Stability of the Motor Optimality Score Revised (MOS-R) in medically complex infants.

BACKGROUND: The Motor Optimality Score-Revised (MOS-R) is a clinical test of infant spontaneous movement at 3-5 months of age and has been associated with neurodevelopmental outcomes in infants with medical complexity. However the stability of the MOS-R tested at different developmental ages is not yet known. AIM: To determine if the repeated scoring of the MOS-R remained consistent when tested at two developmental ages in young infants. STUDY DESIGN: In this prospective cohort study, infants were tested twice with the MOS-R between 12 and 13 weeks corrected age (CA) and 14-16 weeks CA. Bland Altman Plots were used to calculate agreement between the scores. Infants were grouped as having higher or lower medical complexity. MOS-R threshold scores were analyzed to assess changes over time within each group using Fisher's exact test. SUBJECTS: 85 infants with history of hospitalization in a neonatal intensive care unit (NICU). RESULTS: The MOS-R scores had a high agreement with negligible bias (0.058) between timepoints (95 % CI -1.10, 1.22). Using a MOS-R cut point of 19, infants with higher medical complexity were more likely to change groups between timepoints than infants with lower medical complexity (p = 0.008), but this was not significantly different using cut points of 20 or 21. CONCLUSION: The MOS-R scores were stable when measured repeatedly in infants who were hospitalized in a NICU. Infants with high medical complexity had less stable MOS-R scores using certain cut points than infants with lower medical complexity.

Baby Observational Selective Control AppRaisal (BabyOSCAR): Convergent and discriminant validity and reliability in infants with and without spastic cerebral palsy.

AIM: To describe the development of an observational measure of spontaneous independent joint motion in infants with spastic cerebral palsy (CP), the Baby Observational Selective Control AppRaisal (BabyOSCAR), and to test its convergent validity and reliability. METHOD: A retrospective sample of 75 infants (45 with spastic CP and 30 without CP) at 3 months of age were scored with the BabyOSCAR and compared with diagnosis of spastic CP, limbs affected, and Gross Motor Function Classification level at 2 years of age or later for convergent validity using t-tests, Kruskal-Wallis tests, and Spearman's rank correlation coefficients. BabyOSCAR interrater and test-retest reliability was also evaluated using intraclass correlation coefficients. RESULTS: Infants with spastic CP had significantly lower BabyOSCAR scores than children without CP (p < 0.001) and scores were significantly correlated with Gross Motor Function Classification System levels (p < 0.001). Children with unilateral CP had significantly higher asymmetry scores than children with bilateral CP or no CP (p < 0.01). Interrater and test-retest reliabilities were good to excellent. INTERPRETATION: Reductions in independent joint control measured in infancy are a hallmark of eventual diagnosis of spastic CP, and influence gross motor function later in childhood (with or without a diagnosis of CP).

Baby Observational Selective Control AppRaisal (BabyOSCAR): Construct validity and test performance.

AIM: To investigate the construct validity of the Baby Observational Selective Control AppRaisal (BabyOSCAR), an assessment of independent joint motion in infants with cerebral palsy (CP). METHOD: BabyOSCAR was scored for 75 infants (45 with CP and 30 without CP). Rasch analysis was used in combination with classical test theory to assess areas of strength or improvement. Overall fit and precision, unidimensionality, local independence, reliability indices, Wright's child-item map, and differential item functioning were examined as part of Rasch analysis to investigate the item properties, internal construct validity, and reliability of BabyOSCAR. Cronbach's α was used to evaluate items' internal consistency. RESULTS: Analysis demonstrated good fit to the Rasch model, with only one erratic item. Unidimensionality results suggest two dimensions, split between arm and leg items. Item calibration reliability was between 0.84 and 0.86, with three distinct item difficulty levels. Infant measure reliability was between 0.82 and 0.91, separating infants into three ability levels. Together, the two subscales covered the full range of skills, with redundancy mostly between the same motion on both sides of the body. Cronbach's α was between 0.90 and 0.95. INTERPRETATION: BabyOSCAR's construct validity was supported. Arm and leg subscales can be translated to a logit scale.

Baby Observational Selective Control AppRaisal (BabyOSCAR): Scores at 3 months predict functional ability, spastic cerebral palsy distribution, and diagnosis at 2 years.

AIM: To assess the predictive capabilities of the Baby Observational Selective Control AppRaisal (BabyOSCAR) tool, administered at 3 months corrected age, in determining spastic cerebral palsy (CP) outcome, functional abilities, and body topography at 2 years of age or later. METHOD: Independent joint motions were measured at age 10 to 16 weeks from video recordings of spontaneous movement using BabyOSCAR in a sample of 75 infants. All included infants had known 2-year outcomes (45 with spastic CP and 30 without CP) including Gross Motor Functional Classification System (GMFCS) levels and CP body distribution. Receiver operating characteristic curves and cut points indicating greatest sensitivity and specificity were generated for predictive performance. RESULTS: Total BabyOSCAR score was a strong predictor of future outcome of spastic CP (cut score of 22.5, sensitivity = 98%, specificity = 100%, area under the curve = 0.99), and was able to distinguish children classified in GMFCS levels I and II from those in III to V (cut score of 13.5, sensitivity = 92%, specificity = 89%, area under the curve = 0.94). Having an (absolute) asymmetry score on the BabyOSCAR of more than 5 was a predictor of having unilateral CP at age 2 years (sensitivity = 56%, specificity = 100%, area under the curve = 0.86). INTERPRETATION: BabyOSCAR scores are predictors of diagnosis, body distribution, and future gross motor function in infants with spastic CP at 2 years of age or later.

Assessing Neonatal Intensive Care Unit (NICU) Graduates Across Varied Settings: A Study on the Feasibility of the Baby Moves App.

We assessed the feasibility of obtaining parent-collected General Movement Assessment videos using the Baby Moves app. Among 261 participants from 4 Chicago NICUs, 70% submitted videos. Families living in higher areas of childhood opportunity used the app more than those from areas of lower opportunity.

Perfil epidemiológico e cobertura vacinal do sarampo no Brasil / Epidemiological profile and vaccination coverage of measles in Brazil

Verificar o perfil epidemiológico e a cobertura vacinal do sarampo no Brasil.Foi realizado um estudo epidemiológico descritivo retrospectivo a respeito da cobertura vacinal do sarampo no Brasil a partir de dados disponibilizados pelo Departamento de Informática do Sistema Único de Saúde. A partir da análise dos dados, observou-se maior número de casos na região Norte. O maior número de casos registrados foi no ano de 2019. Os indivíduos mais acometidos eram do sexo masculino. A faixa etária ≤ 1 ano representou 41,12% dos casos, e pessoas de cor parda, 47% dos casos. Foram registrados 6 óbitos no período estudado. Por fim, em relação à cobertura vacinal do imunizante tríplice viral, observou-se maior cobertura no ano de 2019. Dentre as regiões geográficas, o maior índice de cobertura foi na região Sul. Percebe-se a necessidade de intensificação de campanhas de conscientização sobre a importância vacinal.

To verify the status and the immunization coverage of measles in Brazil It is a descriptive retrospective epidemiological study about the immunization coverage of measles in Brazil based on data provided by the Department of Informatics of the Unified Health System.From the data analysis, there was a greater number of cases in the North region. The highest number of registered cases was in 2019. The most affected individuals were males. The age group ≤ 1 year old represented 41,12% of cases, and people of mixed color, 47% of cases. Six deaths occurred during the study period. Finally, in relation to vaccination coverage, with immunization with two doses of the MMR vaccine, there was greater coverage in 2019. Among the geographic regions, the highest coverage index was in the South region. There is a need to intensify awareness campaigns about the importance of vaccination.

Polymorphisms in Toll-Like receptors genes and their associations with immunological parameters in Plasmodium vivax malaria in the Brazil-French Guiana Border.

BACKGROUND: The innate immune response plays an important role during malaria. Toll-like receptors (TLR) are capable of recognizing pathogen molecules. We aimed to evaluate five polymorphisms in TLR-4, TLR-6, and TLR-9 genes and their association with cytokine levels and clinical parameters in malaria from the Brazil-French Guiana border. METHODS: A case-control study was conducted in Amapá, Brazil. P. vivax patients and individuals not infected were evaluated. Genotyping of five SNPs was carried out by qPCR. Circulating cytokines were measured by CBA. The MSP-119 IgG antibodies were performed by ELISA. RESULTS: An association between TLR4 A299G with parasitemia was observed. There was an increase for IFN-ɤ, TNF-ɑ, IL-6, and IL-10 in the TLR-4 A299G and T3911, TLR-6 S249P, and TLR-9 1486C/T, SNPs for the studied malarial groups. There were significant findings for the TLR-4 variants A299G and T3911, TLR-9 1237C/T, and 1486C/T. For the reactivity of MSP-119 antibodies levels, no significant results were found in malaria, and control groups. CONCLUSIONS: The profile of the immune response observed by polymorphisms in TLRs genes does not seem to be standard for all types of malaria infection around the world. This can depend on the human population and the species of Plasmodium.

Rosette formation by Plasmodium vivax gametocytes favors the infection in Anopheles aquasalis.

Plasmodium vivax is a public health problem and the most common type of malaria outside sub-Saharan Africa. The capacity of cytoadhesion, rosetting, and liver latent phase development could impact treatment and disease control. Although the ability to P. vivax gametocyte develop rosetting is known, it is not yet clear which role it plays during the infection and transmission process to the mosquito. Here, we used ex vivo approaches for evaluate the rosetting P. vivax gametocytes capacity and we have investigated the effect of this adhesive phenotype on the infection process in the vector Anopheles aquasalis mosquito. Rosette assays were performed in 107 isolates, and we have observed an elevated frequency of cytoadhesive phenomena (77,6%). The isolates with more than 10% of rosettes have presented a higher infection rate in Anopheles aquasalis (p=0.0252). Moreover, we found a positive correlation between the frequency of parasites in rosetting with the infection rate (p=0.0017) and intensity (p=0.0387) in the mosquito. The disruption of P. vivax rosette formation through mechanical rupture assay confirmed the previously findings, since the paired comparison showed that isolates with disrupted rosettes have a lower infection rate (p<0.0001) and intensity (p=0.0003) compared to the control group (no disruption). Herein we have demonstrated for the first time a potential effect of the rosette phenomenon on the infection process in the mosquito vector An. aquasalis, favoring its capacity and intensity of infection, thus allowing the perpetuation of the parasite cycle life.

Impact of the COVID-19 pandemic on the actions of the Schistosomiasis Control Program in an endemic area in Northeastern Brazil.

Schistosomiasis remains a serious public health concern in Brazil and the Schistosomiasis Control Program (PCE) was elaborated to assist in the control of the disease. Nevertheless, the irruption of the COVID-19 pandemic may have impacted the program. Herein, we assessed the impact of the pandemic on PCE actions in an endemic area in the region with the highest positivity rate for schistosomiasis in Brazil. We conducted an ecological, population-based study using data from the PCE of the state of Alagoas, between 2015 and 2021, to calculate the percentage of change. The temporal trend analysis was performed using the segmented log-linear regression model. To evaluate the spatial distribution of the data, choropleth maps were made showing the values of the% of change. Moran maps was elaborated to indicate the critical areas. Our analysis showed a decrease in the population surveyed in 2020 (-41.00%) and 2021 (-18.42%). Likewise, there was a reduction in the number of Kato-Katz tests performed (2020 = -43.45%; and in 2021 = -19.63%) and, consequently, a drop in the rate of positive tests (-37.98% in 2020 and -26.14% in 2021). Importantly, treatment of positive cases was lower than 80% (77.44% in 2020 and 77.38% in 2021). Additionally, spatial clusters with negative percentage values of up to -100% of the PCE indicators were identified mostly in the municipalities of the coastal areas that are historically most affected by schistosomiasis. Taken together, our analyzes corroborate that PCE actions in endemic municipalities of Alagoas were impacted by the COVID-19 pandemic.

Reciprocating instrumentation for endodontic treatment of primary molars: 24-month randomized clinical trial.

BACKGROUND: Although reciprocating instrumentation has been extensively studied for permanent teeth, stronger evidence for its use in primary teeth is lacking. AIM: The aim of this randomized clinical trial was to compare the efficacy of endodontic treatment in primary molars using reciprocating (RECIP) and manual (MAN) instrumentation techniques after 24 months. DESIGN: Primary molars with indication of endodontic treatment were randomly divided into two groups: MAN and RECIP. Treatments were performed, and root canals were filled with calcium hydroxide and iodoform paste. Teeth were later restored with bulk-fill composite resin and re-evaluated after 6, 12, 18, and 24 months. The primary outcome was the success of the endodontic treatment evaluated by Cox regression analysis adjusted by cluster and success rate after 24 months in the intention-to-treat (ITT) population. Instrumentation time, discomfort, postoperative pain, and quality of root canal filling were also evaluated as secondary endpoints. RESULTS: A total of 151 primary win 107 children were included, and 137 were followed up for 24 months. Success rate of teeth allocated to the MAN group was 57.3% and 55.3% for RECIP (p = .792); MAN instrumentation, however, was more time-consuming (p = .005). CONCLUSION: The efficacy of endodontic treatment in primary molars using reciprocating and manual instrumentation is similar after 24 months.

Knowledge of elementary school teachers about first aid / Conocimientos de los profesores de enseñanza primaria sobre primeros auxilios / Conhecimentos de professores do ensino fundamental acerca de primeiros socorros

ABSTRACT Objective: evaluate the knowledge of elementary school teachers on urgency/emergency care in the school environment. Method: this is a quantitative, cross-sectional, analytical study. The study participants were 269 elementary school teachers - Cycle I, from 19 schools under the management of the Municipality of Marilia - SP. Data collection occurred in September 2021 and the instrument used was a questionnaire prepared in the digital platform Google Forms, divided into three sections: the first containing the informed consent and socioeconomic questions, followed by objective questions about previous experiences of the participants and simulated cases of emergency in the school environment. The data collected was analyzed using the SPSS software (version 24.0), using the chi-square test for association of the proportion distribution with a significance level of 5%. Results: among the participants, 53.2% had already witnessed some emergency situation inside the school, in which 11.9% had acted safely. Less than half (42.7%) of the teachers had content about the subject during their graduation, and 68.8% reported never having received training on school accident prevention and first aid. Conclusion: based on the results, we identified that there is a need for teacher training regarding urgency and emergency situations related to the care of children in the school environment, thus trying to provide subsidies for coping with serious situations that may occur at school.

RESUMEN Objetivo: evaluar los conocimientos de los profesores de enseñanza primaria sobre la atención de urgencia/emergencia en un entorno escolar. Método: se trata de un estudio cuantitativo, transversal y analítico. Participaron en este estudio 269 profesores de escuelas primarias - Ciclo I, de las 19 escuelas que están bajo la gestión del Municipio de Marilia, SP. La recolección de datos ocurrió en septiembre de 2021 y el instrumento utilizado fue un cuestionario elaborado en la plataforma digital Google Forms, dividido en tres secciones: la primera conteniendo el consentimiento informado y preguntas socioeconómicas, seguida de preguntas objetivas sobre experiencias previas de los participantes y casos simulados de emergencia en el ambiente escolar. Los datos recogidos fueron analizados en el software SPSS (versión 24.0), realizándose la prueba de Chi-cuadrado para asociación de la distribución de proporciones con el nivel de significación adoptado del 5%. Resultados: entre los participantes, el 53,2% ya había presenciado alguna situación de emergencia dentro de la escuela, en la que el 11,9% había actuado con seguridad. Menos de la mitad (42,7%) de los profesores tuvieron contenidos sobre el tema durante la graduación, y el 68,8% declararon no haber recibido nunca formación sobre prevención de accidentes escolares y primeros auxilios. Conclusión: con base en los resultados, identificamos que existe la necesidad de capacitación de los profesores en relación a situaciones de emergencia y urgencia para el cuidado de los niños en el ambiente escolar, en el intento de proporcionar subsidios para el abordaje de situaciones graves que puedan ocurrir en la escuela.

RESUMO Objetivo: avaliar o conhecimento dos professores do ciclo fundamental I no atendimento de urgência/emergência em ambiente escolar. Método: trata-se de um estudo de abordagem quantitativa, de caráter transversal, analítico. Participaram deste estudo 269 professores do ensino fundamental - Ciclo I, das 19 escolas que estão sob gestão do Município de Marília, SP. A coleta de dados ocorreu em setembro de 2021 e o instrumento utilizado foi um questionário elaborado na plataforma digital Google Forms, divido em três seções: a primeira contendo o termo de consentimento livre e esclarecido e questões de cunho socioeconômico, seguida de questões objetivas sobre vivências prévias dos participantes e casos simulados de urgência em ambiente escolar. Os dados coletados foram analisados no software SPSS (versão 24.0), sendo realizado o teste do Qui-quadrado para associação da distribuição da proporção com o nível de significância adotado de 5%. Resultados: entre os participantes, 53,2% já presenciaram alguma situação de urgência dentro da escola, em que 11,9% atuaram com segurança. Menos da metade (42,7%) dos professores tiveram conteúdo acerca do tema durante a graduação, e 68,8% relatam nunca terem recebido treinamentos sobre prevenção de acidentes escolares e primeiros socorros. Conclusão: mediante os resultados, identificamos que há necessidade de treinamentos para os professores no que se refere às situações de urgência emergência voltadas ao atendimento de crianças no ambiente escolar, procurando, desta forma, dar subsídios para o enfrentamento em situações consideradas graves que podem ocorrer na escola.

Epidemiological aspects of visceral leishmaniasis in Rio Grande do Norte, Brazil

Visceral Leishmaniasis (VL) is a parasitic disease caused by Leishmania protozoa and transmitted by the bite of sand fly insects. This study aimed to describe the epidemiological aspects of VL in Rio Grande do Norte (RN), using variables inserted in the Information System for Notifiable Diseases, for the period from 2013 to 2019. The chi-square test of independence was used with p<0.05 considered statistically significant. 635 cases of VL were reported in RN, with stability of new cases in the analyzed period. 60% of cases were autochthonous, 84 (50.2%) municipalities in RN had autochthonous cases, with 70 (18.2%) cases in Natal and 58 (15.1%) in Mossoró. The most affected age group was 20-59 year old (57.3%) followed by 0-9 year old (23.8%), 10-19 year old (10.4%) and 60 year old or older (8.5%). There was a positive association between the 0-9 and 10-19 ranges with females and 20-59 with males (p=0.0001). Among the 532 individuals, 54.5% had a low level of education, and these, as well as the illiterate, associated with males (p=0.001). 85.3% of 612 cases were in black/brown group and 77.1% of 632 in urban/periurban residents. 27.6% of 500 were co-infected with HIV, 77.5% in males and 89.8% in adults. 70.7% progressed to cure and 6.8% died from VL. The study shows that the control measures adopted within the scope of the National Program for the Control of Leishmaniasis should be reassessed since there has been no decrease in cases, even though it has had stability over the years in Natal and a tendency to growth in Mossoró, the most affected areas.

Motor Optimality Scores are significantly lower in a population of high-risk infants than in infants born moderate-late preterm.

BACKGROUND: The Motor Optimality Score-Revised (MOS-R) is a detailed scoring of the General Movement Assessment (GMA), measuring the spontaneous behaviors of infants. Infants born moderate-late preterm are not traditionally followed in high-risk clinics, but have increased risk of neurodevelopmental disability. AIMS: Compare MOS-R at 3 months corrected age (CA) in high-risk (HR; very preterm or abnormal neuroimaging) infants to infants born moderate-late preterm (MLP). STUDY DESIGN: In this prospective cohort study, parents of enrolled infants created video recordings using an app at 3 months CA. Videos were scored with the General Movement Assessment (GMA) and MOS-R. MOS-R scores were divided into "higher-risk" (≤19) and "lower-risk" (≥20). SUBJECTS: 181 infants born MLP or categorized as HR. RESULTS: Among enrolled infants, 68 (38 %) were in the MLP group, and 113 infants were in the HR group. The HR group had 3.8 increased odds of having an aberrant GMA score compared to the MLP group (p < 0.01, 95 % CI 1.38-10.52). The HR group had significantly lower MOS-R scores (mean 20) than the MLP group (mean 24; p < 0.001; 95%CI 3.3-7.3). The HR group had 11.2 increased odds of having a higher-risk MOS-R score (95%CI 2.5-47.6, p < 0.001) than MLP group. Infants were most likely to have a lower MOS-R score if they had any of the following: VP shunt placement, periventricular leukomalacia, or bronchopulmonary dysplasia. CONCLUSIONS: Aberrant GMA and higher-risk MOS-R scores were more common in infants at high-risk, reflecting history of brain lesions and younger gestational age at birth.

Anticancer activity of ß-Lapachone derivatives on human leukemic cell lines.

ß-lapachone is a 1,2-naphthoquinone of great therapeutic interest that induces cell death by autophagy and apoptosis in tumor cells due to oxidative stress increasing. However, its high toxicity in healthy tissues limits its clinical use, which stimulates the planning and synthesis of more selective analogs. The aim of this study was to investigate the cytotoxic activity of three thiosemicarbazones derived from ß-lapachone (BV2, BV3 and BV5) in leukemia cells. Cytotoxicity tests were performed on tumor cells (HL-60, K562, K562-Lucena and MOLT-4) and normal peripheral blood mononuclear cells (PBMCs). Subsequently, the mode of action of compounds was accessed by optical microscopy, transmission electron microscopy or fluorescence microscopy. Flow cytometry analysis was performed to investigate apoptosis induction, cell cycle, DNA fragmentation and mitochondrial depolarization. All derivatives inhibited tumor cell growth after 72 h (IC50 < 10 µM to all cell lines, including the resistant K562-Lucena) with less toxic effects in PBMC cells, being BV3 the most selective compound with selective index (SI) of 275 for HL-60; SI of 40 to K562; SI of 10 for MOLT-4 and SI of 50 to K562-Lucena compared to ß-lapachone with SI of 18 to HL-60, SI of 3.7 to K562; SI of 2.4 to MOLT-4 and SI of 0.9 to K562-Lucena. In addition, the K562 or MOLT-4 cells treated with BV3 showed characteristics of both apoptosis and autophagy cell death, mainly by autophagy. These results demonstrate the potent cytotoxic effect of thiosemicarbazones derived from ß-lapachone as promising anticancer drugs candidates, encouraging the continuity of in vivo tests.

Assessing population genetic structure of three New Zealand stream insects using mitochondrial and nuclear DNA markers.

Assessing genetic differentiation among natural populations can aid understanding of dispersal patterns and connectivity among habitats. Several molecular markers have become increasingly popular in determining population genetic structure for this purpose. Here, we compared the resolution of mitochondrial cytochrome c oxidase subunit I (COI) and nuclear single nucleotide polymorphism (SNP) markers for detecting population structure among stream insects at small spatial scales. Individuals of three endemic taxa-Coloburiscus humeralis (Ephemeroptera), Zelandobius confusus (Plecoptera), and Hydropsyche fimbriata (Trichoptera)-were collected from forested streams that flow across open pasture in the North Island of New Zealand. Both COI and SNP data indicated limited population structure across the study area, and small differences observed among these species were likely related to their putative dispersal abilities. For example, fine-scale genetic differentiation between and among neighbouring stream populations for H. fimbriata suggests that gene flow, and hence dispersal, may be more limited for this species relative to the others. Based on the generally similar results provided by both types of markers, we suggest that either COI or SNP markers can provide suitable initial estimates of fine-scale population genetic differentiation in stream insects.

Cross-cultural validation of the Brazilian Little Developmental Coordination Disorder Questionnaire (LDCDQ-BR) for preschool children.

INTRODUCTION: Motor difficulties associated with Developmental Coordination Disorder (DCD) are frequently apparent before the accepted diagnostic age of 5. Tools to support identification of DCD markers would allow provision of early intervention to reduce negative sequelae. OBJECTIVE: Establish psychometric properties and define preliminary cut-off scores for the Brazilian Little Developmental Coordination Disorder Questionnaire - Brazil (LDCDQ-BR). METHODS AND PROCEDURES: Parents of 3- and 4-year-old children (n = 312; 154 girls) from Belo Horizonte/MG, Brazil, completed the LDCDQ-BR, the Brazil Economic Classification Criterion and a demographic questionnaire. One sub-set of children (n = 119) was assessed with the Movement Assessment Battery for Children-2nd Edition; another sub-set (n = 77) completed the LDCDQ-BR a second time. RESULTS: Rasch analysis indicated good item functioning with only one erratic item, suggesting unidimensionality. Item calibration reliability was excellent (0.97), children's measures reliability was low (0.72), but implying separation of 2.46 motor ability levels. Significant, low correlations were found between the LDCDQ-BR and MABC-2 (r = 0.30, p < 0.01). Test-retest reliability was 0.77 (total score) and 0.44-0.78 (individual items). ROC curve analysis revealed sensitivity of 68% at a cut-off score of 64. CONCLUSION: The LDCDQ-BR shows promising psychometric properties to support early identification of DCD.

Microscopic investigations of Ocotea paranaensis-A Brazilian endemic and endangered species.

This article describes the morpho-anatomies of the leaves and stems of Ocotea paranaensis Brotto, Baitello, Cervi & Santos (Lauraceae) using light and scanning electron microscopy. The main anatomical features characterizing the species are the presence of simple non-glandular trichomes in the leaves and stems, large secretory cells in the leaves, flat-convex petioles with two small lateral ribs, brachysclereids in the stem cortex and pith, and the presence of starch grains and various types of calcium oxalate crystals in the pith. Histochemical tests indicated the presence of lignin in stone cells, fibers, and xylem. Lipophilic contents were found in the secretory cells. Phenolic compounds were detected in the epidermis, hypodermis, phloem, and xylem. The present study's findings can contribute to the taxonomy and authentication of O. paranaensis. RESEARCH HIGHLIGHTS: This article is the first morpho-anatomical study of Ocotea paranaensis. Anatomy and histochemistry of the leaves and stems were studied by light microscopy, FESEM and EDS. The findings of this study would aid in the species identification and taxonomy.

A novel approach to Cestrum intermedium (mata-boi): anatomical and physical-chemical characterization, in vitro biological activities, and metabolites of a Brazilian native species

Abstract The Brazilian native species Cestrum intermedium, known as mata-boi, induces hepatotoxicity and death when ingested by cattle. While most studies on this species focus on toxicological features, our study is the first to describe the anatomy and in vitro biological activities of Cestrum intermedium. We investigated adult leaves and stems by histochemistry, described their anatomy, performed physical-chemical analysis, determined in vitro antioxidant and antimicrobial activities, and identified secondary metabolites. A few noteworthy anatomical features were the anomocytic stomata on the abaxial surface and the absence of trichomes, in addition to the circular shaped petiole with two projections on the adaxial surface. Histochemical analysis showed chemical markers such as alkaloids, usually reported as toxic, and terpenoids. Potassium nitrate (ATR-FTIR) and lupeol palmitate (NMR) were detected on the crude stem extract. Thermogravimetric and physical-chemical analysis provided fingerprint parameters for the species. Minimal Inhibitory Concentration (MIC) assay revealed that Staphylococcus aureus, Staphylococcus epidermidis, and Candida albicans were weakly inhibited by extract samples. Chloroform and ethyl acetate fractions presented high phenolic content, which resulted in in vitro antioxidant activity. These novel features expand the knowledge about this species, considering that previous studies mainly focused on its toxicity. Our study also provided characteristics that may help in avoiding misidentification between Cestrum members, especially when taxonomic keys cannot be employed, as in the absence of flowers and fruits.

Case report of a coral snake bite (Micrurus ibiboboca) in the state of Pernambuco, northeast Brazil / Relato de caso de picada de cobra coral (Micrurus ibiboboca) no estado de Pernambuco, nordeste do Brasil / Informe de caso de mordedura de serpiente coral (Micrurus ibiboboca) en el estado de Pernambuco, noreste de Brasil

The Elapidae family comprises 35 snake species in Brazil, with Micrurus ibiboboca being widely distributed in the northeast of the country. Despite the high number of Micrurus species in Brazil, there are few cases of human envenomation in literature. This study describes a clinical report of envenomation due to the bite of M. ibiboboca in the State of Pernambuco, Northeast Brazil, that took place in 2017. The patient presented symptoms of muscle paralysis and sweating. He was admitted to the intensive care unit. A total of 10 ampoules of anti-elapidic serum were administered. The patient complained of local pain that extended through the arm, paresthesia in the lower limbs, headache, and chest pain. Changes in the visual, respiratory, and neurological systems were not observed. This clinical case report on coral snake poisoning is useful for increasing the knowledge on the toxicological action of snake poison and its effect on injured individuals, thereby helping in the clinical evaluation and treatment.(AU)

A família Elapidae compreende 35 espécies de serpentes no Brasil, com Micrurus ibiboboca amplamente distribuída no Nordeste. Apesar do elevado número de espécies de Micrurus no Brasil, são poucos os casos de envenenamento humano na literatura. Descrevemos aqui um relato clínico de envenenamento por picada de M. ibiboboca no Estado de Pernambuco, Nordeste do Brasil, ocorrido em 2017. O paciente apresentava sintomas de paralisia muscular e sudorese. Ele foi internado na Unidade de Terapia Intensiva. Um total de 10 ampolas de soro anti-elapídico foi administrado. O paciente queixava-se de dor local que se estendia pelo braço, parestesia em membros inferiores, cefaleia e dor torácica. Não foram observados alterações nos sistemas de visão, respiratório e neurológico. Este relato de caso clínico de intoxicação por cobra coral é útil para aumentar o conhecimento sobre a ação toxicológica da peçonha da serpente e seu efeito sobre os acidentados, auxiliando na avaliação clínica e no tratamento.(AU)

La familia Elapidae comprende 35 especies de serpientes en Brasil como la Micrurus ibiboboca ampliamente distribuidas en el Noreste. A pesar de lo alto número de especies de Micrurus en Brasil, hay pocos casos de envenenamiento humano en la literatura. Describimos aquí un informe clínico de envenenamiento por mordedura de M. ibiboboca en el estado de Pernambuco, Noreste de Brasil, ocurrido en 2017. El paciente presentaba síntomas de parálisis muscular y sudoración. Fue ingresado en la unidad de cuidados intensivos. Se administraron un total de 10 ampollas de suero antielapídico. El paciente se quejaba de dolor local que se extendía por el brazo, parestesias en las extremidades inferiores, cefalea y dolor torácico. No se observaron cambios en los sistemas visual, respiratorio y neurológico. Este informe de caso clínico sobre la intoxicación por serpiente coral es útil para aumentar el conocimiento sobre la acción toxicológica del veneno de serpientes y su efecto en los individuos lesionados, ayudando así en la evaluación clínica y el tratamiento.(AU)

Fucoidan-Coated Liposomes: A Target System to Deliver the Antimicrobial Drug Usnic Acid to Macrophages Infected with Mycobacterium tuberculosis.

The present study describes the use of fucoidan, a negative sulfated polysaccharide, as a coating material for the development of liposomes targeted to macrophages infected with Mycobacterium tuberculosis. First, fucoidan was chemically modified to obtain a hydrophobized-fucoidan derivative (cholesteryl-fucoidan) using a two-step microwave-assisted (µW) method. The total reaction time was decreased from 14 hours to 1 hour while maintaining the overall yield. Cholesterylfucoidan was then used to prepare surface-modified liposomes containing usnic acid (UA-LipoFuc), an antimicrobial lichen derivative. UA-LipoFuc was evaluated for mean particle size, polydispersity index (PDI), surface charge (ζ), and UA encapsulation efficiency. In addition, a cytotoxicity study, competition assay and an evaluation of antimycobacterial activity against macrophages infected with M. tuberculosis (H37Ra) were performed. When the amount of fucoidan was increased (from 5 to 20 mg), vesicle size increased (from 168 ± 2.82 nm to 1.18 ± 0.01 µm). Changes in from +20 ± 0.41 mV for uncoated liposomes to -5.41 ± 0.23 mV for UA-LipoFuc suggested that the fucoidan was placed on the surface of the liposomes. UA-LipoFuc exhibited a lower IC50 (8.26 ± 1.11 µM) than uncoated liposomes (18.37 ± 3.34 µM), probably due to its higher uptake. UA-LipoFuc5 was internalized through the C-type carbohydrate recognition domain of the cell membrane. Finally, usnic acid, both in its free form and encapsulated in fucoidan-coated liposomes (UA-LipoFuc5), was effective against infected macrophages. Hence, this preliminary investigation suggests that encapsulated usnic acid will aid in further studies related to infected macrophages and may be a potential option for tuberculosis treatment.