Association between Late Manifestations of Testicular Dysgenesis Syndrome and Anogenital Distance: A Systematic Review and Meta-analysis.

Background: In 2001, Skakkebæk et al. proposed that certain male reproductive disorders might be grouped into a syndrome called testicular dysgenesis syndrome (TDS), as they all appear to be associated with disruption of the embryonic and foetal programming of gonadal development. TDS may be manifested in early life by the presence of genital malformations (hypospadias and cryptorchidism) and in adult life as disorders represented by low sperm counts and testicular cancer. Changes in androgen hormones during the foetal development, in addition to resulting in TDS, can also cause permanent changes in anopenile anogenital distance (AGDap) and anoscrotal anogenital distance (AGDas). Aims: The objective of this study was to determine whether there is a relationship between late manifestations of TDS and reduced anogenital/anoscrotal distance. Materials and Methods: The present study is a systematic review and meta-analysis. The research included papers from 2001 to 2020, comprising a total of 737 articles, and 13 articles were selected. Results: Linear regression analysis was performed to evaluate the relationship between the two anogenital distance measures, which showed a significant positive association (P = 0.039). A meta-analysis was also performed and compared AGDap and AGDas between control and case groups, with cases defined as men with any late TDS manifestation. These data showed a significant reduction in AGDas in the affected population (P = 0.04), but no differences in the AGDap measure (P = 0.59). Conclusion: Our study confirmed a significant relationship between reduced AGDas and late manifestations of TDS, providing further support to the association between prenatal androgen deficiency and late-onset reproductive disorders.

Assessment of image quality in digital radiology using the CDRAD contrast-detail phantom in pediatrics / Evaluación de la calidad de la imagen en radiología digital utilizando el fantoma de detalle de contraste CDRAD en pediatría

ABSTRACT The transition from analog to digital radiology has expanded the capabilities of radiological imaging but has also made it possible to increase the radiation dose received by patients. Image quality in radiology is determined by factors such as radiographic techniques (kVp and mAs), which directly impact the dose and image quality. This study focuses on pediatric radiological exams considering their greater radiosensitivity and longer life expectancy. The study aimed to investigate the correlation between image quality and applied radiographic techniques using the CDRAD contrast-detail phantom. The results showed a direct linear relationship between the increase in kVp and the corresponding increase in image quality. Nonetheless, there was a significant variation in image quality between current-time products ranging from 0.5 to 2.5 mAs, in contrast to the nearly linear relationship observed within the 2.5 and 10 mAs range

RESUMEN La transición de la radiología analógica a la digital ha ampliado las capacidades de las imágenes radiológicas, pero ha también permitió aumentar la dosis de radiación que reciben los pacientes. La calidad de la imagen en radiología está determinada por factores como las técnicas radiográficas (kVp y mAs), que impactan directamente en la dosis y la calidad de la imagen. Este estudio se centra en exámenes radiológicos pediátricos considerando su mayor radiosensibilidad y mayor espe ranza de vida. El estudio está dirigido a investigar la correlación entre la calidad de la imagen y las técnicas radiográficas aplicadas utilizando el detalle de contraste CDRAD fantasma. Los resultados mostraron una relación lineal directa entre el aumento de kVp y el correspondiente aumento de calidad de la imagen. No obstante, hubo una variación significativa en la calidad de la imagen entre los productos actuales que van desde 0,5 a 2,5 mAs, en contraste con la relación casi lineal observada dentro del rango de 2,5 y 10 mAs.

Biotech Application of Exopolysaccharides from Curvularia brachyspora: Optimization of Production, Structural Characterization, and Biological Activity.

C. brachyspora, a widespread dematiaceous fungus, was evaluated in this study to optimize the production of exopolysaccharides (CB-EPS). Optimization was performed using response surface methodology, and the best production yielded 75.05% of total sugar at pH 7.4, with 0.1% urea, after 197 h. The obtained CB-EPS showed typical signals of polysaccharides, which was confirmed by FT-IR and NMR. The HPSEC analysis indicated a polydisperse polymer, showing a non-uniform peak, with an average molar mass (Mw) of 24,470 g/mol. The major monosaccharide was glucose (63.9 Mol%), followed by mannose (19.7 Mol%), and galactose (16.4 Mol%). Methylation analysis encountered derivatives that indicated the presence of a ß-d-glucan and a highly branched glucogalactomannan. CB-EPS was tested on murine macrophages to verify its immunoactivity, and the treated cells were able to produce TNF-α, IL-6, and IL-10. However, the cells did not produce superoxide anions or nitric oxide nor stimulated phagocytosis. The results demonstrated an indirect antimicrobial activity of macrophages by stimulating cytokines, showing another biotech applicability for the exopolysaccharides produced by C. brachyspora.

Biomarkers associated with persistence and severity of IgE-mediated food allergies: a systematic review.

OBJECTIVE: The prevalence of food allergies (FA) has increased worldwide over the last few decades. Milk, eggs, and peanuts are among the most common allergens and can cause anaphylaxis. Therefore, we aimed to identify biomarkers that could predict the persistence and/or severity of IgE-mediated allergies to milk, eggs, and peanuts via a systematic review. METHODS: This systematic review proceeded according to a protocol registered in the International Prospective Register of Systematic Reviews. Two independent authors extracted studies of interest from PubMed, SciELO, EMBASE, Scopus, and Ebsco databases and assessed their quality using the Newcastle-Ottawa Scale. RESULTS: We selected 14 articles describing 1,398 patients. Among eight identified biomarkers, total IgE, specific IgE (sIgE), and IgG4 were the most often cited biomarkers of persistent allergies to milk, eggs, and peanuts. Skin prick tests, endpoint tests, and sIgE cutoff levels may predict positive responses to challenges with these foods. The basophil activation test is a biomarker for the severity and/or threshold of allergic reactions to milk and peanuts. CONCLUSION: Only a few publications identified possible prognostic indicators of the persistence or severity of FA and outcomes of oral food challenges, indicating that more accessible biomarkers are needed to determine the likelihood of having a severe food allergic reaction.

Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review.

INTRODUCTION: This review aimed at investigating the impact of bundle components on the prevention of ventilator-associated pneumonia (VAP) in adults and the elderly. METHODOLOGY: The databases consulted were PubMed, EBSCO, and Scielo. The terms Bundle and Pneumonia were searched in combination. The original articles were selected in Spanish and English; published between January 2008 and December 2017. After eliminating the duplicate papers, an analysis of the titles and the abstracts was performed in order to select the assessed articles. A total of 18 articles were included in this review that were evaluated according to the following criteria: research reference, country of data collection, type of study, characteristics of the studied patients, analysis and intervention performed, bundle items investigated and their results, and research outcome. RESULTS: Four bundle items were presented in all the investigated papers. 61% of those works were considered from seven to eight bundle items. Daily evaluation of sedation interruption and daily assessment for verifying extubation condition, head-of-bed elevation at 30 degrees, cuff pressure monitoring, coagulation prophylaxis, and oral hygiene were the most reported bundle items. One study described the increased mortality of patients under mechanical ventilation when omitted the bundle items of oral hygiene and stress ulcer prophylaxis. Head-of-bed elevation at 30 degrees was the item reported in 100% of the studied papers. CONCLUSIONS: Existing research demonstrated that VAP reduction occurred when bundle items were performed for adults and the elderly. Four works showed the relevance of team education as a central approach to the event reduction related to the ventilator.

Opinião dos estudantes da área da saúde sobre a utilização de metodologias ativas no ensino remoto de fisiologia humana / Health students' opinion on the use of active methodologies in the remote teaching of human physiology / Opinión de los estudiantes de sanidad sobre el uso de metodologías activas en la enseñanza a distancia de la fisiología humana

A pandemia Covid-19 foi um desafio que os sistemas educacionais enfrentaram. As instituições de ensino tiveram de se adaptar às novas correlações entre ensino e aprendizagem. O objetivo deste estudo foi compreender a percepção dos alunos do ensino superior em relação ao uso de metodologias ativas no estudo remoto de fisiologia humana. Trata-se de um estudo descritivo transversal com abordagem mista. Foram obtidas 35 respostas e 25 dos alunos consideraram positivo o uso de metodologias ativas no ensino de fisiologia humana. Nas últimas décadas, o ensino na área da saúde tem sido debatido e o currículo de metodologias ativas tem se destacado, pois busca uma formação com uma visão ampla do homem, formando um sujeito ético, crítico, reflexivo, humanizado e capaz de transformar o seu entorno. O uso de metodologias ativas durante o período de ensino remoto propiciou um maior ganho de conhecimento em fisiologia humana.

The Covid-19 pandemic was a challenge for education systems. Educational institutions have had to adapt to the new correlations between teaching and learning. The aim of this study was to understand the perception of higher education students regarding the use of active methodologies in the remote study of Human Physiology. This is a cross-sectional descriptive study with a mixed methods approach. Thirty-five responses were obtained and 25 of the students considered the use of active methodologies in the teaching of Human Physiology to be positive. In recent decades, teaching in the health area has been debated, and the curriculum of active methodologies has stood out, as it seeks training with a broad view of man, forming an ethical, critical, reflective, humanized subject capable of transforming his surroundings. The use of active methodologies during the remote teaching period led to greater gain in the knowledge of human physiology

La pandemia de la Covid-19 ha puesto a prueba los sistemas educativos y las instituciones han tenido que adaptarse a nuevas técnicas de enseñanza. El objetivo de este estudio era conocer las percepciones de los estudiantes de enseñanza superior sobre el uso de metodologías activas en la enseñanza a distancia de la fisiología. Se trata de un estudio descriptivo transversal con un enfoque de métodos diversificados. Hubo 35 respuestas y 25 de los estudiantes consideraron positivo el uso de metodologías activas en la enseñanza de la fisiología. La enseñanza de la salud ha sido objeto de debate, con énfasis en el currículo de metodologías activas, que busca formar alumnos con una visión amplia del hombre, formando un individuo ético, reflexivo, humanizado y capaz de transformar su entorno. El uso de metodologías activas durante el periodo de enseñanza a distancia permitió adquirir un mayor conocimiento de la fisiología humana.

Chemical Evaluation of Liquidambar styraciflua L. Fruits Extracts and Their Potential as Anticancer Drugs.

Liquidambar styraciflua L. is an aromatic species, popularly used in traditional Chinese medicine to treat diarrhea, dysentery, coughs, and skin sores. The present study was designed to investigate the chemical composition and biological potential of extracts obtained from the fruits of this plant. For the chemical evaluation, it was used mainly liquid and gas chromatography, plus NMR, and colorimetric methods. The aqueous extract (EA) originated two other fractions: an aqueous (P-EA) and an ethanolic (S-EA). The three extracts were composed of proteins, phenolic compounds, and carbohydrates in different proportions. The analyses showed that the polysaccharide extract (P-EA) contained pectic polysaccharides, such as acetylated and methyl esterified homogalacturonans together with arabinogalactan, while the fraction S-EA presented phenolic acids and terpenes such as gallic acid, protocathecuic acid, liquidambaric acid, combretastatin, and atractyloside A. EA, P-EA, and S-EA showed antioxidant activity, with IC50 values of 4.64 µg/mL, 16.45 µg/mL, and 3.67 µg/mL, respectively. The cytotoxicity followed the sequence S-EA > EA > P-EA, demonstrating that the toxic compounds were separated from the non-toxic ones by ethanol precipitation. While the fraction S-EA is very toxic to any cell line, the fraction P-EA is a promising candidate for studies against cancer due to its high toxicity to tumoral cells and low toxicity to normal cells.

Biomarkers associated with persistence and severity of IgE-mediated food allergies: a systematic review

Abstract Objective The prevalence of food allergies (FA) has increased worldwide over the last few decades. Milk, eggs, and peanuts are among the most common allergens and can cause anaphylaxis. Therefore, we aimed to identify biomarkers that could predict the persistence and/or severity of IgE-mediated allergies to milk, eggs, and peanuts via a systematic review. Methods This systematic review proceeded according to a protocol registered in the International Prospective Register of Systematic Reviews. Two independent authors extracted studies of interest from PubMed, SciELO, EMBASE, Scopus, and Ebsco databases and assessed their quality using the Newcastle-Ottawa Scale. Results We selected 14 articles describing 1,398 patients. Among eight identified biomarkers, total IgE, specific IgE (sIgE), and IgG4 were the most often cited biomarkers of persistent allergies to milk, eggs, and peanuts. Skin prick tests, endpoint tests, and sIgE cutoff levels may predict positive responses to challenges with these foods. The basophil activation test is a biomarker for the severity and/or threshold of allergic reactions to milk and peanuts. Conclusion Only a few publications identified possible prognostic indicators of the persistence or severity of FA and outcomes of oral food challenges, indicating that more accessible biomarkers are needed to determine the likelihood of having a severe food allergic reaction.

Psychological Impact of TP53-Variant-Carrier Newborns and Counselling on Mothers: A Pediatric Surveillance Cohort.

Counselling and genetic testing (CGT) after neonatal screening may increase depression and anxiety (DA) levels during cancer surveillance. This study assessed the DA scores in mothers of newborns from Paraná state, Southern Brazil, carrying the TP53 p.R337H variant. To understand and adjust DA conditions during term of pregnancy, we initially detected sociodemographic covariates [marital status (MS), number of children (NC), and/or education level (EL): MS-NC-EL] on an independent group of pregnant women (not subjected to genetic testing). The Hospital Anxiety and Depression Scale (HADS) was used to assess risk factors in pregnant (cross-sectional analysis) and unrelated mothers (at 2-month intervals, longitudinal study) of TP53 p.R337H-tested newborns (three sessions of HADS analysis) using Wilcoxon (Mann-Whitney) and Kruskal-Wallis nonparametric tests. Lower anxiety levels were observed in mothers of noncarriers (without MS-NC-EL = 6.91 ± 1.19; with MS-NC-EL = 6.82 ± 0.93) than in mothers of p.R337H carriers in the first session (without MS-NC-EL = 6.82 = 8.49 ± 0.6025, with MS-NC-EL = 6.82 = 9.21 ± 0.66). The anxiety levels significantly decreased 4 months after CGT (third session) in mothers of p.R337H carriers. We did not find a significant change in depression scores. Mothers with mental health instability requiring medications need periodical psychological support during and after CGT.

A experiência de ser paciente simulado durante a formação na área de saúde / The experience of being a simulated patient in healthcare training / La experiencia de ser paciente simulado durante la capacitación en el área de la salud

A aprendizagem baseada em simulação ganha espaço nos currículos para formação em saúde com a utilização de paciente simulado, proporcionando aos estudantes o desenvolvimento de competências em ambiente protegido de ensino-aprendizagem. O contato com situação simulada estimula o treino das habilidades clínicas, antes do contato com pacientes reais. Tem-se como objetivo identificar como a experiência em ser paciente simulado influencia na formação acadêmica de estudantes da área de saúde. O método foi exploratório-descritivo, com abordagem quantitativa, desenvolvido por meio de pesquisa transversal com questionário contendo escala Likert, aplicado por meio de survey on-line. Ficou evidente neste estudo que os estudantes da área da saúde que participam das simulações clínicas, como Paciente Simulado, perceberam benefícios em seu desenvolvimento enquanto futuros profissionais. O fato de interpretar um caso clínico advindo da realidade faz desse aprendizado mais significativo comparado a uma aula com método tradicional de ensino sobre o mesmo assunto.

Simulation-based learning gains space in health education curricula with the use of simulated patients, providing students with skills development in a protected teaching-learning environment. The contact with a simulated situation stimulatesclinical skills training before the contact with real patients. The objective is to identify how the experience of being a simulated patient influences the academic formation of healthcare students. The method was exploratory-descriptive, with a quantitative approach, developed through cross-sectional research with a Likert scale questionnaire, applied through an online survey. This study evidenced that health students who participated in clinical simulations as Simulated Patients perceived benefits for their development as future professionals. Interpreting a clinical case arising from reality makes this learning more meaningful compared to a class with a traditional teaching method on the same subject.Keywords: Patient Simulation. Students, Health Occupations. Problem-Based Learning. RESUMENEl aprendizaje basado en simulación gana espacio en los currículos de educación para la salud con el uso de pacientes simulados, lo que proporciona a los estudiantes el desarrollo de habilidades en un entorno de enseñanza-aprendizaje protegido. El contacto con una situación simulada estimula el entrenamiento de habilidades clínicas, antes del contacto con pacientes reales. El objetivo es identificar cómo la experiencia de ser un paciente simulado influye en la formación académica de los estudiantes del área de la salud. El método fue exploratorio-

El aprendizaje basado en simulación gana espacio en los currículos de educación para la salud con el uso de pacientes simulados, lo que proporciona a los estudiantes el desarrollo de habilidades en un entorno de enseñanza-aprendizaje protegido. El contacto con una situación simulada estimula el entrenamiento de habilidades clínicas, antes del contacto con pacientes reales. El objetivo es identificar cómo la experiencia de ser un paciente simulado influye en la formación académica de los estudiantes del área de la salud. El método fue exploratorio-descriptivo, con enfoque cuantitativo, desarrollado a través de una investigación transversal con un cuestionario que contenía una escala de Likert, aplicado a través de una encuesta en línea. Se evidenció en este estudio que los estudiantes de salud que participan en simulacros clínicos, como Paciente Simulado, perciben beneficios en su desarrollo como futuros profesionales. El hecho de interpretar un caso clínico que vino de la realidad hace que este aprendizaje sea más significativo frente a una clase con un método de enseñanza tradicional sobre el mismo tema.

Newborn Screening for the Detection of the TP53 R337H Variant and Surveillance for Early Diagnosis of Pediatric Adrenocortical Tumors: Lessons Learned and Way Forward.

The incidence of pediatric adrenocortical tumors (ACT) is high in southern Brazil due to the founder TP53 R337H variant. Neonatal screening/surveillance (NSS) for this variant resulted in early ACT detection and improved outcomes. The medical records of children with ACT who did not participate in newborn screening (non-NSS) were reviewed (2012-2018). We compared known prognostic factors between the NSS and non-NSS cohorts and estimated surveillance and treatment costs. Of the 16 non-NSS children with ACT carrying the R337H variant, the disease stages I, II, III, and IV were observed in five, five, one, and five children, respectively. The tumor weight ranged from 22 to 608 g. The 11 NSS children with ACT all had disease stage I and were alive. The median tumor weight, age of diagnosis, and interval between symptoms and diagnosis were 21 g, 1.9 years, and two weeks, respectively, for the NSS cohort and 210 g, 5.2 years, and 15 weeks, respectively, for the non-NSS cohort. The estimated surveillance/screening cost per year of life saved is US$623/patient. NSS is critical for improving the outcome of pediatric ACT in this region. Hence, we strongly advocate for the inclusion of R337H in the state-mandated universal screening and surveillance.

Systematic review and single-centre toxicology study identified analgesics and benzodiazepines as the main causes of paediatric medication poisoning.

AIM: This study evaluated medication poisoning in paediatric patients through a systematic review and a retrospective documentary analysis in a Brazilian toxicological centre. METHODS: The data were systematically collected on PubMed, Scopus and SciELO databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included epidemiologic and prevalence studies that were published in English or Portuguese from 2013 to 2017 and covered paediatric patients. The retrospective incidence study was carried out in a Brazilian toxicological centre and was a documentary analysis of paediatric medication poisoning cases from 2005 to 2015. RESULTS: The systematic review comprised 13 papers covering 895 206 poisoning cases from six different countries. The main agents of intoxication were analgesics and antihistamines. The eight papers that explored the reasons for the poisonings showed that 93% of those 762 863 cases were accidental. The Brazilian toxicological centre recorded 443 paediatric patients poisoned by medication such as benzodiazepines, analgesics and antibiotics and found that 63.2% were accidental. However, it agreed with the global findings in many other aspects. CONCLUSION: The systematic review showed a sustained number of paediatric medication toxicity cases worldwide and the key findings were broadly reflected by the retrospective study carried out in the Brazilian toxicological centre.

Correlação entre Trihalometanos e o Desenvolvimento do Câncer de Bexiga / Correlation between Trihalomethanes and the Development of Bladder Cancer / Correlación entre Trihalometanos y el Desarrollo del Cáncer de Vejiga

Introdução: Os trihalometanos (THM) constituem um grupo de subprodutos gerados pela desinfecção da água por meio da cloração. Desde a primeira vez em que foram reportados, em 1974, são alvos de estudos que buscam estabelecer uma relação positiva entre a exposição dos humanos a esses compostos e o desenvolvimento de câncer. Objetivo: Revisão da literatura científica disponível sobre a presença de THM na água e sua relação com o desenvolvimento do câncer de bexiga. Método: Levantamento bibliográfico da revisão feito nas bases de dados ScienceDirect e PubMeb. Os descritores utilizados foram ''trihalomethane'', ''disinfection by-products'' e ''bladder cancer'' dos Descritores em Ciências da Saúde (DeCS) da Biblioteca Virtual em Saúde. Os artigos selecionados foram publicados nos últimos cinco anos. Resultados: A amostra final desta revisão foi constituída por 31 artigos, sendo a maioria deles publicados em jornais e revistas sobre meio ambiente. Analisaram-se estudos descritivos, metanálises e outros estudos individuais com delineamento experimental, encontrando uma associação positiva, mas controversa, entre os THM e o câncer, associada a diferentes mecanismos. A relação mais consistente tem sido entre a exposição crônica e o câncer de bexiga. Conclusão: Os estudos reconhecem que existem riscos significativos à saúde relacionados aos THM, no entanto, evidências que esclareçam os mecanismos de ação e o papel que outros fatores de risco possuem, juntamente com os THM, ainda permanecem incertas. Palavras-chave: Trihalometanos; Subprodutos da Desinfecção; Neoplasias da Bexiga Urinária

Introduction: The trihalomethanes (THM) are one of the by-products created from the chlorination process, the most applied technique for water disinfection. Since the first time they were reported in 1974, studies attempted to find a positive correlation between human's exposure to THM and cancer. Objective: Review the available scientific literature reported about the presence of THM in drinking water's treatment and its relation with the carcinogenic process of bladder cancer. Method: The present study consists of an integrative literature review. The articles were searched in the ScienceDirect and PubMed databases utilizing the following keywords obtained from the Subject Descriptors in Health Science (Virtual Health Library): "trihalomethanes", "disinfection by-products" and "bladder cancer". Results: In total, 31 articles were selected for this review, most of them published in environmental or toxicological journals. The authors analyzed descriptive studies, meta-analysis and other experimental studies, finding a positive, but controversial relationship between the t THM exposures, specifically the chronic, and the carcinogenic process associated with many pathological mechanisms. Conclusion: The studies recognized the potential risk of the THM exposure in humans, however, more evidence is needed for a better understanding of THM's toxicological aspects and the influence of other health risk factors in the carcinogenicity process

Introducción: Los trihalometanos (THM) constituyen un grupo de subproductos generado por la desinfección del agua mediante cloración. Desde la primera notificación en 1974, son objeto de estudios que buscan establecer una relación positiva entre la exposición humana a estos compuestos y el desarrollo de cáncer. Objetivo: Revisión de la literatura científica disponible sobre la presencia de THM en la agua y su relación con el desarrollo del cáncer de vejiga. Método: El estudio bibliográfico de la revisión se realizó em las bases de datos ScienceDirect y PubMeb. Los descriptores utilizados fueron ''trihalomethane'', ''disinfection byproducts'' e ''bladder cancer'' ­ de Descriptores de Ciencias de la Salud (DeCS) de la Biblioteca Virtual en Salud. Los artículos seleccionados han sido publicados en los últimos 5 años. Resultados: La muestra final de esta revisión consistió en 31 artículos, la mayoría publicados en periódicos y revistas ambientales. Se analizaron estudios descriptivos, metaanálisis y otros estudios individuales con diseño experimental, encontrando una asociación positiva, pero controvertida, entre los THM y el cáncer asociado con diferentes mecanismos. La relación más consistente ha sido entre la exposición crónica y el cáncer de vejiga. Conclusión: Los estudios reconocen que existen riesgos significativos para la salud relacionados con los THM, sin embargo, las pruebas que aclaran los mecanismos de acción y el papel que otros factores de riesgo tienen, junto con los THM, siguen siendo inciertos

Exopolysaccharides from Aspergillus terreus: Production, chemical elucidation and immunoactivity.

Aspergillus terreus, a fungus commonly used in pharmaceutical industry to produce lovastatin and other secondary metabolites, has been reported to have beneficial biological properties. In this study the exopolysaccharides (AT-EPS) produced by A. terreus were evaluated as potential modulators of certain functions of macrophages. The production parameters for EPS obtained from the liquid culture broth of the studied fungus were optimized using response surface methodology (RSM) and indicated good correlation between the experimental and predicted values. The optimum conditions for AT-EPS extraction included fermentation at 28 °C, pH 8.79, under 98 rpm of agitation, using 2.39% glucose (carbon source) and 0.957% ammonium nitrate (nitrogen source). Under these optimized conditions, AT-EPS production was 1.34 g/L medium. The chemical analyses showed that AT-EPS was composed by mannose (Man; 40.5 mol%), galactose (Gal; 35.2 mol%), and glucose (Glc; 24.3 mol%), and the spectroscopic (FTIR; NMR) and methylation analyses indicated the presence of galactomannans, ß-1,3-glucans, and glycogen-like glucans. AT-EPS was tested on murine macrophages to verify its immunoactivity and the treated cells were able to produce nitric oxide, superoxide anion, TNF-α and interleukin 6 similarly to the positive control cells. Furthermore, the macrophages treated with AT-EPS showed activated-like morphological alterations.

Liquidambar styraciflua L.: A new potential source for therapeutic uses.

Liquidambar styraciflua L., ALTINGIACEAE, popularly known as sweet gum or alligator tree, is an aromatic tree with a natural distribution in North America and acclimated in Brazil. In traditional medicine, L. styraciflua L is used for the treatment of stomach disorders, wounds, and coughs. The present study was designed to investigate the biological potential and chemical profile of extracts obtained from aerial parts of L. styraciflua L. The chemical profile was established using liquid chromatography-mass spectrometry analysis and the extracts were tested for total phenolics, flavonoids, and tannins using spectrophotometric assays. The anti-inflammatory activity of L. styraciflua L was tested using an inhibition of hyaluronidase enzyme assay, and cytotoxic activities were tested by the 3-(4,5-dimethylthiazol-2 yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay. The synergy between the plant extracts with ciprofloxacin and tetracycline was studied by the checkerboard assay method against eight bacterial strains.The phytochemical investigation showed that the leaves and stem are rich in phenolics compounds (1419.34-1614.02 mg GAE/g, 875.21-1557.57 mg GAE/g, respectively), mainly flavonoids and hydrolyzable tannins. The samples of the stem exhibited the best anti-inflammatory activity. The butanol fraction of the stem was better than the commercial propolis extract. The hydroalcoholic extract of the stem and the propolis did not exhibit significant differences (p < 0.05) at any of the concentrations tested. A synergistic interaction was observed against the Gram-positive bacterial Enterococcus faecalis (hydroalcoholic extract of leaves and tetracycline) and Staphylococcus aureus (hydroalcoholic extract of stem and tetracycline). The IC50 values obtained for the extracts indicate the absence of toxicity and moderate cytotoxic for the hydroalcoholic extract of the stem. On the basis of our findings, L. styaciflua may be considered as a potential therapeutic source with high anti-inflammatory activity and synergistic interactions with antibiotics against bacteria.

Simulação realística como ferramenta de ensino na saúde; uma revisão integrativa / Realistic simulation as a teaching tool in health: an integrative review

A forma de ensino na saúde mudou em todo o mundo, com a implementação da simulação realística, que adquiriu um papel importante na educação, porque é uma forma ativa de aprendizado. O estudo objetivou pesquisar publicações brasileiras sobre a utilização dessa metodologia de ensino-aprendizagem nas escolas de saúde, analisando os cursos e áreas que mais utilizam a técnica, limitações, desafios e benefícios alcançados. Trata-se de uma revisão integrativa da literatura. Totalizaram-se 25 publicações, selecionadas nas bases de dados BVS e SciELO utilizando os descritores "simulação realística" e "ensino baseado em simulação". Constatou-se que a simulação é metodologia indispensável no ensino em saúde, porque promove o protagonismo do estudante no processo ensino-aprendizagem. Concluiu-se que a simulação pode ser utilizada no desenvolvimento de competências essenciais do profissional de saúde. No entanto, existem limitações na sua implementação. Também são escassos os estudos além das graduações de medicina e enfermagem e na atenção primária.

Spatial trends in congenital malformations and stream water chemistry in Southern Brazil.

The incidence of variable congenital malformation (CM) among 399 municipalities in the state of Paraná, southern Brazil, suggests the etiological role of environmental factors. This study examined a) environmental concentrations of chlorine anions (Cl-) associated with organochlorines (OCs) and b) associations between these chemicals and agricultural output with CMs using a geographical information system. In one of the three years during the sampling period (2008, 2009 or 2010) Cl-, dichlorodiphenyltrichloroethane (p,p'-DDT), dichlorodiphenyldichloroethylene (p,p'-DDE), dichlorodiphenyldichloroethane (p,p'-DDD), and endosulfan levels were measured in 465 (465/736, 63%) catchment basins. Agricultural outputs for crops during 2006-2010 were also evaluated (t/km2). Further, CM kernel density for the 399 municipalities in Paraná during 2007-2014 was investigated. Cl- levels increased significantly in one of the three years (2008, 2009 or 2010) in western catchment basins, compared to 1996 (p < 0.0001). The municipalities were divided according to the obtained Cl- levels, where sub-region C2 (central-southern) < 1.8 mg/L ≤ sub-regions C1 (northern-western) and C3 (eastern-southern). We identified 8756 cases of CMs among 1,221,287 newborns (NB) in all sub-regions. C1 had higher DDT-DDE-DDD (p,p'-DDT + p,p'-DDE + p,p'-DDD) concentrations, agricultural output, and CM kernel density. C2 and C3 had minor agricultural outputs (per square kilometer) and CM densities. A 2.96 mg/L increase in Cl- between sub-regions C1 and C2 was co-localized with a 45% increase in CM density (spatial relative risk = 1.45, CI 95%: 1.36-1.55). C1 had the highest log likelihood ratios (p = 0.001) identified via SaTScan clustering analyses. Organochlorines and other toxic chlorinated chemicals may contribute to CMs in humans, and these chemicals are ultimately transformed and release Cl- in rivers. Higher Cl- levels were correlated significantly with higher agricultural productivity, DDT-DDE-DDD levels, and CMs in some parts of the northern and western sub-regions (C1).

ß-(1→6)-D-glucan secreted during the optimised production of exopolysaccharides by Paecilomyces variotii has immunostimulatory activity.

Paecilomyces variotii is a filamentous fungus that occurs worldwide in soil and decaying vegetation. Optimization of the fermentation process for exopolysaccharide (EPS) production from the fungus P. variotii, structure determination and immuno-stimulating activity of EPS were performed. Response surface methodology (RSM) coupled with central composite design (CCD) was used to optimize the physical and chemical factors required to produce EPS in submerged fermentation. Preliminary investigations to choose the three factors for the present work were made using a factorial experimental design. Glucose, ammonium nitrate (NH4NO3) and pH were used as variables for which, with constant temperature of 28 °C and agitation of 90 rpm, the optimal process parameters were determined as glucose values of 0.96%, NH4NO3 0.26% and pH 8.0. The three parameters presented significant effects. In this condition of culture, the main composition of the isolated EPS was a linear ß-(1 â†’ 6)-linked-D-glucan, as determined by Nuclear Magnetic Resonance (NMR) and methylation analysis. This polysaccharide is a very unusual as an EPS from fungi, especially a filamentous fungus such as P. variotii. Murine peritoneal macrophages cultivated with ß-glucan for 6 and 48 h showed an increase in TNF-α, IL-6 and nitric oxide release with increased polysaccharide concentrations. Therefore, we conclude that the ß-(1 â†’ 6)-linked-D-glucan produced in optimised conditions of P. variotii cultivation has an immune-stimulatory activity on murine macrophages.

Pró-Ensino no projeto Ensino, Saúde e Desenvolvimento - rede de saberes e práticas: avanços e desafios no Paraná e em Santa Catarina, Brasil / Pro-Enseñanza en el Proyecto Enseñanza, Salud y Desarrollo: red de saberes y prácticas: avances y desafíos en los estados de Paraná y Santa Catarina, Brasil / Pró-Ensino in the project "Teaching, Health and Development - network of knowledge and practices": advances and challenges in Paraná and Santa Catarina, Brazil

O projeto Ensino, Saúde e Desenvolvimento: rede de saberes e práticas foi uma proposição conjunta inicialmente de professores e pesquisadores da Faculdades Pequeno Príncipe, da Universidade Estadual de Londrina, da Universidade Federal de Santa Catarina e posteriormente da Universidade Estadual de Maringá e da Universidade Federal de Alagoas. O objetivo deste relato é uma autoavaliação, buscando analisar os resultados alcançados com um olhar crítico na busca de alternativas que levassem a maiores avanços. A avaliação foi dividida em tópicos: Contexto e problemática; A construção do projeto: seus a(u)tores e históricos envolvidos; Ousadia número 1: ensino, saúde e desenvolvimento; Ousadia número 2: rede de saberes e práticas; O desenvolvimento do projeto: avanços e recuos; Lições aprendidas; e Perspectivas. Os autores reconhecem a pertinência da iniciativa do Ministério da Saúde e da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e se posicionam para a continuidade do Programa Pró-Ensino na Saúde.(AU)

El proyecto "Enseñanza, Salud y Desarrollo: red de saberes y prácticas" fue inicialmente una propuesta conjunta de profesores e investigadores de las Facultades Pequeno Príncipe, Universidad Estadual de Londrina y Universidad Federal de Santa Catarina y posteriormente de la Universidad Estadual de Maringá y de la Universidad Federal de Alagoas. El objetivo de este relato es una autoevaluación buscando analizar los resultados alcanzados con una mirada crítica en la búsqueda de alternativas que llevaran a mayores avances. La evaluación se dividió en tópicos: Contexto y problemática; La construcción del proyecto: sus autores y actores e historiales envueltos; Osadía Número 1: Enseñanza, salud y desarrollo; Osadía Número 2: Red de saberes y prácticas; El desarrollo del proyecto: avances y retrocesos; Lecciones aprendidas; Perspectivas. Los autores reconocen la pertinencia de la iniciativa del Ministerio de la Salud y de CAPES y se posicionan en favor de la continuidad del Programa "Pro-Enseñanza en la salud".(AU)

The project "Teaching, Health and Development: Network of Knowledge and Practices" was a joint proposal of teachers and researchers from Faculdades Pequeno Príncipe, Universidade Estadual de Londrina and Universidade Federal de Santa Catarina and, subsequently, from Universidade Estadual de Maringá and Universidade Federal de Alagoas. The objective of this report is a self-evaluation to analyze the results achieved with a critical eye in search of alternatives that could lead to greater advances. The evaluation was divided into topics: Context and problem; The construction of the Project: Its stakeholders and history; Boldness Number 1: Teaching, health and development; Boldness Number 2: Network of knowledge and practices; The development of the project: Advances and retreats; Lessons Learned; Perspectives. The authors acknowledge the relevance of the initiative of the Ministry of Health and CAPES and stand up for the continuity of the Program Pró-Ensino na Saúde.(AU)