Milk Contamination by Mycobacterium tuberculosis Complex, Implications for Public Health in Amazonas, Brazil.

ABSTRACT: In Brazil, contamination of raw milk with Mycobacterium tuberculosis complex (MTC) has been reported in several states. The highest rate of consumption of raw milk and its derivatives in Brazil occurs in Amazonas. This state also has the highest prevalence of tuberculosis in both humans and livestock. We assessed the contamination of cow's milk and buffalo's milk with MTC in Amazonas, focusing on Mycobacterium bovis, the species most commonly found in cattle and buffalo. In 2019, 250 samples of raw milk (91 from cattle, 159 from buffalo) were collected before processing from three milk plants in the state of Amazonas. The samples were placed into 21 pools and analyzed using shotgun metagenomic sequencing and taxonomic classification with Kraken 2 and MegaBLAST. To confirm the identity of mycobacterial species found, BLASTN was used to identify specific genomic positions in the TbD1 and RD1 regions and flanking RD4 region. MTC genetic material was identified in all pools of raw milk. Genetic material consistent with M. bovis was identified in seven pools of raw milk (1 from cattle, 6 from buffalo). Buffalo's milk had significantly higher MTC reads than did cow's milk. The common practice of consumption of raw milk and its derivatives in Amazonas presents a risk to public health. Urgent measures to prevent transmission of foodborne tuberculosis are needed in the Amazon region. Greater efforts and resources also should be directed toward elimination of bovine tuberculosis in cattle and buffalo herds in Amazonas and the rest of Brazil.

High fidelity defines the temporal consistency of host-parasite interactions in a tropical coastal ecosystem.

Host-parasite interactions represent a selective force that may reduce hosts' lifespan, their reproductive success and survival. Environmental conditions can affect host-parasite communities, leading to distinct patterns of interactions with divergent ecological and evolutionary consequences for their persistence. Here, we tested whether climatic oscillation shapes the temporal dynamics of bird-haemosporidian associations, assessing the main mechanisms involved in the temporal dissimilarity of their interactions' networks. For two years, we monthly sampled birds in a tropical coastal ecosystem to avian malaria molecular diagnosis. The studied networks exhibited high specialization, medium modularity, with low niche overlap among parasites lineages. Moreover, alpha and ß-diversity of hosts, parasites and their interactions, as well as the structure of their networks were temporally consistent, i.e., stable under fluctuations in temperature or precipitation over seasons. The structure and temporal consistency of the studied antagonistic networks suggest a high fidelity between partners, which is likely relevant for their evolutionary persistence.

Effect of Calendula officinalis cream on achilles tendon healing.

In recent years, the scientific community has undertaken research on plant extracts, searching for compounds with pharmacological activities that can be used in diverse fields of medicine. Calendula officinalis L. is known to have antioxidant, anti-inflammatory, antibacterial, and wound healing properties when used to treat skin burns. Therefore, the purpose of this study was to analyze the effects of C. officinalis on the initial phase of Achilles tendon healing. Wistar rats were separated in three groups: Calendula (Cal)-rats with a transected tendon were treated with topical applications of C. officinalis cream and then euthanized 7 days after injury; Control (C)-rats were treated with only vehicle after transection; and Normal (N)-rats without tenotomy. Higher concentrations of hydroxyproline (an indicator of total collagen) and non-collagenous proteins were observed in the Cal group in relation to the C group. Zymography showed no difference in the amount of the isoforms of metalloproteinase-2 and of metalloproteinase-9, between C and Cal groups. Polarization microscopy images analysis showed that the Cal group presented a slightly higher birefringence compared with the C group. In sections of tendons stained with toluidine blue, the transected groups presented higher metachromasy as compared with the N group. Immunocytochemistry analysis for chondroitin-6-sulfate showed no difference between the C and Cal groups. In conclusion, the topical application of C. officinalis after tendon transection increases the concentrations of collagen and non-collagenous proteins, as well as the collagen organization in the initial phase of healing.

New values anthropometry for classification of nutritional status in the elderly.

Anthropometry provides information on the physical status of the individual and can be associated with aspects of health including nutritional status. Currently, the stratification of the arm and calf circumferences is classified into only two situations: "malnourished" and "well-nourished". A total of 513 interviews were conducted, and 391 elderly people (≥ 65 years) completed the assessment using the Mini Nutritional Assessment (MNA) and anthropometry of selected samples of the population of Cuiabá-MT. The body mass index (BMI, kg/m2) was calculated for the elderly people, establishing five new reference values for circumferences, arm relaxed (RAC), abdomen (AC), and calf (CC) in centimeters (cm). The median age was 71 years (64% women and 36% men) and was correlated to the RAC (r=-0.180, p<0.001) and CC (r=-0.202, pp<0.001). The BMI obtained the median of 27 (15% malnourished, risk of malnutrition 13%, eutrophic 24%; overweight 33%, obese 16%), and it was correlated to the RAC (r=0.798, pp<0.001), AC (r=0.823 p p<0.001) and CC (r=0.605, pp<0.001). The MNA was 26 (malnourished 13.8%, risk of malnutrition 12.3%, well-nourished, 73.9%). The BMI stratification by morbidity vs no morbidity was 27.50 (n=287) and 24.4 (n=104) to total sample respectively (pp<0,05). The RAC x AC (r=0.798, pp<0.001), RAC x CC (r=0.648, pp<0.001), and CC x AC (r=0.496, pp<0.001) were correlated between themselves. The eutrophic classification by circumference for both genders: RAC=27.1-29.00 cm, AC=88.1-95.00 cm, CC=32.60-33.00 cm. There are more overweight and obese than malnourished, which is a risk factor for morbidity and MNA only identifies malnutrition. Circumferences showed good association with BMI and are easy to apply. Therefore, the proposal of the circumferences can simplify and expand the nutritional assessment.

Propriedades farmacológicas da Aloe vera (L. ) Burm. f / Pharmacological activities of Aloe vera (L. ) Burm. f

A Aloe vera (L.) Burm.f. tem sido utilizada há milhares de anos na medicina tradicional para o tratamento de diversos males. O intuito desse trabalho foi o levantamento bibliográfico de artigos que evidenciassem a atividade farmacológica da Aloe vera. A revisão contemplou livros e periódicos nacionais e internacionais indexados nas bases de dados MEDLINE, LILACS e SciElo, nos idiomas português, inglês e espanhol, utilizando as palavras-chave citadas. Após o levantamento bibliográfico, constatou-se que várias atividades biológicas são atribuídas a Aloe vera. Evidências sugerem eficácia no tratamento da psoríase, herpes genital, queimaduras e hiperglicemia. Além disto, também foram demonstradas atividades antineoplásica, antimicrobiana, anti-inflamatória e imunomodulatória por estudos in vitro e in vivo, entretanto, na cicatrização de feridas, os resultados foram conflitantes. No tratamento de dermatite por radiação e em queimaduras solares sua eficácia não foi comprovada e foram relatados casos de hepatite aguda devido ao consumo de preparações orais. Tendo em vista as várias atividades comprovadas e poucos relatos acerca de sua contra indicação, conclui-se que o uso desta espécie corrobora o vasto uso popular.

The Aloe vera (L.) Burm.f. has been used for thousands of years in traditional medicine to treat various ailments. The aim of this study was to carry out a bibliographical review on the pharmacological activity of Aloe vera. This review included books and national and international journals indexed to MEDLINE, LILACS and SciELO, in Portuguese, English and Spanish, using the key words mentioned. After the literature review, we found that several biological activities have been attributed to Aloe vera. Evidence suggests efficacy in the treatment of psoriasis, genital herpes, burns and hyperglycemia. Moreover, antineoplastic, antimicrobial, anti-inflammatory and immunomodulatory activities have also been demonstrated by in vitro and in vivo studies; however, in wound healing, the results were conflicting. In the treatment of radiation dermatitis and sunburn, its efficacy has not been proven, and cases of acute hepatitis from the consumption of oral preparations have been reported. Considering the various proven activities and the few reports about the contraindications of Aloe vera, we conclude that the use of this species confirms its wide popular usage.

Structural and biochemical alterations during the healing process of tendons treated with Aloe vera.

AIMS: The tendon is composed of highly organized collagen fibers that form a complex supramolecular structure. After lesions, the organization and composition of the tendon are not completely restored. Our purpose was to evaluate if the application of Aloe vera improves tendon healing, considering the effectiveness in the stimulus of collagen synthesis. MAIN METHODS: The calcaneal tendon of male Wistar rats was partially transected with subsequent topical application of A. vera ointment at the injury. The animals were separated into groups with tendons treated with the A. vera extract for 7days and excised on the 7th, 14th and 21st days after surgery; control rats received only ointment base without plant extract. KEY FINDINGS: Morphological analysis using polarization microscopy showed that the entire tendon undergoes a remodeling process, with disorganized collagen fibers by days 7 and 14 in plant-treated and non-treated groups and with a higher birefringence in tendons of the plant-treated group on the 21st day. A higher concentration of hydroxyproline was found in plant-treated tendons on days 7 and 14 compared with their controls. Western blots showed lower amounts of type I collagen in the plant-treated group on day 14 compared with the control. MMP-9 diminished 14days after lesion and the active isoform of MMP-2 increased on day 21 in plant-treated groups. SIGNIFICANCE: The present study indicates a beneficial effect of A. vera in the tissue reorganization in the transected region of the tendon 21days after injury and is supported by an increase of active MMP-2.

Liposomes incorporating essential oil of Brazilian cherry (Eugenia uniflora L.): characterization of aqueous dispersions and lyophilized formulations.

Multilamellar liposomes incorporating essential oil of Brazilian cherry (Eugenia uniflora L.) leaves were produced by dry film hydration. Gas chromatography demonstrated the compounds found in the essential oil were effectively incorporated in the aqueous dispersions of liposomes. Differential scanning calorimetry analyses revealed the incorporation of the essential oil did not cause phase separation in the membrane structure; the gel-liquid crystalline transition temperature (main transition) remained the same despite the higher heterogeneity indicated by the transition peak broadening. Different cryoprotectors (sucrose and trehalose) were added to the liposomal formulations to be tested in their ability to protect the liposomal structure during the lyophilization. The morphological aspect of the lyophilized powders analysed by scanning electron microscopy showed significant differences among the samples with and without cryoprotectors. Fourier-transform infrared spectroscopy indicated the cryoprotectors interacted effectively with the polar heads of phospholipids in the bilayer. In terms of water absorption, trehalose was identified as a much more effective protector agent against it than sucrose. The cryoprotectors showed different degrees of effectiveness of preservation of the liposomal structure when the rehydration assays of lyophilized liposomes were carried out, as particle size measurements indicated a moderate process of fusion when the formulations with sucrose were rehydrated.

In vitro degradation of linamarin by microorganisms isolated from cassava wastewater treatment lagoons

This study aimed at isolating and characterizing of microorganisms able to use linamarin as sole carbon source. Thirty one microbial strains were isolated from manipueira, a liquid effluent of cassava processing factories. Among these strains, Bacillus licheniformis (isolate 2_2) and Rhodotorulla glutinis (isolate L1) were able to degrade 71 percent and 95 percent of added linamarin, respectively, within 7 days, showing high biodegradation activity and great potential for detoxification of cassava processing wastewaters.

In vitro degradation of linamarin by microorganisms isolated from cassava wastewater treatment lagoons.

This study aimed at isolating and characterizing of microorganisms able to use linamarin as sole carbon source. Thirty one microbial strains were isolated from manipueira, a liquid effluent of cassava processing factories. Among these strains, Bacillus licheniformis (isolate 2_2) and Rhodotorulla glutinis (isolate L1) were able to degrade 71% and 95% of added linamarin, respectively, within 7 days, showing high biodegradation activity and great potential for detoxification of cassava processing wastewaters.

Cashew gum microencapsulation protects the aroma of coffee extracts.

Microencapsulation of materials rich in volatile compounds by spray drying presents the challenge of removing water by vapourization without loss of odour and/or flavour components. Crioconcentrated coffee extracts rich in odour components were used as a substrate core to evaluate microencapsulation with cashew gum from Anacardium occidentale L. In Brazil, cashew gum is a low cost alternative to the traditional Arabic gum. A suspension containing coffee extract and the wall material was dissolved in water and then passed through a spray dryer. Core microcapsules were microwave-assisted extracted (MAE) and the aroma protection of the microcapsules produced was evaluated using gas chromatography and mass spectroscopy (GC/MS). The external morphology and size distribution of the microcapsules were obtained by scanning electron microscopy (SEM) and light scattering techniques, respectively. When comparing Arabic and cashew gum microencapsulation of coffee extracts both wall materials were observed to have similar aroma protection, external morphology and size distribution. Sensory analysis was employed to examine flavour protection and consumer preference with microencapsulation. These biochemical, sensory and structural data suggest that low cost cashew gum is a well suited alternative for odour microencapsulation to the more costly Arabic gum currently used in Brazil.

Endoscopic dacryocystorhinostomy vs KTP 532 laser-assisted endoscopic dacryocystorhinostomy.

OBJECTIVES: Advances in endoscopy and lasers have improved surgical management of chronic nasolacrimal duct obstruction. This is a preliminary comparison between standard and laser assisted endoscopic dacryocystorhinostomy (DCR). STUDY DESIGN: Combined retrospective and prospective study. SETTING: Tertiary referral hospital. PATIENTS AND METHODS: Thirty-eight cases of chronic nasolacrimal duct obstruction underwent endoscopic DCR (26 standard and 12, laser-assisted) and were assessed at 3 and at 6 months postoperatively by nasal endoscopy. RESULTS: Three months postoperatively (n=38), total relief of epiphora among the nonlaser group was 80.76 vs 75% in the laser group (P=0.982). At 6 months (n=19), the laser group had recorded 100% symptomatic relief compared to 85.71% in the nonlaser group (P=0.964). The laser group suffered fewer complications (33.33 vs 46.15% for nonlaser group). CONCLUSION: Lasers show promise in long-term management of duct obstruction and are associated with fewer complications. A larger study is required before and generalization is made.

Diel vertical migration of copepods in a Brazilian lake: a mechanism for decreasing risk of Chaoborus predation?

A comparison between two studies on diel vertical migration of two cyclopoid copepod species, in Lake Monte Alegre, undertaken in 1985/86 and 1999, revealed a change in their migratory behavior. In summer, during a period of marked stratification with low dissolved oxygen near the bottom, the organisms avoided the deepest layers, and migration was nocturnal or undetectable, in both periods. On other occasions, with partial or total circulation in the lake, a weak twilight migration of copepodites and adults in 1985 was replaced by the reverse in 1999. Differences were found among stages, with the weakest or undetectable migration being observed for nauplii. The migratory pattern change for copepodites and adults might be related with a recent predation pressure increase by Chaoborus larvae on copepods, after the virtual disappearance of their main cladoceran prey.

Diel vertical migration of copepods in a Brazilian lake: a mechanism for decreasing risk of Chaoborus predation?

A comparação entre dois estudos sobre migração vertical diária de duas espécies de copépodos ciclopóides no Lago Monte Alegre, realizados entre 1985/86 e 1999, revelou mudança em seu comportamento migratório. No verão, durante período de marcada estratificação, com pouco oxigênio dissolvido próximo ao fundo, as camadas mais profundas foram evitadas pelos organismos e a migração foi noturna ou não ocorreu. Em outras ocasiäes, com circulação parcial ou total do lago, uma fraca migração crepuscular de copepoditos e adultos, em 1985, foi substituída por reversa em 1999. Foram encontradas diferenças entre os estágios, sendo que os náuplios não migraram ou migraram fracamente. A mudança do padrão migratório de copepoditos e adultos poderia estar relacionada a recente aumento da predação de copépodos por larvas de Chaoborus, depois do desaparecimento virtual do cladócero, sua presa principal.

[Social representations of the care given to the elderly by health professionals in a nursing home]. / Representaciones sociales del cuidado del anciano en trabajadores de salud en un ancianato.

This study aimed at identifying the social representations of the care given to the elderly by caregivers in a nursing home. Fifteen caregivers aged 28 to 32 years old who worked in a nursing home in the city of Ribeirão Preto, São Paulo, Brazil were subjects for this work and the Theory of Social Representations was used as reference. Data were collected by means of semi-structured interviews and analyzed by content analysis, which enabled the elaboration of categories, thus facilitating comprehension. Among such categories are: informal education, formal education, satisfaction, sadness, modes of confrontation and denegation.

Prognosis in patients with heart failure and preserved left ventricular systolic function.

BACKGROUND: It is recognized that heart failure patients with preserved left ventricular systolic function have better prognosis; nevertheless, there are some studies with conflicting results. Also, there is a paucity of data concerning the prognostic factors in this group of patients. OBJECTIVES: To determine possible variables with prognostic relevance in heart failure patients with preserved left ventricular systolic function (ejection fraction > 40%). METHODS: 157 consecutive ambulatory patients with heart failure were assessed; those patients with ejection fraction > 40% were included in the study (n = 46). All patients were evaluated by clinical interview and physical examination, ECG, echocardiogram (M-mode, 2D and pulsed Doppler of mitral flow), biochemical study and determination of type B natriuretic peptide (BNP). The patients were grouped according to the rhythm presented on ECG: Group I--patients with atrial fibrillation; Group II--patients in sinus rhythm Group II was further subdivided in two groups according to the presence or absence of restrictive left ventricular filling pattern. All patients had a clinical follow-up, with recording of events (death or hospitalization from cardiac cause). The mean follow-up time was 682.2 +/- 55 days. RESULTS: The mean age of the patients was 70.4 +/- 1.2 years; 54.3% were women; mean ejection fraction was 49.6 +/- 1%; mean BNP levels were 202.9 +/- 41.3 pg/ml. Mortality was 19.6% and the combined event death or hospitalization from cardiac cause) occurred in 26.1% of the patients. Among the clinical, demographic, biochemical, echocardiographic and neurohumoral parameters, only BNP levels had prognostic significance in the whole population. In Group II patients, BNP levels, heart rate and restrictive left ventricular filling pattern were identified as having prognostic significance. Kaplan-Meyer curve analysis showed that both BNP and restrictive left ventricular filling pattern seemed to be important prognostic markers. CONCLUSIONS: This preliminary study suggests thar neurohumoral activity (determined by plasma BNP levels) and a restrictive ventricular filling pattern may be important factors in prognostic stratification of heart failure patients with preserved left ventricular systolic function.

Echocardiographic patterns and prognosis in heart failure.

BACKGROUND: There are many variables with prognostic value in patients with heart failure (HF). Those related to left ventricular function are among the most important. Recently, the evaluation of the patterns of ventricular filling by pulsed Doppler echocardiography has been studied as a variable with prognostic value. OBJECTIVES: To evaluate the prognostic value of echocardiography variables (diastolic and systolic) in patients with HF. These variables were analysed in respect to hospital admission for cardiovascular reasons or death. MATERIAL AND METHODS: We evaluated 157 consecutive patients with HF and included 110 patients who were in sinus rhythm. The mean age was 68.2 +/- 0.9 years. HF was ischemic in 52.7%. Patients underwent echocardiography examination within the week of reference. The patients were grouped according to left ventricular (LV) systolic dysfunction (LV ejection fraction < 40%). We also classified patients in two groups according to the presence of a restrictive pattern in diastolic transmitral flow profile. Finally, we classified all patients in four groups according to their systolic function and diastolic pattern: Group I--systolic dysfunction and restrictive ventricular filling pattern. Group II--systolic dysfunction without restrictive ventricular filling pattern. Group III--without systolic dysfunction with restrictive ventricular filling pattern. Group IV--without systolic dysfunction without restrictive ventricular filling pattern. The events were death or hospital admission. The mean follow up time was 625 +/- 55 days. We did a statistical analysis and for all tests a p value < 0.05 was considered statistically significant. RESULTS: We found impaired LV systolic function (systolic HF) in 73.6% and restrictive ventricular filling pattern in 45.5%. During the follow-up 41.8% died or were admitted to hospital. Patients with systolic HF had lower admission free survival rate. Patients with restrictive ventricular filling pattern had lower admission free survival rate than those without. Group I had lower admission free survival rate than Group II and Group IV. Group IV had a higher admission free survival than all other Groups. CONCLUSIONS: These results support and expand previous observations that diastolic function variables, such as the pattern of ventricular filling (namely the restrictive) have independent prognostic value in patients with HF.

[Role of the family in the care of an elderly person with cerebrovascular disease]. / Representaciones del cuidador familiar. Ante el anciano con ACV.

This study tries to identify the roles family members have in the care of an elderly person experiencing the effects of cerebral-vascular disease in the home and the main strategies to employ in the treatment of such a patient. The theoretical methodological procedure was based on a psychological project, a historical drawing about a theme, in which five subjects who were caretakers drew two achromatic pictures narrating corresponding stories individually in their homes. This form of expression allowed the project designers to have an interpretation of the daily situations involved in the care of these patients. In the first analysis phase, we drew the conclusion that caretakers construct their own particular knowledge system regarding the care of the elderly patient in their home. We verified that this construction started with a network relating common, daily elements which are interwoven in the treatment process occurring within a specific social milieu which as a result generates strategies that rely heavily on common sense knowledge in the manner of carrying out this social function.

[Family care for elderly patients with cerebrovascular accident sequelae]. / O cuidado familiar ao idoso com seqüela de acidente vascular cerebral.

This study had as objectives to identify the nature of the family care given to the elderly with sequels of Cerebral Vascular Accident (AVC); to understand its major problems; and to discuss its meaning from the caregiver's vision. It was developed through a qualitative/descriptive methodology. The subjects, five caregivers of elderly with sequels of Cerebral Vascular Accident, were interviewed at their homes. Semi-structured interviews and the projective technique (story drawing with a theme proposed by Trinca) were used. The data analysis was done through thematic analysis (the first phase of the Enunciation Analysis recommended by d'Unrug, in Bardin, 1994) which rose the following categories: "nature of the family care"; "social-economic changes of the caregiver"; "emotional and physical burnout of the caregiver"; and "the meaning of the family care". The results allowed a characterization of the caregivers group and the identification of total care to the elderly.

Problem-posing in education: transformation of the practice of the health professional.

This study was developed by a group of professionals from different areas (nurses and educators) concerned with health education. It proposes the use of a problem-posing model for the transformation of professional practice. The concept and functions of the model and their relationships with the educative practice of health professionals are discussed. The model of problem-posing education is presented (compared to traditional, "banking" education), and four innovative experiences of teaching-learning are reported based on this model. These experiences, carried out in areas of environmental and occupational health and patient education have shown the applicability of the problem-posing model to the practice of the health professional, allowing transformation.