Immune cells and checkpoints in pancreatic adenocarcinoma: Association with clinical and pathological characteristics.

INTRODUCTION: Pancreatic adenocarcinoma is an extremely aggressive neoplasm, with many challenges to be overcome in order to achieve a truly effective treatment. It is characterized by a mostly immunosuppressed environment, with dysfunctional immune cells and active immunoinhibitory pathways that favor tumor evasion and progression. Thus, the study and understanding of the tumor microenvironment and the various cells subtypes and their functional capacities are essential to achieve more effective treatments, especially with the use of new immunotherapeutics. METHODS: Seventy cases of pancreatic adenocarcinoma divided into two groups 43 with resectable disease and 27 with unresectable disease were analyzed using immunohistochemical methods regarding the expression of programmed cell death ligand 1 (PD-L1), programmed cell death ligand 2 (PD-L2), and human leukocyte antigen G (HLA-G) molecules as well as the populations of CD4+ and CD8+ T lymphocytes, regulatory T cells (Tregs), and M2 macrophages (MM2). Several statistical tests, including multivariate analyses, were performed to examine how those immune cells and immunoinhibitory molecules impact the evolution and prognosis of pancreatic adenocarcinoma. RESULTS: CD8+ T lymphocytes and M2 macrophages predominated in the group operated on, and PD-L2 expression predominated in the unresectable group. PD-L2 was associated with T stage, lymph node metastasis, and clinical staging, while in survival analysis, PD-L2 and HLA-G were associated with a shorter survival. In the inoperable cases, Tregs cells, MM2, PD-L1, PD-L2, and HLA-G were positively correlated. CONCLUSIONS: PD-L2 and HLA-G expression correlated with worse survival in the cases studied. Tumor microenvironment was characterized by a tolerant and immunosuppressed pattern, mainly in unresectable lesions, where a broad positive influence was observed between immunoinhibitory cells and immune checkpoint proteins expressed by tumor cells.

The male effect associated with prostaglandins and reproductive outcomes in photo-stimulated Saanen goats during the non-breeding season.

The efficiency of combining oestrous induction via a light program (16 h of light and 8 h of darkness for 60 days, ending on Day 0 - D0) with cloprostenol administration, followed by the male effect or not, was tested in acyclic Saanen goats during the non-breeding season (June/2019 to January/2020). Initially, all animals (males and females) were submitted to the described light program; 60 days after its ending (D60), the females were divided into two groups, with (G1; n = 67) or without (G2; n = 61) a male effect from D60 to D75 after the light program. At D75, both groups received two cloprostenol doses (120 µg; intramuscular) 7.5 days apart (D75 and D82.5). Artificial insemination was performed at a specific time according to the oestrous onset (approximately 68.4 ± 1.2 h between the second cloprostenol dose and IA). Ultrasound scans were performed at different intervals to evaluate follicular dynamics and confirm pregnancy. At the first cloprostenol dose (D75), the proportion of does with at least a corpus luteum (CL), which indicates resumed cyclicity, was greater in G1 than in G2 (85.2% vs. 48.8%; p < .05), although no difference was found at the second dose (p > .05). The adjusted pregnancy rates (number of pregnant goats/oestrous goats) differed between G1 and G2 (21.7% vs. 42.0%; p < .05). G1 also showed a higher frequency of functional CL (based on blood flow and morphology) compared to G2 (96.9% vs. 66.7%; p < .05) at D116. A male effect using photo-stimulated bucks after the first cloprostenol dose increased the number of does presenting CL after buck removal, and no impairment in the pregnancy rates of multiparous does was found.

Identification of established and novel extracellular matrix components in glioblastoma as targets for angiogenesis and prognosis.

Glioblastomas (GBM) are aggressive tumors known for their heterogeneity, rapid proliferation, treatment resistance, and extensive vasculature. Angiogenesis, the formation of new vessels, involves endothelial cell (EC) migration and proliferation. Various extracellular matrix (ECM) molecules regulate EC survival, migration, and proliferation. Culturing human brain EC (HBMEC) on GBM-derived ECM revealed a decrease in EC numbers compared to controls. Through in silico analysis, we explored ECM gene expression differences between GBM and brain normal glia cells and the impact of GBM microenvironment on EC ECM transcripts. ECM molecules such as collagen alpha chains (COL4A1, COL4A2, p < 0.0001); laminin alpha (LAMA4), beta (LAMB2), and gamma (LAMC1) chains (p < 0.0005); neurocan (NCAN), brevican (BCAN) and versican (VCAN) (p < 0.0005); hyaluronan synthase (HAS) 2 and metalloprotease (MMP) 2 (p < 0.005); MMP inhibitors (TIMP1-4, p < 0.0005), transforming growth factor beta-1 (TGFB1) and integrin alpha (ITGA3/5) (p < 0.05) and beta (ITGB1, p < 0.0005) chains showed increased expression in GBM. Additionally, GBM-influenced EC exhibited elevated expression of COL5A3, COL6A1, COL22A1 and COL27A1 (p < 0.01); LAMA1, LAMB1 (p < 0.001); fibulins (FBLN1/2, p < 0.01); MMP9, HAS1, ITGA3, TGFB1, and wingless-related integration site 9B (WNT9B) (p < 0.01) compared to normal EC. Some of these molecules: COL5A1/3, COL6A1, COL22/27A1, FBLN1/2, ITGA3/5, ITGB1 and LAMA1/B1 (p < 0.01); NCAN, HAS1, MMP2/9, TIMP1/2 and TGFB1 (p < 0.05) correlated with GBM patient survival. In conclusion, this study identified both established and novel ECM molecules regulating GBM angiogenesis, suggesting NCAN and COL27A1 are new potential prognostic biomarkers for GBM.

Siparuna guianensis Essential Oil Antitumoral Activity on Ehrlich Model and Its Effect on Oxidative Stress.

This work aims to evaluate the chemical composition, in vitro antioxidant capacity, and in vivo antitumoral activity of S. guianensis essential oil against Ehrlich's ascitic carcinoma and the effects on oxidative stress. The animals (Mus musculus) received a daily dose of S. guianensis oil orally (100 mg/kg) for 9 days. The main constituents of essential oil were curzerenone (16.4±1.5 %), drimenol (13.7±0.2 %), and spathulenol (12.4±0.8 %). S. guianensis oil showed antioxidant activity, inhibiting 11.1 % of DPPH radicals (95.7 mgTE/g); and 15.5 % of the ß-carotene peroxidation. The group treated with S. guianensis showed a significant reduction in tumor cells (59.76±12.33) compared to the tumor group (96.88±19.15). Essential oil of S. guianensis decreased MDA levels and increased SOD levels in liver tissue. The essential oil of S. guianensis reduced oxidative stress, and showed antitumor and antioxidant activity, being characterized as a new chemical profile in the investigation of pathologies such as cancer.

Relationship of Testosterone, LH, Estradiol, IGF-1, and SHBG with Physical Performance of Master Athletes.

Purpose: The aim of this study was to investigate and compare the levels of luteinizing hormone (LH), testosterone (T), estradiol (ES), sex hormone-binding globulin (SHBG), and insulin-like growth factor 1 (IGF-1) in master sprint (MS) and master endurance (ME) athletes. Additionally, the possible associations between these hormones, body composition, and lipid profile with athletic performance (% of performance in relation to the current world record) were analyzed. Materials and Methods: The participants were all men: (i) 34 MS (51.0 ± 6.8 years); and (ii) 32 ME (51.7 ± 9.4 years). Student's t-tests for independent samples were performed to compare all variables between groups. Results: MS had a significantly higher (p = .008) average IGF-1 (154.78 ± 29.85 ng/mL) when compared to ME (129.92 ± 25.48 ng/mL). Performance was significantly correlated with IGF-1 (r = 0.424). The MS group had a moderately lower body fat than ME athletes (MS 12.54 ± 4.07 vs. ME 14.60 ± 4.12; p = .078; d = 0.503). Conclusions: Thus, strength/power training exercise/sport seems to be more beneficial for obtaining a higher IGF-1 compared to aerobic/distance exercise/sport. In addition, LH, T, ES, and SHBG were similar between the two groups of athletes and were comparable to the reference values of younger adults.

Characterization of T Helper 1 and 2 Cytokine Profiles in Newborns of Mothers with COVID-19.

An infectious disease caused by SARS-CoV-2, COVID-19 greatly affects the pediatric population and is 3 times more prevalent in newborns than in the general population. In newborns, the overexpression of immunological molecules may also induce a so-called cytokine storm. In our study, we evaluated the expression of cytokines in newborns admitted to a neonatal ICU whose mothers had SARS-CoV-2 and symptoms of SARS. The blood of newborns of infected and healthy mothers was collected to identify their Th1 and Th2 cytokine profiles, and via flow cytometry, the cytokines TNF-α, IFN-γ, IL-2, IL-6, and IL-10 were identified. Overexpression was observed in the Th1 and Th2 cytokine profiles of newborns from infected mothers compared with the control group. Statistical analysis also revealed significant differences between the cellular and humoral responses of the infected group versus the control group. The cellular versus humoral responses of the newborns of infected mothers were also compared, which revealed the prevalence of the cellular immune response. These data demonstrate that some cytokines identified relate to more severe symptoms and even some comorbidities. IL-6, TNF-α, and IL-10 may especially be related to cytokine storms in neonates of mothers with COVID-19.

Intensity of Depression Symptoms Is Negatively Associated with Catalase Activity in Master Athletes.

BACKGROUND: This study examined associations between scores of depression (DEPs), thiobarbituric acid-reactive substances (TBARS), superoxide dismutase (SOD), and catalase activity (CAT) in master athletes and untrained controls. METHODS: Participants were master sprinters (MS, n = 24; 50.31 ± 6.34 year), endurance runners (ER, n = 11; 51.35 ± 9.12 year), untrained middle-aged (CO, n = 13; 47.21 ± 8.61 year), and young untrained (YU, n = 15; 23.70 ± 4.02 year). CAT, SOD, and TBARS were measured in plasma using commercial kits. DEPs were measured by the Beck Depression Inventory-II. An ANOVA, Kruskal-Wallis, Pearson's, and Spearman's correlations were applied, with a significance level of p ≤ 0.05. RESULTS: The CATs of MS and YU [760.4 U·µL 1 ± 170.1 U·µL 1 and 729.9 U·µL 1 ± 186.9 U·µL 1] were higher than CO and ER. The SOD levels in the YU and ER [84.20 U·mL-1 ± 8.52 U·mL-1 and 78.24 U·mL-1 ± 6.59 U·mL-1 (p < 0.0001)] were higher than CO and MS. The TBARS in CO [11.97 nmol·L-1 ± 2.35 nmol·L-1 (p < 0.0001)] was higher than in YU, MS and ER. MS had lower DEPs compared to the YU [3.60 ± 3.66 vs. 12.27 ± 9.27 (p = 0.0002)]. A negative correlation was found between CAT and DEPs for master athletes [r = -0.3921 (p = 0.0240)] and a weak correlation [r = -0.3694 (p = 0.0344)] was found between DEPs and the CAT/TBARS ratio. CONCLUSIONS: In conclusion, the training model of master sprinters may be an effective strategy for increasing CAT and reducing DEPs.

Higher sirt1 is associated with a better body composition in master sprinters and untrained peers.

Sirt1 is an enzyme involved in several anti-aging pathways. Associations between Sirt1, age, and body fat (BF) were assessed in master sprinters (MS; n = 35; 50.25 ±5.93 yr.), untrained young non-athletes (UY; n = 32; 23.78 ±3.98 yr.), and untrained middle-aged (UMA; n = 24; 47.29 ±8.04 yr.). BF was assessed using a skinfold protocol, and Sirt1 was measured in plasma by using commercial kits. Sirt1 of MS (17.18 ±4.77 ng/mL) was higher than UMA (6.36 ±2.29 ng/mL; p<0.0001) and did not differ from UY (20.26 ±6.20 ng/mL). Relative BF of MS was lower than UMA (12.71 ±4.07% vs. 22.13 ±4.18%; p<0.0001). Sirt1 was negatively correlated with chronological age (r = -0.735; p<0.0001) when combining UY and UMA in the analysis. However, when Sirt1 of MS and UY was analyzed together, no significant relationship between Sirt1 and chronological age was observed (r = -0.243; p = 0.083). Sirt1 correlated inversely with BF (r = -0.743; p<0.0001) for UY and UMA. Stepwise multiple regression revealed that being either a young or master athlete and body adiposity are possible predictors of Sirt1 levels. MS and UY were associated with higher levels of Sirt1, while UMA and increased BF were associated with lower levels of this enzyme. The relationships among Sirt1, BF, and chronological age of young and middle-aged non-athletes were not statistically significant when the middle-aged participants were MS. These findings suggest possible links between Sirt1 and body composition, which may play roles in the rate of biological aging.HighlightsLower levels of Sirt1 are associated with higher body fat.Master athlete lifestyle seems to promote higher Sirt1 Levels.

ß-caryophyllene, a cannabinoid receptor 2 agonist, decreases the motivational salience and conditioning place preference for palatable food in female mice.

ß-caryophyllene (BCP) is a cannabinoid receptor CB2 agonist plant-derived terpenoid found in different essential oil plants, including rosemary, black pepper, copaiba and cannabis. It has GRAS (generally recognized as safe) status and is approved by the FDA (Food and Drug Administration) for food use. BCP displays agonist activity on the CB2 receptor and is a potential therapeutic target in several neuropsychiatric disorders, including anxiety and drug addiction. Unlike CB1 receptors, activation of the CB2 receptors is devoid of psychotomimetic and addictive properties. In this regard, this study aimed to evaluate the effects of BCP on incentive salience ("wanting") performance and motivational properties elicited by sweetened palatable foods in female Swiss mice. After 9 days of training for incentive salience performance for a sweet reward (hazelnut cream with chocolate), food-restricted mice received a systemic injection of BCP (50 and 100 mg/kg) before testing over 3 days. Moreover, independent groups of female mice were tested on sweet reward-induced conditioned place preference (CPP) for 22 consecutive days. To evaluate BCP effects on the expression of seeking behaviour for sweetened food, mice received a single intraperitoneal injection of BCP (50 mg/kg) 30 min before testing on the CPP task. BCP significantly decreased the incentive performance for a sweet reward compared with the control group in a CB2 receptor-dependent manner. Also, BCP suppressed the expression of sweet reward-CPP. Altogether, these preclinical data demonstrate the potential role of BCP in treating disorders associated with food addiction-like behaviour.

Metformin improves neurobehavioral impairments of streptozotocin-treated and western diet-fed mice: Beyond glucose-lowering effects.

Brain insulin resistance has been pointed to as a possible link between diabetes and neuropsychiatric disorders; therefore, therapeutic approaches using anti-diabetic drugs to improve insulin levels or signaling could prevent type 1 (T1D) and type 2 diabetes mellitus (T2D)-induced brain dysfunction. The present study aimed to determine whether metformin exerts beneficial effects on metabolic and neurobehavioral outcomes in the streptozotocin (STZ)-induced T1D model and western diet (WD)-induced obesity model in male Swiss mice. T1D was induced by intraperitoneal injection of STZ (50 mg/kg, for five consecutive days). The animals were then treated daily with saline or metformin (200 mg/kg/day, oral gavage), and a battery of tests recapitulating different neurobehavioral anomalies related to anxiogenic/depressive-like phenotype was conducted after 18 days. WD-induced obesity was modeled in mice by high-fat and high-fructose diet (HFFD) feeding for 15 days. In the sequence, control and diet-induced obesity mice were treated daily with saline or metformin (200 mg/kg/day), and a battery of behavioral tests was performed after 17 days. STZ injection and WD feeding induced metabolic and neurobehavioral impairments in mice. Remarkably, metformin improved the metabolic and neurobehavioral parameters in WD-induced obesity mice. Moreover, metformin ameliorated STZ-induced neurobehavioral deficits while it failed to improve the associated metabolic impairments. The beneficial effects of metformin in STZ-induced neurobehavioral impairments were not mediated by improving peripheral insulin signaling. Our results suggest that conventional diabetes treatment could be repurposed to simultaneously improve neurobehavioral symptoms and diabetes.

Conhecimento de pacientes com câncer sobre cuidados paliativos: estudo bibliométrico / Knowledge of patients with cancer about palliative care: a bibliometric study / Conocimiento de los pacientes con cáncer sobre cuidados paliativos: un estudio bibliométrico

Resumo Esta pesquisa busca caracterizar os indicadores bibliométricos acerca do conhecimento de pacientes com câncer sobre cuidados paliativos. Por meio da associação dos descritores " patient ", " palliative care ", " knowledge " e " neoplasm " encontrou-se baixa taxa de publicação, com tendência a elevação, além de rede de conexão limitada entre os autores. Os países asiáticos foram os que mais publicaram, mas observou-se nível de conhecimento limitado sobre o tema, pois há forte associação com cuidados de fim de vida, destinados apenas a pacientes com câncer, internados em hospital e sem cura. Este estudo permitiu mapear os principais indicadores bibliométricos a respeito do conhecimento de pacientes com câncer sobre os cuidados paliativos, sendo perceptível o crescimento de publicações sobre o tema, mas ainda com baixa quantidade total. Evidencia-se, assim, a necessidade de mais publicações para a obtenção de maior entendimento sobre o tema.

Abstract This research seeks to characterize the bibliometric indicators regarding cancer patients's knowledge about palliative care. Bibliographic search associating the descriptors " patient, " " palliative care, " " knowledge " and " neoplasm " found low publication ratio and limited conexion among authors. Asian countries account for most publications, but the level of knowledge on the topic was limited given its strong association with end-of-life care aimed at hospitalized cancer patients without possibility of cure. Mapping the main bibliometric indicators on knowledge about palliative care pointed out the need for further publications on the topic to provide better understanding.

Resumen Este estudio tiene como objetivo caracterizar los indicadores bibliométricos de conocimiento de los pacientes con cáncer sobre cuidados paliativos. A partir de la asociación entre las palabras clave " patient ", " palliative care ", " knowledge " y " neoplasm ", se constató una baja tasa de publicación, con tendencia al alza, así como una limitada red de conexiones entre autores. Los países asiáticos fueron los que más publicaron, aunque el nivel de conocimientos sobre el tema era limitado, ya que lo asocian a los cuidados al final de la vida, destinados únicamente a los pacientes oncológicos, hospitalizados y no curados. Este estudio permitió trazar los principales indicadores bibliométricos sobre el conocimiento de los cuidados paliativos por parte de los pacientes con cáncer, y se observó que hubo un aumento de las publicaciones sobre el tema, aunque el número total sigue siendo bajo. Esto pone de manifiesto la necesidad de más publicaciones para conocer mejor el tema.

Ansiedade no período pré-operatório: uma análise bibliométrica / Anxiety in the preoperative period: a bibliometric analysis / Ansiedad en el periodo preoperatorio: un análisis bibliométrico

Objetivo: caracterizar os indicadores bibliométricos da produção científica disponível em periódicos online que abordam a ansiedade no período pré-operatório. Método: Trata-se de uma análise bibliométrica descritiva com abordagem quantitativa de base documental. Para a busca utilizou-se sete bases de dados, com os descritores "ansiedade" e "período pré-operatório". Realizado análise estatística descritiva simples. Resultados: Foram encontrados 10224 artigos e após análises 148 artigos constituíram-se a amostra do estudo. Conclusão: Os indicadores bibliométricos indicam que a produção científica acerca da ansiedade pré-operatória destaca-se no âmbito nacional e internacional, tendo portanto, predomínio as publicações nacionais no idioma inglês, com sistema de produção em coautoria; o Brasil, os EUA e a Turquia foram os países que mais publicaram, sendo a grande maioria no cenário acadêmico das universidades brasileiras. As publicações foram realizadas por diferentes áreas do conhecimento, com destaque para as áreas médica e de enfermagem, o que indica um caráter interdisciplinar acerca da temática.

Objective: to characterize the bibliometric indicators of science available in online journals that address anxiety in the preoperative period. Method: This is a descriptive bibliometric analysis with a document-based quantitative approach. For the search, seven databases were used, with the descriptors "anxiety" and "preoperative period". Simple descriptive statistical analysis. Results: 10224 articles were found and after analysis 148 articles constituted the study sample. Conclusion: The bibliometric indicators indicate that the scientific production about pre-surgical anxiety stands out at the national and international level, having, therefore, domain of national publications in the English language, with a co-authorship production system; Brazil, the USA and Turkey were the countries that published the most, with the vast majority in the academic scenario of Brazilian universities. The publications were carried out by different areas of knowledge, with emphasis on the medical and nursing areas, which indicates an interdisciplinary character regarding the theme.

Objetivo: Caracterizar los indicadores bibliométricos de la producción científica disponible en revistas online que abordan la ansiedad en el periodo preoperato- rio. Método: Se trata de un análisis bibliométrico descriptivo con un enfoque cuantitativo de base documental. Para a busca utilizou-se sete bases de dados, com os descritores "an- siedade" e "período pré-operatório". Se realizó un análisis estadístico descriptivo simple. Resultados: Fueron encontrados 10224 artículos y después del análisis 148 artículos con- stituyeron la muestra del estudio. Conclusión: Los indicadores bibliométricos indican que la producción científica sobre ansiedad preoperatoria se destaca nacional e internacional- mente, con predominio, por lo tanto, de publicaciones nacionales en inglés, con sistema de producción en coautoría; Brasil, EE.UU. y Turquía fueron los países que más publica- ron, y la gran mayoría en el ámbito académico de universidades brasileñas. Las publica- ciones fueron realizadas por diferentes áreas del conocimiento, especialmente las áreas médica y de enfermería, lo que indica un carácter interdisciplinario sobre el tema.

Influenza and other respiratory viruses in children: prevalence and clinical features.

With the COVID-19 pandemic still ongoing, the annual season of influenza and other respiratory virus epidemics has arrived. Specimens from patients suspected of respiratory viruses infection were collected. Viral detection was performed following RNA extraction and real-time RT-PCR. During the study period, we received and tested a total of 606 specimens. Rhinovirus virus was the viral type most prevalent, detected in 186 (45.47%) specimens. The age range of patients positive for influenza A, influenza A (H1N1), and influenza B was 18 days to 13 years. With female prevalence for this viral type, cough and asthma were the main clinical manifestations presented by this viral type. Our results indicate that rhinoviruses, adenoviruses, metapneumoviruses, and influenza are among the most important agents of ARI in pediatrics. The epidemic period of respiratory infections observed in Goiânia can be useful for planning and implementing some prevention strategies.

Exploring Conditions for Handling Packing and Shipping Aedes aegypti Males to Support an SIT Field Project in Brazil.

The sterile insect technique (SIT) application, as an alternative tool for conventional mosquito control methods, has recently gained prominence. Nevertheless, some SIT components require further development, such as protocols under large-scale conditions, focusing on packing and shipping mosquitoes, and considering transporting time. Immobilization of Aedes aegypti males was tested at temperatures 4, 7, 10, and 14 °C, and each temperature was assessed for 60, 90, and 120 min. The recovery after 24 h was also studied. Chilled and control-reared males had comparable survival rates for all conditions, although 4 °C for 120 min impacted male survival. The male escape rate was affected after 60 min of exposure at 4 °C; this difference was not significant, with 24 h of recovery. First, we defined the successful immobilization at 4 °C for 60 min, thus enabling the evaluation of two transportation intervals: 6 and 24 h, with the assessment of different compaction densities of 100 and 150 mosquitoes/cm3 at 10 °C to optimize the shipment. Compaction during simulated mosquito shipments reduced survival rates significantly after 6 and 24 h. In the mating propensity and insemination experiments, the sterile males managed to inseminate 40 to 66% for all treatments in laboratory conditions. The male insemination propensity was affected only by the highest compaction condition concerning the control. The analysis of the densities (100 and 150 males/cm3) showed that a higher density combined with an extended shipment period (24 h) negatively impacted the percentage of inseminated females. The results are very helpful in developing and improving the SIT packing and shipment protocols. Further studies are required to evaluate all combined parameters' synergetic effects that can combine irradiation to assess sexual competitiveness when sterile males are released into the field.

Elevated Mortality Risk from CRKp Associated with Comorbidities: Systematic Review and Meta-Analysis.

Carbapenem-resistant Klebsiella pneumoniae has become a public health problem with therapeutic limitations and high mortality associated with comorbidities. Methods: This is a systematic review and meta-analysis with a search in PubMed, SciELO, and Lilacs. Ten articles were selected, considering cohort, case-control, and cross-sectional studies. Tests for proportions and relative risk of mortality were performed, considering a 5% threshold for significance. Statistical analyses were performe dusing Rstudio® software, version 4.0.2 of Ross Ihaka and Robert Genleman in Auckland, New Zealand. Results: Klebsiella pneumoniae, associated with chronic kidney disease, was responsible for 26%/258 deaths, chronic lung disease 28%/169, diabetes 31%/185, liver disease 15%/262, and heart disease 51%/262 deaths. Carbapenem-resistant Klebsiella pneumoniae associated with chronic kidney disease was responsible for 49%/83 deaths, with diabetes 29%/73, and with liver disease 33%/73 deaths. The risk of death from carbapenem-resistant Klebsiella pneumoniae was twice as high as the number of deaths associated with carbapenem-sensitive Klebsiella pneumoniae, RR = 2.07 (p < 0.00001). Conclusions: The present study showed an increase in mortality from carbapenem-resistant Klebsiella pneumoniae when associated with comorbidities.

Fatores associados à infecção pelo papilomavírus humano na gestação: Uma revisão integrativa / Factores asociados a la infección por el virus del papiloma humano durante el embarazo: Una revisión integradora / Factors associated with human papillomavirus infection during pregnancy: An integrative review

Objetivo: Identificar os fatores associados à infecção pelo papilomavírus humano em gestantes. Método: Revisão integrativa realizada nas seguintes bases de dados: BDENF, LILACS, MEDLINE e IBECS. Foram utilizados os seguintes descritores: "Papilomavirus Humano", "HPV", "Gravidez", "Infecções Sexualmente Transmissíveis" e "IST" (com respectivas traduções para o inglês). Resultados: Seis artigos compuseram a amostra final deste estudo. O design de pesquisa mais prevalente foi o estudo transversal (n: 03). Verificou-se que os fatores associados à infecção pelo HPV estavam relacionados a características sociodemográficas (menor idade, baixa escolaridade, estado civil solteira e consumo de álcool na gestação) e maternas (multiparidade). Conclusão: Verificou-se que alguns fatores podem estar associados à presença de infecção pelo HPV em gestantes, como características sociodemográficas e maternas. Faz-se necessário que os profissionais de saúde tenham um olhar mais atento a este público, afim de contribuir para disseminação da informação e consequente prevenção.(AU)

Objective: To identify factors associated with human papillomavirus infection in pregnant women. Method: Integrative review carried out in the following databases: BDENF, LILACS, MEDLINE and IBECS. The following descriptors were used: "Papilomavirus Humano", "HPV", "Gravidez", "Infecções Sexualmente Transmissíveis" and "IST" (with respective translations into English). Results: Six articles made up the final sample of this study. The most prevalent research design was the cross-sectional study (n: 03). It was found that the factors associated with HPV infection were related to sociodemographic (younger age, low education, single marital status and alcohol consumption during pregnancy) and maternal (multiparity) characteristics. Conclusion: It was found that some factors may be associated with the presence of HPV infection in pregnant women, such as sociodemographic and maternal characteristics. It is necessary that health professionals have a closer look at this public, in order to contribute to the dissemination of information and consequent prevention.(AU)

Objetivo: Identificar los factores asociados a la infección por el virus del papiloma humano en mujeres embarazadas. Método: Revisión integrativa realizada en las siguientes bases de datos: BDENF, LILACS, MEDLINE e IBECS. Se utilizaron los siguientes descriptores: "Papilomavirus Humano", "HPV", "Gravidez", "Infecções Sexualmente Transmissíveis" y "IST" (con sus respectivas traducciones al inglés). Resultados: Seis artículos constituyeron la muestra final de este estudio. El diseño de investigación más prevalente fue el estudio transversal (n: 03). Se encontró que los factores asociados a la infección por VPH se relacionaron con características sociodemográficas (menor edad, baja escolaridad, estado civil soltero y consumo de alcohol durante el embarazo) y maternas (multiparidad). Conclusión: Se encontró que algunos factores pueden estar asociados a la presencia de infección por VPH en gestantes, como las características sociodemográficas y maternas. Es necesario que los profesionales de la salud tengan una mirada más cercana a este público, a fin de contribuir a la difusión de información y consecuente prevención.(AU)

A Single Bout of Fatiguing Aerobic Exercise Induces Similar Pronounced Immunological Responses in Both Sexes.

Introduction: Physical exercise can acutely and chronically modulate immunological responses. Women and men have different innate and adaptive immune responses, and in this sense, these two groups may also have different acute immunological responses induced by exercise. In addition, it is essential to understand further whether the effects of physical exercise on the immune system responses depend on sex because limited scientific evidence on this topic is available. This information may allow athletes and coaches to improve the training process, mainly to understand if the physiological impact of given training stimuli in women is similar to that in men. Objective: The present study aimed to investigate the acute effects of continuous submaximal exercise until fatigue on physiological and immunological parameters in amateur female and male runners. Methods: This study included 18 female and 15 male volunteers. Each participant visited the laboratory on four consecutive days. The first visit consisted of medical history taking and explaining the study design. On the second visit, the participants were subjected to an incremental test to determine their maximal rate of oxygen consumption (VO2max) that was required to prescribe the intensity of the submaximal exercise protocol. On the third visit, the fatiguing exercise protocol was performed at 77%-80% of the VO2max. During this submaximal exercise, the heart rate, rating of perceived exertion (RPE), and blood lactate were recorded. Blood samples were collected before, immediately after, and 1 h after the fatiguing protocol to analyze the plasma levels of cytokines and creatine kinase (CK) and to count leukocytes. Finally, on the fourth visit, the participants underwent physical evaluations to measure their body composition using dual-energy X-ray absorptiometry (DXA) imaging. Results: The average ages of the female and male groups were 34.2 ± 3.7 and 30.5 ± 4.3 years old, respectively. The female group ran 57 ± 27 min, while the male group ran 52 ± 15 min before fatiguing. In the female group, when comparing before and after the submaximal exercise, marked increases were observed in the following variables: heart rate (from 68.5 to 180.4 bpm), RPE (from 3.6 to 8.2), lactate (from 2.1 to 4.49 mmol/L), and CK (from 89.5 to 126.3 U/L). In addition, the female group showed an increased number of total leukocytes (from 7222.3 to 11162.9 × 106/µl), neutrophils (from 4,403 to 6,480 × 106/µl), and lymphocytes (from 2,342 ± to 3,562 × 106/µl) from pre- to post-submaximal exercise. In the male group, similar elevations in psychophysiological variables were observed, as evidenced by comparing the heart rate (from 52.8 to 184.1 bpm), RPE (from 0.0 to 8.9), lactate (from 2.7 to 7.2 mmol/L), and CK (from 106.2 to 165 U/L) before and after the submaximal exercise. The male group also showed an augmented number of total leukocytes (from 6,245 to 8,050 × 106/µl), neutrophils (from 3,335 to 4,128 × 106/), and lymphocytes (from 2,191 to 3,212 × 106/µl) when comparing pre- and post-submaximal exercise. There were no differences in the changes between women and men for these parameters. Conclusion: The aerobically fatiguing exercise protocol induced pronounced changes in the heart rate, plasma levels of lactate and CK, total leukocyte count, especially the number of neutrophils and lymphocytes, in both sexes. The fatiguing exercise protocol also changed the plasma levels of IL-6 and IL-10 in the female and male groups. Under the present conditions, the physiological changes induced by fatiguing submaximal exercise, including the immunological changes, were not influenced by sex. This study shows that the same aerobic physical exercise can alter immunological parameters in women and men, and this response is similar between sexes.

The Curcumin Supplementation with Piperine Can Influence the Acute Elevation of Exercise-Induced Cytokines: Double-Blind Crossover Study.

BACKGROUND: to evaluate the effects of one week of supplementation with curcumin combined with piperine on physical performance, immune system cell counts, muscle damage, and plasma levels of inflammatory markers after a treadmill running training session. METHODS: This study is a double-blind, crossover-balanced clinical trial with a three-week intervention. Sixteen male runners with a mean age of 36 ± 9 years and VO2 max of 60.6 ± 9.03 mL.kg -1 min -1 were recruited and randomly divided into 2 groups: the first group (CPG) was supplemented daily for 7 days with 500 mg of curcumin + 20 mg piperine, and the second group (PG) was supplemented with 540 mg of cellulose. After the 7th day of supplementation, the volunteers participated in the experimental running protocol, where blood samples were collected before, after, and one hour after exercise for analysis of the number of leukocytes, creatine kinase, and cytokine concentration (IL-2, TNF-α, IFN, IL-6, and IL-10) using flow cytometry. This process was repeated, reversing the supplementation offered to the groups. RESULTS: curcumin and piperine supplementation could not change the physical performance, immune cell counts, and muscle damage; however, the aerobic fatiguing exercise protocol inhibited the elevation of the plasmatic levels of some cytokines. The running exercise protocol could elevate the circulating levels of IL-2 (from 49.7 to 59.3 pg/mL), TNF-α (from 48.5 to 51.5 pg/mL), INF (from 128.8 to 165.0 pg/mL), IL-6 (from 63.1 to 77.3 pg/mL), and IL-10 (from 48.9 to 59.6 pg/mL) 1 h after the end of the running protocol. However, the curcumin and piperine supplementation could inhibit this elevation. CONCLUSIONS: curcumin and piperine supplementation had no effect on physical performance, immune cell counts, or muscle damage; however, the supplementation could modulate the kinetics of IL-2, TNF-α, INF, IL-6, and IL-10 1 h after the end of exercise.

The contact lens dry eyes questionnaire (CLDEQ-8) validation and ocular surface dysfunction among soft contact lens wearers / Validação do questionário de olho seco em lentes de contato (CLDEQ-8) e a disfunção de superfície ocular em usuários de lente de contato

ABSTRACT Purpose: To translate and validate the Contact Lens Dry Eyes Questionnaire (CLDEQ-8) to Portuguese language and to describe the impact of soft contact lenses on the ocular surface. Methods: We conducted a descriptive transversal study with the aim to: (1) translate and validate the CLDEQ-8 questionnaire to Portuguese language and (2) apply the CLDEQ-8 to a group of contact lens wearers along with a broad evaluation of the impact of soft contact lens on the ocular surface. The evaluation of the impact of soft contact lens was performed for a study population of 81 subjects, categorized in two groups: Group A: 61 contact lens wearers and Group B (control): 20 noncontact lens wearers. The study exclusion criteria were rigid contact lens wear, systemic or ocular diseases, the use of medications predisposing to ocular surface damage, and previous ocular surgeries. Results: For the CLDEQ-8 questionnaire translation and validation, Kappa agreement values were ³0.7 in all questions, implying a good agreement between the Portuguese and English language versions. Considering the ocular surface evaluation of the subjects, all parameters differed in Soft contact lens wearers when compared with the controls (p<0.05), except in those related to tear volume, such as the tear meniscus height and Schirmer test. Conclusions: This study provided a translated and validated Portuguese version of CLDEQ-8 questionnaire, which represents an important tool for the evolution of contact lens wearers. The broad evaluation of the ocular surface revealed an association between soft contact lens wearing and ocular surface disturbances.

RESUMO Objetivo: Traduzir e validar o questionário de olho seco e lentes de contato (CLDEQ-8) para o português e descrever o impacto das lentes de contato gelatinosas na superfície ocular. Métodos: Estudo transversal e descritivo com o objetivo de (1) traduzir e validar o CLDEQ-8 para o português e (2) aplicar o CLDEQ-8 em um grupo de usuários de lentes de contato, juntamente com uma ampla avaliação do impacto das lentes gelatinosas na superfície ocular. A avaliação do impacto das lentes gelatinosas foi realizada em uma amostra composta por 81 indivíduos, divididos em dois grupos: 61 usuários de lente de contato (Grupo A) e um grupo controle de 20 não usuários (Grupo B). Como critério de exclusão: usuário de lentes de contato rígidas, doenças sistêmicas ou oculares prévias, uso de medicamentos que podem causar danos a superfície ocular e cirurgias oculares prévias. Resultados: Para a tradução e validação do questionário CLDEQ-8, os valores de concordância Kappa foram iguais ou superiores a 0,7 em todas as perguntas, o que implica em uma boa concordância entre as versões em português e inglês. Considerando a avaliação da superfície ocular dos sujeitos, todos os parâmetros diferiram nos usuários de lente de contato em comparação com os controles (com p<0,05), exceto naqueles relacionados ao volume lacrimal, como altura do menisco lacrimal e teste de Schirmer. Conclusões: Este estudo forneceu uma versão traduzida para o português e validada do questionário CLDEQ-8, que representa uma importante ferramenta na avaliação de usuários de lente de contato. A avaliação da superfície ocular realizada demonstra a relação entre o uso de lentes de contato gelatinosas e os distúrbios da superfície ocular.

The contact lens dry eyes questionnaire (CLDEQ-8) validation and ocular surface dysfunction among soft contact lens wearers.

PURPOSE: To translate and validate the Contact Lens Dry Eyes Questionnaire (CLDEQ-8) to Portuguese language and to describe the impact of soft contact lenses on the ocular surface. METHODS: We conducted a descriptive transversal study with the aim to: (1) translate and validate the CLDEQ-8 questionnaire to Portuguese language and (2) apply the CLDEQ-8 to a group of contact lens wearers along with a broad evaluation of the impact of soft contact lens on the ocular surface. The evaluation of the impact of soft contact lens was performed for a study population of 81 subjects, categorized in two groups: Group A: 61 contact lens wearers and Group B (control): 20 noncontact lens wearers. The study exclusion criteria were rigid contact lens wear, systemic or ocular diseases, the use of medications predisposing to ocular surface damage, and previous ocular surgeries. RESULTS: For the CLDEQ-8 questionnaire translation and validation, Kappa agreement values were ³0.7 in all questions, implying a good agreement between the Portuguese and English language versions. Considering the ocular surface evaluation of the subjects, all parameters differed in Soft contact lens wearers when compared with the controls (p<0.05), except in those related to tear volume, such as the tear meniscus height and Schirmer test. CONCLUSIONS: This study provided a translated and validated Portuguese version of CLDEQ-8 questionnaire, which represents an important tool for the evolution of contact lens wearers. The broad evaluation of the ocular surface revealed an association between soft contact lens wearing and ocular surface disturbances.