The inhibitor of the redox activity of APE1/REF-1, APX2009, reduces the malignant phenotype of breast cancer cells

Apurinic/apyrimidinic endonuclease 1/redox factor-1 (APE1/REF-1) is a multifunctional protein acting on cellular signaling pathways, including DNA repair and redox activities. APE1/REF-1 has emerged as a target for cancer therapy, and its role in breast cancer models would reveal new strategies for cancer therapy. APX2009 is a specific APE1/REF-1 redox inhibitor whose anticancer properties have not been described in breast cancer cells. Here, we investigated the effect of the APX2009 treatment in the breast cancer cell lines MDA-MB-231 and MCF-7. Breast cancer cell lines were cultured, and WST1 and colony formation assays were performed to evaluate cell proliferation. Annexin V-FITC/7-AAD and LDH-Glo™ assays were performed to evaluate cell death. The wound healing assay and Matrigel transwell assay were performed after APX2009 treatment to evaluate the cellular migration and invasion processes, respectively. Our findings demonstrated that APX2009 treatment decreased breast cancer cell proliferative, migratory, and invasive properties. Furthermore, it induced apoptosis in both cell lines. Our study is the first to show the effects of APX2009 treatment on apoptosis in a breast cancer cell. Therefore, this study suggested that APX2009 treatment is a promising anticancer molecule for breast cancer.

The high biodiversity of benthic organisms in a coastal ecosystem revealed by an integrative approach / A alta biodiversidade de organismos bentônicos em um ecossistema costeiro revelada por uma abordagem integrativa

Abstract Increasing habitat modification and species loss demand consistent efforts to describe and understand biodiversity patterns. The BIOTA/FAPESP Program was created in this context and it has been a successful initiative to promote studies on biodiversity and conservation in Brazil. The BIOTA/Araçá is an interdisciplinary project that provided a detailed evaluation of the biodiversity of Araçá Bay, a coastal seascape located on the North coast of the state of São Paulo, Southeast Brazil. The bay encompasses multiple habitats, such as beaches, mangroves, rocky shores, and a tidal flat, and provides important ecosystem services. Unfortunately, the bay is the subject of complex social-environmental conflicts that oppose economic, social, and environmental demands (i.e., the expansion of neighboring harbor activities vs. small-scale artisanal fisheries and protection of biodiversity). The present study presents a survey of the benthic species occurring in the different habitats of Araçá Bay, including data obtained during the BIOTA/Araçá project and previous assessments of the area. The benthic species play an important role in marine environments and studying the diversity of these organisms that live associated with the bottom is indispensable for comprehending the environment's functioning. The macrofauna, meiofauna, and microorganisms associated with soft and hard bottom were listed, and additional information, such as the habitat and geographical distribution, were provided for each species. The checklist includes 826 species, almost 70% recorded during the BIOTA/Araçá project. The most speciose taxa were the annelids (225 spp.), mollusks (194 spp.), and crustaceans (177 spp.). Seven benthic species are endemic to Araçá Bay, 14 are considered threatened, and seven are economically exploited. Furthermore, the bay is the type locality of many taxa, and 11 new benthic species were described based on specimens sampled during the project. This project shows the importance of Araçá Bay as a unique biologically rich environment and highlights the need for conservation efforts in light of the current threats.

Resumo O aumento da modificação dos habitats e da perda de espécies demanda esforços consistentes para descrever e compreender os padrões de biodiversidade. O programa BIOTA/FAPESP foi criado nesse contexto e é uma iniciativa de sucesso para promover estudos em biodiversidade e conservação no Brasil. O BIOTA/Araçá é um projeto interdisciplinar que promoveu uma avaliação detalhada da biodiversidade da Baía do Araçá, um ecossistema costeiro localizado ao Norte do estado de São Paulo, Sudeste do Brasil. A baía engloba múltiplos habitats, tais como praias, manguezais, costões rochosos, e uma planície de maré, e também fornece importantes serviços ecossistêmicos. Infelizmente, a baía está sujeita à conflitos sócio-ambientais complexos que contrastam demandas econômicas, sociais e ambientais (i.e. a expansão das atividades do porto vizinho vs. a pesca artesanal de pequena escala e a proteção da biodiversidade). O presente estudo apresenta um levantamento das espécies bentônicas que ocorrem nos diferentes habitats da Baía do Araçá, incluindo dados obtidos durante o projeto BIOTA/Araçá e de investigações realizadas anteriormente na área. As espécies bentônicas desempenham um papel importante no ambiente marinho, e estudar a diversidade desses organismos que vivem associados ao fundo é indispensável para compreender o funcionamento do meio ambiente. A macrofauna, meiofauna, e microorganismos associados aos fundos consolidado e inconsolidado foram listados, e informações adicionais foram fornecidas para cada espécie, tais como a distribuição geográfica e nos habitats. O checklist inclui 826 espécies, quase 70% registradas durante o projeto BIOTA/Araçá. Os taxa mais especiosos foram os anelídeos (225 spp.), moluscos (194 spp.), e crustáceos (177 spp.). Entre as espécies bentônicas listadas, sete são endêmicas da Baía do Araçá, 14 são consideradas ameaçadas de extinção, e sete são exploradas economicamente. A baía é a localidade tipo de vários taxa, e 11 novas espécies bentônicas foram descritas com base em espécimes amostrados durante o projeto. Este projeto mostra a importância da Baía do Araçá como um ambiente de riqueza biológica única e demonstra a necessidade de esforços para a sua conservação considerando as atuais ameaças.

One-day voiding diary in the evaluation of Lower Urinary Tract Symptoms in children

ABSTRACT Introduction: Voiding diary (VD) is an important tool in the evaluation of children with voiding symptoms. Voiding frequency, maximal voided volume (MVV), average voided volume (AVV) and nocturnal volume (NV) can be extracted and are valuable in diagnosing and monitoring these disorders. Recently, ICCS has reduced the period of data recording on VD from 3 to 2 days. We hypothesized that one day voiding diary would be enough for guiding treatment. Materials and Methods: Children with overactive bladder (OAB) and primary monosymptomatic enuresis (PMNE) were oriented to fulfill a 3-day VD. Data obtained from VD were evaluated for the first day (1dVD), the first two days (2dVD), and all 3 days (3dVD) and compared according to the MVV, AVV, frequency, NV and expected bladder capacity (EBC). The Friedman, Student's t test and the Fisher's exact was used. ANOVA was used for multiple comparisons. We also used Pearson correlation test. Results: Ninety-eight children were included, 59 had PMNE and 30 OAB. Frequency, AVV and VN were similar regardless how many days the voiding episodes were recorded. Only MVV was higher by a mean of only 32 mL on 3dVD compared to 1dVD. A 1dVD has a sensitivity of 93,9% and a positive likelihood ratio of 2.2. As for the correlation of MVV and EBC it was observed that in 83% of children, MVV was lower than EBC. MVV corresponds to 67% and 69% of EBC in children with PMNE and OAB, respectively. Conclusion: We believe that 1dVD is sufficient to assess these children. It has a high sensitivity and good correlation to 3dVD in evaluating these children. Bladder capacity in this population, evaluated by maximum voided volume, was close to 68% of that obtained by the EBC.

Turner Syndrome associated with Mayer-Rokitansky-KusterHauser Syndrome: A case report and review of related literature

@#Turner syndrome and Mayer-Rokitansky-Kuster-Hauser syndrome are the most common causes of primary amenorrhea. However, mullerian agenesis in patients with Turner syndrome is rare, with only 15 reported cases worldwide. Described in this report is an 18-year-old female who presented with primary amenorrhea, absent secondary sexual characteristics, short stature, webbed neck, and shield chest. Work up revealed hypergonadotropic hypogonadism, absence of normal ovaries and uterus, and hypothyroidism. She had a 45,X karyotype and was diagnosed with a very rare case of Turner syndrome with associated Mayer-Rokitansky-Kuster-Hauser syndrome. Early detection of the etiology of amenorrhea is critical for prompt management and initiation of hormonal replacement. She was counseled on the possible systemic problems associated with her condition. The importance of regular follow-up and continuous care were also emphasized. With the coexistence of these two conditions, adoption is the only option for having children in the Philippines, where oocyte donation and uterine transplantation are currently unavailable.

Myeloperoxidase as a biomarker for intestinal-brain axis dysfunction induced by malnutrition and Cryptosporidium infection in weanling mice

Abstract Cryptosporidiosis is a waterborne protozoal infection that may cause life-threatening diarrhea in undernourished children living in unsanitary environments. The aim of this study is to identify new biomarkers that may be related to gut-brain axis dysfunction in children suffering from the malnutrition/infection vicious cycle is necessary for better intervention strategies. Myeloperoxidase (MPO) is a well-known neutrophil-related tissue factor released during enteropathy that could drive gut-derived brain inflammation. We utilized a model of environmental enteropathy in C57BL/6 weanling mice challenged by Cryptosporidium and undernutrition. Mice were fed a 2%-Protein Diet (dPD) for eight days and orally infected with 107-C. parvum oocysts. C. parvum oocyst shedding was assessed from fecal and ileal-extracted genomic DNA by qRT-PCR. Ileal histopathology scores were assessed for intestinal inflammation. Prefrontal cortex samples were snap-frozen for MPO ELISA assay and NF-kb immunostaining. Blood samples were drawn by cardiac puncture after anesthesia and sera were obtained for serum amyloid A (SAA) and MPO analysis. Brain samples were also obtained for Iba-1 prefrontal cortex immunostaining. C. parvum-infected mice showed sustained stool oocyst shedding for six days post-infection and increased fecal MPO and inflammation scores. dPD and cryptosporidiosis led to impaired growth and weight gain. C. parvum-infected dPD mice showed increased serum MPO and serum amyloid A (SAA) levels, markers of systemic inflammation. dPD-infected mice showed greater MPO, NF-kB expression, and Iba-1 immunolabeling in the prefrontal cortex, an important brain region involved in executive function. Our findings suggest MPO as a potential biomarker for intestinal-brain axis dysfunction due to environmental enteropathy.

Improvement of indirect immunofluorescence technique to detect antineutrophil cytoplasmic antibodies and its impact on test positivity rate

The indirect immunofluorescence (IIF) technique for antineutrophil cytoplasmic antibodies (ANCA) detection is subject to substantial differences across laboratories. This study aimed to assess the impact of improvements in the IIF-ANCA technique on the positivity rate of ANCA tests. A cross-sectional study was performed with serum samples from patients with ANCA-associated vasculitis (AAV), autoimmune hepatitis (AIH), and ulcerative colitis (UC). A paired analysis was performed for IIF-ANCA results using the traditional method and a modified protocol after a series of specific adjustments in the technique based on the protocol of IIF-ANCA test performed at a nation-wide private laboratory in Brazil. ANCA specificity was assessed by ELISA for anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) antibodies. Sixty-one patients were evaluated. The positivity rate of IIF-ANCA tests at disease presentation performed at the University reference laboratory was 32.3% in AAV, AIH, and UC patients, whereas the positivity rates of IIF-ANCA and ELISA tests in other laboratories were 75.0 and 72.7%, respectively. After modifications in the IIF-ANCA technique, there was a significant increase in the positivity rate (14.8 vs 34.3%; P=0.0002) and in median titers [1/40 (1/30-1/160) vs 1/80 (1/40-1/80); P=0.0003] in AAV, AIH, and UC patients. UC had the highest increment in positive results from 5.3 to 36.8%. There was poor agreement between MPO- or PR3-ANCA and both IIF-ANCA techniques. In conclusion, modifications in the IIF-ANCA protocol led to a significant improvement in its positivity rate and titers.

Burnout Syndrome Assessment Scale in Public Safety: Psychometric Parameters / Escala de Avaliação da Síndrome de Burnout na Segurança Pública: Parâmetros Psicométricos

ABSTRACT The burnout variable has been studied in different professions; however, it presents challenges in its measurement. The present study provides evidence of validity based on the internal structure of the Burnout Syndrome Assessment Scale in Public Security Workers (EASB-SP) and presents the estimation of item parameters through the Item Response Theory (IRT). A total of 10,885 public security agents from all states of Brazil participated in the study. The analyses indicated a three-factor structure, with adequate reliability indices and discrimination of the items. The Professional Fulfillment factor presented a lower theta value to be endorsed. The instrument was shown to be an adequate measure, with evidence of validity for the context of Brazilian public security.

RESUMO O Burnout tem sido uma variável estudada em diferentes profissões, embora com desafios em sua medida. O presente estudo apresenta evidências de validade baseada na estrutura interna da Escala de Avaliação da Síndrome de Burnout (EASB-SP) para a segurança pública, além de apresentar a estimativa dos parâmetros dos itens por meio da Teoria de Resposta ao Item (TRI). Participaram do estudo 10.885 agentes da segurança pública de todas as unidades federativas do Brasil. As análises indicaram uma estrutura tri-fatorial, com índices de fidedignidade e discriminação dos itens adequados. O fator de realização profissional indicou menor theta para ser endossado. O instrumento em questão apresenta-se como uma medida adequada e com evidências de validade para o contexto de segurança pública brasileira.

Total rupture of Achilles tendon induces inflammatory response and glial activation on the spinal cord of mice

Rupture of Achilles tendon is a common accident affecting professional and recreational athletes. Acute and chronic pain are symptoms commonly observed in patients with rupture. However, few studies have investigated whether Achilles tendon rupture is able to promote disorders in the central nervous system (CNS). Therefore, the current study aimed to evaluate nociceptive alterations and inflammatory response in the L5 lumbar segment of Balb/c mice spinal cord after Achilles tendon rupture. We found increased algesia in the paw of the ruptured group on the 7th and 14th days post-tenotomy compared with the control group. This phenomenon was accompanied by overexpression of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase-2 (NOS-2) as well as hyperactivation of astrocytes and microglia in nociceptive areas of L5 spinal cord as evidenced by intense GFAP and IBA-1 immunostaining, respectively. Biochemical studies also demonstrated increased levels of nitrite in the L5 spinal cord of tenotomized animals compared with the control group. Thus, we have demonstrated for the first time that total rupture of the Achilles tendon induced inflammatory response and nitrergic and glial activation in the CNS in the L5 spinal cord region.

An economic analysis of selective laser trabeculoplasty versus topical prostaglandin analogues as initial therapy for primary open-angle glaucoma in a tertiary government hospital in the Philippines

Objective@# This study compared the economic viability of initial medical therapy with topical prostaglandin analogues (PGAs) versus selective laser trabeculoplasty (SLT) in the treatment of primary open-angle glaucoma (POAG).@*Method@#This was an economic analysis using actual, current treatment costs of PGA therapy versus SLT applied to theoretical, literature-derived clinical efficacy data projected for a period of 19 years. A socioeconomic and demographic survey conducted among POAG patients at the Department of Health Eye Center of the East Avenue Medical Center from March-April 2022 provided the economic context and setting for the analysis. The treatment regimens were compared in terms of total cost, clinical efficacy, cost-effectiveness and cost-utility in the setting of a tertiary government hospital.@*Results@#Thirty-one (31) patients were included in the study. The total annual cost of topical PGAs was Philippine Pesos (Php) 13,532 versus Php 6,195 for SLT. Cost-effectiveness was Php 1,933 for PGAs/mmHg reduction in intraocular pressure (IOP) versus Php 983 for SLT. Cost-utility was Php 59,793/Quality Adjusted Life Years (QALY) gained for PGAs versus Php 27,373/QALY gained for SLT projected for 19 years. With government insurance coverage, cost-utility ratio was Php 47,831/QALY gained for topical PGAs versus 16,327/QALY gained for SLT.@*Conclusion@#In POAG patients, SLT was more cost-effective versus PGAs with a lower cost per mmHg IOP reduction, and lower cost-utility ratio for every QALY gained. SLT can be recommended as initial therapy for POAG especially for patients being treated at tertiary government hospitals.

Soursop (Annona muricata L.) Fruit Peels as Source of Phenolic Constituents and Annonacin with Biological Activities

Aims: In this study, chemical constituents and biological activities of the Annona muricata L. fruit peels were evaluated using methanol extract (MEAM) and hexane (HFAM), dichloromethane (DFAM), ethyl acetate (EFAM), and butanol (BFAM) fractions. Place and Duration of Study: All the experiments were done in the Department of Pharmaceutical Sciences and Department of Biochemistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, 36026-900, Brazil, between January 2012 and July 2016. Methodology: Phytochemical screening (specific chemical reactions), total phenolic and flavonoid contents (Spectrophotometric methods) and chemical compounds were assessed (High performance liquid chromatography analysis). The antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP), beta-carotene, and thiobarbituric acid assays. The inhibitory effect against digestive enzymes (lipase, ?-amylase and ?-glucosidase) was measured by spectrophotometric assays and and toxicity by the brine shrimp lethality bioassay. Results: Tannins, flavonoids, coumarins, terpenes and steroids, saponins, and alkaloids were detected. EFAM had the highest values of total phenolic and flavonoids, while a similar compound to annonacin was found in MEAM by HPLC. EFAM was also more active in DPPH and FRAP assays, and HFAM was effective in inhibiting the linoleic acid oxidation and the malondialdehyde. MEAM and fractions blocked lipase, ?-amylase and ?-glucosidase, while HFAM and DFAM were toxic against Artemia salina. Conclusion: The results showed that the A. muricata fruit peels have important biological effects, which can bring great benefits to human and animal health.

Analysis of the Anti-inflammatory and Antioxidant Potential of the Fractions Obtained From the Ethyl Acetate Partition of the Leaves of Diplopterys Pubipetala

Aims: The objective of this work was to analyze the anti-inflammatory, cytotoxic and antioxidant activity of the fractions of ethyl acetate from the leaves of D. pubipetala. Methodology: Liquid-liquid partitioning was performed, the ethyl acetate partition was eluted in classical liquid chromatography, followed by thin layer chromatography. Antioxidant activity was performed by the DPPH photochlorimetric method and the levels of interleukin (IL?6), tumor necrosis factor ? (TNF??), interleukin-10 (IL-10) and nitric oxide (NO) were identified in supernatants of cell cultures. Results: Fractions F4, F5 and F10 showed antioxidant activity. The F10 fraction indicated efficient anti-inflammatory activity by the production of IL-10 and nitric oxides. Fractions F4, F5 and F9 stimulated the production of IL-6 and TNF-?. Conclusion: These results indicate a possible synergistic action of the extract and the partition of ethyl acetate, since after fractionation the potential presented in previous studies was lower.

Feline Injection-Site Sarcoma Complete Remission After Treatment with Isopathic medicine: a case repor

Feline injection-site sarcomas (FISS) were described for the first time in 1991. They are neoplasms of mesenchymal origin that appear in body regions routinely used for the application of vaccines or other injections [1]. Those are very aggressive tumours that relapse and have a high rate of mortality. The tumour can appear between 3 months and 3 years after the injection, but in some cases, it can happen after 15 years of the vaccineor otherinjections. Isopathy is one approach of homeopathy, in which the biological agent thatcausesa disease are prepared in high dilution to treat the same disease. This case report is about a 13-year-old mix breed spay cat. In September 2019 it received the vaccine Rabsin® (Boehringer Ingelheim) and 4 months later the owner noticed a lump at the injection area. One year later (September 2020) the lump start growing rapidly and on January 12th, 2021,started the appointments.The other veterinarians recommend euthanasia since the tumour was very bigand the catwasnot mild, was losing weightand appetite. The owner wanted to try another treatment before euthanasia since the cat was still active, interacting with the other cat and the people at the house.The lump was located on her back, in the end of the right ribcage, and it was around 7cm of diameter. It wasfirmandattachedto the muscles. AnIsopathy medicine with the same vaccinewas prepared, being the isotherapic 12CH administered 5 drops BID.Beside the isopathyvitaminsof Bcomplex and Omega 3were prescribed.The cat was seen every15 days andcontact telephonically was kept as well. The treatment started on January 19th, 2021. On January 21st, 2021,all the tumour was ulcerated and looser. On February 2nd,2021 the potencywas changedto 14CH, 5 drops, BID. On February 4ththe tumour felt away and was sent for histopathological study. On February 20th, 2021,the result described it as a Fibrosarcoma grade II. The ulcer that appeared after the tumour felt away became a big wound and the ownerstarted cleaning itwith propolis and lavender oleateeveryday anditwas controlledonce a week. OnMarch31st, 2021,the catwas eating well,strong, not mild,didnot allowedit to be cleaned. The woundseems to be more superficial,largerand it appears thata small lump was growing again.Isotherapic 15CH, 5 drops once a weekwas indicated.On April4th, 2021,the cat waseating well, good general conditionand the small lump that was growing wasshrinkingand the wound becoming more superficial. OnApril 9th,2021the cat seems painful, not eating well, constipated. Isopathy was suspended and started with Meloxican0,1mg/kg SID for 3 days.Was indicatedNatrum muriaticum30CH, 5 drops every hour, total 3 treatments and then once a day. On April 13th, 2021,the cat was better, defecate. But since April 9ththe cat could never be stable again. It has ups and downs and was treated withdifferent homeopathic remedies (Natrum muriaticum30Ch, Silicea200CHand Silicea1000CH, Staphisagria 200CH)until June 8th, 2021,when it was euthanised.No necropsy was done. The question was,what happenedwith the catsince itwas getting better?The following aphorisms could explain it:§156 "...The restoration, however, leads to the goal of the cure, if it is not preventedby strange medicinal influence, by errors in the lifestyle or by passions." And§10"With no vital powerthe material organism is not capable of any sensation, function or self-preservation..."[2].The informed consent formwas obtained from the owner of the cat.

Revisão taxonômica de Psalidodon eigenmanniorum (Cope) com base em análises morfométrica, merística e padrão de colorido (Characiformes: Characidae) / Taxonomic review of Psalidodon eigenmanniorum (Cope) based on morphometric and meristic analysis and color pattern (Characiformes: Characidae)

A identidade de Psalidodon eigenmanniorum (Cope, 1894) e a possibilidade de se constituir em mais de uma espécie é testada através de análises da morfometria (19 medidas), dos caracteres merísticos (14 contagens) e do padrão de colorido de 705 exemplares provenientes dos sistemas dos rios Tramandaí/Mampituba, da laguna dos Patos e drenagem do baixo rio Uruguai. Foram diafanizados e corados 40 exemplares. Os dados morfométricos foram utilizados na Análise de Componentes Principais, Análise Discriminante, Morfometria Geométrica e Função Discriminante. As análises foram feitas considerando os sexos em separado dentro de cada sistema hidrográfico, bem como comparando as populações entre os sistemas hidrográficos e finalmente no conjunto de sistemas representando a área de ocorrência da espécie. A partir dos dados analisados não foram encontradas diferenças entre os sexos. Os resultados mostraram variação morfológica que não sustenta o reconhecimento de possíveis espécies crípticas. A variação encontrada nos dados merísticos, morfométricos e no padrão de colorido justifica a redescrição da espécie. Os resultados das comparações entre as populações indicaram variações nesses caracteres indicando que a espécie possui considerável plasticidade fenotípica.(AU)

The identity of Psalidodon eigenmanniorum (Cope, 1894) and the possibility of constituting more than one species is tested through analyzes of morphometry (19 measurements), meristic characters (14 counts) and the color pattern of 705 specimens from the Tramandaí/Mampituba, from the Patos lagoon and from the lower Uruguay River drainage. Forty specimens were cleared and stained. Morphometric data were used in Principal Component Analysis, Discriminant Analysis, Geometric Morphometry and Discriminant Function. The analysis was carried out considering the sexes separately within each hydrographic system, as well as comparing the populations between the hydrographic systems and finally in the set of systems representing the area of occurrence of the species. No differences were found between the sexes in the analyzed data. The results showed morphological variation that does not support the recognition of possible cryptic species. The variation found in meristic, morphometric and color pattern data justifies the redescription of the species. The species is described to the aforementioned drainages, and the results demonstrate its phenotypic plasticity.(AU)

Plantas medicinais e políticas públicas de saúde: novos olhares sobre antigas práticas / Medicinal plants and public health policies: new perspectives on old practices

Resumo As plantas medicinais são utilizadas nos cuidados a saúde desde a Antiguidade, mas apenas na década de 1970 a OMS se manifestou sobre sua importância para a saúde da população. Este artigo teve por objetivo identificar a sequência temporal e evolução dos marcos legais associados às políticas públicas de plantas medicinais, discutindo as implicações dessa evolução, bem como sua inserção no sistema de saúde, e apresentar essa evolução no Brasil. Foram identificados e analisados os conteúdos de Leis, Decretos, Resoluções, Políticas, Portarias e Instruções Normativas relacionadas ao tema. Apesar do longo histórico de uso da flora nacional, as primeiras legislações sobre seu emprego no campo da saúde são recentes. O Brasil, país com maior biodiversidade do planeta, aprovou, apenas em 2006, a Política Nacional de Práticas Integrativas e Complementares e a Política Nacional de Plantas Medicinais e Fitoterápicos. Necessita-se, entretanto, ampliar o investimento em pesquisas científicas para que haja segurança, qualidade e eficácia no seu uso.

Abstract Medicinal plants have been used in health care since Antiquity, but it was only in the 1970s that the WHO expressed its importance for the health of the population. This article aimed to identify the temporal sequence and evolution of legal frameworks associated with public policies on medicinal plants, discussing the implications of this evolution, as well as its insertion in the health system, and to present this evolution in Brazil. The contents of Laws, Decrees, Resolutions, Policies, Ordinances and Normative Instructions related to the topic were identified and analyzed. Despite the long history of using the national flora, the first legislation on its use in the health field is recent. Only in 2006, Brazil, the country with the greatest biodiversity on the planet, approved the National Policy on Integrative and Complementary Practices and the National Policy on Medicinal Plants and Phytotherapeutics. It is necessary, however, to increase investment in scientific research so that there is safety, quality and effectiveness in its use.

Genetic polymorphisms and protein levels in vocal fold leukoplakia: a systematic review

Vocal fold leukoplakia (VFL) has a risk of malignant transformation. Therefore, patients can have symptoms such as dysphonia, vocal strain, difficulty breathing, and dysphagia. Additionally, there is a genetic predisposition that can be associated with genetic polymorphisms. We aimed to evaluate the influence of genetic polymorphisms and protein levels in the etiology of VFL. Our study followed the PRISMA checklist and was registered on PROSPERO database. The questions were: "Are genetic polymorphisms involved in the etiology of VFL? Are protein levels altered in patients with VFL?". Eligibility criteria were case control studies that compared the presence of polymorphisms or/and protein levels of subjects diagnosed with VFL and healthy controls. Of the 905 articles retrieved, five articles with a total of 1038 participants were included in this study. The C allele of the single nucleotide polymorphisms (SNP)-819 T/C IL-10, A allele of the SNP -592 A/C IL-10, CT genotype of the SNP rs11886868 C/T BCL11A, GG genotype of the SNP rs4671393 A/G BCL11A, LL genotype, and L allele of (GT)n repeat polymorphisms of the HO-1 were risk factors for VFL development. Nevertheless, there was a lack of association between VFL and the -1082 A/G IL-10, rs14024 CK-1, and -309 T/G Mdm2 SNPs. The concentrations of the MDM2, BCL11A, and HO-1 proteins were modified, while IL-10 levels were normally expressed in these subjects. In conclusion, most markers evaluated in this review could be potential indicators to develop effective therapies, avoiding a malignant transformation of the lesion.

Structure-function correlations of glaucoma in Filipinos

Introduction@#To determine the structure-function correlations of glaucoma in Filipinos using the average peripapillary retinal nerve fiber layer (RNFL) thickness and rim area (RA) of the spectral-domain optical coherence tomography (SD-OCT) and mean defect (MD), pattern standard deviation (PSD), and visual field (VF) clusters of standard automated perimetry (SAP)@*Methods@#Consecutive tests consisting of SD-OCT, SAP, and disc photos were reviewed and selected based on abnormalities in VFs or OCTs or both. Each set of tests was classified as to VF defect type and severity. Mean threshold of VF clusters, MD, and PSD were correlated with average and sectoral RNFL thicknesses and RA. @*Results@#One hundred eighty-six (168) eyes of 121 patients with mean age of 60.2 ± 14.7 years had an average MD, PSD, RNFL thickness, RA of -9.5 ± 8.5 dB, 5.4 ± 3.3 dB, 75.9 ± 15.9 μm, and 0.9 ± 0.4 mm2, respectively. Among VF tests, 23.1% were normal, 16.5% had early, 9.1% moderate, 12.4% advanced, and 8.3% severe glaucoma damage. Most common VF defect types were central islands, combined, and paracentral (16.5%, 14.4%, and 12.2%, respectively). The most commonly affected RNFL segments were inferior, followed by superior, and combined superior and inferior (51.2%, 47.1, and 34%, respectively). Among the OCT parameters, RNFL thickness and RA were strongly correlated (p<0.0001). Between the VF and OCT parameters, the strongest correlation was between the clusters of superior VF defects and the 6-8 o’clock RNFL thinning, followed by the inferior VF defects and the 12-1 o’clock RNFL thinning. Inferior RNFL thinning was strongly correlated with MD and PSD. @*Conclusion@#Among Filipino glaucomatous eyes monitored with SD-OCT and SAP, correlation was strongest between the superior VF defects and the infero-temporal RNFL thinning.

Peripapillary microvascular parameters in unilateral open-angle glaucoma using the optical coherence tomography-angiography

Objective@#This study compared the peripapillary retinal nerve fiber layer (pRNFL) microangiographic properties [vessel area density (VAD) and blood flux index (BFI)] of unilateral open-angle glaucomatous eyes to contralateral eyes-at-risk, and to eyes of healthy age- and sex-matched subjects.@*Methods@#This was a single-center, case-control study of Filipinos diagnosed with unilateral primary openangle glaucoma (POAG) or normal-tension glaucoma (NTG). Mean overall and quadrantal VAD and BFI of the three groups were measured with optical coherence tomography- angiography (OCT-A). Area under the receiver operating characteristic (AROC) was used to measure diagnostic ability.@*Results@#Twenty-two (22) glaucomatous subjects (15 POAG and 7 NTG eyes), 22 contralateral eyes-at-risk, and 22 normal eyes from age- and sex-matched control subjects completed the study. Eyes with glaucoma showed lower mean overall VAD (40%) and BFI (0.37) compared to eyes-at-risk (44.4% and 0.42, respectively; p <0.001) and control eyes (45.6% and 0.44, respectively; p <0.001). Mean VAD and BFI values of eyes-at-risk and control groups did not significantly differ from each other. Overall pRNFL thickness showed highest diagnostic accuracy for glaucoma (AROC = 0.97), followed by VAD (0.94), and BFI (0.88) (p=0.46).@*Conclusion@#VAD and BFI were significantly diminished in unilateral open-angle glaucoma, suggesting that the utility of OCT-A in the detection of glaucoma is comparable to pRNFL thickness.

Identifying predictive factors and clinical outcomes for high-risk pneumonia among hospitalized pediatric patients with measles in a national tertiary infectious disease hospital from January 2019 to December 2019: A cohort study

Background@#Measles surged worldwide in 2019, which recorded the highest number of cases in the last 23 years. In the Philippines, the peak of the outbreak occurred in January-February 2019.1-3 Pneumonia was the most common severe complication and cause of death of measles. Age, sex, area of residence, immunization history, nutrition status and presence of comorbidities may contribute to the development of high-risk pneumonia in measles patients, affecting clinical outcomes.@*Objective@#This study aimed to determine predictive factors for high-risk pneumonia among hospitalized pediatric patients with measles and clinical outcomes in San Lazaro Hospital from January 2019 to December 2019.@*Methods@#A cohort study was conducted through a review of medical records of pediatric patients with measles admitted at San Lazaro Hospital from January 2019 to December 2019. The following data were extracted: demographic data, immunization history, nutrition status, presence of comorbidities, development of high-risk pneumonia, and clinical outcomes were extracted. Logistic regression was done to determine the factors associated with development of high-risk pneumonia.@*Results@#A total of 530 medical records were reviewed, and 27.9% of these documented severe pneumonia. Most of the patients were less than 5 years of age (84.53%) and were residing in Metro Manila (85.47%). Majority (73.40%) had no vaccination for measles. Chi-square test showed that the variables of age (p=0.001), measles vaccination status (p=0.011), BMI-for-age (p=0.005), weight-for-age (p=0.027), and weight-for-height (p=0.004) were significantly different between those who developed high-risk pneumonia and those who did not. However, in the final multiple logistic regression analysis, only nutritional status was predictive of high-risk pneumonia. Patients with severe wasting were 1.85 times (p=0.010) and patients who were overweight were 4.24 times (p=0.003) more likely to develop high-risk pneumonia. There was also a significant difference in clinical outcomes between those without high-risk and with high-risk pneumonia (p=<0.001). All mortality cases had high-risk pneumonia, were less than 5 years of age, and were unvaccinated.@*Conclusion@#Age, measles vaccination status and nutrition status were the factors identified to be associated with high-risk pneumonia among pediatric patients with measles. Thus, it is important to encourage parents to vaccinate their children against measles and to promote proper nutrition.

The predictive value of chest x-ray and plain chest CT scan as adjunct screening tools for COVID-19 patients in a national tertiary infectious disease hospital from March 1 to November 30, 2020

Background@#COVID-19 is diagnosed via Real Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), with plain chest CT and chest x-ray as adjuncts. In the Philippines, chest x-ray is used as initial screening in assessing potential COVID-19 cases, with plain chest CT scan not routinely used due to higher cost and decreased availability.@*Objective@#This study determined the validity of chest x-ray and plain chest CT as initial screening tools for admitted COVID-19 patients from March 1 to November 30, 2020, at San Lazaro Hospital, comparing these with RT-PCR testing for COVID-19 as initial basis for considering a patient as a possible case of COVID-19.@*Methods@#This was a cross-sectional study of radiographic literature of admitted COVID-19 patients from March 1 to November 30, 2020, at San Lazaro Hospital, all with confirmatory RT-PCR, chest X-rays, and plain chest CTs. Baseline chest x-rays, with initial plain chest CT results, were compared with RT-PCR results. A tally was made, noting radiographic findings on both Chest X-ray and Plain Chest CT most frequently seen among patients with corresponding positive real time RT-PCR results.@*Results@#Chest X-rays done < 2 days from admission revealed involvement of both lungs, with infiltrates located centrally and peripherally, with major predilection for both lower lobes. Plain chest CT was similar, with ground glass opacities as the most common finding, consolidation second. Chest x-ray had a sensitivity of 88.11%, plain chest CT 94.71%. Sensitivity of combined chest x-ray and plain chest CT was 86.78%. Specificity and predictive value were not computed due to non-inclusion of admitted patients with COVID negative RT-PCR swab.@*Conclusion@#Chest X-ray and plain chest CT are useful modalities with high sensitivity in screening patients with fever, cough, and colds on admission. However, initial chest x-ray and plain chest CT scan results do not translate into a prognosis without context of initial diagnostics and management done during confinement.