Assessing the potential fasting and postprandial mechanisms involved in the acute hypoglycemic and anti-hyperglycemic effects of four selected plants from Iran used in traditional Persian medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: In traditional Persian medicine (TPM), people often use herbal infusions as a dosage form to treat diseases related to hyperglycemia, known as 'dam-kardeh'. Traditionally, herbal preparations of Eryngium bungei Boiss. (E. b), Tragopogon buphthalmoides (DC.) Boiss. (T. b), Salvia hydrangea DC. ex Benth. (S. h), and Juniperus polycarpos K. Koch. (J. p) are used to manage diabetes in Iran. However, there is no evidence of their effectiveness in controlling glucose levels and their mechanisms remain unclear. AIM OF THE STUDY: This study aimed to investigate whether traditional doses of plant infusions can have hypoglycemic and/or anti-hyperglycemic effects during fasting and/or postprandial states and establish the basis for future research on their potential mechanisms of action. MATERIALS AND METHODS: The effects of traditional doses of herbal extracts on blood glucose levels in STZ-NA-induced hyperglycemic rats were investigated in 2-h acute tests during fasting and postprandial states (with a glucose load). In addition, the potential inhibitory effect in vitro of enzymes involved in relevant pathways, such as gluconeogenesis (fructose-1,6-bisphosphatase, FBPase and glucose-6-phosphatase, G6Pase), carbohydrate breakdown (intestinal α-glucosidases), and insulin sensitivity (protein tyrosine phosphatase 1B, PTP-1B) was evaluated. Acute toxicity tests were carried out and HPLC-SQ-TOF was used to analyze the chemical profiles of the plant extracts. RESULTS: In the fasting state, T. b, S. h, and E. b were as effective as glibenclamide in lowering blood glucose levels in hyperglycemic rats. Moreover, all three suppressed G6Pase and FBPase enzymatic activity by 90-97% and 80-91%, respectively. On the other hand, significant postprandial hypoglycemic efficacy was observed for E. b, S. h, and T. b. Based on the AUC values, T. b caused a reduction comparable to the therapeutic efficacy of repaglinide. When investigating the possible mechanisms of action involved in this activity, E. b, S. h, and T. b showed significant inhibition of PTP-1B in vitro (>70%). Finally, all plant extracts showed no signs of acute toxicity. Several compounds that may contribute to biological activities were identified, including phenolic acids and flavonoid glycosides. CONCLUSIONS: The present study supports the traditional use of T. b, E. b and S. h for the control of diabetes in the fasting and postprandial state. Moreover, these plants were found to be rich in bioactive compounds with hypoglycemic and antihyperglycemic activities. On the other hand, J. p, showed a modest effect only in the fasting state and after 90 min. Further studies are needed to expand these results by analyzing the chemical composition and using complementary experimental models.

Religiosity and alcohol use in adolescents with orofacial cleft: correlational study / Religiosidade e uso de álcool em adolescentes com fissura orofacial: estudo correlacional

ABSTRACT Objective: To evaluate the correlation between religiosity and alcohol use among adolescents with orofacial clefts. Methods: Cross-sectional study, developed in a Brazilian public and tertiary hospital, between December 2021 and March 2022. Data collection was hybrid, and three instruments were used: Sociodemographic Questionnaire, Durel Religiosity Scale, and the Alcohol Use Disorders Identification Test. For statistical analysis, the following tests were used: χ2, Fisher's Exact, Mann-Whitney and Spearman's Correlation Coefficient, in addition to analyses of linear correlation strength and bivariate logistic regression. The significance level adopted for all tests was 5% (p≤0.05). Results: 370 adolescents participated, with a mean age of 15.2 years (±1.8). Among them, 23 (5.4%) used alcohol riskly or harmfully, being more frequent among male adolescents (p=0.001), those of mixed race (p=0.046), attending high school (p=0.011), with no religion (p<0.001), or who did not attend religious services (p<0.001). Levels of organizational, non-organizational and intrinsic religiosity were significantly lower among adolescents with risky or harmful alcohol use (p=0.005; p<0.001 and p=0.002, respectively). There was a moderate correlation between risky or harmful alcohol use and non-organizational (r=0.31; p=0.002) and intrinsic (r=0.36; p<0.001) religiosity. Male adolescents (p<0.001; OR=6.58), closest in age to 18 years (p<0.001; OR=1.37), and non-practitioners of religion (p<0.001; OR=6. 48) presented higher odds of risky or harmful alcohol use. Conclusions: Adolescents with higher levels of organizational and intrinsic religiosity used less alcohol, while males, closest in age to 18 years, and non-practitioners of religion presented higher odds of using alcohol riskly or harmfully.

RESUMO Objetivo: Avaliar a correlação entre a religiosidade e o uso de álcool em adolescentes com fissura orofacial. Métodos: Estudo transversal, desenvolvido em um hospital público e terciário brasileiro entre dezembro de 2021 e março de 2022. A coleta de dados foi híbrida, e foram utilizados três instrumentos: Questionário Sociodemográfico, Escala de Religiosidade de Durel e o Alcohol Use Disorders Identification Test. Para a análise estatística foram empregados os testes: qui-quadrado, exato de Fisher, Mann-Whitney e o coeficiente de correlação de Spearman, além das análises de forças de correlação linear e de regressão logística bivariada. O nível de significância adotado para todos os testes foi de 5% (p≤0,05). Resultados: Participaram 370 adolescentes, com média de idade de 15,2 anos (±1,8). Entre eles, 23 (5,4%) usavam o álcool de forma arriscada ou prejudicial. A religiosidade organizacional, não organizacional e a intrínseca foram significativamente menos frequentes entre adolescentes que utilizavam o álcool de forma arriscada ou prejudicial (p=0,005; p<0,001 e p=0,002, respectivamente). Evidenciou-se correlação moderada entre o uso arriscado ou prejudicial do álcool e a religiosidade não organizacional (r=0,31; p=0,002) e a intrínseca (r=0,36; p<0,001). Apresentaram maiores chances de usar o álcool adolescentes do sexo masculino (p<0,001; odds ratio — OR=6,58), com idade mais próxima aos 18 anos (p<0,001; OR=1,37) e que não praticavam a religião (p<0,001; OR=6,48). Conclusões: Adolescentes com maiores níveis de religiosidade organizacional e intrínseca utilizaram menos frequentemente álcool de forma arriscada ou prejudicial, enquanto ser homem, possuir idade mais próxima aos 18 anos e não praticar a religião aumentou a chance de utilizar álcool.

Instruções em bulas destinadas ao uso de medicamentos para dispepsia e constipação durante a lactação / Instructions in package inserts intended for the use of medicines for dyspepsia and constipation during lactation / Instrucciones en prospectos destinados al uso de medicamentos para la dispepsia y el estreñimiento durante la lactancia

Introdução: A segurança e eficácia do uso de medicamentos durante a lactação são preocupações para mães e profissionais de saúde. Esta pesquisa analisa as orientações das bulas de medicamentos comumente prescritos para dispepsia e constipação, que visa fornecer informações essenciais para orientar as decisões terapêuticas durante esse período crucial da maternidade. Objetivos: Analisar as informações das bulas sobre contraindicações de medicamentos para dispepsia e constipação durante a amamentação, verificando se estão de acordo com as evidências científicas. Métodos: Medicamentos para dispepsia e constipação foram selecionados de acordo com a classificação da Anatomical Therapeutic Chemical (ATC) e o registro ativo no Brasil. A presença de contraindicações para o uso de medicamentos nas bulas do profissional de saúde e do paciente foi comparada com as informações contidas no manual técnico do Ministério da Saúde, Medicamentos e Leite Materno, LactMed, UptoDate, Micromedex, Documento Científico da Sociedade Brasileira de Pediatria e Reprotox. Resultados: Nenhuma informação sobre o uso durante a amamentação foi encontrada em 20,0 e 24,3% das bulas para dispepsia e constipação, respectivamente. A concordância entre as bulas dos medicamentos para dispepsia e as fontes consultadas foi baixa (27,2% das bulas contraindicavam o medicamento na lactação, enquanto nas fontes o percentual de contraindicação variou de 0 a 8,3%). Com relação a medicamentos para constipação, 26,3% das bulas os contraindicavam, enquanto nas fontes o percentual variou de 0 a 4,8%. Conclusões: O estudo mostrou que pelo menos duas em cada dez bulas para dispepsia e constipação não fornecem informações adequadas sobre o uso desses medicamentos em lactentes, e também que houve baixa concordância entre o texto das bulas e as fontes de referência quanto à compatibilidade do medicamento com a amamentação.

Introduction: The safety and effectiveness of medication use during lactation are concerns for mothers and healthcare professionals. This research analyzes the instructions on the leaflets of medications commonly prescribed for dyspepsia and constipation, which aims to provide essential information to guide therapeutic decisions during this crucial period of motherhood. Objectives: To analyze the information in package inserts about contraindications of drugs for dyspepsia and constipation during breastfeeding, verifying whether these are consistent with scientific evidence. Methods: Drugs for dyspepsia and constipation were selected according to the Anatomical Therapeutic Chemical (ATC) classification and active registry in Brazil. The presence of contraindications for the use of medications in the health professional's and patient's package inserts was compared with the information in the technical manual of the Ministry of Health, Medications and Mothers' Milk, LactMed, UptoDate, Micromedex, Documento Científico da Sociedade Brasileira de Pediatria and Reprotox. Results: No information about use during breastfeeding was found in 20.0 and 24.3% of leaflets for dyspepsia and constipation, respectively. The agreement between the leaflets of medications for dyspepsia and the sources consulted was low (27.2% of the leaflets contraindicated the medication during lactation, while in the sources the percentage of contraindication varied from 0 to 8.3%). In relation to medicines for constipation, 26.3% of the leaflets contraindicated them, while in the sources the percentage ranged from 0 to 4.8%. Conclusions: The study pointed out that at least two out of every ten package inserts for dyspepsia and constipation do not provide adequate information on the use of these drugs in infants, and also shows low concordance between the text of the package inserts and the reference sources regarding compatibility of the drug with breastfeeding.

Introducción: La seguridad y eficacia del uso de medicamentos durante la lactancia son preocupaciones para las madres y los profesionales de la salud. Esta investigación analiza las instrucciones contenidas en los prospectos de medicamentos comúnmente recetados para la dispepsia y el estreñimiento, con el objetivo de proporcionar información esencial para guiar las decisiones terapéuticas durante este período crucial de la maternidad. Objetivos: Analizar la información contenida en los prospectos sobre las contraindicaciones de los medicamentos para la dispepsia y el estreñimiento durante la lactancia, verificando si estas son consistentes con la evidencia científica. Métodos: Se seleccionaron medicamentos para la dispepsia y el estreñimiento de acuerdo con la clasificación ATC y el registro activo en Brasil. Se comparó la presencia de contraindicaciones para el uso de medicamentos en los prospectos del profesional de la salud y del paciente con la información del manual técnico del Ministerio de Salud, Medicamentos y Leche Materna, LactMed, UptoDate, Micromedex, Documento Científico da Sociedade Brasileira de Pediatria y Reprotox. Resultados: No se encontró información sobre su uso durante la lactancia en el 20% y el 24,3% de los prospectos para dispepsia y estreñimiento, respectivamente. La concordancia entre los prospectos de los medicamentos para la dispepsia y las fuentes consultadas fue baja (el 27,2% de los prospectos contraindicaba el medicamento durante la lactancia, mientras que en las fuentes el porcentaje de contraindicación variaba del 0% al 8,3%). Con relación a los medicamentos para el estreñimiento, el 26,3% de los prospectos los contraindicaba, mientras que en las fuentes el porcentaje osciló entre el 0% y el 4,8%. Conclusiones: El estudio señaló que al menos dos de cada diez prospectos para dispepsia y estreñimiento no brindan información adecuada sobre el uso de estos medicamentos en lactantes, y también muestra la baja concordancia entre el texto de los prospectos y la referencia. fuentes sobre la compatibilidad del fármaco con la lactancia.

Percepções e ações da equipe multiprofissional em saúde sobre a medicina tradicional indígena / Perceptions and actions of the multi-professional health team on traditional indigenous medicine / Percepciones y acciones del equipo multidisciplinario de salud sobre la medicina tradicional indígena

Objetivo: compreender as percepções e as ações de uma equipe multiprofissional em saúde quanto à prática da medicina tradicional indígena em uma Casa de Atenção à Saúde Indígena. Método: estudo qualitativo descritivo, realizado em uma de Casa de Apoio à Saúde Indígena em um município do Pará, que incluiu oito profissionais de uma equipe multiprofissional. A coleta de dados foi realizada no ano de 2018 e estes foram examinados pelo método da análise de conteúdo. Resultados: inserção e prática do cristianismo; ritos e lideranças xamânicas; e postura da equipe de multidisciplinar foram as categorias elencadas, que apontam os entendimentos e atuações da equipe multiprofissional e da organização espacial da Casa de Saúde do município. Considerações finais: há novos costumes e valores entre as etnias, em virtude da aproximação de grupos religiosos, cujas ações foram registradas e apreendidas pela equipe de trabalhadores em saúde.

Objective: understanding the perceptions and actions of a multi-professional health team regarding the practice of traditional indigenous medicine in an Indigenous Health Care Center. Method: this is a descriptive qualitative study carried out in an Indigenous Health Support Center in a municipality in the state of Pará, which included eight professionals from a multi-professional team. Data was collected in 2018 and examined using the content analysis method. Results: insertion and practice of Christianity; shamanic rites and leadership; and the attitude of the multidisciplinary team were the categories listed, which point to the understandings and actions of the multi-professional team and the spatial organization of the Health Center in the municipality. Final considerations: there are new customs and values among ethnic groups, due to the approach of religious groups, whose actions were recorded and apprehended by the team of health workers.

Objetivo: comprender las percepciones y acciones de un equipo multidisciplinario de salud sobre la práctica de la medicina tradicional indígena en una Casa de Atención para la Salud Indígena. Método: estudio descriptivo cualitativo, realizado en una Casa de Apoyo a la Salud Indígena de un municipio de Pará, que incluyó ocho profesionales de un equipo multidisciplinario. La recolección de datos se realizó en 2018 y los datos fueron sometidos al método de análisis de contenido. Resultados: inserción y práctica del cristianismo; ritos y líderes chamánicos; y actitud del equipo multidisciplinario fueron las categorías enumeradas, que indican la percepción y las acciones del equipo multidisciplinario y la organización espacial de la Casa de Salud del municipio. Consideraciones finales: existen nuevas costumbres y valores entre las etnias, debido a la presencia de grupos religiosos, el equipo de los trabajadores de la salud registró y aprendió las acciones de los indígenas.

Implementing cardiac POCUS in obstetric patients during the preanesthetic period. Narrative review / Implementación del POCUS cardiaco en pacientes obstétricas durante el periodo preanestésico. Revisión narrativa

Abstract During the preanesthetic assessment of the obstetric patient, it is critical to assess the patient's cardiovascular baseline condition, identify any potential risks, and facilitate behavioral modification to develop an individualized management strategy aimed at minimizing complications. Cardiac point-of-care ultrasound (POCUS) is a valuable instrument for assessing the morphology and function of the heart prior to surgery. Cardiac POCUS is not designed to replace comprehensive transthoracic echocardiography, which is the realm of cardiovascular anesthesiology and cardiology. However, when used in conjunction with anamnesis, physical examination, electrocardiogram, and previous laboratory results, cardiac POCUS is a valuable adjunct in the diagnostic toolbox of anesthesiologists. It allows for direct visualization of the heart and great vessels, with added benefits of speed, availability, and low risk for the patient. The purpose of this manuscript is to explore and describe the advantages of cardiac POCUS in the preanesthetic period of obstetric patients and its potential value for anesthesiologists through the identification of potentially hazardous conditions that may require individualized preoperative management.

Resumen Durante la valoración preanestésica de la paciente obstétrica, es fundamental evaluar la condición cardiovascular basal de la paciente, identificar riesgos potenciales y facilitar modificaciones conductuales para desarrollar una estrategia de manejo individualizada, dirigida a minimizar las complicaciones. La ecografía cardíaca a la cabecera del paciente (POCUS) es un instrumento valioso para evaluar la morfología y la función del corazón antes de un procedimiento quirúrgico. El POCUS cardiaco no está diseñado para sustituir a la ecocardiografía transtorácica formal, que corresponde al área de anestesiología cardiovascular y a la cardiología. Sin embargo, cuando se usa en conjunto con la anamnesis, el examen físico, el electrocardiograma y los resultados de exámenes de laboratorio previos, el POCUS cardiaco es un complemento valioso dentro del arsenal diagnóstico de los anestesiólogos. Permite la visualización directa del corazón y de los grandes vasos, con beneficios adicionales de velocidad, disponibilidad y bajo riesgo para la paciente. El objetivo del presente manuscrito es explorar y describir las ventajas del POCUS cardiaco durante el periodo preanestésico en pacientes obstétricas y su valor potencial para los anestesiólogos, a través de la identificación de condiciones eventualmente peligrosas que pudieran requerir un manejo preoperatorio individualizado.

Efectos cardiovasculares de la exposición ocupacional a pesticidas / Cardiovascular effects of occupational exposure to pesticides

Resumen Los trabajadores agrícolas se exponen frecuentemente a los pesticidas, los cuales pueden afectar el sistema cardiovascular. El objetivo de la investigación fue revisar la asociación entre la exposición ocupacional a pesticidas, el desarrollo de enfermedades cardiovasculares y los biomarcadores utilizados en la vigilancia de la salud de los trabajadores. Para ello se realizó una revisión no sistemática de la literatura en tres bases de datos: Pubmed, Embase y Scopus, con ecuaciones de búsqueda elaboradas con los términos "agrochemicals", "myocardial infarction", "occupational exposure" y "farmers", y se incluyeron artículos publicados entre 2007 y 2022. Se encontró que los pesticidas causan elevación de las cifras de presión arterial en trabajadores expuestos y en mujeres embarazadas se relaciona con hipertensión gestacional y preeclampsia. Respecto al infarto agudo de miocardio (IAM), el contacto con los pesticidas clorpirifós, coumafós, carbofurano, pendimetalina, trifluralina y acilalanina aumentan el riesgo de IAM en mujeres, y entre los trabajadores masculinos la exposición a dibromuro de etileno, maneb/mancozeb y dimetil-ditiocarbamato de zinc se asoció con mayor mortalidad. La vigilancia epidemiológica se realiza principalmente con la medición de la actividad de la acetilcolinesterasa eritrocitaria (AChE). Se puede concluir que la exposición a pesticidas puede desencadenar enfermedades cardiovasculares agudas y crónicas, como elevación de las cifras de presión arterial, IAM fatal y no fatal. Los pesticidas dimetil ditiocarbamato de zinc, clorpirifós, coumafós, carbofurano, paratión y malatión son las sustancias que tienen mayor relación con el desarrollo de enfermedad cardiovascular.

Abstract Farmworkers are frequently exposed to pesticides, which can affect the cardiovascular system. The objective of the research was to review the association between occupational exposure to pesticides and the development of cardiovascular diseases, and the biomarkers used in monitoring the health of workers. For this, a non-systematic review of the literature was carried out in three databases: Pubmed, Embase and Scopus, with search equations prepared with the terms "agrochemicals", "myocardial infarction", "occupational exposure" and "farmers". Articles published between 2007 and 2022 were included. Pesticides were found to cause elevated blood pressure levels in exposed workers, and in pregnant women it is related to gestational hypertension and preeclampsia. Regarding acute myocardial infarction (AMI), contact the pesticides chlorpyrifos, coumaphos, carbofuran, pendimethalin, trifluralin, and acylalanine increased the risk of AMI in women, and among male workers exposure to ethylene dibromide, maneb/mancozeb, and zinc dimethyldithiocarbamate was associated with increased mortality. Epidemiological surveillance is mainly carried out by measuring erythrocyte acetylcholinesterase (AChE) activity. It can be concluded that exposure to pesticides can trigger acute and chronic cardiovascular diseases, such as elevated blood pressure, fatal and non-fatal AMI. Zinc dimethyl dithiocarbamate, chlorpyrifos, coumafos, carbofuran, parathion and malathion pesticides are the substances most closely related to the development of cardiovascular disease.

In Silico Design of miniACE2 Decoys with In Vitro Enhanced Neutralization Activity against SARS-CoV-2, Encompassing Omicron Subvariants.

The COVID-19 pandemic has overwhelmed healthcare systems and triggered global economic downturns. While vaccines have reduced the lethality rate of SARS-CoV-2 to 0.9% as of October 2024, the continuous evolution of variants remains a significant public health challenge. Next-generation medical therapies offer hope in addressing this threat, especially for immunocompromised individuals who experience prolonged infections and severe illnesses, contributing to viral evolution. These cases increase the risk of new variants emerging. This study explores miniACE2 decoys as a novel strategy to counteract SARS-CoV-2 variants. Using in silico design and molecular dynamics, blocking proteins (BPs) were developed with stronger binding affinity for the receptor-binding domain of multiple variants than naturally soluble human ACE2. The BPs were expressed in E. coli and tested in vitro, showing promising neutralizing effects. Notably, miniACE2 BP9 exhibited an average IC50 of 4.9 µg/mL across several variants, including the Wuhan strain, Mu, Omicron BA.1, and BA.2 This low IC50 demonstrates the potent neutralizing ability of BP9, indicating its efficacy at low concentrations.Based on these findings, BP9 has emerged as a promising therapeutic candidate for combating SARS-CoV-2 and its evolving variants, thereby positioning it as a potential emergency biopharmaceutical.

Advanced therapy with mesenchymal stromal cells for knee osteoarthritis: Systematic review and meta-analysis of randomized controlled trials.

Background: Advanced cell therapies emerged as promising candidates for treatment of knee articular diseases, but robust evidence regarding their clinical applicability is still lacking. Objective: To assess the efficacy and safety of advanced mesenchymal stromal cells (MSC) therapy for knee osteoarthritis (OA) and chondral lesions. Methods: Systematic review of randomized controlled trials conducted in accordance with Cochrane Handbook and reported following PRISMA checklist. GRADE approach was used for assessing the evidence certainty. Results: 25 randomized controlled trials that enrolled 1048 participants were included. Meta-analyses data showed that, compared to viscosupplementation (VS), advanced MSC therapy resulted in a 1.91 lower pain VAS score (95 % CI -3.23 to -0.59; p < 0.00001) for the treatment of knee OA after 12 months. Compared to placebo, the difference was 0.99 lower pain VAS points (95 % CI -1.94 to -0.03; p = 0.76). According to the GRADE approach, the evidence was very uncertain for both comparisons. By excluding studies with high risk of bias, there was a similar size of effect (VAS MD -1.54, 95 % CI -2.09 to -0.98; p = 0.70) with improved (moderate) certainty of evidence, suggesting that MSC therapy probably reduces pain slightly better than VS. Regarding serious adverse events, there was no difference from advanced MSC therapy to placebo or to VS, with very uncertain evidence. Conclusion: Advanced MSC therapy resulted in lower pain compared to placebo or VS for the treatment of knee OA after 12 months, with no difference in adverse events. However, the evidence was considered uncertain. The Translational Potential of this Article: Currently, there is a lack of studies with good methodological structure aiming to evaluate the real clinical impact of advanced cell therapy for knee OA. The present study was well structured and conducted, with Risk of Bias, GRADE certainty assessment and sensitivity analysis. It explores the translational aspect of the benefits and safety of MSC compared with placebo and gold-standard therapy to give practitioners and researchers support to expand this therapy in their practice. PROSPERO registration number: CRD42020158173. Access at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=158173.

[60 years after the death of Prof. Pablo Luis Mirizzi. Family pantheon in the San Jerónimo Cementery] / A 60 años de la muerte del Prof. Pablo Luis Mirizzi. Panteón familiar en el Cementerio San Jerónimo.

60° aniversario del fallecimiento del Dr. Mirizzi.

Impact of active breaks on sedentary behavior and perception of productivity in office workers.

Introduction: The increasing prevalence ofsedentary behavior at work, which has been exacerbated by technological advancement and remote work models, can compromise worker health, leading to both physical and mental problems. Increasing research on sedentary behavior has resulted in interventions such as active breaks. Objectives: This study addresses the impact of sedentary behavior at work and the effects of active breaks. Methods: This descriptive-exploratory study with a mixed-methods approach included 70 professionals of both sexes, 86% women (35.2 [SD, 10.2] years) and 14% men (33.5 [SD, 11] years), who worked remotely in administrative roles. The intervention was a 25-week active break protocol involving lectures, a questionnaire, and an app. Results: At the end of the intervention, 64% of participants were taking active breaks. Spending > 10 hours a day in sedentary behavior reduced significantly (from 31% to 14%), as did the proportion of workers who did not exercise (from 43% to 26%; p = 0.002). There were also reductions in post-lunch sleepiness, perceived stress (p < 0.01), and pain/discomfort (p < 0.01). Conclusions: Management programs for sedentary behavior should consider the use of active breaks, since they can reduce sedentary behavior and perceived sleepiness, stress, and pain. This will result in a healthier work environment, increasing employee quality of life as well as company productivity.

Introdução: Com a predominância do sedentarismo ocupacional, agravado pelo avanço tecnológico e pelo trabalho remoto, a saúde dos trabalhadores pode ser comprometida, incluindo problemas físicos e mentais, o que faz com que estudos sobre o comportamento sedentário e intervenções como pausas ativas ganhem destaque. Objetivos: O estudo aborda o impacto do sedentarismo no ambiente de trabalho e a relevância das pausas ativas para mitigar seus efeitos. Métodos: Tratou-se de estudo descritivo-exploratório com abordagem qualiquantitativa, realizado com 70 profissionais de ambos os sexos, 86% mulheres (35,2±10,2 anos) e 14% homens (33,5±11 anos). Todos trabalhavam remotamente em funções administrativas. Os participantes foram orientados a seguir uma rotina de pausas ativas durante 25 semanas. O estudo usou palestras, um questionário e um aplicativo para a prática. Resultados: Dos participantes, 64% adotaram as pausas ativas após a intervenção. Foi observada uma redução significativa no tempo sedentário (superior a 10 horas), de 31 para 14%, e no número de trabalhadores que não se exercitavam, de 43 para 26% (p = 0,002). Notou-se também uma redução na sonolência após o almoço, na percepção do estresse (p < 0,01) e nas dores e/ou desconforto no corpo (p < 0,01). Conclusões: A rotina de pausas ativas parece ser uma estratégia para diminuir o comportamento sedentário e melhorar a percepção quanto a sonolência, estresse e dores. Portanto, a implementação de programas de gestão ativa do comportamento sedentário, por meio de pausas ativas, pode proporcionar um ambiente de trabalho mais produtivo e saudável, beneficiando a qualidade de vida dos funcionários e a produtividade da empresa.

Decision Support Techniques for determination of the causal relationship between health problems of workers and their work activities.

Reflecting on the complexity and impacts of determination of the causal relationship between health problems of workers and the exercise of their work activities, there is a need to learn about scientific articles that expose techniques to determine this type of causal relationship. There is also a need to reveal whether any article exposes multicriteria decision analysis technique. The aim is to quantify the techniques used to determine the causal relationship between health problems of workers and the exercise of their work activities. Bibliometric analysis was performed, searching for articles in Portuguese, Spanish and English. An advanced search was performed on the website of the ministerial journals portal and then on the Gale Academic OneFile, SciVerse Scopus, Scientific Electronic Library Online (SciELO) and PubMed Central collections. In summary, 38 articles were selected from portal, 50 from Gale Academic OneFile, 20 from SciVerse Scopus, 37 from SciELO and 5 from PubMed Central, totaling 150 articles of interest for analysis of their contents. Among these 150 articles, 33.33% addressed the causal relationship between illness and work, 3.33% described some process related to occupational diagnostic investigation and 0.66%, which represents only one article, exhibited a technique to determine this type of causal relationship: the probability of causality in neoplastic diseases. No article described multicriteria decision analysis method as a technique for determine this type of causal relationship. Therefore, there is a need to carry out and disseminate scientific research on methods to help determine a causal relationship between illness and work.

Ao refletir sobre a complexidade e os impactos do estabelecimento do nexo causal entre o agravo à saúde dos trabalhadores e o exercício de suas atividades laborais, surge a necessidade de conhecer artigos científicos que expõem técnicas para estabelecer esse tipo de nexo. Surge também a necessidade de revelar se algum artigo expõe auxílio multicritério à decisão. O objetivo foi quantificar as técnicas utilizadas no estabelecimento do nexo causal entre o agravo à saúde dos trabalhadores e o exercício de suas atividades laborais. Foi realizada uma análise bibliométrica, buscando artigos em português, espanhol e inglês. Realizou-se uma busca avançada no site do portal ministerial de periódicos e, em seguida, nas coleções Gale Academic OneFile, SciVerse Scopus, Scientific Electronic Library Online (SciELO) e PubMed Central. Em síntese, foram selecionados 38 artigos do portal ministerial de periódicos, 50 da Gale Academic OneFile, 20 da SciVerse Scopus, 37 do SciELO e 5 da PubMed Central, totalizando 150 artigos para análise de conteúdo. Entre esses 150 artigos, 33,33% abordavam o nexo causal entre doença e trabalho, 3,33% descreviam algum processo relacionado à investigação diagnóstica ocupacional, e 0,66%, o que representa apenas um artigo, exibia uma técnica para se estabelecer esse tipo de nexo causal: a probabilidade de causalidade em doenças neoplásicas. Nenhum artigo descrevia o auxílio multicritério à decisão como técnica para estabelecer esse tipo de nexo causal. Portanto, nota-se a necessidade da realização e divulgação de pesquisas científicas sobre métodos de auxílio ao estabelecimento de nexo causal entre doença e trabalho.

Myofibroma with Atypical Features can Mimic Low-Grade Myofibroblastic Sarcoma: Two Paediatric Cases.

Myofibroma is a rare benign mesenchymal tumor that frequently affects the pediatric population with a predilection for the head and neck region. About 10% of myofibroma cases, presenting atypical features, can be misinterpreted as low-grade myofibroblastic sarcoma (LGMS), with therapeutic and prognostic impact. Here, we report two pediatric cases of benign myofibroblastic tumors, one of them showing typical characteristics of myofibroma, the other was an atypical myofibroma, which initially mimicked low-grade myofibroblastic sarcoma. Atypical myofibromas, despite its distinctive characteristics, follow a benign course, similar with typical myofibroma. It is necessary to distinguish atypical myofibroma from low-grade myofibroblastic sarcoma and avoid unnecessary invasive therapy.

Prevalence and factors associated with the use of traditional medicine in individuals with hypercholesterolemia, hyperglycaemia, and arterial hypertension in Ecuador: results from a population-based study in two health districts.

BACKGROUND: While traditional medicine (TM) is employed by a significant portion of the global population for managing health issues, clinical guidelines and state recommendations often overlook this practice. The aim of this study was to describe the frequency of use of TM to control 3 metabolic risk factors (MRF): hypertension, hypercholesterolemia, and hyperglycaemia; and the sociodemographic, economic, and clinical characteristics associated with the use of TM. METHODS: Cross-sectional descriptive study that analyses data obtained from a representative population survey in 2 health districts, one urban in the south of Quito and another in a forested rural area with diverse ethnic groups in Esmeraldas, Ecuador. We include 602 individuals with at least one MRF. We calculated the proportion of people reporting the regular use of TM (herbal or traditional remedy) to control their MRF and we assessed potential associations with sociodemographic, economic, and clinical characteristics with a multivariable logistic regression model. RESULTS: In two very different sociocultural contexts in Ecuador we found that use of TM to control MRF was frequent (39.4% in Esmeraldas, 31.1% in Quito), frequently in combination with CM. There is a notable percentage of people, 33.9% in Esmeraldas and 39.0% in Quito, who did not take any treatment for their MRF, and the remainder used CM alone. In both settings, an individual's education lever was significantly associated with TM use. Whereas in Quito individuals with higher education more frequently treated their MRF with TM (aOR 2.04, 95% CI 1.03-3.90), in the rural, hard-to-reach context of Esmeraldas, it was more frequent among people with no formal schooling (aOR: 3.76; 95%CI 1.59-8.88), as well as those of younger age (aOR by year: 0.97; 95% CI 0.95-0.99) and afro ethnicity (aOR: 2.13; 95%CI 1.02-4.45). CONCLUSION: Traditional medicine is used by a significant proportion of the population in Ecuador, highlighting the need for a more accessible and intercultural healthcare approach. The health system should ensure access to the necessary information and resources for the management of their metabolic risk factors.

Ethnobotanical knowledge and utilization patterns of Burseraceae resins in Brazil.

ETHNOPHARMACOLOGICAL RELEVANCE: Amid all the Brazilian phytodiversity, in all its shades and shapes, black and white amorphous masses glued to the barks of Burseraceae species stand out as some of the nation's most appreciated plant medicinal resources. Burseraceae resins have been used in all macroregions of Brazil, wherever they occur, for a variety of medicinal purposes. However, despite ongoing interest in them, their cultural and health relevance in the country has been underexamined. AIM OF THE STUDY: This review aimed to illuminate the therapeutic importance and potential of Brazilian Burseraceae by assembling the ethnomedicinal, chemical, and pharmacological data available on its resins used in Brazil. MATERIALS AND METHODS: A search for journal articles documenting local ethnomedicinal uses of Burseraceae resins and reporting chemical and pharmacological data associated with their botanical sources was conducted in ScienceDirect, Google Scholar, and PubMed databases. Books and theses were also appraised for such information. RESULTS: At least 21 Burseraceae taxa, belonging to Protium, Trattinnickia, and Commiphora, are recorded as sources of medicinal resins in Brazil. Protium and Trattinickia yield oleoresins typically rich in mono- and triterpenoids, especially the pentacyclic triterpenoids α- and ß-amyrin. Although Commiphora oleo-gum-resins are expected to differ significantly from Protium and Trattinickia oleoresins by the presence of gum fractions, they often exhibit distinct terpenoid compositional patterns, characterized by a high proportion of sesquiterpenoids and tetracyclic triterpenoids. Burseraceae resins are more frequently cited in the Brazilian ethnomedicinal literature for relieving headaches and healing wounds. Pharmacological evidence corroborates the potential of Burseraceae resins against these and some other conditions and diseases, however, further studies are needed to confirm their efficacy and safety when used topically and through inhalation-the two primary routes of administration explored for them in Brazil. CONCLUSIONS: The present review unearths a consistent, persistent, and cross-cultural pattern of using Burseraceae resins against pain conditions. But to really tap into the Burseraceae's therapeutic potential in Brazil, we first need to address the following gaps: (a) conduct more thorough pharmacological studies, including clinical trials; (b) give more attention to the triterpenoid fraction of Burseraceae oleoresins, not only to essential oils and α- and ß-amyrin; and (c) deepen our understanding of the impact of resin aging on chemical composition.

Prevalence of single-nucleotide variants in twenty-five pharmacogenes from a Cuban sample cohort.

Introduction: The Cuban population is genetically diverse, and information on the prevalence of genetic variants is still limited. As complex admixture processes have occurred, we hypothesized that the frequency of pharmacogenetic variants and drug responses may vary within the country. The aims of the study were to describe the frequency distribution of 43 single-nucleotide variants (SNVs) from 25 genes of pharmacogenetic interest within the Cuba population and in relation to other populations, while taking into consideration some descriptive variables such as place of birth and skin color. Materials and Methods: SNVs were analyzed in 357 unrelated healthy Cuban volunteers. Genotype, allele frequencies, and ancestry proportions were determined, and the pairwise fixation index (FST ) was evaluated. Results: Hardy-Weinberg equilibrium (HWE) deviations in six loci (rs11572103, rs2740574, rs776746, rs3025039, rs861539, and rs1762429) were identified. Minor allele frequencies (MAFs) ranged from 0.00 to 0.15 for variants in genes encoding xenobiotic metabolizing enzymes. They also ranged from 0.01 to 0.21 for variants in DNA repair, growth factors, methyltransferase, and methyl-binding proteins, while they ranged from 0.04 to 0.27 for variants in the O-6-methylguanine-DNA methyltransferase enzyme. Moderate genetic divergence was observed upon comparison to Africans (FST = 0.071 and SD 0.079), with 19 markers exhibiting moderate-to-large genetic differentiation. The average European, African, and Amerindian ancestry proportions were 67.8%, 27.2%, and 5.3%, respectively. Ancestry proportions differed by skin color and birthplace for both African and European components, with the exception of the European component, which showed no significant difference between individuals from Western and Eastern regions. Meanwhile, the statistical significance varied in comparisons by skin color and birthplace within the Amerindian component. Low genetic divergence was observed across geographical regions. We identified 12 variants showing moderate-to-large differentiation between White/Black individuals. Conclusion: Altogether, our results may support national strategies for the introduction of pharmacogenetic tools in clinical practice, contributing to the development of precision medicine in Cuba.

Botulinum toxin for the management of bruxism: an overview of reviews protocol.

INTRODUCTION: Bruxism is characterised by a repetitive activity in the masticatory muscles that involves teeth clenching or grinding and/or forceful mandibular movements. Its management is typically initiated when individuals start experiencing the adverse effects of the condition. One of the available intervention forms is the administration of botulinum toxin type A (BoNT-A). Numerous systematic reviews have addressed the use of BoNT-A to manage bruxism; however, the results are controversial. The current overview aims to determine BoNT-A's effectiveness for managing bruxism in relation to placebo, the absence of treatment or alternative interventions in the adult population. METHODS AND ANALYSIS: This study will include systematic reviews (SRs), with or without meta-analysis, aiming to evaluate the efficacy of BoNT-A for bruxism in adults. A broad literature search will be carried out on Cochrane Library, EMBASE, LILACS, Livivo, PubMed/MEDLINE, Scopus, Web of Science and the grey literature. Experts in the topic and reference lists of included SRs will also be consulted. The study selection will be conducted in two phases by two independent reviewers. Data collection will be performed by one author and cross-checked by another. The methodological quality of included SRs will be evaluated using AMSTAR-II. A narrative synthesis will be employed as the formal method to combine individual study data. The overlap across studies will be quantified by the corrected covered area and illustrated by the Graphical Representation of Overlap for Overviews. ETHICS AND DISSEMINATION: This overview does not require ethics approval, as it uses secondary data from previously published studies. The results will be disseminated through the publication in a high-impact journal. OSF OF REGISTRATION: DOI: 10.17605/OSF.IO/RB45T.

Occupational accidents in mining workers: scoping review of studies published in the last 13 years.

OBJECTIVE: Mining activity represents one of the most hazardous occupations related to health, with 8% of fatal injuries concentrated in this sector worldwide. Thus, it is crucial to timely identify the factors involved in such injuries. We aimed to explore the sociodemographic and occupational/organisational factors associated with injuries, causative agents and subsequent disabilities and fatality of workers exposed to occupational injuries in the mining sector. DESIGN: A secondary scoping review was conducted following the Joanna Briggs Institute guidelines. DATA SOURCES: Scopus, Embase, Virtual Health Library, SciELO and PubMed databases were searched in February 2022 and updated in October 2023. The protocol was developed in April 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included observational studies published within the last 13 years (2010-2022) which provided information on injuries of the mining workers and reported associated factors as well as health consequences. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers examined the eligibility criteria, screened and coded the extracted information using prevalidated data extraction tools, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews reporting guidelines. RESULTS: A total of 123 studies were found, of which nine were selected for inclusion in this review. Participants were between 15 and 80 years old, and the rate of injuries ranged from 4.4% to 10.6% of reported cases. Among the total selected studies, mechanical agents were identified as the leading cause of injuries in six studies. The factors associated with injuries included age, gender (female) and biochemical characteristics. On the other hand, occupational and organisational factors encompassed work shift, outsourcing (contractors) and less than 2 years of experience in the sector. CONCLUSION: This review emphasises that both work-related and individual characteristics are significantly related factors of injuries. Moreover, commonly reported health consequences of injuries encompass mortality, average days lost and permanent, partial or total disability.

Perceptions and attitudes about the contribution of the environment to childhood cancer: a pilot study in a medical guild and undergraduate students.

BACKGROUND: Identifying and recognizing environmental risk factors for childhood cancer is crucial to prevent it. Medical guild are the first contact to monitor children's health. Therefore, courses about the contribution of chemical toxins in the environment and health outcomes such as cancer should be included in their professional training. This study aimed to evaluate the perceptions and attitudes of a medical guild and undergraduate students in health sciences about the contribution of the environment to childhood cancer. METHODS: A pilot study was conducted, an online survey including thirteen questions was shared among medical guild members and undergraduate students in health sciences. Frequencies, percentages, and chi-square homogeneity tests were calculated to compare groups. RESULTS: Genetic factors ranked as the first possible cause of childhood cancer (88.2% medical guild and 97.7% undergraduate students). However, 70.6% of medical guild and 64.6% of undergraduate students reported that they have ever suspected that childhood cancer could be related to the environmental conditions in which children live. More than 95% of the participants reported that they would find it useful to have more knowledge about environmental risks and cancer. When data were analyzed by profession (medical guild) and academic year (undergraduate students), no significant differences were observed. Nonetheless, comparisons by academic discipline between undergraduate students, showed that a higher percentage of medicine and environmental sciences and health (over 98%) reported environmental exposure as risk factors associated with childhood cancer compared to 75% from physiotherapy, (p = 0.001). CONCLUSIONS: In this study, the environmental contribution to childhood cancer is not clear among the medical guild and undergraduate students. They should be trained on the topic of cancer and the environment.

V Brazilian Consensus on Rhinitis - 2024.

Since we published the "IV Brazilian Consensus on Rhinitis", in2017, several advances have been achieved and have enabled a further understanding of the different aspects of "Rhinitis". This new guideline, developed jointly by ASBAI, SBP and SBORL, represents a relevant milestone in the updated and integrated management of the different forms of the disease, and it aims to unify evidence-based approaches to improve the diagnosis and treatment of this common and often underestimated condition. The document covers a wide range of topics, including clear definitions of the different phenotypes and endotypes of rhinitis, risk factors, updated diagnostic criteria, and recommended methods for clinical and laboratory investigation. We stress the importance of detailed clinical history and objective assessment, as well as tools for control and assessing severity tools an accurate diagnostic approach to the disease. Regarding treatment, it emphasizes the treatment customization, considering the severity of symptoms, the presence of comorbidities and the impact on the patient's quality of life. We discuss different drug treatment, in addition to non-pharmacological measures, such as environmental control and specific immunotherapy; and the possible role of immunobiological agents. Furthermore, the consensus addresses issues related to patient education, prevention and management of special situations, such as rhinitis in children, in pregnant women and in the elderly. In short, the "V Brazilian Consensus on Rhinitis" represents a comprehensive and updated guide for healthcare professionals involved in the diagnosis and management of rhinitis, aiming to improve patients' quality of life through an integrated and evidence-based approach.