Changes in body composition of burn patients during the phases of response to trauma.

OBJECTIVE: To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma. METHODS: a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student's t test. RESULTS: the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005). CONCLUSION: metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.

Anti-Inflammatory, Antimicrobial, Antioxidant and Photoprotective Investigation of Red Propolis Extract as Sunscreen Formulation in Polawax Cream.

Many activities have been described for propolis, including, antiviral, antibacterial, antifungal, anti-inflammatory, immunoregulatory, antioxidant and wound healing properties. Recently, propolis has been highlighted due to its potential application in the pharmaceutical and cosmetic industries, motivating a better understanding of its antioxidant and anti-inflammatory activities. Propolis and its main polyphenolic compounds presented high antioxidant activity, and effectiveness as broad spectrum UVB and UVA photoprotection sunscreens. Through a qualitative phytochemical screening, the ethanolic red propolis extracts (EEPV) (70% at room temperature and 70% at a hot temperature) presented a positive result for flavonoids and terpenoids. It presented an antioxidant activity for reducing 50% of DPPH of 17 and 12 µg/mL for extraction at room temperature and at a hot temperature, respectively. The UPLC-QTOF-MS/MS analysis allowed the annotation of 40 substances for EEPV-Heated and 42 substances for EEPV-Room Temperature. The IC50 results of the ABTS scavenging activity was 4.7 µg/mL for both extractions, at room temperature and at a hot temperature. Additionally, we also evaluated the cytotoxic profile of propolis extracts against macrophage (RAW 264.7 cells) and keratinocytes (HaCaT cells), which showed non-cytotoxic doses in cell viability assays even after a long period of exposure. In addition, propolis extracts showed antibacterial activity for Gram-positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis), demonstrating potential biological activity for the creation of formulations aimed at disease control and prevention.

Hit-to-lead optimization of a 2-aminobenzimidazole series as new candidates for chagas disease.

Chagas disease is a neglected tropical disease caused by Trypanosoma cruzi. Because current treatments present several limitations, including long duration, variable efficacy and serious side effects, there is an urgent need to explore new antitrypanosomal drugs. The present study describes the hit-to-lead optimization of a 2-aminobenzimidazole hit 1 identified through in vitro phenotypic screening of a chemical library against intracellular Trypanosoma cruzi amastigotes, which focused on optimizing potency, selectivity, microsomal stability and lipophilicity. Multiparametric Structure-Activity Relationships were investigated using a set of 277 derivatives. Although the physicochemical and biological properties of the initial hits were improved, a combination of low kinetic solubility and in vitro cytotoxicity against mammalian cells prevented progression of the best compounds to an efficacy study using a mouse model of Chagas disease.

Changes in body composition of burn patients during the phases of response to trauma / Alterações na composição corporal de pacientes queimados durante as fases de resposta ao trauma / Cambios en la composición corporal de pacientes quemados durante las fases de respuesta al trauma

ABSTRACT Objective: To assess the changes in body composition of burn patients through electrical bioimpedance in the phases of response to trauma. Methods: a longitudinal observational study, carried out from October 2019 to March 2020. Sociodemographic, clinical, epidemiological, anthropometric and body composition data were collected. Statistical analysis was performed with SPSS, considering a significance of 5%. The comparison between variables was performed using the paired Student's t test. Results: the sample consisted of 58 adult burn patients, with a mean age of 38.2±12.5 years. The mean body surface area (BSA) with burns was 10.8±7.3%. Nutritional assessment demonstrated a depletion of body weight, Body Mass Index, fat-free mass and muscle mass in the phases of response to trauma (p<0.005). Conclusion: metabolic alterations in the different phases of the metabolic response to trauma led to a depletion of the nutritional status of burn patients of both sexes during hospitalization.

RESUMO Objetivo: avaliar as alterações na composição corporal de pacientes queimados por meio da bioimpedância elétrica nas fases de resposta ao trauma. Métodos: estudo observacional longitudinal, realizado de outubro de 2019 a março de 2020. Foram coletados dados sociodemográficos, clínicos, epidemiológicos, antropométricos e de composição corporal. A análise estatística foi realizada com o SPSS, considerando significância de 5%. Comparação entre as variáveis foi realizada por meio do teste t de Student pareado. Resultados: a amostra foi composta por 58 pacientes adultos queimados, com média de 38,2±12,5 anos. A média da área de superfície corporal (ASC) com queimaduras foi de 10,8±7,3%. A avaliação nutricional demonstrou depleção do peso corporal, índice de massa corporal, massa magra e massa muscular nas fases de resposta ao trauma (p<0,005). Conclusão: alterações metabólicas nas diferentes fases da resposta metabólica ao trauma levaram a depleção do estado nutricional de pacientes queimados de ambos os sexos durante a internação.

RESUMEN Objetivo: evaluar alteraciones en la composición corporal de pacientes quemados mediante bioimpedancia eléctrica en las fases de respuesta al trauma. Métodos: estudio observacional longitudinal, realizado de octubre de 2019 a marzo de 2020. Se recogieron datos sociodemográficos, clínicos, epidemiológicos, antropométricos y de composición corporal. El análisis estadístico se realizó mediante SPSS, considerando una significancia del 5%. La comparación entre variables se realizó mediante la prueba de la t de Student pareada. Resultados: la muestra estuvo compuesta por 58 pacientes adultos quemados, con una edad media de 38,2±12,5 años. El área de superficie corporal media (ASC) con quemaduras fue de 10,8±7,3%. La evaluación nutricional mostró disminución del peso corporal, índice de masa corporal, masa magra y masa muscular en las fases de respuesta al trauma (p<0,005). Conclusión: los cambios metabólicos en las diferentes fases de la respuesta metabólica al trauma llevaron a la disminución del estado nutricional de los pacientes quemados de ambos sexos durante la hospitalización.

In vitro approaches to antioxidant screening for the development of a sunscreen formulation

Abstract The incorporation of antioxidants into sunscreens may provide additional skin photoprotection against the harmful photobiological effects of ultraviolet radiation. The present study evaluated the applicability of a screening approach to the assessment of the antioxidant and photoprotective properties of vitamin C, vitamin E, and coenzyme Q10 and then determined the performance of the most effective antioxidant in a sunscreen formulation. Antioxidant activity was assessed by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, 2,2`-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assay, and oxygen radical absorbance capacity (ORAC) assay, and the photoprotective potential was investigated by the yeast photoprotection assay. The antioxidant with the best effect was incorporated into sunscreen formulations which were evaluated for 120 days regarding their in vitro photoprotective parameters. Vitamin C showed high antioxidant capacity as well as a photoprotective potential against simulated solar irradiation applied for times longer than 1 h. Although the Sun Protection Factor, UVA/UVB ratio and critical wavelength did not differed significantly (p<0.05) between the formulation blank and the formulations containing 0.5% or 1% vitamin C, formulations with vitamin C kept their photostability for 6 months. Consequently, the proposed screening approach seems to be promising for the development of an antisolar photostable formulation containing vitamin C as an antioxidant.

Fatigue in amyotrophic lateral sclerosis and correlated factors.

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach. OBJECTIVE: To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom. METHODS: Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA). RESULTS: Among the 65 individuals evaluated, 44.6% (n = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex (p = 0.049), pain intensity (p = 0.026), functioning (p = 0.004), disease severity (p = 0.029), and QoL (p = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p = 0.001), muscle strength (r = - 0.356; p = 0.004), functioning (r = - 0.363; p = 0.003), and QoL (r = 0.481; p = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters. CONCLUSIONS: Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS.

ANTECEDENTES: Esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa fatal que leva à fraqueza muscular e paralisia. Fadiga é um sintoma incapacitante, frequentemente relatado na ELA, mas permanece pouco investigado nessa população. Assim, uma investigação acurada deste sintoma e dos possíveis fatores associados é necessária para auxiliar em uma abordagem terapêutica adequada. OBJETIVO: Investigar a presença de fadiga em indivíduos com ELA e possíveis fatores correlacionados a este sintoma. MéTODOS: Participaram 65 indivíduos com ELA esporádica. Aspectos demográficos, clínicos e funcionais foram investigados. Foram utilizadas: Escala de Severidade de Fadiga (FSS, na sigla em inglês), Escala Funcional de ELA (ALSRFS-R, na sigla em inglês) e questionário de Qualidade de Vida (QV) (ALSAQ-40, na sigla em inglês). Análises descritivas e de correlação foram realizadas no programa SPSS para Windows versão 19.0 (IBM Corp., Armonk, NY, USA). RESULTADOS: Dos 65 indivíduos avaliados, 44,6% (n = 29) apresentaram fadiga pela FSS. A intensidade da fadiga foi 5,4 ± 1,2 e apenas 10,4% usavam medicamento específico para fadiga. Diferenças entre os grupos com e sem fadiga foram encontradas em relação ao sexo (p = 0,049), intensidade da dor (p = 0,026), funcionalidade (p = 0,004), gravidade da doença (p = 0,029) e QV (p = 0,000). A fadiga foi correlacionada com a intensidade da dor (r = 0,425; p = 0,001), força muscular (r = - 0,356; p = 0,004), funcionalidade (r = - 0,363; p = 0,003) e QV (r = 0,481; p = 0,000). Não foram encontradas correlações com idade, tempo de diagnóstico, cãibras ou outros parâmetros de mobilidade. CONCLUSõES: A fadiga é um sintoma comum entre os indivíduos com ELA e pode estar presente em todos os estágios da doença. Este sintoma estava correlacionado à pior funcionalidade, pior QV, gravidade, intensidade da dor, fraqueza muscular e sexo feminino em indivíduos com ELA.

Eficácia in sílico do florfenicol no tratamento de pododermatite infecciosa por Fusobacterium necrophorum em ovelhas / In sílico efficacy of florfenicol in the treatment of Fusobacterium necrophorum infectious pododermatitis in sheep

Objetivou-se comparar o efeito in silico do florfenicol nas doses de 20 e 30 mg/Kg em ovinos pelas vias intravenosa (IV) e intramuscular (IM), usando a modelagem PK/PD. Realizou-se uma simulação de Monte Carlo com base nos dados de concentração plasmática de um estudo publicado anteriormente. Calculou-se a área sob a curva (ASC) e as taxas de eficácia do florfenicol para os efeitos bacteriostático, bactericida e de erradicação bacteriológica. A dose de 20 mg/Kg IV demonstrou efeitos de erradicação de 100, 93 e 0% para CIM de 0,5, 1 e acima, respectivamente. O efeito bacteriostático foi de 99 e 90% para CIM de 4 e 2 µg/ml, enquanto o bactericida foi de 14% para CIM de 2 µg/ml. A dose de 30 mg/Kg IV apresentou 100% de erradicação para CIM de 1 µg/mL e 100% de efeito bactericida para CIM de 2 µg/mL. Há 100% de efeito bacteriostático em CIM de 4 µg/ml. As doses de 20 e 30 mg/Kg IM mostraram 100% de erradicação para CIM até 1 µg/mL e 0% para CIM maiores. O efeito bacteriostático foi mantido em 100% para uma CIM de 4 µg/mL em ambas as doses. Este estudo mostra o efeito de erradicação bacteriológica do florfenicol nas doses de 20 e 30 mg/Kg, IV e IM. Recomenda-se que seja feito um estudo de eficácia in vivo com a dose de 30mg/Kg IM em ovinos infectados por F. necrophorum com MIC superior a 2 µg/mL.

We aimed to compare the in silico effect of florfenicol at doses of 20 and 30 mg/Kg in sheep by intravenous (IV) and intramuscular (IM) routes, using PK/PD modeling. We performed a Monte Carlo simulation based on plasma concentration data from a previously published study. We calculated the area under the curve (AUC) and the efficacy rates of florfenicol to bacteriostatic, bactericidal, and bacteriological eradication effects. The dose of 20 mg/Kg IV demonstrated 100, 93, and 0% eradication effects for MICs of 0.5, 1, and above, respectively. The bacteriostatic effect was 99 and 90% for MIC of 4 and 2 µg/ml, while the bactericide was 14% for MIC of 2 µg/ml. The 30 mg/Kg IV dose showed 100% eradication for MIC of 1 µg/mL and 100% bactericidal effect for MIC of 2 µg/mL. There is a 100% of bacteriostatic effect at MIC of 4 µg/ml. Doses of 20 and 30 mg/Kg IM showed 100% eradication for MIC up to 1 µg/mL and 0% for MIC above. The bacteriostatic effect was maintained at 100% for a MIC of 4 µg/mL at both doses. This study shows the bacteriological eradication effect of florfenicol at doses of 20 and 30 mg/Kg, IV, and IM. Therefore, we recommend an in vivo efficacy study with a dose of 30mg/Kg IM in sheep infected with F. necrophorum with MIC greater than two µg/mL.

Fatigue in amyotrophic lateral sclerosis and correlated factors / Fadiga na esclerose lateral amiotrófica e fatores correlacionados

Abstract Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach. Objective To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom. Methods Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA). Results Among the 65 individuals evaluated, 44.6% (n = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex (p = 0.049), pain intensity (p = 0.026), functioning (p = 0.004), disease severity (p = 0.029), and QoL (p = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p = 0.001), muscle strength (r = - 0.356; p = 0.004), functioning (r = - 0.363; p = 0.003), and QoL (r = 0.481; p = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters. Conclusions Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS.

Resumo Antecedentes Esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa fatal que leva à fraqueza muscular e paralisia. Fadiga é um sintoma incapacitante, frequentemente relatado na ELA, mas permanece pouco investigado nessa população. Assim, uma investigação acurada deste sintoma e dos possíveis fatores associados é necessária para auxiliar em uma abordagem terapêutica adequada. Objetivo Investigar a presença de fadiga em indivíduos com ELA e possíveis fatores correlacionados a este sintoma. Métodos Participaram 65 indivíduos com ELA esporádica. Aspectos demográficos, clínicos e funcionais foram investigados. Foram utilizadas: Escala de Severidade de Fadiga (FSS, na sigla em inglês), Escala Funcional de ELA (ALSRFS-R, na sigla em inglês) e questionário de Qualidade de Vida (QV) (ALSAQ-40, na sigla em inglês). Análises descritivas e de correlação foram realizadas no programa SPSS para Windows versão 19.0 (IBM Corp., Armonk, NY, USA). Resultados Dos 65 indivíduos avaliados, 44,6% (n = 29) apresentaram fadiga pela FSS. A intensidade da fadiga foi 5,4 ± 1,2 e apenas 10,4% usavam medicamento específico para fadiga. Diferenças entre os grupos com e sem fadiga foram encontradas em relação ao sexo (p = 0,049), intensidade da dor (p = 0,026), funcionalidade (p = 0,004), gravidade da doença (p = 0,029) e QV (p = 0,000). A fadiga foi correlacionada com a intensidade da dor (r = 0,425; p = 0,001), força muscular (r = - 0,356; p = 0,004), funcionalidade (r = - 0,363; p = 0,003) e QV (r = 0,481; p = 0,000). Não foram encontradas correlações com idade, tempo de diagnóstico, cãibras ou outros parâmetros de mobilidade. Conclusões A fadiga é um sintoma comum entre os indivíduos com ELA e pode estar presente em todos os estágios da doença. Este sintoma estava correlacionado à pior funcionalidade, pior QV, gravidade, intensidade da dor, fraqueza muscular e sexo feminino em indivíduos com ELA.

Environmental life cycle assessment of cow milk in a conventional semi-intensive Brazilian production system.

The environmental performance of cow milk produced in a conventional semi-intensive system was assessed using a cradle-to-farm gate attributional life cycle assessment. The impacts of 1 kg FPCM-fat and protein corrected milk were obtained considering six midpoint impact categories from the ReCiPe 2016 method: climate change (CC), terrestrial acidification (TA), freshwater eutrophication (FE), land use (LU), water consumption (WC), and fossil resource scarcity (FRS). The modeling of the product system and calculating the environmental impacts considered the use of SimaPro™ software. Enteric methane and nitrogen emissions and inputs for feeding animals (fertilization for pasture production, use of seed in corn crops, and milk replacer in calves feed) were the main contributors to impacts in milk production in most categories. In addition, the indirect energy use and wastewater generation in milking and milk cooling also were relevant. Literature-based strategies are suggested to mitigate the identified environmental impacts to achieve the best environmental performance without decreasing technical and quality milk production. We emphasize the importance of improving productivity per milk cow, knowing the origin of the supply chain inputs, and using it efficiently to produce animal feeds as the main strategies to improve milk's environmental performance. Changes in allocation methods did not substantially differ in impact categories. Sensitivity analysis foregrounds the consistency of results and conclusions of the current study despite the uncertainties associated with methodological choices, simplifications, suppositions, and the use and adaptation of international databases.

Clinical and nutritional predictors of hospital readmission within 30 days.

BACKGROUND/OBJECTIVES: Identify clinical, sociodemographic, and nutritional predictors of hospital readmission within 30 days. SUBJECTS/METHODS: A longitudinal study was conducted with patients hospitalised at a public institution in Recife, Brazil. Sociodemographic (age, sex, race, and place of residence), clinical (diagnosis, comorbidities, medications, polypharmacy, hospital outcome, hospital stay, and occurrence of readmission within 30 days), and nutritional (% of weight loss, body mass index, arm circumference [AC], and calf circumference [CC]) characteristics were collected from the nutritional assessment files and patient charts. Nutritional risk was determined using the 2002 Nutritional Risk Screening tool and the diagnosis of malnutrition was based on the GLIM criteria. RESULTS: The sample was composed of 252 patients, 58 (23.0%; CI95%: 17.2-28.8%) of whom were readmitted within 30 days after discharge from hospital, 135 (53.5%; CI95%: 46.7-60.5%) were at nutritional risk and 107 (42.4%; CI95%: 35.6-49.3%) were malnourished. In the bivariate analysis, polypharmacy, nutritional risk, malnutrition, low AC, and low CC were associated with readmission. In the multivariate analysis, low CC was considered an independent risk factor, increasing the likelihood of hospital readmission nearly fourfold. In contrast, the absence of polypharmacy was a protective favour, reducing the likelihood of readmission by 81%. CONCLUSIONS: The use of six medications or more and low calf circumference are risk factors for hospital readmission within 30 days after discharge.

Eficácia do florfenicol no tratamento de pododermatite infecciosa por Fusobacterium necrophorum em ovelhas

This study aims to compare the dose of 20 and 30 mg/kg of florfenicol, intravenously (IV) and intramuscularly (IM) in sheep.  The Monte Carlo simulation was performed using the area under the curve (AUC) data obtained from a previously published study. AUC and the minimum inhibitory concentration (MIC) were evaluated to determine the efficacy rates of florfenicol. At dose of 20 mg/kg IV, florfenicol demonstrated 100, 93 and 0% eradication for MICs of 0.5, 1 and above 1 µg/mL, respectively. The bacteriostatic effect was 99 and 90% for MICs of 4 and 2 µg/mL, while the bactericidal effect was 14% for MIC of 2 µg/mL. The 30 mg/Kg IV dose, demonstrated 100% eradication for MIC 1 µg/mL and 100% bactericidal effect for MIC 2 µg/mL. The bacteriostatic effect remained at 100% for MIC 4 µg/mL. The doses of 20 and 30 mg/kg IM, showed 100% eradication for MIC of 1 µg/mL and 0% for higher MIC. The bacteriostatic effect remained at 100% for MIC 4 µg/mL for both doses. This study demonstrated that the doses of 20 and 30 mg/Kg, IV, and IM, show high efficacy rates for Fusobacterium necrophorum strains with MICs up to 1 µg/mL.

Objetivou-se comparar o efeito in silico do florfenicol nas doses de 20 e 30 mg/Kg em ovinos pelas vias intravenosa (IV) e intramuscular (IM), usando a modelagem PK/PD. Realizou-se uma simulação de Monte Carlo com base nos dados de concentração plasmática de um estudo publicado anteriormente. Calculou-se a área sob a curva (ASC) e as taxas de eficácia do florfenicol para os efeitos bacteriostático, bactericida e de erradicação bacteriológica. A dose de 20 mg/Kg IV demonstrou efeitos de erradicação de 100, 93 e 0% para CIM de 0,5, 1 e acima, respectivamente. O efeito bacteriostático foi de 99 e 90% para CIM de 4 e 2 µg/ml, enquanto o bactericida foi de 14% para CIM de 2 µg/ml. A dose de 30 mg/Kg IV apresentou 100% de erradicação para CIM de 1 µg/mL e 100% de efeito bactericida para CIM de 2 µg/mL. Há 100% de efeito bacteriostático em CIM de 4 µg/ml. As doses de 20 e 30 mg/Kg IM mostraram 100% de erradicação para CIM até 1 µg/mL e 0% para CIM maiores. O efeito bacteriostático foi mantido em 100% para uma CIM de 4 µg/mL em ambas as doses. Este estudo mostra o efeito de erradicação bacteriológica do florfenicol nas doses de 20 e 30 mg/Kg, IV e IM. Recomenda-se que seja feito um estudo de eficácia in vivo com a dose de 30mg/Kg IM em ovinos infectados por F. necrophorum com MIC superior a 2 µg/mL.

Structure optimization of lipopeptide assemblies for aldol reactions in an aqueous medium.

Four amphiphilic peptides were synthesized, characterized, and evaluated regarding their efficiency in the catalysis of direct aldol reactions in water. The lipopeptides differ by having a double lipid chain and a guanidinium pyrrole group functionalizing one Lys side chain. All the samples are composed of the amino acids l-proline (P), l-arginine (R), or l-lysine (K) functionalized with the cationic guanidiniocarbonyl pyrrole unit (GCP), l-tryptophan (W), and l-glycine (G), covalently linked to one or two long aliphatic chains, leading to surfactant-like designs with controlled proline protonation state and different stereoselectivity. Critical aggregation concentrations (cac) were higher in the presence of the GCP group, suggesting that self-assembly depends on charge distribution along the peptide backbone. Cryogenic Transmission Electron Microscopy (Cryo-TEM) and Small Angle X-ray Scattering (SAXS) showed a rich polymorphism including spherical, cylindrical, and bilayer structures. Molecular dynamics simulations performed to assess the lipopeptide polymorphs revealed an excellent agreement with core-shell arrangements derived from SAXS data and provided an atomistic view of the changes incurred by modifying head groups and lipid chains. The resulting nanostructures behaved as excellent catalysts for aldol condensation reactions, in which superior conversions (>99%), high diastereoselectivities (ds = 94 : 6), and enantioselectivities (ee = 92%) were obtained. Our findings contribute to elucidate the effect of nanoscale organization of lipopeptide assemblies in the catalysis of aldol reactions in an aqueous environment.

2-aminobenzimidazoles for leishmaniasis: From initial hit discovery to in vivo profiling.

Leishmaniasis is a major infectious disease with hundreds of thousands of new cases and over 20,000 deaths each year. The current drugs to treat this life-threatening infection have several drawbacks such as toxicity and long treatment regimens. A library of 1.8 million compounds, from which the hits reported here are publicly available, was screened against Leishmania infantum as part of an optimization program; a compound was found with a 2-aminobenzimidazole functionality presenting moderate potency, low metabolic stability and high lipophilicity. Several rounds of synthesis were performed to incorporate chemical groups capable of reducing lipophilicity and clearance, leading to the identification of compounds that are active against different parasite strains and have improved in vitro properties. As a result of this optimization program, a group of compounds was further tested in anticipation of in vivo evaluation. In vivo tests were carried out with compounds 29 (L. infantum IC50: 4.1 µM) and 39 (L. infantum IC50: 0.5 µM) in an acute L. infantum VL mouse model, which showed problems of poor exposure and lack of efficacy, despite the good in vitro potency.

Nutritional assessment of hospitalized patients: Comparison of real and estimated anthropometric measures

ABSTRACT The assessment of the nutritional status of hospitalized patients is fundamental to the establishment of the diagnosis. For bedridden patients, however, it is not possible to determine simple measures, such as weight and height, which are the most widely used variables for nutritional assessments. Objective: Compare real and estimated anthropometric measures in hospitalized patients. Methods: A cross-sectional study was conducted with adult (>18 years of age) and senior patients (>60 years of age) admitted for clinical or surgical treatment in the general surgery infirmary of Governador Paulo Guerra Restauração Hospital. Data (sex, age, clinical diagnosis, real weight, real height, body mass index, knee height and arm circumference) were collected using nutritional follow-up charts and tabulated using Excel 2016. Statistical analyses were performed in SPSS® version 21.0. Results: One hundred and twenty patients participated in the study (median age: 55 years). Most were adults (73.3%) and women (53.3%). The mean differences in weight between the estimated and real measures were statistically significant (p=0.000), with an overestimation of this variable. Regarding height, the estimated values differed significantly from the real values in both men and women (p<0.000) and the difference was larger among the seniors (mean: -0.072). No significant difference was found between the real and estimated body mass index (p= 0.44). Conclusion: In the comparison of methods for estimating weight and height to real measures, a tendency was found to overestimate these body measures.

RESUMEN La evaluación del estado nutricional de los pacientes hospitalizados es esencial para establecer su diagnóstico. Sin embargo, para los pacientes postrados en cama, no se pueden realizar medidas sencillas como el peso y la altura, que son las más utilizadas para el diagnóstico nutricional. Objetivo: Comparar mediciones antropométricas reales y estimadas en pacientes hospitalizados. Metodología: Estudio transversal, que incluye pacientes adultos (>18 años) y personas mayores de 60 años, ingresados para tratamiento clínico o quirúrgico en la sala de cirugía general del Hospital da Restauração Governador Paulo Guerra. Los datos (sexo, edad, diagnóstico clínico, peso real, altura real, índice de masa corporal, altura de la rodilla y circunferencia del brazo) se recopilaron mediante los formularios de monitoreo nutricional y se tabularon en el software Excel 2016. Los análisis estadísticos se realizaron con SPSS®, versión 21.0. Resultados: 120 pacientes con mediana de 55 años, en su mayoría adultos (73,3%) y mujeres (53,3%). Las diferencias promedio entre las mediciones estimadas y reales fueron estadísticamente significativas, con sobreestimación del peso (p<0,0001). Con respecto a la altura, fue posible identificar que las medidas estimadas diferían significativamente (p<0,0001) de las reales para hombres y mujeres, y que esta variación era aún mayor entre los ancianos (media: -0,072). No hubo diferencias estadísticamente significativas entre el índice de masa corporal real y el estimado (p= 0,44). Conclusión: Al comparar las metodologías para estimar el peso y la altura con las mediciones reales, fue posible observar una tendencia de los métodos a sobreestimar estas mediciones corporales.

Imunomodulação em paciente queimado fasciotomizado: Relato de caso / Immunomodulation in a burned fasciotomized patient: A case report

OBJETIVO: Descrever a evolução clínica e nutricional de paciente queimado fasciotomizado com uso de terapia nutricional imunomoduladora. RELATO DO CASO: Estudo do tipo relato de caso, realizado durante 52 dias na Unidade de Tratamento de Queimados do Hospital da Restauração Governador Paulo Guerra, em Recife-PE. Paciente do sexo masculino, adulto, 27 anos, proveniente do interior de Pernambuco, sem comorbidades, queimado por eletricidade de alta voltagem após acidente de trabalho, evoluindo com síndrome compartimental do membro superior esquerdo e submetido a fasciotomia. Prescrita dieta por via oral associada à suplementação imunomoduladora de característica hipercalórica, hiperproteica, contendo arginina e alto teor de oligoelementos e micronutrientes. Durante o internamento, o paciente apresentou manutenção do estado nutricional, com adesão de novos hábitos alimentares que contribuíram para a cicatrização do membro afetado. CONCLUSÃO: A terapia nutricional imunomoduladora individualizada beneficiou a reparação tecidual, cicatrização e redução do risco de amputação em paciente queimado fasciotomizado.

OBJECTIVE: To describe the clinical and nutritional evolution of a burn patient submitted to fasciotomy and immunomodulating nutritional therapy. CASE REPORT: A case-report study was conducted over a 52-day period at the Burn Treatment Unit of Governador Paulo Guerra Restauração Hospital in the city of Recife, Brazil. A 27-year-old male patient, brown skin color, from the instate region of the state of Pernambuco, without comorbidities, suffered a high-voltage electrical burn after a work accident, developing compartment syndrome of the left upper limb, and was submitted to fasciotomy. An orally diet was prescribed associated with immunomodulatory supplementation with a hypercaloric, hyper protein character, with arginine and high content of trace elements and micronutrients. During hospitalization, the patient's nutritional status was maintained with the adherence to new dietary habits, which contributed to the healing of the affected limb. CONCLUSIONS: Individualized immunomodulating nutritional therapy benefits the tissue repair and healing processes, reducing the risk of amputation in burn patients submitted to fasciotomy.

Utilização da posição prona em ventilação espontânea em paciente com COVID-19: relato de caso / The use of the prone position in spontaneous ventilation in a patient with COVID-19: a case report

OBJETIVO: Descrever caso de uma paciente adulta com COVID-19, internada em unidade de terapia intensiva (UTI) e submetida à posição prona. RELATO DO CASO: paciente do sexo feminino, 44 anos, portadora de síndrome metabólica prévia, com síndrome da imunodeficiência adquirida, chegou ao pronto atendimento apresentando febre, congestão nasal, negando dispneia. Após a realização de exames clínicos e de imagem, foi transferida para a UTI, com suspeita de COVID-19. Na chegada na unidade intensiva, estava respirando espontaneamente com oxigenoterapia de baixo fluxo à 5L/min, apresentando hipoxemia (SpO2 = 88% e PaO2=76mmHg). Além das terapias médicas instituídas, foi orientada a se posicionar na PP durante um período de 15 a 30 minutos, realizado uma vez por turno. Após o primeiro posicionamento foi possível observar melhora na difusão pulmonar, pois a gasometria arterial demonstrou aumento da PaO2 para 96mmHg e de 18% na relação PaO2/FiO2, além de evolução clínica favorável. CONCLUSÕES: A indicação precoce da PP como terapia adicional no tratamento de paciente com COVID-19 pode ter contribuído para o desfecho clínico favorável, principalmente no que tange à oxigenação, evidenciada através da melhora de parâmetros de PaO2, relação PaO2/FiO2 e progressão com alta hospitalar.

OBJECTIVE: Describes a case of an adult COVID-19, who was addmited patient admitted to an intensive care unit (ICU) and submitted to the prone position. CASE REPORT: Female patient, 44 years old, with a previous metabolic syndrome and acquired immuno-deficiency syndrome, arrived at the emergency department. She had fever, nasal congestion, but without dyspnea. After clinical and imaging tests, she was transferred to an ICU, with suspected COVID-19. Upon arrival at the intensive unit, she was breathing spontaneously with low flow oxygen therapy, presenting hypoxemia. In addition to the established medical therapies, he was instructed to position himself in the PP for a period of 15 to 30 minutes, performed once when turning. Arterial blood gases increase to 96mmHg in PaO2 and consequently 18% in the PaO2 / FiO2 ratio, in addition to the favorable clinical evolution. CONCLUSIONS: The early indication of PP as an additional therapy in the treatment of COVID-19 patients, can have contributed to the favorable clinical outcome, especially with regard to oxygenation, evidenced by the improvement of PaO2 parameters, PaO2/FiO2 ratio and progress discharged.

Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults.

OBJECTIVE: To investigate the discriminative power of Nutritional Risk Screening 2002. METHODS: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. RESULTS: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). CONCLUSION: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.

Barriers for the use of outdoor gyms in adults and elderly from a southern city of Brazil / Barreiras para o uso de academias ao ar livre em adultos e idosos de uma cidade do Sul do Brasil

The aim of this study was to identify barriers to use Outdoor Gyms (OGs) for physical activity (PA) practice and to examine their association with leisure-time PA, demographic and socioeconomic var-iables in adults and elderly. This cross-sectional population-based study enrolled 431 adults and elderly (66.8% women) aged 18 to 87 years living in the surroundings (up to 500 meters) of four OGs. Information about using OGs for PA practice, barriers to use OGs, leisure-time PA, demographic and socioeconomic variables were collected by domiciliary interview. Associations between barriers to use OGs with other included variables were analyzed using Chi-Square test. None barriers was re-ported for 29.2% (95%CI: 24.9-33.5) of the participants, being almost of then OGs' users. The most reported barriers to use OGs were lack of time (21.6%; 95%CI: 17.7-25.5), lack of interest (16.5%; 95%CI: 13.0-20.0) and laziness (10.7%; 95%CI: 7.8-13.6). Intrapersonal barriers were more often among men, interpersonal among women and environmental among those with less educational level (p < 0.05). In conclusion, OGs' users perceived fewer barriers than non-users, and most barriers to the use of OGs were intrapersonal with lack of time being the most prevalent

O objetivo deste estudo foi identificar as barreiras para o uso de Academias ao Ar Livre (AAL) para a prática de Atividade Física (AF) e examinar sua associação com a AF no lazer, variáveis demográficas e socioeconômicas em adultos e idosos. Este estudo transversal de base populacional incluiu 431 adultos e idosos (66,8% mulheres) com idades entre 18 e 87 anos moradores do entorno (até 500 metros) de quatro AAL. Informações sobre o uso da AAL para prática de AF, barreiras para o uso de AAL, AF de lazer, variáveis demográficas e socioeconômicas foram coletadas por entrevista domiciliar. As associações entre barreiras para o uso de AAL com as demais variáveis foram analisadas pelo teste do Qui-quadrado. Não perceber barreiras foi relatada por 29,2% (IC95%: 24,9-33,5) dos participantes, sendo praticamente todos os usuários de AAL. As barreiras mais relatadas para o uso de AAL foram falta de tempo (21,6%; IC95%: 17,7-25,5), falta de interesse (16,5%; IC95%: 13,0-20,0) e preguiça (10,7%; IC95%: 7,8-13,6). As barreiras intrapessoais foram mais frequentes entre os homens, as interpessoais entre as mulheres e as ambientais entre aqueles com menor nível educacional (p <0,05). Em conclusão, os usuários de AAL perceberam menos barreiras do que os não usuários, e a maioria das barreiras para o uso de AAL é intrapessoal, sendo a falta de tempo a mais prevalente

Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults / Poder diagnóstico discriminativo da versão adaptada do Nutritional Risk Screening 2002 administrada em idosos brasileiros

ABSTRACT Objective: To investigate the discriminative power of Nutritional Risk Screening 2002. Methods: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. Results: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). Conclusion: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.

RESUMO Objetivo: Avaliar o poder de discriminação diagnóstica da ferramenta Nutritional Risk Screening 2002. Métodos: Estudo transversal com cem participantes com idade ≥60 anos. Foram aplicados o Nutritional Risk Screening 2002 original, o Nutritional Risk Screening 2002 adaptado e o Mini Nutritional Assessment. A adaptação do Nutritional Risk Screening 2002 consistiu em diminuir o critério de idade, incluindo pontuação adicional para 60 anos de idade ou mais. Resultados: Maior risco nutricional ocorreu nos ≥70 anos quando aplicado o Nutritional Risk Screening 2002 original (p=0,009), enquanto o Nutritional Risk Screening 2002 adaptado apresentou risco nutricional semelhante em ambos os grupos (60-69 anos e ≥70 anos; p=0,117). A frequência de risco nutricional foi maior no Mini Nutritional Assessment (52,7%), seguido do Nutritional Risk Screening 2002 adaptado (35,5%) e do Nutritional Risk Screening 2002 original (29,1%). Conclusão: A adaptação do Nutritional Risk Screening 2002 mostrou-se descritivamente mais eficaz do que a original, porém mais estudos devem ser realizados para confirmar os achados.

Atividades motoras e qualidade de vida de adolescentes de Paranaguá, Paraná / Motor practices and quality of life of adolescents of Paranagua, Parana

O objetivo do estudo foi analisar as relações entre o envolvimento em diferentes atividades motoras, de acordo com a frequência de prática, e a percepção da qualidade de vida de adolescentes. Partici-param do estudo 773 adolescentes das escolas estaduais de Paranaguá (Paraná), com idade de 14 a 19 anos. Por meio de um questionário autoaplicável, foram coletadas informações sociodemográficas, a atividade motora (Physical Activity Questionnaire for Adolescents) e percepção da qualidade de vida (Pediatric Quality of Life Inventory™, versão 4.0). Adolescentes que praticavam futebol (p < 0,005), basquete (p < 0,005), lutas (p < 0,005), musculação (p < 0,001), tênis/tênis de mesa (p < 0,005), natação (p < 0,0005), voleibol (p < 0,005), ginástica na academia (p < 0,005) e andavam de bicicleta (p < 0,005) apresentaram percepção mais positiva de qualidade de vida em diferentes domínios. Os domínios da qualidade de vida com mais atividades motoras associadas foram "saúde e atividade" e "convívio com outras pessoas". Envolvimento em diversas atividades motoras associou-se a melhor percepção da qualidade de vida, diferindo-se conforme frequência. Adolescentes que praticavam uma ou duas vezes por semana o futebol, basquete, lutas, natação, corrida, tênis/tênis de mesa e mus-culação, também como, os que praticavam, de três ou mais vezes na semana, a caminhada, voleibol, fazer exercício em academias de ginástica, corrida e andavam de bicicleta apresentaram percepção mais positiva da qualidade de vida que os não praticantes

The aim of the study was to analyze the relationships between the involvement in different motor activities, according to the frequency of practice, and the perception of the quality of life of adolescents. A total of 773 adolescents from the state's schools of Paranagua (Paraná), aged 14 to 19, participated in the study. Using a self-administered questionnaire, was investigated sociodemographic information, motor activity (Physical Activity Questionnaire for Adolescents and perception of quality of life (Pediatric instrument Quality of Life Inventory ™ version 4.0. Adolescents was practiced soccer (p < 0.005), basketball (p < 0.005), fights (p < 0.005), bodybuilding (p< 0.001), tennis / table tennis (p < 0.005), swimming (p < 0.005), volleyball (p < 0.005), exercise in gymnasiums (p < 0.005) and cycling (p < 0.005) had a more positive perception of quality of life in different domains. The domains of quality of life with more associated motor activities were "health and activity" and "living with other people". Involvement in several motor activities was associated with a better perception of quality of life, differing according to frequency. Teenagers who practiced once or twice a week soccer, basketball, fights, swimming, running, tennis / table tennis and bodybuilding, as well as, practicing, three or more times a week, walking, volleyball, gymnastics, running and cycling had a more positive perception of quality of life than non-practitioners