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PURPOSE: To compare arm-ergometry and treadmill supervised exercise training on cardiorespiratory fitness and walking distances in patients with peripheral artery disease (PAD). METHODS: ARMEX was a single-center, single-blinded, parallel group, non-inferiority trial enrolling symptomatic patients with PAD. Patients were randomized (1:1 ratio) to a 12-wk arm-ergometry (AEx) or standard treadmill (TEx) supervised exercise training protocol. The powered primary end point was the change in peak oxygen uptake (VO2) at 12 wk, measured on a treadmill cardiopulmonary exercise test (CPX). Secondary outcomes included changes in VO2 at the first ventilatory threshold (VT-1), ventilatory efficiency (ratio of minute ventilation [VE] to carbon dioxide production [VCO2], VE/VCO2), walking distances by CPX and 6-min walking test (6MWT), and self-reported walking limitations. RESULTS: Fifty-six patients (66 ± 8 yr; 88% male) were randomized (AEx, n = 28; TEx, n = 28). At 12 wk, VO2peak change was not significantly different between groups (0.75 mL/kg/min; 95% CI, -0.94 to 2.44; P= .378), despite a significant increase only in AEx. VO2 at VT-1 improved in both groups without between-group differences, and VE/VCO2 slope improved more in AEx. The TEx attained greater improvements in walking distance by CPX (121.08 m; 95% CI, 24.49-217.66; P= .015) and 6MWT (25.08 m; 95% CI, 5.87-44.29; P= .012) and self-perceived walking distance. CONCLUSIONS: Arm-ergometry was noninferior to standard treadmill training for VO2peak, and treadmill training was associated with greater improvements in walking distance. Our data support the use of treadmill as a first-line choice in patients with PAD to enhance walking capacity, but arm-ergometry could be an option in selected patients.
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OBJECTIVE: To investigate the effects of Araucaria sp. brown propolis (ABP) against trinitrobenzenesulfonic acid (TNBS)-induced colitis in rats. METHODS: Animals received vehicle (1% DMSO, 1 ml/kg) or hydroalcoholic extract of ABP (hydroalcoholic extract of Araucaria sp. brown propolis (HEABP), 30, 100, and 300 mg/kg) orally, or dexamethasone (25 mg/kg, s.c.) for 5 days. On day 4, the animals received intracolonic TNBS (150 mg/kg), on day 6 they were euthanized. The weight of the animals, the macroscopic and microscopic colonic damage, reduced glutathione (GSH) and malondialdehyde (MDA) levels, and the activity of glutathione S-transferase (GST), catalase (CAT), superoxide dismutase (SOD), and myeloperoxidase (MPO) were measured in colon homogenate. The action of HEABP and two isolated compounds in neutrophil migration was recorded. KEY FINDINGS: HEABP (100 and 300 mg/kg), but not dexamethasone, decreased colonic lesion, and increased colonic mucin staining. In parallel, HEABP decreased MDA and restored GSH levels and the activity of SOD, CAT, and GST in the colon. A dose-dependent inhibition of MPO activity was observed (LogIC50 = 1.9). Moreover, HEBPA and the junicedric and abietic acids inhibited the neutrophil chemotaxis in vitro and HEBPA reduced neutrophil migration in vivo. CONCLUSION: HEABP may be promising in the therapies for inflammatory bowel diseases, reducing oxidative and inflammatory damage, especially mediated by neutrophils.
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AIMS: Many European healthcare providers struggle to adopt multidisciplinary, integrated care pathways for people with heart failure (HF) as recommended by the European Society of Cardiology. PRO-HF (Program to Optimize Heart Failure Patient Pathways) was developed to help clinicians identify strengths, gaps, and shortcomings in their HF pathways and support tailored interventions to optimize pathways and enhance patient care. We report initial findings from baseline assessments of HF pathway characteristics and challenges from 10 hospitals in six European countries (France, Ireland, Portugal, Spain, The Netherlands, and United Kingdom). METHODS AND RESULTS: Baseline assessments were holistic appraisals of full HF services to calibrate current status and development needs and assist management teams in prioritizing improvement projects. Assessments were performed using a comprehensive checklist of measures covering the HF patient journey from diagnosis to ongoing follow-up. These included a digital survey sent to full HF care teams and one-to-one interviews. The digital survey focused on four key areas (HF outpatient clinic; remote patient management; efficient device implantation and inpatient pathways; and network maximization) and 16 dimensions of excellence. Priority areas and themes for action identified in baseline assessments were (i) provision of HF specialist care; (ii) data capture and analysis; (iii) institutional care protocols; (iv) hospital-wide strategies; and (v) multidisciplinary teams (MDTs). Suboptimal specialist care of emergency inpatients was an issue at all hospitals and prioritized at 8/10. Availability and accessibility of data on patients, activities, and outcomes was an issue at all hospitals and prioritized by 4/10. A lack of clear protocols, templates, and tools for some HF activities created variability in patient care (e.g., HF specialist consultations, diagnostic testing, follow-up appointments, medications, and device eligibility) and inefficient use of clinician time. This made it difficult to initiate new technologies (e.g., remote patient monitoring) due to the risk of overburdening staff. MDTs were frequently understaffed. Multiple interventions were identified to address gaps and shortcomings that could be tailored to specific needs of individual hospitals (e.g., inpatient pathway optimization, creation/optimization of HF outpatient clinics, development of an HF performance dashboard, enhancement of protocol adherence, streamlining cardiac resynchronisation therapy pathways, and MDT coordination). CONCLUSIONS: PRO-HF provides a valuable opportunity to identify gaps and significant shortcomings in HF pathways in European hospitals. Preliminary findings from hospitals that have initiated suggested changes to address these challenges are encouraging, though longer-term follow-up from more hospitals is needed to confirm the impact of PRO-HF on HF pathway optimization and patient care.
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Effective communication in relation to pregnancy and birth is crucial to quality care. A recent focus in reproductive healthcare on "sexed language" reflects an ideology of unchangeable sex binary and fear of erasure, from both cisgender women and the profession of midwifery. In this paper, we highlight how privileging sexed language causes harm to all who birth-including pregnant trans, gender diverse, and non-binary people-and is, therefore, unethical and incompatible with the principles of midwifery. We show how this argument, which conflates midwifery with essentialist thinking, is unstable, and perpetuates and misappropriates midwifery's marginalized status. We also explore how sex and gender essentialism can be understood as colonialist, heteropatriarchal, and universalist, and therefore, reinforcing of these harmful principles. Midwifery has both the opportunity and duty to uphold reproductive justice. Midwifery can be a leader in the decolonization of childbirth and in defending the rights of all childbearing people, the majority of whom are cisgender women. As the systemwide use of inclusive language is central to this commitment, we offer guidance in relation to how inclusive language in perinatal and midwifery services may be realized.
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Age-related cataract is the most frequent cause of blindness in the world being responsible for 48% of blindness and affecting more than 10% of the working population. Currently there is no objective data of the lens biomechanical properties so the process by which the cataract affects the lens's properties (e.g. hardness and elasticity) is still unclear. A modified animal model was produced to create different severities of nuclear cataract. Different doses of sodium selenite were injected in two different moments of the rat' eyes maturation resulting in 12, 13 and 11 rats with incipient, moderate and severe cataract, respectively. The nucleus and cortex's hardness and the stiffness were measured using NanoTest™. Statistically significant differences were found between healthy and cataractous lenses. Statistically significant differences were also found between the different nuclear cataract degrees (p = 0.016), showing that the lens' hardness increases with cataract formation. The nucleus shows a higher hardness increase with cataract formation (p = 0.049). The animal model used in this study allowed for the first time the characterization of the lens's hardness and elasticity in two regions of the lens, in healthy and cataractous lenses.
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Catarata , Modelos Animales de Enfermedad , Elasticidad , Dureza , Cristalino , Catarata/fisiopatología , Animales , Ratas , Masculino , Ratas Wistar , Fenómenos BiomecánicosRESUMEN
BACKGROUND: A cardio-oncology rehabilitation model among cancer survivors showed superior results comparing to a community-based exercise intervention. However, questions remain about its cost-effectiveness. AIMS: To assess the cost-effectiveness of a center-based cardiac rehabilitation (CBCR) program when compared to usual care encompassing a community-based exercise training (CBET), among cancer survivors with high cardiovascular risk. METHODS: The CORE study was a single-center, prospective, randomized controlled trial; 80 adult cancer survivors with previous exposure to cardiotoxic cancer treatment and/or with previous cardiovascular disease were assigned (1:1 ratio) to an 8-week CBCR or CBET, twice/week. Cost-effectiveness was a pre-specified secondary endpoint. Outcomes included healthcare resource use and costs, quality-adjusted life-years (QALYs) and cost-effectiveness; incremental cost-effectiveness ratio (ICER) was computed from a societal perspective. RESULTS: 75 patients completed the study (CBCR N=38; CBET N=37). The CBCR had significantly higher cost per patient (477.76 ± 39.08) compared to CBET group (339.32 ± 53.88), with a significant between-group difference 138.44 (95% CI, 116.82 to 160.05, p<0.01). A between-group difference by 0.100 points in QALYs was observed, favouring the CBCR (95% CI, -0.163 to -0.037, p=0.002). When CBCR was compared with CBET, the ICER was 1,383.24 per QALY gained; at a willingness-to-pay threshold of 5,000 per QALY, the probability of CBCR being cost-effective was 99.9% (95% CI, 99.4 to 100.0). CONCLUSION: The CORE trial shows that a CBCR is a cost-effective intervention in the management of cancer survivors with high cardiovascular risk, reinforcing the potential benefits of this multidisciplinary approach in supportive care of this specific subset of cancer patients.
The CORE study was a randomized clinical trial including 80 cancer survivors with high cardiovascular risk; an 8-week cardio-oncology rehabilitation framework promoted superior results on cardiorespiratory fitness (peak oxygen consumption) and quality of life, but questions remained about the cost-effectiveness of this option. This study findings suggest that: a center-based cardiac rehabilitation proved to be cost-effective, when compared to usual care encompassing community-based exercise training the value-added of a comprehensive approach delivered in an oncological setting reinforce the potential benefits of including this intervention in supportive care of a specific subset of cancer patients, within existing contemporary cardiac rehabilitation resources and infrastructures.
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Brazilian green propolis is used in folk medicine because of its various biological properties. The hydroalcoholic extract of Brazilian green propolis is characteristic for possessing several pharmacological properties. Phytochemical investigations have attributed some of these properties to the presence of compounds, which were chosen as analytical markers. This paper reports the development and analytical validation using UPLC-MS/MS in MRM mode. Veratraldehyde was used as an internal standard in qualitative and quantitative analyses of the extracts. Relative standard deviation values obtained for intra-day and inter-day precision were lower than 4%. Of the five parameters for robustness, wavelength detection and flow rate were the critical ones. Limits of detection and quantification ranged from 0.300 to 39.500 ng.mL-1 and from 1.400 to 85.00 ng.mL-1, respectively. The recoveries were between 94.00 and 119.00%, with relative standard deviation values around 5.0%. The developed method is precise, sensitive, and reliable for analysing Brazilian green propolis.
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Cardiopulmonary exercise testing (CPET) provides a noninvasive and integrated assessment of the response of the respiratory, cardiovascular, and musculoskeletal systems to exercise. This information improves the diagnosis, risk stratification, and therapeutic management of several clinical conditions. Additionally, CPET is the gold standard test for cardiorespiratory fitness quantification and exercise prescription, both in patients with cardiopulmonary disease undergoing cardiac or pulmonary rehabilitation programs and in healthy individuals, such as high-level athletes. In this setting, the relevance of practical knowledge about this exam is useful and of interest to several medical specialties other than cardiology. However, despite its multiple established advantages, CPET remains underused. This article aims to increase awareness of the value of CPET in clinical practice and to inform clinicians about its main indications, applications, and basic interpretation.
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Prueba de Esfuerzo , Humanos , Prueba de Esfuerzo/métodosRESUMEN
In the original publication [...].
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Baccharin is one of the major compounds found in Brazilian green propolis and its botanical source, Baccharis dracunculifolia. Considering the biological effects of propolis and B. dracunculifolia, this study aims to evaluate the analgesic and anti-inflammatory potential of baccharin. The neurodepressor potential was performed by the open field test, analgesia by mechanical stimulation with Dynamic Plantar Aesthesiometer, and by thermal stimulation with Hargreaves apparatus. In addition, the anti-inflammatory potential was achieved by the paw edema assay, histopathological evaluation, and NF-kB expression. Doses of 2.5, 5, and 10 mg/kg of baccharin were evaluated. After euthanasia, plantar tissue was collected and prepared for histology. As a result, analgesic activity was observed at a dose of 10 mg/kg of baccharin in thermal stimulation under an inflammatory process and anti-inflammatory potential at a dose of 5 mg/kg of baccharin from the second hour in the paw edema test. A decrease in cellular infiltrate and down-modulation of NF-kB, besides the reduction of edema in the histopathology was observed. There was no evidence of kidney and liver toxicity and neurodepressive potential at the doses tested. Thus, baccharin has a promising anti-inflammatory effect possibly associated with antiedematogenic activity by inhibiting mediators such as prostaglandins, inhibiting the migration of polymorphonuclear cells, and modulating NF-kB expression.
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Analgésicos , Antiinflamatorios , Baccharis , Edema , FN-kappa B , Própolis , Animales , Masculino , Ratas , Analgésicos/farmacología , Antiinflamatorios/farmacología , Antiinflamatorios/aislamiento & purificación , Baccharis/química , Brasil , Edema/tratamiento farmacológico , Edema/inducido químicamente , FN-kappa B/metabolismo , Própolis/farmacología , Ratas Wistar , TricotecenosRESUMEN
Among the several terpenes existing in nature, Citronellal, a monoterpene aldehyde, deserves to be highlighted for its biological properties that have been pointed out in numerous studies. This work aimed to conduct a literature review on its biological properties. Citronellal is a prominent compound in the essential oils of Cymbopogon genus plants. Apart from being employed as a fragrance ingredient in aromas, fragrances, and cosmetics, it is also used as an intermediate in synthesising (-)-menthol. Various studies have demonstrated Citronellal's potential as an antibacterial compound, particularly anti-Staphylococcus and Escherichia bacteria. Citronellal also has antifungal properties against several fungi, especially fungi of the genus Candida. The studies found showed that Citronellal also has insecticidal, acaricidal, antiparasitic, anaesthetic, antiviral, antioxidant, antinociceptive, cardioprotective, antihypertensive, anti-inflammatory, antidiabetic, and anticancer properties.
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Tetranychus urticae, popularly known as spider mite, is a pest that causes several economic losses to crops. Thus, this work evaluated the effect of essential oils from the leaves of Piper macedoi and Piper arboreum on managing T. urticae. The chemical compounds present in essential oils were identified by gas chromatography. Tests were carried out to evaluate the acaricidal activity by fumigation effect and direct contact with T. urticae. The results showed that LC50 values for the essential oils of P. macedoi and P. arboreum in the fumigation effect were 16.15 and 50.53 µL L-1 air, respectively. Using the contact application route, the LC50 values for the essential oil of P. macedoi was 17.16 µL mL-1, and for P arboreum, it was 15.17 µL mL-1. So, this work showed that essential oils of Piper macedoi and Piper arboreum could be used as possible alternative to managing T. urticae.
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The Croton genus is known for its various biological properties, which inspired this study to investigate the anti-bacterial pro-perties and chemodiversity of the essential oils of three Croton species: Croton blanchetianus, Croton jacobinensis, and Croton nepetifolius. The essential oils were characterised by gas chromatography (GC-MS) and demonstrated anti-bacterial activity against Staphylococcus aureus and Escherichia coli using the disc diffusion method. The essential oil composition of C. blanchetianus showed bicyclogermacrene (16.04%) and spathulenol (16.44%) as the main compounds. In C. jacobinensis, bicyclogermacrene (22.04%), caryophyllene (17.95%), and ß-phellandrene (12.30%) were the most prevalent. Meanwhile, C. nepetifolius's essential oil consisted mainly of bicyclogermacrene (17.69%), caryophyllene (15.15%), and germacrene D (11.78%). The principal component analysis (PCA) results showed three distinct chemotypes for each Croton species, suggesting that they have well-defined and unique chemical profiles. Interestingly, the three Croton species demonstrated activity only against Staphylococcus aureus bacteria.
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Food processing includes operations that transform raw materials into new products, ensuring the preservation and supply of safe food; however, this view is not always understood by consumers who tend to associate any type of processing with something negative and harmful to health. Given this, the objective of this study was to explore the associations of Brazilian consumers in relation to healthy foods, industrialized foods, and ultra-processed foods, as well as to evaluate the role of socio-demographic characteristics and interest in health in these associations. To this end, 512 Brazilians completed a word association task on these three concepts and then answered a questionnaire about interest in health and socio-demographic issues. In general, participants associated "Healthy food" mainly with "Unprocessed products." Conversely, "Industrialized foods" and "Ultra-processed foods" were associated with "Processed products," "Negative perceptions," "Health harm," and "Industry". Despite this, it was found that "Industrialized foods" were also perceived positively, mainly due to convenience. Consumer associations were influenced (p ≤ 0.05) both by interest in health and by socio-demographic profile. Individuals with a high interest in health mainly associated "Industrialized foods" and "Ultra-processed foods" with the presence of preservatives, additives, and pesticides, and with diseases. As for those with low interest in health, there was a greater lack of knowledge of the concepts. Doubts and lack of knowledge were observed for "Industrialized foods" and "Ultra-processed foods," mainly among consumers with low educational level. The results indicate the need to develop communication strategies that reach consumers to facilitate understanding and, in this way, help them to make more conscious food choices.
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Alimentos Procesados , Alimentos , Pueblos Sudamericanos , Humanos , Brasil , ComunicaciónRESUMEN
Endophytic fungi residing symbiotically in plant tissues are promising sources of bioactive natural products. This study explored the anti-inflammatory potential of an endophytic fungus isolated from the Brazilian medicinal plant Poincianella pluviosa (Sibipiruna). The extract from the endophyte FPD13 exhibited potential ex vivo anti-inflammatory effects by inhibiting prostaglandin E2 (PGE2) release by 75.22%. Phytochemical analysis using High-Performance Liquid Chromatography (HPLC), Nuclear Magnetic Resonance (NMR), and Liquid Chromatography-High Resolution Mass Spectrometry (LC-HRMS) enabled the isolation and identification of three compounds, including the macrolide Nigrosporolide, the phenyl-propanol Tyrosol, and the terpene Decarestrictine A. Morphological characteristics and Internal Transcribed Spacers region (ITS) sequencing classified fungus FPD13 as Nigrospora zimmermanii. The results reveal the anti-inflammatory potential and chemical diversity of P. pluviosa endophytes, warranting further investigation into the bioactivity and structure elucidation of their bioactive metabolites.
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Melanoma, an aggressive and potentially fatal skin cancer, is constrained by immunosuppression, resistance, and high toxicity in its treatment. Consequently, there is an urgent need for innovative antineoplastic agents. Therefore, this study investigated the antimelanoma potential of guttiferone E (GE). In an allogeneic murine B16 melanoma model, GE was administered subcutaneously and intraperitoneally. Antitumor evaluation included tumor volume/weight measurements and histopathological and immunohistochemical analysis. Furthermore, the toxicity of the treatments was evaluated through body/organ weights, biochemical parameters, and genotoxicity. Subcutaneous administration of 20 mg/kg of GE resulted in a significant reduction in both tumor volume and weight, effectively suppressing melanoma cell proliferation as evidenced by a decrease in mitotic figures. The tumor growth inhibition rate was equivalent to 54%. This treatment upregulated cleaved caspase-3, indicating apoptosis induction. On the other hand, intraperitoneal administration of GE showed no antimelanoma effect. Remarkably, GE treatments exhibited no toxicity, evidenced by non-significant differences in body weight gain, as well as organ weight, biochemical parameters of nephrotoxicity and hepatotoxicity, and genotoxic damage. This study revealed, for the first time, the efficacy of subcutaneous administration of GE in reducing melanoma, in the absence of toxicity. Furthermore, it was observed that the apoptotic signaling pathway is involved in the antimelanoma property of GE. These findings offer valuable insights for further exploring GE's therapeutic applications in melanoma treatment.
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Melanoma Experimental , Ratones Endogámicos C57BL , Animales , Melanoma Experimental/tratamiento farmacológico , Melanoma Experimental/patología , Melanoma Experimental/metabolismo , Apoptosis/efectos de los fármacos , Ratones , Masculino , Antineoplásicos/toxicidad , Antineoplásicos/administración & dosificación , Benzofenonas/farmacología , Benzofenonas/administración & dosificación , Benzofenonas/toxicidad , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patología , Proliferación Celular/efectos de los fármacos , Carga Tumoral/efectos de los fármacos , Línea Celular Tumoral , Inyecciones Subcutáneas , FemeninoRESUMEN
Strawberry is a food rich in bioactive compounds with great antioxidant potential. However, due to the high incidence of pests that affect crop cultivation, phytosanitary management still lacks control methods for agroecological cultivation. Thus, the present research aimed to evaluate the chemical composition and the potential of the essential oil of the leaves of Piper macedoi in the control of Cerosipha forbesi in laboratory and semi-field conditions. The concentration of essential oil in the leaves of P. macedoi that showed the highest mortality was 2.0 ml/L of oil, with a mortality above 91% under laboratory conditions. A mortality rate of 80% for all concentrations tested was observed after 24 h in all conditions tested. Thus, using essential oil from the leaf of P. macedoi can be a highly viable strategy in managing the aphid C. forbesi since it showed high mortality rates with small doses of oil.
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Áfidos , Fragaria , Aceites Volátiles , Piper , Animales , Aceites Volátiles/química , Piper/químicaRESUMEN
The use of various herbs and their compounds has been a strategy widely used in the fight against various human diseases. For example, rosmarinic acid, a bioactive phenolic compound commonly found in Rosemary plants (Rosmarinus officinalis Labiatae), has multiple therapeutic benefits in different diseases, such as cancer. Therefore, the study aimed to evaluate in silico and in vitro the inhibition potential of the enzyme Elastase from the porcine pancreas by rosmarinic acid isolated from the plant species R. officinalis Linn. Through Molecular Docking, the mechanism of action was investigated. In addition, rosmarinic acid presented a range of 5-60 µg/mL and significantly inhibited Elastase. At 60 µg/mL, there was an inhibition of 55% on the enzymatic activity. The results demonstrate the inhibition of Elastase by rosmarinic acid, which can lead to the development of new enzyme inhibitors that can be an inspiration for developing various drugs, including anticancer drugs.
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Ácido Rosmarínico , Rosmarinus , Humanos , Elastasa Pancreática , Simulación del Acoplamiento Molecular , Extractos Vegetales/farmacología , Cinamatos/farmacología , Depsidos/farmacologíaRESUMEN
Tomato is one of the most produced and consumed fruits in the world. However, it is a crop that faces several phytosanitary problems, such as fusarium wilt, caused by Fusarium oxysporum. Thus, this study aimed to evaluate citronella and melaleuca essential oils in vitro potential in the fungus F. oxysporum management. The chemical identification of the components in the essential oils was performed by gas chromatography with flame ionization and mass spectrometer detectors. The IC50 and IC90 were determined by linear regression and the percentage of inhibition of the fungus by analysis of variance. The major compounds in citronella essential oil were citronellal, Geraniol, and citronellol; in melaleuca (tea tree) oil were terpinen-4-ol and α-terpinene. Both oils promoted more significant inhibition at concentrations of 1.5 and 2.5 µL/mL, besides not presenting significant differences with commercial fungicides, confirming the high potential for using this control method in agriculture.
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Cymbopogon , Fungicidas Industriales , Fusarium , Lamiaceae , Aceites Volátiles , Solanum lycopersicum , Aceite de Árbol de Té , Fungicidas Industriales/farmacología , Árboles , Hongos , Aceites Volátiles/farmacología , Aceites Volátiles/química , Té , Enfermedades de las Plantas/microbiologíaRESUMEN
Neglected tropical diseases are significant causes of death and temporary or permanent disability for millions living in developing countries. Unfortunately, there is no effective treatment for these diseases. Thus, this work aimed to conduct a chemical analysis using HPLC/UV and GC/MS to identify the major constituents of the hydroalcoholic extracts of Capsicum frutescens and Capsicum baccatum fruits, evaluating these extracts and their constituents' schistosomicidal, leishmanicidal and trypanocidal activities. The results obtained for the extracts of C. frutescens are better when compared to those obtained for C. baccatum, which can be related to the different concentrations of capsaicin (1) present in the extracts. The lysis of trypomastigote forms results for capsaicin (1) led to a significant value of IC50 = 6.23 µM. Thus, the results point to capsaicin (1) as a possible active constituent in these extracts.