Environmental enrichment interaction for laboratory beagle dogs used in research.

Experimental animal facilities can have a negative impact on the well-being of animals owing to confinement. To mitigate this, environmental enrichment (EE) is implemented confinement. The purpose of EE is to enhance the complexity of an animal's natural environment. The objective of this study was to identify the types of EE most enjoyed by dogs used in experimental research and housed in individual kennels. A total of six adult Beagle dogs, housed at the Laboratório de Quimioterapia Experimental em Parasitologia Veterinária (LQEPV) at the Universidade Federal Rural do Rio de Janeiro (UFRRJ) were included in the study. The EE tools used included Petball® toys, a grassy outdoor area, interaction with other dogs and with a team member, a "pool" made of plastic bottles, and dog's wet food ice cream. A team member assessed the usage of these tools every 5 min for a 30-min period, six times per day, one day per week, over the course of eight weeks. The study revealed that the grass area was the tool most commonly used for physical enrichment, accounting for 58% of the occurrences (p < 0.05). Social and food enrichment were enjoyed in second and third place, with 23% and 19% of occurrences, respectively. that the study findings suggest that dogs housed in individual kennels enjoy engaging in their natural behaviors.

Os animais de biotério podem viver em situações que afetem o seu bem-estar, como o confinamento. Um dos métodos que buscam para reduzir os impactos negativos é o Enriquecimento Ambiental (EA), o qual objetiva a promoção da complexidade do ambiente dos animais. Foi possível, com esta pesquisa, atingir o objetivo de identificar quais tipos de EA são mais aproveitados por cães utilizados em pesquisas experimentais que viviam em canis individuais. Foram utilizados seis cães adultos, Beagles, oriundos do Laboratório de Quimioterapia Experimental em Parasitologia Veterinária (LQEPV) da Universidade Federal Rural do Rio de Janeiro (UFRRJ). Como ferramentas de EA foram utilizados brinquedos Petball®, área de grama ao ar livre, interação com outros cães e com uma pessoa da equipe, "piscina" de garrafas plásticas e sorvete de ração úmida. Um membro da equipe avaliou o uso a cada 5 minutos, por período de 30 minutos (6 avaliações) por dia, um dia por semana ao longo de 8 semanas. O estudo revelou que a ferramenta mais usufruída pelos cães foi a área de grama através do enriquecimento físico, quantificado em 58% de ocorrência (p<0,05). Os enriquecimentos sociais e alimentar, foram usufruídos em segundo e terceiro lugar, com 23% e 19% de ocorrência, respectivamente. Pode-se concluir que os cães mantidos em canis individuais individualizados mais necessitam exercer seu comportamento natural específico, para que seu grau de bem-estar seja mantido em nível satisfatório e em consequência sua saúde mental.

MTOR gene variants are associated with severe COVID-19 outcomes: A multicenter study.

BACKGROUND: The worst outcomes linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been attributed to the cytokine storm, which contributes significantly to the immunopathogenesis of the disease. The mammalian target of rapamycin (mTOR) pathway is essential for orchestrating innate immune cell defense including cytokine production and is dysregulated in severe Coronavirus Disease 2019 (COVID-19) individuals. The individual genetic background might play a role in the exacerbated immune response. OBJECTIVE: In this study, we aimed to investigate the association between MTOR genetic variants and COVID-19 outcomes. METHODS: This study enrolled groups of individuals with severe (n = 285) and mild (n = 207) COVID-19 from Brazilian states. The MTOR variants, rs1057079 and rs2536, were genotyped. A logistic regression analysis and Kaplan-Meier survival curves were performed. We applied a genotyping risk score to estimate the cumulative contribution of the risk alleles. Tumor necrosis factor (TNF) and interleukin-6 (IL-6) plasma levels were also measured. RESULTS: The T allele of the MTOR rs1057079 variant was associated with a higher likelihood of developing the most severe form of COVID-19. In addition, higher levels of IL-6 and COVID-19 death was linked to the T allele of the rs2536 variant. These variants exhibited a cumulative risk when inherited collectively. CONCLUSIONS: These results show a potential pathogenetic role of MTOR gene variants and may be useful for predicting severe outcomes following COVID-19 infection, resulting in a more effective allocation of health resources.

Survival of severely compromised endodontically treated teeth restored with or without a fiber glass post.

OBJECTIVE: The use of a fiber glass post (FGP) type and choice of FGP diameter to restore endodontically treated incisors without ferrule is controversial. This study evaluated survival rate and failure mode of severely compromised central incisors without ferrule rehabilitated using resin-based composite (RBC) with or without FGP with different diameters. METHODOLOGY: A total of 60 decoronated bovine incisors without a ferrule were endodontically treated and prepared for 1.4, 1.6, and 1.8 mm diameter FGPs (Whitepost System DC 0.5, Fit 0.4, and DCE 0.5; FGM). Half of the teeth received FGPs cemented using dual-cure resin cement (Allcem Core; FGM), the other half were filled using only bulk-fill RBC (OPUS Bulk Fill; FGM). The crowns were directly restored with RBC. The roots were embedded in polystyrene resin and the periodontal ligament was simulated with polyether impression material. Fatigue testing was conducted under 5 Hz cyclic loading at 30 degrees to the incisal edge, beginning at 50 N (5,000 cycles) as a warmup. After, the load was increased 100 N every 15,000 cycles until fracture occurred. All specimens were subjected to transillumination, micro-CT analysis, and digital radiography before and after fatigue testing. Fracture mode was classified according to severity and repair potential. Data were analyzed with Kaplan-Meier survival test and post hoc log-rank test (α=0.05) for pairwise comparisons. RESULTS: Using FGP significantly increased the number of cycles to failure, irrespective of FGP diameters (p=0.001). The FGP diameters had no statistically significant effect on cycles to failure or failure mode. CONCLUSION: Using FGP without ferrule improved survival rate of structurally severely compromised central incisors compared with rehabilitation without FGP. The diameter of the FGPs had no effect on the survival rate and failure mode.

Sociodemographic and clinical characterization of cases of 1,103 non-syndromic and 66 syndromic odontogenic keratocyst: a Brazilian multicenter study.

OBJECTIVES: This multicenter study aimed to evaluate cases of non-syndrome and syndromic odontogenic keratocyst, as well as cases of recurrence within these two groups. METHODS: This descriptive, analytical, retrospective cross-sectional study evaluated the sex, age and presence of multiple lesions in 1,169 individuals seen at 10 Brazilian oral and maxillofacial pathology centers. Of these, 1,341 odontogenic keratocysts were analyzed regarding clinical diagnosis, size, site, imaging appearance, signs and symptoms, type of biopsy, treatment, and recurrence. RESULTS: There was a similar distribution by sex. The median age of non-syndromic and syndromic patients was 32 and 17.5 years, respectively. The posterior mandible was the site most affected by small and large lesions in both groups and in recurrent cases. Unilocular lesions were more frequent, also in recurrent cases. Mainly small lesions showed this imaging appearance. Signs and symptoms were absent in most cases. Conservative treatment was the most frequent modality in all age groups, regardless of the patient's condition and recurrence. Recurrences were uncommon. CONCLUSION: This study showed a higher frequency of non-syndromic keratocysts in the population. Clinicopathological features related to the involvement of multiple sites, age, and recurrence may differ between syndromic and non-syndromic cases. Furthermore, we found an association between lesion size and some clinical features and between the time interval to recurrence and the syndromic spectrum. CLINICAL RELEVANCE: To contribute to a better understanding of the distribution and association between clinical, imaging, and sociodemographic characteristics in each spectrum of the lesion.

Immune thrombocytopenia associated with lymph node tuberculosis: a case report.

Extrapulmonary tuberculosis associated with immune thrombocytopenia (ITP) is extremely rare. A likely association between ITP and pulmonary and lymph node tuberculosis was reported in a 29-year-old male patient. His platelet count decreased to 4,000/µL. Chest tomography revealed mediastinal adenomegaly, lymph node clusters in the aorta, and consolidation in the left upper lung lobe. Immunoglobulin and methylprednisolone were administered intravenously. The histopathology of the left upper lung lobe confirmed tuberculosis. The rifampicin/isoniazid/pyrazinamide/ethambutol regimen was initiated, and the corticosteroids were tapered off. This case suggests an association of tuberculosis with ITP, since the platelet count effectively normalized after tuberculosis treatment.

Epithelial salivary gland tumors in pediatric patients: An international collaborative study.

OBJECTIVE: Salivary gland tumors (SGT) are a diverse group of uncommon neoplasms that are rare in pediatric patients. This study aimed to characterize the clinicopathological profile of pediatric patients affected by SGT from a large case series derived from an international group of academic centers. STUDY DESIGN: A retrospective analysis of pediatric patients with SGT (0-19 years old) diagnosed between 2000 and 2021 from Brazil, South Africa, and the United Kingdom was performed. SPSS Statistics for Windows was used for a quantitative analysis of the data, with a descriptive analysis of the clinicopathological characteristics and the association between clinical variables and diagnoses. RESULTS: A total of 203 cases of epithelial SGT were included. Females were slightly more commonly (56.5%), with a mean age of 14.1 years. The palate was the most common site (43.5%), followed by the parotid gland (29%), lip (10%), and submandibular gland (7.5%). The predominant clinical presentation was a flesh-colored, smooth, and painless nodule. Pleomorphic adenoma (PA) was the most frequently diagnosed SGT (58.6%), followed by mucoepidermoid carcinoma (MEC) (26.6%). Surgery (90.8%) was the favored treatment option. CONCLUSIONS: Benign SGT in pediatric patients are more commonly benign than malignant tumors. Clinicians should keep PA and MEC in mind when assessing nodular lesions of possible salivary gland origin in pediatric patients.

Features of the triggering of the yellow code and factors associated with the occurrence of adverse events.

OBJECTIVE: to analyze the characteristics of the activation of the yellow code in wards and identify the factors associated with adverse events after the Rapid Response Team. METHODS: a cross-sectional study with retrospective analysis of medical records of adults admitted to medical or surgical clinic wards of the University Hospital of São Paulo. RESULTS: among the 91 patients, the most frequent signs of triggers (n=107) were peripheral oxygen saturation of less than 90% (40.2%) and hypotension (30.8%). Regarding the associated factors the research identified each minute of attendance of the Rapid Response Team in the wards increased by 1.2% odds of adverse events (twenty-four unplanned admission in the ICU and one cardiac arrest) in the sample (p=0.014). CONCLUSIONS: decreased oxygen saturation and hypotension were the main reasons for the triggering, and the length of care was associated with the frequency of adverse events.

Survival of severely compromised endodontically treated teeth restored with or without a fiber glass post

Abstract Objective The use of a fiber glass post (FGP) type and choice of FGP diameter to restore endodontically treated incisors without ferrule is controversial. This study evaluated survival rate and failure mode of severely compromised central incisors without ferrule rehabilitated using resin-based composite (RBC) with or without FGP with different diameters. Methodology A total of 60 decoronated bovine incisors without a ferrule were endodontically treated and prepared for 1.4, 1.6, and 1.8 mm diameter FGPs (Whitepost System DC 0.5, Fit 0.4, and DCE 0.5; FGM). Half of the teeth received FGPs cemented using dual-cure resin cement (Allcem Core; FGM), the other half were filled using only bulk-fill RBC (OPUS Bulk Fill; FGM). The crowns were directly restored with RBC. The roots were embedded in polystyrene resin and the periodontal ligament was simulated with polyether impression material. Fatigue testing was conducted under 5 Hz cyclic loading at 30 degrees to the incisal edge, beginning at 50 N (5,000 cycles) as a warmup. After, the load was increased 100 N every 15,000 cycles until fracture occurred. All specimens were subjected to transillumination, micro-CT analysis, and digital radiography before and after fatigue testing. Fracture mode was classified according to severity and repair potential. Data were analyzed with Kaplan-Meier survival test and post hoc log-rank test (α=0.05) for pairwise comparisons. Results Using FGP significantly increased the number of cycles to failure, irrespective of FGP diameters (p=0.001). The FGP diameters had no statistically significant effect on cycles to failure or failure mode. Conclusion Using FGP without ferrule improved survival rate of structurally severely compromised central incisors compared with rehabilitation without FGP. The diameter of the FGPs had no effect on the survival rate and failure mode.

Potential of Tetradenia riparia leaf essential oil and its fractions in controlling Aedes aegypti and Rhipicephalus microplus larvae

Tetradenia riparia (Hochst.) Codd (Lamiaceae) is a shrub, commonly known as ginger bush or false myrrh, and several studies have shown that T. riparia exhibits a variety of biological properties. This study aimed to determine the chemical composition of T. riparia essential oil and its fractions, investigate their anticholinesterase activity, and assess their larvicidal activity against the cattle tick Rhipicephalus microplus and the mosquito Aedes aegypti. Eleven essential oil fractions were obtained by fractionation and analyzed by gas chromatography/mass spectrometry. Larvicidal activity against R. microplus and third-instar A. aegypti was assessed using a larval packet test and a larval immersion test, respectively. Anticholinesterase activity was determined by a bioautographic method. Forty-nine compounds were identified in the essential oil, of which the major classes were oxygenated sesquiterpenes (45.95%) and sesquiterpene hydrocarbons (35.20%) and the major components were isospathulenol (17.40%), ß-caryophyllene (15.61%), 14-hydroxy-9-epi-caryophyllene (10.07%), 14-hydroxy-α-muurolene (8.32%), and 9ß,13ß-epoxy-7-abietene (5.53%). Bioassays showed that T. riparia essential oil (LC50 = 1.56 µg/mL) and FR3 (LC50 = 0.30 µg/mL) were the most active against R. microplus and A. aegypti larvae, respectively. The essential oil and FR1, FR2, and FR3 exhibited acetylcholinesterase inhibitory activity. These results indicate that T. riparia essential oil and its fractions hold promise in the development of novel, environmentally safe agents for the control of R. microplus and A. aegypti larvae.

Features of the triggering of the yellow code and factors associated with the occurrence of adverse events / Características de la activación del código amarillo y factores relacionados a la ocurrencia de eventos adversos / Características do acionamento do código amarelo e fatores associados à ocorrência de eventos adversos

ABSTRACT Objective: to analyze the characteristics of the activation of the yellow code in wards and identify the factors associated with adverse events after the Rapid Response Team. Methods: a cross-sectional study with retrospective analysis of medical records of adults admitted to medical or surgical clinic wards of the University Hospital of São Paulo. Results: among the 91 patients, the most frequent signs of triggers (n=107) were peripheral oxygen saturation of less than 90% (40.2%) and hypotension (30.8%). Regarding the associated factors the research identified each minute of attendance of the Rapid Response Team in the wards increased by 1.2% odds of adverse events (twenty-four unplanned admission in the ICU and one cardiac arrest) in the sample (p=0.014). Conclusions: decreased oxygen saturation and hypotension were the main reasons for the triggering, and the length of care was associated with the frequency of adverse events.

RESUMEN Objetivo: analizar características de la activación del código amarillo en unidades de internación e identificar factores relacionados a ocurrencia de eventos adversos después de la atención del Equipo de Respuesta Rápida. Métodos: estudio transversal con análisis retrospectivo de prontuarios de adultos internados en enfermerías de Clínica Médica o Quirúrgica de hospital universitario de São Paulo. Resultados: entre 91 pacientes, los signos más frecuentes de las activaciones (n=107) fueron saturación periférica de oxígeno inferior a 90% (40,2%) y hipotensión arterial (30,8%). Cuanto a factores relacionados, identificado que cada minuto de atención del Equipo de Respuesta Rápida en enfermerías aumentó en 1,2% la chance de ocurrencia de eventos adversos (24 admisiones no planeadas en Unidad de Cuidado Intensivo y un paro cardíaco) en la amuestra (p=0,014). Conclusiones: caída de saturación de oxígeno e hipotensión arterial fueron los principales motivos de activación, y tiempo de ateción fue relacionado a ocurrencia de eventos adversos.

RESUMO Objetivo: analisar as características do acionamento do código amarelo em unidades de internação e identificar os fatores associados à ocorrência de eventos adversos após o atendimento do Time de Resposta Rápida. Métodos: estudo transversal com análise retrospectiva de prontuários de adultos internados em enfermarias de Clínica Médica ou Cirúrgica de hospital universitário de São Paulo. Resultados: entre os 91 pacientes, os sinais mais frequentes dos acionamentos (n=107) foram saturação periférica de oxigênio inferior a 90% (40,2%) e hipotensão arterial (30,8%). Quanto aos fatores associados, identificou-se que cada minuto de atendimento do Time de Resposta Rápida nas enfermarias aumentou em 1,2% a chance de ocorrência de eventos adversos (24 internações não planejadas em Unidade de Terapia Intensiva e uma parada cardiorrespiratória) na amostra (p=0,014). Conclusões: queda da saturação de oxigênio e hipotensão arterial foram os principais motivos de acionamento, e o tempo de atendimento foi associado à ocorrência de eventos adversos.

Immune thrombocytopenia associated with lymph node tuberculosis: a case report

ABSTRACT Extrapulmonary tuberculosis associated with immune thrombocytopenia (ITP) is extremely rare. A likely association between ITP and pulmonary and lymph node tuberculosis was reported in a 29-year-old male patient. His platelet count decreased to 4,000/µL. Chest tomography revealed mediastinal adenomegaly, lymph node clusters in the aorta, and consolidation in the left upper lung lobe. Immunoglobulin and methylprednisolone were administered intravenously. The histopathology of the left upper lung lobe confirmed tuberculosis. The rifampicin/isoniazid/pyrazinamide/ethambutol regimen was initiated, and the corticosteroids were tapered off. This case suggests an association of tuberculosis with ITP, since the platelet count effectively normalized after tuberculosis treatment.

Estudo do potencial antiviral sobre o Sars-Cov-2 dos compostos identificados no extrato bruto das folhas de Tetradenia riparia / Study of antiviral potential on Sars-Cov-2 of compounds identified in Tetradenia riparia leaves crude extract / Estudio del potencial antiviral sobre el Sars-Cov-2 de los componentes identificados en el extracto crudo de las hojas de Tetradenia riparia

A COVID-19 surgiu de forma repentina, acometendo milhões de pessoas e causando muitas mortes no mundo todo. Diante disso, torna-se necessário a busca de substâncias bioativas com propriedades antivirais. No Brasil, a espécie Tetradenia riparia foi inserida como planta ornamental exótica, com aroma intenso e agradável, sendo cultivada em parques, jardins, residenciais e hortos. O objetivo deste estudo foi identificar compostos presentes no extrato bruto das folhas de Tetradenia riparia com interesse antiviral. O extrato bruto das folhas secas foi obtido por maceração dinâmica por esgotamento do solvente e após, concentrado em evaporador rotativo. A composição química do extrato bruto foi analisada por cromatografia líquida de ultra eficiência acoplada à espectrometria de massas de alta resolução (UHPLC-ESI/qTOF). Foram identificados 31 compostos que foram investigados por meio de levantamento bibliográfico quanto ao seu potencial anti- SARS-CoV-2. Os compostos rosmanol, procianidina, cianidina, betulina, ácido betulínico e o ácido sagerínico, apresentaram potencial atividade antiviral sobre o SARS-CoV-2. Esta investigação é promissora, indicando possivelmente que no extrato bruto das folhas de T. ripária existem compostos que podem combater o SARS-CoV-2. Neste sentido, estudos de ancoramento molecular (docking) e análises in silico sobre a proteína Mpro do vírus devem ser realizadas corroborando desta forma a ação dos compostos identificados.

COVID-19 appeared suddenly, affecting millions of people and causing many deaths worldwide. Therefore, it is necessary to search for bioactive substances with antiviral properties. In Brazil, Tetradenia riparia was inserted as an exotic ornamental plant, with an intense and pleasant aroma, cultivated in parks, residential and vegetable gardens. This study aimed to identify compounds present in the crude extract of Tetradenia riparia leaves with antiviral interest. The crude extract of the dried leaves was obtained by dynamic maceration with solvent exhaustion and then concentrated in a rotary evaporator. The chemical composition of the crude extract was analyzed by ultra- performance liquid chromatography coupled with high-resolution mass spectrometry (UHPLC- ESI/qTOF). We identified 31 compounds investigated through a literature review for their anti- SARS-CoV-2 potential. The compounds rosmanol, procyanidin, cyanidin, betulin, betulinic acid, and sagerinic acid showed potential antiviral activity against SARS-CoV-2. Therefore, this investigation is promising, possibly indicating that in the crude extract of T. riparia leaves, there are compounds that can fight SARS-CoV-2. In this sense, molecular docking studies and in silico analyzes on the virus Mpro protein must be carried out, thus corroborating the action of the identified compounds.

SARS-CoV-19 ha aparecido repentinamente, afectando a millones de personas y causando muchas muertes en todo el mundo. Por ello, se hace necesaria la búsqueda de sustancias bioactivas con propiedades antivirales. En Brasil, la especie Tetradenia riparia ha sido introducida como planta ornamental exótica, con un aroma intenso y agradable, siendo cultivada en parques, jardines, residencias y centros de jardinería. El objetivo de este estudio fue identificar los compuestos presentes en el extracto crudo de las hojas de Tetradenia riparia con interés antiviral. El extracto crudo de las hojas secas se obtuvo por maceración dinámica por agotamiento del disolvente y después, se concentró en el evaporador rotatorio. La composición química del extracto crudo se analizó mediante cromatografía líquida de ultra rendimiento acoplada a espectrometría de masas de alto rendimiento (UHPLC-ESI/qTOF). Se identificaron 31 compuestos y se investigó su potencial anti-SARS-CoV-2 mediante un estudio bibliográfico. Los compuestos rosmanol, procianidina, cianidina, betulina, ácido betulínico y ácido sagerínico, mostraron una potencial actividad antiviral sobre el SARS-CoV-2. Esta investigación es prometedora, pues posiblemente indica que en el extracto crudo de las hojas de T. riparia hay compuestos que pueden combatir el SARS-CoV-2. En este sentido, deben realizarse estudios de docking y análisis in silico sobre la proteína Mpro del virus para corroborar la acción de los compuestos identificados.

ß-Mercaptoethanol in culture medium improves cryotolerance of in vitro-produced bovine embryos.

The objective of this study was to investigate the effects of adding ß-mercaptoethanol (ßME) to culture medium of bovine in vitro-produced (IVP) embryos prior to or after vitrification on embryo development and cryotolerance. In Experiment I, Day-7 IVP blastocysts were vitrified and, after warming, cultured in medium containing 0, 50 or 100 µM ßME for 72 h. Embryos cultured in 100 µM ßME attained higher hatching rates (66.7%) than those culture in 0 (47.7%) and 50 (52.4%) µM ßME. In Experiment II, IVP embryos were in vitro-cultured (IVC) to the blastocyst stage in 0 (control) or 100 µM ßME, followed by vitrification. After warming, embryos were cultured for 72 h (post-warming culture, PWC) in 0 (control) or 100 µM ßME, in a 2 × 2 factorial design: (i) CTRL-CTRL, control IVC and control PWC; (ii) CTRL-ßME, control IVC and ßME-supplemented PWC; (iii) ßME-CTRL, ßME-supplemented IVC and control PWC; or (iv) ßME-ßME, ßME-supplemented IVC and ßME-supplemented PWC. ßME during IVC reduced embryo development (28.0% vs. 43.8%) but, following vitrification, higher re-expansion rates were seen in ßME-CTRL (84.0%) and ßME-ßME (87.5%) than in CTRL-CTRL (71.0%) and CTRL-ßME (73.1%). Hatching rates were higher in CTRL-ßME (58.1%) and ßME-ßME (63.8%) than in CTRL-CTRL (36.6%) and ßME-CTRL (42.0%). Total cell number in hatched blastocysts was higher in ßME-ßME (181.2 ± 7.4 cells) than CTRL-CTRL (139.0 ± 9.9 cells). Adding ßME to the IVC medium reduced development but increased cryotolerance, whereas adding ßME to the PWC medium improved embryo survival, hatching rates, and total cell numbers.

Effect of the national early warning score on monitoring the vital signs of patients in the emergency room.

OBJECTIVE: To verify the effect of using the National Early Warning Score (NEWS) system on the compliance of the vital signs monitoring interval with those recommended for patients in the emergency room. METHODS: This is a quasi-experimental, before-and-after study, performed in an emergency room with 280 adult patients selected by convenience. The effect of NEWS on the compliance of the vital signs monitoring interval with those recommended by the system was analyzed by linear regression. RESULTS: In the Pre-NEWS phase, 143 patients were analyzed (mean age ± standard deviation: 54.4 ± 20.5; male: 56.6%) and, in the Post-NEWS phase, 137 patients (mean age ± standard deviation: 55.5 ± 20.8; male: 50.4%). There was compliance of the vital signs monitoring interval with what is recommended by NEWS in 92.6% of vital signs records after adopting this instrument. This compliance was 9% (p < 0.001) higher in the Post-NEWS phase. CONCLUSION: The use of the NEWS system increased the compliance of the vital signs monitoring intervals with the ones recommended, but this compliance decreased when the NEWS score pointed to a shorter interval in the monitoring of vital signs.

Use of a silver-based sanitizer to accelerate Escherichia coli die-off on fresh-cut lettuce and maintain produce quality during cold storage: Laboratory and pilot-plant scale tests.

Outbreaks and product recalls involving romaine and iceberg lettuce are frequently reported in the United States. Novel technologies are needed to inactivate pathogens without compromising product quality and shelf life. In this study, the effects of a process aid composed of silver dihydrogen citrate, glycerin, and lactic acid (SGL) on Escherichia coli and Listeria monocytogenes concentrations on lettuce immediately after washing and during cold storage were evaluated. Sensory and quality attributes of fresh-cut iceberg lettuce were also evaluated. Laboratory results indicated that application of SGL solution for 30 s as a first step in the washing process resulted in a 3.15 log reduction in E. coli O157:H7 immediately after washing. For E. coli O157:H7 a significant difference between SGL treatment and all other treatments was maintained until day 7. On day zero, SGL led to a 2.94 log reduction of L. monocytogenes. However, there was no significant difference between treatments with or without SGL regardless of storage time. Pilot-plant results showed that samples receiving SGL spray followed by chlorinated flume wash exhibited a greater reduction (1.48 log) in nonpathogenic E. coli populations at the end of shelf life than other treatments (p < 0.05). Additional pilot plant tests were conducted to investigate the hypothesis that SGL residues could continue to impact microbial survival on the final washed lettuce. Results show that pathogens introduced subsequent to flume washing of lettuce pretreated with SGL solution were not affected by antimicrobial residues. The final quality and shelf life of flume washed lettuce were also unaffected by pretreatment with SGL. In conclusion, the results of this study demonstrate that this new technology has the potential to accelerate E. coli die-off on fresh-cut lettuce during cold storage and improve product safety, while not affecting quality throughout the shelf life of the finished products.

The Effect of Clomiphene Citrate and Letrozole in Apoptotic Pathways and Cell Cycle in Human Primary Cumulus Cells and the Protective Effect of Estradiol.

Clomiphene citrate (CC) and letrozole are ovulatory stimulants that, despite high ovulation rates, achieve low pregnancy rates. This study aimed to investigate the in vitro effects of CC and letrozole, alone or in combination with estradiol, on apoptosis in human cumulus cells. We performed a controlled prospective study using primary cumulus cell cultures from patients undergoing in vitro fertilization (n=22). Alpha-inhibin immunocytochemistry was used to assess cell culture purity and morphology. Cell viability was evaluated by MTT assay, cell cycle status by flow cytometry, and Caspase-3, Bax and SOD-2, and S26 gene expression by qPCR. Cells were treated for 24 hours in 5 conditioned media: CC, CC + estradiol, letrozole, letrozole + estradiol and control. None of the treatments affected cell viability, but letrozole reduced the mean percentage of cells in the S phase compared to control (24.79 versus 21.70, p=0.0014). Clomiphene treatment increased mRNA expression of Bax (4 fold) and SOD-2 (2 fold), which was reversed by co-treatment with estradiol. SOD-2 expression increased in cells treated with letrozole compared to control (4 fold), which was also reversed by estradiol. These findings suggest that clomiphene citrate and letrozole do not significantly affect the viability of human cumulus cells. Still, the expression of genes involved in apoptosis was modulated by these drugs alone and in association with estradiol, suggesting that CC and letrozole may have direct effects on cumulus cells beyond their known mechanisms of action.

Active surveillance and early detection of community transmission of SARS-CoV-2 Mu variant (B.1.621) in the Brazilian Amazon.

Through active surveillance and contact tracing from outpatients, we aimed to identify and characterize SARS-CoV-2 variants circulating in Porto Velho-Rondônia, a city in the Brazilian Amazon. As part of a prospective cohort, we gathered information from 2,506 individuals among COVID-19 patients and household contacts. Epidemiological data, nasopharyngeal swabs, and blood samples were collected from all participants. Nasopharyngeal swabs were tested for antigen rapid diagnostic test and reverse transcription-polymerase chain reaction (RT-PCR) followed by genomic sequencing. Blood samples underwent ELISA testing for IgA, IgG, and IgM antibody levels. From 757 specimens sequenced, three were identified as Mu variant, none of the individuals carrying this variant had a travel history in the previous 15 days before diagnosis. One case was asymptomatic and two presented mild symptoms. Two infected individuals from different households caring viruses with additional amino acid substitutions ORF7a P45L and ORF1a T1055A compared to the Mu virus reference sequence. One patient presented IgG levels. Our results highlight that genomic surveillance for SARS-CoV-2 variants can assist in detecting the emergency of SARS-CoV-2 variants in the community, before its identification in other parts of the country.

Rapid triage performed by nurses: Signs and symptoms associated with identifying critically ill patients in the emergency department.

AIM: Aim of this study is to identify signs and symptoms associated with identifying critically ill patients by rapid triage assessment performed by nurses in an emergency department. BACKGROUND: In some emergency services, the immediate assessment of critically ill patients occurs before opening the hospital formal registration and it is based on the nurse's experience. Studies on the topic are essential to improve this process. DESIGN: This is a cross-sectional, quantitative study. METHODS: This study was conducted in a Brazilian emergency department in 2017. Adult patients who presented potentially life-threatening symptoms underwent rapid triage to determine the medical urgency. Those identified as being critically ill were classified as high priority and streamed to the emergency room. RESULTS: A total of 154 (84.6%) patients were classified as high priority from the total of 182 evaluations. Altered state of consciousness (35.2%) and altered skin perfusion (25.3%) were frequently identified. Signs and symptoms associated with identifying critically ill patients by rapid triage were alterations in ventilation (OR 6.09; p = 0.028), neurological dysfunction (OR 44.96; p < 0.001) and pain (OR 5.80; p = 0.004). CONCLUSION: Nurses should value neurological and ventilation alterations and pain in patients during rapid triage, since these signs and symptoms are associated with high care priority.

Effect of the national early warning score on monitoring the vital signs of patients in the emergency room / Efecto del national early warning score en el monitoreo de los signos vitales de los pacientes en urgencias / Efeito do national early warning score no monitoramento dos sinais vitais de pacientes no pronto-socorro

ABSTRACT Objective: To verify the effect of using the National Early Warning Score (NEWS) system on the compliance of the vital signs monitoring interval with those recommended for patients in the emergency room. Methods: This is a quasi-experimental, before-and-after study, performed in an emergency room with 280 adult patients selected by convenience. The effect of NEWS on the compliance of the vital signs monitoring interval with those recommended by the system was analyzed by linear regression. Results: In the Pre-NEWS phase, 143 patients were analyzed (mean age ± standard deviation: 54.4 ± 20.5; male: 56.6%) and, in the Post-NEWS phase, 137 patients (mean age ± standard deviation: 55.5 ± 20.8; male: 50.4%). There was compliance of the vital signs monitoring interval with what is recommended by NEWS in 92.6% of vital signs records after adopting this instrument. This compliance was 9% (p < 0.001) higher in the Post-NEWS phase. Conclusion: The use of the NEWS system increased the compliance of the vital signs monitoring intervals with the ones recommended, but this compliance decreased when the NEWS score pointed to a shorter interval in the monitoring of vital signs.

RESUMEN Objetivo: Verificar el efecto del uso del sistema National Early Warning Score (NEWS) sobre el cumplimiento del intervalo de monitoreo de los signos vitales conforme a lo recomendado a pacientes en urgencias. Método: Estudio casi experimental, de tipo antes y después, realizado con 280 pacientes adultos seleccionados por conveniencia en un servicio de urgencias. Con el uso de la regresión lineal se analizó el efecto del NEWS sobre el cumplimiento del intervalo de monitoreo de los signos vitales conforme a lo recomendado por el sistema. Resultados: En la fase Pre-NEWS se analizaron 143 pacientes (edad media ± desviación estándar: 54,4 ± 20,5; sexo masculino: 56,6%) y, en la fase Post-NEWS, 137 pacientes (edad media ± desviación estándar: 55,5 ± 20,8; sexo masculino: 50,4%). El 92,6% de los registros de signos vitales después de la adopción de este instrumento presentaron cumplimiento del intervalo de monitoreo de los signos vitales conforme a lo recomendado por el NEWS. Este cumplimiento fue mayor en la fase Post-NEWS con un 9% (p < 0,001). Conclusion: El uso del sistema NEWS tuvo un incremento del cumplimiento de los intervalos de monitoreo de los signos vitales conforme a lo recomendado, pero este cumplimiento disminuyó cuando el puntaje NEWS apuntó a un intervalo más corto en el monitoreo de los signos vitales.

RESUMO Objetivo: Verificar o efeito do uso do sistema National Early Warning Score (NEWS) na conformidade do intervalo de monitoramento dos sinais vitais com o recomendado em pacientes no pronto-socorro. Método: Estudo quasi-experimental, do tipo antes e depois, realizado em um pronto-socorro com 280 pacientes adultos selecionados por conveniência. O efeito do NEWS na conformidade do intervalo de monitoramento dos sinais vitais com o recomendado pelo sistema foi analisado por regressão linear. Resultados: Na fase Pré-NEWS, foram analisados 143 pacientes (idade média ± desvio-padrão: 54,4 ± 20,5; sexo masculino: 56,6%) e, na fase Pós-NEWS, 137 pacientes (idade média ± desvio-padrão: 55,5 ± 20,8; sexo masculino: 50,4%). Houve conformidade do intervalo de monitoramento dos sinais vitais com o recomendo pelo NEWS em 92,6% dos registros de sinais vitais após adoção desse instrumento. Essa conformidade foi maior na fase Pós-NEWS em 9% (p < 0,001). Conclusão: O uso do sistema NEWS aumentou a conformidade dos intervalos de monitorização dos sinais vitais com o recomendado, porém essa conformidade diminuiu quando o escore NEWS apontou para intervalo menor no monitoramento dos sinais vitais.