Does the use of a diving mask adapted for non-invasive ventilation in hypoxemic acute respiratory failure in individuals with and without COVID-19 increase the ratio of arterial oxygen partial pressure to fractional inspired oxygen? A randomized clinical trial.

Non-invasive ventilation (NIV) can be used in acute hypoxemic respiratory failure (AHRF); however, verifying the best interface for its use needs to be evaluated in the COVID-19 pandemic scenario. The objective of this study was to evaluate the behavior of the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio) in patients with AHRF with and without COVID-19 undergoing NIV with the conventional orofacial mask and the adapted diving mask. This is a randomized clinical trial in which patients were allocated into four groups: i) group 1: COVID-19 + adapted mask (n=12); ii) group 2: COVID-19 + conventional orofacial mask (n=12); iii) group 3: non-COVID-19 + adapted mask (n=2); iv) group 4: non-COVID-19 + conventional orofacial mask (n=12). The PaO2/FiO2 ratio was obtained 1, 24, and 48 hours after starting NIV, and the success of NIV was evaluated. This study followed the norms of the Consolidated Standards of Reporting Trials statement and was registered in the Brazilian Registry of Clinical Trials under registration RBR-7xmbgsz. Both the adapted diving mask and the conventional orofacial mask increased the PaO2/FiO2 ratio. The interfaces differed in terms of the PaO2/FiO2 ratio in the first hour [309.66 (11.48) and 275.71 (11.48), respectively] (p=0.042) and 48 hours [365.81 (16.85) and 308.79 (18.86), respectively] (p=0.021). NIV success was 91.7% in groups 1, 2, and 3, and 83.3% in group 4. No adverse effects related to interfaces or NIV were observed. NIV through the conventional orofacial mask interfaces and the adapted diving mask was effective in improving the PaO2/FiO2 ratio; however, the adapted mask presented a better PaO2/FiO2 ratio during use. There was no significant difference between interfaces regarding NIV failure.

Effectiveness of an adapted diving mask (Owner mask) for non-invasive ventilation in the COVID-19 pandemic scenario: study protocol for a randomized clinical trial.

BACKGROUND: Non-invasive ventilation (NIV) is indicated to avoid orotracheal intubation (OTI) to reduce hospital stay and mortality. Patients infected by SARS-CoV2 can progress to respiratory failure (RF); however, in the initial phase, they can be submitted to oxygen therapy and NIV. Such resources can produce aerosol and can cause a high risk of contagion to health professionals. Safe NIV strategies are sought, and therefore, the authors adapted diving masks to be used as NIV masks (called an Owner mask). OBJECTIVE: To assess the Owner mask safety and effectiveness regarding conventional orofacial mask for patients in respiratory failure with and without confirmation or suspicion of COVID-19. METHODS: A Brazilian multicentric study to assess patients admitted to the intensive care unit regarding their clinical, sociodemographic and anthropometric data. The primary outcome will be the rate of tracheal intubation, and secondary outcomes will include in-hospital mortality, the difference in PaO2/FiO2 ratio and PaCO2 levels, time in the intensive care unit and hospitalization time, adverse effects, degree of comfort and level of satisfaction of the mask use, success rate of NIV (not progressing to OTI), and behavior of the ventilatory variables obtained in NIV with an Owner mask and with a conventional face mask. Patients with COVID-19 and clinical signs indicative of RF will be submitted to NIV with an Owner mask [NIV Owner COVID Group (n = 63)] or with a conventional orofacial mask [NIV orofacial COVID Group (n = 63)], and those patients in RF due to causes not related to COVID-19 will be allocated into the NIV Owner Non-COVID Group (n = 97) or to the NIV Orofacial Non-COVID Group (n = 97) in a randomized way, which will total 383 patients, admitting 20% for loss to follow-up. DISCUSSION: This is the first randomized and controlled trial during the COVID-19 pandemic about the safety and effectiveness of the Owner mask compared to the conventional orofacial mask. Experimental studies have shown that the Owner mask enables adequate sealing on the patient's face and the present study is relevant as it aims to minimize the aerosolization of the virus in the environment and improve the safety of health professionals. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC): RBR - 7xmbgsz . Registered on 15 April 2021.

Anti-Inflammatory Effects of Rosmarinic Acid-Loaded Nanovesicles in Acute Colitis through Modulation of NLRP3 Inflammasome.

Ulcerative colitis (UC), one of the two main types of inflammatory bowel disease, has no effective treatment. Rosmarinic acid (RA) is a polyphenol that, when administered orally, is metabolised in the small intestine, compromising its beneficial effects. We used chitosan/nutriose-coated niosomes loaded with RA to protect RA from gastric degradation and target the colon and evaluated their effect on acute colitis induced by 4% dextran sodium sulphate (DSS) for seven days in mice. RA-loaded nanovesicles (5, 10 and 20 mg/kg) or free RA (20 mg/kg) were orally administered from three days prior to colitis induction and during days 1, 3, 5 and 7 of DSS administration. RA-loaded nanovesicles improved body weight loss and disease activity index as well as increased mucus production and decreased myeloperoxidase activity and TNF-α production. Moreover, RA-loaded nanovesicles downregulated protein expression of inflammasome components such as NLR family pyrin domain-containing 3 (NLRP3), adaptor protein (ASC) and caspase-1, and the consequent reduction of IL-1ß levels. Furthermore, nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) protein expression increased after the RA-loaded nanovesicles treatment However, these mechanistic changes were not detected with the RA-free treatment. Our findings suggest that the use of chitosan/nutriose-coated niosomes to increase RA local bioavailability could be a promising nutraceutical strategy for oral colon-targeted UC therapy.

Static and dynamic balance of children and adolescents with sensorineural hearing loss.

OBJECTIVE: To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss. METHODS: A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test. RESULTS: Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037. CONCLUSION: Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

Static and dynamic balance of children and adolescents with sensorineural hearing loss / Equilíbrio estático e dinâmico de crianças e adolescentes com perda auditiva sensório-neural

ABSTRACT Objective To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss. Methods A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test. Results Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037. Conclusion Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

RESUMO Objetivo Avaliar o desempenho do equilíbrio estático e dinâmico de escolares ouvintes e com perda auditiva sensório-neural. Métodos Estudo de corte transversal que avaliou 96 escolares, sendo 48 ouvintes e 48 com perda auditiva sensório-neural, de ambos os sexos, na faixa etária entre 7 e 18 anos. Para a avaliação do equilíbrio estático, foram utilizados os testes de Romberg, Romberg-Barré e Fournier, e, para avaliar o equilíbrio dinâmico, foi usado o teste de Unterberger. Resultados Os escolares com perda auditiva apresentaram maior ocorrência de alterações no equilíbrio estático e dinâmico, comparados aos ouvintes, em todos os testes empregados (p<0,001). O mesmo foi observado quando os escolares foram agrupados pelos sexos. Para o sexo feminino, os valores de p para os testes de Romberg, Romberg-Barré, Fournier e Unterberger foram, respectivamente, p=0,004, p<0,001, p<0,001 e p=0,023; para o sexo masculino, foram p=0,009, p<0,001, p<0,001 e p=0,002. A mesma diferença foi observada quando os escolares foram estratificados pelas faixas etárias. Para aqueles de 7 a 10 anos, os valores de p foram, respectivamente, para os testes de Romberg, Romberg-Barré e Fournier p=0,007, p<0,001 e p=0,001; entre 11 e 14 anos, para os testes de Romberg, Romberg-Barré, Fournier e Unterberger, foram, respectivamente p=0,002, p<0,001, p<0,001, p=0,015; entre 15 e 18 anos, para os testes Romberg-Barré, Fournier e Unterberger foram, respectivamente, p=0,037, p<0,001 e p=0,037. Conclusão Os escolares com perda auditiva apresentaram maior ocorrência de alterações no desempenho do equilíbrio estático e dinâmico que os ouvintes, do mesmo sexo e faixa etária.

Trasplante de órganos en Brasil y en España: ¿cómo los criterios ético-legales protegen al donante vivo en ambos los países? / Organ Transplantation in Brazil y Spain: How the ethics and legal criteria protect the living donor in both countries?

Este artículo realiza una comparación entre las legislaciones específicas de trasplantes de órganos de España y Brasil. Su objetivo es averiguar cómo los dispositivos legales protegen a los donantes vivos de órganos. Tomando como base el documento del Grupo de Opinión del Observatorio de Bioética y Derecho (en adelante, OBD), de la Universidad de Barcelona, sobre «Trasplante de órganos de donante vivo», publicado en 2011, los autores concluyen que las donaciones a partir de personas vivas deben ser estimuladas sólo en algunos casos muy específicos (AU)

This study compares the specific Organ Transplantations Laws from Spain and Brazil. Its objective is investigate how the legal devices protect the organ living donors in both countries, where the incentives for living donation has been stimulated lately. From the analysis of the «Document on Transplantation from Living Donors», published from Bioethics and Law Observatory Opinion Group from Barcelona University (OBD-UB), in 2011, it has been concluded that the living donations should not be stimulated (AU)

A reproducibility study on musculotendinous stiffness quantification, using a new transportable ankle ergometer device.

The use of biomechanical methods to quantify functional/physiological parameters in malnourished humans can provide new insights into the understanding of effects of malnutrition on human muscles. Therefore, a transportable ankle ergometer device was developed, which allows the quantification of mechanical properties of the human plantarflexor muscles in field experiments. More precisely, the ergometer quantifies isometric force in static conditions and musculotendinous stiffness in dynamic conditions. This latter parameter is obtained by the quick-release technique. The aim of the study was first to conduct a reproducibility study on musculotendinous stiffness. Seven healthy subjects were tested three times in alternate days. The results showed the well-known linear relationship between musculotendinous stiffness and torque, where the slope was used as a stiffness index (SI(MT)). Individual regression line comparison indicated that SI(MT) values were not significantly different between the three repeated measurements (P>0.05). Mean coefficient of variation was 4.5+/-1.0%. The individual SI(MT) data were within the range of those reported in the literature. The reproducibility study showed that the quantification of musculotendinous stiffness by means of the quick-release technique is a reliable method, using a transportable ankle ergometer device.

Infecção do trato urinário e bacteriúria assintomática: estudo em gestantes adolescentes atendidas em Serviço Público da cidade do Recife-Pernambuco / Urinary tract infection and asymptomatic bacteriuria: a study in pregnant teenagers in attendance at two public hospitals in the city of Recife-Pernambuco

O objetivo deste estudo foi avaliar a ocorrência de infecção do trato urinário e bacteriúria assintomática em gestantes adolescentes com 16 ou mais semanas de gestação, acompanhadas em pré-natais do Recife, no período entre junho de 2001 e agosto de 2003. Realizou-se um estudo de coorte abrangendo 153 gestantes atendidas nos pré-natais do Hospital das Clínicas da Universidade Federal de Pernambuco e da Maternidade da Encruzilhada. O exame bacteriológico foi realizado a partir de amostra de urina e consistiu na realização do exame direto, da cultura e do antibiograma. A ocorrência de infecção urinária foi de 24,2 e a de bacteriúria assintomática 14,4. As principais bactérias encontradas foram: Escherichia coli (28,7), Streptococcus agalactiae (23,8) e Klebsiella pneumoniae (19). Das gestantes com bacteriúria a resistência aos antimicrobianos foi de 70, e os que apresentaram maior resistência foram ampicilina (20,9), gentamicina (13,9) e cefalotina (11,62). Estes resultados indicam uma elevada ocorrência de infecção urinária e bacteriúria assintomática nas gestantes adolescentes com 16 ou mais semanas de gestação, além de alta resistência bacteriana. Este estudo enfatiza a importância da indicação de urocultura também em fases gestacionais mais tardias nas adolescentes da rede pública.

Efeitos do tratamento neonatal com inibidor seletivo de recaptura da 5-HT sobre o desenvolvimento anatômico crânio-encefálico / Neonatal treatment effect with selective inibitor of 5-HT recapture over the cranium-encephalic anatomic development

Pesquisadas repercussões neonatais do tratamento crônico com inibidores seletivos de recaptura da serotonina (ISRS) sobre crescimento somático, do encéfalo e crânio. Ratos machos foram divididos em grupos: controle (NaCl) e Cit (10 æL/Kg citalopram 10 mg). Durante 21 dias pós-natais, foram aferidos peso corporal, eixo látero-lateral, ântero-posterior e circunferência do crânio. Aos 8, 15 e 22 dias pós-natais, os animais foram sacrificados para retirada do encéfalo para avaliar as medidas citadas acima. A utilização de ISRS provocou déficit de crescimento corporal, diminuição das medidas craniais e do encéfalo. O retardo é possivelmente decorrência de alteração na magnitude da ação trófica da serotonina sobre morfogênese crânio-facial, reforçando a participação do sistema serotoninérgico sobre o crescimento somático e ontogenético. O possível efeito hipofágico dos ISRS não é descartado.

Neonatal repercussion researched of the serotonin selective recapture inibitor (SSRI) chronic treatment about the somatic growth, of the encephalon and skull. Male rats were divided into groups: control (NaCl) and Cit (10 æL/Kg citalopram 10 mg). In 21 post birth days were measured body weight, side axle , front and rear and skull circle. At 8, 15, 22 days after birth, animals were sacrified for the encephalon withdrawal to evaluate the measurements mentioned above. SSRI use caused body growth deficit, skull and encephalon reduction. The retard is possibly caused by the magnitude change of the trophic serotonin action over the skull-facial morphogenesis, reinforcing the serotoninergic system participation over the somatic and ontogenic growth. The SSRI possible hypophagic effects are not discarded.

[Neonatal treatment effect with selective inhibitor of 5-HT recapture on [corrected] the cranium-encephalic anatomic development]. / Efeitos do tratamento neonatal com inibidor seletivo de recaptura da 5-HT sobre o desenvolvimento anatômico crânio-encefálico.

Neonatal repercussion researched of the serotonin selective recapture inibitor (SSRI) chronic treatment about the somatic growth, of the encephalon and skull. Male rats were divided into groups: control (NaCl) and Cit (10 microL/Kg citalopram 10 mg). In 21 post birth days were measured body weight, side axle , front and rear and skull circle. At 8, 15, 22 days after birth, animals were sacrified for the encephalon withdrawal to evaluate the measurements mentioned above. SSRI use caused body growth deficit, skull and encephalon reduction. The retard is possibly caused by the magnitude change of the trophic serotonin action over the skull-facial morphogenesis, reinforcing the serotoninergic system participation over the somatic and ontogenic growth. The SSRI possible hypophagic effects are not discarded.

Protocol of Mensuration to Avaliation of Indicators of Somatic Development of Wistar Rats / Protocolo de Medidas para Evaluación de Indicadores de Desarrollo Somático en Ratas Wistar

Evaluations of weight and cephalic perimeter are very used to study the growth and development in human beings. Similar measures, called murinometrics, have been an efficient resource to study the effects of nutritional and pharmacologic manipulations on the somatic development in rat. The aim of this study is to describe a method of evaluation which offers a higher accuracy in the collect of data in the study of somatic development in Wistar rat. Measurements were realized in latero-lateral axis of skull; Antero-posterior axis of skull; Longitudinal axis; Length of tail in 60 wistar rat during breastfeeding period. The most suitable method of measurement respects predetermined anatomic points, the use of the suitable scapus of pachymeter as well as its accuracy.

Evaluaciones de peso y perímetro cefálico son muy utilizadas para el estudio del crecimiento y desarrollo en humanos. Medidas semejantes, denominadas murinométricas, han sido un recurso eficiente para el estudio de los efectos de manipulaciones nutricionales y farmacológicos sobre el desarrollo somático en ratas. El objetivo de este trabajo fue describir un método de evaluación que ofrece mayor exactitud en la recolección de los datos, en el estudio del desarrollo somático en ratas Wistar. Fueron realizadas medidas en el eje látero-lateral del cráneo (ELLC); eje ántero-posterior del cráneo (EAPC); eje longitudinal (EL) y largo de la cola (LC), en 60 ratas Wistar, durante el periodo de amamantación. Se observó, como método más adecuado de medición, el que se relaciona con puntos anatómicos predefinidos, uso del asta adecuada del instrumento de medida (paquímetro), así como la precisión de su exactitud.

Estudo retrospectivos terapêutico da neurocriptococose em 112 aidéticos ou näo / A retrospective therapeutic study of neurocryptococcosis in 112 AIDS and non-AIDS patients

Cento e doze aidéticos ou näo com neurocriptococose, admitidos no Hospital Emílio Ribas - Säo Paulo, Brasil, receberam anfotericina B (AMB) - grupo III ou a associaçäo AMB/5 fluorcitosina (5FC): grupos I e II. Testes de Goodman aplicados revelaram: 1. leuco e glicorraquia semelhantes nos três grupos e proteinorraquia inferior a 85 mg/dl após 1,5g/AMB; 2. a coloraçäo pelo método da tinta da China e a cultura para Cryptococcus neoformans, positiva até 1,0g/AMB; 3. hipocalemia na monoterapia, hipo e hipercalemia durante a associaçäo; 4. as reaçöes adversas mais evidentes a > 0,7g AMB/250g 5FC; 5. óbitos (precoce e tardio) frequentes no grupo I e nos grupos I e II entre 2,5 a 4,0g de AMB; 6. remissäo e morte semelhantes nos grupos. A associaçäo terapêutica inicial e a manutençäo pelo AMB conduziram à recaída tardia