The impact of ageing on the incidence and mortality rate of bloodstream infection: A hospital-based case-cohort study in a tertiary public hospital of Brazil.

OBJECTIVE: Over the past few decades, life expectancy in Brazil has increased from 48 years in 1950s to 76 years in 2017. The aim of this study was to investigate the impact of ageing on: (1) the frequency of hospitalisations due to bloodstream infection (BSI); (2) the incidence of hospital-acquired BSI (H-BSI); (3) the incidence of BSI caused by multidrug-resistant (MDR) agents and (4) the mortality rate of BSI in a public hospital. METHODS: A hospital-based case-cohort study was conducted between 1 December 2013 and 31 December 2015. The data were analysed using multivariable logistic regression. RESULTS: A total of 500 BSI episodes were detected, among 11,102 hospitalizations. The incidence of hospitalisations resulting from BSI was significantly higher in older than younger patients (3.7/100 vs. 2.0/100, p < 0.01). Similarly, the incidence of hospital-acquired BSI was significantly higher in older patients (2.7/100 vs. 0.9/100, p < 0.01). Klebsiella pneumoniae (15.9%), Staphylococcus aureus (14.3%), Escherichia coli (13.1%) and Acinetobacter spp. (12.1%) were the most common agents isolated. MDR agents caused 37.6% of the BSI episodes; enteric Gram-negative bacilli resistant to third- or fourth-generation cephalosporins (9.7%) and carbapenem-resistant Acinetobacter spp. (9.2%) were the most common MDR agents. The following complications were independently associated with ageing: Charlson comorbidity index (OR = 1.16; 95% CI = 1.09-1.24); BSI secondary to urinary tract infection (OR = 2.14; 95% CI = 1.29-3.55); BSI secondary to pneumonia (OR = 1.77; 95% CI = 1.07-2.93) and 30-day mortality following BSI (OR = 2.19; 95% CI = 1.43-3.36). CONCLUSIONS: These data suggest ageing has a significant impact on hospitalisations due to BSI, H-BSI incidence and mortality from BSI in older patients attending a Brazilian public hospital. Age was not significantly associated with MDR-related BSI. These results indicate that age plays an important role in the increase in morbidities and mortality resulting from BSI in Brazil and that with the increased life expectancy observed over recent decades in Brazil, the burden of BSI will be expected to continue to increase. This dynamic needs to be better understood with additional studies.

Effect of different cryopreservation extenders added with antioxidants on semen quality and in vitro embryo production efficiency in cattle.

To evaluate the addition of antioxidants in extenders on post-thaw bovine semen quality and in vitro embryo production efficiency. Six semen samples were collected from five Holstein bulls. In the experiment I, the samples were diluted with AndroMed® and Bovimix® and added antioxidants glutathione (1.5 and 2.5 mM) and melatonin (0.5 and 1.0 mM). In the experiment II, the best treatments obtained in experiment I were used for in vitro fecundation. Glutathione did not improve sperm viability. Melatonin had a negative effect on semen characteristics. Andromed® showed better results in sperm kinetics parameters. Bovimix® was more efficient in maintaining cell integrity parameters. Significant correlation was found between sperm kinetics parameters and between cell integrity parameters. For in vitro embryo production, after oocyte selection, maturation, fertilization and cultivation were performed using the four treatments previously evaluated. Andromed® was more efficient in the cleavage rate, no effect of the addition of glutathione. However, the addition of 2.5 mM glutathione in the Bovimix® improved the cleavage rate. There was a significant moderate correlation between cleavage rate and sperm kinetic characteristics. Glutathione did not improve sperm viability. Melatonin reduced the maintenance of sperm characteristics. Andromed® was more efficient in in vitro embryo production and no effect of glutathione was found in this extender. Addition of 2.5 mM glutathione in the Bovimix® extender provided a higher cleavage rate.

Associations Between Skin Surface Temperature and Pressure Pain Tolerance Thresholds of Asymptomatic Individuals Exposed to Cryotherapy and Thermotherapy.

OBJECTIVE: The purpose of this study was to evaluate associations between skin surface temperature and pressure pain tolerance thresholds (PPTs) of asymptomatic individuals exposed to cryotherapy and thermotherapy. METHODS: Twenty-two asymptomatic female university students aged between 18 and 35 years underwent thermography and algometry assessments at 6 points in both knees before, immediately after, and 20 minutes after the application of frozen (cryotherapy) or heated (thermotherapy) gel bags in the right knee for 20 minutes. Data were analyzed by 1-way analysis of variance, Student t test, and Pearson or Spearman correlation tests. RESULTS: There was a significant change in skin surface temperature after cryotherapy and thermotherapy, which was maintained after 20 minutes of withdrawal (P < .001). After the intervention, no significant differences were observed regarding PPT compared with the baseline measurements, nor between the experimental and control knees. CONCLUSION: Cryotherapy and thermotherapy produced significant changes in the temperature of the evaluated points after their application. No differences in pain tolerance were observed in these asymptomatic participants. There was little association between skin surface temperature and PPT in the knees of healthy women after application of the resources.

Pain Tolerance: The Influence of Cold or Heat Therapy.

OBJECTIVES: Resources of heat or cold therapies have been widely used for their low cost, analgesic action and for assisting the rehabilitation of acute or chronic injuries. The objective of this study was to search for associations between skin surface temperature and pressure pain tolerance thresholds (PPTs) of healthy individuals undergoing cryotherapy and thermotherapy. METHODS: This is an experimental clinical trial with 22 healthy university students aged between 18 and 35 years. Volunteers underwent thermography and algometry assessments at 6 points in both knees before, immediately after, and 20 minutes after the application of frozen (cryotherapy) or heated (thermotherapy) gel bags in the right knee for 20 minutes. Data were analyzed by 1-way analysis of variance, Student's t test, and Pearson or Spearman correlation tests. RESULTS: There was a significant change in skin surface temperature after cryotherapy and thermotherapy, which was maintained after 20 minutes of withdrawal (P < .001). After the intervention, no significant differences were observed regarding the PPT compared to the baseline measurements, nor between the experimental and control knees. CONCLUSION: Cryotherapy and thermotherapy produced significant changes in the temperature of the evaluated points after their application. Despite this, no differences in pain tolerance were observed, and there was little association between skin surface temperature and PPT in the knees of healthy women after application of the resources.

Effect of Foot Reflexology on Capillary Blood Glucose, Tissue Temperature, and Plantar Pressure of Individuals With Diabetes Mellitus (Type 2): A Pilot Study.

OBJECTIVE: The purpose of this study was to assess the effect of foot reflexology on capillary blood glucose, feet tissue temperature, and plantar pressure of the feet of individuals with diabetes mellitus (type 2). METHODS: Forty-five individuals with type 2 diabetes mellitus were stratified into 2 groups: treated (n = 21), which received orientation about foot self-care and received 12 foot reflexology sessions; and control (n = 24), which received only orientations about foot self-care. A portable glucose meter, an infrared thermography camera, and a baropodometer evaluated the variables. RESULTS: The data indicate that, after 12 therapy sessions, there were no significant differences between the groups for producing effects on capillary blood glucose, feet tissue temperature, and plantar pressure. CONCLUSION: No significant effect was observed after 12 foot reflexology sessions in the variables that were evaluated.

Soybean straw nanocellulose produced by enzymatic or acid treatment as a reinforcing filler in soy protein isolate films.

This work is a comparative study of the application of mercerized soybean straw (MSS) and nanocellulose produced by acid (CNCs) or enzymatic hydrolysis (CNFs) as reinforcing fillers in soy protein isolate (SPI) films. CNCs presented average dimensions of about 10 nm-thick and 300 nm-long with a crystallinity index of 57%, whereas CNFs have similar diameters, though with greater lengths (>1 µm), lower crystallinity index (50%) and greater thermal stability. Incorporation of 5% of CNCs and CNFs (g/100 g of SPI) improved the SPI film tensile strength by 38 and 48% respectively, and decreased the SPI film elongation at break when compared to control films. The SPI-CNC films showed the lowest values for solubility, probably due to their higher crystallinity (63%). On the other hand, the water vapor permeability was solely reduced with CNF addition, which can be attributed to their higher aspect ratio (length/diameter) and a better incorporation into the protein matrix.

Reliability of Infrared Thermography Images in the Analysis of the Plantar Surface Temperature in Diabetes Mellitus.

OBJECTIVE: The purpose of this study was to evaluate the intraexaminer and interexaminer reliability of image assessment of infrared thermography of the plantar surface of people with diabetes mellitus. METHODS: Fifty-one participants with diabetes were included. The interexaminer reliability (test) consisted of measuring the temperature of the plantar surface by 2 evaluators who separately performed the analysis of thermographic images. The intraexaminer reliability (retest) consisted of the revaluation of the images by a single evaluator 10 days after the first analysis. RESULTS: The analysis of intrareliability and interreliability indicated excellent levels of correlation (intraclass correlation coefficient >0.75, 95% confidence interval >0.70) in the plantar surface points analyzed. CONCLUSION: Infrared thermography image evaluation identified intrareliability and interreliability for temperature analysis of the plantar surface of people with diabetes mellitus. However, further studies need to be conducted to assess validity and its application in health care.

Chemical treatment and characterization of soybean straw and soybean protein isolate/straw composite films.

This work investigated changes in the chemical composition and structure of soybean straw (SS) treated with alkali (NaOH 5% and 17.5%) and bleached with hydrogen peroxide (H2O2) or sodium hypochlorite (NaOCl). Removal of the amorphous constituents increased the degree of crystallinity and the content of cellulose fibers particularly after reaction with high concentrations of alkali. Treatment with NaOH 17.5% contributed to the allomorph transition from cellulose I to II regardless of the bleaching agent, but H2O2 as bleaching agent promoted more effective delignification. This work also evaluated the potential use of treated and non-treated SS as reinforcement filler in soy protein isolate film (SPI). Films added with treated SS presented higher mechanical resistance, lower elongation at break, and lower solubility in water. Addition of non-treated SS did not affect the properties of the SPI film significantly. The low solubility and the reasonable water vapor permeability of the composite films make them suitable packaging materials for fresh fruit and vegetables.

Liver damage is not reversed during the lean period in diet-induced weight cycling in mice.

AIM: Weight cycling (WC) is frequent in obesity treatment. We evaluated the degree of regression of the liver damage in WC. METHODS: C57BL/6 male mice received standard chow (SC, 10% energy from lipids) or high-fat diet (HF, 60% energy from lipids) for 6 months (SC6 or HF6) or a diet that alternated every 2 months (SC2/HF2/SC2 or HF2/SC2/HF2). RESULTS: The body mass gain followed the HF intake and induced WC in the animals. The liver alanine aminotransferase, triglyceride and cholesterol levels were higher in the groups receiving the HF diet for any period. The plasma insulin and glucose levels were the highest in the HF6 and HF2/SC2/HF2 groups. Any HF intake increased the liver mass. All the groups had some degree of liver steatosis, with the SC6 group exhibiting the lowest level (∼23% compared with 50-70%). The activated hepatic stellate cells were sparse throughout the liver sections from the HF6 and HF2/SC2/HF2 groups. The lowest sterol regulatory element-binding protein-1c (SREBP-1c) level was detected in the SC6 group. The peroxisome proliferator-activated receptor (PPAR)-α expression was higher in the SC6 and SC2/HF2/SC2 groups than in the HF6 and HF2/SC2/HF2 groups that showed reduced expression. CONCLUSION: WC induced by diet leads to adverse response in the liver, including biochemical and molecular alterations that are not reversed during the lean period of the WC, which must be maintained for a long period to allow the liver to recover from the damage associated with obesity.