Building Capacity and Advancing Regulatory Measures to Improve Food Environments in the Region of the Americas.

Noncommunicable diseases (NCDs) are the main cause of death globally (70%) and in the Region of the Americas (80%), and poor diets are a leading driver of NCDs. In response, the Pan American Health Organization (PAHO)/World Health Organization (WHO) introduced a set of evidence-based regulatory measures to help countries improve diets through the reduced consumption of processed and ultra-processed foods. This paper aims to describe the needs of and propose actions for key actors to advance these measures. A workshop was designed to assess member states' regulatory capacity. A thematic analysis was conducted to analyze regional needs, successes and challenges. Thereafter, the Government Capacity-Building Framework for the prevention and control of NCDs was used to examine findings. The findings were organized in two sets: (i) PAHO/WHO actions to support member states and (ii) key actors' actions to advance regulatory policies. The results show notable regulatory progress across the Region of the Americas. However, progress differs between countries, with opportunities to strengthen measures in most countries, mainly in conflict of interest management. The results identified important actions to strengthen the regulatory capacity of PAHO/WHO member states. To maximize momentum for these actions, timelines must be identified, and political commitment can be boosted by applying human rights-based and food system-wide approaches.

Development of a crowdsourcing- and gamification-based mobile application to collect epidemiological information and promote healthy lifestyles in Mexico.

We developed a mobile application to promote healthy lifestyles and collect non-communicable disease (NCD) data in Mexico. Its theoretical foundations are supported by a framework-guided literature review. With design sprints, Scrum, Model-View-Controller, and Representational State Transfer architecture, we operationalized evidence-based nutrition/physical activity information into a crowdsourcing- and gamification-based application. The application was piloted for three months to monitor the response of 520 adults. Potential improvements were characterized, considering benchmarking, expert guidance, and standards. Salud Activa (English: Active Health) has two crowdsourcing modules: Nutritional scanner, scanning products' bar codes, providing nutritional data, and allowing new product registry feeding our databases; Surveys, comprising gradually-released NCD questions. Three intervention modules were generated: Drinks diary, a beverage assessment component to receive hydration recommendations; Step counter, monitoring users' steps via Google Fit/Health-iOS; Metabolic Avatar, interconnecting modules and changing as a function of beverage and step records. The 3-month median of Salud Activa use was seven days (IQR = 3-12), up to 35% of participants completed a Survey section, and 157 food products were registered through Nutritional scanner. Better customization might benefit usability and user engagement. Quantitative and qualitative data will enhance Salud Activa's design, user uptake, and efficacy in interventions delivered through this platform.

Assessing transnational spillover effects of Mexico's front-of-package nutritional labeling system among Mexican Americans in the US.

OBJECTIVE: In 2020, Mexico implemented innovative front-of-package nutrition warning labels (FoPWLs) for packaged foods to increase the salience and understanding of nutrition information. This study evaluated Mexican Americans' self-reported exposure to Mexican FoPWLs and self-reported effects of FoPWLs on purchasing behavior. METHODS: The 2021 International Food Policy Study surveyed online panels of adult Mexican Americans in the US (n = 3361) to self-report on buying food at Mexican-oriented stores, noticing Mexican FoPWLs, and being influenced by FoPWLs to purchase less of eight different unhealthy foods (each assessed separately). After recoding the frequency of buying foods in Mexican stores and noticing FoPWLs (i.e., "often" or "very often" vs. less often), logistic models regressed these outcomes on sociodemographics, adjusting for post-stratification weights. RESULTS: Most participants (88.0%) purchased foods in Mexican stores. Of these, 64.1% reported noticing FoPWLs, among whom many reported that FoPWLs influenced them to buy fewer unhealthy foods (range = 32% [snacks like chips] - 44% [colas]). Participants were more likely to buy foods in Mexican stores and notice FoPWLs if they were younger, had ≥two children at home vs no children (AOR = 1.40, 95%CI = 1.15-1.71; AOR = 1.37, 95%CI = 1.03-1.80, respectively), and more frequently used Spanish (AOR = 1.91, 95%CI = 1.77-2.07; AOR = 1.87, 95%CI = 1.69-2.07). Also, high vs. low education (AOR = 1.51, 95%CI = 1.17-1.94) and higher income adequacy (AOR = 1.37, 95%CI = 1.25-1.51) were positively associated with noticing FoPWLs. Being female and more frequent Spanish use were consistently associated with reporting purchase of fewer unhealthy foods because of FoPWLs. CONCLUSIONS: Many Mexican Americans report both exposure to Mexican FOPWLs and reducing purchases of unhealthy foods because of them.

Sequential Sampling Plans for Thrips (Thysanoptera: Thripidae) in Soybean Crops With Insecticide Applications Using Tractor or Airplane.

Sampling plans are an essential part of integrated pest management programs. Sequential sampling plans enable rapid and low-cost assessment of pest densities. Thrips are emerging pests in soybean crops, and the main method used in pest control is chemical. In soybean crops, insecticides are applied mainly using tractors or airplanes. Thus, this work aimed to determine sequential sampling plans for thrips in soybean crops with insecticide applications using a tractor or airplane. Data were collected in 56 soybean fields, and each field was 20 ha. Sampling plans were determined and validated. The lower (m0) and upper (m1) limits of the sequential sampling plans were: m0 = 1.72 and m1 = 3.43 (by tractor applications) and, m0 = 2.27 and m1 = 4.53 thrips. sample-1 (by airplane applications). The slope (S) and the lower (h0) and upper (h1) intercepts of the sequential sampling plans were: S = 2.42, h0 = -5.79, and h1 = 5.79 (by tractor applications) and, S = 3.19, h0 = -6.83, and h1 = 6.83 (by airplane applications). Sequential sampling plans allowed for correct decisions to be made in all situations using a maximum of 10 samples. The sequential plan reduced the sampling effort by over 87% compared to conventional sampling plans. Therefore, these control decision-making systems have proven feasible and advantageous for implementing integrated pest management programs for controlling thrips species in soybean crops.

Integrating health intervention into existing program structure of the neglected tropical diseases: lessons learned from Yobe and Ebonyi states.

Background: Nigeria has a national policy on neglected tropical diseases (NTD) which is coordinated by the Federal Ministry of Health and integrated into the health system at all government levels. A network of grassroots mobilizers, named community drug distributors (CDDs), deliver NTD drugs and commodities to rural and hard-to-reach communities throughout Nigeria. Methods: Interviews with state and local government coordinators of Nigerian NTD programs and focus group discussions with CDDs in Yobe and Ebonyi states were conducted to understand the working modalities of NTD programs in Nigeria to identify the potential of leveraging the NTD structure for additional health interventions such as COVID-19 vaccine rollouts. Collected data was coded and managed on NVivo version 12 using content analysis. Results and discussion: The study found that the NTD committee had the following: a structured planning and coordination process, a community mobilization approach for the effective delivery of routine Mass Administration of Medication (MAM) activities. Challenges encountered included little or no incentives for the CDDs, insecurity, transportation and logistics, and lack of equipment and drug commodities. Nigerian NTD health structures have a wide reach, with a presence in all states and local government areas (LGAs), and this has previously been leveraged to deliver commodities and interventions to rural and hard-to-reach communities for non-NTD health programs and could thus be used similarly for COVID-19 vaccination programs. The enablers of integrating health interventions into the NTD structure are increased availability of finances and manpower, while lack of financial incentives and partners' buy-in were identified as possible. challenges. Conclusion: The study suggests that integrating COVID-19 interventions into the NTD program in Nigeria would be a significant accomplishment, as the existing structure can support future interventions. The study also highlights the efficiency of the NTD program's modalities and processes, indicating that an organized structural system for public health interventions can. increase the services of existing interventions while allowing for the integration of future interventions.

Is Icatibant Safe for the Treatment of Hereditary Angioedema During Pregnancy?

PURPOSE OF REVIEW: Hereditary angioedema (HAE) is a disorder affecting bradykinin regulation presenting as recurrent cutaneous or mucosal swelling. Treatment options include plasma-derived or human-recombinant C1-inhibitor, icatibant, or ecallantide. Due to the lack of knowledge and experience on the topic, the treatment of choice in pregnancy is plasma-derived C1-inhibitor, and reporting any new experience is recommended. This review presents current guidelines for HAE treatment with a focus on pregnancy and reviews all experience with icatibant use during pregnancy. RECENT FINDINGS: Our experience of treating a pregnant nC1-INH HAE patient with icatibant is presented, with no adverse effects or abnormalities, to add to the growing knowledge of icatibant use during pregnancy. Considering the limited number of attacks that our patient usually experiences, which continued at more or less the same frequency during pregnancy, we feel icatibant to be a safe choice for on-demand HAE treatment during pregnancy for such cases.

Risk factors associated with metastatic site failure in patients with high-risk neuroblastoma.

Purpose: This retrospective study sought to identify predictors of metastatic site failure (MSF) at new and/or original (present at diagnosis) sites in high-risk neuroblastoma patients. Methods and materials: Seventy-six high-risk neuroblastoma patients treated on four institutional prospective trials from 1997 to 2014 with induction chemotherapy, surgery, myeloablative chemotherapy, stem-cell rescue, and were eligible for consolidative primary and metastatic site (MS) radiotherapy were eligible for study inclusion. Computed-tomography and I-123 MIBG scans were used to assess disease response and Curie scores at diagnosis, post-induction, post-transplant, and treatment failure. Outcomes were described using the Kaplan-Meier estimator. Cox proportional hazards frailty (cphfR) and CPH regression (CPHr) were used to identify covariates predictive of MSF at a site identified either at diagnosis or later. Results: MSF occurred in 42 patients (55%). Consolidative MS RT was applied to 30 MSs in 10 patients. Original-MSF occurred in 146 of 383 (38%) non-irradiated and 18 of 30 (60%) irradiated MSs (p = 0.018). Original- MSF occurred in post-induction MIBG-avid MSs in 68 of 81 (84%) non-irradiated and 12 of 14 (85%) radiated MSs (p = 0.867). The median overall and progression-free survival rates were 61 months (95% CI 42.6-Not Reached) and 24.1 months (95% CI 16.5-38.7), respectively. Multivariate CPHr identified inability to undergo transplant (HR 32.4 95%CI 9.3-96.8, p < 0.001) and/or maintenance chemotherapy (HR 5.2, 95%CI 1.7-16.2, p = 0.005), and the presence of lung metastases at diagnosis (HR 4.4 95%CI 1.7-11.1, p = 0.002) as predictors of new MSF. The new MSF-free survival rate at 3 years was 25% and 87% in patients with and without high-risk factors. Conclusions: Incremental improvements in systemic therapy influence the patterns and type of metastatic site failure in neuroblastoma. Persistence of MIBG-avidity following induction chemotherapy and transplant at MSs increased the hazard for MSF.

Lógicas institucionais do policiamento comunitário: esquema analítico e agenda de pesquisa para o contexto brasileiro / Lógicas institucionales de la policía comunitaria: esquema analítico y agenda de investigación para el contexto brasileño / Institutional logics of community policing: an analytical framework and research agenda for the Brazilian context

Resumo Modelos de policiamento comunitário vêm sendo disseminados em diferentes países como resposta aos altos índices de criminalidade e violência. Apesar da ampla defesa da efetividade de tais modelos, há dúvidas acerca de sua efetividade e do que, de fato, se trata o policiamento comunitário. Olhando como fenômeno, o policiamento comunitário se mostra híbrido, multifacetado e com várias contradições entre o que é idealizado e o que é efetivamente posto em prática, dificultando sua compreensão. Neste ensaio, propomos um esquema analítico metateórico pautado na ideia de que o policiamento comunitário é regido por quatro tipos puros de lógicas institucionais - militar, profissional, gerencial e comunitário -, em que a interseção entre tais lógicas ajuda a compreendê-lo. Com base nesse esquema, enquadramos as pesquisas sobre o tema em elementos societários e culturais, ambientais, organizacionais, práticos e identitários, buscando delinear uma agenda de pesquisa acerca do policiamento comunitário.

Resumen Los modelos de policía comunitaria se han difundido en diferentes países en respuesta a los altos niveles de delincuencia y violencia. A pesar de la amplia defensa de la efectividad de tales modelos, existen dudas no solo sobre su efectividad, sino también sobre de qué se trata realmente la policía comunitaria. Mirándolo como un fenómeno, la policía comunitaria se ve como un híbrido, multifacético y con varias contradicciones entre lo que se idealiza y lo que efectivamente se implementa, lo que dificulta su comprensión. En este ensayo, proponemos un esquema analítico metateórico basado en la idea de que la policía comunitaria se rige por cuatro tipos puros de lógicas institucionales ‒militar, profesional, gerencial y comunitario‒ en el que la intersección entre tales lógicas ayuda a comprender cómo se manifiesta. Con base en este esquema, enmarcamos la investigación sobre el tema en elementos sociales y culturales; ambientales; organizativos; y, prácticos e identitarios, buscando esbozar una agenda de investigación sobre la policía comunitaria.

Abstract Community policing models have been disseminated in different countries in response to high levels of crime and violence. Despite the broad defense of such models, their effectiveness and concept are still unclear. The phenomenon of community policing is hybrid and multifaceted, with several contradictions between what is idealized and what happens in practice, making it difficult to understand. In this essay, we propose a metatheoretical analytical scheme based on the idea that community policing is based on four pure types of institutional logics - military, professional, managerial, and community - and the intersection of these logics helps to understand the phenomenon. We used this scheme to frame the studies on community policing considering societal and cultural, environmental, organizational, and practical and identity elements, seeking to outline a research agenda.

Prevalence of Aminotransferase Macroenzymes in Rheumatoid Arthritis Patients and Impact on Their Management.

INTRODUCTION: Rheumatoid arthritis (RA) treatment can be hepatotoxic, but liver enzymes can be falsely elevated due to macroenzyme presence. Macroenzymes are often found in autoimmune diseases, but prevalence and effect on treatment is unclear. This study aimed to determine aminotransferase macroenzyme prevalence and effect in RA patients. MATERIALS AND METHODS: This study included consecutive RA patients without liver disease sent for laboratory tests. Samples with elevated AST or ALT were processed for macroenzymes. Presence was determined using polyethylene glycol precipitation (PEG). RESULTS: Out of 126 patients, 21 had elevated aminotransferase levels. Due to liver disease, 6 patients were excluded, another 3 were unavailable for informed consent, leaving 12 patients for inclusion. Out of 12 patients, 1 had increased AST levels, 2 increased ALT levels, and 9 both. Macro-ALT was detected in 5/11 patients, 1 also had macro-AST. Out of 5 patients with macroenzymes, treatment change was seen in 3/5 patients, imaging in 2/5, both in 2/5. CONCLUSION: Elevated liver enzymes in RA patients is not always indicative of hepatotoxicity, as shown by the fact that about half of patients in our study had macroenzymes detected. Before assuming drug hepatotoxicity and changing treatment or ordering imaging, rheumatologists could consider macroenzyme presence.

Simulium maiaherzogae sp. nov., a new species of black fly (Diptera, Simuliidae) from rock fields of southeastern Brazil.

A new species of black fly from rock fields of southeaster Brazil, Simulium maiaherzogae sp. nov., is described based on morphological features of larval, pupal and adult specimens. Morphological features of this new species were compared with members of Simulium (Trichodagmia) Enderlein 1934, showing a high similarity with S. scutistriatum Lutz 1909 and S. itajara Nascimento, et al. 2020. However, features of the male and female scutum and genitalia, pupal tubercles disposition, pupal gills, larval cephalic appendages, larval gill histoblast, numbers of posterior proleg hooks and rectal papillae lobules, allow to differentiate S. maiaherzogae sp. nov. Moreover, a more detailed analysis using Scanning Electron Microscopy (SEM) showed significant differences and numerical variations in meristic data between the new species and S. scutistriatum. The known distribution of this new species is restricted to the Rio do Salto sub-basin, headland of the Middle Paraíba do Sul River, near the Ibitipoca State Park, a region recognised for its biodiversity richness, but with rare simuliids records.

How Having a Clear Why Can Help Us Cope With Almost Anything: Meaningful Well-Being and the COVID-19 Pandemic in México.

Background: Coronavirus disease 2019 (COVID-19) has resulted in an increase in known risk factors for mental health problems. Mexico adopted lockdown and physical distancing as a containment strategy with potential consequences on day to day life, such as social isolation, loss of income and loneliness that can have important consequences in terms of mental health. Objective: We aimed to examine the effect of the initial phases of the COVID-19 pandemic on psychological distress, well-being and perceived physical health among Mexican-base respondents and to examine whether coping strategies would play a potential intermediating role in relation to these variables. Under the Existential Positive Psychology perspective, an emphasis was made on meaning-centered coping. Methods: A cross-sectional study was conducted between April 30 and June 16th 2020 among 604 Mexicans-base respondents of which 471 were women and 132 men. Data was collected by using online questionnaires. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The Brief COPE Inventory was used to assess problem-focused and emotion-focused coping strategies. We also used the Meaning-Centered Coping Scale (MCCS). PERMA-Profiler was used to assess well-being, perceived physical health, and loneliness. Profiler and Descriptive analyses and bivariate linear regression were performed to examine the association of variables. Results: 45.9% of the participants reported moderate to extremely severe psychological distress. Our results demonstrate that problem-focused and emotion-focused coping were positively related to psychological distress, whereas meaning-centered coping was negatively associated with distress. Furthermore, psychological distress played a potential negative role in the perceived physical health, while meaning-centered coping and well-being buffered the negative influence of psychological distress on perceived physical health (completely standardized indirect effect = -0.01, SE: 0.012, 95% CI [-0.065; -0.017]. Conclusion: Meaning-centered coping was found to suppress the negative influence of psychological distress on sensation of decreased physical health corroborating the critical role of meaning in life in promoting well-being. Future studies can further examine the value of the critical role of meaning in life in promoting well-being as a protective factor against severe distress during traumatic events. Findings of this study can be used to orient policies and interventions aimed to alleviate suffering in the midst of the COVID-19 pandemic.

Lockdown measures and their impact on single- and two-age-structured epidemic model for the COVID-19 outbreak in Mexico.

The role of lockdown measures in mitigating COVID-19 in Mexico is investigated using a comprehensive nonlinear ODE model. The model includes both asymptomatic and presymptomatic populations with the latter leading to sickness (with recovery, hospitalization and death as possible outcomes). We consider situations involving the application of social-distancing and other intervention measures in the time series of interest. We find optimal parametric fits to the time series of deaths (only), as well as to the time series of deaths and cumulative infections. We discuss the merits and disadvantages of each approach, we interpret the parameters of the model and assess the realistic nature of the parameters resulting from the optimization procedure. Importantly, we explore a model involving two sub-populations (younger and older than a specific age), to more accurately reflect the observed impact as concerns symptoms and behavior in different age groups. For definiteness and to separate people that are (typically) in the active workforce, our partition of population is with respect to members younger vs. older than the age of 65. The basic reproduction number of the model is computed for both the single- and the two-population variant. Finally, we consider what would be the impact of partial lockdown (involving only the older population) and full lockdown (involving the entire population) on the number of deaths and cumulative infections.

Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates.

BACKGROUND: People with a previous diagnosis of non-communicable diseases (NCDs) are more likely to develop serious forms of COVID-19 or die. Mexico is the country with the fourth highest fatality rate from SARS-Cov-2, with high mortality in younger adults. OBJECTIVES: To describe and characterize the association of NCDs with the case-fatality rate (CFR) adjusted by age and sex in Mexican adults with a positive diagnosis for SARS-Cov-2. METHODS: We studied Mexican adults aged ≥20 years who tested positive for SARS-Cov-2 during the period from 28 February to 31 July 2020. The CFR was calculated and associations with history of NCDs (number of diseases and combinations), severity indicators and type of institution that treated the patient were explored. The relative risk (RR) of death was estimated using Poisson models and CFR was adjusted using logistic models. RESULTS: We analysed 406 966 SARS-Cov-2-positive adults. The CFR was 11.2% (13.7% in men and 8.4% in women). The CFR was positively associated with age and number of NCDs (p trend <0.001). The number of NCDs increased the risk of death in younger adults when they presented three or more NCDs compared with those who did not have any NCDs [RR, 46.6; 95% confidence interval (CI), 28.2, 76.9 for women; RR, 16.5; 95% CI, 9.9, 27.3 for men]. Lastly, there was great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions. CONCLUSION: In younger adults, higher CFRs were associated with the total number of NCDs and some combinations of type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease.

Effect of COVID-19 pandemic on practice in European radiation oncology centers.

ESTRO surveyed European radiation oncology department heads to evaluate the impact of COVID-19. Telemedicine was used in 78% of the departments, and 60% reported a decline in patient volume. Use of protective measures was implemented on a large scale, but shortages of personal protective equipment were present in more than half of the departments.

Surto de toxoplasmose no município de Gouveia, Minas Gerais / Outbreak of toxoplamosis in Goveia, Minas Gerais

Objetivo: investigar surto de toxoplasmose no município de Gouveia-MG, no período entre fevereiro e maio de 2015. Método: foram realizados estudos descritivo e caso-controle, com análise multivariada (regressão logística) e nível de significância de 5%. Definiu-se como caso o indivíduo com toxoplasmose aguda, confirmada laboratorialmente (IgM e/ou IgG reagentes e baixa avidez de IgG), e controle o indivíduo susceptível (IgM e IgG não reagentes). Resultado: o estudo contemplou 50 casos e 68 controles, sendo a maioria dos casos do sexo masculino (43 pacientes, 86%). Os casos tiveram 10 vezes mais chance de tomar água procedente do Manancial (IC95%: 2,8-37,4; p=0,01), 5,1 vezes mais chance de ingerir linguiça (IC95%: 1,2-20,4; p=0,02) e 4,5 vezes mais chance de ser do sexo masculino (IC95%: 1,2-16,7; p=0,02), quando comparados aos controles. Conclusão: foi confirmado um surto de toxoplasmose aguda, em Gouveia - MG, de transmissão hídrica e/ou alimentar. A maior ocorrência no sexo masculino pode estar relacionada a hábitos de risco, envolvidos na transmissão da doença. Foram propostas medidas que resultaram na diminuição e no controle dos casos da doença.

Objective: to investigate the outbreak of toxoplasmosis in the municipality of Gouveia-MG, between February and May 2015. Methods: Descriptive and case control study, with multivariate analysis (logistic regression) and level of significance of 5%. For the purpose of the study, a case was defined on an individual with laboratory which confirmed acute toxoplasmosis (IgM and/or IgG with low IgG avidity) and a control was a susceptible individual (nonreactive IgM and IgG). Results: The study comprised 50 cases and 68 controls, with most cases being male (43 patients, 86%). When compared to controls, cases had 10 times greater odds of having drunk water from Stream A (IC95%: 2,8-37,4; p=0,01), 5,1 times greater odds of having ingested sausage (IC95%: 1,2-20,4; p=0,02) and 4.5 times greater odds of being of male sex (IC95%: 1,2-16,7; p=0,02). Conclusion: A water/foodborne outbreak of acute toxoplasmosis was confirmed in Gouveia-MG, affecting predominantly men. This may be associated with habits regarding disease transmission. Measures that resulted in the reduction and control of cases of this disease have been proposed.

Comparison of clinical assessment and multifrequency bioimpedance analysis as methods of estimating volume status in peritoneal dialysis patients - A single-center experience
.

INTRODUCTION: Clinical assessment (CA) is frequently used for the evaluation of volume status in peritoneal dialysis (PD) patients despite its subjectivity. Multiple-frequency bioelectrical impedance analysis (MF-BIA) is objective, accurate, and quick, proving to be a promising technique for measuring volume status. The aim of this study was to assess volume status in PD patients using CA and MF-BIA and to compare results. MATERIALS AND METHODS: Incident PD patients were prospectively analyzed between January 1, 2014, and January 1, 2016, at the Clinical Hospital Center of -Rijeka, Croatia. Volume status measurements were performed once a month for 6 consecutive months. The presence of symptoms and signs associated with hyper- or hypovolemia were detected by CA. Euvolemia was defined as a symptom-free state or up to 2 symptoms maximum. Patients lacking up to 1.2 L of volume or with up to 1.2 L in excess were considered euvolemic, as measured by MF-BIA. RESULTS: A total of 45 PD patients were analyzed; 51% were men, 27% were diabetic, the mean age was 52 ± 26 years, and PD duration was 11.5 ± 6.5 months. In comparison to MF-BIA, CA showed a significant difference in detected hypervolemia between baseline and follow-up (p = 0.708 vs. p = 0.01, respectively) and among all measurements (p < 0.01). Contrary to CA, volume status measured by MF-BIA correlated significantly with systolic and diastolic blood pressure (R = 0.29; p ≤ 0.01 and R = 0.26; p ≤ 0.01, respectively). CA showed low sensitivity (0.24) and high specificity (0.92) in detecting hypervolemia. CONCLUSION: MF-BIA is an effective, objective, and safe method for assessing volume status in PD patients. Longitudinal monitoring of body composition changes - including hydration state - leading to adequate therapeutic intervention is a promising and potential application of MF-BIA along with CA.

Detection of Mansonella ozzardi among blood donors from highly endemic interior cities of Amazonas state, northern Brazil.

BACKGROUND: In the Brazilian Amazon, the filarial nematode Mansonella ozzardi co-exists with malaria parasites and thick blood smear microscopy is considered the diagnostic gold standard. Transfusion of M. ozzardi microfilariae does not establish new infections, however microfilariae can survive approximately 2 years in blood-recipients with unknown risk of pathology. Data on transfusion-transmitted filariasis are lacking. This study investigated M. ozzardi parasitemias in blood donors from decentralized centers of "Fundação Hematologia e Hemoterapia do Estado do Amazonas/HEMOAM," Northern Brazil. STUDY DESIGN AND METHODS: Cross-sectional investigation employing blood smear microscopy (n = 356) and qualitative nested-M. ozzardi-PCR (227 out of 356) in donor candidates from 19 hemocenters in interior/rural municipalities of Amazonas state. FINDINGS: Participants were mostly young males. Positivity by microscopy was 7.9% (28 out of 356) and 23.8% by M. ozzardi-PCR (54 out of 227). Parasitaemias were found in 16 out of 19 municipalities. In 54 M. ozzardi-positives, 24 were ineligible; among 30 that donated, 27 were interdicted by seropositivity (22 anti-HBc, 3 anti-HBc + HBsAg, 1 Chagas+malaria, 1 VDRL). Seropositivty was higher in M. ozzardi-PCR-positives vs M. ozzardi-PCR-negatives (OR = 15.8, 95% CI 4.5-56.1, p < 0.0001). Three M. ozzardi contaminated blood units were transfused, but no follow-up information on the recipients is available. MAIN CONCLUSIONS: Our study provides important baseline data on M. ozzardi among blood donors from the Brazilian Amazon. Further investigations in endemic areas are necessary to clarify possible association between M. ozzardi and other infections and also to elucidate whether there is any significant clinical effect upon transfusion of contaminated blood.

Effect of photobiomodulation on connective tissue remodeling and regeneration of skeletal muscle in elderly rats.

The purpose of this study was to evaluate the effects of low-level laser therapy (LLLT) on morphological aspects, IL-6 and IL-1ß expressions, as well as the distribution and organization of collagen in the tibialis anterior (TA) muscle of elderly rats submitted to cryoinjury. Histological photomicrographs were taken of TA muscles stained with HE and picrosirius red. Immunohistochemistry was used for the evaluation of IL-6 and IL-1ß. Male Wistar rats, aged 20 months, were distributed into three groups: (1) control animals not injured or treated with LLLT (n = 5), (2) cryoinjury without LLLT treatment (n = 15), and (3) cryoinjury treated with infrared LLLT (n = 15). LLLT was applied to the TA 2 h after of the injury induction and consisted of daily applications until the sacrifice (1, 3, and 7 days). The following parameters were used: λ = 780 nm, power density 1 W/cm2, output power 40 mW, 10 s per point, 8 points, and 3.2 J of total energy. In the histomorphological analysis, the treated group exhibited a significant decrease in inflammatory infiltrate (p < 0.001) as well as an increase immature fibers and new blood vessels at 7 days compared to the untreated group (p < 0.05). Furthermore, treatment induced a better collagen distribution and organization at 7 days in comparison to the untreated group (p < 0.05). In conclusion, LLLT demonstrated a modulatory effect on the muscle repair process in elderly animals with regard to the collagen remodeling and morphological aspects of muscle tissue.

[Pleomorphic adenoma causing a peritonsillar abscess]. / Pleomorft adenom som årsag til peritonsillær abscess.

Pleomorphic adenoma located in the soft palate is extremely rare. We report a 42-year-old woman, who presented to the ear nose & throat department with a mucosal swelling of the right soft palate mimicking a peritonsillar abscess. Drainage was attempted several times without significant results. Emergency tonsillectomy was carried out, which showed a tumour intraorally beside the right tonsil. The tumour and the tonsil were radically excised. Histological analysis of the tumour revealed a pleomorphic adenoma. At three-month follow-up the patient was doing well and MRI scan revealed a residual tumour of 6 mm.

Healing of the Achilles tendon in rabbits--evaluation by magnetic resonance imaging and histopathology.

BACKGROUND: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could provide valuable findings for tendon regeneration. A non-invasive image method that can effectively evaluate the quality of the scar tissue has not yet been employed. METHODS: Thirteen New Zealand rabbits were divided into two groups: group 1--non-treated control (n = 4); group 2--surgical intervention (n = 9). The central portion of the Achilles tendon was resected, and after 30 days, DCE-MRI was performed. Contrast enhancement methods were applied using the region of interest (ROI) technique. In the medium third of the Achilles tendon, the intra-substantial signal intensity and the presence of hyper-intense intra-tendon focus points and of signal heterogeneity were evaluated. Antero-posterior and transversal diameters of the tendon were measured. The Achilles tendon was removed and dissected free from other tissues. Sections from the central part of the tendon were stained for histological analysis. RESULTS: The difference between the contrast enhancement curves of the control and surgical groups (p < 0.0001) was observed. The surgical group had an intense contrast enhancement in the contrast sequences, enlargement of the diameter and intra-substantial signal intensity alteration, with hyper-signal focus points and widening of the tendon sheath, which presented irregular contours and intense contrast enhancement. On histology, the Achilles tendon presented diffuse widening of the tendon sheath and wedge-shaped areas with scarring tissue rich in disordered collagen fibres. These findings were related to alteration in the intra-substantial signal intensity, with hyper-signal focus points in the DCE-MRI. CONCLUSIONS: MRI with perfusion could be a useful technique for evaluating tissue and fibrous scarring in tendons.