Cellular Therapy in Experimental Autoimmune Encephalomyelitis as an Adjuvant Treatment to Translate for Multiple Sclerosis.

This study aims to evaluate and compare cellular therapy with human Wharton's jelly (WJ) mesenchymal stem cells (MSCs) and neural precursors (NPs) in experimental autoimmune encephalomyelitis (EAE), a preclinical model of Multiple Sclerosis. MSCs were isolated from WJ by an explant technique, differentiated to NPs, and characterized by cytometry and immunocytochemistry analysis after ethical approval. Forty-eight rats were EAE-induced by myelin basic protein and Freund's complete adjuvant. Forty-eight hours later, the animals received intraperitoneal injections of 250 ng/dose of Bordetella pertussis toxin. Fourteen days later, the animals were divided into the following groups: a. non-induced, induced: b. Sham, c. WJ-MSCs, d. NPs, and e. WJ-MSCs plus NPs. 1 × 105. Moreover, the cells were placed in a 10 µL solution and injected via a stereotaxic intracerebral ventricular injection. After ten days, the histopathological analysis for H&E, Luxol, interleukins, and CD4/CD8 was carried out. Statistical analyses demonstrated a higher frequency of clinical manifestation in the Sham group (15.66%) than in the other groups; less demyelination was seen in the treated groups than the Sham group (WJ-MSCs, p = 0.016; NPs, p = 0.010; WJ-MSCs + NPs, p = 0.000), and a lower cellular death rate was seen in the treated groups compared with the Sham group. A CD4/CD8 ratio of <1 showed no association with microglial activation (p = 0.366), astrocytes (p = 0.247), and cell death (p = 0.577) in WJ-MSCs. WJ-MSCs and NPs were immunomodulatory and neuroprotective in cellular therapy, which would be translated as an adjunct in demyelinating diseases.

Near Infrared Biomimetic Hybrid Magnetic Nanocarrier for MRI-Guided Thermal Therapy.

Cell-membrane hybrid nanoparticles (NPs) are designed to improve drug delivery, thermal therapy, and immunotherapy for several diseases. Here, we report the development of distinct biomimetic magnetic nanocarriers containing magnetic nanoparticles encapsulated in vesicles and IR780 near-infrared dyes incorporated in the membranes. Distinct cell membranes are investigated, red blood cell (RBC), melanoma (B16F10), and glioblastoma (GL261). Hybrid nanocarriers containing synthetic lipids and a cell membrane are designed. The biomedical applications of several systems are compared. The inorganic nanoparticle consisted of Mn-ferrite nanoparticles with a core diameter of 15 ± 4 nm. TEM images show many multicore nanostructures (∼40 nm), which correlate with the hydrodynamic size. Ultrahigh transverse relaxivity values are reported for the magnetic NPs, 746 mM-1s-1, decreasing respectively to 445 mM-1s-1 and 278 mM-1s-1 for the B16F10 and GL261 hybrid vesicles. The ratio of relaxivities r2/r1 decreased with the higher encapsulation of NPs and increased for the biomimetic liposomes. Therapeutic temperatures are achieved by both, magnetic nanoparticle hyperthermia and photothermal therapy. Photothermal conversion efficiency ∼25-30% are reported. Cell culture revealed lower wrapping times for the biomimetic vesicles. In vivo experiments with distinct routes of nanoparticle administration were investigated. Intratumoral injection proved the nanoparticle-mediated PTT efficiency. MRI and near-infrared images showed that the nanoparticles accumulate in the tumor after intravenous or intraperitoneal administration. Both routes benefit from MRI-guided PTT and demonstrate the multimodal theranostic applications for cancer therapy.

Lower limb muscles' thicknesses are weakly associated with dynamic knee valgus during single-leg squat in women with patellofemoral pain.

INTRODUCTION: Patellofemoral pain (PFP) patients often show an altered lower limb alignment during the single-leg squat (SLS). There is evidence that proximal and distal-to-the-knee muscle alterations can modify the lower limb alignment in PFP patients. However, we observed a lack of studies investigating the possible association between the thickness and strength of proximal and distal-to-the-knee muscles and lower limb alignment during SLS in women with PFP. Therefore, this study aimed to investigate the association between the thickness and strength of lower limb muscles and dynamic knee valgus (DKV) during SLS in women with PFP. METHODS: Cross-sectional study, where fifty-five women with PFP were submitted to the following evaluations: (1) muscle thickness (MT) of Gluteus Medius (GMed), Gluteus Maximus (GMax), Vastus Lateralis (VL), and Tibialis Anterior (TA); (2) isometric peak torque of hip abductors, hip external rotators, knee extensors, and foot inversors; and (3) DKV during SLS. RESULTS: There was a significant negative association between GMax's MT and DKV (r = -0.32; p = 0.01), and between TA's MT and DKV (r = -0.28; p = 0.03). No significant correlations were observed between isometric torques and DKV. Regression analysis found that GMax's MT explained 10% of the DKV's variance during SLS. DISCUSSION: Poor lower limb alignment during SLS is weakly associated with proximal and distal-to-the-knee muscle thicknesses, with no association with isometric torque in PFP women. CONCLUSION: Our results suggest that other factors besides strength and muscle thicknesses may explain and improve lower limb alignment in women with PFP.

An algorithm for the National Institute of Health Stroke Scale assessment: A multicenter, two-arm and cluster randomized study.

BACKGROUND: The NIH Stroke Scale (NIHSS) is a validated tool for assessing stroke severity, increasingly used by general practitioners in telemedicine services. Mobile apps may enhance its reliability. We aim to validate a digital platform (SPOKES) for NIHSS assessment in telemedicine and healthcare settings. METHODS: Hospitals using a telemedicine service were randomly allocated to control or SPOKES-user groups. The discrepancy between the NIHSS scores reported and those confirmed by experts was evaluated. Healthcare providers from comprehensive stroke centers were invited for interrater validation. Participants were randomized to assess the NIHSS using videos of real patients. Weighted Kappa (wk) statistics analyzed the agreement, and logistic regression determined the correlation with the congruency. RESULTS: A total of 299 telemedicine consultations from 12 hospitals were included. The difference between the NIHSS scores reported and double-checked was lower in the SPOKES group (p = 0.03), with a significantly higher level of complete agreement (72.5 % vs. 50.4 %, p = 0.005). Adoption of SPOKES was associated with complete congruency (OR 4.01, 95 %CI 1.42-11.35, p = 0.009). For interrater validation, 20 participants were considered. In the SPOKES group, almost-perfect and strong agreement occurred in 13.3 %(n = 6/45) and 84.4 %(n = 38/45) of ratings, respectively; in the control group, 6.7 %(n = 3/45) were almost-perfect, 28.9 %(n = 13/45) strong and 51 %(n = 23/45) were minimal. CONCLUSION: A free and reliable mobile application for NIHSS assessment can significantly improve interrater agreement between healthcare professionals, and between NIHSS-certified neurologists and general practitioners. Our results underscore the importance of ongoing training and education in enhancing the consistency and reliability of NIHSS scores.

Altered purinergic P2X7 and A2B receptors signaling limits macrophage-mediated host defense in schistosomiasis.

BACKGROUND: The occurrence of co-infections during schistosomiasis, a neglected tropical disease, with other parasites have been reported suggesting an impaired host immune defense. Macrophage purinergic P2X7 receptor (P2X7R) play an important role against intracellular pathogens. Therefore, we investigated the P2X7R-mediated phagocytosis and killing capacity of Leishmania amazonensis by macrophages during schistosomiasis in vitro and in vivo. METHODS: Swiss and C57BL/6 (Wild type) and P2X7R-/- were randomized in two groups: control (uninfected) and Schistosoma mansoni-infected. Alternatively, control Swiss and S. mansoni-infected mice were also infected with L. amazonensis. RESULTS: The pre-treatment of macrophages with the P2X7R antagonist (A74003) or TGF-ß reduced the phagocytosis index, mimicking the phenotype of cells from S. mansoni-infected mice and P2X7R-/- mice. Apyrase also reduced the phagocytosis index corroborating the role of ATP to macrophage activation. Moreover, l-arginine-nitric oxide pathway was compromised, which could explain the reduced killing capacity in response to ATP in vitro and in vivo. We found an increased extracellular nucleotide (ATP, ADP and AMP) hydrolysis along with an increased frequency of F4/80+ CD39+ macrophages from the S. mansoni-infected group. Moreover, the content of adenosine in the cell supernatant was higher in the S. mansoni-infected group in relation to controls. Schistosomiasis also increased the expression of macrophage adenosine A2BR. In good accordance, both ADA and the selective A2BR antagonist restored the phagocytosis index of macrophages from S. mansoni-infected group. CONCLUSIONS: Altogether, the altered P2X7R and A2BR signaling limits the role of macrophages to host defense against L. amazonensis during schistosomiasis, potentially contributing to the pathophysiology and clinically relevant co-infections.

Idiopyrgus souleyetianus (Gastropoda: Tomichiidae) as an intermediate host of the liver fluke Amphimerus sp. (Trematoda: Opisthorchiidae) in Brazil.

Despite the importance of fish-borne trematodes of the family Opisthorchiidae as causative agents of human liver fluke disease, studies on these parasites outside Asia are relativally scarce. In South America, human focus of amphimerosis is known in Ecuador since the mid-20th century, and Amphimerus spp. have also been reported in wild and domestic mammals. Nevertheless, the knowledge on the snails that act as the first intermediate host of these potentially zoonotic parasites are scarce. Herein, a new cercaria of the pleurolophocercous morphotype found in the freshwater snail Idiopyrgus souleyetianus from Brazil was subjected to morphological and molecular studies. Multigene phylogenetic analyses based on 28S, 5.8S-ITS-2 and Cox-1 sequences enabled the identification of Amphimerus sp., a species distinct from that reported in humans from Ecuador. This cercariae was morphologically compared with other opisthorchiid cercariae known. The possible occurrence of human amphimerosis in Brazil is discussed.

Meta-analysis of the Mesenchymal Stem Cells Immortalization Protocols: A Guideline for Regenerative Medicine.

BACKGROUND: This systematic review describes the most common methodologies for immortalizing human and animal mesenchymal stem cells (MSCs). This study follows the rules of PRISMA and is registered in the Institutional Review Board of PROSPERO International of systematic reviews, numbered protocol code: CRD42020202465. METHOD: The data search systematization was based on the words "mesenchymal stem cell" AND "immortalization." The search period for publications was between 2000 and 2022, and the databases used were SCOPUS, PUBMED, and SCIENCE DIRECT. The search strategies identified 384 articles: 229 in the SCOPUS database, 84 in PUBMED, and 71 in SCIENCE DIRECT. After screening by titles and abstracts, 285 articles remained. This review included thirty-nine articles according to the inclusion and exclusion criteria. RESULT: In 28 articles, MSCs were immortalized from humans and 11 animals. The most used immortalization methodology was viral transfection. The most common immortalized cell type was the MSC from bone marrow, and the most used gene for immortalizing human and animal MSCs was hTERT (39.3%) and SV40T (54.5%), respectively. CONCLUSION: Also, it was observed that although less than half of the studies performed tumorigenicity assays to validate the immortalized MSCs, other assays, such as qRT-PCR, colony formation in soft agar, karyotype, FISH, and cell proliferation, were performed in most studies on distinct MSC cell passages.

Synthesis and evaluation of hybrid sulfonamide-chalcones with potential antileishmanial activity.

Leishmaniasis is an emerging tropical infectious disease caused by a protozoan parasite of the genus Leishmania. In this work, the molecular hybridization between a trimethoxy chalcone and a sulfonamide group was used to generate a series of sulfonamide-chalcones. A series of eight sulfonamide-chalcone hybrids were made with good yields (up to 95%). These sulfonamide-chalcones were tested against promastigotes of Leishmania amazonensis and cytotoxicity against mouse macrophages, which showed good antileishmanial activity with IC50 = 1.72-3.19 µM. Three of them (10c, 10g, and 10h) were also highly active against intracellular amastigotes and had a good selectivity index (SI > 9). Thus, those three compounds were docked in the cytosolic tryparedoxin peroxidase (cTXNPx) enzyme of the parasite, and molecular dynamics simulations were carried out. This enzyme was selected as a target protein for the sulfonamide-chalcones due to the fact of the anterior report, which identified a strong and stable interaction between the chalcone NAT22 (6) and the cTXNPx. In addition, a prediction of the drug-likeness, and the pharmacokinetic profile of all compounds were made, demonstrating a good profile of those chalcones.

The Brazilian version of the High-Activity Arthroplasty Score: cross-cultural adaptation

ABSTRACT BACKGROUND: The High Activity Arthroplasty Score (HAAS) is a self-administered questionnaire, developed in British English, that reliably and validly measures the levels of sports activities in patients following hip and knee arthroplasty surgery. OBJECTIVE: To cross-culturally adapt the HAAS to Brazilian Portuguese language. DESIGN AND SETTING: A cross-sectional study was conducted at a public university hospital in Brazil. METHODS: The Brazilian version of the HAAS was created through a six-step process: translation, synthesis, committee review, pretesting, back-translation, and submission to developers. The translation step was conducted by two independent bilingual translators, both native speakers of Brazilian Portuguese. The back-translation was performed by an independent translator, a native speaker of British English. To ensure the questionnaire's comprehensibility, 46 volunteers (51% men; average age 34-63) participated in the pre-testing step. RESULTS: The cross-cultural adaptation process necessitated modifications to certain terms and expressions to achieve cultural equivalence with the original HAAS. CONCLUSION: The HAAS has been translated from English into Brazilian Portuguese and culturally adapted for Brazil. The validation process for HAAS-Brazil is currently underway.

The Brazilian version of the High-Activity Arthroplasty Score: cross-cultural adaptation.

BACKGROUND: The High Activity Arthroplasty Score (HAAS) is a self-administered questionnaire, developed in British English, that reliably and validly measures the levels of sports activities in patients following hip and knee arthroplasty surgery. OBJECTIVE: To cross-culturally adapt the HAAS to Brazilian Portuguese language. DESIGN AND SETTING: A cross-sectional study was conducted at a public university hospital in Brazil. METHODS: The Brazilian version of the HAAS was created through a six-step process: translation, synthesis, committee review, pretesting, back-translation, and submission to developers. The translation step was conducted by two independent bilingual translators, both native speakers of Brazilian Portuguese. The back-translation was performed by an independent translator, a native speaker of British English. To ensure the questionnaire's comprehensibility, 46 volunteers (51% men; average age 34-63) participated in the pre-testing step. RESULTS: The cross-cultural adaptation process necessitated modifications to certain terms and expressions to achieve cultural equivalence with the original HAAS. CONCLUSION: The HAAS has been translated from English into Brazilian Portuguese and culturally adapted for Brazil. The validation process for HAAS-Brazil is currently underway.

O contexto vivido pelo familiar e pessoa em tratamento hemodialítico / The context experienced by family members and people under hemodialytic treatment / El contexto vivido por familiares y personas en tratamiento de hemodiálisis

Objetivo: compreender o contexto vivido pelo familiar e pessoa em tratamento hemodialítico. Método: estudo descritivo exploratório, qualitativo e transversal, aprovado pelo comitê de ética em pesquisa, realizado com pacientes com doença renal crônica e seus familiares, em um munícipio do interior do estado do Rio Grande do Norte, entre junho e julho de 2019. Utilizada entrevista semiestruturada, com perguntas norteadoras para a composição estrutural do genograma e ecomapa. Posteriormente à transcrição das falas, seguiu-se a leitura e construção das categorias a partir das informações encontradas. Resultados: Foram realizadas 18 entrevistas, compondo nove famílias participantes, obtendo-se as categorias: Apoio da família, Apoio externo à família, Renúncia e Enfrentamento da doença. Conclusão: a maneira com que cada paciente e família irão vivenciar o estar doente e interpretar esse significado fará essa adaptação particular e pessoal, assim como o seu enfrentamento, particularmente ao considerar que, no núcleo familiar, ocorre uma reestruturação em meio às demandas de cuidado(AU)

Objective: to understand the context experienced by the family member and person undergoing hemodialysis treatment. Method: exploratory, qualitative and cross-sectional descriptive study, approved by the research ethics committee, carried out with patients with chronic kidney disease and their families, in a municipality in the interior of the state of Rio Grande do Norte, between June and July 2019. Used semi-structured interview, with guiding questions for the structural composition of the genogram and ecomap. After transcribing the speeches, the categories were read and constructed based on the information found. Results: comprising nine participating families, 18 interviews were carried out, obtaining the categories: Family support, External support to the family, Resignation and Coping with the disease. Conclusion: the way in which each patient and family will experience being sick and interpret this meaning will make this particular and personal adaptation, as well as coping, particularly when considering that, within the family nucleus, a restructuring occurs amid the demands of care(AU)

Objetivo: comprender el contexto vivido por el familiar y la persona en tratamiento de hemodiálisis. Método: estudio descriptivo exploratorio, cualitativo y transversal, aprobado por el comité de ética en investigación, realizado con pacientes con enfermedad renal crónica y sus familiares, en un municipio del interior del estado de Rio Grande do Norte, entre junio y julio de 2019. Se utilizó una entrevista semiestructurada, con preguntas orientadoras para la composición estructural del genograma y del ecomapa. Luego de transcribir las declaraciones, se leyó la construcción de las categorías a partir de las informaciones encontradas. Resultados: Se realizaron 18 entrevistas, comprendiendo nueve familias participantes, obteniendo las categorías: Apoyo familiar, Apoyo externo a la familia, Rendimiento y Enfrentamiento de la enfermedad. Conclusión: la forma en que cada paciente y familia vivirá el estar enfermo e interpretará este significado, condicionará esa adaptación particular y personal, así como su enfrentamiento, particularmente si se considera que, dentro del núcleo familiar, se produce una reestructuración en medio de las demandas del cuidado(AU)

Leishmanicidal and healing effects of 3ß,6ß,16ß-trihydroxy lup-20 (29)-ene isolated from Combretum leprosum on Leishmania braziliensis infection in vitro and in vivo.

Treatment of cutaneous leishmaniasis depends on drugs that potentially cause serious side effects and resistance. Thus, topical therapies are attractive alternatives to the drugs currently used. 3ß, 6ß, 16ß-trihydroxylup-20 (29)-ene is a lupane triterpene isolated from Combretum leprosum Mart. leaves (CLF-1), with reports of in vitro antileishmanial effect against L. amazonensis and to promote lesion healing in animal model. Herein, we evaluated the in vitro and in vivo antileishmanial and healing effects of CLF-1 against L. braziliensis. CLF-1 treatment showed low toxicity in macrophages and significantly reduced parasite load in vitro. CLF-1 induced higher IL-12 and TNF-α production and more discrete IL-4 and IL-10 production. For in vivo evaluation, a CLF-1 cream formulation was prepared to treat hamsters infected with L. braziliensis. CLF-1 treatment was able to reduce parasite load of the infected skin and lymph node more efficiently than the conventional treatment. Histopathological analysis indicated a strong inflammatory response accompanied by an important healing response. Data from this study indicate that topical CLF-1 treatment was effective and non-toxic in L. braziliensis infected hamsters suggesting its potential for further development as a future therapeutic intervention.

Dose-response effect of lower limb resistance training volume on pain and function of women with patellofemoral pain: A systematic review and meta-regression.

OBJECTIVE: Analyze whether the effects of lower limb resistance training on pain and self-reported function were associated with the exercise volume prescribed for women with patellofemoral pain (PFP). METHODS: A systematic search was undertaken in four databases from inception to May 2023. Eligible trials examined the effects of resistance training programs on pain (visual analogue scale or numerical pain scale) and function (Anterior Knee Pain Scale) in women with PFP. Meta-analysis was undertaken with a random-effects model. The association of resistance training volume-related variables with mean difference effects on pain and function were tested by exploratory univariable meta-regression models. RESULTS: From 1,404 estudies retained for screening after duplicate removals, 16 studies (579 patients) were included. Changes in knee pain were inversely associated with weekly training frequency (ß = 0.5 ± 0.2, P = 0.012). No associations were found between the amount of resistance exercise prescribed per session or per week and effects on pain. Changes in function were associated with the number of sets per week (ß = 0.1 ± 0.1, P = 0.044) and number of sets per session (ß = 0.6 ± 0.2, P < 0.001) over the intervention. Most favorable results were achieved with 17 to 27 sets per session and >45 sets per week. CONCLUSIONS: The amount of prescribed resistance exercise does not seem to be critical for pain reduction in women with PFP. However, our findings support a dose-response effect in terms of improving function.

Cognitive performance, burden and stress in aged caregivers of older adults with and without cognitive impairment.

There is an increasing number of aged people who provide care for other older people. Commonly existing burden and stress can change the forms of cognitive performance depending on the context of the aged caregivers. Objective: To compare the cognitive performance, burden and stress of aged caregivers of older adults with and without signs of cognitive impairment. Methods: A cross-sectional and quantitative study conducted with 205 aged caregivers of older adults with signs of cognitive impairment and 113 aged caregivers of older adults without signs of cognitive impairment treated in Primary Health Care. They were evaluated for sociodemographic characteristics, cognition, burden, and stress. Descriptive (Kolmogorov-Smirnov test) and comparative (Student's t-test and Pearson's χ² test) analyses were performed. Results: Aged caregivers of older adults with signs of cognitive impairment were older, had lower schooling levels, and a higher percentage of daily care hours compared to the aged caregivers of older adults without signs of cognitive impairment. Regarding cognitive performance, the means were lower for all domains. In addition, this same group had higher scores, with a statistically significant difference for perceived stress and burden. Conclusion: Aged caregivers of older adults with signs of cognitive impairment showed lower cognitive performance, as well as higher burden and stress levels. These findings guide the planning of interventions with aged caregivers in the Primary Health Care.

Nota-se um crescente número de idosos que prestam cuidados a outros idosos. A sobrecarga e o estresse comumente existentes podem afetar de formas diferentes o desempenho cognitivo, a depender do contexto desses idosos cuidadores. Objetivo: Comparar o desempenho cognitivo, a sobrecarga e o estresse de idosos cuidadores de idosos com e sem indícios de alterações cognitivas. Métodos: Estudo transversal e quantitativo realizado com 205 idosos cuidadores de idosos com indícios de alterações cognitivas e 113 idosos cuidadores de idosos sem indícios de alterações cognitivas atendidos na Atenção Primária à Saúde. Eles foram avaliados quanto às características sociodemográficas, cognição, sobrecarga e estresse. Análises descritivas (teste de Kolmogorov-Smirnov) e comparativas foram realizadas (teste t de Student e χ² de Pearson). Resultados: Os idosos cuidadores de idosos com indícios de alterações cognitivas eram mais velhos, com menor escolaridade e maior percentual de horas diárias de cuidado em comparação aos idosos cuidadores de idosos sem indícios de alterações cognitivas. Já quanto ao desempenho cognitivo, as médias foram inferiores para todos os domínios. Além disso, esse mesmo grupo apresentou maior pontuação, com diferença estatisticamente significante, para o estresse percebido e para a sobrecarga. Conclusão: Os cuidadores de idosos com indícios apresentaram menor desempenho cognitivo e maiores níveis de sobrecarga e estresse. Tais achados norteiam o planejamento de intervenções voltadas aos idosos cuidadores na Atenção Primaria à Saúde.

Differentiation of peripheral sensory neurons from iPSCs derived from stem cells from human exfoliated deciduous teeth (SHED).

Peripheral nervous system (PNS) sensory alterations are present in several pathologies and syndromes. The use of induced pluripotent stem cell (iPSC) technology is an important strategy to produce sensory neurons in patients who are accomplished in terms of sensory symptoms. The iPSC technology relies on manipulating signaling pathways to resemble what occurs in vivo, and the iPSCs are known to carry a transcriptional memory after reprogramming, which can affect the produced cell. To this date, protocols described for sensory neuron production start using iPSCs derived from skin fibroblasts, which have the same ontogenetic origin as the central nervous system (CNS). Since it is already known that the cells somehow resemble their origin even after cell reprogramming, PNS cells should be produced from cells derived from the neural crest. This work aimed to establish a protocol to differentiate sensory neurons derived from stem cells from human exfoliated deciduous teeth (SHED) with the same embryonic origin as the PNS. SHED-derived iPSCs were produced and submitted to peripheral sensory neuron (PSN) differentiation. Our protocol used the dual-SMAD inhibition method, followed by neuronal differentiation, using artificial neurotrophic factors and molecules produced by human keratinocytes. We successfully established the first protocol for differentiating neural crest and PNS cells from SHED-derived iPSCs, enabling future studies of PNS pathologies.

Diversity of Anal HPV and Non-HPV Sexually Transmitted Infections and Concordance with Genital Infections in HIV-Infected and HIV-Uninfected Women in the Tapajós Region, Amazon, Brazil.

The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital infections in HIV-infected and uninfected women living in the Tapajós region, Amazon, Brazil. A cross-sectional study was performed with 112 HIV-uninfected and 41 HIV-infected nonindigenous women. Anal and cervical scrapings were collected and analyzed for HPV, Chlamydia trachomatis (CT), Neisseria gonorrheae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Human alphaherpesvirus 2 (HSV-2). The Kappa test evaluated the concordance between anal and genital infections. The overall prevalence of anal HPV infection was 31.3% in HIV-uninfected and 97.6% in HIV-infected women. The most frequent anal high-risk HPV (hrHPV) types were HPV18 and HPV16 in HIV-uninfected women and HPV51, HPV59, HPV31, and HPV58 in HIV-infected women. Anal HPV75 Betapapillomavirus was also identified. Anal non-HPV STIs were identified in 13.0% of all participants. The concordance analysis was fair for CT, MG, and HSV-2, almost perfect agreement for NG, moderate for HPV, and variable for the most frequent anal hrHPV types. Thus, a high prevalence of anal HPV infection with moderate and fair concordance between anal and genital HPV and non-HPV STIs was observed in our study.

Sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers: a cross-sectional study.

The task of caring can negatively affect the physical and mental health; therefore, it is important to understand which factors are associated with burden in older caregivers of older adults. Objective: This study aimed to explore sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers of older adults. Methods: This is a cross-sectional study developed with 349 older caregivers who were registered at a Family Health Unit of a city in the state of São Paulo, Brazil. Household interviews were conducted and data were collected on the sociodemographic (profile, family income), clinical (self-reported pain, sleep, frailty), and psychosocial (burden, family functioning, depressive symptoms, stress) characteristics of the caregivers as well as dependence on activities of daily living and cognition in the care recipients. Results: Women predominated in the sample (76.5%) and mean age was 69.5 years. The mean burden score was 18.06 points, with 47.9% above the cutoff of 16 points, denoting excessive burden. The bivariate model revealed associations between burden and financial insufficiency, family dysfunction, difficulty sleeping, pain, perceived stress, depressive symptoms, frailty, and multimorbidity among the caregivers as well as worse functional and cognitive performance in the care recipients. The controlled model revealed an association between burden and depressive symptoms (ß=16.75; 95%CI 1.80-31.68). Conclusions: We identified an association between burden and depressive symptoms, underscoring the need for the planning and implementation of specific actions directed at caregivers in order to minimize the impact on health and to improve the quality of life.

A tarefa de cuidar pode afetar negativamente a saúde física e mental, sendo importante compreender quais os fatores associados à sobrecarga em idosos cuidadores de idosos. Objetivo: Explorar os fatores sociodemográficos, clínicos e psicossociais associados à sobrecarga em idosos cuidadores de idosos. Métodos: Estudo transversal desenvolvido com 349 idosos cuidadores cadastrados nas unidades de Saúde da Família de um município do interior paulista. Foram realizadas entrevistas domiciliares e coletados dados sobre as informações sociodemográficas (perfil, renda familiar), clínicas (dor autorrelatada, sono, fragilidade) e psicossociais (sobrecarga, funcionalidade familiar, sintomas depressivos, estresse) do cuidador, bem como dados de funcionalidade e cognição dos receptores de cuidados. Resultados: Houve prevalência do sexo feminino (76,5%), com média de idade de 69,5 anos. A média do escore da sobrecarga foi 18,06 pontos, com 47,9% dos idosos cuidadores acima da nota de corte de 16 pontos. O modelo univariado revelou associação entre sobrecarga e percepção de insuficiência financeira, disfunção familiar, dificuldade de dormir, dor, estresse percebido, sintomas depressivos, fragilidade e multimorbidade, além de pior desempenho funcional e cognitivo dos idosos receptores de cuidados. No modelo controlado houve associação entre sobrecarga e sintomas de depressão (ß=16,75; intervalo de confiança ­ IC95% 1,80­31,68). Conclusão: Identificamos associação entre sobrecarga e sintomas depressivos, de modo que é necessário planejar e implementar cuidados específicos a fim de minimizar o impacto na saúde dos cuidadores e favorecer a qualidade de vida.

State of the Art of microRNAs Signatures as Biomarkers and Therapeutic Targets in Parkinson's and Alzheimer's Diseases: A Systematic Review and Meta-Analysis.

Identifying target microRNAs (miRNAs) might serve as a basis for developing advanced therapies for Parkinson's disease (PD) and Alzheimer's disease. This review aims to identify the main therapeutic targets of miRNAs that can potentially act in Parkinson's and Alzheimer's diseases. The publication research was conducted from May 2021 to March 2022, selected from Scopus, PubMed, Embase, OVID, Science Direct, LILACS, and EBSCO. A total of 25 studies were selected from 1549 studies evaluated. The total number of miRNAs as therapeutic targets evidenced was 90 for AD and 54 for PD. An average detection accuracy of above 84% for the miRNAs was observed in the selected studies of AD and PD. The major signatures were miR-26b-5p, miR-615-3p, miR-4722-5p, miR23a-3p, and miR-27b-3p for AD and miR-374a-5p for PD. Six miRNAs of intersection were found between AD and PD. This article identified the main microRNAs as selective biomarkers for diagnosing PD and AD and therapeutic targets through a systematic review and meta-analysis. This article can act as a microRNA guideline for laboratory research and pharmaceutical industries for treating Alzheimer's and Parkinson's diseases and offers the opportunity to evaluate therapeutic interventions earlier in the disease process.

Telework in health: where are we heading to?

OBJECTIVE: To identify the legal norms published in 2020 and 2021 aimed at directly or indirectly regulating telework in health in Brazil, focusing on these contexts: workday length; ergonomics; work environment; worker safety and health. METHODS: Legislative and documentary research, with a descriptive qualitative approach. We collected and selected all legal norms dealing directly or indirectly with the regulation of telework in health in Brazil, published in the bases of the National Press and Health Professional Councils until June 2021. RESULTS: Until June 2021, there were 113 valid legal norms on the regulation of telework in health, and more than half of them (64) were published in 2020. We identified only a few norms aimed at regulating or guiding aspects related to workday length; ergonomics; work environment; and worker safety and health. From the 113 norms, only one deals with workday length and just 13 pointed out the importance of working environments for offering a good service. DISCUSSION: We identified that the selected legal norms lack of devices which regulate telework in health, failing to defend workers' and patients' rights, or to guarantee favorable remote work conditions, whether at home or somewhere else.