Responses to graded levels of zinc amino acid complex in Nile tilapia (Oreochromis niloticus).

Zinc (Zn) is an essential micronutrient that plays a crucial role in fish development and physiology. This study aimed to evaluate the effects on growth and health in Nile tilapia (Oreochromis niloticus) supplemented with graded levels of zinc amino acid complex (Zn-AA) and subjected to transport stress. Nile tilapia (21.78 ± 0.17 g; (n = 12 fish per tank; stocking density of 1.045 kg- 3) were fed with 0, 25, 50, 75, or 100 mg Zn-AA kg- 1 (equivalent to 77.49, 102.69, 127.89, 153.09, or 178.29 mg Zn kg- 1) in extruded diets (280 g kg- 1 digestible protein; isoproteic and isocaloric) for 60 days. At the end of the experimental period, after growth performance measurements, the fish were transported by car for 3 h, and blood collection was performed. The linear regression showed that the best growth performance (final weight, final biomass, weight gain, specific growth rate, and feed intake) was found in fish fed with 100 mg Zn-AA kg diet- 1 (p < 0.05). The increased dietary Zn-AA increased linearly plasma triglyceride levels, hemoglobin, mean corpuscular hemoglobin, and leukocyte values and reduced plasma total protein, cholesterol (total and LDL), and aspartate aminotransferase levels (p < 0.05). According to quadratic regression, the highest plasma glucose and alanine aminotransferase values were found in the control group (p < 0.05). In conclusion, under the conditions of this study, 100 mg Zn-AA kg diet- 1 is recommended for Nile tilapia as it can improve their growth, metabolism, physiology, and immunity.

The impact of COVID-19 on vitamin E concentrations and oxidative stress markers in adult subjects: A systematic review

Objective: To determine the impact of COVID-19 on vitamin E concentrations and oxidative stress in patients affected by the disease. Method: We conducted a systematic review using observational studies published between 2020 and 2023, which addressed the impact of COVID-19 on vitamin E concentrations and oxidative stress in patients affected by the disease. Review articles, clinical trials, letters to the editor, as well as studies conducted with pregnant women, animals and/or in vitro tests, and in languages other than English were excluded from this search. Studies were selected through a literature search in the following electronic databases: PubMed, Science Direct, and Web of Science, from October 2022 to May 2023. Results: Three articles were included in this review, consisting of patients with mild to severe symptoms, including those hospitalized in the intensive care unit. The reduction in vitamin E concentrations was in all studies accompanied by a reduction in enzymes involved in antioxidant action, such as superoxide dismutase, glutathione peroxidase, and glutathione reductase. In parallel to this, studies showed elevated concentrations of lipid peroxidation markers, such as malondialdehyde and myeloperoxidase. Conclusion: Infection with the SARS-COV-2 alters the activity of antioxidant cells and free radical defense agents.

Objetivo: Determinar el impacto del COVID-19 sobre las concentraciones de vitamina E y el estrés oxidativo en pacientes afectados por la enfermedad. Método: Se trata de una Revisión Sistemática, realizada mediante una prospección de estudios observatorios publicados entre 2020 y 2023, que abordaron el impacto de la COVID-19 sobre las concentraciones de vitamina E y el estrés oxidativo en pacientes afectados por la enfermedad. Se excluyeron de esta búsqueda artículos de revisión, ensayos clínicos, cartas al editor, así como estudios realizados con mujeres embarazadas, animales y/o ensayos in vitro, y en idiomas distintos al inglés. Los estudios se seleccionaron mediante una búsqueda bibliográfica en las siguientes bases de datos electrónicas: PubMed, Science Direct y Web of Science, desde octubre de 2022 hasta mayo de 2023. Resultados: Se incluyeron tres artículos en esta revisión, que consistían en pacientes con síntomas de leves a graves, incluidos los hospitalizados en la unidad de terapia intensiva. La reducción de las concentraciones de vitamina E se acompañó en todos los estudios de una reducción de las enzimas implicadas en la acción antioxidante, como la superóxido dismutasa, la glutatión peroxidasa y la glutatión reductasa. Paralelamente, los estudios mostraron concentraciones elevadas de marcadores de peroxidación lipídica, como el malondialdehído y la mieloperoxidasa. Conclusiones: La infección por el virus del SARS-CoV-2 altera la actividad de las células antioxidantes y de los agentes de defensa contra los radicales libres.

Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV / Circunferencia del cuello como predictor de riesgo cardiometabólico y obesidad del tronco superior en personas que viven con VIH

Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV).Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using astructured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC),arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance.Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men. (AU)

Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente.Conclusión: ... (AU)

Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV.

Introduction: Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.

Introducción: Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente. Conclusión: la CN demostró ser un indicador prometedor en la evaluación de la nutrición y la salud de las personas que viven con el VIH, especialmente en los hombres.

Genome-Wide Association Study Reveals CLEC7A and PROM1 as Potential Regulators of Paracoccidioides brasiliensis-Induction of Cytokine Production in Peripheral Blood Mononuclear Cells.

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by fungi of the genus Paracoccidioides and the different clinical forms of the disease are associated with the host immune responses. Quantitative trait loci mapping analysis was performed to assess genetic variants associated with mononuclear-cells-derived cytokines induced by P. brasiliensis on 158 individuals. We identified the rs11053595 SNP, which is present in the CLEC7A gene (encodes the Dectin-1 receptor) and the rs62290169 SNP located in the PROM1 gene (encodes CD133) associated with the production of IL-1ß and IL-22, respectively. Functionally, the blockade of the dectin-1 receptor abolished the IL-1ß production in P. brasiliensis-stimulated PBMCs. Moreover, the rs62290169-GG genotype was associated with higher frequency of CD38+ Th1 cells in PBMCs cultured with P. brasiliensis yeasts. Therefore, our research indicates that the CLEC7A and PROM1 genes are important for the cytokine response induced by P. brasiliensis and may influence the Paracoccidioidomycosis disease outcome.

Consumption and supplementation of vitamin E in breast cancer risk, treatment, and outcomes: A systematic review with meta-analysis.

BACKGROUND: Robust evidence have shown diet or dietary components in playing a direct role on cancer chemoprevention such as breast cancer (BC), and also prevention against cancer therapy side effects. In this context, vitamin E isoforms have been associated with tumor suppression pathways, mainly related to proliferation, invasion, metastasis, tumor metabolism and chemoresistance. OBJECTIVE: Therefore, we performed a systematic review with meta-analysis to assess the effects of vitamin E consumption and/or supplementation on breast cancer risk, treatment, and outcomes. METHODS: The studies were selected in the electronic databases PubMed, Science Direct, Scopus and Web of Science. RESULTS: A total of 22 articles were selected, which nine manuscripts we perform the meta-analysis. The summary effect estimate did not indicate any significant association between consumption versus non-consumption of total vitamin E and breast cancer risk. After assessing the effects of vitamin E supplementation on breast cancer risk, only two had data for comparison and vitamin E supplementation presented no impact on breast cancer risk. However, the summary effect estimate from the included studies indicated that vitamin E consumption was inversely associated with breast cancer recurrence in the control group. There are no significant results regarding dietary or supplemental vitamin E intake and BC risk reduction. CONCLUSION: Finally, regarding recurrence, survival, and mortality, the results indicated that vitamin E consumption was inversely associated with breast cancer recurrence, although no association was found for breast cancer mortality.

Dementia's Unique Burden: Function and Health Care in the Last 4 Years of Life.

BACKGROUND: Dementia is a terminal illness marked by progressive cognitive decline. This study characterized trajectories of functional status and health care use for people with and without dementia at the end of their life. METHODS: We used the Health and Retirement Study linked with Medicare claims to generate a series of generalized linear models. Models predicted functional status and health care use for decedents with and without dementia during each month in the last 4 years of life (48 months). RESULTS: People with dementia have high, sustained functional impairments during the entire last 4 years of life. People with dementia have the same predicted average activities of daily living score (1.92) at 17 months before death (95% confidence interval [CI]: 1.857, 1.989) as individuals without dementia at 6 months before death (95% CI: 1.842, 1.991). Dementia was associated with significantly less hospice during the final 3 months of life, with a 12.5% (95% CI: 11.046, 13.906) likelihood of hospice in the last month of life with dementia versus 17.3% (95% CI: 15.573, 18.982) without dementia. Dementia was also associated with less durable medical equipment (p < .001), less home health care (p < .005), and fewer office visits (p < .001). There were not significant differences in likelihood of hospitalization in the last 48 months with or without dementia. CONCLUSIONS: People with dementia can functionally appear to be at end of life (EOL) for years before their death. Simultaneously, they receive less health care, particularly home health and hospice, in their last months. Models of care that target people with dementia should consider the unique and sustained burden of dementia at EOL.

Chemopreventive and anti-tumor potential of vitamin E in preclinical breast cancer studies: A systematic review.

BACKGROUND: Vitamin E has been investigated for its antitumor potential, including the ability to change cancer gene pathways as well as promote antioxidant and pro-oxidant activity. OBJECTIVE: Therefore, this systematic review aimed to evaluate antitumor and chemopreventive activity of different vitamin E isoforms (tocopherols and tocotrienols) through in vitro and in vivo studies. METHOD: The systematic review was registered in PROSPERO (No. CRD4202126207) and the search was carried out in four electronic databases (PubMed, Science Direct, Scopus and Web of Science) in June 2021 by three independent reviewers. The search equation used was: "Supplementation" AND ("Vitamin E" OR Tocopherol OR Tocotrienol) AND "breast cancer" AND (chemotherapy OR therapy OR prevention). In vitro studies and animal models of breast cancer supplemented with tocopherol or tocotrienol vitamers, alone or in combination, were included. RESULTS: The results revealed 8546 relevant studies that were initially identified in our search. After analysis, a total of 12 studies were eligible for this systematic review. All studies included animal models, and 5 of them also performed in vitro experiments on cancer cell lines. The studies performed supplementation with tocopherols, mixtures (tocopherols and tocotrienols) and synthetic vitamin E forms. There was an significant association of estradiol, dendritic cells and pterostilbene in combined therapy with vitamin E. Vitamin E delayed tumor development, reduced tumor size, proliferation, viability, expression of anti-apoptotic and cell proliferation genes, and upregulated pro-apoptotic genes, tumor suppressor genes and increased immune response. The effects on oxidative stress markers and antioxidant activity were conflicting among studies. Only one study with synthetic vitamin E reported cardiotoxicity, but it did not show vitamin E genotoxicity. CONCLUSION: In conclusion, vitamin E isoforms, isolated or associated, showed antitumor and chemopreventive activity. However, due to studies heterogeneity, there is a need for further analysis to establish dose, form, supplementation time and breast cancer stage.

Bloodstream infection in pediatric patients with febrile neutropenia induced by chemotherapy.

INTRODUCTION: Febrile neutropenia (FN) is a serious complication of cancer chemotherapy. The present study aimed to identify risk factors for documented infection in pediatric patients with FN and cancer. METHODS: This prospective cohort study included patients under 18 years from 2016 to 2018. Infection was defined according to the Centers for Disease Control and Prevention criteria. RESULTS: A total of 172 febrile neutropenic episodes were evaluated. From univariate analysis, the risk factors were: female gender; monocyte count < 100 cell/mm³, platelets < 50,000, C-reactive protein (CRP) > 90 mg/dl and hemoglobin < 7mg/dl at the onset of an episode; two or more episodes of FN, and; fever onset; positive blood culture at the fever onset. Independent risk factors according to the multivariate analysis were: CRP at the onset of a febrile episode > 90mg/dl, fever onset and first blood culture with a positive result. The lowest probability of infection was related to first episode and to platelets > 50,000 at the onset of fever. CONCLUSION: A CRP > 90 at the onset of a febrile episode, platelets < 50,000, second episode or more, first fever episode during hospitalization and positive first blood culture were found to be associated with a higher risk of infection and they could be useful for the establishment of risk scores for infection in neutropenic children.

Vitamin A Nutritional Status and Clinical Outcomes in COVID-19: A Systematic Review.

The role of vitamin A in the pathophysiological context of coronavirus disease 2019 (COVID-19) represents a current challenge, given the major impact of COVID-19 on morbidity and mortality and the importance of retinol in pulmonary and immunomodulatory functions. The aim of this review is to assess the relationship between vitamin A nutritional status and clinical outcomes in people with COVID-19. The PubMed, Web of Science, Scopus and ScienceDirect databases were used to search for observational studies that assessed retinol levels in hospitalized individuals with COVID-19, following the PRISMA recommendations. A total of 1,912 articles were identified and seven met the inclusion criteria. Four studies showed borderline or deficient retinol blood levels (retinol <0.20 mg/L or <0.70 mol/L) in people with COVID-19, associated with worsened clinical outcomes. In the other three studies lower mean values of this vitamin were identified in COVID-19 symptomatic groups compared to asymptomatic or convalescent groups that showed worse clinical outcomes. The results suggest a possible association between retinol and COVID-19 outcomes. However, there is a clear need to develop clinical trials to elucidate the role of vitamin A in the pathophysiological process of COVID-19.

Bloodstream infection in pediatric patients with febrile neutropenia induced by chemotherapy

Abstract Introduction Febrile neutropenia (FN) is a serious complication of cancer chemotherapy. The present study aimed to identify risk factors for documented infection in pediatric patients with FN and cancer. Methods This prospective cohort study included patients under 18 years from 2016 to 2018. Infection was defined according to the Centers for Disease Control and Prevention criteria. Results A total of 172 febrile neutropenic episodes were evaluated. From univariate analysis, the risk factors were: female gender; monocyte count < 100 cell/mm³, platelets < 50,000, C-reactive protein (CRP) > 90 mg/dl and hemoglobin < 7mg/dl at the onset of an episode; two or more episodes of FN, and; fever onset; positive blood culture at the fever onset. Independent risk factors according to the multivariate analysis were: CRP at the onset of a febrile episode > 90mg/dl, fever onset and first blood culture with a positive result. The lowest probability of infection was related to first episode and to platelets > 50,000 at the onset of fever. Conclusion A CRP > 90 at the onset of a febrile episode, platelets < 50,000, second episode or more, first fever episode during hospitalization and positive first blood culture were found to be associated with a higher risk of infection and they could be useful for the establishment of risk scores for infection in neutropenic children.

Rates of nursing home closures were relatively stable over the past decade, but warrant continuous monitoring.

For years, nursing home closures have been a concern for the industry, policymakers, consumer advocates, and other stakeholders. We analyzed data from 2011 through 2021 and did not find persistent increases in the closure rates. Closures were relatively stable from 2011 to 2017, averaging 118 facilities (0.79%) per year and increasing to 143 (0.96%) in 2018 and 200 (1.34%) in 2019. Closures decreased during the COVID-19 pandemic, averaging 133 facilities in 2020 and 2021 (0.90%). Medicaid-only nursing facilities had higher closure rates than Medicare-only skilled-nursing facilities and dually certified nursing homes. The Census regions (divisions) of the South (West South Central) and Northeast (New England) had the highest closure rates, while the South (South Atlantic and East South Central) had the lowest rates. Facility characteristics associated with increased closure risk included smaller size, lower occupancy rate, urban location, no ownership changes, lower inspection survey ratings, higher staffing ratings, higher percentages of non-White residents and Medicaid residents, lower percentages of Medicare residents and residents with severe acuity, and location in states with more nursing home alternatives. Additional research should examine the impact of closures on resident outcomes and access to care.

Reward modality modulates striatal responses to reward anticipation in ADHD: Effects of affiliative and food stimuli.

Altered reward sensitivity has been proposed to underlie symptoms of attention deficit hyperactivity disorder (ADHD). Functional magnetic resonance imaging (fMRI) studies have reported hypoactivation to reward-predicting cues in the ventral striatum among individuals with ADHD, using experimental designs with and without behavioral response requirements. These studies have typically used monetary incentives as rewards; however, it is unclear if these findings extend to other reward types. The current study examined striatal responses to anticipation and delivery of both affiliative and food reward images using a classical conditioning paradigm. Data from 20 typically developing young adults, and 20 individuals diagnosed with ADHD were included in a region-of-interest analysis for a priori striatal regions. Consistent with findings from studies using monetary rewards, individuals with ADHD showed decreased activation to cues predicting affiliative rewards in the bilateral ventral and dorsal striatum and increased activation to the delivery of affiliative rewards in the ventral striatum. No group differences were found in striatal responses to food reward cues or images. These results suggest hyposensitivity to reward-predicting cues in ADHD extends to affiliative rewards, with important implications for understanding and managing the learning and social functioning of those with ADHD.

Single nucleotide polymorphisms in genes involved in immune responses and outcome of tegumentary leishmaniasis.

Leishmaniases are neglected tropical diseases with a broad clinical spectrum. Tegumentary leishmaniasis (TL) is a disease caused by different Leishmania species, transmitted by phlebotomine sand flies and distributed worldwide. TL can present a cutaneous (CL) or mucocutaneous (MCL) clinical form depending on factors inherent to the parasite, the host and the vector. Polymorphisms in the immune response genes are host genetic factors that influence the pathogenesis or control of leishmaniasis. Single nucleotide polymorphisms (SNPs) in immune genes have been evaluated in several countries where leishmaniasis is endemic. In this review, we report studies on SNPs in several immune genes that might be associated with susceptibility or resistance to TL. We summarize studies from around the world and in Brazil, highlight the difficulties of these studies and future analyses needed to enhance our knowledge regarding host genetic factors in TL. Understanding the genetic characteristics of the host that facilitate resistance or susceptibility to leishmaniasis can contribute to the development of immunotherapy schedules for this disease. The current treatment methods are toxic, and no human vaccine is available.

Translation and cross-cultural adaptation of the Brazilian version of BREAST-Q©: breast reconstruction expectations module.

OBJECTIVE: This study aimed to translate the BREAST-Q© - Breast Reconstruction Expectations Module (preoperative) 2.0 into Portuguese and adapt it to the Brazilian cultural context. METHODS: Authorization for translation and cross-cultural adaptation of the questionnaire was obtained from the holders of the instrument's distribution rights. The questionnaire was translated and retro-translated. For cultural adaptation, the instrument was applied to 40 patients who had breast reconstruction surgery scheduled. Cronbach's alpha was used to assess the internal consistency. RESULTS: The mean age of the patients was 53.5 years, and the majority (72.5%) was undergoing reconstruction with implants. Good and excellent internal consistencies were observed for the Coping and Appearance expectations scales (Cronbach's alpha values of 0.878 and 0.909, respectively). For the Pain scale, the internal consistency was moderate (0.738), and it was acceptable (0.587) for the Medical team. CONCLUSION: The BREAST-Q© - Breast Reconstruction Expectations Module (preoperative) 2.0 was successfully translated and adapted to the Brazilian context.

Essential oils from Cymbopogon citratus and Lippia sidoides in the anesthetic induction and transport of ornamental fish Pterophyllum scalare.

This study verified the effects of essential oils from Lippia sidoides (EOLS) and Cymbopogon citratus (EOCC) on the anesthesia of freshwater angelfish (Pterophyllum scalare) of two different sizes (juveniles I (0.82 g) and II (2.40 g)) and the transport (8 h) of juveniles II. Fish were exposed to different concentrations of EOLS and EOCC: 0, 10, 25, 50, 75, 100, 150, 200, and 250 mg L-1. Ventilatory rate (VR) and transport for 8 h with 0, 10, and 15 mg L-1 of each essential oil were evaluated in juveniles II. The major components found in EOLS and EOCC were carvacrol (44.50%) and α-citral (73.56%), respectively. The best sedation and anesthesia times for both essential oils were obtained with 10 and 25 mg L-1 and 200 and 250 mg L-1 for juveniles I and II, respectively. Fish sedated with EOLS had lower VR values than the other treatments. Blood glucose levels were higher in ornamental fish transported with 10 and 15 mg EOLS L-1 and 15 mg EOCC L-1. Hepatic glycogen values were higher in the control group. In general, fish transported with 10 mg EOLS L-1 showed fewer gill histological alterations than other transported fish. When the type of lesion was evaluated, the highest gill alterations occurred in fish transported with EOCC. In conclusion, 10 mg EOLS L-1 could be used to transport of juveniles II because although this concentration increased blood glucose levels, it decreased the VR and muscle glycogen levels and caused only mild alterations to the gills.

Translation and cross-cultural adaptation of the Brazilian version of BREAST-Q©: breast reconstruction expectations module

SUMMARY OBJECTIVE: This study aimed to translate the BREAST-Q© — Breast Reconstruction Expectations Module (preoperative) 2.0 into Portuguese and adapt it to the Brazilian cultural context. METHODS: Authorization for translation and cross-cultural adaptation of the questionnaire was obtained from the holders of the instrument's distribution rights. The questionnaire was translated and retro-translated. For cultural adaptation, the instrument was applied to 40 patients who had breast reconstruction surgery scheduled. Cronbach's alpha was used to assess the internal consistency. RESULTS: The mean age of the patients was 53.5 years, and the majority (72.5%) was undergoing reconstruction with implants. Good and excellent internal consistencies were observed for the Coping and Appearance expectations scales (Cronbach's alpha values of 0.878 and 0.909, respectively). For the Pain scale, the internal consistency was moderate (0.738), and it was acceptable (0.587) for the Medical team. CONCLUSION: The BREAST-Q© — Breast Reconstruction Expectations Module (preoperative) 2.0 was successfully translated and adapted to the Brazilian context.

A Critical Overview of Interleukin 32 in Leishmaniases.

Interleukin-32 (IL-32) has several immune regulatory properties, which have driven its investigation in the context of various diseases. IL-32 expression is reported to be induced in the lesions of patients with American tegumentary leishmaniasis (ATL) by the New World Leishmania spp. that are responsible for causing ATL and visceral leishmaniasis (VL). IL-32 expression may elevate the inflammatory process through the induction of pro-inflammatory cytokines and also via mechanisms directed to kill the parasites. The genetic variants of IL-32 might be associated with the resistance or susceptibility to ATL, while different isoforms of IL-32 could be associated with distinct T helper lymphocyte profiles. IL-32 also determines the transcriptional profile in the bone marrow progenitor cells to mediate the trained immunity induced by ß-glucan and BCG, thereby contributing to the resistance against Leishmania. IL-32γ is essential for the vitamin D-dependent microbicidal pathway for parasite control. In this context, the present review report briefly discusses the data retrieved from the studies conducted on IL-32 in leishmaniasis in humans and mice to highlight the current challenges to understanding the role of IL-32 in leishmaniasis.

Stepwise aggregation method for the WQI-CCME to generate a water quality profile for a long river: case study-São Francisco River, Brazil.

This paper presents a new aggregation method to calculate the WQI-CCME, named stepwise aggregation method, to communicate the water quality of the São Francisco River, Brazil, a river of national expression, with more than 2700 km long. Differently from the original proposal for the WQI-CCME, the new aggregation method uses data from a single monitoring campaign, to avoid the loss of data, as many variables are not systematically measured in all monitoring campaigns. The stepwise aggregation method also requires to combine data from a minimum of four monitoring locations per section of the river, to attend the statistical requirement, a proposal already presented in the literature. After using the first four points, the next calculation requires to abandon the first point (upstream) and to include the next point (downstream), and the sequential calculation will generate the results to build the river water quality profile. In the present work, with 31 monitoring points, the stepwise aggregation method allowed to calculate the WQI-CCME for 25 sections. The stepwise method has the advantage of multiplying the number of index calculations, allowing to construct a more uniform water quality profile for a long river. The choice of using the WQI-CCME in this work, is because this index has many successful applications all over the world, favored by its flexibility of parameter selection, ease of calculation, adaptability to legal requirements of different locations and different water uses. The WQI-CCME profiles were compared with those for the WQI-CETESB, an index derived from the WQI-NSF and extensively used by the Brazilian Monitoring Programs. The comparison demonstrated similarity, only if the same number of parameters were used, but WQI-CETESB gives better water quality, similarly reported for the WQI-NSF, which systematically classify the water quality in the superior range. In this paper, the calculation of the WQI-CCME, with 38 and 20 parameters, confirmed the dependence of the WQI-CCME factors (F1, F2) on the number of variables considered. The calculation with more variables (38) gave better results for the water quality than the calculation with less variable (20). Thus, while the application of the WQI-CCME has a variety of advantages, it requires careful evaluation about the variables to use, and the objectives for the index calculation, as considered by many authors.