0.07) compared with a volume of 1,000 mL. CONCLUSION: The quality of computed tomography enterography was not influenced by the contrast volume. However, acceptance and tolerance were better in the 1,000 mL group.

RESUMO CONTEXTO: A doença de Crohn (DC) é uma doença inflamatória intestinal caracterizada por uma inflamação crônica e recorrente do trato gastrointestinal causada por uma interação de fatores genéticos e ambientais. OBJETIVO: Comparar a qualidade e aceitação de dois volumes diferentes de contraste oral para enterografia por tomografia computadorizada em pacientes com doença de Crohn. MÉTODOS: Um estudo transversal foi conduzido em 58 pacientes com doença de Crohn que receberam aleatoriamente um agente de contraste oral composto por 78,75 g de polietilenoglicol diluído em 1.000 mL ou 2.000 mL de água. Um exame foi realizado para avaliar a presença de inflamação ou complicações no intestino delgado. As variáveis incluíram a qualidade do preenchimento do segmento intestinal e distensão luminal e aceitação e tolerância do contraste oral nos pacientes. A análise estatística incluiu estatística descritiva e testes de associação. RESULTADOS: Foram avaliados 58 pacientes, dos quais 58,6% eram mulheres, 34,5% apresentavam doença clinicamente ativa e 63,8% estavam recebendo terapia biológica. Quanto à análise comparativa entre os dois diferentes volumes de contraste oral, não foi encontrada diferença estatisticamente significativa em relação ao enchimento da alça intestinal (P=0,58) e distensão luminal adequada (P=0,45). Pacientes que receberam um volume maior (2.000 mL) exibiram efeitos colaterais com mais frequência (51,7% vs 31,0%; P=0,06) e tiveram maior dificuldade para ingerir o agente (65,5% vs 37,9%; P=0,07) em comparação com um volume de 1.000 mL. CONCLUSÃO: A qualidade da entero-tomografia computadorizada não foi influenciada pelo volume de contraste. No entanto, aceitação e tolerância foram melhores no grupo de 1.000 mL.

Effects of chronic stretching on soleus muscle of Wistar female rats / Efectos del estiramiento crónico en el músculo sóleo de ratas hembras Wistar

The purpose of this study was to evaluate the chronic effects of stretching exercise on soleus muscle histomorphology and histomorphometry of young and aged rats. Thirty-eight female rats were divided into young control group (YCG, n=10;274±50 g); young stretching group (YSG, n=8;274±12 g); aged control group (ACG, n=10;335±39 g); and aged stretching group (ASG, n=10;321±32g). A mechanical apparatus was used to stretch muscle in 4 repetitions, 60 s each, 30 s interval between repetitions in each session, 3 times a week for 3 weeks. Twenty-four hours after the last stretching session, soleus muscle was removed for micromorphology and immunostaining analysis. Data analyses were performed with one-way ANOVA, post-hoc Tukey, or Kruskal-Wallis tests for parametric and nonparametric, respectively (p≤0.05). Muscle fiber cross-sectional area (MFCSA) of ACG was lower (18 %) compared to the YCG. Stretching increased MFCSA comparing YSG to YCG (5,681.15± 1,943.61 µm2 vs 5,119.84±1,857.73 µm2, p=0.00), but decreased comparing ASG to ACG (3,919.54± 1,694.65 µm2 vs 4,172.82±1,446.08 µm2, p=0.00). More serial sarcomere numbers were found in the YSG than YCG (12,062.91±1,564.68 vs 10,070.39±1,072.38, p=0.03). Collagen I and collagen III were higher in YSG than ASG (7.44±7.18 % vs 0.07±0.09 %, p=0.04) and (14.37 %± 9.54 % vs 5.51 %±5.52 %, p=0.00), respectively. TNF-a was greater in ASG than YSG (43.42 %±40.19 % vs 1.72 ± 2.02 %, p=0.00). Epimysium was larger in the YSG compared to YCG (201.83±132.07 % vs 181.09±147.04 %, p=0.00). After 3-week stretching the soleus muscles from aged rats were smaller than their younger counter-parts. Interestingly, while stretching appeared to positively affect young soleus muscle, the opposite was detected in the muscle of the aged rats.

El propósito de este estudio fue evaluar los efectos crónicos del ejercicio de estiramiento sobre la histomorfología e histomorfometría del músculo sóleo de ratas jóvenes y envejecidas. Se dividieron 38 ratas hembras en un grupo control joven (YCG, n = 10; 274 ± 50 g); grupo de estiramiento joven (YSG, n = 8; 274 ± 12 g); grupo control de edad (ACG, n = 10; 335 ± 39 g); y grupo estiramiento envejecido (ASG, n = 10; 321 ± 32 g). Se usó un aparato mecánico para estirar el músculo en 4 repeticiones, 60 s cada una, intervalo de 30 s entre repeticiones en cada sesión, 3 veces por semana, durante 3 semanas. Veinticuatro horas después de la última sesión de estiramiento, se extrajo el músculo sóleo para análisis de micromorfología e inmunotinción. Los análisis de datos se realizaron con pruebas ANOVA de una vía, Tukey post-hoc o Kruskal-Wallis para pruebas paramétricas y no paramétricas, respectivamente (p≤0,05). El área de la sección transversal de fibra muscular (MFCSA) de GCE fue menor (18 %) en comparación con el GCJ. El estiramiento aumentó ASTFM comparando GEJ con GCJ (5.681,15 ± 1.943,61 µm2 vs 5.119,84 ± 1.857,73 µm2, p = 0,00), pero disminuyó comparando GEE con GCE (3.919,54 ± 1.694,65 µm2 vs 4.172,82 ± 1.446,08 µm2, p = 0,00). Se encontraron más sarcómeros en serie en el GEJ que en el GCJ (12.062,91 ± 1.564,68 vs 10.070,39 ± 1,072.38, p = 0,03). El colágeno I y el colágeno III fueron más numerosos en GEJ que en GEE (7,44 ± 7.18 % vs 0,07 ± 0,09 %, p = 0,04) y (14,37 % ± 9,54 % vs 5,51 % ± 5,52 %, p = 0,00), respectivamente. TNF-α fue mayor en GEE que GEJ (43,42 % ± 40,19 % vs 1,72 ± 2,02 %, p = 0,00). El epimisio fue mayor en el GEJ en comparación con el GCJ (201,83 ± 132,07 % vs 181,09 ± 147,04 %, p = 0,00). Después de 3 semanas de estiramiento, los músculos sóleo de las ratas envejecidas eran más pequeños que sus contrapartes más jóvenes. Curiosamente, si bien el estiramiento pareció afectar positivamente el músculo sóleo joven, se detectó lo contrario en el músculo de las ratas envejecidas.

Determinação do limiar anaeróbio pela carga crítica superestima teste de lactato mínimo / Determination the anaerobic threshold for critical workload overestimates lactate minimum test

Introdução: A utilização de métodos específicos de mensuração é de fundamental importância para a identificação da capacidade aeróbia e prescrição da intensidade de exercício. Normalmente esta definição é feita pela determinação do limiar anaeróbio (Lan) que corresponde à máxima fase estável entre produção e remoção de lactato sanguíneo (MFEL). Dentre as mais variadas formas de se det ermin ar a MFEL estão os testes de lactato mínimo (LM) e carga crítica (CC). No entanto, não se sabe se a utilização dessas formas de avaliação pode acarretar em resultados distintos. Objetivo: O objetivo do presente estudo foi comparar os valores de Lan obtidos por meio dos testes de CC e de LM em rat o s W istar. Método : Foram utilizados 32 ratos machos (Wistar), com peso médio 411,0 (± 4 0 ,7 gramas), o s quais fo ram submetidos às baterias de testes de CC e de LM. O teste de LM foi realizado com a indução à hiperlactacidemia com dois estímulos correspondentes a 13% do peso corporal (PC), seguido de intervalo passivo de nove minutos e teste incremental composto por estágios com duração de cin co m inut os e cargas equivalentes a 4.0, 4.5, 5.0, 5.5, 6.0 e 7.0 % do PC. Já a CC foi obtida p o r m eio da in dução ao exercício em quatro diferentes estímulos randomizados, com cargas correspondentes a 7, 9, 11 e 1 3 % do PC. Resultados: Os resultados demonstraram que o Lan médio determinado pelo Teste de CC foi de 5,8 ± 1,2% do peso corporal (PC) e 4,9 ± 0,6% do PC determinado pelo Teste de LM. Co nclusão: P ode ­ se concluir que o limiar anaeróbio determinado por meio do teste CC superestimou em 18,4% o valor obtido por meio do teste de LM...(AU)

Introduction: The utilization of specific measurement methods is of fundamental importance for the identification of aerobic capacity and prescription of exercise. This determination is usually m ade through measurement of the anaerobic threshold (Lan) which corresponds to the maximal lactate st eady state (MLSS). Among the more varied forms of determination of MLSS are the minimum lactate (LM) and critical overload tests (CC). However, it is not known if the utilization of these forms o f ev aluatio n can lead to different results. Objective: The aim of this study was to compare the Lan v alues o btained through the CCand LM tests in Wistar rats. Method: For this purpose, 32 male Wistar rats were used, with an average weight of 411.0 ± 40.7 grams, submitted to CC and LM tests. The LM test was performed fo r the induction of a hyperlactacidemia with two stimuli corresponding to 13% of body weight (BW), followed by a passive interval of nine minutes and an incremental test composed of stages with a duratio n of five minutes and loads equivalent to 4.0, 4.5, 5.0, 5.5, 6.0, and 7.0% of BW . T he CC was o bt ain ed through induced exercise in four randomized stimuli, with loads corresponding to 7, 9 , 1 1, and 1 3 % o f BW. Results: It was observed that the mean anaerobic threshold determined by CC was 5.8 ± 1 .2 % BW , and determined by LM was 4.9 ± 0.6% BW. Conclusion: It is concluded that th e an aero bic th resho ld determined through the critical workload test overestimates the value obtained through the lactate minimum test by 18.4%, thus impeding its use as an aerobic training intensity predictor in Wistar rats. Keywords: Lactic acid, Critical load, Anaerobic threshold, Wistar rats...(AU)

Effect of pre-anesthetic fasting on gastric emptying and plasma glucose in healthy dogs of different age groups / Efeito do jejum pré-anestésico sobre o esvaziamento gástrico e a glicemia plasmática em cães hígidos de diferentes faixas etárias

Gastric emptying and plasma glucose were evaluated in young and adult dogs, fed with dry and wet food, submitted to different periods of pre-anesthetic fasting (6, 8, and 12 hours). Forty healthy dogs were selected, which were segmented into four groups according to the age group and type of diet. It was evaluated the gastric emptying by ultrasound and serum glycemia. Only 17.5% presented complete gastric emptying, and no significant differences were found between the 6 and 8-hour fasting evaluations, or between the age groups and the diets, considering significance level p<0.05. Mean plasma glucose values from the groups indicated normal glycemia at all times of evaluation. A significant difference was found between the means of glycemia in young and adult dogs, with the 8-hour fasting with wet diet (p=0.03) and with 12 hours with dry diet (p=0.04). Healthy young and adult dogs, in physiological equilibrium, maintain average values of plasma glucose despite prolonged periods of pre-anesthetic fasting, which may be necessary, since 8-hour fasting for solid food is not enough to provide complete gastric emptying.(AU)

Avaliou-se o esvaziamento gástrico e a glicemia plasmática em cães jovens e adultos, alimentados com ração seca e úmida, submetidos a diferentes períodos de jejum pré-anestésico (6, 8 e 12 horas). Foram selecionados 40 cães hígidos, os quais foram segmentados em 4 grupos de acordo com a faixa etária e o tipo de dieta administrada. Foi avaliado o esvaziamento gástrico por ultrassonografia e a glicemia sérica. Apenas 17,5% apresentaram completo esvaziamento gástrico, não sendo encontradas diferenças significativas entre as avaliações com 6 e 8 horas de jejum, ou entre as faixas etárias e dietas, considerando nível de significância p<0,05. Os valores médios da glicose plasmática dos grupos indicaram normoglicemia em todos os momentos de avaliação. Foi encontrada diferença significativa entre as médias da glicemia dos cães jovens e adultos, no período de 8 horas de jejum com dieta úmida (p=0,03) e com 12 horas nos animais com dieta seca (p=0,04). Conclui-se que cães hígidos jovens e adultos, em equilíbrio fisiológico, mantêm valores normais de glicemia plasmática apesar de períodos prolongados de jejum pré-anestésico, os quais podem ser necessários, tendo em vista que 8 horas de jejum alimentar de sólidos não é suficiente para proporcionar completo esvaziamento gástrico.(AU)

Morphometric and molecular muscle remodeling after passive stretching in elderly female rats

OBJECTIVES: To determine the effects of three sessions of a passive stretching exercise protocol on the muscles of elderly female rats. METHODS: The effects of the stretching exercises on the soleus muscle were analyzed using immunohistochemistry [tissue inhibitors of matrix metalloproteinases (TIMP), the tumor necrosis factor-alpha (TNF-α), and the gene expression levels using real-time PCR of the transforming growth factor-beta 1 (TGF-β1), collagen type 1 (COL1), and collagen type 3 (COL3)]. Fifteen 26-month-old female Wistar rats were randomly divided into two groups, namely, Stretching (SG, n=8) and Control (CG, n=7). The passive mechanical stretching protocol consisted of a set of 4 1-minute repetitions, with 30 seconds between each repetition (total treatment of 4 minutes), three times a week for 1 week. RESULTS: Immunohistochemical analysis revealed an increase of 71.4% in the TNF-α (p=0.04) gene expression levels for the SG and a 58% decrease in the TGF-β1 gene expression levels (p=0.005) in the SG compared to that in the CG. No significant differences were observed between the groups for the immunostaining of TIMP-1 or the gene expression levels of COL1 and COL3. CONCLUSION: Three sessions of static stretching reduced the gene expression level of TGF-β1, which, owing to its anti-fibrotic role, might contribute to the remodeling of the intramuscular connective tissue of the aging muscle. In addition, immunostaining revealed that TNF-α levels increased in the aging muscle tissue in response to stretching, indicating its effect on stimulating extracellular matrix degradation. These outcomes have important clinical implications in reinforcing the use of stretching exercises in the elderly, considering that the aging muscle presents an infiltration of connective tissue.

In vitro evaluation of apical microleakage in retrofillings with different resection angles / Avaliaçâo in vitro da microinfiltraçâo apical de retrobturaçoes com diferentes ángulos de ressecçâo

ABSTRACT Paraendodontic surgery is a procedure that aims to solve problems that could not be solved by, or when it is not possible to perform conventional endodontic treatment. The aim of this experimental study was to compare the apical microleakage of teeth sectioned at 45° or 90° to the long axis of the tooth and root-end filled with mineral trioxide aggregate (MTA) using stereomicroscopy. In this study, 26 maxillary central incisors were used. Cleaning and shaping were performed with use of the Oregon technique and the samples were randomly divided into two groups. In Group A (n=10) apical section was performed at an angle of 90°, making a retrocavity with an ultrasonic tip and retrofilling with MTA. In group B (n=10) the same procedures were performed, but the apical section was at a 45° angle. Then the samples were immersed in a dye (India ink), placed in an oven at 37° for 48 h before applying the clearing technique. Afterwards the teeth were assessed by stereomicroscope at 20x magnification to analyze dye leakage. Data were submitted to the Student's-t test with significance level p<0.05. There was statistically significant difference between groups. Group B showed higher apical microleakage values compared with group A (P=0.004), but both groups showed dye leakage. The results showed that the 90° apical section promoted lower dye microleakage values at the dentin-retrofilling material interface than the 45°-section and could be considered the most effective technique for apical preparation in paraendodontic surgery.

RESUMO A cirurgia paraendodontica é um procedimento que visa resolver problemas que nao poderiam ser resolvidos, ou quando nao é possível realizar o tratamento endodontico convencional. O objetivo deste estudo experimental foi comparar a microinfiltragao apical de dentes seccionados a 45° ou 90° em relagao ao longo eixo do dente e extremidade radicularpreenchida com agregado de trióxido mineral (MTA) utilizando estereomicroscopia. Neste estudo, 26 incisivos centrais superiores foram utilizados. Limpeza e modelagem foram realizadas com o uso da técnica de Oregon e as amostras foram divididas aleatoriamente em dois grupos. No Grupo A (n = 10) foi realizada segao apical em ángulo de 90°, realizando retrocavidade com ponta ultrassonica e retrobturagao com MTA. No grupo B (n = 10), os mesmos procedimentos foram realizados, mas a segao apical estava em um ángulo de 45°. Em seguida, as amostras foram imersas em um corante (nanquim), colocadas em estufa a 37°Cpor 48 h, antes da aplicagao da técnica de clareamento. Posteriormente, os dentes foram avaliados por estereomicroscópio, com aumento de 20x, para análise do vazamento de corante. Os dados foram submetidos ao teste t de Student, com nivel de significáncia p <0,05. Houve diferenga estatisticamente significante entre os grupos. O grupo B apresentou maiores valores de microinfil-tragao apical em comparagao ao grupo A (P = 0,004), mas ambos os grupos apresentaram vazamento de corante. Os resultados mostraram que a segao apical de 90° promoveu menores valores de microinfiltragao de corante na interface do material retrobturador dentinário do que a segao 45° e pode ser considerada a técnica mais efetiva para preparo apical em cirurgia paraendodontica.

Sufentanil during anesthetic induction of remifentanil-based total intravenous anesthesia: a randomized controlled trial / Sufentanil durante a indução da anestesia intravenosa total à base de remifentanil: ensaio clínico randômico

Abstract Background Postoperative pain represents an important concern when remifentanil is used for total intravenous anesthesia because of its ultrashort half-life. Longer acting opioids, such as sufentanil, have been used during induction of remifentanil-based total intravenous anesthesia as a means to overcome this shortcoming. However, the effectiveness and safety of such strategy still lacks evidence from randomized clinical trials. Hence, we aimed to assess the postoperative analgesic efficacy and safety of a single dose of sufentanil administered during the induction of remifentanil-based total intravenous anesthesia. Methods Forty patients, scheduled for elective open abdominal surgery, were randomized to receive remifentanil-based total intravenous anesthesia with or without a single dose of sufentanil upon induction. We assessed the postoperative morphine consumption administered through a patient-controlled analgesia pump. Self-reported pain scores and the occurrence of nausea, vomiting, pruritus, agitation, somnolence and respiratory depression were also assessed up to 2 days after surgery. Results The mean difference between the sufentanil and control groups regarding morphine consumption in the post-anesthetic care unit and at 12, 24 and 48 h after surgery were -7.2 mg (95%CI: -12.5 to -2.1, p < 0.001), -3.9 mg (95%CI: -11.9 to 4.7, p = 0.26), -0.6 mg (95%CI: (-12.7 to 12.7, p = 0.80), and -1.8 mg (95%CI: (-11.6 to 15.6, p = 0.94), respectively. Neither self-reported pain nor the incidence of adverse events were significantly different between groups at any time point. Conclusion Our findings suggest that the administration of sufentanil during induction of remifentanil-based total intravenous anesthesia is associated with decreased early postoperative opioid consumption.

Resumo Justificativa A dor pós-operatória é uma grande preocupação quando o remifentanil é usado para anestesia intravenosa total devido à sua meia-vida ultracurta. Os opioides de ação mais longa, como o sufentanil, têm sido usados durante a indução de anestesia intravenosa total à base de remifentanil como um meio de superar essa deficiência. Porém, a eficácia e segurança de tal estratégia ainda precisam de evidências advindas de ensaios clínicos randômicos. Portanto, objetivamos avaliar a eficácia analgésica e a segurança pós-operatória de uma dose única de sufentanil administrada durante a indução de anestesia intravenosa total à base de remifentanil. Métodos Quarenta pacientes eletivamente agendados para cirurgia abdominal aberta foram randomizados para receber anestesia intravenosa total à base de remifentanil, com ou sem uma dose única de sufentanil, após a indução da anestesia. Avaliamos o consumo de morfina no pós-operatório, administrado através de uma bomba de analgesia controlada pelo paciente. Os escores de dor autorrelatados e a ocorrência de náusea, vômito, prurido, agitação, sonolência e depressão respiratória também foram avaliados até dois dias após a cirurgia. Resultados A diferença média entre os grupos sufentanil e controle em relação ao consumo de morfina em sala de recuperação pós-anestesia e após 12, 24 e 48 horas da cirurgia foi de -7,2 mg (IC 95%: -12,5 a -2,1, p < 0,001), -3,9 mg (IC 95%: -11,9 a 4,7, p = 0,26), -0,6 mg (IC 95%: (-12,7 a 12,7, p = 0,80) e -1,8 mg (IC 95%: -11,6 para 15,6, p = 0,94), respectivamente. Não houve diferença significativa tanto nos escores de dor autorrelatados, quanto na incidência de eventos adversos entre os grupos. Conclusão Nossos achados sugerem que a administração de sufentanil durante a indução de anestesia intravenosa total à base de remifentanil está associada à redução do consumo de opioides no pós-operatório imediato.

Anti-inflammatory properties of bergenin in mice

Inflammation is a protective biological reaction against infection and has undesirable effects. Although bergenin (BG),a C-glycoside derivative of 4-O-methyl gallic acid, has many pharmacological properties, no study has demonstratedthe activity of BG in inflammatory mediators, such as histamine and prostaglandin E2 (PGE2). The present studyinvestigated the anti-inflammatory activity of BG obtained from Peltophorum dubium Taub, in edema models inducedby carrageenan and inflammatory mediators in Swiss mice. The assessment of its toxicity was also conducted. Theevaluations of this study indicated that the pre-treatment with BG (25 mg/kg) significantly reduced edema induced bycarrageenan, compound 48/80, histamine, and PGE2 (p < 0.05). Also, pre-treatment with BG inhibited the recruitmentof leukocytes and neutrophils, reducing adhesion and rolling of these cells, myeloperoxidase (MPO) activity,malondialdehyde (MDA) levels, and vascular permeability. Treatment with BG (2,000 mg/kg) showed no toxicsigns in hippocratic screening, weight of animals, water and feed intake, vital organs weight and histopathologicalevaluation, and hematological and biochemical parameters. In conclusion, these results show that the BG obtainedfrom P. dubium Taub has anti-inflammatory activity against different models of inflammation, reducing neutrophilmigration and damage caused by oxidative stress and lipid peroxidation. BG did not present toxic effects in theevaluated parameters.

Ultrasound power and irrigation volume in different lens opacity grades: comparison of femtosecond laser-assisted cataract surgery and conventional phacoemulsification

OBJECTIVES: To compare the amount of ultrasound energy and irrigation volume in conventional phacoemulsification cataract surgery versus femtosecond laser-assisted phacoemulsification at different nuclear-cortical cataract grades. METHOD: This was a prospective, consecutive, investigator-masked nonrandomized parallel cohort study. Patients were divided into 4 groups (Phaco1, Phaco2, Femto1 and Femto2) according to the surgical technique (conventional phacoemulsification [Group Phaco] or femtosecond laser-assisted cataract surgery [Group Femto]) and the Lens Opacity Classification System III (LOCS) grade (LOCS<11 [group 1] or LOCS≥11 [group 2]). The measured outcomes were effective phacoemulsification time (EPT), indicating the ultrasound energy, and balanced salt solution (BSS) use, indicating the irrigation volume, to indirectly estimate the damage to the corneal endothelium caused by the cataract surgery. RESULTS: A total of 160 eyes from 109 patients were included: 87 eyes in Group Phaco, 73 eyes in Group Femto, 76 eyes in group 1 and 84 eyes in group 2. The EPT mean in Femto1 was 53% less (2.73±1.88, 0.1 to 8.65) than that in Phaco1 (5.80±2.86) (p=0.00) and in Femto2 (8.38±9.32) was 33% less than that in Phaco2 (12.55±8.38) (p=0.00). No significant differences in mean LOCS grades between the Phaco1 (8.21±1.44) and Femto1 (7.90±1.90) groups (p=0.73) or between the Phaco2 (13.15±2.55) and Femto2 (12.72±2.18) groups (p=0.95) were found. There were no significant differences in the mean BSS use between the Phaco1 (55.73±12.45) and Femto1 (59.37±10.93) groups (p=0.48) or between the Phaco2 (64.34±21.00) and Femto2 (65.71±17.60) groups (p=0.47). CONCLUSIONS: Compared to conventional phacoemulsification at different nuclear-cortical cataract grades, femtosecond laser-assisted cataract surgery provides an EPT reduction but does not influence the BSS use.

Synergistic antibacterial effect of statins with the complex {[1-(4-bromophenyl)-3-phenyltriazene N 3 -oxide-κ 2 N 1,O 4 ](dimethylbenzylamine-κ 2 C 1, N 4 )palladium(II)}

Abstract The treatment of infections caused by resistant microorganisms represents a big challenge in healthcare due to limited treatment options. For this reason, the discovery of new active substances which are able to perform innovative and selective actions is of great impact nowadays. Statins and triazenes (TZC) have consolidated as a promising class of compounds, characterized by the expressive biological activity, especially antimicrobial activities. The aim of this study was to assess the in vitro synergistic antibacterial effect of the association of statins and a new TZC complex {[1-(4-bromophenyl)-3-phenyltriazene N 3-oxide-κ 2 N 1,O 4](dimethylbenzylamine-κ 2 C 1,N 4)palladium(II)} (Pd(DMBA)LBr) against American Type Culture Collection (ATCC) strains and clinical isolates. The complex and the statins showed bacterial activity of all tested strains and clinical isolates, evidencing that TZC complexion with metals can be promising. Simvastatin showed synergy when associated to the complex (FICI≤0.5), being the minimum inhibitory concentration (MIC) of 16 µg mL-1 found in 6 samples. Thus, it is possible to infer that the association between Pd(DMBA)LBr and simvastatin consists of an alternative to increase the pontential of these compounds, since statins have low toxicity.

Energy Analysis in Supermarkets

ABSTRACT This study shows, through several analyses, ways to reduce costs with electric power in supermarkets. For this purpose, one of those establishments was visited and several data were collected for subsequent analysis. The results have shown that the combinations of several actions of energy efficiency can be applied when the objective is the reduction of costs with electric power.

Capacidade de sprints repetidos e níveis de potência muscular em jogadores de futsal das categorias sub-15 e sub-17 / Repeated sprint ability and muscle power levels of the futsal players of U15 and U17 categories / Capacidad de sprints repetidos y niveles de potencia muscular en jugadores de fútbol sala de las categorías cadete y júnior

Resumo O principal objetivo deste estudo foi comparar o desempenho nos saltos verticais e sprints repetidos feitos com mudança de sentido (SRMS) e linha reta (SRLR) entre jogadores de futsal das categorias sub-15 e sub-17. Foram avaliados 15 jogadores do sexo masculino, que fizeram saltos verticais e testes de sprints repetidos em linha reta e mudança de sentido. Não foi encontrada diferença no desempenho dos sprints e no índice de fadiga (p > 0,05) nos SRMS e SRLR, assim como nos saltos verticais (p > 0,05) entre as categorias. Observou-se correlação significativa (p < 0,05) do desempenho nos SRMS e SRLR com os saltos verticais. O desempenho nos sprints e saltos verticais foi similar entre jogadores das categorias. A potência muscular foi relacionada com o desempenho nos sprints.

Abstract The main purpose of the study was to compare the performance of vertical jumps and shuttle (RSS) and straight line (RSL) repeated sprint running between futsal players of U15 and U17 categories. Fifteen male futsal players performed vertical jumps and repeated sprints tests in straight line and change of direction. There were no significant differences of sprint performance and fatigue index (p > 0.05) in the RSS and RSL, as well as vertical jumps (p > 0.05) between categories. Significant correlation (p < 0.05) of sprint performance in both RSS and RSL with vertical jumps performance were observed. Sprints performance and vertical jumps were similar between U15 and U17 categories. The level of muscle power was related to sprint performance.

Resumen El principal objetivo del estudio fue comparar el rendimiento en los saltos verticales y en los sprints repetidos con cambio de dirección (SRCD) y línea recta (SRLR) entre jugadores de fútbol sala de las categorías cadete y júnior. Quince jugadores realizaron los saltos verticales y las pruebas de sprints con cambio de dirección y línea recta. No se encontró ninguna diferencia en el rendimiento de los sprints y el índice de fatiga (p > 0,05) en los SRCD y los SRLR, así como en los saltos verticales entre las categorías. Hubo una correlación significativa (p < 0,05) del rendimiento en los SRCD y SRLR con los saltos verticales. El rendimiento en los sprints y saltos verticales fueron similares entre las categorías. El nivel de potencia muscular se relacionó con el rendimiento en los sprints.

Acute effects of Expiratory Positive Airway Pressure (EPAP) on different levels in ventilation and electrical activity of sternocleidomastoid and parasternal muscles in Chronic Obstructive Pulmonary Disease (COPD) patients: a randomized controlled trial

ABSTRACT Objective To investigate the acute effects of EPAP on the activity of sternocleidomastoid (SCM), parasternal muscles and ventilatory parameters in COPD patients. Method Twenty-four patients with COPD were studied using surface electromyography (sEMG) and a ventilometer. Patients were randomly assigned to EPAP 10 cmH2O-EPAP10 or 15 cmH2O-EPAP15 for 20 minutes. Results The parasternal muscle sEMG activity increased during EPAP10 and EPAP15; however, a greater and significant increase was observed with EPAP10 (mean between-group difference: 12.5% RMS, 95% CI: 9.5 to 15.4, p<0.001). In relation to the baseline, at 10 and 20 minutes and upon recovery, respectively parasternal activity increased by 23.9%, 28.9% and 19.1% during EPAP10 and by 10.7% at 10 and 20 minutes and upon recovery, respectively, 11.4% and 6.9% during EPAP15 at 10 and 20 minutes and upon recovery, respectively. The sEMG activity of SCM muscle showed an opposite pattern, increasing with EPAP15 and decreasing with EPAP10 (mean between-group difference: 15.5% RMS, 95% CI: 12.6 to 18.4, p<0.001). SCM muscle activity during EPAP15, increased by 4.8% and 6.1% at 10 and 20 minutes and decreased by -4.0% upon recovery compared to decreases of –5.6%, –20.6% and –21.3% during EPAP10 at 10, 20 minutes, and recovery. Ventilation at both EPAP intensities promoted significant reductions in respiratory rate (RR) and dyspnea, more pronounced in EPAP15: RR (mean between-group difference: –3,8bpm, 95%CI: –7,5 to –0,2, p=0,015) and dyspnea (mean between-group difference: –1.01, 95%CI: –1.4 to –0.53, p=0.028) . Conclusion In COPD patients, the use of EPAP10 was more effective in reducing accessory inspiratory activity and increasing parasternal activity, which was accompanied by an improvement in ventilation and a reduction in dyspnea.

Uso de antimicrobiano nanoparticulado para o tratamento da mastite subclínica de ovelhas de corte no período seco / Use of nanoparticulated antimicrobians to treat subclinical mastitis of ewes during the dry period

A inflamação da glândula mamária é uma das principais causas de prejuízo na ovinocultura. Este estudo teve como objetivo investigar as taxas de cura do tratamento da mastite subclínica após infusão intramamária de princípio ativo antimicrobiano no momento da secagem, em formulações convencional e nanoparticulada. Os rebanhos estavam localizados em São Carlos, São Paulo, Brasil. Analisou-se um total de 584 glândulas mamárias de 307 ovelhas de aptidão para produção de carne. Triagem prévia dos casos subclínicos de mastite foi efetuada por meio do California Mastitis Test (CMT) e/ou da contagem de células somáticas (CCS). Análises microbiológicas foram realizadas para confirmação da etiologia infecciosa. As glândulas mamárias com mastite subclínica foram distribuídas em três grupos: G1 (Controle; glândulas mamárias que não receberam tratamento antimicrobiano); G2 (glândulas mamárias em que foi administrado 100 mg de cloxacilina benzatina em estrutura convencional) e G3 (glândulas mamárias em que foi administrado 50 mg de cloxacilina benzatina em estrutura nanoencapsulada). O tratamento aplicado ao G3 mostrou-se mais eficiente (P=0,047) na cura de glândulas mamárias com mastite subclínica. O uso da cloxacilina nanoencapsulada no momento da secagem de ovelhas de corte auxilia no controle da mastite subclínica infecciosa e reduz os prejuízos consequentes.(AU)

Inflammation of the mammary gland is one of the main causes of losses in sheep-rearing. This study aimed to investigate the cure rates from treating subclinical mastitis after intramammary infusion of active antimicrobial agents as conventional formulations or as nanoparticles, at the time when the ewes are being dried off. A total of 584 mammary glands in 307 ewes in meat-producing herds located in São Carlos, São Paulo, Brazil, were analyzed. Prescreening of subclinical mastitis cases was done using the California mastitis test (CMT) and/or the somatic cell count (SCC). Microbiological analyses were performed to confirm the infectious etiology. The mammary glands with subclinical mastitis were distributed into three groups: G1 (control; mammary glands that did not receive any antimicrobial treatment); G2 (mammary glands to which 100mg of benzathine cloxacillin in conventional form were administered); and G3 (mammary glands to which 50mg of benzathine cloxacillin in nanoparticulate form were administered). The treatment applied to G3 was more efficient (P=0.047) in curing mammary glands with subclinical mastitis. Use of cloxacillin nanoparticles at the time when the ewes are being dried off helps to control infectious subclinical mastitis and reduces consequential losses among meat-producing herds.(AU)

Effects of non-invasive ventilation and posture on chest wall volumes and motion in patients with amyotrophic lateral sclerosis: a case series

ABSTRACT Background The effects of non-invasive ventilation (NIV) on the breathing pattern and thoracoabdominal motion of patients with amyotrophic lateral sclerosis (ALS) are unknown. Objectives 1) To analyze the influence of NIV on chest wall volumes and motion assessed by optoelectronic plethysmography in ALS patients and 2) to compare these parameters in the supine and sitting positions to those of healthy individuals (without NIV). Method Nine ALS patients were evaluated in the supine position using NIV. In addition, the ALS patients and nine healthy individuals were evaluated in both sitting and supine positions. Statistical analysis was performed using the paired Student t-test or Wilcoxon test and the Student t-test for independent samples or Mann-Whitney U test. Results Chest wall volume increased significantly with NIV, mean volume=0.43 (SD=0.16)L versus 0.57 (SD=0.19)L (p=0.04). No significant changes were observed for the pulmonary rib cage, abdominal rib cage, or abdominal contribution. The index of the shortening velocity of the diaphragmatic muscle, mean=0.15 (SD=0.05)L/s versus 0.21 (SD=0.05)L/s (p<0.01), and abdominal muscles, mean=0.09 (SD=0.02)L/s versus 0.14 (SD=0.06)L/s (p<0.01), increased during NIV. Comparisons between the supine and sitting positions showed similar changes in chest wall motion in both groups. However, the ALS patients presented a significantly lower contribution of the abdomen in the supine position compared with the controls, mean=56 (SD=13) versus 69 (SD=10) (p=0.02). Conclusions NIV improved chest wall volumes without changing the contribution of the chest wall compartment in ALS patients. In the supine position, ALS patients had a lower contribution of the abdomen, which may indicate early diaphragmatic dysfunction.

Physiologic parameters in female red-billed curassows (Crax blumenbachii) in rehabilitation / Parâmetros fisiológicos em fêmeas de mutum do Sudeste (Crax blumenbachii) em reabilitação

The present paper reports blood gas analysis, hematologic and micro bacteriologic information on four female Red-billed curassows, rescued from illegal wild animal trading, that were undergoing habilitation for reintroduction into the wild through Projeto Centrofauna/Botucatu-SP. There is a lack of physiological data on this species, endemic to the region of Atlantic Forest (Mata Atlântica), now under threat of extinction. This lack of information makes the clinical evaluation of these birds very difficult and has a direct and adverse effect on any of these birds received for medical treatment in hospitals, veterinary clinics and centers for research and conservation, as well as in reintroduction centers.

O presente artigo reporta dados inéditos de análise hemogasométrica, hematológica e bacteriológica de quatro fêmeas de Mutum do Sudeste, resgatadas do tráfico ilegal de animais silvestres e em processo de habilitação e reintrodução para vida-livre pelo Projeto Centrofauna, Botucatu/SP. Na literatura há uma falta de dados fisiológicos sobre esta espécie, endêmica da região da Mata Atlântica e ameaçada de extinção. Esta falta de informação faz com que avaliações clínicas nesta espécie aviária sejam muito difíceis de interpretar, causando um efeito direto e negativo nestas aves para a realização de tratamento médico em hospitais, clínicas veterinárias, centros de pesquisa e/ou conservação, bem como centros de reintrodução.

Effects of diaphragmatic control on the assessment of sniff nasal inspiratory pressure and maximum relaxation rate

OBJECTIVE: To assess the influence of diaphragmatic activation control (diaphC) on Sniff Nasal-Inspiratory Pressure (SNIP) and Maximum Relaxation Rate of inspiratory muscles (MRR) in healthy subjects. METHOD: Twenty subjects (9 male; age: 23 (SD=2.9) years; BMI: 23.8 (SD=3) kg/m2; FEV1/FVC: 0.9 (SD=0.1)] performed 5 sniff maneuvers in two different moments: with or without instruction on diaphC. Before the first maneuver, a brief explanation was given to the subjects on how to perform the sniff test. For sniff test with diaphC, subjects were instructed to perform intense diaphragm activation. The best SNIP and MRR values were used for analysis. MRR was calculated as the ratio of first derivative of pressure over time (dP/dtmax) and were normalized by dividing it by peak pressure (SNIP) from the same maneuver. RESULTS: SNIP values were significantly different in maneuvers with and without diaphC [without diaphC: -100 (SD=27.1) cmH2O/ with diaphC: -72.8 (SD=22.3) cmH2O; p<0.0001], normalized MRR values were not statistically different [without diaphC: -9.7 (SD=2.6); with diaphC: -8.9 (SD=1.5); p=0.19]. Without diaphC, 40% of the sample did not reach the appropriate sniff criteria found in the literature. CONCLUSION: Diaphragmatic control performed during SNIP test influences obtained inspiratory pressure, being lower when diaphC is performed. However, there was no influence on normalized MRR.