Acute ST-Elevation Myocardial Infarction in a Young Adult: Rare Presentation of Giant Atrial Myxoma. / Infarto com Supra-ST em Adulto Jovem: Rara Apresentação de Mixoma Atrial Gigante.

Cardiac tumors are rare entities, among which atrial myxoma (AM) stands as the most frequent, accounting for approximately half of all reported cases. The incidence of AM is estimated to range from 0.001% to 0.3% within the general population, yet only about 0.06% of these cases present with coronary embolic events. We report on a 33-year-old male smoker who experienced acute, severe precordial pain radiating to the left upper limb, lasting for one hour. The electrocardiographic evaluation demonstrated ST-segment elevation in leads D2, D3, and aVF, alongside significantly elevated serum troponin levels, confirming a diagnosis of ST-segment elevation myocardial infarction (STEMI). Subsequent coronary angiography revealed proximal occlusion of the right coronary artery due to thrombus. An initial attempt of thrombus aspiration was unsuccessful, followed by primary angioplasty with balloon inflation without stent placement. Further diagnostic exploration through transthoracic echocardiography identified a homogenous, smooth-surfaced mass measuring 5.2 cm x 2.3 cm attached to the interatrial septum. This mass, characterized by lobulations, prolapsed into the mitral valve and left ventricle during diastole, consistent with AM. Surgical resection of the mass was successfully performed, with the patient being discharged asymptomatic. In the reported case, the patient's profile, notably his age, and gender, diverges from the typical epidemiological characteristics associated with AM. This case adds to the limited number of reports where the inferior wall is affected by the right coronary artery being occluded. This report emphasizes the significance of differential diagnoses in younger patients presenting with STEMI.

Neoplasias cardíacas são raras, tendo como principal representante o mixoma atrial (MA), que corresponde a cerca de metade de todos os casos. O MA tem incidência estimada entre 0.001% e 0.3% na população em geral, no entanto apenas aproximadamente 0,06% desses cursam com eventos embólicos coronarianos. Homem de 33 anos, tabagista, admitido com quadro de precordialgia intensa e irradiação para membro superior esquerdo com duração de uma hora. O eletrocardiograma evidenciou elevação de segmento ST nas derivações D2, D3 e aVF troponina sérica elevada, confirmando infarto com supra desnivelamento do segmento ST (IAMCSST). Foi realizada cineangiocoronariografia, a qual revelou oclusão em terço proximal de artéria coronária direita por trombo. Realizada tentativa de aspiração do trombo, sem sucesso, seguido por angioplastia primária com balão sem colocação de stent. Durante a investigação do quadro, paciente realizou ecocardiograma transtorácico o qual demonstrou massa homogênea de superfície regular, de 5.2 cm x 2.3 cm, aderida ao septo interatrial, com lobulações de características emboligênicas prolapsando para valva mitral e ventrículo esquerdo na diástole, compatível com MA. Foi realizada ressecção cirúrgica com paciente evoluindo assintomático, recebendo alta para seguimento ambulatorial. O caso relatado difere em idade e sexo do perfil epidemiológico típico sendo um dos poucos descritos com acometimento da parede inferior apresentando a artéria coronária direita como culpada. Este relato ratifica a importância do diagnóstico diferencial frente às apresentações de IAMCSST em jovens.

Infarto com Supra-ST em Adulto Jovem: Rara Apresentação de Mixoma Atrial Gigante / Acute ST-Elevation Myocardial Infarction in a Young Adult: Rare Presentation of Giant Atrial Myxoma

Resumo Neoplasias cardíacas são raras, tendo como principal representante o mixoma atrial (MA), que corresponde a cerca de metade de todos os casos. O MA tem incidência estimada entre 0.001% e 0.3% na população em geral, no entanto apenas aproximadamente 0,06% desses cursam com eventos embólicos coronarianos. Homem de 33 anos, tabagista, admitido com quadro de precordialgia intensa e irradiação para membro superior esquerdo com duração de uma hora. O eletrocardiograma evidenciou elevação de segmento ST nas derivações D2, D3 e aVF troponina sérica elevada, confirmando infarto com supra desnivelamento do segmento ST (IAMCSST). Foi realizada cineangiocoronariografia, a qual revelou oclusão em terço proximal de artéria coronária direita por trombo. Realizada tentativa de aspiração do trombo, sem sucesso, seguido por angioplastia primária com balão sem colocação de stent. Durante a investigação do quadro, paciente realizou ecocardiograma transtorácico o qual demonstrou massa homogênea de superfície regular, de 5.2 cm x 2.3 cm, aderida ao septo interatrial, com lobulações de características emboligênicas prolapsando para valva mitral e ventrículo esquerdo na diástole, compatível com MA. Foi realizada ressecção cirúrgica com paciente evoluindo assintomático, recebendo alta para seguimento ambulatorial. O caso relatado difere em idade e sexo do perfil epidemiológico típico sendo um dos poucos descritos com acometimento da parede inferior apresentando a artéria coronária direita como culpada. Este relato ratifica a importância do diagnóstico diferencial frente às apresentações de IAMCSST em jovens.

Abstract Cardiac tumors are rare entities, among which atrial myxoma (AM) stands as the most frequent, accounting for approximately half of all reported cases. The incidence of AM is estimated to range from 0.001% to 0.3% within the general population, yet only about 0.06% of these cases present with coronary embolic events. We report on a 33-year-old male smoker who experienced acute, severe precordial pain radiating to the left upper limb, lasting for one hour. The electrocardiographic evaluation demonstrated ST-segment elevation in leads D2, D3, and aVF, alongside significantly elevated serum troponin levels, confirming a diagnosis of ST-segment elevation myocardial infarction (STEMI). Subsequent coronary angiography revealed proximal occlusion of the right coronary artery due to thrombus. An initial attempt of thrombus aspiration was unsuccessful, followed by primary angioplasty with balloon inflation without stent placement. Further diagnostic exploration through transthoracic echocardiography identified a homogenous, smooth-surfaced mass measuring 5.2 cm x 2.3 cm attached to the interatrial septum. This mass, characterized by lobulations, prolapsed into the mitral valve and left ventricle during diastole, consistent with AM. Surgical resection of the mass was successfully performed, with the patient being discharged asymptomatic. In the reported case, the patient's profile, notably his age, and gender, diverges from the typical epidemiological characteristics associated with AM. This case adds to the limited number of reports where the inferior wall is affected by the right coronary artery being occluded. This report emphasizes the significance of differential diagnoses in younger patients presenting with STEMI.

DSP2 for sex determination of miscegenated contemporary hip bones.

The bones of the human pelvis are used in sexual diagnosis generating a high level of accuracy for this type of identification. Morphological and/or morphometric methods are used in the identification of sex. Sexual dimorphism may be affected by ethnic differences in the population. One of the methods for determining sex using hip bone is the 'Diagnose Sexuelle Probabiliste (DSP)' or Probabilistic Sexual Diagnosis (DSP) method. The method presents a new version (Probabilistic Sexual Diagnosis v.2-DSP2) more advisable to be used because it has a more up-to-date database. The objective of this study is to investigate the applicability of the DSP2 method in a population in the Northeast region of Brazil. We used 128 hip bones, 50 female and 78 males, aged between 17 and 101 years, belonging to the Laboratory of Human Identification and Forensic Osteology of the University Federal Government of Pernambuco. The research was conducted between 2019 and 2020 and approved by the Research Ethics Committee of the Federal University of Pernambuco no. 43228015.0.0000.5208. The probability equal to or greater than 0.95 was used as the limit for the determination of sex, and the results were compared with the actual sex of each bone. In the Brazilian collection study, it was observed that the percentage of sex estimation provided by the DSP2 tool using all reference samples was 71.09%, and accuracy was 64.06%. In the analysis of the gender estimate, 82.0% and 78% were obtained for females and males, respectively. Regarding accuracy, it was 64.10% and 55.13% for females and males, respectively. In the contemporary osteological collection of the Northeast region of Brazil, which presents immigrant peoples, we obtained a high index of assertiveness in the DSP2 method. The study concluded that the DSP2 method is important for determining the sex of human skeletons in a miscegenated population.

Impaired proliferation and migration of HUVEC and melanoma cells by human anti-FGF2 mAbs derived from a murine hybridoma by guided selection.

Disadvantages of using murine monoclonal antibodies (mAb) in human therapy, such as immunogenicity response, led to the development of technologies to transform murine antibodies into human antibodies. The murine anti-FGF2 3F12E7 mAb was proposed as a promising agent to treat metastatic melanoma tumors; once it blocks the FGF2, responsible for playing a role in tumor growth, angiogenesis, and metastasis. Considering the therapeutic potential of anti-FGF2 3F12E7 mAb and its limited use in humans due to its origin, we used this antibody as the template for a guided selection humanization technique to obtain human anti-FGF2 mAbs. Three Fab libraries (murine, hybrid, and human) were constructed for humanization. The libraries were phage-displayed, and the panning was performed against recombinant human FGF2 (rFGF2). The selected human variable light and heavy chains were cloned into AbVec vectors for full-length IgG expression into HEK293-F cells. Surface plasmon resonance analyses showed binding to rFGF2 of seven mAbs out of 20 expressed. Assays performed with these mAbs resulted in two that showed proliferation reduction and cell migration attenuation of HUVEC and SK-Mel-28 melanoma cells. In-silico analyses predicted that these two human anti-FGF2 mAbs interact with FGF2 at a similar patch of residues than the chimeric anti-FGF2 antibody, comprehending a region within the heparin-binding domains of FGF2, essential for its function. These results are comparable to those achieved by the murine anti-FGF2 3F12E7 mAb and showed success in the humanization process and selection of two human mAbs with the potential to inhibit undesirable FGF2 roles.

The guided selection humanization process enabled the production of 20 human mAbs anti-FGF2;Seven human anti-FGF2 mAbs showed binding to the rFGF2 antigen in the SPR binding assay;Two human anti-FGF2 mAbs inhibited the proliferation and migration of HUVEC and SK-Mel-28 cells and were predicted to contact the FGF2 at a similar patch of residues than the original mAb.

Use of Infrared Thermography for Abdominoplasty Procedures in Patients with Extensive Subcostal Scars: A Preliminary Analysis.

Subcostal scars may increase the risk of healing complications in abdominoplasty. The authors evaluated the use of thermography as a potential tool for patient selection and surgery planning to avoid complications and improve abdominoplasty outcomes. Two candidates for abdominoplasty procedures who presented with extensive subcostal scars were submitted to an infrared thermography protocol at all phases of the procedure: preoperative, intraoperative, and postoperative at 1 and 6 months. The preoperative thermography for both patients revealed near-normal abdominal wall perfusion. The thermograms captured intraoperatively during flap elevation did not show perfusion deficits on the upper abdominal flap. At 1 month and 6 months postoperative, dynamic thermography for both patients showed normal to near-normal perfusion. The procedures had a complication-free course with a good aesthetic result. Plastic surgeons may be reluctant to perform a full abdominoplasty in patients with a previous subcostal incision. In this preliminary analysis, we raise the potential usefulness of thermography for patients with recent subcostal scars and/or important comorbidities as a strategy for adequate patient and technique selection, avoiding possible complications. Future studies, with an increased number of patients and adequate statistical analysis, may allow us to validate the utility of thermography in these cases and reassure that the presence of previous extensive subcostal scars may not be a contraindication for a full abdominoplasty, especially if they are not recent.

Protective effect of exogenous melatonin on testicular histopathology and histomorphometry of adult rats with domperidone-induced hyperprolactinemia.

Hyperprolactinemia is a pathological condition resulting from increased prolactin that directly affects reproduction, as this condition inhibits the release of LH, FSH and gonadal steroidogenesis, bringing several negative clinical associations in reproduction. In contrast, melatonin (MEL) plays an important role in the regulation of steroidogenesis and modulates damages to the process of spermatogenesis. The objective was to analyze the protective effects of exogenous melatonin on the testis of hyperprolactinemic adult rats. Forty-eight male rats were used, divided into two treatment periods: 30 and 60 days, each treatment was subdivided into three groups: Control, Hyper (hyperprolactinemia), and Hyper+MEL (hyperprolactinemia and melatonin). Treatment with melatonin was 200 µg/100 g, subcutaneously. Induction of hyperprolactinemia was obtained with a dose of 4 mg/kg of domperidone, subcutaneously. The results of the histopathology demonstrated that the animals in the Hyper group presented degeneration of germ cells when compared to the control. In addition, the degenerations were presented in smaller quantities in the Hyper+MEL, in both treatment periods, evidencing the benefits of the melatonin in gonadal regeneration. The Hyper group of both treatment periods showed a decrease in tubular diameter, epithelium height, and tubular area, in addition to a decrease in Sertoli cells, when compared to the control and the Hyper+MEL group. In conclusion, the hyperprolactinemia can affect the germinal epithelium and testicular microstructure; the exogenous melatonin has a protective effect against hyperprolactinemia, reducing testicular damage.

Classic Versus Scarpa-sparing abdominoplasty: An infrared thermographic comparative analysis.

BACKGROUND: Scarpa fascia preservation during abdominoplasty has been shown to have several clinical advantages. The mechanisms behind its efficiency have been the subject of several studies. Three theories have been proposed, relating to mechanical factors, lymphatic preservation, and improved vascularization. This study aimed to further investigate the possible vascular impact of Scarpa fascia preservation by using a thermographic analysis. METHODS: A single-center prospective study was conducted, involving 12 female patients randomly and equally assigned to one of two surgical procedures: classic (Group A) and Scarpa-sparing abdominoplasty (Group B). Dynamic thermography was applied before and after surgery (one and six months), and two regions of interest (ROIs) were considered. The latter had the same location on every sample, and corresponded to areas where different surgical planes had been used. Static thermography was applied intraoperatively, and four ROIs were considered, located over Scarpa and over the deep fascia. The respective thermal data were analyzed. RESULTS: The general characteristics of both groups were identical. Preoperative thermography demonstrated no differences between groups. Intraoperative higher thermal gradients between lateral and medial ROIs were observed in Group B (P = 0.037, right side). Dynamic thermography at one month demonstrated a trend for better thermal recovery and better thermal symmetry (P = 0.035, 1-min mark) in Group B. No other differences were found. CONCLUSION: Dynamic thermography presented a better response when Scarpa fascia was preserved: stronger, faster, and more symmetric. Based on these results, improved vascularization may have a role in explaining the clinical efficiency of a Scarpa-sparing abdominoplasty.

Paradigmas no diagnóstico da trabeculação excessiva do ventrículo esquerdo: relato de caso / Paradigms in the diagnosis of excessive left ventricular trabeculation: case report

INTRODUÇÃO: A prática regular e intensa de exercício físico pode provocar adaptações cardíacas fisiológicas em níveis estrutural, elétrico, funcional e periférico. O diagnóstico diferencial entre coração de atleta e patologias se faz necessário e tem se tornado desafiador. Em estudos com atletas, a prevalência de trabeculação excessiva (TE) preenchendo critérios ecocardiográficos para Miocardiopatia não compactada (MNC) varia de 1 a 10%. Ainda não se sabe, por exemplo, como o treinamento físico pode alterar definições para MNC ou se a TE caracteriza uma variante normal ou fisiológica a condições de pré-carga ou pós-carga aumentadas, como em atletas ou na gravidez. DESCRIÇÃO DO CASO: O seguinte relato de caso aborda jovem masculino, 17 anos, jogador de futebol, assintomático e sem comorbidades prévias conhecidas; que em avaliação de rotina com a pediatria foi detectado em ecocardiograma transtorácico (ECOTT), maio de 2019 (aos 14 anos), intensa trabeculação do ventrículo esquerdo (VE), porém sem critérios para MNC. No setor de Cardiopatia Congênita de um hospital terciário iniciou investigação adicional com ressonância magnética cardíaca (RMC), a qual possui função sistólica biventricular preservada, miocárdio do VE no limite superior da normalidade com trabeculação discreta no ápex e parede lateral, sem critérios para MNC e ausência de fibrose miocárdica. Testes ergométricos assintomáticos, com excelente capacidade funcional e presença de ectopias supraventriculares isoladas e frequentes no esforço. Em 2021 fora encaminhado ao setor de Cardiologia do Esporte para avaliar elegibilidade. Em discussão conjunta com equipe de Miocardiopatia, optado por realizar afastamento das atividades competitivas, devido ao ventrículo esquerdo possuir aspecto dilatado. Em fevereiro de 2023, paciente retorna mantendose assintomático, com renovação dos exames ECOTT, RMC, que obtiveram mesmos achados da trabeculação, porém sem critérios para MNC; com função biventricular e dimensões cavitárias dentro danormalidade, além de investigação adicional com a angiotomografia arterial de coronárias sem alterações significativas. Sendo assim, em nova reunião multidisciplinar e familiar, optado por iniciar reabilitação cardíaca para avaliar possibilidade futura da elegibilidade ao esporte. CONCLUSÃO: Evidências atuais mostram que a TE pode ser uma variante normal ou uma resposta às condições de exercícios intensivos. Considerar que diagnósticos incidentais com trabeculação excessiva e função miocárdica normal tenham o manejo clínico em caso de sintomas cardiovasculares, outras situações clínicas como história familiar, ou anormalidades independentes do padrão trabecular; pode evitar afastamentos equivocados na prática desportiva.

Os desafios da avaliação e manejo clínico dos atletas idosos com fibrilação atrial / The challenges of evaluation and clinical management of elderly athletes with atrial fibrillation

INTRODUÇÃO: Embora o exercício regular esteja associado com a redução dos riscos de doenças cardiovasculares (DCV) há evidências de que o exercício de resistência de longo prazo pode aumentar o risco de desenvolver fibrilação atrial (FA). Além dos vários fatores de riscos (FR) para desenvolvimento de FA já estabelecidos para população geral, há evidências do risco aumentado em indivíduos que praticam exercícios deforma vigorosa. Estes indivíduos podem desenvolver adaptações cardiovasculares como aumento no tônus vagal, fibrose e remodelação cardíaca. As possibilidades terapêuticas em atletas sintomáticos com FA vão desde o controle da frequência cardíaca (FC), uso de agentes antiarrítmicos ou procedimento de ablação com radiofrequência. Atletas que necessitam de anticoagulação não devem participar de esportes com risco de colisão corporal. DESCRIÇÃO DO CASO: Idoso, 73 anos, ex-atleta, corredor de maratona, pré-diabético, hipertenso, hipotireoidismo, dislipidêmico. Atualmente praticando corrida de rua, com frequência 7x/semana, 6 km/dia, em 40-45 min. Na investigação inicial, identificaram-se arritmias ventriculares frequentes e aumento de câmaras atriais, foi descartado isquemia do miocárdio através de cintilografia de perfusão miocárdica sob estresse físico .Realizado posteriormente ressonância magnética de coração que confirmou aumento biatrial, bem como queda importante da fração de ejeção (FE) biventricular e presença realce tardio juncional, sugestivo de fibrose compatível com sobrecarga mecânica. Em consulta subsequente, eletrocardiograma de 12 derivações, realizado evidenciou FA, foi indicado anticoagulação (CHA2DS2-VASc= 3), houve proposta de controle de FC com beta-bloqueador, em decorrência do aumento importante de câmaras atriais e consequente progressão para taquicardiomiopatia dilatada, secundário a taquiarritmias supraventriculares e ventriculares, evidenciadas em holter 24h. Isto posto, solicitado teste cardiopulmonar e iniciado reabilitação cardíaca, bem como tratamento direcionado para insuficiência cardíaca FE reduzida. CONCLUSÃO: Diante dos distintos FR e mecanismos fisiopatológicos no desenvolvimento de FA em atletas e não atletas é importante reconhecer as modificações estruturais e funcionais que ocorrem no coração do atleta. A despeito de o atleta ter uma FA autolimitada e controlada, o que não o impossibilitaria de treinar, a maior preocupação é com relação àqueles que não estão com as arritmias controladas, pelo alto risco de evolução para taquicardiomiopatias dilatadas e suas complicações.

Perspectivas de estudantes de Medicina sobre a própria formação e competências para trabalhar com populações indígenas / Perspectives of Medical students on their training and skills to work with indigenous populations

Resumo: Introdução: A formação médica brasileira tem sido repensada a partir das Diretrizes Curriculares Nacionais que mostram a necessidade de inserir nos currículos abordagens que considerem a formação de médicos generalistas, voltados à assistência de populações vulneráveis. Objetivo: Este estudo teve como objetivos descrever o perfil de estudantes de Medicina das universidades de Santa Catarina e analisar quais competências eles consideram necessárias para atender a população indígena. Método: Trata-se de uma pesquisa com abordagens quantitativa do tipo transversal e qualitativa de natureza exploratória. A coleta de dados ocorreu por meio de questionário on-line com estudantes de Medicina do estado de Santa Catarina. Realizou-se a análise quantitativa dos dados por meio de estatística descritiva, e, no caso dos dados qualitativos, adotou-se a análise de conteúdo. Resultado: No perfil foi identificado predomínio de mulheres (66,95%), com idade média de 24,47 anos (± 5,35). Dos estudantes, 83,26% se autodeclararam de raça/cor branca, 76,99% nasceram na Região Sul do Brasil, 41,43% cursavam o ciclo básico do curso, e 45,61% não ingressaram por cota. Em relação à renda, 52,3% possuíam renda familiar de até cinco salários mínimos. As categorias que emergiram da análise foram habilidades comunicativas (capacidade de construir uma boa relação médico-paciente e de se comunicar), empatia (vontade de olhar o indivíduo pelas experiências dele e utilizar isso para auxiliar o tratamento), aspectos culturais (conhecimento antropológico e cultural da comunidade à qual for prestar assistência) e determinantes sociais (compreensão das vulnerabilidades específicas dessa população). Conclusão: O presente artigo permitiu refletir sobre o estudo da pluralidade acerca dos processos de saúde e doença no que diz respeito à saúde indígena, e analisou quem são os estudantes e de que forma a saúde indígena e as competências médicas para atender essa população estão sendo abordadas ao longo da formação no estado de Santa Catarina.

Abstract: Introduction: Brazilian medical training has been rethought from the National Curriculum Guidelines, which show the need to include approaches in the curricula that consider the training of general practitioners, aimed at assisting vulnerable populations. Objective: The objective was to describe the profile of medical students at universities in Santa Catarina and to analyse which skills they describe as necessary to medical care for the indigenous population. Method: This was a cross-sectional quantitative and exploratory qualitative study. Data was collected using an online questionnaire with medical students from the state of Santa Catarina. Quantitative data was analysed using descriptive statistics and content analysis was used for qualitative data. Results: The profile reflected a predominance of women (66.95%), a mean age of 24.47 years (± 5.35), and 83.26% self-declared as being of white race/colour. In addition, 76.99% of the students were born in the southern region of Brazil; 41.43% are taking the basic cycle of the course; 45.61% did not enroll due to ethnic quota; in relation to income, 52.3% of the students have a household income of up to five minimum wages. The categories that emerged from the analysis were communication skills (the ability to build a good doctor-patient relationship and to communicate), empathy (willingness to look at the individual through their experiences and use this to aid treatment), cultural aspects (anthropological and cultural knowledge of the community to which assistance is provided), social determinants (understanding of the specific vulnerabilities of this population). Final considerations: This article as allowed us to reflect on the study of plurality about health and disease processes relating to indigenous health and has analysed who the students are and how indigenous health and medical competencies to assist this population are being addressed during training in the state of Santa Catarina.

Uma análise das representações sociais da obesidade por profissionais de saúde na atenção primária à saúde / An analysis of social representations of obesity by health professionals in primary health care

Introdução: A compreensão do que seja obesidade vai influenciar a maneira como estruturamos as políticas públicas, o processo formativo dos profissionais de saúde e, principalmente, as práticas de cuidado. Objetivo: Analisar as representações sociais sobre obesidade para profissionais de saúde da Atenção Primária do estado da Bahia, Brasil. Método: Esta comunicação breve refere-se a uma pesquisa qualitativa, ancorada na Teoria das Representações Sociais, desenvolvida no contexto de um curso sobre a qualificação do cuidado às pessoas com sobrepeso e obesidade. Para a produção dos dados, utilizaram-se um questionário semiestruturado on-line e a Técnica de Associação Livre de Palavras, a partir do estímulo "Escreva as três primeiras palavras que vêm a sua mente quando você pensa em obesidade". A análise prototípica foi realizada com a ajuda do software OpenEvoc. Resultados: Os resultados indicam que o núcleo central das representações sociais sobre obesidade foi formado pelos elementos doença, alimentação, sobrepeso e gordura, enquanto os vocábulos saúde mental, qualidade de vida, atividade física, estigma, saúde e multifatorialidade compõem o sistema periférico. Revelaram que há predominância da perspectiva patológica e individualizada, em que pesem a ampliação do conhecimento científico moderno e das orientações institucionais sobre a obesidade; a assunção dos fatores psicoemocionais no desenvolvimento da obesidade; assim como a incipiência da abordagem multifatorial, ecológica e/ou sindêmica da obesidade. Conclusão: Este estudo sugere que pesquisas aprofundem o estudo de tais representações sociais, suas motivações no campo formativo, laboral e social, bem como a análise do que consolida e provoca as novas narrativas anunciadas.

Introduction: The understanding of whatobesity is will influence the way we structure public policies, the training process of health professionals, and, mainly, care practices. Objective: To analyze the social representations of obesity among Primary Health Care professionals in the state of Bahia, Brazil. Method: This brief communication refers to qualitative research, anchored in the Theory of Social Representations, developed in the context of a course on the qualification of care for people with overweight and obesity. For data production, we used an online semi-structured questionnaire and the Free Word Association Technique, based on the stimulus "Write the first three words that come to your mind when you think about obesity". The prototypical analysis was carried out with the assistance of the OpenEvoc software. Results: The results indicate that the central core of social representations about obesity was formed by the elements disease, food, overweight and fat, while the words mental health, quality of life, physical activity, stigma, health, and multifactorial constitute the peripheral system. They revealed that the pathological and individualized perspective is predominant, despite the enhancement of modern scientific knowledge and institutional guidelines on obesity; the assumption of psycho-emotional factors in the development of obesity; as well as the incipience of the multifactorial, ecological, and/or syndemic approach to obesity. Conclusion: This study suggests that research deepens the study of such social representations, and their motivations in the educational, labor, and social field, like the analysis of what consolidates and provokes the newly announced narratives.

Permanent health education in the context of obesity: a scoping review

ABSTRACT OBJETIVE To map the international literature on Permanent Health Education initiatives to care for people with obesity. METHODS In total, six databases were searched without any language or publication period restriction according to the Joana Briggs Institute manual for evidence synthesis and the Prisma extension for scoping reviews (Prisma-ScR). Articles were independently analyzed by four reviewers and data, by two authors, which were then analyzed and discussed with our research team. RESULTS After screening 8,780 titles/abstracts and 26 full texts, 10studies met our eligibility criteria. We extracted data on methodologies, themes, definitions of obesity, outcomes, and gaps. Most initiatives came from North American countries without free or universal health systems and lasted a short period of time (70%), had multidisciplinary teams (70%), and addressed sub-themes on obesity approaches (90%). Results included changes in participants' understanding, attitude, and procedures (80%) and gaps which pointed to the sustainability of these changes (80%). CONCLUSION This review shows the scarce research in the area and a general design of poorly effective initiatives, with traditional teaching methodologies based on information transmission techniques, the understanding of obesity as a disease and a public health problem, punctual actions, disciplinary fragmentation alien to the daily work centrality, and failure to recognize problems and territory as knowledge triggers and to focus on health care networks, line of care, the integrality of care, and food and body cultures.

Impaired proliferation and migration of HUVEC and melanoma cells by human anti-FGF2 mAbs derived from a murine hybridoma by guided selection

Disadvantages of using murine monoclonal antibodies (mAb) in human therapy, such as immunogenicity response, led to the development of technologies to transform murine antibodies into human antibodies. The murine anti-FGF2 3F12E7 mAb was proposed as a promising agent to treat metastatic melanoma tumors; once it blocks the FGF2, responsible for playing a role in tumor growth, angiogenesis, and metastasis. Considering the therapeutic potential of anti-FGF2 3F12E7 mAb and its limited use in humans due to its origin, we used this antibody as the template for a guided selection humanization technique to obtain human anti-FGF2 mAbs. Three Fab libraries (murine, hybrid, and human) were constructed for humanization. The libraries were phage-displayed, and the panning was performed against recombinant human FGF2 (rFGF2). The selected human variable light and heavy chains were cloned into AbVec vectors for full-length IgG expression into HEK293-F cells. Surface plasmon resonance analyses showed binding to rFGF2 of seven mAbs out of 20 expressed. Assays performed with these mAbs resulted in two that showed proliferation reduction and cell migration attenuation of HUVEC and SK-Mel-28 melanoma cells. In-silico analyses predicted that these two human anti-FGF2 mAbs interact with FGF2 at a similar patch of residues than the chimeric anti-FGF2 antibody, comprehending a region within the heparin-binding domains of FGF2, essential for its function. These results are comparable to those achieved by the murine anti-FGF2 3F12E7 mAb and showed success in the humanization process and selection of two human mAbs with the potential to inhibit undesirable FGF2 roles.

Skin temperature response to thermal stimulus in patients with hyperhidrosis: A comparative study.

Primary hyperhidrosis (HH), the excessive sweating exceeding physiological demand, has been associated to a complex dysfunction of the autonomic nervous system which may explain the disfunction in sweating but may also cause unrevealed alterations in skin blood flow regulation. In fact, HH patients present a sympathetic over-function with less reflex bradycardia in response to the Valsalva maneuver and higher sympathetic skin responses. We aimed to identify response patterns to room thermal stimulus in HH patients compared to a control group in order to investigate putative differences in blood flow assuming that skin temperature in glabrous (non-hairy) areas reflect the sympathetic tone in arteriovenous anastomoses (AVAs). Infrared thermography images were obtained from a cohort of patients diagnosed with HH, followed at a hospital pediatric surgical department and to a sex- and age-matched control group of patients admitted for other surgical procedures. With the participants in Fowler's position, a set of 3 images were captured simultaneously and 44 regions of interest were analyzed, distributed on the palms of the hands, soles of the feet, axilla, and inner canthus. After an acclimatization period at 20 °C, the room temperature was increased to 24, 28 and 32 °C to obtain similar sets of thermograms. A total of 37 patients with HH and 16 participants in the control group were included in the study. At baseline (20 °C), body core temperature (measured in the inner canthus) was significantly higher in the HH patients compared to the controls (p = 0.019 and p = 0.003 in right and left inner canthi, respectively), without any significant differences in the other thermograms. When room temperature was increased, differences in core temperature disappeared, while differences appeared in axilla and palms of the hands with HH patients presenting significantly lower temperature at the three thermal stimulus stages. Patients with HH presented a lower thermoregulatory response when submitted to room temperature increase, which may reflect a vasomotor sympathetic over-function in AVAs.

Inorganic element profile of medicinal Cannabis extracts consumed by pediatric patients

Abstract The increasing number of reports of web-based experiences on the success of Cannabis-based therapies in controlling seizures in children suffering from refractory epilepsy have led to efforts by governments and associations to a recent change in legislation. The Brazilian Health Regulatory Agency (ANVISA) allowed the import of Cannabis extracts in 2015 and the registration of the first industrialized drug in 2017. In 2019, ANVISA approved procedures for the granting of a Sanitary Authorization for manufacturing and imports, establishing marketing requirements, prescribing, dispensing, monitoring and surveillance of cannabis products for medicinal purposes. Similar to other consumer products of health concern, is necessary to ensure the quality and health safety of these products worldwide. The aim of the present study to evaluate the presence of As, Cd, Pb, Ni, Cu, Co, Cr and Mn present in Cannabis extracts and resins used in the treatment of pediatric patients with neurological diseases. Samples (48 national and 24 imported) were analyzed by Inductively Coupled Plasma Mass Spectrometry - ICP-MS. The imported extracts presented more homogeneous inorganic element values, while national extracts showed varied levels, thus indicating the highest health risk.

Addition of Honey to an Apple and Passion Fruit Mixed Beverage Improves Its Phenolic Compound Profile.

The addition of honey to mixed beverages is interesting due to its contribution to the sweet taste, as well as because it is a dietary source of bioactive compounds. In this study, we investigated the chemical composition and sensory acceptance of an apple and passion fruit mixed beverage with added honey. The addition of honey did not produce a noticeable change in instrumental color but led to an increase in total soluble solids contents, and FRAP (20%), TEAC (72%), and DPPH (62%) values. The honey mixed beverages exhibited a better phenolic compound profile with an increase in catechin contents and an enrichment of quercetin when compared to the control mixed beverage, as well presenting good sensory acceptance. In conclusion, our results show that the addition of honey can be an alternative for improving the nutritional and sensorial characteristics of an apple and passion fruit mixed beverage.

Novel phage display-derived recombinant antibodies recognizing both MPT64 native and mutant (63-bp deletion) are promising tools for tuberculosis diagnosis.

Tuberculosis (TB) is one of the top 10 causes of death in humans worldwide. The most important causative agents of TB are bacteria from the Mycobacterium tuberculosis complex (MTC), although nontuberculous mycobacteria (NTM) can also cause similar infections. The ability to identify and differentiate MTC isolates from NTM is important for the selection of the correct antimicrobial therapy. Immunochromatographic assays with antibodies anti-MPT64 allow differentiation between MTC and NTM since the MPT64 protein is specific from MTC. However, studies reported false-negative results mainly due to mpt64 63-bp deletion. Considering this drawback, we selected seven human antibody fragments against MPT64 by phage display and produced them as scFv-Fc. Three antibodies reacted with rMPT64 mutant (63-bp deletion) protein and native MPT64 from M. tuberculosis H37Rv in ELISA and Western blot. These antibodies are new biological tools with the potential for the development of TB diagnosis helping to overcome limitations of the MPT64-based immunochromatographic tests currently available.