Novel B-cell subsets as potential biomarkers in idiopathic inflammatory myopathies: insights into disease pathogenesis and disease activity.

Idiopathic inflammatory myopathies are a heterogeneous group of rare autoimmune disorders characterized by progressive muscle weakness and the histopathologic findings of inflammatory infiltrates in muscle tissue. Although their pathogenesis remains indefinite, the association of autoantibodies with clinical manifestations and the evidence of high effectiveness of depleting therapies suggest that B cells could be implicated. Therefore, we explored the landscape of peripheral B cells in this disease by multiparametric flow cytometry, finding significant numerical decreases in memory and double-negative subsets, as well as an expansion of the naive compartment relative to healthy controls, that contribute to defining disease-associated B-cell subset signatures and correlating with different clinical features of patients. Additionally, we determined the potential value of these subsets as diagnostic biomarkers, thus positioning B cells as neglected key elements possibly participating in idiopathic inflammatory myopathy onset or development.

PERORAL ENDOSCOPIC MYOTOMY FOR ACHALASIA: SAFETY PROFILE, COMPLICATIONS AND RESULTS OF 94 PATIENTS.

BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients' symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05). CONCLUSIONS: POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life.

Influence of SARS-CoV-2 mRNA Vaccine Booster among Cancer Patients on Active Treatment Previously Immunized with Inactivated versus mRNA Vaccines: A Prospective Cohort Study.

Cancer patients on chemotherapy have a lower immune response to SARS-CoV-2 vaccines. Therefore, through a prospective cohort study of patients with solid tumors receiving chemotherapy, we aimed to determine the immunogenicity of an mRNA vaccine booster (BNT162b2) among patients previously immunized with an inactivated (CoronaVac) or homologous (BNT162b2) SARS-CoV-2 vaccine. The primary outcome was the proportion of patients with anti-SARS-CoV-2 neutralizing antibody (NAb) seropositivity at 8-12 weeks post-booster. The secondary end points included IgG antibody (TAb) seropositivity and specific T-cell responses. A total of 109 patients were included. Eighty-four (77%) had heterologous vaccine schedules (two doses of CoronaVac followed by the BNT162b2 booster) and twenty-five had (23%) homologous vaccine schedules (three doses of BNT162b2). IgG antibody positivity for the homologous and heterologous regimen were 100% and 96% (p = 0.338), whereas NAb positivity reached 100% and 92% (p = 0.13), respectively. Absolute NAb positivity and Tab levels were associated with the homologous schedule (with a beta coefficient of 0.26 with p = 0.027 and a geometric mean ratio 1.41 with p = 0.044, respectively). Both the homologous and heterologous vaccine regimens elicited a strong humoral and cellular response after the BNT162b2 booster. The homologous regimen was associated with higher NAb positivity and Tab levels after adjusting for relevant covariates.

Um instrumento de avaliação do interno de pediatria na Atenção Primária à Saúde / An instrument for evaluation of medical students during the internship of pediatrics Primary Health Care / Un instrumento de evaluación de estudiantes de pediatría en Atención Primaria de Salud

Os estudantes de Medicina têm contato com diferentes áreas e cenários durante o internato e devem ter seu desempenho avaliado em cada um deles. Contudo, muitos estudantes não se sentem devidamente avaliados e, diante disso, nosso objetivo foi desenvolver um instrumento de avaliação do desempenho de estudantes de Medicina, no período do internato em pediatria, para uso durante o estágio realizado na Atenção Primária à Saúde. Realizou-se uma pesquisa metodológica com elaboração de um instrumento e contribuição de especialistas com experiência em ensino, por meio de convites eletrônicos. Ao final do estudo, utilizando-se a técnica Delphi, dos vinte itens constantes no instrumento original, dezessete foram aceitos pelos 11 especialistas que participaram das duas rodadas de análise. Dessa forma, a pesquisa alcançou seu objetivo e, por meio deste artigo, divulgamos a proposta de um "Instrumento de avaliação de internos de Medicina no estágio de pediatria na Atenção Primária à Saúde".

Medical students have contact with different areas and scenarios during their internship and must have their performance evaluated in each of them. However, as many students do not feel properly evaluated, our objective was to develop an instrument to evaluate the performance of Medical students, during their internship in pediatrics, to be used during their practice in Primary Health Care. A methodological research was carried out with the elaboration of an instrument and the contribution of specialists with experience in teaching, using electronic invitations. At the end of the study, through the Delphi technique, seventeen of the twenty items contained in the original instrument were accepted by the 11 specialists who participated in the two rounds of analysis. Thus, the research reached its objective and, through this article, we disseminate the proposal of an "Instrument for the evaluation of Medical interns in the pediatric internship in Primary Health Care".

Los estudiantes de Medicina tienen contacto con diferentes áreas y escenarios durante su pasantía y deben evaluar su desempeño en cada uno de ellos. Sin embargo, muchos estudiantes no se sienten debidamente evaluados y, ante eso, nuestro objetivo fue desarrollar un instrumento para evaluar la actuación de los estudiantes de Medicina, durante su pasantía en pediatría, para ser utilizado mientras ejecutan la Atención Primaria de Salud. Se realizó una investigación metodológica con la elaboración de un instrumento y el aporte de especialistas con experiencia en la docencia, a través de invitaciones electrónicas. Al final del estudio, utilizando la técnica Delphi, de los veinte ítems contenidos en el instrumento original, se aceptaron diecisiete por los 11 especialistas que participaron en las dos rondas de análisis. De esta forma, la investigación alcanzó su objetivo y, por medio de este artículo, divulgamos la propuesta de un "Instrumento para la evaluación de Médicos internos en el internado de pediatría en Atención Primaria de Salud".

Effect of COVID-19 Quarantine on Voice Handicap Index in Female Classical Singers.

OBJECTIVE: This study aimed to verify the impact of vocal deviation in the quality of life of classical female singers over the quarantine imposed by the COVID-19 pandemic through self-assessments. METHODS: Fifty five professional classical female singers filled out an online questionnaire including general questions such as identification, age, professional experience time, vocal classification, time of singing, and rehearsal studies. They all answered the protocol Classical Singing Handicap Index, adapted for this research, which analyses three subscales: Disability, Handicap, and Impairment. RESULTS: There was no significant difference in the perceived total handicap index score (40% of 120 points). Regarding the three domains analyzed, Disability was significantly higher than Impairment (P = 0.012). In addition, the correlation with the variables identified that Impairment subscale showed a negative correlation with the variable hours of rehearsal (r = -0.335, P = 0.040). CONCLUSIONS: The COVID-19 quarantine does not seem to cause a significant impact on the voice of professional classical female singers probably due to their degree of experience and vocal preparation.

Peroral endoscopic myotomy for achalasia: safety profile, complications and results of 94 patients / Miotomia endoscópica peroral para acalásia: perfil de segurança, complicações e resultados de 94 pacientes

ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients' symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05). CONCLUSIONS: POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life.

RESUMO RACIONAL: A acalasia é uma desordem da motilidade esofágica, com apresentação clínica de disfagia e regurgitação, uma condição crônica sem cura. As opções de tratamentos atuais visam reduzir o tônus do esfíncter esofagiano inferior (EEI) por meios farmacológicos, endoscópicos ou cirúrgicos, com o objetivo de aliviar os sintomas dos pacientes. A miotomia endoscópica peroral, sigla do inglês (POEM) é uma cirurgia endoscópica alternativa à cardiomiotomia a Heller (CH), em que a miotomia é realizada por via oral, por endoscopia, oferecendo eficácia comparável a miotomia cirúrgica, com relativa facilidade e mínima invasão, sem incisões externas. OBJETIVOS: Analisar a segurança do POEM analisando seus resultados, eventos adversos, complicações perioperatórias e suas principais formas de contorná-los, além de avaliar a eficácia do procedimento e a qualidade de vida pós-operatória, em curto prazo. MÉTODOS: Estudo qualitativo e quantitativo, observacional e transversal avaliando pacientes que realizaram o POEM em um centro de referência, entre dezembro de 2016 até dezembro de 2022, mantendo padrão técnico de preparo pré, peri e pós-operatório. RESULTADOS: Foram incluídos no estudo 94 pacientes e apenas 3 apresentaram complicações pós-operátorias. O escore de Eckardt médio precoce pós-operatório foi de 0,93 e o tardio de 1,40, com melhora média de 7,1 em resultados precoces e de 6,63 em resultados tardios (p<0,05). CONCLUSÕES: O POEM pode ser reproduzido com excelente perfil de segurança, alívio significativo dos sintomas e melhora do esvaziamento do esôfago, oferecendo melhora na qualidade de vida.

Uso del twin-block en niños de 5 a 12 años con maloclusión Clase II y III. Revisión de la literatura / Use of the twin-block in patients aged 5 to 12 years with class II and III malocclusion. Literature Review

Introducción: las maloclusiones Clase II y III pueden ser tratadas desde edades tempranas y su manejo oportuno incluye el reconocimiento, diagnóstico y tratamiento adecuado. Desde la visión ortopédica, teniendo en cuenta la presencia de momentos de crecimiento y desarrollo, podrían planificarse diversas aparatologías removibles, ortopédicas, miofuncionales y/o fijas. El twin-block está constituido por bloques de mordida superior e inferior con un plano inclinado que dirige la fuerza de oclusión a fomentar la función mandibular normal. Objetivo: efectuar una revisión de la literatura sobre el uso del twin-block y su efectividad en pacientes de 5 a 12 años con maloclusión Clase II y III. Métodos: se realizó una revisión de literatura en las bases de datos electrónicas en inglés PUBMED/MEDLINE, Elsevier, Epistemonikos y Google Schoolar; y en idioma español, imbiomed. org, Scielo.org y Google académico. Se incluyeron un total de 16 artículos. Los años límites para la búsqueda fueron enero de 2011 a junio de 2022. La revisión abarcó aspectos referidos al uso del twin-block en niños con maloclusión Clase II y III. Resultados: los estudios reportaron resultados favorables al uso efectivo del twin-block para la corrección de las maloclusiones, con cambios esqueléticos y dentoalveolares en dentición permanente y mixta. Conclusiones: la evidencia científica revisada sugiere que el uso del twin-block es efectivo en pacientes pediátricos con maloclusión Clase II o III.

Introduction: Class II and III malocclusions could be treated from early ages and their timely management includes recognition, diagnosis and adequate treatment; this from the orthopedic view due to the presence of moments of growth and development, various removable, orthopedic, myofunctional and/or fixed appliances could be planned. The twinblock consists of upper and lower bite blocks with an inclined plane that directs the occlusal force to promote normal mandibular function. Objective: To review the literature on the use of the twin-block in patients 5 to 12 years of age with class II and III malocclusion. Methods: A descriptive, retrospective research was carried out in the electronic databases PUBMED/MEDLINE, Elsevier, Epistemonikos and Google Scholar; and in the Spanish language imbiomed.org, Scielo.org and Google Scholar a total of 16 articles were included. The years for the search were January 2011 to June 2022. The review covered aspects referring to the effectiveness of the use of the twin-block in children with type II and III malocclusion. Results: The studies reported favorable results for the effective use of the twin-block for the correction of malocclusions producing skeletal and dentoalveolar changes in permanent and mixed dentition. Conclusions: The scientific evidence reviewed suggests that the use of the twin-block is effective in pediatric patients with class II or III malocclusion

Towards an Eco-Friendly Coffee Rust Control: Compilation of Natural Alternatives from a Nutritional and Antifungal Perspective.

Hemileia vastatrix (HV) is the pathogen responsible for the coffee leaf rust (CLR) disease that has spread globally. CLR causes losses of up to a billion dollars annually and affects all types of crops regardless of their production regime (organic or inorganic). Additionally, smallholders produce approximately 80% of coffee in developing countries. The condition causes losses of up to a billion dollars annually. It affects all types of crops regardless of their production regime (organic or inorganic). Approximately 80% of coffee is produced by smallholders in developing countries. Until the 90s, shaded-production systems and native varieties were encouraged; however, the rapid spread of CLR has forced farmers to migrate towards inorganic schemes, mainly due to a lack of knowledge about natural alternatives to pesticides that can be implemented to control HV. Therefore, the purpose of this article is to compile the currently existing options, emphasizing two key factors that guarantee efficient rust control: selective fungicidal activity against HV and the nutrition of coffee crops. Thus, by comprehending how these natural compounds (such as plant, bacteria, fungi, animals, or algae metabolites) impact coffee rust proliferation. Furthermore, since a various range of biochar effects contributes to the control of foliar fungal pathogens through modification of root exudates, soil properties, and nutrient availability, which influence the growth of antagonist microorganisms, we present a review of the pathogen-suppressive effects of biochar, and new control strategies suitable for organic schemes can be developed.

Enhancing the Recovery of Bioactive Compounds of Soybean Fermented with Rhizopus oligosporus Using Supercritical CO2: Antioxidant, Anti-Inflammatory, and Oxidative Proprieties of the Resulting Extract.

The aim of the present study was to evaluate the use of supercritical CO2 combined with cosolvent for the recovery of bioactive compounds of soybean fermented with Rhizopus oligosporus NRRL 2710. Soxhlet extractions using seven different organic solvents (n-hexane, petroleum ether, ethyl acetate, acetone, ethanol, methanol, and water) were initially performed for comparative purposes. The extracts obtained were characterized by physicochemical, antioxidant, total phenolic, and oxidative proprieties. For the Soxhlet extractions, the highest and lowest yields obtained were 45.24% and 15.56%, using methanol and hexane, respectively. The extraction using supercritical CO2 combined with ethanol as a static modifier (scCO2 + EtOH) presented, at a high pressure (25 MPa) and temperature (80 °C), a phenolic compound content of 1391.9 µg GAE g-1 and scavenging of 0.17 g, reaching a 42.87% yield. The extracts obtained by sCO2 + EtOH were characterized by high contents of essential fatty acids (linoleic acid and oleic acid) and bioactive compounds (gallic acid, trans-cinnamic acid, daidzein, and genistein). These extracts also showed a great potential for inhibiting hyaluronidase enzymes (i.e., anti-inflammatory activity). Thermogravimetric analyses of the samples showed similar profiles, with oil degradation values in the range from 145 to 540 °C, indicating progressive oil decomposition with a mass loss ranging from 93 to 98.7%. In summary, this study demonstrated the flexibility of scCO2 + EtOH as a green technology that can be used to obtain high-value-added products from fermented soybean.

Novel Eco-Friendly Stability Indicating Capillary Zone Electrophoresis Method for Determination of Aripiprazole in Tablet Dosage form: DoE Directed Optimization, Development and Method Validation.

In this work, a novel environment-friendly stability indicating capillary zone electrophoresis (CZE) method has been developed and validated for assaying the aripiprazole (ARP) in tablet dosage form. The separation of ARP from its degradation products and internal standard was achieved using a fused silica capillary column (30.2 cm x 75 µm ID), a background electrolyte containing 6 mmol L-1 ammonium formate buffer (pH 3) with 5% methanol under a potential of 15 kV and detection at 214 nm. The stability indicating ability of the method was investigated by analyzing ARP after being subjected to acidic, alkaline, thermal, photolytic, and oxidative stress conditions, according to ICH guidelines. Design of experiments was used during forced degradation and method optimization. Oxidation was the main degradation pathway among those evaluated. The drug was separated from its oxidative degradation products in less than 4 min. CZE method was linear between 60 - 140 µg mL-1, R2 = 0.9980, precise (intra-day 0.88% and inter-day 1.30%). The average recovery was 100.93 ± 0.77%. This is the first method in the literature for quantification of ARP in the presence of its related degradation products with high separation efficiency, low operation cost and minimum solvent consumption. This method could be helpful in the routine quality control analysis in the pharmaceutical industries with least harmful effect on the environment. CZE is considered an eco-friendly alternative of conventionally HPLC methods.

Recent Advances in Prodigiosin as a Bioactive Compound in Nanocomposite Applications.

Bionanocomposites based on natural bioactive entities have gained importance due to their abundance; renewable and environmentally benign nature; and outstanding properties with applied perspective. Additionally, their formulation with biological molecules with antimicrobial, antioxidant, and anticancer activities has been produced nowadays. The present review details the state of the art and the importance of this pyrrolic compound produced by microorganisms, with interest towards Serratia marcescens, including production strategies at a laboratory level and scale-up to bioreactors. Promising results of its biological activity have been reported to date, and the advances and applications in bionanocomposites are the most recent strategy to potentiate and to obtain new carriers for the transport and controlled release of prodigiosin. Prodigiosin, a bioactive secondary metabolite, produced by Serratia marcescens, is an effective proapoptotic agent against bacterial and fungal strains as well as cancer cell lines. Furthermore, this molecule presents antioxidant activity, which makes it ideal for treating wounds and promoting the general improvement of the immune system. Likewise, some of the characteristics of prodigiosin, such as hydrophobicity, limit its use for medical and biotechnological applications; however, this can be overcome by using it as a component of a bionanocomposite. This review focuses on the chemistry and the structure of the bionanocomposites currently developed using biorenewable resources. Moreover, the work illuminates recent developments in pyrrole-based bionanocomposites, with special insight to its application in the medical area.

Effects of UV and UV-vis Irradiation on the Production of Microalgae and Macroalgae: New Alternatives to Produce Photobioprotectors and Biomedical Compounds.

In the last decade, algae applications have generated considerable interest among research organizations and industrial sectors. Bioactive compounds, such as carotenoids, and Mycosporine-like amino acids (MAAs) derived from microalgae may play a vital role in the bio and non-bio sectors. Currently, commercial sunscreens contain chemicals such as oxybenzone and octinoxate, which have harmful effects on the environment and human health; while microalgae-based sunscreens emerge as an eco-friendly alternative to provide photo protector agents against solar radiation. Algae-based exploration ranges from staple foods to pharmaceuticals, cosmetics, and biomedical applications. This review aims to identify the effects of UV and UV-vis irradiation on the production of microalgae bioactive compounds through the assistance of different techniques and extraction methods for biomass characterization. The efficiency and results focus on the production of a blocking agent that does not damage the aquifer, being beneficial for health and possible biomedical applications.

Lymphocyte Subsets in Defense Against New Pathogens in Patients with Cancer.

INTRODUCTION: Immunity in cancer patients is modified both by the cancer itself and by oncospecific treatments. Whether a patient's adaptive immunity is impaired depends on their levels of naive lymphocytes and other cell populations. During the COVID-19 pandemic, cancer patients are at greater risk of progressing to severe forms of the disease and have higher mortality rates than individuals without cancer, particularly while they are receiving cancer-specific therapies. An individual's protection against infection, their response to vaccines, and even the tests that determine the humoral immune response to SARS-CoV-2, depend on lymphocyte populations, meriting their study. OBJECTIVE: Estimate blood concentrations of lymphocytes involved in the immune response to new pathogens in cancer patients. METHODS: We carried out an analytical study of 218 cancer patients; 124 women and 94 men, 26-93 years of age, who were treated at the National Oncology and Radiobiology Institute in Havana, Cuba, March-June, 2020. Patients were divided into five groups: (1) those with controlled disease who were not undergoing cancer-specific treatment; (2) those undergoing debulking surgery; (3) patients undergoing chemotherapy; (4) patients undergoing radiation therapy and (5) patients currently battling infection. We evaluated the following peripheral blood lymphocyte subpopulations via flow cytometry: B lymphocytes (total, naive, transitional, memory, plasmablasts and plasma cells); T lymphocytes (total, helper, cytotoxic and their respective naive, activated, central memory and effector memory subsets); and total, secretory and cytotoxic natural killer cells and T natural killer cells. We also estimated neutrophil/lymphocyte ratios. Lymphocyte concentrations were associated with controlled disease and standard cancer therapy. For variables that did not fall within a normal distribution, ranges were set by medians and 2.5-97.5 percentiles. The two-tailed Mann-Whitney U test was used to measure the effect of sex and to compare lymphocyte populations. We calculated odds ratios to estimate lymphopenia risk. RESULTS: All cancer patients had lower values of naive helper and cytotoxic T lymphocyte populations, naive B lymphocytes, and natural killer cells than normal reference medians. Naive helper T cells were the most affected subpopulation. Memory B cells, plasmablasts, plasma cells, activated T helper cells, and cytotoxic central memory T cells were increased. Patients undergoing treatment had lower levels of naive lymphocytes than untreated patients, particularly during radiation therapy. The risk of B lymphopenia was higher in patients in treatment. The odds ratio for B lymphopenia was 8.0 in patients who underwent surgery, 12.9 in those undergoing chemotherapy, and 13.9 in patients in radiotherapy. CONCLUSIONS: Cancer and conventional cancer therapies significantly affect peripheral blood B lymphocyte levels, particularly transitional T helper lymphocytes, reducing the immune system's ability to trigger primary immune responses against new antigens.

Asociación del inmunofenotipo linfocitario de sangre periférica con la presencia de linfomas no Hodgkin / Association of peripheral blood lymphoid immunophenotype with presence of non-Hodgkin lymphomas

Introducción: Los cambios en el inmunofenotipo de los linfocitos en los pacientes con linfoma no Hodgkin están asociados con el pronóstico y las respuestas terapéuticas. Sin embargo, no se ha establecido sistemáticamente la asociación con la enfermedad y por tanto su contribución al diagnóstico. Objetivo: Evaluar la asociación del inmunofenotipo linfocitario en sangre periférica con la presencia del linfoma no Hodgkin. Métodos: Se analizaron 31 muestras de sangre periférica de pacientes con diagnóstico confirmado de linfoma no Hodgkin y de 68 individuos sanos como controles, durante el período de 2018 a 2020. Se empleó la citometría de flujo multiparamétrica para el inmunofenotipado. Se calculó el área bajo la curva y el índice de Youden para establecer puntos de corte en los porcentajes linfocitarios. La asociación de los cambios inmunofenotípicos con el linfoma no Hodgkin, se realizó mediante cálculos de Odd ratio. Resultados: El aumento de linfocitos TCD8+ y NKCD56opaco se asoció significativamente con la presencia de linfoma no Hodgkin (OR= 3,4 y 2,9; respectivamente). Por el contrario, la disminución de linfocitos TCD4+, T doble positivo, T doble negativo y NKCD56brillante también se asoció con la existencia de linfoma no Hodgkin (OR= 23,0; 10,7; 6,9 y 15,8; respectivamente). Además, la disminución del índice CD4/CD8 también fue asociada con la enfermedad. Conclusiones: Los cambios encontrados en los inmunofenotipos linfocitarios se asociaron de forma significativa con la presencia del linfoma no Hodgkin, lo cual representa una expresión sistémica de la enfermedad y sugiere su valor diagnóstico(AU)

Introduction: Lymphocyte immunophenotype changes in non-Hodgkin lymphoma patients are associated with prognosis and therapeutic responses. However, its association with the disease has not been systematically established. Therefor its contribution to the diagnosis process. Objective: To assess the association of lymphocyte immunophenotype in peripheral blood with the presence of non-Hodgkin lymphoma. Methods: 31 peripheral blood samples were analyzed from patients with a confirmed diagnosis of non-Hodgkin lymphoma and from 68 healthy individuals as controls, during the period 2018 to 2020. Multiparametric flow cytometry was used for immunophenotyping. The area under the curve and the Youden index were calculated to establish cut-off points in lymphocyte percentages. The association of immunophenotypic changes with non-Hodgkin's lymphoma was made using Odd ratio calculations. Results: The increase in TCD8+ and NKCD56dim lymphocytes from peripheral blood was significantly associated with the presence of non-Hodgkin lymphoma (OR= 3.4 and 2.9, respectively). Oppositely, the decrease in TCD4+, double positive T, double negative T and NKCD56bright lymphocytes was associated with the existence of non-Hodgkin lymphoma (OR= 23.0, 10.7, 6.9 and 15.8, respectively). Therefore, the decrease in the CD4/CD8 rate was also associated with the disease. Conclusion: The changes found in these lymphocytic immunophenotypes were significantly associated with the presence of non-Hodgkin lymphoma, which represents a systemic expression of the disease and suggests its diagnostic value(AU)

Carbon dots-based nanomaterials for fluorescent sensing of toxic elements in environmental samples: Strategies for enhanced performance.

Rapid industrialization and manufacturing expansion have caused heavy metal pollution, which is a critical environmental issue faced by global population. In addition, the disadvantages presented by conventional detection methods such as the requirement of sophisticated instruments and qualified personnel have led to the development of novel nanosensors. Recently, carbon dots (CDs) have been presented as a multifunctional nanomaterial alternative for the accurate detection of heavy metal ions in water systems. The capacity of CDs to detect contaminants in wastewater -including heavy metals- can be found in the literature; however, to the best of our knowledge, none of them discusses the most recent strategies to enhance their performance. Therefore, in this review, beyond presenting successful examples of the use of CDs for the detection of metal ions, we further discuss the strategies to enhance their photoluminescence properties and their performance for environmental monitoring. In this manner, strategies such as heteroatom-doping and surface passivation are reviewed in detail, as well as describing the mechanisms and the effect of precursors and synthesis methods. Finally, the current challenges are described in detail to propose some recommendations for further research.

Biosensors for the detection of disease outbreaks through wastewater-based epidemiology.

Wastewater-Based Epidemiology (WBE) is a novel community-wide monitoring tool that provides comprehensive real-time data of the public and environmental health status and can contribute to public health interventions, including those related to infectious disease outbreaks (e.g., the ongoing COVID-19 pandemic). Nonetheless, municipalities without centralized laboratories are likely still not able to process WBE samples. Biosensors are a potentially cost-effective solution to monitor the development of diseases through WBE to prevent local outbreaks. This review discusses the economic and technical feasibility of eighteen recently developed biosensors for the detection and monitoring of infectious disease agents in wastewater, prospecting the prevention of future pandemics.

Pathways Involved in the Development of Vasculogenic Mimicry in Canine Mammary Carcinoma Cell Cultures.

Vasculogenic mimicry (VM) is the ability of highly aggressive cancer cells to form fluid-conducting channels that facilitate the nutrition and metastasis of cancer cells. Considering the importance of VM in the prognosis of canine mammary gland tumours, this study aimed to investigate global gene expression in two canine mammary carcinoma cell cultures associated with the capacity for VM in vitro. The cell lines were subjected to an in-vitro assay to form VM channels (3D culture). Each cell line was then used in 2D conditions as controls and we compared the global gene expression with that of the 3D cultures. A total of 1,217 differentially expressed genes (DEGs) (P <0.05, fold change >2.0 or <2.0) were observed in 3D conditions compared with 2D culture in the UNESP-CM9 cell line, of which 677 were upregulated genes and 540 were downregulated. In contrast, the UNESP-CM60 cell line had only one upregulated and two downregulated genes. Overall, we identified several genes and pathways involved in the development of VM and these molecular data will be useful for future studies aimed at identifying diagnostic and therapeutic targets for VM in canine mammary carcinoma.

Saccharomyces boulardii CNCM I-745 supplementation modifies the fecal resistome during Helicobacter pylori eradication therapy.

BACKGROUND: The gut microbiota is a significant reservoir of antimicrobial resistance genes (ARGs). The use and misuse of antimicrobials can select multi-resistant bacteria and modify the repertoire of ARGs in the gut. Developing effective interventions to manipulate the intestinal resistome would allow us to modify the antimicrobial resistance risk. MATERIALS AND METHODS: Applying shotgun metagenomics, we compared the composition of fecal resistome from individuals treated with triple therapy for Helicobacter pylori plus Saccharomyces boulardii CNCM-I 745 (Sb) versus triple antibiotherapy without S. boulardii (control) before, after, and one month after treatments. DNA samples were sequenced on an Illumina NovaSeq 6000 platform. Reads were trimmed and filtered for quality, and the reads classified as host genome were removed from further analysis. We used the ResFinder database for resistome analysis and the web-based tool ResistoXplorer and RStudio for graphical representation and statistical analysis. RESULTS: We identified 641 unique ARGs in all fecal samples, conferring resistance to 18 classes of antibiotics. The most prevalent ARGs found in at least 90% of the samples before the treatments were against tetracyclines, MLS-B (macrolide, lincosamide, and streptogramin B), beta-lactams, and aminoglycosides. Differential abundance analysis allowed the identification of ARGs significantly different between treatment groups. Thus, immediately after the treatments, the abundance of ARGs that confer resistance to lincosamides, tetracyclines, MLS-B, and two genes in the beta-lactam class (cfxA2 and cfxA3) was significantly lower in the group that received Sb than in the control group (edgeR, FDR <0.05). CONCLUSION: Our study demonstrated that the addition of S. boulardii CNCM-I 745 to the conventional antibiotic eradication therapy for H. pylori reduced the abundance of ARGs, particularly those genes that confer resistance to lincosamides, tetracyclines, MLS-B, and a few genes in the beta-lactams class.

[Diagnostic and treatment alternatives for the correction of facial asymmetries: a literature review]. / Alternativas diagnósticas y de tratamiento para la corrección de asimetrías faciales: revisión bibliográfica.

Facial symmetry refers to a complete coincidence of each facial component on the sagittal plane, while asymmetry refers to the bilateral difference between these components. The presence of perfect bilateral symmetry is almost never present in human, so it is more common for individuals to predominate facial asymmetry. However, this condition can result from functional and esthetic problems. This research seeks to determine the alternatives, diagnosis and ideal treatment plan for the correction of each type of facial asymmetry through orthognathic surgery. For this purpose, a review of articles published between 2015 to date was carried out. Selecting those that were focused on describing or evaluating facial and dentofacial symmetry and asymmetry, type of diagnosis or treatment plan, including clinical cases. The Google search engine, SciELO and databases of medical interest, such as PubMed, PMC and Medigraphic were used. According to the research and treatments carried out during the last few years in the dental clinic, it has been proven that orthognathic treatment accompanied by previous planning is the best option for the management of skeletal facial asymmetries.

Pandemia de Covid-19 e Transtorno de Estresse Pós-traumático em Mulheres com Câncer de Mama / Covid-19 Pandemic and Post-Traumatic Stress Disorder in Women with Breast Cancer / Pandemia de Covid-19 y Trastorno de Estrés Postraumático en Mujeres con Cáncer de Mama

Introdução: Pacientes com câncer possuem um risco maior de contrair covid-19 e apresentar piores resultados. Objetivo: Avaliar o estresse pós-traumático advindo da pandemia de covid-19 em mulheres com câncer de mama. Método: Escala do Impacto do Evento ­ Revisada (IES-R) composta por 22 itens, em três subescalas (evitação, intrusão e hiperestimulação), que contemplam os critérios de avaliação de transtornos de estresse pós-traumáticos. O convite foi enviado via WhatsApp ou nas reuniões on-line de um núcleo de reabilitação para o câncer de mama juntamente com um link de um formulário do Google Docs e o Termo de Consentimento Livre e Esclarecido. Resultados: Participaram do estudo 50 mulheres que apresentaram idade entre 34 e 81 anos, 88% faziam uso de algum tipo de medicação para comorbidades e 10% usavam antidepressivos. As participantes não apresentaram transtornos de estresse pós-traumáticos, no entanto, os números mostraram que mulheres com idades mais avançadas apresentaram índices menores de transtornos de estresse pós-traumáticos: escala total (p=0,002), subescalas intrusão (p=0,001) e hiperestimulação (p=0,003). Houve também uma diferença significativa quanto à medicação antidepressiva para a escala total (p=0,032) e para as subescalas intrusão (p=0,026) e hiperestimulação (p=0,030). Conclusão: As participantes não apresentaram estresse pós-traumático, o que pode ter sido em razão de já frequentarem um núcleo de reabilitação para o câncer de mama que oferece uma assistência integral, inclusive durante a pandemia (atendimento on-line)

Introduction: Cancer patients are at higher risk of contracting COVID-19 and present worse outcomes. Objective: To evaluate COVID-19 pandemic post-traumatic stress disorder in women with breast cancer. Method: The Event Impact Scale ‒ Revised (IES-R) was used, consisting of 22 items, in 3 subscales (avoidance, intrusion and hyperstimulation), including criteria for evaluating post-traumatic stress disorders. The invitation was made through WhatsApp or in online meetings of a rehabilitation center for women with breast cancer, further to a link to a Google Docs form and the Informed Consent Form (ICF) sent electronically. Results: 50 women were enrolled, aged between 34 and 81 years, 88% in use of some type of comorbidities medication and 10% used antidepressants. Participants did not have posttraumatic stress disorders, however the figures showed that older women had lower rates of post-traumatic stress disorders: total scale (p=0.002), subscales intrusion (p=0.001) and hyperstimulation (p=0.003). There was also a significant difference of antidepressant medication for the total scale (p=0.032) and for the intrusion (p=0.026) and hyperstimulation (p=0.030) subscales. Conclusion: The participants did not present post-traumatic stress disorder, possibly due to the fact that they are already attending a breast cancer rehabilitation center that offers online comprehensive care during the pandemic as well

Introducción: Los pacientes con cáncer tienen mayor riesgo de contraer covid-19 y pejores resultados. Objetivo: Evaluar el trastorno de estrés postraumático de la pandemia covid-19 en mujeres con cáncer de mama. Método: Event Impact Scale ‒ Revised (IES-R), que consta de 22 ítems, en tres subescalas (evitación, intrusión e hiperestimulación), que incluyen los criterios para evaluar el trastorno de estrés postraumático. La invitación se realizó a través de WhatsApp o en reuniones online de un centro de rehabilitación para mujeres con cáncer de mama, se envió un enlace a un formulario de Google Docs y el Formulario de Consentimiento Informado por vía electrónica. Resultados: Participaron del estudio 50 mujeres, con edades comprendidas entre 34 y 81 años, el 88% utiliza algún tipo de medicación para las comorbilidades y el 10% utiliza antidepresivos. Las participantes no tenían trastornos por estrés postraumático, sin embargo, los números mostraron que las mujeres mayores tenían tasas más bajas de trastornos por estrés postraumático: escala total (p=0,002), subescalas de intrusión (p=0,001) e hiperestimulación (p=0,003). También hubo una diferencia significativa con respecto a la medicación antidepresiva para la escala total (p=0,032) y para las subescalas de intrusión (p=0,026) e hiperestimulación (p=0,030). Conclusión: Las participantes no presentaban trastorno de estrés postraumático, lo que puede deberse a que ya están asistiendo a un centro de rehabilitación de cáncer de mama que ofrece atención integral, incluso durante la pandemia (asistencia en línea)