Nutritional, chemical and functional potential of Inga laurina (Fabaceae): A barely used edible species.

Inga laurina is a plant species which produces edible fruits, and until now there is little information available concerning its nutritional, chemical and bioactive composition. In this study, we evaluated for the first time the proximate composition and mineral contents in its fruit (peel, pulp and seed), that is the traditionally consumed part. The seeds obtained the highest protein (19.52 g/100 g), carbohydrate (22.5 g/100 g) and mineral contents, mainly Cu, Cr, P, Mn, Se and Zn. The peel and pulp were excellent sources of fiber (4.5 and 11.05 g/100 g) as well as mineral content, with Cr and Cu standing out in the pulp. This study is notably the first to provide a detailed assessment of the nutritional compositions of traditionally consumed and not consumed parts of this fruit. Sensory analysis of the pulp was also performed, which indicated good acceptance. The antioxidant properties were characterized in the fruit, peels and leaves. The ABTS test showed that leaf supernatant hydroethanolic crude extract (EC50 = 2.70 µg/mL) and its corresponding ethyl acetate (EC50 = 1.68 µg/mL) and butanol (EC50 = 2.48 µg/mL) partitions presented higher antioxidant potential compared to the control Ginkgo biloba (EC50 = 12.17 µg/mL). The most active precipitate extract regarding DPPH was from the peel (EC50 = 13.30 µg /mL) and the most active partition was the ethyl acetate (EC50 = 13.37 µg/mL), both with better activity compared to the control Ginkgo biloba (EC50 = 46.97 µg/mL). The ethyl acetate partition (EC50 = 13.45 µg/mL) and butanol partition (EC50 = 7.97 µg/mL) from the leaves showed the highest antioxidant capacity. Thus, extracts and partitions from the peels and leaves were studied from a phytochemical point of view due to presenting the best results for antioxidant capacity. The presence of phenolic compounds such as myricetin-3-O-rhamnopyranoside, myricetin-3-O-(2″-O-galloyl)-rhamnopyranoside and myricetin-3-O-(2″,4″-di-O-galloyl)-arabinopentoside-methyl ether were observed in the leaf crude extract and polar partitions, being reported for the first time in the Inga genus and Fabaceae family. Moreover, quercetin, quercetin-3-O-galatoctoside, quercetin-3-O-rhamnopyranoside, quercetin-3-O-(2″-O-galloyl)-rhamnoside, and quercetin tri-hexose were identified in the peel crude extract and ethyl acetate partition, in which the galloyl derivative of quercetin was identified for the first time in I. laurina fruit peels. GC-MS enabled separating and identifying substances such as palmitic and stearic acids, and ethyl oleate. It is possible to conclude that I. laurina pulp can be a supplementary food as a source of phenolic compounds, and the other organs of the plant (leaves and peel) are rich in flavonoids with great antioxidant capacity, making this species a promising source of antioxidants.

Electro-flocculation of aquaculture wastewater microalgal communities reduces nutrient loading.

Land-based aquaculture provides dietary protein to the world's population in a sustainable way, but issues related to release of nitrogen rich wastewater limits its expansion. Sedimentation of naturally occurring microalgae that assimilate excess nitrogen, is slow and land intensive. Electro-flocculation, used in wastewater treatment processes, is a potential alternative for aquaculture. Trials of different electro-flocculation configurations applied to three prawn farm pondwater samples containing varying microalgal assemblages are reported. In 64 % of trials, electro-flocculation reduced total nitrogen (TN) and dissolved inorganic nitrogen (DIN) loads within regulatory limits.TN was reduced up to 83.2 % (10.93 to 1.83 mg.L-1) within 20 mins in stationary water, and DIN to 90.6 % (3.19 to 0.30 mg.L-1) in 102 mins trials in flowing water. Bellerochea andGloeocapsa spp. were dominant in wastewater. The role of microalgal community composition on flocculation is discussed, including evidence Bellerocheapromotes flocculation. This study confirmed electro-flocculation quickly reduces TN and DIN.

Are implant-supported removable partial dentures a suitable treatment for partially edentulous patients? A systematic review and meta-analysis.

STATEMENT OF PROBLEM: A consensus on the clinical performance of implant-supported removable partial dentures (ISRPDs) is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the clinical performance of ISRPDs in terms of the implant survival rates, marginal bone loss, and patient-reported outcome measures (PROMs). MATERIAL AND METHODS: Four electronic databases (MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane Library) were independently searched by 2 reviewers for articles published up to December 2020. A single-arm meta-analysis was performed to evaluate the implant survival rates and marginal bone loss by using the R program. The Cochrane collaboration tool was used to evaluate the risk of bias of randomized controlled trials (RCTs), and the Newcastle-Ottawa scale for non-RCT studies. RESULTS: Sixteen studies were included, with a total of 334 participants and a mean age of 58 years. The participants received a total of 581 dental implants, 475 conventional and 106 mini-implants. All included studies reported implant survival rate above 90% (range: 92% to 100%). Meta-analysis indicated a high proportion of implant survival rates of 3% (95% confidence interval [CI]: 2% to 5%) and a low mean raw score of marginal bone loss 0.98 mm (CI: 0.61 to 1.36 mm). Compared with conventional RPDs, improved patient quality of life and satisfaction were reported by studies that evaluated ISRPDs. RCT studies exhibited a low risk of bias for most domains, while most non-RCT studies were classified as good quality. CONCLUSIONS: ISRPDs exhibited high implant survival rates and acceptable bone loss with improvement in the quality of life and satisfaction of patients when compared with conventional RPDs. Therefore, they can be considered suitable for the rehabilitation of partially edentulous patients.

Impact of the COVID-19 pandemic in the treatment of patients with acromegaly in a tertiary center: a wake-up call on the importance of telemedicine

ABSTRACT Objective: The COVID-19 pandemic has profoundly disrupted health care worldwide. We aimed to evaluate the impact of the first COVID-19 wave on the treatment of our patients with acromegaly. Subjects and methods: A standard questionnaire was systematically applied to all patients and included questions on general health status, whether all laboratory workup had been done, common signs and symptoms of acromegaly, treatment adherence, and previous COVID-19 symptoms and diagnosis. Results: We attempted to contact 136 patients with acromegaly at regular follow-up at our institution and contacted 101 of them successfully. In all, 37% of the patients reported symptoms of acromegaly, which was more common among women. A total of 27 patients were lost to follow-up (including 19 who interrupted treatment during the pandemic) mainly for fear of becoming infected by the SARS-CoV-2. Of these, 24 resumed follow-up after our contact. Conclusions: The current COVID-19 pandemic has strongly impacted the follow-up of patients with acromegaly. Telemedicine can be an important tool to maintain regular treatment in the current or future pandemics.

Assessment of The Addition of Epinephrine to Intra-articular Bupivacaine for the Control of Acute Pain in Patients underwent to Anterior Cruciate Ligament Reconstruction.

Objective To evaluate postoperative pain, using the visual analog scale (VAS), in patients undergoing anterior cruciate ligament reconstruction (ACLR) and receiving intra-articular anesthetic solutions. Methods The present is a randomized clinical trial with a sample of 48 patients divided into 4 groups: Group I (n = 12) - 20 mL of saline solution (control); Group II (n = 12) - 20 mL of 0.5% bupivacaine; Group III (n = 12) - 20 mL of 0.5% bupivacaine + 0.1 mg of epinephrine; and Group IV (n = 12) - 20 mL of saline solution + 0.1 mg of epinephrine. These solutions were injected into the knee at the end of the surgery. Pain was assessed using the VAS immediately and 6, 12, 24 and 48 hours after the procedure. Results The VAS scores were highly variable among the groups. A Kruskal-Wallis analysis of variance (ANOVA), considering a level of significance of 5%, revealed that all intra-articular anesthetic solutions influenced the assessment of pain ( p = 0.003), and that Group-III subjects presented less postoperative pain. There was no evidence of a higher or lower use of supplemental analgesic agents, or of adverse effects resulting from these anesthetic solutions. Conclusion Bupivacaine combined with epinephrine was the most effective solution for pain control in patients undergoing ACLR, but with no statistically significant differences when compared to Group II ( p = 0.547). There was no decrease or increase in the use of supplemental analgesics or in the occurrence of adverse systemic effects ( p > 0.05).

Impact of the COVID-19 pandemic in the treatment of patients with acromegaly in a tertiary center: a wake-up call on the importance of telemedicine.

Introduction: The COVID-19 pandemic has profoundly disrupted health care worldwide. We aimed to evaluate the impact of the first COVID-19 wave on the treatment of our patients with acromegaly. Subjects and methods: A standard questionnaire was systematically applied to all patients and included questions on general health status, whether all laboratory workup had been done, common signs and symptoms of acromegaly, treatment adherence, and previous COVID-19 symptoms and diagnosis. Results: We attempted to contact 136 patients with acromegaly at regular follow-up at our institution and contacted 101 of them successfully. In all, 37% of the patients reported symptoms of acromegaly, which was more common among women. A total of 27 patients were lost to follow-up (including 19 who interrupted treatment during the pandemic) mainly for fear of becoming infected by the SARS-CoV-2. Of these, 24 resumed follow-up after our contact. Conclusion: The current COVID-19 pandemic has strongly impacted the follow-up of patients with acromegaly. Telemedicine can be an important tool to maintain regular treatment in the current or future pandemics.

Assessment of The Addition of Epinephrine to Intra-articular Bupivacaine for the Control of Acute Pain in Patients underwent to Anterior Cruciate Ligament Reconstruction / Avaliação da adição da epinefrina à bupivacaína intra-articular no controle da dor aguda em pacientes submetidos a reconstrução do ligamento cruzado anterior

Abstract Objective To evaluate postoperative pain, using the visual analog scale (VAS), in patients undergoing anterior cruciate ligament reconstruction (ACLR) and receiving intra-articular anesthetic solutions. Methods The present is a randomized clinical trial with a sample of 48 patients divided into 4 groups: Group I (n » 12) - 20 mL of saline solution (control); Group II (n » 12) - 20 mL of 0.5% bupivacaine; Group III (n » 12) - 20 mL of 0.5% bupivacaine þ 0.1 mg of epinephrine; and Group IV (n » 12) - 20 mL of saline solution þ 0.1 mg of epinephrine. These solutions were injected into the knee at the end of the surgery. Pain was assessed using the VAS immediately and 6, 12, 24 and 48 hours after the procedure. Results The VAS scores were highly variable among the groups. A Kruskal-Wallis analysis of variance (ANOVA), considering a level of significance of 5%, revealed that all intra-articular anesthetic solutions influenced the assessment of pain (p » 0.003), and that Group-III subjects presented less postoperative pain. There was no evidence of a higher or lower use of supplemental analgesic agents, or of adverse effects resulting from these anesthetic solutions. Conclusion Bupivacaine combined with epinephrine was the most effective solution for pain control in patients undergoing ACLR, but with no statistically significant differences when compared to Group II (p » 0.547). There was no decrease or increase in the use of supplemental analgesics or in the occurrence of adverse systemic effects (p > 0.05).

Resumo Objetivo Avaliar primariamente a dor pós-operatória, por meio da escala visual analógica (EVA), nos pacientes submetidos a reconstrução do ligamento cruzado anterior (RLCA) que receberam soluções anestésicas intra-articulares (IAs). Métodos Ensaio clínico randomizado com uma amostra de 48 pacientes, divididos em 4 grupos: Grupo I (n » 12) - 20 ml de solução fisiológica (controle); Grupo II (n » 12) - 20 ml de bupivacaína a 0,5%; Grupo III (n » 12) - 20 ml de bupivacaína a 0,5% þ 0,1 mg de epinefrina; e Grupo IV (n » 12) - 20 ml de solução fisiológica þ 0,1 mg de epinefrina, injetados no joelho ao término da cirurgia. A dor foi avaliada pela EVA imediatamente e 6, 12, 24 e 48 horas após o procedimento. Resultados Observou-se grande variabilidade nos resultados da EVA entre os pacientes avaliados em cada grupo. Verificou-se, pela análise de variância (analysis of variance, ANOVA) de Kruskal-Wallis, considerando um nível de 5% de significância, que as soluções anestésicas IAs de cada grupo influenciaram na avaliação da dor desses pacientes (p » 0,003), sendo os do Grupo III os que apresentaram menor dor pósoperatória. Não se evidenciou um maior ou menor consumo de drogas analgésicas suplementares, ou efeitos adversos das decorrentes das soluções empregadas. Conclusão A solução combinada de bupivacaína e epinefrina foi a mais eficaz no controle da dor nos pacientes submetidos a RLCA, mas sem diferenças estatisticamente significativas com relação ao grupo II (p » 0,547). Não se observou diminuição ou aumento no consumo de analgésicos suplementares, ou o aparecimento de efeitos sistêmicos adversos (p > 0,05).

Antioxidant capacity and fragmentation features of C-glycoside isoflavones by high-resolution electrospray ionization tandem mass spectrometry using collision-induced and high-energy collisional dissociation techniques.

The rapid annotation and identification by mass spectrometry techniques of flavonoids remains a challenge, due to their structural diversity and the limited availability of reference standards. This study applies a workflow to characterize two isoflavonoids, the orobol-C-glycosides analogs, using high-energy collisional dissociation (HCD)- and collision-induced dissociation (CID)-type fragmentation patterns, and also to evaluate the antioxidant effects of these compounds by ferric reducing antioxidant power (FRAP), 2,2'-azino-bis(3-ethylbenzothiazolin acid) 6-sulfonic acid (ABTS), and 2,2-diphenyl-1-picrylhydrazyl (DPPH) methods. By the CID-type fragmentation, in positive mode and at all high-resolution mass spectrometry (HRMS) multiple stage, there were shown differences in the annotation of the compounds, mainly concerning some ratios of relative abundance. At CID-MS2 20 eV, the compounds could be efficiently characterized, because they present distinct base peaks [M + H]+ and [M + H-H2 O]+ for the orobol-8-C- and orobol-6-C-glycoside, respectively. Similarly, by the HCD-type fragmentation, in HRMS2 stage, differences between orobol analogs in both mode of ionization were observed. However, the HR HCD-MS2 at 80 eV, in positive mode, generated more ions and each isomer presented different base peaks ions, [0,2X]+ for the orobol-8-C-glycoside and [0,3X]+ for the orobol-6-C-glycoside. By the DPPH, the 8-C-derivative showed a very close value compared with the standard rutin and, in the ABTS method, a higher radical-scavenging activity. In both methods, the EC50 of orobol-8-C-glycoside was almost twice better compared with orobol-6-C-glycoside. In FRAP, both C-glycosides showed a good capacity as Fe+3 reducing agents. We could realize that combined MS techniques, highlighting the positive mode of ionization, can be used to evaluate the isoflavones analogs being useful to differentiate between the isomeric flavones; therefore, these data are important to mass spectrometry dereplication studies become more efficient. HIGHLIGHTS: The MS2, in positive mode of ionization, at low CID energies (15 and 20 eV) and at high HCD energies (50 eV), was suitable to characterize orobol 8 and 6-C-derivatives. Positive mode of ionization was effective to rapid annotation of each orobol C-glycoside. The orobol C-derivatives showed high radical scavenging effects. Orobol-8-C-glycoside showed higher antioxidant capacity.

Pens versus syringes to deliver insulin among elderly patients with type 2 diabetes: a randomized controlled clinical trial.

BACKGROUND: Diabetes mellitus (DM) is a prevalent disease among elderly population. As the disease progresses, insulin may become necessary. The use of pens application seems to be more practical. However, the influence of this method on glycemic control needs to be defined in elderly people. METHODS: Randomized clinical trial comparing pens and syringes for insulin application among patients with type 2 DM over 60 years old and Glycated Hemoglobin > 8.5% at baseline. The follow-up was 24 weeks, with monthly medical visits to adjust the treatment. All patients received insulin NPH and, if necessary, insulin Regular. We assessed glycemic control, adherence to treatment, hypoglycemia occurrence, need for adjustment in treatment and impact on quality of life, RESULTS: We included 121 patients with mean age of 65.75 years. Sixty-one were randomized for pen group (PG) and 60 patients for syringe group (SG). At baseline, mean HbA1c was 10.34 ± 1.66% and 9.90 ± 1.25% (p = 0.103) in PG and SG respectively. Mean HbA1c was 8.39 ± 1.28% in PG and 8.85 ± 1.74% in SG (p = 0.101) at 24 weeks. However, there was a more significant reduction in PG (- 1.94 ± 1.93% in PG and - 1.04 ± 1.46% in SG, p < 0.05) during follow-up. We found no difference in treatment adherence rates, hypoglycemia, greater need for insulin doses or oral medication, and progression to basal-bolus insulin scheme. We also found no difference in the impact of the disease on quality of life between groups. CONCLUSION: Although we did not find any difference in the impact on quality of life, frequency of hypoglycemia or adherence, the PG showed a reduction in HbA1c higher in 24 weeks of follow-up. CLINICAL TRIAL REGISTRATION: NCT02517242.

Algal proteins: Production strategies and nutritional and functional properties.

Animal-based proteins are the most consumed worldwide given their well-balanced nutritional composition. However, the growing demand for animal proteins will not be sustainable due to their low conversion efficiency and high environmental footprint. Specific consumers' dietary restrictions and modern trends emphasize the importance of finding alternative sustainable non-animal sources to meet future food (and, in particular, protein) global needs. Algal biomass is considered a relevant alternative, presenting advantages over terrestrial biomass such as higher growth rate, low water consumption, no competition for arable land, carbon-neutral emissions, and production of numerous bioactive compounds. This review provides an overview of recent research advances on algae as source of proteins, including production strategies from relevant protein-producing species. Particular emphasis will be given to algae protein current applications and forthcoming challenges of their use. Nutritional and functional aspects of algae biomass or its protein-enriched fractions will be overviewed.

Lactoferrin-based nanoemulsions to improve the physical and chemical stability of omega-3 fatty acids.

Omega-3 (ω-3) polyunsaturated fatty acids are highly susceptible to oxidation and have an intense odour and poor water solubility, which make their direct applications in foods extremely difficult. In order to reduce their oxidation process and improve their stability in aqueous medium, protein-based nanoemulsions were produced and characterized. Lactoferrin (Lf) was used as an emulsifier at different concentrations (0.2% to 4% w/w). High energy methods (Ultra-Turrax and high-pressure homogenizer) were applied to produce Lf-based nanoemulsions with ω-3 PUFAs encapsulated. The nanoemulsions were characterized in terms of physical and chemical stability at 4 and 25 °C. The results obtained revealed that the Lf concentration influences the nanoemulsion size in a manner that higher Lf concentrations decrease the nanoemulsion size. It was also observed that the nanoemulsions are physically stable when stored at 4 °C for 69 days while at 25 °C they showed instability. The radical scavenging capacity of the nanoemulsions did not show significant changes over storage at 4 and 25 °C while a significant increase in oxidation was observed. The release profile at 37 °C showed that ω-3 PUFAs were slowly released at pH 2 but was rapidly released at pH 7.4 from Lf nanoemulsions. Moreover, MTT assay revealed that 2% (w/w) Lf nanoemulsions with 12.5 µg mL-1ω-3 PUFAs were not cytotoxic to Caco-2 cells. Nanoemulsions with high physical and chemical stability were selected and dried by two different methodologies: freeze-drying and nano spray-drying. ATR-FTIR spectroscopy, Raman spectroscopy and Circular Dichroism (CD) showed Lf structural changes after the drying processes. This work provides important information regarding nanoemulsions' design and drying technologies aiming at the encapsulation of lipophilic compounds for pharmaceutical and food applications.

Lippia gracilis essential oil in ß-cyclodextrin inclusion complexes: an environmentally safe formulation to control Aedes aegypti larvae.

BACKGROUND: One of the most efficient ways to prevent arboviruses, such as dengue fever, yellow fever, chikungunya and Zika, is by controlling their vector, the Aedes aegypti. Because this vector is becoming resistant to most larvicides used, the development of new larvicides should be considered. ß-Cyclodextrin (ß-CD) complexes have been investigated as an interesting way of enabling the use of essential oils in water as larvicides. This study comprised the development of Lippia gracilis essential oil (LGEO) and ß-CD inclusion complexes for control of Ae. aegypti. RESULTS: Thermal analysis clearly showed the formation of complexes using kneading and co-evaporation methods. Gas chromatography analysis showed that kneading without co-solvent (KW) gave the highest content (∼ 15%) of the LGEO major component. Moreover, KW showed that the complex had a 50% lethal concentration (LC50 ; 33 ppm) lower than that of pure LGEO (39 ppm); in other words, complexing LGEO with ß-CD improved the larvicidal activity. In addition, LGEO complexed with ß-CD (KW) was not harmful to non-target organisms at the concentrations needed to control Ae. aegypti larvae. CONCLUSION: The inclusion complex with LGEO was a feasible formulation, being economically viable, easy-to-apply and without impact on non-target organisms and, therefore, is a potential alternative larvicide for Ae. aegypti control. © 2018 Society of Chemical Industry.

Evaluation of (-)-borneol derivatives against the Zika vector, Aedes aegypti and a non-target species, Artemia sp.

Zika, dengue, and chikungunya are vector-borne diseases of pronounced concern transmitted by the mosquito Aedes aegypti Linn. (Diptera: Culicidae). The most important method to avoid outbreaks is to control mosquito spreading by the employment of insecticides and larvicides. Failure to control mosquito dispersal is mostly accounted to Ae. aegypti resistance to currently available larvicides and insecticides, encouraging the development of novel pesticides. In addition, the excessive use of larvicides poses serious threats to human health and the environment. Evaluation of natural products as larvicides in an attempt to overcome this situation is often found in the literature because products originated from nature are considered less toxic to non-target species and more eco-friendly. (-)-Borneol is a bicyclic monoterpene present in essential oils with moderate larvicidal activity. On account of these facts, it was of our interest to synthesize (-)-borneol ester derivatives aiming to study its structure-activity relationships against Ae. aegypti larvae. With the goal to estimate toxicity to a non-target species, evaluation of the lethal concentration 50% (LC50) on Artemia sp. (Artemiidae) and calculation of selectivity towards Ae. aegypti were carried out. The most potent derivative, (-)-Bornyl chloroacetate, exhibited the highest suitability index, demonstrating lower environmental toxicity than other borneol ester derivatives. A parabolic relationship between (-)-borneol esters larvicidal activity and partition coefficient (Log P) was achieved and a correlation equation obtained, validating the importance of lipophilicity to the larvicidal activity of these compounds.

Multifactorial intervention for diabetes control among older users of insulin.

OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day). Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22%) and 8.54% (SE = 0.24%, p < 0.001) and 8.09% (SE = 0.21%, p < 0.001) at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up). Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes.

Multifactorial intervention for diabetes control among older users of insulin

ABSTRACT OBJECTIVE: To evaluate if the closer follow-up with the supply of insulin pens and the measurement of capillary blood glucose improve the management of older patients with type 2 diabetes without adequate glycemic control despite extensive therapy. METHODS: This is a prospective, non-randomized, quasi-experimental study. We have included 45 patients over 60 years old, from both sexes, with glycated hemoglobin (HbA1c) > 8.5% using oral hypoglycemic agents and insulin. The intervention consisted of monthly medical visits, with the provision of insulin pens and strips for blood glucose measurement. All patients received insulin pen, refills of Neutral Protamine Hagedorn and regular insulin, needles for the pen, blood glucose meter, and capillary blood glucose tests (three tests/day). Treatment was adjusted with the same endocrinologist monthly for six months. Glycated hemoglobin was measured at baseline and 12 and 24 weeks after intervention. RESULTS: Glycated hemoglobin at baseline was 10.34% (SE = 0.22%) and 8.54% (SE = 0.24%, p < 0.001) and 8.09% (SE = 0.21%, p < 0.001) at 12 and 24 weeks after intervention, respectively, with a significant reduction from baseline. CONCLUSIONS: More frequent medical visits, with treatment inputs including the use of insulin pens and self-monitoring, have improved glycemic control (reduction of 2.25% in HbA1C, on average, at 24 weeks of follow-up). Our data support a change in the management and medical behavior of older patients with chronically decompensated diabetes.

Liraglutide, a glucagon-like peptide-1 analog, induce autophagy and senescence in HepG2 cells.

It has been reported that glucagon-like peptide-1 (GLP-1) agents have been associated with both the increased risk of cancer and inhibition of tumor growth and metastases. The aim of this study is to evaluate the effect of liraglutide on hepatocellular carcinoma cells - HepG2. Cytometry was used to evaluate mechanism related to decreased cell proliferation. Nuclear staining and morphometric analysis were also used to verify the process that was taking place after treatment with liraglutide, and in order to better understand the mechanism, TGF-ß1 was performed. HepG2 cells decreased proliferation after liraglutide treatment without altering oxidative stress levels. Liraglutide was able to induce autophagy and senescence through the increase of TGF-ß1 which possibly explains the growth decrease. We have demonstrated that liraglutide has an antiproliferative effect in HepG2 cells inducing autophagy and senescence by the increase of TGF-ß1.

Exposição ocupacional de trabalhadores rurais a agrotóxicos / Occupational exposure of rural workers to pesticides

Resumo Objetivos Avaliar o perfil dos trabalhadores rurais do município de Picos, no Estado do Piauí e suas práticas e atitudes quanto à utilização de agrotóxicos. Métodos A coleta dos dados (n=159) foi realizada em Picos com levantamento de dados socioeconômicos, utilização de equipamentos de proteção individual (EPIs), armazenamento e destino das embalagens de agrotóxicos, toxicidade e risco ambiental. Resultados A maioria dos agricultores era do sexo feminino (63%), não concluiu o ensino fundamental (55,6%), tinha entre 31 e 50 anos (55,3%), com renda de até um salário mínimo (66%) e possuía água encanada (84,3%). Quanto ao uso, 64,1% (102) utilizavam agrotóxicos, principalmente na agricultura (86,3%). Eles obtiveram informações sobre essas substâncias com vizinhos (44,2%), liam o rótulo para utilizar o produto (64,8%), usavam agroquímicos devido à ação rápida (81,4%), compravam em casas agropecuárias (87,4%), sem receituário agronômico (92%) e armazenavam embalagens dentro da própria casa (33,6%). Mais da metade não usava EPIs (56,8%), embora considerassem os agrotóxicos prejudiciais à saúde humana (94,1%) e ao meio ambiente (80,4%), além de 15% (24 pessoas) terem sentido algum sintoma de envenenamento. Conclusões Os entrevistados, em sua maioria, usavam agrotóxicos inadequadamente, tinham baixa escolaridade e conheciam sobre os riscos individuais e coletivos aos quais estavam expostos, mas não usavam EPIs.

Abstract Objectives To evaluate rural workers’ profile at Picos (Piauí, Brazil) and their practices and attitudes regarding the use of pesticides. Methods Data collection (n=159) was performed in Picos (Piauí, Brazil) to describe socioeconomic information, use of personal protective equipment (PPE), storage and disposal of pesticide packaging, toxicity and environmental risk. Results Most farmers were women (63%), with incomplete primary education (55.6%), age between 31-55 years-old (55.3%), income of up to a 1 minimum wage (66%) and with access to city water (84.3%). In relation to the use, 64.1% (102) use pesticides, especially in agriculture (86.3%). They receive information about pesticides with neighbors (44.2%), read label to use the product (64.8%), use pesticides due to their quick action (81.4%), purchase in agricultural houses (87.4%) without agronomic prescription (92%) and store packages indoors (33.6%). More than half do not use PPE (56.8%), though they consider pesticides damaging products to the human health (94.1%) and environment (80.4%) and 15% (24 persons) reported some poisoning symptoms. Conclusions The majority of the farmers use pesticides incorrectly, has low educational status and know about the individual and collective risks to which they are exposed but do not use PPE.

Perfil do uso populacional de inseticidas domésticos no combate a mosquitos / Profile of the population use of household insecticides against mosquitoes

Esse trabalho descreve a utilização doméstica de inseticidas pela população de Picos (Piauí, Brasil),identifica quais são os tipos de inseticidas mais utilizados e descreve a incidência de intoxicação e a consciência ambiental da população. Após visitas domiciliares (n=700), notou-se que a maioria dos entrevistados foi representada por mulheres (75%), com idade entre 31-55 anos (49%), ensino fundamental incompleto (38,1%) e renda familiar entre 1-2 salários mínimos (64%). A maioria das residências tem entre 1-3 moradores (48%), 85% dos entrevistados usam inseticidas escolhidos principalmente em propagandas de TV e radio e apenas 54% leem o rótulo antes de aplicar o produto. A forma de apresentação mais usada é o aerossol (70,7%). A maioria (79%) reconhece que inseticidas são maléficos à saúde, mas 74% não usam nenhum Equipamento de Proteção Individual (EPI). Sintomas de toxicidade foram relatados por 27%dos entrevistados. Duas mulheres relataram irritação, tonturas e problemas respiratórios e necessidade de intervenção médica e internação hospitalar. Todos os entrevistados descartam as embalagens como lixo comum, uma vez que em Picos não há coleta seletiva. Em conclusão, a maioria das pessoas usam inseticidas, conhecem sobre os riscos individuais e coletivos aos quais estão expostos mas não usam EPI mesmo acreditando que sejam tóxicos. Notou-se que aquisição de conhecimentos não resulta,necessariamente, em mudanças de comportamento, uma vez que o conhecimento não se traduz em atitudes e práticas preventivas adequadas, ressaltando-se a necessidade de campanhas de conscientização quanto à toxicidade e aos riscos ambientais, capacitação de profissionais e política fiscalizatória contra a venda indiscriminada.

This study described the use of household insecticides in Picos (Piauí, Brazil), identify which are the mostused types of insecticides and describes the incidence of poisoning and environmental awareness of the population. After home visits (n = 700), it was seen that the majority of respondents was represented by women (75%), with 31-55 years-old (49%), incomplete primary education (38.1%) and income between 1-2 earnings (64%). Most homes have between 1-3 residents (48%), 85% of the persons use insecticides mainly chosen in TV and radio and only 54% of them read the label before employing the product. The most used form of presentation is the aerosol (70.7%). Majority (79%) recognizes that insecticides are harmful to health, but 74% do not use any Personal Protective Equipment (PPE). Symptoms of toxicity were reported by 27% of people interviewed. Two women reported irritation, dizziness and respiratory problems and need for medical intervention and hospitalization. All interviewed discard the package as regular trash, since Picos does not has selective collection. In conclusion, most people use insecticides, know about the individual and collective risks to which they are exposed but do not use PPE, though they believe insecticides are toxic. It was noted that acquisition of knowledge does not necessarily result in behavioral changes, since learning does not translate into appropriate preventive attitudes and practices, emphasizing the requirement for awareness campaigns about toxicity and environmental risks, preparation of professionals and surveillance policy against indiscriminate sale.

Produção científica da enfermagem oncológica: recorte temporal 2002 a 2012 / Scientific production of oncology nursing: temporal cut 2002 to 2012 / Producción científica de enfermería oncológica: recorte temporal 2002 a 2012

Objetivo: identificar as publicações da enfermagem referentes à quimioterapia no âmbito nacional. Método: pesquisa bibliométrica e cienciométrica, realizada na BDENF, MEDLINE, LILACS e SCIELO a partir dos descritores "enfermagem" e "quimioterapia", período 2002-2012. Variáveis investigadas: objetivo do estudo, titulação e vínculo do primeiro autor; ano, periódico e classificação na WEBQUALIS do CAPES da publicação; delineamento e referencial teórico do estudo. Foram incluídas 70 publicações, analisadas por estatística descritiva simples. Resultados: 48,58% dos conhecimentos foram produzidos por mestres e enfermeiros vinculados às instituições de ensino da região Sudeste; 62,86% publicados em periódicos nos estratos A2 e B1; 41,44% das temáticas abrangeram o cuidado de enfermagem, câncer de mama, colo do útero, efeitos colaterais ocasionados pela quimioterapia; os estudos foram predominantemente qualitativos, 75,71% não utilizaram referencial teórico específico. Conclusão: a produção de conhecimento na área investigada ainda é incipiente, mas vem aumentando com o crescimento da incidência do câncer e com o desenvolvimento da oncologia.(AU)

Objective: to identify the nursing publications related to chemotherapy at a national level. Method: bibliometric and scientometric research held in BDENF, MEDLINE, LILACS and SciELO with the descriptors "nursing" and "chemotherapy", from 2002 to 2012. Variables investigated: objective of the study, degrees and affiliation of the first author; year, journal and classification in WebQualis of CAPES publication; design and theoretical framework of the study. 70 publications analyzed by simple descriptive statistics were included. Results: 48.58% of knowledge were produced by masters and nurses linked to educational institutions in the Southeast region; 62.86% were published in journals in the strata A2 and B1; 41.44% of the subjects covered nursing care, breast cancer, cervical cancer, side effects caused by chemotherapy; the studies were predominantly qualitative, 75.71% used no specific theoretical framework. Conclusion: the production of knowledge in the investigated area is still in incipient, but has been increasing with the growing incidence of cancer and the development of oncology.(AU)

Objetivo: identificar las publicaciones de enfermería referentes a la quimioterapia en el ámbito nacional. Método: investigación bibliométrica y cienciométrica, realizada en la BDENF, MEDLINE, LILACS y SCIELO a partir de los descriptores "enfermería" y "quimioterapia", período 2002-2012. Variables investigadas: objetivo del estudio, título y vínculo del primer autor; año, periódico y clasificación en la WEBQUALIS del CAPES de la publicación; delineamiento y referencial teórico del estudio. Fueron incluidas 70 publicaciones, analizadas por estadística descriptiva simple. Resultados: 48,58% de los conocimientos fueron producidos por maestros y enfermeros vinculados a las instituciones de enseñanza de la región Sudeste; 62,86% publicados en periódicos en los extractos A2 y B1; 41,44% de las temáticas envuelven el cuidado de enfermería, cáncer de mama, cuello del útero, efectos colaterales ocasionados por la quimioterapia; los estudios fueron predominantemente cualitativos, 75,71% no utilizaron referencial teórico específico. Conclusión: la producción de conocimiento en el área investigada aún es incipiente, pero viene aumentando con el crecimiento de la incidencia del cáncer y con el desarrollo de la oncología.(AU)