Ultrastructural Changes in the Midgut of Brazilian Native Stingless Bee Melipona scutellaris Exposed to Fungicide Pyraclostrobin.

Melipona scutellaris is a Brazilian stingless bee that is important for pollinating wild flora and agriculture crops. Fungicides have been widely used in agriculture, and floral residues can affect forager bees. The goal of our study was to evaluate the effects of sublethal concentrations of pyraclostrobin on the midgut ultrastructure of M. scutellaris forager workers. The bees were collected from three non-parental colonies and kept under laboratory conditions. The bees were orally exposed continuously for five days to pyraclostrobin in syrup at concentrations of 0.125 ng a.i./µL (FG1) and 0.005 ng a.i./µL (FG2). The control bees (CTL) were fed a no-fungicide sucrose solution, and the acetone solvent control bees (CAC) received a sucrose solution containing acetone. At the end of the exposure, the midguts were sampled, fixed in Karnovsky solution, and routinely processed for transmission electron microscopy. Ultrastructural analysis demonstrated that both the fungicide concentrations altered the midgut, such as cytoplasmic vacuolization (more intense in FG1), the presence of an atypical nuclear morphology, and slightly dilated mitochondrial cristae in the bees from the FG1 and FG2 groups (both more intense in FG1). Additionally, there was an alteration in the ultrastructure of the spherocrystals (FG1), which could be the result of cellular metabolism impairment and the excretion of toxic metabolites in the digestive cells as a response to fungicide exposure. The results indicate that ingested pyraclostrobin induced cytotoxic effects in the midgut of native stingless bees. These cellular ultrastructural responses of the midgut are a prelude to a reduced survival rate, as observed in previous studies.

Sensitivity of the Neotropical Solitary Bee Centris analis F. (Hymenoptera, Apidae) to the Reference Insecticide Dimethoate for Pesticide Risk Assessment.

Currently, only Apis mellifera is used in environmental regulation to evaluate the hazard of pesticides to pollinators. The low representativeness of pollinators and bee diversity in this approach may result in insufficient protection for the wild species. This scenario is intensified in tropical environments, where little is known about the effects of pesticides on solitary bees. We aimed to calculate the medium lethal dose (LD50) and medium lethal concentration (LC50) of the insecticide dimethoate in the Neotropical solitary bee Centris analis, a cavity-nesting, oil-collecting bee distributed from Brazil to Mexico. Males and females of C. analis were exposed orally to dimethoate for 48 h under laboratory conditions. Lethality was assessed every 24 h until 144 h after the beginning of the test. After the LD50 calculation, we compared the value with available LD50 values in the literature of other bee species using the species sensitivity distribution curve. In 48 h of exposure, males showed an LD50 value 1.33 times lower than females (32.78 and 43.84 ng active ingredient/bee, respectively). Centris analis was more sensitive to dimethoate than the model species A. mellifera and the solitary bee from temperate zones, Osmia lignaria. However, on a body weight basis, C. analis and A. mellifera had similar LD50 values. Ours is the first study that calculated an LD50 for a Neotropical solitary bee. Besides, the results are of crucial importance for a better understanding of the effects of pesticides on the tropical bee fauna and will help to improve the risk assessment of pesticides to bees under tropical conditions, giving attention to wild species, which are commonly neglected. Environ Toxicol Chem 2023;42:2758-2767. © 2023 SETAC.

Mechanical and morphological responses of osteoblast-like cells to two-photon polymerized microgrooved surfaces.

Microgrooved surfaces are recognized as an important strategy of tissue engineering to promote the alignment of bone cells. In this work, we have investigated the mechanical and morphological aspects of osteoblasts cells after interaction with different micro-structured polymeric surfaces. Femtosecond laser writing technique was used for the construction of circular and parallel microgrooved patterns in biocompatible polymeric surfaces based on pentaerythritol triacrylate. Additionally, we have studied the influence of the biocompatible TiO2 nanocrystals (NCs) related to the cell behavior, when incorporated to the photoresin. The atomic force microscopy technique was used to investigate the biomechanical reaction of the human osteoblast-like MG-63 cells for the different microgroove. It was demonstrated that osteoblasts grown on circular microgrooved surfaces exhibited significantly larger Young's modulus compared to cells sown on flat films. Furthermore, we could observe that TiO2 NCs improved the circular microgrooves effects, resulting in more populated sites, 34% more elongated cells, and increasing the cell stiffness by almost 160%. These results can guide the design and construction of effective scaffold surfaces with circular microgrooves for tissue engineering and bone regeneration.

Krüppel-like factor 6 participates in extravillous trophoblast cell differentiation and its expression is reduced in abnormally invasive placenta.

Trophoblast cell differentiation is of paramount importance for successful pregnancy. Krüppel-like factor 6 (KLF6), a transcription factor with diverse roles in cell physiology and tumor biology, is required for trophoblast differentiation through the syncytial pathway. Herein, we demonstrate that extravillous trophoblast (EVT) cell migration and mesenchymal phenotype are increased upon KLF6 downregulation or the expression of a deletion mutant lacking its transcriptional regulatory domain (KΔac). Raman spectroscopy revealed molecular modifications compatible with increased differentiation in cells stably expressing the KΔac mutant. Moreover, abnormally invasive placenta showed lower KLF6 immunostaining compared with the normal placenta. Thus, impaired KLF6 expression or function stimulates EVT migration and differentiation in vitro and may contribute to the physiopathology of the abnormally invasive placenta.

Tuning the photoluminescence by engineering surface states/size of S, N co-doped carbon dots for cellular imaging applications.

In this research, we have synthesized carbon dots (CDs) co-doped with nitrogen and sulfur by facile hydrothermal method, using citric acid and cysteine as carbon source. The effect of solid-state thermic treatment (STT) at 303-453 K on the size, surface, fluorescence and cellular cytotoxicity of the CDs were systematically investigated. Through a simple STT, it was possible to tune surface states and the average size of the CDs, causing a permanent red shift. Initially, CDs showed a decrease in cell viability with increasing concentration. However, after STT, its viability remained constant with an increase in concentration. Here, we show the possibility to label the cells cytoplasm according to the CDs fluorescence emission before (blue emission) and after STT (red emission). The CDs studied in this paper show selective luminescence properties, which are fundamental for any cell imaging application.

Consequences of thimerosal on human erythrocyte hemoglobin: Assessing functional and structural protein changes induced by an organic mercury compound.

BACKGROUND: Thimerosal (TM) is an organic mercury compound used as a preservative in many pharmacological inputs. Mercury toxicity is related to structural and functional changes in macromolecules such as hemoglobin (Hb) in erythrocytes (Ery). METHOD: Human Hb and Ery were used to evaluate O2 uptake based on the TM concentration, incubation time, and temperature. The influence of TM on the sulfhydryl content, production of reactive oxygen species (ROS), and membrane fragility was also evaluated. Raman spectra and atomic force microscopy (AFM) profiles for Ery in the presence and absence of TM were calculated, and docking studies were performed. RESULTS: At 37 °C, with 2.50 µM TM (higher concentration) and after 5 min of incubation in Hb and Ery, we observed a reduction in O2 uptake of up to 50 %, while HgCl2, which was used as a positive control, showed a reduction of at least 62 %. Total thiol assays in the presence of NEM (thiol blocker) quantified the preservation of almost 60 % of free SH in Ery. Based on the Raman spectrum profile from Ery-TM, structural differences in the porphyrinic ring and the membrane lipid content were confirmed. Finally, studies using AFM showed changes in the morphology and biomechanical properties of Ery. Theoretical studies confirmed these experimental results and showed that the cysteine (Cys) residues present in Hb are involved in the binding of TM. CONCLUSION: Our results show that TM binds to human Hb via free Cys residues, causing conformation changes and leading to harmful effects associated with O2 transport.

Krüppel-like factor 6 (KLF6) requires its amino terminal domain to promote villous trophoblast cell fusion.

INTRODUCTION: Villous cytotrophoblast (vCTB) cells fuse to generate and maintain the syncytiotrophoblast layer required for placental development and function. Krüppel-like factor 6 (KLF6) is a ubiquitous transcription factor with an N-terminal acidic transactivation domain and a C-terminal zinc finger DNA-binding domain. KLF6 is highly expressed in placenta, and it is required for proper placental development. We have demonstrated that KLF6 is necessary for cell fusion in human primary vCTBs, and in the BeWo cell line. MATERIALS AND METHODS: Full length KLF6 or a mutant lacking its N-terminal domain were expressed in BeWo cells or in primary vCTB cells isolated from human term placentas. Cell fusion, gene and protein expression, and cell proliferation were analyzed. Moreover, Raman spectroscopy and atomic force microscopy (AFM) were used to identify biochemical, topography, and elasticity cellular modifications. RESULTS: The increase in KLF6, but not the expression of its deleted mutant, is sufficient to trigger cell fusion and to raise the expression of ß-hCG, syncytin-1, the chaperone protein 78 regulated by glucose (GRP78), the ATP Binding Cassette Subfamily G Member 2 (ABCG2), and Galectin-1 (Gal-1), all molecules involved in vCTB differentiation. Raman and AFM analysis revealed that KLF6 reduces NADH level and increases cell Young's modulus. KLF6-induced differentiation correlates with p21 upregulation and decreased cell proliferation. Remarkable, p21 silencing reduces cell fusion triggered by KLF6 and the KLF6 mutant impairs syncytialization and decreases syncytin-1 and ß-hCG expression. DISCUSSION: KLF6 induces syncytialization through a mechanism that involves its regulatory transcriptional domain in a p21-dependent manner.

Serum From Preeclamptic Women Triggers Endoplasmic Reticulum Stress Pathway and Expression of Angiogenic Factors in Trophoblast Cells.

Preeclampsia (PE) is a hypertensive disease of pregnancy-associated with placental cell death and endoplasmic reticulum (ER) stress. It is unknown whether systemic factors aggravate placental dysfunction. We investigated whether serum factors in pregnant women with PE activate ER stress and unfolded protein responses (UPRs) in placental explants and trophoblast cells lineage. We cultured placental explants from third-trimester term placentas from control non-preeclamptic (NPE) pregnant women with serum from women with PE or controls (NPE). In PE-treated explants, there was a significant increase in gene expression of GADD34, CHOP, and SDF2. At the protein level, GRP78, SDF2, p-eIF2α, and p-eIF2α/eIF2α ratio were also augmented in treated explants. Assays were also performed in HTR8/SV-neo trophoblast cell line to characterize the putative participation of trophoblast cells. In PE serum-treated protein levels of p-eIF2a and the ratio p-elF2 α/elF2α increased after 12 h of treatment, while the gene expression of GADD34, ATF4, and CHOP was greater than control. Increased expression of SDF2 was also detected after 24 h-cultured HTR8/SV-neo cells. PE serum increased sFLT1 gene expression and decreased PlGF gene expression in placental explants. Morphologically, PE serum increased the number of syncytial knots and reduced placental cell metabolism and viability. Analysis of the serum of pregnant women with PE through Raman spectroscopy showed changes in amino acids, carotenoids, lipids, and DNA/RNA, which may be associated with the induction of ER stress found in chorionic villi treated with this serum. In conclusion, this study provides evidence that the serum of pregnant women with PE may impact placental villi changing its morphology, viability, and secreted functional factors while triggers ER stress and an UPR. The differences between PE and control sera include molecules acting as inducing factors in these processes. In summary, the results obtained in our assays suggest that after the development of PE, the serum profile of pregnant women may be an additional factor that feeds a continuous imbalance of placental homeostasis. In addition, this study may expand the possibilities for understanding the pathogenesis of this disorder.

Temperature-dependence on the optical properties of chitosan carbon dots in the solid state.

We report the synthesis of chitosan-derived aminated carbon dots with dual fluorescence bands and their influence on the morphology, absorption and emission spectral profiles as well as on the band gap energy in relation to thermal treatment after synthesis. To unravel these changes, we performed spectroscopic measurements in the solid state on two stages at temperatures ranging from 303 to 453 K. For the first heating stage, the emission spectrum showed a 20 nm red shift and a new absorption band at 350 nm, possibly related to new bonds and/or nitrogenous molecular fractions. For the second heating stage in the same temperature range, no displacements in the emission spectrum were observed and both the energy gap and bandwidths for the two emission bands are practically constant, indicating a change nitrogen moiety exposed on the surface. Furthermore, through atomic force microscopy it was noted that the morphology and size of the CDs were not significantly affected by the increase in temperature. It is noteworthy that the values of the Huang-Rhys factor, respectively, 2.584 × 10-10 and 2.315 × 10-9 for band I and II emission after the second heating indicate a mechanism of weak electron-phonon interactions. This work may open a novel perspective for the development of new surface modulation strategies for carbon dots subjected to thermal treatment in the solid state.

Flavonoids induce cell death in Leishmania amazonensis: in vitro characterization by flow cytometry and Raman spectroscopy.

Leishmaniasis comprises a group of infectious diseases with worldwide distribution, of which both the visceral and cutaneous forms are caused by Leishmania parasites. In the absence of vaccines, efficacious chemotherapy remains the basis for leishmaniasis control. The available drugs are expensive and associated with several secondary adverse effects. Due to these limitations, the development of new antileishmanial compounds is imperative, and plants offer various perspectives in this regard. The present study evaluated the in vitro leishmanicidal activity of flavonoids isolated from Solanum paludosum Moric. and investigated the mechanisms of cell death induced by them. These compounds were evaluated in vitro for their antileishmanial activity against Leishmania amazonensis promastigotes and they showed prominent leishmanicidal activity. The EtOAc fraction, gossypetin 3,7,8,4'-tetra-O-methyl ether (1), and kaempferol 3,7-di-O-methyl ether (3) were selected to be used in an in vitro assay against L. amazonensis amastigotes and cell death assays. The flavonoids (1) and (3) presented significant activity against L. amazonensis amastigotes, exhibiting the IC50 values of 23.3 ± 4.5 µM, 34.0 ± 9.6 µM, and 10.5 ± 2.5 µM for the EtOAc fraction, (1), and (3), respectively, without toxic effects to the host cells. Moreover, (1) and (3) induced blocked cell cycle progression at the G1/S transition, ultimately leading to G1/G0 arrest. Flavonoid (3) also induced autophagy. Using Raman spectroscopy in conjunction with principal component analysis, the biochemical changes in the cellular components induced by flavonoids (1) and (3) were presented. The obtained results indicated that the mechanisms of action of (1) and (3) occurred through different routes. The results support that the flavonoids derived from S. paludosum can become lead molecules for the design of antileishmanial prototypes.

Osteonecrose dos maxilares associada ao uso de bisfosfonatos: recidiva após radioterapia de cabeça e pescoço / Bisphosphonates osteonecrosis of the jaws: Recurrence after head and neck radiotherapy

O processo natural de remodelação óssea ocorre através de atividadescelulares, mediada principalmente por osteoblastos e osteoclastos.A interrupção desse processo pode levar a ocorrência de alterações como a osteonecrose. A osteonecrose é causada por diversos fatores, dentre eles locais e sistêmicos, destacando-se o uso de medicamentos e radioterapia. A osteonecrose dos maxilares associada ao uso de bisfosfonatos (ONB) é caracterizada pela presença de um osso necrótico exposto na cavidade bucal, por mais de 8 semanas, em pacientes tratados com este medicamento, sem o histórico de terem sido submetidos à radioterapia de cabeça e pescoço. Já osteorradionecrose (ORN), em conseqüência da radioterapia para tratamento de neoplasias malignas, reduz o potencial de vascularização do tecido ósseo, afetando a atividadecelular, a formação de colágeno e a capacidade de reparo do tecido, podendo levar à necrose. A ONB e ONR apresentam como principais sinais e sintomas: dor intensa, edema, parestesia, infecções, ulceração dos tecidos moles e alterações radiográficas. Por apresentarem características semelhantes, clinicamente a diferenciação entre a ONB e ORN se dá apenas pela história de uso ou não de bisfosfonatos. Este trabalho teve como objetivo abordar um caso sem precedentes, em que descreveu-se a recidiva de uma osteonecrose mandibular, após o debridamento cirúrgico e a infusão de PRP, em uma paciente que posteriormente foi submetida à radioterapia de cabeça e pescoço para tratamento de um caso de reincidência de um mieloma múltiplo (MM).

The natural bone remodeling process occurs mediated by osteoblasts and osteoclasts. Disturbances in this process may lead to osseous changes as osteonecrosis. Osteonecrosis is caused by several factors, including local and systemic factors, highlighting the use of drugs or radiation. The Bisphonates related osteonecrosis of the jaw (BRONJ) is characterized by the presence of an exposed necrotic bone in the oral cavity for more than 8 weeks in patients treated with this drug, with no history of being subjected to radiotherapy. Osteoradionecrosis (ORN), as a result of radiotherapy, reduces the vascularization potencial of bone, affectingcellular activity, the collagen formation and the capacity of tissue repair, leading to necrosis. As signs and symptoms of BRONJ and ONR is described: intense pain, edema, paresthesia, infection, ulceration, soft tissue and radiographic changes. Because they have similar characteristics, clinical differentiation between the BRONJ and ORN is given only by the history of bisphosphonates intake. This study aimed to discuss an unprecedented case in which was described an mandibular osteonecrosis relapse, after surgical debridement and the PRP infusion, in a patient who has subsequently submitted to radiotherapy for the treatment of a recurrence of multiple myeloma (MM) in head and neck region.

Low pressure support changes the rapid shallow breathing index (RSBI) in critically ill patients on mechanical ventilation / Baixos níveis de pressão de suporte alteram o índice de respiração rápida e superficial (IRRS) em pacientes graves sob ventilação mecânica

BACKGROUND: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. OBJECTIVE: To investigate the influence of low levels of pressure support (PS) on the RSBI value of ill patients. METHOD: Prospective study including 30 patients on mechanical ventilation (MV) for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (DragerTM Evita XL) and receiving pressure support ventilation (PSV) and 5 cmH2O of positive end expiratory pressure or PEEP (RSBI_MIN) and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP). Patients were divided into groups according to the outcome: successful extubation group (SG) and failed extubation group (FG). RESULTS: Of the 30 patients, 11 (37%) failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP), the values for RSBI_MIN were lower in both groups: SG (34.79±4.67 and 60.95±24.64) and FG (38.64±12.31 and 80.09±20.71; p<0.05). In the between-group comparison, there was no difference in RSBI_MIN (34.79±14.67 and 38.64±12.31), however RSBI_ESP was higher in patients with extubation failure: SG (60.95±24.64) and FG (80.09±20.71; p<0.05). CONCLUSIONS: In critically ill patients on MV for more than 72h, low levels of PS overestimate the RSBI, and the index needs to be measured with the patient breathing spontaneously without the aid of pressure support.

CONTEXTUALIZAÇÃO: O índice de respiração rápida e superficial (IRRS) tem sido o mais utilizado dentro das unidades de terapia intensiva (UTIs) como preditor do resultado do desmame, porém diferenças no método de obtenção têm gerado dúvidas quanto a seu valor preditivo. OBJETIVO: Verificar a influência de baixos níveis de pressão de suporte (PS) no valor do IRRS em pacientes graves. MÉTODO: Estudo prospectivo, incluindo 30 pacientes sob ventilação mecânica (VM) por 72 horas ou mais, prontos para extubação. Anteriormente à extubação, o IRRS foi obtido com o paciente conectado ao ventilador Evita-XL da DragerTM recebendo pressão de suporte ventilatório (PSV) e PEEP=5 cmH2O (IRRS_MIN) e, logo após, desconectado da VM e conectado a um ventilômetro de WrightTM, onde sua frequência respiratória e o volume corrente exalado eram registrados durante 1 minuto (IRRS_ESP). Os pacientes foram divididos de acordo com o desfecho em grupo sucesso extubação (GS) e grupo insucesso extubação (GI). RESULTADOS: Dos 30 pacientes, 11 (37%) falharam no processo de extubação. Na comparação intragrupos (IRRS_MIN x IRRS_ESP), os valores foram menores para o IRRS_MIN em ambos os grupos: GS (34,79±4,67 e 60,95±24,64) e GI (38,64±12,31 e 80,09±20,71) (p<0,05). Na comparação intergrupos não houve diferença entre IRRS_MIN (34,79±14,67 e 38,64±12,31), por outro lado, IRRS_ESP foi maior nos pacientes com falha na extubação: GS (60,95±24,64) e GI (80,09±20,71) (p<0,05). CONCLUSÃO: Em pacientes graves e sob VM acima de 72 horas, níveis mínimos de PS superestimam o IRRS, sendo necessária sua obtenção com o paciente respirando de forma espontânea sem o auxílio de PS.

Lung function monitoring in patients with duchenne muscular dystrophy on steroid therapy.

BACKGROUND: Duchenne muscular dystrophy (DMD) is a sex-linked inherited muscle disease characterized by a progressive loss in muscle strength and respiratory muscle involvement. After 12 years of age, lung function declines at a rate of 6 % to 10.7 % per year in patients with DMD. Steroid therapy has been proposed to delay the loss of motor function and also the respiratory involvement. METHOD: In 21 patients with DMD aged between seven and 16 years, the forced vital capacity (FVC) and the forced expiratory volume in one second (FEV1) were evaluated at three different times during a period of two years. RESULTS: We observed in this period of evaluation the maintenance of the FVC and the FEV1 in this group of patients independently of chronological age, age at onset of steroid therapy, and walking capacity. CONCLUSION: The steroid therapy has the potential to stabilize or delay the loss of lung function in DMD patients even if they are non-ambulant or older than 10 years, and in those in whom the medication was started after 7 years of age.

Low pressure support changes the rapid shallow breathing index (RSBI) in critically ill patients on mechanical ventilation.

BACKGROUND: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. OBJECTIVE: To investigate the influence of low levels of pressure support (PS) on the RSBI value of ill patients. METHOD: Prospective study including 30 patients on mechanical ventilation (MV) for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (DragerTM Evita XL) and receiving pressure support ventilation (PSV) and 5 cmH2O of positive end expiratory pressure or PEEP (RSBI_MIN) and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP). Patients were divided into groups according to the outcome: successful extubation group (SG) and failed extubation group (FG). RESULTS: Of the 30 patients, 11 (37%) failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP), the values for RSBI_MIN were lower in both groups: SG (34.79±4.67 and 60.95±24.64) and FG (38.64±12.31 and 80.09±20.71; p<0.05). In the between-group comparison, there was no difference in RSBI_MIN (34.79±14.67 and 38.64±12.31), however RSBI_ESP was higher in patients with extubation failure: SG (60.95±24.64) and FG (80.09±20.71; p<0.05). CONCLUSIONS: In critically ill patients on MV for more than 72h, low levels of PS overestimate the RSBI, and the index needs to be measured with the patient breathing spontaneously without the aid of pressure support.

Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy.

OBJECTIVE: To assess the evolution of motor function in patients with Duchenne muscular dystrophy (DMD) treated with steroids (prednisolone or deflazacort) through the Motor Function Measure (MFM), which evaluates three dimensions of motor performance (D1, D2, D3). METHODS: Thirty-three patients with DMD (22 ambulant, 6 non-ambulant and 5 who lost the capacity to walk during the period of the study) were assessed using the MFM scale six times over a period of 18 months. RESULTS: All the motor functions remained stable for 14 months in all patients, except D1 for those who lost their walking ability. In ambulant patients, D2 (axial and proximal motor capacities) motor functions improved during six months; an improvement in D3 (distal motor capacity) was noted during the total follow-up. D1 (standing posture and transfers) and total score were useful to predict the loss of the ability to walk. CONCLUSIONS: The use of the MFM in DMD patients confirms the benefits of the steroid treatment for slowing the progression of the disease.

Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy / Medida de função motora, corticoterapia e pacientes com distrofia muscular de Duchenne

OBJECTIVE: To assess the evolution of motor function in patients with Duchenne muscular dystrophy (DMD) treated with steroids (prednisolone or deflazacort) through the Motor Function Measure (MFM), which evaluates three dimensions of motor performance (D1, D2, D3). METHODS: Thirty-three patients with DMD (22 ambulant, 6 non-ambulant and 5 who lost the capacity to walk during the period of the study) were assessed using the MFM scale six times over a period of 18 months. RESULTS: All the motor functions remained stable for 14 months in all patients, except D1 for those who lost their walking ability. In ambulant patients, D2 (axial and proximal motor capacities) motor functions improved during six months; an improvement in D3 (distal motor capacity) was noted during the total follow-up. D1 (standing posture and transfers) and total score were useful to predict the loss of the ability to walk. CONCLUSIONS: The use of the MFM in DMD patients confirms the benefits of the steroid treatment for slowing the progression of the disease.

OBJETIVO: Avaliar a evolução da função motora de pacientes com distrofia muscular de Duchenne (DMD) em corticoterapia (predinisolona e deflazacort), por meio da escala Medida da Função Motora (MFM), que avalia três dimensões de funções motoras (D1, D2, D3). MÉTODOS: Trinta e três pacientes com DMD (22 deambulantes, seis cadeirantes e cinco que perderam a capacidade de andar ao longo do estudo) foram avaliados pela escala MFM em seis momentos durante 18 meses. RESULTADOS: Todas as funções motoras mantiveram-se estáveis durante 14 meses, exceto D1 para os pacientes que perderam a marcha. Nos pacientes deambulantes, a D2 (função motora axial e proximal) apresentou melhora durante seis meses. Melhora em D3 (função motora distal) também foi observada durante o seguimento. A D1 (postura em pé e transferências) e o escore total foram importantes para predizer a perda de marcha. CONCLUSÕES: O uso da MFM nos pacientes com DMD confirma os benefícios do tratamento com corticoides na diminuição da velocidade de progressão da doença.

Stress and anxiety in pregnant women exposed to ultrasound.

AIM: To investigate the levels of anxiety and stress during pregnancy among women who are routinely offered ultrasound at first and second trimesters. METHODS: This is a cross-sectional study involving 296 women, in which 146 pregnant women without any medical problem were compared with 150 nonpregnant women. Both groups were submitted to the Lipp Inventory of Stress Symptoms for Adults and to the State-Trait Anxiety Inventory. Logistic regression analysis was used to evaluate the effect of pregnancy on the anxiety and stress levels. RESULTS: There was no statistical difference between pregnant and nonpregnant women [56.8% (83/146) vs. 48.6% (73/150), odds ratio (OR) 1.39 95% confidence interval (CI) 0.88-2.19] regarding the level of stress. Logistic regression analysis demonstrated that the only significant independent predictor of stress was maternal age (OR 0.95, 95% CI 0.91-0.96; P = 0.045) for the pregnant women and monthly income and religious belief for the nonpregnant group. Pregnant women had a higher level of anxiety compared with the nonpregnant (15.7% vs. 2.6%, P = 0.0002) and ultrasound examination decreased the anxiety level. CONCLUSION: Pregnant women did not have a higher level of stress compared with the nonpregnant women, and maternal age is the only significant independent predictor of stress. Pregnant women are more anxious, and after the ultrasound examination, the level of anxiety decreased.

A enfermeira e o cuidado de enfermagem no pré-natal / The nurse and nursing care for the prenatal

Esta pesquisa qualitativa tem como objetivos: classificar os problemas apresentados pelas gestantes no decorrer da consulta pré-natal realizada por enfermeiras; identificar as terapêuticas de enfermagem prescritas para o atendimento da gestante de baixo risco...

Avaliaçäo da funçäo pulmonar em adolescentes com aumento da cifose torácica / A assessment of lung function in adolescents with increased thoracic kyphosis

Foi realizado um estudo da funçäo pulmonar em pacientes portadores de doença de Scheuermann ou dorso curvo postural juvenil, que apresentavam cifose torácica maior que 45 Graus Celsius e inferior a 80 Graus Celsius, sem sinais clínicos de outras patologias associadas. O estudo da funçäo pulmonar foi realizado por meio de espirometria, tendo sido avaliados a capacidade vital, capacidade pulmonar total, volume residual e volume expiratório forçado no primeiro segundo. Comparando-se os valores previstos com os observados das variáveis espirométricas estudadas, verificou-se que 28 por cento dos pacientes apresentavam disfunçäo ventilatória restritiva leve. Os resultados representam novo achado, ainda que sujeito a controvérsias, devendo ser melhor estudado, pois sua confirmaçäo introduzirá novo e importante tópico no tratamento e orientaçäo dos pacientes com aumento da cifose torácica.