Chemopreventive and immunomodulatory effects of phenolic-rich extract of Commiphora leptophloeos against inflammatory bowel disease: Preclinical evidence.

ETHNOPHARMACOLOGY RELEVANCE: Commiphora leptophloeos (Mart.) J.B. Gillet (Burseraceae) is a medicinal plant native to Brazil, popularly known as "imburana". Homemade leaf decoction and maceration were used to treat general inflammatory problems in the Brazilian Northeast population. Our previous research confirmed the anti-inflammatory activity of the C. leptophloeos hydroalcoholic leaf extract. AIM OF THE STUDY: Inflammatory bowel disease (IBD) is a chronic and relapsing inflammatory disorder of the gut with no ideal treatment to maintain the remissive status. This work aimed to characterize the phytochemical composition and physicochemical properties of the C. leptophloeos hydroalcoholic leaf extract and its efficacy in chemopreventive and immunomodulatory responses in inflammatory bowel disease in non-clinical models. MATERIALS AND METHODS: Mass spectrometry and physicochemical tests determined the phytochemical profile and physicochemical characteristics of the Commiphora leptophloeos (CL) extract. The chemopreventive and immunomodulatory effects of CL extract (50 and 125 µg/mL) were evaluated in vitro in the RAW 264.7 lipopolysaccharide (LPS) induced cell assay and in vivo in the model of intestinal inflammation induced by 2,4-Dinitrobenzenesulfonic acid (DNBS) in mice when they were treated with CL extract by intragastric gavage (i.g.) at doses of 300, 400 and 500 mg/kg. RESULTS: Phytochemical annotation of CL extract showed a complex phenolic composition, characterized as phenolic acids and flavonoids, and satisfactory physicochemical characteristics. In addition, CL extract maintained the viability of RAW macrophages, reduced ROS and NO production, and negatively regulated COX-2, iNOS, TNF-α, IL-1ß, IL-6, and IL-17 (p < 0.05). In the intestinal inflammation model, CL extract was able to downregulate NF-κB p65/COX-2, mTOR, iNOS, IL-17, decrease levels of malondialdehyde and myeloperoxidase and cytokines TNF-α, IL-1ß and IL-6 (p < 0.05). CONCLUSION: Based on these findings, CL extract reduced inflammatory responses by down-regulating pro-inflammatory markers in macrophages induced by LPS and DNBS-induced colitis in mice through NF-κB p65/COX-2 signaling. CL leaf extract requires further investigation as a candidate for treating inflammatory bowel disease.

Prevalence and impact of sarcopenia in individuals with heart failure with reduced ejection fraction (the SARC-HF study): A prospective observational study protocol.

Sarcopenia, a clinical syndrome primarily associated with reduced muscle mass in the elderly, has a negative impact on quality of life and survival. It can occur secondarily to other diseases such as heart failure (HF), a complex clinical syndrome with high morbidity and mortality. The simultaneous occurrence of these two conditions can worsen the prognosis of their carriers, especially in the most severe cases of HF, as in patients with reduced left ventricular ejection fraction (LVEF). However, due to the heterogeneous diagnostic criteria for sarcopenia, estimates of its prevalence present a wide variation, leading to new criteria having been recently proposed for its diagnosis, emphasizing muscle strength and function rather than skeletal muscle mass. The primary objective of this study is to evaluate the prevalence of sarcopenia and/or dynapenia in individuals with HF with reduced LVEF according to the most recent criteria, and compare the gene and protein expression of those patients with and without sarcopenia. The secondary objectives are to evaluate the association of sarcopenia and/or dynapenia with the risk of clinical events and death, quality of life, cardiorespiratory capacity, ventilatory efficiency, and respiratory muscle strength. The participants will answer questionnaires to evaluate sarcopenia and quality of life, and will undergo the following tests: handgrip strength, gait speed, dual-energy X-ray absorptiometry, respiratory muscle strength, cardiopulmonary exercise, as well as genomic and proteomic analysis, and dosage of N-terminal pro-B-type natriuretic peptide and growth differentiation factor-15. An association between sarcopenia and/or dynapenia with unfavorable clinical evolution is expected to be found, in addition to reduced quality of life, cardiorespiratory capacity, ventilatory efficiency, and respiratory muscle strength.

Guidance provided by pharmacists to customers regarding to destination of unused household medications: disposal of household medications.

BACKGROUND: Discarding pharmaceuticals in the garbage or into the sewage system are still the most common methods in many countries. This study aims to investigate the guidance provided by pharmacists to customers on the disposal of unused and expired household medications in São Paulo State, Brazil. METHOD: The study population consisted of 630 pharmacists from the State of São Paulo, who work in community pharmacies. They answered an online questionnaire with questions composed in three blocks: demographic, work, and academic information on the pharmacist; guidance about the disposal of household medications; and knowledge regarding the reverse logistics of these medications. An invitation to participate in the questionnaire was made via WhatsApp, individually and collectively. Inferential statistics were performed using the chi-square test and were considered significant when p < 0.05%. RESULTS: Among the participating pharmacists, the majority were women under 60 years old,56 (8.89%) stated that they never orient the customer regarding the disposal of unused and expired household medications, while 574 (91,12%) indicated that they almost provide guidance. The frequency with which they provided guidance was influenced by the number of years since graduation (p = 0.0047), the time they had worked in pharmacies and drugstores (p = 0.0007), and whether or not they had a graduate degree (p = 0.0181). Regarding the disposal of medications, among the 643 responses provided by the pharmacists,516 (80.25%) indicated that they oriented customers to return them to a pharmacy. CONCLUSION: A small number of pharmacists always orient customers on the proper disposal that should be followed for unused and expired household medications, prioritizing their return to a pharmacy. In general, these pharmacists have longer periods of work experience and higher academic qualifications. Thus, it is important to increase knowledge through professional training and further education programs.

Efficacy of Carotenoid-Loaded Gelatin Nanoparticles in Reducing Plasma Cytokines and Adipocyte Hypertrophy in Wistar Rats.

The present study investigated the effect of gelatin-based nanoparticles (EPG) loaded with a carotenoid-rich crude extract (CE) on systemic and adipose tissue inflammatory response in a model with inflammation induced by a high glycemic index and high glycemic load diet (HGLI). Nanoparticles synthesized were characterized by different physical and chemical methods. The in vivo investigation evaluated Wistar rats (n = 20, 11 days, adult male with 21 weeks) subdivided into untreated (HGLI diet), conventional treatment (nutritionally adequate diet), treatment 1 (HGLI + crude extract (12.5 mg/kg)), and treatment 2 (HGLI + EPG (50 mg/kg)) groups. Dietary intake, caloric intake and efficiency, weight, inflammatory cytokines tissue concentration, visceral adipose tissue (VAT) weight, histopathological analysis, and antioxidant activity in plasma and VAT were investigated. EPG showed the same physical and chemical characteristics as previous batches (95.2 nm, smooth surface, and chemical interactions between materials). The EPG-treated group was the only group promoting negative ∆dietary intake, ∆caloric efficiency, and ∆weight. In addition, it presented a significant reduction (p < 0.05) in IL-6 and leptin levels and a greater presence of multilocular adipocytes. The results suggest that EPG can act as a nutraceutical in adjuvant therapy for treating inflammatory diseases associated with adipose tissue accumulation.

Inflammatory cytokines and chemokines in obese adolescents with antibody against to adenovirus 36.

Obesity in adolescents has reached epidemic proportions and is associated with the inflammatory response and viral infections. The aim of this study was to understand the profile of inflammatory cytokines and chemokines associated with the inflammatory response and metabolic syndrome (MetS) in obese adolescents with positive serology for adenovirus 36 (ADV36). Thirty-six overweight, 36 obese, and 25 severe obesity adolescents aged 10 to 16 years were included in the study. The following variables were analyzed: sex, age, body mass index (BMI), blood pressure, total cholesterol and fractions, triglycerides, glucose, serum cytokine concentrations, and ADV36 antibodies. Cytokines and chemokines were quantified by cytometry and ADV36 serology was determined by enzyme-linked immunosorbent assay (ELISA). The results showed higher levels of the cytokines interleukin-1beta (IL-1ß), IL-6, IL-10 and of the chemokine interferon-gamma-inducible protein 10 (IP-10) in severe obesity adolescents compared to the obese and overweight groups, as well as in the group with MetS compared to the group without this syndrome. The frequency of ADV36-positive individuals did not differ between groups. The findings revealed differences in BMI between the obese and severe obesity groups versus the overweight group in the presence of positivity for ADV36, suggesting an association with weight gain and possibly MetS installation.

Repeated donkey milk consumption reduces anxiety-like behaviors and brain oxidative damage to lipids in mice.

Donkey milk (DM) is a source of bioactive compounds that can benefit neural functioning. In the present study, we investigated the effects of DM consumption on anxiolytic-related, despair-like, locomotion and coordination behaviors, as well as the provision of protection from oxidative damage to lipids and proteins in brain tissues and melatonin plasma levels. To achieve this, male mice orally received DM (4 g.kg-1) or vehicle for 18 days. Their behavior was assessed in the following tests: elevated plus maze (EPM), open field and rotarod tests (OF, RR) and forced swimming test (FST). Acute treatments with diazepam (DZP, 1.5 mg.kg-1, v.o.), fluoxetine (FLX, 20 mg.kg-1, i.p.) and nortriptyline (NTP, 20 mg.kg-1, i.p.) were used as positive controls. On the eighteenth day, the animals were euthanized and brain tissue and blood were collected to measure oxidative damage, and melatonin plasma levels. Similar to DZP, repeated DM consumption reduced exploration to open areas in the EPM test. Under our experimental conditions, conventional antidepressants reduced immobility time in the FST, and the benzodiazepine treatment impaired motor coordination in mice. No significant differences in locomotion, motor coordination and despair-related behaviors were observed in the mice treated with DM when assessed in the EPM, OF, RR and FST, respectively. Biochemical assays showed that repeated DM exposition protected against oxidative damage to lipids and increased plasma levels of melatonin. These findings suggest consumption of DM may be a promising food for the treatment of anxiety-related disorders, without depressant effects on the central nervous system.

Phenolic-rich extract of Nopalea cochenillifera attenuates gastric lesions induced in experimental models through inhibiting oxidative stress, modulating inflammatory markers and a cytoprotective effect.

Nopalea cochenillifera (Cactaceae), popularly known as "palma" or "palma doce", is from Mexico, but it was widely introduced in Brazil through crops. It has been used as food and in traditional medicine and is a good source of phenolic compounds. In this study the phytochemical profile and gastroprotective activity of phenolic-rich extract of N. cochenillifera in acute gastric lesion models induced by ethanol and indomethacin were evaluated. High-performance liquid chromatography coupled with mass spectrometry (HPLC/ESI/MSn) allowed the characterization of 12 compounds such as sugars, phenolics and flavonoids. Among polyphenols, the main peak was assigned to isorhamnetin-3-O-(2'',3''-O-di-rhamnose)-glucoside. The TPC and TFC in the dry extract were 67.85 mg of gallic acid equivalent per g/extract and 46.16 mg quercetin equivalent per g/extract, respectively. In the in vitro MTT assay, the extract showed no cytotoxicity and suppressed ROS levels in LPS-treated RAW 264.7 cells. Preclinical models in rats showed that a dose of 100 mg kg-1 (p < 0.0001) in the ethanol model and doses of 100 mg kg-1 (p < 0.5) and 200 mg kg-1 (p < 0.01) in the indomethacin model reduced the gastric lesions. Also, the extract reduced the MPO, MDA, TNF-α and IL-1ß levels and increased the GSH and IL-10 levels. The pre-treatment with the extract led to the upregulation of SOD and the downregulation of COX-2 by immunohistochemical analysis. It also showed a cytoprotective effect in the histopathological analysis and stimulated the restoration of the mucus content as observed in the periodic acid-Schiff analysis without modifying the pH, volume or total acidity of the gastric juice. Taken together, N. cochenillifera extract can be applied as a novel gastroprotective ingredient for food or pharmaceutical products.

Toxicity and Anti-Inflammatory Activity of Phenolic-Rich Extract from Nopalea cochenillifera (Cactaceae): A Preclinical Study on the Prevention of Inflammatory Bowel Diseases.

Phenolic compounds have been scientifically recognized as beneficial to intestinal health. The cactus Nopalea cochenillifera, used as anti-inflammatory in traditional medicine, is a rich source of these bioactive compounds. The present study aimed to investigate the phytochemical profile of N. cochenillifera extract and evaluate its acute toxicity and anti-inflammatory effect on 2,4-dinitrobenzenesulfonic acid (DNBS)-induced colitis in rats. The total phenolic content per gram of dry extract was 67.85 mg. Through HPLC-IES-MSn, a total of 25 compounds such as saccharides, organic acids, phenolic acids and flavonoids were characterized. The dose of 2000 mg/kg of extract by an oral route showed no signs of toxicity, mortality or significant changes in biochemical and hematological parameters. Regarding intestinal anti-inflammatory effects, animals were treated with three different doses of extract or sulfasalazine. Macroscopic analysis of the colon indicated that the extract decreased the disease activity index. Levels of IL-1ß and TNF-α decreased, IL-10 increased and MDA and MPO enzyme levels decreased when compared with the control group. In addition, a down-regulation of MAPK1/ERK2 and NF-κB p65 pathway markers in colon tissue was observed. The epithelial integrity was improved according to histopathological and immunohistological analysis. Thus, the extract provided strong preclinical evidence of being effective in maintaining the remission of colitis.

Landscape dynamics and diversification of the megadiverse South American freshwater fish fauna.

Landscape dynamics are widely thought to govern the tempo and mode of continental radiations, yet the effects of river network rearrangements on dispersal and lineage diversification remain poorly understood. We integrated an unprecedented occurrence dataset of 4,967 species with a newly compiled, time-calibrated phylogeny of South American freshwater fishes-the most species-rich continental vertebrate fauna on Earth-to track the evolutionary processes associated with hydrogeographic events over 100 Ma. Net lineage diversification was heterogeneous through time, across space, and among clades. Five abrupt shifts in net diversification rates occurred during the Paleogene and Miocene (between 30 and 7 Ma) in association with major landscape evolution events. Net diversification accelerated from the Miocene to the Recent (c. 20 to 0 Ma), with Western Amazonia having the highest rates of in situ diversification, which led to it being an important source of species dispersing to other regions. All regional biotic interchanges were associated with documented hydrogeographic events and the formation of biogeographic corridors, including the Early Miocene (c. 23 to 16 Ma) uplift of the Serra do Mar and Serra da Mantiqueira and the Late Miocene (c. 10 Ma) uplift of the Northern Andes and associated formation of the modern transcontinental Amazon River. The combination of high diversification rates and extensive biotic interchange associated with Western Amazonia yielded its extraordinary contemporary richness and phylogenetic endemism. Our results support the hypothesis that landscape dynamics, which shaped the history of drainage basin connections, strongly affected the assembly and diversification of basin-wide fish faunas.

Estrutura das representações sociais da enfermagem sobre a morte decorrente da COVID-19 / Structure of nursing social representations on death due to COVID-19 / Estructura de las representaciones sociales de enfermería sobre la muerte por COVID-19

Introdução: Ainda que se saiba que a morte faz parte do ciclo da vida, diante de uma doença com muitos aspectos ainda desconhecidos como a COVID-19, torna-se importante compreender como os trabalhadores de enfermagem representam esse fenômeno, uma vez que são os únicos profissionais de saúde que continuam o cuidado ao indivíduo mesmo após a finitude da vida. Objetivo: analisar a estrutura das representações sociais sobre morte e morrer decorrentes de COVID-19 elaboradas por profissionais de enfermagem. Materiais e métodos: estudo qualitativo ancorado na vertente estrutural da Teoria das Representações Sociais com ênfase na Teoria do Núcleo Central, desenvolvido junto a 32 profissionais de enfermagem da cidade de Natal, estado do Rio Grande do Norte, Brasil. A coleta de dados foi realizada online mediante utilização da técnica de associação livre de palavras. Para a análise dos dados recorreu-se às análises prototípica e de similitude. Resultados: o provável núcleo central das representações foi constituído pelos termos tristeza e medo, e a composição do sistema periférico e da zona de contraste reforçam esse núcleo. Discussão: o núcleo central das representações dos profissionais de enfermagem sobre morte e morrer decorrentes de COVID-19 se constitui em um Themata polêmico de representação, e destaca os prejuízos à saúde psicossocial dos trabalhadores de enfermagem da linha de frente. Conclusões: perante às representações elaboradas sobre a morte e morrer decorrentes de COVID-19, é necessário o desenvolvimento de estratégias de enfrentamento que colaborem para a saúde psicossocial dos trabalhadores de enfermagem.

Introduction: Although it is known that death is part of the life cycle, in the face of a disease with many aspects still unknown, such as COVID-19, it is important to understand how nursing workers represent this phenomenon, since they are the only professionals that continue to care for the individual even after the end of life. Objective: to analyze the structure of social representations about death and dying due to COVID-19 elaborated by nursing professionals. Materials and methods: qualitative study anchored in the structural aspect of the Theory of Social Representations with emphasis on the Theory of the Central Nucleus, developed with 32 nursing professionals from the city of Natal, state of Rio Grande do Norte, Brazil. Data collection was performed online using the free word association technique. For data analysis, prototypical and similarity analyzes were used. Results: the probable central nucleus of the representations was constituted by the terms sadness and fear, and the composition of the peripheral system and the contrast zone reinforce this nucleus. Discussion: the core of nursing professionals' representations about death and dying from COVID-19 constitutes a controversial issueof representation and highlights the damage to the psychosocial health of frontline nursing workers. Conclusions: in view of the elaborated representations about death and dying resulting from COVID-19, it is necessary to develop coping strategies that contribute to the psychosocial health of nursing workers.

Introducción: Si bien se sabe que la muerte es parte del ciclo de vida, ante una enfermedad con muchos aspectos aún desconocidos, como lo es el COVID-19, es importante comprender cómo los trabajadores de enfermería representan este fenómeno, ya que son los únicos profesionales que continuan cuidando al individuo incluso después del final de la vida. Objetivo: analizar la estructura de las representaciones sociales sobre la muerte y el morir por COVID-19 elaboradas por profesionales de enfermería. Materiales y métodos: estudio cualitativo anclado en el aspecto estructural de la Teoría de las Representaciones Sociales con énfasis en la Teoría del Núcleo Central, desarrollado con 32 profesionales de enfermería de la ciudad de Natal, estado de Rio Grande do Norte, Brasil. La recolección de datos se realizó en línea utilizando la técnica de asociación libre de palabras. Para el análisis de los datos se utilizaron análisis prototípicos y de similitud. Resultados: el probable núcleo central de las representaciones estuvo constituido por los términos tristeza y miedo, y la composición del sistema periférico y la zona de contraste refuerzan este núcleo. Discusión: el núcleo de las representaciones de los profesionales de enfermería sobre la muerte y el morir por COVID-19 constituye un temade representación controvertido, y destaca el daño a la salud psicosocial de los trabajadores de enfermería de primera línea. Conclusiones: frente a las representaciones elaboradas sobre la muerte y el morir como consecuencia de la COVID-19, es necesario desarrollar estrategias de enfrentamiento que contribuyan a la salud psicosocial de los trabajadores de enfermería.

Anti-Inflammatory Protein Isolated from Tamarind Promotes Better Histological Aspects in the Intestine Regardless of the Improvement of Intestinal Permeability in a Preclinical Study of Diet-Induced Obesity.

Obesity is associated with metabolic and physiological effects in the gut. In this study, we evaluated the anti-inflammatory effect of trypsin inhibitor isolated from tamarind seeds (TTI) in vitro (interaction with lipopolysaccharide (LPS) and inhibitory activity against human neutrophil elastase (HNE)), and using intestinal co-cultures of Caco-2:HT29-MTX cell lines inflamed with TNF-α (50 ng/mL) and a Wistar rat model of diet-induced obesity (n = 15). TTI was administered to animals by gavage (10 days), and the treated group (25 mg/kg/day) was compared to animals without treatment or treated with a nutritionally adequate diet. In the in vitro study, it showed inhibitory activity against HNE (93%). In co-cultures, there was no protection or recovery of the integrity of inflamed cell monolayers treated with TTI (1.0 mg/mL). In animals, TTI led to lower plasma concentrations of TNF-α and IL-6, total leukocytes, fasting glucose, and LDL-c (p < 0.05). The intestines demonstrated a lower degree of chronic enteritis, greater preservation of the submucosa, and greater intestinal wall thickness than the other groups (p = 0.042). Therefore, the better appearance of the intestine not reflected in the intestinal permeability added to the in vitro activity against HNE point to possibilities for new studies and applications related to this activity.

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil / Risk factors in neurosurgery: a cohort study in northern Brazil

Introdução: Pacientes neurocirúrgicos apresentam elevado risco de complicações locais e sistêmicas que podem aumentar o tempo de internação e o risco de morte. Este estudo tem como objetivo avaliar a incidência de infecções relacionadas à assistência à saúde e os fatores de risco associados em pacientes submetidos às neurocirurgias. Materiais e métodos: Estudo de coorte prospectiva, realizado em um Hospital de grande porte do estado de Rondônia, no período de 2018 a 2019, incluindo 36 pacientes. Resultados: A incidência de infecções relacionada à assistência à saúde foi 19,4 a cada 100 pacientes (IC95%: 8,19 ­ 36,02). Ter utilizado sonda nasoenteral aumentou em 6,5 vezes o risco de IRAS (IC 95%: 1,26 ­ 33,5), a ventilação mecânica aumentou 5,52 vezes o risco (IC95%: 1,23 ­ 24,6), a presença de traqueostomia aumentou seis vezes (IC95%: 1,34 ­ 26,8) e realização de exame invasivo aumentou o risco em 6,79 para ter infecção (IC95%: 1,31 ­ 35,05). Na análise ajustada as variáveis não apresentaram significância estatística. Discussão: A incidência de infecções foi maior do que em regiões com melhores condições socioeconômicas o que pode estar relacionado à menor adesão de boas práticas na assistência. Conclusão: Nas neurocirurgias além das infecções de sítio cirúrgico outras topografias também devem ser consideradas para investigação de infecção. O uso de dispositivos invasivos foi associado à ocorrência de infecções relacionadas à assistência à saúde, portanto as boas práticas no seu uso são essenciais no momento da indicação e uso destes dispositivos.

Introduction: Neurosurgical patients are at high risk of local and systemic complications that can increase the length of hospital stay and the risk of death. This study aims to assess the incidence of healthcare-associated infections and associated risk factors in patients undergoing neurosurgery. y. Materials and Methods:: Prospective cohort study, carried out in a large hospital in the state of Rondônia, from 2018 to 2019, including 36 patients. Results:The incidence of healthcare-associated infections was 19.4 per 100 patients (95%CI: 8.19 ­ 36.02). Having used a nasoenteral tube increased the risk of HAI by 6.5 times (95% CI: 1.26 ­ 33.5), mechanical ventilation increased the risk by 5.52 times (95% CI: 1.23 ­ 24.6) , the presence of tracheostomy increased six-fold (95%CI: 1.34 ­ 26.8) and performing an invasive examination increased the risk of infection by 6.79 (95%CI: 1.31 ­ 35.05). In the adjusted analysis, the variables did not show statistical significance. Discussion:The incidence of infections was higher than in regions with better socioeconomic conditions, which may be related to lower adherence to good care practices. Conclusions: : In neurosurgery, in addition to surgical site infections, other topographies should also be considered for the investigation of infection. The use of invasive devices was associated with the occurrence of infections related to health care, so good practices in their use are essential when indicating and using these devices.

Introducción:Los pacientes neuroquirúrgicos tienen un alto riesgo de complicaciones locales y sistémicas que pueden aumentar la estancia hospitalaria y el riesgo de muerte. Este estudio tiene como objetivo evaluar la incidencia de infecciones asociadas a la atención médica y los factores de riesgo asociados en pacientes sometidos a neurocirugía. Materiales y métodos: : Estudio de cohorte prospectivo, realizado en un gran hospital del estado de Rondônia, de 2018 a 2019, con 36 pacientes. Resultados: La incidencia de infecciones asociadas a la asistencia sanitaria fue de 19,4 por 100 pacientes (IC95%: 8,19 ­ 36,02). Haber utilizado una sonda nasoenteral aumentó el riesgo de IRAS en 6,5 veces (IC 95%: 1,26 ­ 33,5), la ventilación mecánica aumentó el riesgo en 5,52 veces (IC 95%: 1,23 ­ 24,6), la presencia de traqueotomía aumentó seis veces (IC95%: 1,34 ­ 26,8) y realizar un examen invasivo aumentó el riesgo de infección en 6,79 (IC95%: 1,31 ­ 35,05). En el análisis ajustado, las variables no presentaron significación estadística. Discusión: La incidencia de infecciones fue mayor que en las regiones con mejores condiciones socioeconómicas, lo que puede estar relacionado con una menor adherencia a las buenas prácticas de cuidado. Conclusión: En neurocirugía, además de las infecciones del sitio quirúrgico, también se deben considerar otras topografías para la investigación de la infección. El uso de dispositivos invasivos se asoció con la ocurrencia de infecciones relacionadas con el cuidado de la salud, por lo que las buenas prácticas en su uso son fundamentales a la hora de indicar y utilizar estos dispositivos

Toxicological and pharmacological effects of pentacyclic triterpenes rich fraction obtained from the leaves of Mansoa hirsuta.

Mansoa hirsuta is a medicinal plant native to the Brazilian semi-arid region. This approach aimed to investigate the in vitro and in vivo toxicity and anti-inflammatory and analgesic actions of the M. hirsuta fraction (MHF). In vitro cell viability was assessed in 3T3 cells. In vivo, the acute toxicity test, a single dose of the MHF was administered. For the subchronic toxicity test, three doses of were administered for 30 days. Locomotion and motor coordination were assessed using open field and rota-rod. The anti-inflammatory activity was evaluated in carrageenan-induced paw edema and zymosan-induced air-pouch models. Myeloperoxidase (MPO) and total proteins were also measured. The antinociceptive activity MHF was determined using acid acetic-induced abdominal writhing and formalin models. In the cytotoxicity assay, MHF showed no significative impairment of cell viability and in the acute toxicity study, did not cause mortality or signs of toxicity. Repeated exposure to MHF did not cause relevant toxicological changes. The evaluation in the open field test showed that the MHF did not alter the locomotor activity and there was no change in motor coordination and balance of animals. MHF significantly reduced edema, MPO production, the migration of leukocytes and protein leakage. In addition, MHF reduced abdominal writhing and significantly inhibited the first and second stage of the formalin test. The results of this study indicated that MHF has an anti-inflammatory and analgesic potential without causing acute or subchronic toxic effects and it can be a promising natural source to be explored.

Gel formulated with Bryophyllum pinnatum leaf extract promotes skin wound healing in vivo by increasing VEGF expression: A novel potential active ingredient for pharmaceuticals.

Bryophyllum pinnatum (Crassulaceae) is used in traditional medicine for treating skin wounds. In our previous study, a topical gel containing B. pinnatum aqueous leaf extract showed a preclinical anti-inflammatory effect in in vivo acute edema models. In continuation, the present study aims to evaluate the phytochemical content and the stability of a formulation in gel containing B. pinnatum aqueous leaf extract and its healing properties and mechanism of action through an experimental model of induction of skin wounds in rats and in vitro assays. The animals were treated topically for 7 or 14 days with a formulation in gel containing extract at 5% or a placebo or Fibrinase® in cream. In addition, to establish some quality control parameters, the total phenolic content (TPC), total flavonoid content (TFC), and a study focusing on the phytochemical and biological stability of a gel for 30 days at two different conditions (room temperature and 40°C/75% RH) were performed. Gel formulation containing extract showed a TPC and TFC of 2.77 ± 0.06 mg of gallic acid/g and 1.58 ± 0.03 mg of quercetin/g, respectively. Regarding the stability study, the formulation in gel showed no significant change in the following parameters: pH, water activity, chromatographic profile, and the content of the major compound identified in the extract. The gel formulation containing extract stimulated skin wound healing while reducing the wound area, as well as decreasing the inflammatory infiltrate, reducing the levels of IL-1ß and TNF-α, and stimulating angiogenesis with increased expression of VEGF, an effect similar to Fibrinase. In conclusion, the gel formulation containing extract exhibited relevant skin wound healing properties and, therefore, has the potential to be applied as a novel active ingredient for developing wound healing pharmaceuticals.

Sindrome de Down resultante de uma translocação não Robertsoniana rara t(11; 21) (p13; q22)

Introdução: A síndrome de Down (SD) é um distúrbio genético comum, ocorrendo em aproximadamente 1 em 700 nascimentos. Resulta de uma cópia extra de todo ou de parte do braço longo do cromossomo 21, causada por diferentes alterações citogenéticas: trissomia livre, translocações robertsonianas, mosaicismo, duplicação da região crítica e outros rearranjos estruturais. Translocações cromossômicas não-Robertsonianas são eventos muito raros, com poucos casos relatados. Objetivo: Descrever uma paciente com SD resultante da translocação não-Robertsoniana t(11; 21)(p13; q22). Relato de Caso: Uma menina encaminhada com diagnóstico clínico de trissomia do 21 apresentou dois cromossomos 21 e a translocação não-Robertsoniana t(11; 21)(p13; q22). A criança desenvolveu distúrbio mieloproliferativo transitório aos 17 meses. A análise citogenética foi realizada em metáfases obtidas de linfócitos e de células da medula óssea, de acordo com procedimento padrão - bandamento G e hibridização in situ fluorescente. O estudo do cariótipo dos pais revelou que sua mãe, fenotipicamente normal, é portadora da mesma translocação recíproca. Conclusão: Este é o segundo relato da translocação t(11; 21)(p13; q22), o primeiro resultando na SD. Essa descrição amplia o conhecimento sobre a variabilidade citogenética na etiologia da síndrome de Down. Estudos futuros são necessários para investigar os efeitos clínicos a longo prazo da trissomia do cromossomo 21 associada com a t(11; 21)(p13; q22).

Increase in the Antioxidant and Anti-Inflammatory Activity of Euterpe oleracea Martius Oil Complexed in ß-Cyclodextrin and Hydroxypropyl-ß-Cyclodextrin.

Reactive oxygen species (ROS) are aerobic products generated during cellular respiration, but in the case of oxidative stress, they become key factors in the development of inflammatory processes and chronic diseases such as diabetes and rheumatoid arthritis. In this work, Euterpe oleracea oil (EOO), as well as the complexes produced by slurry (S) and kneading (K), were analyzed for antioxidant capacity in vitro, while only the ß-cyclodextrin complex obtained by kneading (EOO-ßCD-K), which showed better complexation, was selected for anti-inflammatory assays in vivo. In the scavenging activity of OH·, the hydroxypropyl-ß-cyclodextrin complex obtained by kneading (EOO-HPßCD-K) exhibited an activity 437% higher than the pure oil. In the paw edema assay, EOO-ßCD-K reduced edema by 200% and myeloperoxidase (MPO) activity by 112%. In an air pouch model, this treatment showed a reduction in leukocyte, MPO, and Interleukin-1ß (IL-1ß) levels; meanwhile those of glutathione and IL-10 were increased, demonstrating its ability to potentiate the anti-inflammatory effect of EOO.

Impact of metabolic syndrome and its components on bone remodeling in adolescents.

INTRODUCTION: Osteoporosis and metabolic syndrome (MetS) are diseases that have serious public health consequences, reducing the quality of life of patients and increasing morbidity and mortality, with substantial healthcare expenditures. OBJECTIVE: To evaluate the impact of MetS on bone mineral density (BMD) and biochemical markers of bone formation and resorption in adolescents with excess weight. METHOD: A descriptive and analytical cross-sectional study was performed that evaluated 271 adolescents of both sexes (10 to 16 years). From the total sample, 42 adolescents with excess weight and the presence of MetS (14%) were selected. A further 42 adolescents with excess weight and without MetS were chosen, matched for chronological age, bone age, and pubertal developmental criteria to those with MetS, for each sex. Anthropometric measurements, blood pressure collection, and biochemical tests were performed in all adolescents, as well as evaluation of BMD and the bone biomarkers osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal telopeptide (S-CTx). RESULTS: The adolescents with excess weight and MetS exhibited significantly lower transformed BMD and concentrations of BAP, OC, and S-CTx compared to the matched group, except for OC in boys. A negative and significant correlation was observed between total body BMD and BAP (r = -0.55568; p = 0.005), OC (r = -0.81760; p = < .000), and S-CTx (r = -0.53838; p = 0.011) in girls. CONCLUSION: Metabolic syndrome may be associated with reduced bone mineral density and biochemical markers of bone formation and resorption in adolescents with excess weight.

O tratamento da tuberculose sob a ótica dos profissionais da Atenção Primária à Saúde / Tuberculosis treatment under the optics of Primary Health Care professionals

O acesso à saúde, em especial, a Atenção Primária à Saúde (APS), é fundamental para o fortalecimento do Sistema Único de Saúde (SUS). Enquanto problema de saúde pública, o controle da tuberculose (TB) depende desse aspecto, organizacional e de desempenho, que se refere à primeira etapa do percurso realizado pelo usuário quando este busca pela satisfação de uma necessidade de saúde. Em vista disso, objetivou-se analisar as ações e estratégias para o tratamento da TB na APS no município de Porto Velho-RO, sob a ótica dos profissionais de saúde. Estudo descritivo, do tipo inquérito, realizado de forma transversal a partir da abordagem quantitativa. A coleta de dados foi realizada por meio das dimensões acesso ao tratamento e formação profissional da versão para profissionais de saúde do formulário "Primary Care Assessment Tool" (PCATool), validado para o Brasil e adaptado para TB, cuja categoria de resposta varia segundo a escala Likert. Os dados foram analisados por meio de estatística descritiva, após aprovação do Comitê de Ética em Pesquisa, conforme parecer 2.585.934 CEP/UNIR. Responderam ao formulário 266 profissionais, sendo 119 Agentes Comunitários de Saúde (ACS), 77 técnicos/auxiliares de enfermagem, 43 enfermeiros e 27 médicos. A dimensão acesso ao tratamento obteve escore geral igual a 3,15 (às vezes) e a dimensão formação profissional escore geral igual a 3,99 (quase sempre). Verificou-se um desconhecimento quanto às barreiras de acesso enfrentadas pelos usuários, bem como divergências entre as categorias profissionais quanto aos atributos da APS, o que evidencia a fragmentação da assistência. Nesse sentindo, é essencial ampliar a capacitação a todos os membros da equipe de saúde e associá-la ao contexto social da comunidade.

The access to health, in particular, to the Primary Health Care (PHC), is fundamental for the strengthening of the Unified Health System (UHS). As a public health problem, tuberculosis (TB) control depends on this organizational aspect and performance, which refers to the first stage of the path taken by the user when he seeks to satisfy a health need. In view of this, the objective was to analyze the actions and strategies for the treatment of TB in PHC in the city of Porto Velho-RO, from the perspective of health professionals. This descriptive, survey-type study, was cross- sectionally carried out using the quantitative approach. Data collection was carried out through the dimensions of access to treatment and professional training of the form "Primary Care Assessment Tool" (PCATool) in the version for health professionals, validated for Brazil and adapted for TB, whose response category varies according to the Likert scale. The data were analyzed using descriptive statistics, after approval by the Research Ethics Committee, according to opinion 2,585,934 CEP/UNIR. 266 professionals responded to the form, 119 of whom were Community Health Agents (CHA), 77 nursing technicians/assistants, 43 nurses and 27 doctors. The dimension of access to treatment obtained a general score of 3.15 (sometimes), and the dimension of professional training a general score of 3.99 (almost always). There was a lack of knowledge regarding the barriers of access faced by users, as well as differences between the professional categories regarding the attributes of PHC, which shows the fragmentation of care. In this sense, it is essential to expand training to all members of the health team and associate it with the social context of the community.

A new species group to emEdessa/em, the emE. ovina/em group, with description of a new species (Heteroptera: Pentatomidae: Edessinae) from Brazil.

The E. ovina group of species is proposed here to include Edessa ovina Dallas, 1851 from Trinidad and Tobago, Colombia, Paraguay, Brazil, Argentina (new records) and Guyana; E. impura Bergroth, 1891 from Brazil and Argentina (new record); E. sahlbergii Stål, 1872 restricted to Brazil; and E. graziae sp. nov. from Brazil and Argentina. The E. ovina group can be identified by the apex of the second pair of wings narrowing distally and by a tumid area on the ventral surface of the pygophore (male genitalia) projected posteriorly. Descriptions, measurements, and illustrations of the metasternal process, external and internal genitalia of male and female are provided. A map with the distribution of the species is presented. The holotype of Edessa ovina is designated here. Edessa argali Breddin, 1903 is considered a junior synonym of E. impura. Females of E. ovina and E. impura, and male of E. sahlbergii are described for the first time.

Vigna spp. Root-Nodules Harbor Potentially Pathogenic Fungi Controlled By Co-habiting Bacteria.

This study aimed to isolate, identify, and evaluate the pathogenicity of nodule-borne fungi of asymptomatic Vigna spp. plants, grown in soils from preserved tropical dry forests (Caatinga) areas and identify the occurrence of co-habiting bacteria from these plants, and which have potential to control the co-occurring pathogenic fungi. Fungi and bacteria were isolated from three Vigna species (V. unguiculata, V. radiata, and V. mungo), grown in soil samples collected in five preserved Caatinga areas (Northeastern, Brazil). All fungi and selected bacteria were phylogenetically characterized by the sequencing of ITS1-5.8S-ITS2, and the 16S rRNA gene, respectively. The pathogenicity of fungi in cowpea seeds germination was evaluated throughout the inoculation experiment in Petri dishes and pots containing sterile substrate. The potential of nodule-borne bacteria to control pathogenic fungi in cowpea was assessed in a pot experiment with a sterilized substrate by the co-inoculation of fungi and bacteria isolated from the respective individual plants and soils. The 23 fungal isolates recovered were classified within the genera Fusarium, Macrophomina, Aspergillus, Cladosporium, and Nigrospora. The inoculation of fungi in cowpea seeds reduced the emergence of seeds in Petri dishes and pots. Twenty-four bacteria (Agrobacterium sp., Bradyrhizobium sp., Bacillus sp., Enterobacter sp., Pseudomonas sp., Paraburkholderia sp., and Rhizobium sp.) inhibited the harmful effects of Macrophomina sp. and Fusarium sp., increasing the germination and emergency of potted cowpea plants, highlighting the strains Agrobacterium sp. ESA 686 and Pseudomonas sp. ESA 732 that controlled, respectively, the Fusarium sp. ESA 771 and Macrophomina sp. ESA 786 by 100 and 84.6% of efficiency.