Sudden unexpected death in Parkinson's disease: Insights from clinical practice

Abstract Classified as the second most common neurodegenerative disorder associated with aging after Alzheimer's disease, Parkinson's disease (PD) is the most common movement disorder. In the last decade, despite advances in treatment, mortality rates linked with PD continued to reach significant figures. Available studies have shown that compared with healthy controls, patients with PD are accompanied by high rates of premature death. This is usually caused by factors such as pneumonia and cerebrovascular and cardiovascular diseases. Recently, it has been demonstrated that a significant proportion of patients with PD die suddenly. This is referred to as a sudden and unexpected death in PD (SUDPAR). Here, we focus on the magnitude of SUDPAR. Finally, it is important to learn more about SUDPAR for the implementation of effective prevention strategies.

Aspectos epidemiológicos da Leishmaniose Visceral Humana no estado do Piauí, Brasil (2007-2017) / Epidemiological aspects of Human Visceral Leishmaniasis in the state of Piauí, Brazil (2007- 2017) / Aspectos epidemiológicos de la Leishmaniasis Visceral Humana en el estado do Piauí, Brasil (2007-2017)

Justificativa e Objetivos: A leishmaniose visceral apresenta considerável expansão em centros urbanos no Piauí, e a sua ocorrência é marcada por sucessivos registros de surtos. O objetivo deste estudo foi analisar os casos notificados de Leishmaniose Visceral Humana no Piauí, entre os anos de 2007 e 2017. Métodos: Os dados sobre os números de casos e variáveis, como a distribuição no tempo, no espaço e algumas características das pessoas atingidas, óbitos e diagnóstico, foram através do Sistema de Informação de Agravos de Notificação (SINANDatasus). Resultados: Foram notificados 2.447 casos, com 2.265 casos autóctones (92,56%), e o diagnóstico laboratorial conclusivo foi realizado em 86,6% dos casos. O ano de 2014 foi o ano com maior registro (283 casos) e maior coeficiente de letalidade anual de 14,1%. Ao todo, 183 municípios (81,7%) apresentaram casos positivos em residentes. Na capital, Teresina, ocorreu o maior número de casos em residentes (734 casos, 30%) e foi o município que mais notificou em todo o estado (1.859 casos, 75,97%). Os mais acometidos foram indivíduos do sexo masculino (66,30%) e faixa etária menor que 10 anos (43,44%). Em relação à escolaridade, a classificação "não se aplica" foi mais prevalente (39,84%), assim como a raça/cor parda (88,27%) e a zona residencial urbana (67,63%). Conclusão: A realização destas análises fornece informações sobre a situação epidemiológica da leishmaniose visceral no Piauí em uma série histórica de 2007 a 2017, como a distribuição espacial dos casos, municípios com maiores incidências, a dificuldade de acesso ao diagnóstico, grupos sociais mais acometidos e óbitos, podendo auxiliar no direcionamento das ações para o controle da doença no estado.(AU)

Background and Objectives: Visceral leishmaniasis presents considerable expansion in urban centers in the state of Piauí and its occurrence is marked by successive records of outbreaks. To analyze the reported cases of Human Visceral Leishmaniasis in Piauí, between 2007 and 2017. Methods: The data about the number of cases and variables such as distribution in time, space and some characteristics of the affected people, deaths and diagnosis were obtained from Notifiable Diseases Information System (SINAN-Datasus) Results: 2,447 cases were reported, of which 2,265 autochthonous cases (92.56%). The conclusive diagnosis was made in 86.6% of the cases. The year with the highest record (283 cases) was 2014, also the annual lethality rate was 14.1%. Positive cases were registered in residents of 183 municipalities (81.7%). The capital Teresina presents the highest number of cases in residents (734.30%) and notification (1,859, 75.97%). Males (66.30%) were the most affected and individuals under 10 years old (43.44%). Regarding education, the classification "does not apply" (39.84%) was the most prevalent, as well as brown race/color (88.27%) and the urban residential area (67.63%). Conclusion: Epidemiological assay provides knowledge about the real epidemiological situation in the state of Piauí, such as profile characterization, frequency of cases occurrence, assisting in actions for control and eradication of the disease in the state.(AU)

Justificación y Objetivos: La Leishmaniasis visceral presenta una expansión considerable en los centros urbanos de Piauí, y su aparición está marcada por sucesivos registros de brotes. Analizar los casos reportados de Leishmaniasis Visceral Humana en Piauí, entre los años 2007 a 2017. Métodos: Datos sobre el número de casos y variables como distribución en tiempo, espacio y algunas características de las personas afectadas, defunciones y diagnóstico fueron obtenido mediante el Sistema de Información de Enfermedades Notificables (SINAN-Datasus). Resultados: Fueron notificados 2.447 casos, con 2.265 casos autóctonos (92,56%). El diagnóstico de laboratorio concluyente se realizó en el 86,6% de los casos. 2014 fue el año con el récord más alto (283 casos) y la tasa de letalidad anual del 14,1%. 183 municipios (81,7%) presentó casos positivos en residentes. La capital Teresina tuvo el mayor número de casos en residentes (734 casos, 30%) y fue el municipio que más reportó en todo el estado (1.859 casos, 75,97%). Los más afectados pertenecían al sexo masculino (66,30%) y los menores de 10 años (43,44%). En cuanto a la educación, la clasificación "no aplica" fue más prevalente (39,84%) y la zona residencial urbana (67,63%). Conclusión: La realización de estos análisis aporta conocimiento sobre la situación epidemiológica en Piauí en una serie histórica de 2007 a 2017, como la caracterización de los casos, las fallas en los registros y la frecuencia de ocurrencia de los casos, ayudando a orientar las acciones para el control en el estado.(AU)

Sociodrama com estudantes universitários no contexto da pandemia por Covid-19 / Sociodrama with university students in the context of the Covid-19 pandemic / Sociodrama con estudiantes universitarios en el contexto de la pandemia Covid-19

Em 2020, os sistemas educacionais de diversos países foram afetados pela pandemia de Covid-19. No Brasil, o Ministério da Educação autorizou a substituição de aulas presenciais por aulas em meios digitais. Relata-se a experiência em um projeto de estágio em Psicologia Escolar e Educacional com base na metodologia sociodramática e foco nas condições simbólicas de permanência e sucesso escolar vinculadas ao desenvolvimento do papel de estudante universitário em tempos de Ensino Remoto Emergencial.

In 2020, the educational systems of several countries have been affected by the Covid-19 pandemic. In Brazil, the Education Ministry allowed the substitution of in person classes for classes in digital environments. We report our experience in an academic internship project in educational psychology based on the sociodramatic methodology and a focus on permanence and academic success as symbolic conditions linked to the development of the role of university student in times of Emergency Remote Teaching.

En 2020, los sistemas educativos de varios países fueran afectados por la pandemia de Covid-19. En Brasil, el Ministerio de la Educación autorizó la sustitución de las clases presenciales por clases en medios digitales. La experiencia en un proyecto de pasantía en Psicología escolar y educativa se relata con base en la metodología sociodramática y se enfoca en las condiciones simbólicas de permanencia y éxito escolar vinculadas al desarrollo del rol del estudiante universitario en tiempos de Educación Remota de Emergencia.

Extração de biomassa aderida ao meio-suporte de um reator de leito móvel com biofilme: agitação mecânica e ultrassom / Extraction of biomass attached to a support media in a moving bed biofilm reactor: mechanical agitation and ultrasound

RESUMO A quantificação de biomassa fixa em reatores de leito móvel com biofilme (MBBRs) é essencial para avaliação e controle do desempenho deles. Entretanto, observa-se que tal quantificação é realizada empregando-se diversas técnicas, o que dificulta comparações entre resultados. No presente trabalho, foram testadas duas das principais técnicas (agitação mecânica e ultrassom) utilizadas para extração de biomassa aderida aos meios-suporte (mídias) de um MBBR sem utilização de agentes químicos. Os desenhos experimentais foram realizados utilizando-se planejamento fatorial completo, e, para tal, foram selecionadas duas variáveis independentes: tempo (T) de exposição de 15 a 60 min; e volume de água destilada utilizado para extração (V) de 100 a 400 mL. O ultrassom mostrou-se superior à agitação mecânica quanto à eficiência no percentual extraído de sólidos suspensos totais (%SST), e embora nenhuma das variáveis (T ou V) tenha contribuído significativamente nas faixas testadas, com base na superfície de respostas, foi conduzido um novo experimento, ampliando a faixa de T de 5 a 90 min. A variável T contribuiu significativamente para o %SST, e o melhor resultado foi obtido com T = 90 min. Recomenda-se o uso de ultrassom, volume de mais fácil manuseio (250 mL) e T = 90 min. Ensaios adicionais são recomendados, tendo em vista a padronização do método.

ABSTRACT Quantification of attached biomass in Moving Bed Biofilm Reactors (MBBR) is essential for performance assessment and process control. However, it is observed that such quantification is performed using the most diverse techniques, which hampers comparisons between results. In this investigation, two of the main techniques used (mechanical agitation and ultrasound) were compared for removal of the biomass attached to the support media of an MBBR reactor without the use of chemical agents. The experiments were planned following full factorial designs using the two independent variables: Exposure time (T) from 15 to 60 min; and Volume of distillate water used for extraction (V) from 100 to 400 mL. The results revealed that ultrasound is superior to mechanical agitation regarding detachment of the total suspended solids (%TSS) and though neither T or V contributed significantly within the interval tested, based on the response surface, a new experiment was performed using an increased T range from 5 to 90 min. Then, exposure time contributed significantly to the %TSS detachment, with the best result at 90 min. The use of ultrasound is therefore recommended, with volume that is easier to handle (250 mL) and time equal to 90 min. Additional tests are recommended for method standardization.

Formas parasitárias encontradas em hortaliças comercializadas em feira livre de Picos, Piauí: a importância do processo de sanitização / Parasites found in the vegetables sold in open fairs in Picos, Piauí: the importance of sanitation process

O consumo diário de vegetais fornece inúmeros benefícios para a saúde do ser humano, no entanto têm sido um dos alimentos mais relacionados a surtos de toxinfecção alimentar em nível mundial. O objetivo deste estudo foi avaliar a presença de estruturas parasitárias em hortaliças comercializadas na feira livre do município de Picos, Piauí antes e após a utilização de hipoclorito de sódio como sanitizante. Foram analisadas 160 amostras, sendo 40 de alfaces-crespa (Lactuca sativa L.), 40 amostras de acelga (Beta vulgaris var. cicla L.), 40 amostras de coentro (Coriandrum sativum L.) e 40 amostras de cebolinha (Allium fistulosum L.), todas oriundas de plantio convencional. Para a busca parasitária, utilizou-se o método de sedimentação espontânea (Hoffmann). Os resultados mostraram que 75% das amostras, após lavagem com água destilada, estavam contaminadas por alguma estrutura parasitária, incluindo casos de múltipla contaminação. Os parasitos que prevaleceram nas amostras foram Ancilostomídeo (ovo e larva), Ascaris lumbricoides (ovo), Entamoeba histolytica (cisto), Taenia sp. (ovo) e Trichuris trichiura (ovo e larva). Após a sanitização das amostras, houve a redução da carga parasitária, o que torna indispensável esse processo. Esses dados demonstram a situação higiênico-sanitária precária das hortaliças comercializadas na feira livre e a necessidade da realização de campanhas de educação em saúde para produtores, comerciantes e consumidores de hortaliças da região. Essas medidas proporcionam melhora na qualidade das hortaliças e segurança para quem as consome.

Daily intake of vegetables provides numerous benefits to human health, yet they have been one of the foods most related to food poisoning outbreaks worldwide. The aim of this study was to evaluate the presence of parasitic structures in vegetables sold in the open fairs in Picos – Piauí, before and after the use of 2% sodium hypochlorite as a sanitizer. One hundred and sixty samples were analyzed: 40 of lettuce (Lactuca sativa L.), 40 samples of Swiss chard (Beta vulgaris var. cicla L.), 40 samples of coriander (Coriandrum sativum L.) and 40 samples of chives (Allium fistulosum L.), all from conventional planting. For parasitic search, the spontaneous sedimentation method (Hoffmann) was used. All samples examined were contaminated by some parasitic structure and had multiple contamination. The predominant parasites were hookworm (egg and larva), Ascaris lumbricoides (egg), Entamoeba histolytica (cyst), Taenia sp. (egg) and Trichuris trichiura (egg and larva). The samples were sanitized, and the process reduced the parasite load by more than half. It is important to carry out health education campaigns for producers, traders and consumers of vegetables in the region and a strict supervision of the hygienic-sanitary quality of these foods, measures that provide improvement in the quality of vegetables and safety for those who consume them.

Formas parasitárias encontradas em hortaliças comercializadas em feira livre de Picos, Piauí: A importância do processo de sanitização / PARASITES FOUND IN THE VEGETABLES SOLD IN OPEN FAIRS IN PICOS, PIAUÍ: THE IMPORTANCE OF SANITATION PROCESS

O consumo diário de vegetais fornece inúmeros benefícios para a saúde do ser humano, no entanto têm sido um dos alimentos mais relacionados a surtos de toxinfecção alimentar em nível mundial. O objetivo deste estudo foi avaliar a presença de estruturas parasitárias em hortaliças comercializadas na feira livre do município de Picos, Piauí antes e após a utilização de hipoclorito de sódio como sanitizante. Foram analisadas 160 amostras, sendo 40 de alfaces-crespa (Lactuca sativa L.), 40 amostras de acelga (Beta vulgaris var. cicla L.), 40 amostras de coentro (Coriandrum sativum L.) e 40 amostras de cebolinha (Allium fistulosum L.), todas oriundas de plantio convencional. Para a busca parasitária, utilizou-se o método de sedimentação espontânea (Hoffmann). Os resultados mostraram que 75% das amostras, após lavagem com água destilada, estavam contaminadas por alguma estrutura parasitária, incluindo casos de múltipla contaminação. Os parasitos que prevaleceram nas amostras foram Ancilostomídeo (ovo e larva), Ascaris lumbricoides (ovo), Entamoeba histolytica (cisto), Taenia sp. (ovo) e Trichuris trichiura (ovo e larva). Após a sanitização das amostras, houve a redução da carga parasitária, o que torna indispensável esse processo. Esses dados demonstram a situação higiênico-sanitária precária das hortaliças comercializadas na feira livre e a necessidade da realização de campanhas de educação em saúde para produtores, comerciantes e consumidores de hortaliças da região. Essas medidas proporcionam melhora na qualidade das hortaliças e segurança para quem as consome

Daily intake of vegetables provides numerous benefits to human health, yet they have been one of the foods most related to food poisoning outbreaks worldwide. The aim of this study was to evaluate the presence of parasitic structures in vegetables sold in the open fairs in Picos ­ Piauí, before and after the use of 2% sodium hypochlorite as a sanitizer. One hundred and sixty samples were analyzed: 40 of lettuce (Lactuca sativa L.), 40 samples of Swiss chard (Beta vulgaris var. cicla L.), 40 samples of coriander (Coriandrum sativum L.) and 40 samples of chives (Allium fistulosum L.), all from conventional planting. For parasitic search, the spontaneous sedimentation method (Hoffmann) was used. All samples examined were contaminated by some parasitic structure and had multiple contamination. The predominant parasites were hookworm (egg and larva), Ascaris lumbricoides (egg), Entamoeba histolytica (cyst), Taenia sp. (egg) and Trichuris trichiura (egg and larva). The samples were sanitized, and the process reduced the parasite load by more than half. It is important to carry out health education campaigns for producers, traders and consumers of vegetables in the region and a strict supervision of the hygienic-sanitary quality of these foods, measures that provide improvement in the quality of vegetables and safety for those who consume them

Cytotoxic and genotoxic potential of industrialized powdered milk for infants and young children

This study aimed to evaluate the cytotoxicity and genotoxicity and determine the LC50 concentration of powdered infant formulas widely marketed in South American countries. To this, milk samples, called as A, B, C and D, were analyzed in root meristem cells of Allium cepa, at concentrations of 0.075; 0.15 and 0.30 g mL-1, for 24 and 48 hours; and through cell viability in culture of normal line cells, via MTT test, for 24 hours, in the concentrations 0.018; 0.0375; 0.075 and 0.15 g mL-1. In A. cepa, all dairy products in the three concentrations caused significant inhibition of cell division in the meristems within the first 24 hours of exposure. In the in vitro evaluation, all milk formulas at 0.15 g mL-1, as well as milk A at a concentration of 0.037 g mL-1, C at 0.075 g mL-1 and D at 0.037 g mL-1, significantly reduced the cellular viability of the cell culture exposed to the foods studied, being potentially toxic. The milk A was considered the most toxic, with LC50 of 0.031 g mL-1, and B as the least toxic, with LC50 of 0.15 g mL-1. Therefore, the milk evaluated caused significant instability in cells of the test systems used and were characterized as cytotoxic.

Development of a Phytocosmetic Enriched with Pequi (Caryocar brasiliense Cambess) Oil

Abstract The pulp oil of Caryocar brasiliense Camb., better known as pequi, is used in the typical cuisine of the Brazilian Cerrado region. It is also used in folk medicine to combat several types of disease of the respiratory system and skin. However, since its exploration is purely extractive, the exhaustion of this plant is already foreseen. Thus, in order to establish the sustainable use of pequi and contribute to its maintenance, this study aimed to develop a phytocosmetic with antioxidant and photoprotective properties using the oil of this fruit. Initially, the cytotoxicity of the oil was evaluated in order to establish the safety of its use and its fatty acid composition. Then, from the cream enriched with the oil, it was evaluated the antioxidant and photoprotector potentials, quantified the total phenolic content and examined the quality of the formulation. Pequi oil showed high percentages of palmitic (52.11%) and oleic (44.57%) fatty acids and absence of cytotoxicity. The analysis of the cream revealed 168.8 mg of total phenols in gallic acid equivalent per 100 g of oil. The evaluation of antioxidant activity showed an EC50 of 2.921 mg/mL and a capacity of inhibiting the lipoperoxidation process higher than 100%. The obtained sun protection factor was 11.40 at the concentration of 6.25 mg/mL. The quality tests revealed small disturbances in the cream stability that can be solved by further research and improvement of the formulation. The pequi oil can be converted into a phytocosmetic of great commercial value.

Triatomine bugs (Hemiptera, Reduviidae, Triatominae) in the Domiciles of the Guaribas Valley Territory, in Northeastern Brazil

Abstract INTRODUCTION Triatomine bugs are hematophagous insects that are extremely important in public health because they are natural vectors of Trypanosoma cruzi, the causative agent of Chagas disease. In this study, we aimed to assess the occurrence of triatomine species and the natural T. cruzi infection in the Guaribas Valley territory, an endemic region for Chagas disease in northeastern Brazil. METHODS Insects were actively captured from July 2017 to October 2019 in the intra- and peridomiciles of 16 municipalities of the Guaribas Valley territory, in the southeast area of Piauí state. Triatomine species were identified following a taxonomic key, and natural infection was investigated through insects' fresh feces exams. RESULTS A total of 430 triatomines were collected, including 211 nymphs and 219 adults. Of all collected specimens, 39 (9.1%) were from the intradomiciles and 391 (90.9%) from peridomiciles. Nine species, including two subspecies, could be identified: Triatoma brasiliensis brasiliensis, T. brasiliensis macromelasoma, T. pseudomaculata, T. sordida, T. juazeirensis, T. melanocephala, Panstrongylus lutzi, Rhodnius domesticus, R. nasutus, and R. robustus. T. brasiliensis were the most frequently collected bugs, representing 72% of all the identified insects. None of the examined invertebrates presented flagellate forms of T. cruzi. CONCLUSIONS: This is the first report of T. b. macromelasoma and T. juazeirensis in the Guaribas Valley territory. The persistence of triatomine species in the domiciles in an endemic area for Chagas disease emphasizes the relevance of entomological surveillance and vector control measures in the studied area.

Criteria for evaluating studies at scientific medical events

Medical journals value the quality of studies. Scientific events are spaces for discussion in the face of scientific advances, innovation and consensus. In them, space is opened for the presentation of clinical studies, translational studies, experience reports and videos, with the best-designed studies being selected and awarded. The lack of clear criteria allows for differences in assessments, making it difficult to place value on situations associated with research. In order to improve quality, it is necessary to evaluate ethics, the hierarchy of scientific evidence (methodology), the study design, the originality, the relevance, and the linearity of the material presented. The present study aims to discuss these points, presenting proposals to be used in the evaluation of clinical studies, translational studies, case reports and videos in scientific medical events.

Toxic, cytotoxic and genotoxic potential of synthetics food flavorings / Potencial tóxico, citotóxico y genotóxico de saborizantes sintéticos de alimentos

Food flavorings in general are few studied for the toxicological aspect. This condition justifies toxicity, cytotoxicity and genotoxicity assessments of the substances. In the present study, the toxicity of banana, cherry and hazelnut flavorings was evaluated in meristematic cells of roots of Allium cepa, in pure form (as marketed) and in the concentrations of 12.5; 25 and 50%, after 24 and 48 hours of exposure. Toxic potential of these food additives was also evaluated against Artemia salina nauplii at concentrations of 0.78; 1.56; 3.12; 6.25; 12.5; 25 and 50%, after 24 hours of exposure. The three additives, in all treatments and times of analysis considered, caused significant inhibition of cell division in A. cepa, however did not cause cellular alterations to the evaluated meristems. These food flavorings also caused significant mortality to micro crustaceans with LC50<100 μg/mL. From this, under the conditions of mentioned analyzes, cherry, banana and hazelnut flavorings induced significant toxicity and cytotoxicity to the bioassays used.

En general, los aspectos toxicológicos de los saborizantes de los alimentos son poco estudiados. Esta condición justifica las evaluaciones de toxicidad, citotoxicidad y genotoxicidad de estas sustancias. En el presente estudio, se evaluó la toxicidad de los aromas de plátano, cereza y avellana en células meristemáticas de raíces de Allium cepa, en forma pura (según comercializa) y en concentraciones de 12.5; 25 y 50%, después de 24 y 48 horas de exposición. El potencial tóxico de estos aditivos alimentarios también se evaluó frente a nauplios de Artemia salina a concentraciones de 0,78; 1,56; 3.12; 6.25; 12.5; 25 y 50%, después de 24 horas de exposición. Los tres aditivos, en todos los tratamientos y tiempos de análisis considerados, causaron inhibición significativa de la división celular en A. cepa, sin embargo, no causaron alteraciones celulares a los meristemos evaluados. Estos saborizantes alimentarios también causaron una mortalidad significativa a microcrustáceos con LC50 <100 μg/ mL. A partir de esto, bajo las condiciones de los análisis descriptos, los aromatizantes de cereza, plátano y avellana indujeron toxicidad significativa y citotoxicidad para los bioensayos utilizados.

Expression of tumor suppressors miR-195 and let-7a as potential biomarkers of invasive breast cancer

OBJECTIVE: MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression at the posttranscriptional level. Some miRNAs, including let-7a and miR-195, have been described as tumor suppressors. However, the roles of these microRNAs in breast cancer progression remain controversial. The aim of this study is to evaluate miR-195 and let-7a expression as potential biomarkers of invasive breast cancer. METHODS: In the present study, 200 individuals were separated into three groups: (i) 72 women constituting the control group who were selected according to rigorous and well-established criteria; (ii) 56 patients with benign breast tumors; and (iii) 72 patients with malignant breast cancers of different clinical stages. The miR-195 and let-7a expression levels in serum were evaluated by real-time PCR. The results were assessed alone and in combination, and the analysis included an estimation of sensitivity and specificity in ROC curves. RESULTS: Compared with the benign and control groups, both microRNAs were downregulated in the malignant breast cancer patient group. Compared with the malignant group, the combination of both biomarkers in the control and benign groups showed good sensitivity and specificity in the serum with AUCs of 0.75 and 0.72, respectively. The biomarker combination for the control group versus the malignant group exhibited a better sensitivity and specificity than for the benign group versus the malignant group. CONCLUSION: These findings support the evidence that the analysis of miR-195 and let-7a can be used as a non-invasive biomarker for breast cancer detection.

Industrial milk powder in bioassays for evaluation of cytotoxicity and genotoxicity / Leites industrializados, tipo em pó, frente a bioensaios de avaliação de citotoxicidade e genotoxicidade

Considering the widespread consumption of milk powder by the general population as well as the lack of studies on the toxicity of such industrialized foods, this study evaluated the cytotoxic and genotoxic potential of powdered milk from four reputed companies in the food market of Brazil and other South American countries. Milk samples were evaluated in root meristem cells of Allium cepa L., at concentrations of 0.065 and 0.13 g/mL, for 24 and 48 hours of exposure; and by means of cell viability in culture of cells of normal lineage, via MTT test, for 24 hours, at concentrations of 0.016; 0.032; 0.065 and 0.13g/mL. The concentration 0.13 g/mL was the one suggested for consumption in all milk packages evaluated in this study. In A. cepa, we observed that the milks, at both concentrations and at the two exposure times investigated, reduced the cellular proliferation of root meristems demonstrating a significant cytotoxicity. Furthermore, 0.13g/mL milks at the exposure time of 24h induced an expressive frequency of cellular alterations in the plant tissue, showing to be genotoxic. In the in vitro evaluation, three milks at 0.065 g/mL and all milks at 0.13 g/mL have significantly reduced cell viability, proving to be cytotoxic to the analyzed cell culture. Therefore, under the studied conditions, the powdered milks evaluated caused significant genetic instability to the cells of the test systems used.

Devido o amplo consumo de leite em pó pela população em geral, bem como, a carência de estudos sobre a toxicidade de tais alimentos industrializados, objetivou-se na presente pesquisa avaliar o potencial citotóxico e genotóxico de leites em pó provenientes de quatro empresas de reconhecida atuação no mercado de alimentos brasileiro e de outros países da América do sul. As amostras de leite foram avaliadas em células meristemáticas de raízes de Allium cepa L., nas concentrações 0,065 e 0,13g/mL, por 24 e 48 horas de exposição; e por meio da viabilidade celular em cultura de células de linhagem normal, via teste MTT, por 24 horas, nas concentrações 0,016; 0,032; 0,065 e 0,13g/mL. A concentração 0,13 mL/kg foi a sugerida para consumo em todas embalagens de leites avaliados neste estudo. Em A. cepa, verificou-se que os leites, nas duas concentrações e nos dois tempos de análise considerados, reduziram a proliferação celular dos meristemas de raízes demonstrando citotoxicidade significativa. Ainda, os leites na concentração 0,13g/mL induziram, no tempo de exposição 24h, frequência expressiva de alterações celulares ao tecido vegetal, mostrando-se genotóxicas. Na avaliação in vitro, três leites na concentração 0,065g/mL e todos na concentração 0,13g/mL reduziram significativamente a viabilidade celular mostrando-se citotóxicos a cultura de células analisada. Portanto, nas condições de estudo estabelecidas, os leites em pó avaliados causaram significativa instabilidade genética as células dos sistemas testes utilizados.

Antioxidant activity and physicochemical analysis of passion fruit (Passiflora glandulosa Cav) pulp native to Cariri region / Atividade antioxidante e análise físico-química da polpa do maracujá (Passiflora glandulosa Cav) nativo da região do Cariri

The objective of this study was to determine the proximal composition, the physical and chemical characteristics and the in vitro antioxidant capacity (DPPH, ABTS and FRAP) of the pulp of the wild passion fruit (Passiflora glandulosa Cav.) from Cariri region, Ceara, Brazil. The results showed that the proximal composition and the caloric value of this passion fruit are similar to other species, but with a high ascorbic acid content. The fruit pulp showed low level of antioxidant activity and low level of polyphenolic compounds followed by three methodologies used. Due to high levels of titratable acidity (3.52) and total soluble solids (17.80° Brix), this fruit can be considered as a high value fruit for commerce. However, it is a species of passion fruit with few studies described in the literature, and more research is needed to assess its nutritional and functional potential.

O objetivo do estudo foi determinar a composição centesimal, as características físicas e químicas e a capacidade antioxidante (DPPH, ABTS e FRAP) in vitro da polpa do maracujá-do-mato (Passiflora glandulosa Cav.) da região do Cariri, Ceará, Brasil. Os resultados demonstraram que a composição centesimal e o valor calórico desse tipo de maracujá são similares a outras espécies, mas com nível elevado de ácido ascórbico. A polpa apresentou baixo teor de polifenóis e baixa atividade antioxidante para as três metodologias aplicadas. Em razão dos altos níveis de acidez titulável (3,52) e sólidos solúveis totais (17,80° Brix), este fruto pode ser considerado como um fruto de alto valor para o comércio. Porém, esta é uma espécie de maracujá pouco descrita na literatura, sendo necessárias mais análises para avaliar seu potencial valor nutricional e funcional.

Prevalence of fibromyalgia in patients treated at the bariatric surgery outpatient clinic of Hospital de Clínicas do Paraná - Curitiba / Prevalência de fibromialgia em pacientes acompanhados no ambulatório de cirurgia bariátrica do Hospital de Clínicas do Paraná - Curitiba

Abstract Introduction: Fibromyalgia (FM) is a chronic pain syndrome characterized by generalized pain. It is known that obese patients have more skeletal muscle pain and physical dysfunction than normal weight patients. Therefore, it is important that the early diagnosis of FM be attained in obese patients. Objective: To determine the prevalence of FM in a group of obese patients with indication of bariatric surgery. Materials and methods: The patients were recruited from the Bariatric Surgery outpatient clinic of Hospital de Clínicas of UFPR (HC-UFPR) before being submitted to surgery. Patient assessment consisted in verifying the presence or absence of FM using the 1990 and 2011 ACR criteria, as well as the presence of comorbidities. Results: 98 patients were evaluated, of which 84 were females. The mean age was 42.07 years and the BMI was 45.39. The prevalence of FM was 34% (n = 29) according to the 1990 criteria and 45% (n = 38) according to the 2011 criteria. There was no difference in age, BMI, Epworth score and prevalence of other diseases among patients who met or not the 1990 criteria. Only depression was more common in patients with FM. (24.14% vs. 5.45%). The same findings were seen in patients that met the 2011 criteria. Conclusions: The prevalence of FM in patients with morbid obesity is extremely high. However, BMI does not differ in patients with or without FM. The presence of depression may be a risk factor for the development of FM in these patients.

Resumo Introdução: Fibromialgia (FM) é uma síndrome de dor crônica caracterizada por dor generalizada. Sabe-se que pacientes obesos têm mais dor músculo esquelética e disfunção física do que pacientes de peso normal. Portanto, é importante que o diagnóstico precoce da FM seja feito em pacientes obesos. Objetivo: Determinar a prevalência de FM em um grupo de pacientes obesos com indicação de cirurgia bariátrica. Materiais e métodos: Os pacientes foram captados do ambulatório de Cirurgia Bariátrica do Hospital de Clínicas da UFPR (HC-UFPR), antes de serem submetidos à cirurgia. A avaliação dos pacientes consistia em constatar a presença ou ausência de FMG pelos critérios ACR 1990 e 2011 e também a presença de comorbidades. Resultados: Foram avaliados 98 pacientes, 84 mulheres. A idade média foi de 42,07 anos e o IMC de 45,39. A prevalência de FM foi de 34% (n = 29) pelos critérios de 1990 e de 45% (n = 38) pelos de 2011. Não houve diferença em idade, IMC, escala de Epworth e prevalência de outras doenças entre pacientes que preenchiam ou não os critérios de 1990. Apenas depressão foi mais comum nas pacientes com FM (24,14% vs. 5,45%). Os mesmos achados foram vistos nas pacientes que preenchiam os critérios de 2011. Conclusões: A prevalência de FM em pacientes com obesidade mórbida é extremamente alta. Porém o IMC não difere nos pacientes com ou sem FM. A presença de depressão pode ser um fator de risco para o desenvolvimento de FM nesses pacientes.

Consenso brasileiro multi-institucional de pacientes sobre medicamentos biossimilares / Brazilian patients multi-institutional consensus on biosimilar drugs

Objetivo: O presente trabalho tem como objetivo emitir um consenso de diversas associações de pacientes sobre os produtos biossimilares. Métodos: O consenso foi produzido em reunião presencial com 15 representantes de 11 diferentes associações de pacientes. Previamente ao encontro, realizou- -se exercício Delphi contemplando 12 diferentes tópicos referentes a medicamentos biossimilares, sendo os temas de menor concordância selecionados para aulas informativas. Posteriormente, os participantes reuniram-se para discussão dos temas e elaboração do consenso. Resultados: O consenso concentrou-se em torno de oito temas gerais: nomenclatura, farmacovigilância, mercado nacional, RDC nº 55/2010, extrapolação de indicações, substituição automática, intercambialidade e estudos clínicos. Conclusões: Os medicamentos biossimilares representam avanço referente ao acesso à terapia biológica devido, especialmente, à competitividade econômica. Todavia, sua utilização deve ser respaldada por exercícios clínicos apropriados ­ exercício de biossimilaridade ­, respeitando a autonomia do prescritor e sempre apoiado em metodologias apropriadas de farmacovigilância.

Objective: This paper aims to publish a consensus from diverse patient associations on biossimilar drugs. Methods: The consensus was produced in a live meeting that gathered 15 representatives from 11 different patient associations. Previously to the meeting a Delphi exercise was elaborated contemplating 12 different subjects regarding biosimilar drugs. The subjects with smaller agreement were chosen to be discussed in informative lectures. Posteriorly, the attendants discussed the subjects and elaborated the consensus. Results: The consensus focused on eight different general subjects: nomenclature, pharmacovigilance, national Market, RDC nº 55/2010, extrapolation of controindications, automatic substitution, interchangeability, clinical trials. Conclusions: Biosimilar drugs represent progress regarding the access to biologic treatment, especially due to its economic competitiveness. However, its use must be supported by proper clinical trials ­ biosimilarity exercise ­ respecting the prescritor autonomy and counting on solid pharmacovigilance methods.

Ultrastructural study of morphological changes in Schistosoma mansoni after in vitro exposure to the monoterpene rotundifolone

ABSTRACT INTRODUCTION: Schistosomiasis, a parasitic disease caused by trematode flatworms of the genus Schistosoma, affects more than 200 million people worldwide, and its control is dependent on a single drug, praziquantel. Here, we report the in vitro effect of rotundifolone, a monoterpene isolated from Mentha x villosa (Lamiaceae), on Schistosoma mansoni adult worms. METHODS: The in vitro effect of rotundifolone on adult Schistosoma mansoni was evaluated by analysis of behavior and mortality and through a scanning electron microscopic analysis of ultrastructural changes in the tegument of the worms. RESULTS: At concentrations of 3.54 and 7.09μg/mL-1 rotundifolone, no worm mortality was observed at any of the sampling intervals. A minor reduction in movement of the tail, suckers, and gynecophoral canal membrane was observed after 96 h of exposure to 7.09μg/mL-1 rotundifolone. At 70.96μg/mL-1, a lack of movement was observed from 72h onwards and all worms were deemed dead; similar effects were observed at 48h with 177.4μg/mL-1, and at 24h with 354.8μg/mL-1 and 700.96μg/mL-1. Rotundifolone also caused death of all parasites and separation of coupled pairs into individual males and females after 24h at 354.8μg/mL-1. CONCLUSIONS: The main changes in the tegument induced by the different ROT treatments were: after 24h incubation, bubble lesions spread over the entire body and loss of tubercles occurred in some regions of the ventral region.

Free radical scavenging activity of ethanol leaves extracts of Anacardiaceae / Atividade de sequestramento de radical livre dos extratos etanólicos das folhas de Anacardiaceae

Free radicals are responsible for causing many chronic and degenerative diseases. Antioxidants are substances capable of scavenging free radicals and preventing cell damage. In this context, antioxidant activity of alcoholic extracts from leaves of Anacardium occidentale and Myracrodruon urundeuva was evaluated by 2,2-diphenyl-1-picrylhydrazyl DPPH and 2,2'-azinobis-(3-ethyl-benzothiazolin6-sulfonic acid) ABTS methods. Phenolic content and phytochemical analysis were performed for each species. Results showed that both species exhibited free radical scavenging activity. These results are directly related to high phenolic content found in the extracts. M. urundeuva showed antioxidant activity similar to butylhydroxytoluene (BHT) and could be considered a promising plant source of natural antioxidant.

Os radicais livres são responsáveis por causar muitas doenças crônicas e degenerativas. Os antioxidantes são substâncias capazes de eliminar radicais livres e impedi-los de causar danos celulares. Neste contexto, a atividade antioxidante dos extratos alcoólicos das folhas de Anacardium occidentale e Myracrodruon urundeuva foi avaliada pelos métodos de 2,2- difenil-1-picrilhidrazil (DPPH) e 2,2'-azinobis-(3-etil-benzothiazolin-6-sulfónico ácido) (ABTS). O conteúdo fenólico e análise fitoquímica dos extratos também foram avaliados. As duas espécies exibiram atividade sequestradora de radicais livres. Estes resultados estão relacionados com alto teor de compostos fenólicos encontrados nos extratos. M. urundeuva mostrou atividade antioxidante semelhante ao butilhidroxitolueno (BHT), se tornando uma fonte promissora de antioxidante natural.

Análise do controle vetorial da dengue no sertão piauiense entre 2007 e 2011 / Analysis of dengue vector control in the semiarid region of Piauí between 2007 and 2011

Resumo Dois terços da população mundial vivem em áreas infestadas com mosquitos vetores da dengue, especialmente o Aedes aegypti. Este estudo realizou um levantamento de dados sobre casos de dengue no município de Picos, no Estado do Piauí, Brasil, entre os anos de 2007 e 2011, enfatizando alguns fatores envolvidos em sua transmissão. Os dados foram coletados no Centro de Zoonoses de Picos da Secretaria Municipal de Saúde e no Sistema de Informação da Febre Amarela e Dengue (SISFAD) do Programa Nacional do Controle da Dengue (PNCD). Durante os anos de 2007, 2008, 2009, 2010 e 2011, foram visitados, respectivamente, 116.301, 182.024, 181.892, 187.619 e 195.377 imóveis pelos agentes de controle de endemias (ACE). As residências foram os estabelecimentos com maior positividade para focos de larvas de Aedes aegypti (p<0,05). Dentre os depósitos inspecionados, as larvas predominaram em armazenadores de água rebaixados (tambores) e elevados (caixas-d’água). Testes sorológicos confirmaram um total de 85 casos em 2007, 117 em 2008, 221 em 2009, 296 em 2010 e 217 em 2011. A média de casos foi mais expressiva em pacientes com idade entre 20-34 anos (p<0,05). No ano de 2011, foram identificados, pela primeira vez, focos de Aedes albopictus, encontrados principalmente em tambores de água. Portanto, o número de casos vem aumentando, o que sugere que o controle vetorial da transmissão pode sofrer forte impacto a partir da ação de vigilância epidemiológica em âmbito coletivo, uma vez que depósitos de água peri ou intradomiciliares representaram os locais predominantes para a procriação de vetores.

Abstract Two-thirds of the world population live in areas infested with dengue vector mosquitoes, especially Aedes aegypti. This study conducted a survey about dengue cases in Picos (Piauí, Brazil) between 2007 and 2011, emphasizing some transmission factors. Data were collected in the Health Secretary and Municipal Zoonoses Center and in SISFAD Programme (Information System of the National Dengue Control Program). During 2007, 2008, 2009, 2010 and 2011, a total of 116,301; 181,892; 187,619 and 195,377 properties, respectively, were visited by endemic control agents, and presented higher rates of outbreaks for A. aegypti larvae (p<0.05). Among the inspected places, larvae were predominant in lowered (storage tanks) and raised (water tanks) water reservoirs. Serological tests confirmed a total of 85, 117, 221, 296 and 217 cases in 2007, 2008, 2009, 2010 and 2011 and the average number of cases was higher in patients between 20-34 years-old) (p<0.05). In 2011 it was identified, for the first time, Aedes albopictus spots, mainly in storage tanks. Therefore, the number of cases is increasing, suggesting that the transmission vector control may suffer a strong impact by surveillance action based on community contribution, since peri- or household water tanks represented the predominant sites for vectors reproduction.