The Potential of Photodynamic Therapy Using Solid Lipid Nanoparticles with Aluminum Phthalocyanine Chloride as a Nanocarrier for Modulating Immunogenic Cell Death in Murine Melanoma In Vitro.

Photodynamic therapy (PDT) uses a photosensitizer to generate reactive oxygen species (ROS) that kill target cells. In cancer treatments, PDT can potentially induce immunogenic cell death (ICD), which is characterized by a well-controlled exposure of damage-associated molecular patterns (DAMPs) that activate dendritic cells (DCs) and consequently modulate the immune response in the tumor microenvironment. However, PDT still has limitations, such as the activity of photosensitizers in aqueous media and poor bioavailability. Therefore, a new photosensitizer system, SLN-AlPc, has been developed to improve the therapeutic efficacy of PDT. In vitro experiments showed that the light-excited nanocarrier increased ROS production in murine melanoma B16-F10 cells and modulated the profile of DCs. PDT induced cell death accompanied by the exposure of DAMPs and the formation of autophagosomes. In addition, the DCs exposed to PDT-treated B16-F10 cells exhibited morphological changes, increased expression of MHCII, CD86, CD80, and production of IL-12 and IFN-γ, suggesting immune activation towards an antitumor profile. These results indicate that the SLNs-AlPc protocol has the potential to improve PDT efficacy by inducing ICD and activating DCs.

The potential of five c-miRNAs as serum biomarkers for Late-Onset Alzheimer's disease diagnosis: miR-10a-5p, miR-29b-2-5p, miR-125a-5p, miR-342-3p, and miR-708-5p.

The nervous system is rich in miRNAs, indicating an important role of these molecules in regulating processes associated with cognition, memory, and others. Therefore, qualitative and quantitative imbalances involving such miRNAs may be involved in dementia contexts, including Late-Onset Alzheimer's Disease (LOAD). To test the viability of circulating miRNAs (c-miRNAs) as biomarkers for LOAD, we proceed accordingly to the following reasoning. The first stage was to discover and identify profile of c-miRNAs by RNA sequencing (RNA-Seq). For this purpose, blood serum samples were used from LOAD patients (n = 5) and cognitively healthy elderly control group (CTRL_CH) (n = 5), all over 70 years old. We identified seven c-miRNAs differentially expressed (p ≤ 0.05) in the serum of LOAD patients compared to CTRL_CH (miR-10a-5p; miR-29b-2-5p; miR-125a-5p; miR-342-3p, miR-708-5p, miR-380-5p and miR-340-3p). Of these, five (p ≤ 0.01) were selected for in silico analysis (miR-10a-5p; miR-29b-2-5p; miR-125a-5p; miR-342-3p, miR-708-5p), for which 44 relevant target genes were found regulated by these c-miRNAs and related to LOAD. Through the analysis of these target genes in databases, it was possible to observe that they have functions related to the development and progress of LOAD, directly or indirectly connecting the different Alzheimer's pathways. Thus, this work found five promising serum c-miRNAs as options for biomarkers contributing to LOAD diagnosis. Our study shows the complex network between these molecules and LOAD, supporting the relevance of studies using c-miRNAs in dementia contexts.

Characterization of teaching-learning tutors in public health services and topics of interest for their work.

OBJECTIVE: To describe the profile of teaching-learning tutors in public health services and investigate which topics are of greatest interest in development spaces for these actors. METHOD: Cross-sectional study. Eligible tutors of Health Care Planning. Data collection using an electronic questionnaire composed of closed questions on sociodemographic characteristics, training and performance. Chi-square test used to compare proportions according to tutor typologies. RESULTS: A total of 614 tutors worked in Brazil's five geographic regions, the majority in primary care (82%), followed by state/regional work (13%) and specialized outpatient care (5%). The majority reported being female, of brown skin color, from the nursing field, having worked as a tutor for less than a year, and with no previous experience in preceptorship or similar. The most important topics were Health Care Networks, risk stratification for chronic conditions and the functions of specialized outpatient care. CONCLUSION: The predominance of certain characteristics among tutors was identified, with differences between the types of work. The findings can support managers in the process of selecting and developing tutors in Health Care Planning.

Epidemiological and molecular surveillance of norovirus in the Brazilian Amazon: description of recombinant genotypes and improvement of evolutionary analysis.

Noroviruses are highly infectious, genetically diverse viruses. Global outbreaks occur frequently, making molecular surveillance important for infection monitoring. This cross-sectional descriptive study aimed to monitor cases of norovirus gastroenteritis in the Brazilian Amazon. Fecal samples were tested by immunoenzymatic assay, RT-PCR and genetic sequencing for the ORF1/ORF2 and protease regions. Bayesian inference with a molecular clock was employed to construct the phylogeny. The norovirus prevalence was 25.8%, with a higher positivity rate among children aged 0-24 months. Genogroup GII accounted for 98.1% of the sequenced samples, while GI accounted for 1.9% of them. The GII.P16/GII.4 genotype was the most prevalent, with an evolution rate of 2.87x10-3 and TMRCA estimated in 2012. This study demonstrates that norovirus is a primary causative agent of gastroenteritis and provides data on viral genetic diversity that may facilitate infection surveillance and vaccine development.

Proteomic Analysis of a Rat Streptozotocin Model Shows Dysregulated Biological Pathways Implicated in Alzheimer's Disease.

Alzheimer's Disease (AD) is an age-related neurodegenerative disorder characterized by progressive memory loss and cognitive impairment, affecting 35 million individuals worldwide. Intracerebroventricular (ICV) injection of low to moderate doses of streptozotocin (STZ) in adult male Wistar rats can reproduce classical physiopathological hallmarks of AD. This biological model is known as ICV-STZ. Most studies are focused on the description of behavioral and morphological aspects of the ICV-STZ model. However, knowledge regarding the molecular aspects of the ICV-STZ model is still incipient. Therefore, this work is a first attempt to provide a wide proteome description of the ICV-STZ model based on mass spectrometry (MS). To achieve that, samples from the pre-frontal cortex (PFC) and hippocampus (HPC) of the ICV-STZ model and control (wild-type) were used. Differential protein abundance, pathway, and network analysis were performed based on the protein identification and quantification of the samples. Our analysis revealed dysregulated biological pathways implicated in the early stages of late-onset Alzheimer's disease (LOAD), based on differentially abundant proteins (DAPs). Some of these DAPs had their mRNA expression further investigated through qRT-PCR. Our results shed light on the AD onset and demonstrate the ICV-STZ as a valid model for LOAD proteome description.

Epidemiological and molecular surveillance of norovirus in the Brazilian Amazon: description of recombinant genotypes and improvement of evolutionary analysis

ABSTRACT Noroviruses are highly infectious, genetically diverse viruses. Global outbreaks occur frequently, making molecular surveillance important for infection monitoring. This cross-sectional descriptive study aimed to monitor cases of norovirus gastroenteritis in the Brazilian Amazon. Fecal samples were tested by immunoenzymatic assay, RT-PCR and genetic sequencing for the ORF1/ORF2 and protease regions. Bayesian inference with a molecular clock was employed to construct the phylogeny. The norovirus prevalence was 25.8%, with a higher positivity rate among children aged 0-24 months. Genogroup GII accounted for 98.1% of the sequenced samples, while GI accounted for 1.9% of them. The GII.P16/GII.4 genotype was the most prevalent, with an evolution rate of 2.87x10−3 and TMRCA estimated in 2012. This study demonstrates that norovirus is a primary causative agent of gastroenteritis and provides data on viral genetic diversity that may facilitate infection surveillance and vaccine development.

Characterization of teaching-learning tutors in public health services and topics of interest for their work / Caracterización de los tutores de enseñanza-aprendizaje en los servicios de salud pública y temas de interés para su actuación / Caracterização dos tutores de ensino-aprendizagem em serviços públicos de saúde e temas de interesse para atuação

ABSTRACT Objective: To describe the profile of teaching-learning tutors in public health services and investigate which topics are of greatest interest in development spaces for these actors. Method: Cross-sectional study. Eligible tutors of Health Care Planning. Data collection using an electronic questionnaire composed of closed questions on sociodemographic characteristics, training and performance. Chi-square test used to compare proportions according to tutor typologies. Results: A total of 614 tutors worked in Brazil's five geographic regions, the majority in primary care (82%), followed by state/regional work (13%) and specialized outpatient care (5%). The majority reported being female, of brown skin color, from the nursing field, having worked as a tutor for less than a year, and with no previous experience in preceptorship or similar. The most important topics were Health Care Networks, risk stratification for chronic conditions and the functions of specialized outpatient care. Conclusion: The predominance of certain characteristics among tutors was identified, with differences between the types of work. The findings can support managers in the process of selecting and developing tutors in Health Care Planning.

RESUMEN Objetivo: Describir el perfil de los tutores de enseñanza-aprendizaje de los servicios de salud pública e investigar los temas de mayor interés en espacios de desarrollo de estos actores. Método: Se trata de un estudio transversal con Tutores Elegibles de Planificación de la atención en salud; con datos recopilados mediante cuestionario electrónico de preguntas cerradas sobre características sociodemográficas, formación y actuación. Se utilizó la prueba de Chi-cuadrado para comparar las proporciones según las tipologías del tutor. Resultados: Se consideraron 614 tutores que trabajaban en las cinco regiones geográficas del Brasil, la mayoría en Atención Primaria (82%), seguido de actuación estatal/regional (13%) y Atención Ambulatoria Especializada (5%). La mayoría declaró ser mujer, de piel morena, del ámbito de la enfermería, con menos de un año de actuación como tutora y sin experiencia previa como preceptora o similar. Los temas más importantes fueron las Redes de la Atención en Salud, la estratificación del riesgo de las enfermedades crónicas y el papel de la Atención Ambulatoria Especializada. Conclusión: Se identificó el predominio de ciertas características entre los tutores, distintas según los tipos de actuación. Las conclusiones pueden servir de apoyo a los gestores en el proceso de selección y desarrollo de los tutores en Planificación.

RESUMO Objetivo: Descrever o perfil de tutores de ensino-aprendizagem em serviços públicos de saúde e investigar quais são os temas de maior interesse em espaços de desenvolvimento desses atores. Método: Estudo transversal. Elegíveis tutores da Planificação da Atenção à Saúde. Coleta de dados por questionário eletrônico composto por questões fechadas sobre características sociodemográficas, formação e atuação. Teste Qui-quadrado utilizado para comparar proporções segundo tipologias de tutor. Resultados: Considerados 614 tutores, que atuavam nas cinco regiões geográficas brasileiras, sendo a maioria na Atenção Primária (82%), seguido por atuação estadual/regional (13%) e na Atenção Ambulatorial Especializada (5%). A maioria referiu ser mulher, de cor da pele parda, da área de enfermagem, atuação como tutor há menos de 1 ano, e sem experiência prévia em preceptoria ou similar. Temas considerados mais importantes destacam-se Redes de Atenção à Saúde, estratificação de risco de condições crônicas e funções da Atenção Ambulatorial Especializada. Conclusão: Identificou-se a predominância de algumas características entre tutores, com diferenças entre as tipologias de atuação. Os achados podem apoiar gestores no processo de seleção e desenvolvimento de tutores na Planificação.

Association of Parental Support with Reduced Stereotypy in Children with Autism Spectrum Disorder: A Cross-Sectional Study.

Background and Objectives: To analyze the influence of parental presence and use of risperidone on social interaction and apathy among patients with Autism Spectrum Disorder (ASD). Materials and Methods: Cross-sectional study in a reference center for patients with ASD in a city in northeastern Brazil. The research was carried out using a sociodemographic questionnaire, the Dimensional Apathy Scale, and the Social Communication Questionnaire (SCQ) with the domains of social interaction, language, stereotypy, and communication. The referred questionnaire was answered by the parents or guardians of the children with ASD according to the DSM V criteria. Data were analyzed via independent t-test using the SPSS software version 20. Results: Interviews were conducted with 51 parents/guardians of autistic children with a mean age of 8.8 years (±2.95) and a predominance of males, 34 (66.7%). Of this total, 49 (96.1%) of the children attended school; 40 (78.4%) children were on medication, of which 38 (74.5%) were on risperidone. Those children on risperidone had a higher score on the SCQ scale (p = 0.049) and on the domain of stereotyped behaviors (p = 0.033), which indicated greater impairment. Another statistically relevant variable was the presence of married parents, whereby children who did not have the presence of married parents had a higher average of stereotyped behaviors compared to those who had married parents. Conclusions: The results showed differences in the means of social interactions for children on risperidone, especially regarding stereotyped behaviors. However, it is not possible to state whether this difference was due to the use of risperidone or whether they used risperidone precisely because of these behaviors. Also important was that children who had the presence of married parents showed fewer stereotyped behaviors. There was no difference in apathetic behavior between children.

Advance directives in the perspective of the elderly population : Advance directives / Diretivas antecipadas na perspectiva da população idosa: Advance directives

Objective: To analyze the knowledge and acceptance of the elderly person regarding the elaboration of the Advance Directives, their preference in relation to the filling models and the choice of the representative who will replace them in the decision-making process. Methodology: Cross-sectional study carried out by providing participants with two models  of Advance Directives were made available to the participants for completion and applied a questionnaire on knowledge, acceptance, and evaluation of the device. Results: There were 85.63% of the participants who were unaware of the Advance Directives, 98.13% who were unaware of document models, 100% who considered model 1, more complete, to be good or acceptable, and 66.88% who indicated a son as its representative. When asked about the importance of preparing, making available to the population, and passing a law that regulates this right, the participants were assertive respectively by 91.88%, 91.25% and 91.25%. Conclusion: Although lack of knowledge was general among the participants, after clarification there was a high rate of evaluation and acceptance of the Advance Directives, as well as a recommendation for their legalization and availability to the population as a device that contributes to the guarantee of autonomy and human dignity, especially during the end-of-life health care.

Objetivo: Analisar o conhecimento e a aceitação da pessoa idosa acerca da elaboração das Diretivas Antecipadas de Vontade, a sua preferência em relação aos modelos de preenchimento e a escolha do representante que irá substitui-la na tomada de decisão. Metodologia: Estudo transversal realizado por meio da disponibilização aos participantes de dois modelos de Diretivas Antecipadas de Vontade para preenchimento e aplicação de um questionário sobre conhecimento, aceitação e avaliação do dispositivo. Resultados: A grande maioria dos participantes (85,63%) desconhecia as Diretivas Antecipadas de Vontade; 98,13% desconheciam os modelos do documento; 100% consideraram bom ou aceitável o modelo 1, mais completo; e 66,88% indicaram um filho como o seu representante legal. Quando questionados sobre a importância da elaboração, disponibilização à população e aprovação de lei que regulamente esse direito, as respostas foram afirmativas, respectivamente, para 91,88%, 91,25% e 91,25% dos participantes. Conclusão: Embora o desconhecimento fosse geral entre os participantes, após esclarecimento houve elevado índice de avaliação e aceitação das Diretivas Antecipadas de Vontade, bem como recomendação para sua legalização e disponibilização à população como um dispositivo que contribui para a garantia da autonomia e dignidade humana, sobretudo durante a assistência à saúde no final da vida.

Diretivas antecipadas de vontade na perspectiva da população idosa de um município do meio oeste catarinense / Advance directives in the perspective of the older adults of a municipality in the Midwest of Santa Catarina

Resumo Objetivo Analisar o conhecimento da pessoa idosa em um município do meio oeste catarinense acerca da elaboração das Diretivas Antecipadas de Vontade (DAV), a sua preferência em relação aos modelos de preenchimento e a escolha do representante que irá substitui-la na tomada de decisão. Método Estudo transversal realizado por meio da disponibilização aos participantes de dois modelos de DAV para preenchimento e aplicação de um questionário sobre conhecimento, aceitação e avaliação do dispositivo. Resultados A maioria dos participantes (85,63%) desconhecia as DAV; 98,13% desconheciam os modelos do documento; 100% consideraram bom ou aceitável o modelo 1, mais completo; 66,88% indicaram um filho como representante legal. Questionados sobre a importância da elaboração, disponibilização à população e aprovação de lei que regulamente esse direito, as respostas foram afirmativas, respectivamente, para 91,88%, 91,25% e 91,25% dos participantes. Apenas 5% dos respondentes apontaram dificuldades no entendimento dos modelos, sendo a "linguagem" o item de maior dificuldade. Conclusão A maioria das pessoas idosas desconhecia os modelos de DAV, mas referiram o modelo 1, considerando-o bom ou aceitável. A maioria não teve dificuldades no entendimento e reconheceu a importância da elaboração e disponibilização das DAV à população, assim como a necessidade de uma lei para regulamentar esse direito. Observou-se uma alta proporção de participantes indicando um filho como representante legal, enfatizando a importância de envolver a família nesse processo. Esses resultados ressaltam a necessidade de conscientizar as pessoas idosas sobre as DAV e disponibilizar modelos claros e abrangentes.

Abstract Objective To analyze the knowledge of older individuals in a municipality in the Midwestern region of Santa Catarina regarding the development of Advance Directives, their preferences regarding the available models, and the selection of a representative to make decisions on their behalf. Method Cross-sectional study carried out by providing participants with two models of Advance Directives were made available to the participants for completion and applied a questionnaire on knowledge, acceptance, and evaluation of the device. Results There were 85.63% of the participants who were unaware of the Advance Directives, 98.13% who were unaware of document models, 100% who considered model 1, more complete, to be good or acceptable, and 66.88% who indicated an adult child as its representative. When asked about the importance of preparing, making available to the population, and passing a law that regulates this right, the participants were assertive respectively by 91.88%, 91.25% and 91.25%. Conclusion Most older people were unaware of the AD models, but mentioned model 1, considering it good or acceptable. Most had no difficulties in understanding and recognized the importance of preparing and making AD available to the population, as well as the need for a law to regulate this right. There was a high proportion of participants indicating an adult child as a legal representative, emphasizing the importance of involving the family in this process. These results highlight the need to make older people aware of AD and provide clear and comprehensive models.

Western diet-induced mouse model of non-alcoholic fatty liver disease associated with metabolic outcomes: Features of gut microbiome-liver-adipose tissue axis.

OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) has a growing epidemiologic and economic burden. It is associated with Western diet (WD) patterns, and its pathogenesis involves metabolic disorders (obesity, dyslipidemia, hyperglycemia, and diabetes) and gut dysbiosis, features that are usually neglected or not reproduced by most animal models. Thus, we established a 6-mo WD-induced NAFLD mouse model associated with metabolic disorder, investigating its main features at the gut microbiome-liver-adipose tissue axis, also evaluating the correlations of gut dysbiosis to the other disease outcomes. METHODS: Male C57 BL6 mice received a high-fat (30% lard and 0.2% cholesterol, ∼57% calories) and sucrose-rich (20%) chow, and a high-sugar solution (23.1 and 18.9 g/L of D-fructose and D-glucose) for 6 mo. RESULTS: The model featured high serum cholesterol levels, glucose intolerance, and hyperinsulinemia. WD intervention resulted in extensive macro/microvesicular liver steatosis and pericellular fibrosis-resembling human disease-accompanied by hepatic stellate cell activation and CD68+ macrophage infiltration, increased protein levels of proinflammatory p65-nuclear factor-κB, interleukin-6 and tumor necrosis factor-α, with decreased antioxidant regulator Nrf2. Mice showed clear obesity with adipocyte hypertrophy, and CD68+macrophage/mast cell infiltration in adipose tissue while a reduction in number of goblet cells was also observed in the small intestine. Moreover, the pyrosequencing of the 16 S ribosomal RNA of gut cecal content showed decreased bacterial diversity, enriched Firmicutes and Proteobacteria, decreased Bacteroidetes and Fusobacteria, and increased ratio of Firmicutes to Bacteroidetes. Bacteroidetes and Bacteroides had the highest number of significant correlations with liver-adipose tissue axis outcomes. In silico analysis of gut microbiome in NAFLD obese patients revealed a depletion in Bacteroides, which also correlated to disease outcomes. CONCLUSION: This mice model gathered suitable phenotypical alterations in gut-liver-adipose tissue axis that resembled NAFLD associated with metabolic disorders in humans and may be considered for preclinical investigation.

Development of New Natural Lipid-Based Nanoparticles Loaded with Aluminum-Phthalocyanine for Photodynamic Therapy against Melanoma.

Photodynamic therapy (PDT) mediated by photosensitizers loaded in nanostructures as solid lipid nanoparticles has been pinpointed as an effective and safe treatment against different skin cancers. Amazon butters have an interesting lipid composition when it comes to forming solid lipid nanoparticles (SLN). In the present report, a new third-generation photosensitizing system consisting of aluminum-phthalocyanine associated with Amazon butter-based solid lipid nanoparticles (SLN-AlPc) is described. The SLN was developed using murumuru butter, and a monodisperse population of nanodroplets with a hydrodynamic diameter of approximately 40 nm was obtained. The study of the permeation of these AlPc did not permeate the analyzed skin, but when incorporated into the system, SLN-AlPc allowed permeation of almost 100% with 8 h of contact. It must be emphasized that SLN-AlPc was efficient for carrying aluminum-phthalocyanine photosensitizers and exhibited no toxicity in the dark. Photoactivated SLN-AlPc exhibited a 50% cytotoxicity concentration (IC50) of 19.62 nM when applied to B16-F10 monolayers, and the type of death caused by the treatment was apoptosis. The exposed phospholipid phosphatidylserine was identified, and the treatment triggered a high expression of Caspase 3. A stable Amazon butter-based SLN-AlPc formulation was developed, which exhibits strong in vitro photodynamic activity on melanoma cells.

Controle de Dor de Pacientes Com Câncer De Cabeça e Pescoço em Cuidados Paliativos: Uma Revisão de Literatura / Pain management of patients with head and neck cancer in palliative care: a literature review

Pacientes com câncer de cabeça e pescoço (CCP) apresentam limitações e comprometimentos funcionais. A dor orofacial acomete grande parte desses pacientes e pode ser causada por inúmeros fatores, tanto nos tecidos moles quanto nos duros. Pacientes com CCP em estágio avançado, necessitam receber assistência que possibilite melhor qualidade de vida para ele e seus familiares, como forma de cuidado paliativo, principalmente quando a doença não tem mais chance de ser controlada. A analgesia farmacológica é o principal pilar no tratamento da dor oncológica, mas também pode ser realizada por meio de terapias não farmacológicas. Este estudo teve como objetivo revisar a literatura buscando as diferentes formas de controle da dor orofacial de pacientes com CCP em cuidados paliativos. Foram realizadas buscas nas bases de dados PubMed e SciELO com as palavras "(pain control) AND (palliative care) AND (head and neck cancer)", buscando artigos dos dez últimos anos (2011-2021) e restringindo para ensaios clínicos e ensaios clínicos randomizados. Encontramos dez artigos na base PubMed e nenhum na SciELO. Após a leitura do título e resumo, excluímos cinco por não avaliarem pacientes com CCP ou não terem a abordagem analgésica como objetivo do estudo, sendo incluídosfinalmente 5 artigos em nossa revisão. A maioria dos estudos mostrou que a analgesia realizada nos pacientes em cuidados paliativos acometidos por lesões malignas de cabeça e pescoço acontece com opioides. Nesta revisão observamos poucos estudos clínicos, sendo importante a realização de trabalhos que busquem novas formas de diminuir os sintomas e melhorar a qualidade de vida desses pacientes.

Relações entre funções executivas e TDAH em crianças e adolescentes: uma revisão sistemática / Relationships between executive functions and ADHD in children and adolescents: A systematic review

O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) se caracteriza pela desatenção, hiperatividade e impulsividade, que podem ser observadas já no início da infância. O TDAH afeta diretamente as Funções Executivas (FE), responsáveis pela regulação de comportamentos sociais e habilidades cognitivas, reduzindo o desempenho escolar e gerando problemas pessoais. Sendo assim, pesquisas relacionadas ao tema mostram-se importantes do aspecto clínico e educacional, podendo contribuir para a melhora da qualidade de vida dos indivíduos afetados. Portanto, neste estudo de revisão sistemática, buscou-se quantificar e explorar artigos com pesquisas empíricas que relacionam o TDAH e as FE. Foram utilizadas as bases de dados: Periódicos CAPES, LILACS, SciELO, PePSIC e SIBiUSP. Os critérios de inclusão foram o ano de publicação (2009-2019), língua portuguesa e artigos relacionados apenas à infância e à adolescência. No total foram encontrados 112 artigos, dos quais seis foram analisados. Os critérios examinados incluíram neuroanatomia, instrumentos de avaliação utilizados para a detecção do transtorno, entrevistas realizadas, gênero e nível escolar dos participantes. Foi observado que os instrumentos mais utilizados, nos artigos analisados, foram o SNAP IV, o WASI, o Teste de Trilhas, o Teste dos Cinco Pontos, o Teste de Atenção por Cancelamento e o subteste Go-no-Go do Neupsilin Infantil. A atual pesquisa permitiu mostrar o que há de mais recente sobre o assunto. Porém, apesar de sua importância, notou-se que existe uma escassez de estudos nacionais que correlacionam estes temas. Logo, são necessários mais estudos empíricos brasileiros que se dediquem a contribuir para estas áreas do conhecimento.

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity, which can be observed as early as childhood. The disorder directly affects Executive Functions (FE), those responsible for controlling social performance and cognitive skills, school performance, and the management of personal problems. Thus, research related to the theme shows important clinical and educational aspects and may contribute to improve the quality of life of affected individuals. Therefore, look through this systematic review study, quantify and explore articles with empirical research related to ADHD and EF. CAPES, LILACS, SciELO, PePSIC and SIBiUSP were used as Periodic databases. The inclusion requests were the year of publication (2009-2019), Portuguese language and articles related only to childhood and adolescence. We found 112 articles, of which six were analyzed. The tests examined include neuroanatomy, the assessment tools used to detect disorders, interviews, gender, and school level of the survey participants. It was observed that the most used instruments in the analyzed articles were the SNAP IV, the WASI, the Trail Test, the Five Point Test, the Attention for Cancellation Test and the Go-no-Go subtest Neupsilin childish. The current research shows the latest on the subject. However, despite their importance, there is no shortage of national studies that correlate these themes. Therefore, more Brazilian empirical studies are needed to dedicate the contribution to these areas of knowledge.

Beneficial effects of anthocyanin-rich peels of Myrtaceae fruits on chemically-induced liver fibrosis and carcinogenesis in mice.

Hepatocellular carcinoma (HCC) arising from fibrosis/cirrhosis is the most common type of primary liver cancer. Conversely, a higher intake of fruits and vegetables might play a protective role in HCC risk. Recently, Myrtaceae family tropical fruits have raised great interest due to the high levels of anthocyanins especially in their peels, which are usually discarded upon consumption. Anthocyanins are antioxidant pigments known to have beneficial effects in vivo/in vitro cancer bioassays. Thus, we evaluated whether dietary Myrciaria jaboticaba, Syzygium cumini, and Syzygium malaccense fruit peel powders reduce fibrosis and hepatocarcinogenesis in mice. Female C3H/HeJ mice were submitted to the model of diethylnitrosamine/carbon tetrachloride-induced liver fibrosis and carcinogenesis. Concomitantly, mice received a basal diet containing 2% of M. jaboticaba, S. cumini, or S. malaccense fruit peel powders, obtained by convective drying, for 10 weeks. M. jaboticaba peel powder showed the highest levels of total anthocyanins, while S. cumini peel powder displayed the greatest diversity of these pigments. All Myrtaceae family peel powders reduced the serum levels of the liver injury marker alanine aminotransferase. M. jaboticaba peel feeding reduced the incidence of liver preneoplastic foci, hepatocyte proliferation (Ki-67), and the protein levels of hepato-mitogen tumor necrosis factor-alpha (TNF-α). M. jaboticaba peel feeding also diminished liver lipid peroxidation and increased total glutathione levels. S. cumini peel feeding reduced hepatic collagen, lipid peroxidation, and TNF-α levels while increased catalase activity. Although S. malaccense peel powder, which displayed the lowest anthocyanin levels, decreased oxidative stress, and cytokine levels, no effects were observed on liver fibrosis or preneoplastic lesion outcomes. Findings indicate a protective effect of anthocyanin-rich M. jaboticaba and S. cumini peel powder feeding on preneoplastic lesion development and fibrosis, respectively. Results indicate that differential biological responses may be attributed to distinct anthocyanin profiles and levels, assigning a functional/market value to the underutilized peel fraction.

Diagnostic accuracy of Xpert MTB/RIF for tuberculous meningitis: systematic review and meta-analysis.

OBJECTIVE: This systematic review evaluated the diagnostic accuracy of Xpert MTB/RIF to detect tuberculous meningitis (TBM). METHODS: PubMed and five other databases were systematically searched through March 2019. All studies evaluating diagnostic accuracy of Xpert MTB/RIF on cerebrospinal fluid (CSF) samples were included. Reference standards were definitive or definite plus probable TBM. The quality of studies was assessed by the QUADAS-2 tool. We performed bivariate random-effects meta-analysis and calculated summary diagnostic statistics. RESULTS: We identified 30 studies (n = 3972 participants), including 5 cohort studies and 25 cross-sectional studies. Reference standards were definite TB (n = 28 studies) or definite plus probable TBM (n = 6 studies). The pooled Xpert MTB/RIF sensitivity was 85% (95% CI, 70-93%), and specificity was 98% (95% CI, 97-99%) with a negative likelihood ratio of 0.15 (95% CI, 0.04-0.27) for definite TBM. For probable TBM cases, pooled sensitivity was 81% (95% CI, 66-90%), and specificity was 99% (95% CI, 97-99%). For both reference standard types, meta-analyses showed a C-statistic area under the curve of 0.98. The QUADAS-2 tool revealed low risk of bias as well as low concerns regarding applicability. Methodological heterogeneity was high among studies. CONCLUSIONS: Xpert MTB/RIF showed high accuracy for TBM diagnosis, but a negative Xpert MTB/RIF test does not rule out TBM. Repeat Xpert testing may be necessary. In clinical practice, Xpert MTB/RIF adds speed and sensitivity when compared to classic TBM diagnostic methods or previous commercial nucleic acid amplification techniques. More studies and better strategies for rapidly confirming a diagnosis of TBM in children are urgently needed.

OBJECTIF: Cette revue systématique a évalué la précision diagnostique de Xpert MTB/RIF pour détecter la méningite tuberculeuse (MTB). MÉTHODES: PubMed et cinq autres bases de données ont fait l'objet d'une recherche systématique jusqu'en mars 2019. Toutes les études évaluant la précision du diagnostic de Xpert MTB/RIF sur des échantillons de liquide céphalo-rachidien (LCR) ont été incluses. Les étalons de référence étaient des MTB définitives ou définitives et probables. La qualité des études a été évaluée par l'outil QUADAS-2. Nous avons effectué une méta-analyse des effets aléatoires bivariés et calculé des statistiques de résumés diagnostiques. RÉSULTATS: Nous avons identifié 30 études (n = 3.972 participants), dont 5 études de cohorte et 25 études transversales. Les étalons de référence étaient la TB définitive (n = 28 études) ou la MTB définitive et probable (n = 6 études). La sensibilité poolée Xpert MTB/RIF était de 85% (IC95%: 70-93%) et la spécificité était de 98% (IC95%: 97-99%) avec un rapport de vraisemblance négatif de 0,15 (IC95%: 0,04-0,27) pour la MTB définitive. Pour les cas probables de la MTB, la sensibilité poolée était de 81% (IC95%: 66-90%) et la spécificité était de 99% (IC95%: 97-99%). Pour les deux types d'étalons de référence, les méta-analyses ont montré une aire statistique C sous la courbe de 0,98. L'outil QUADAS-2 a révélé un faible risque de biais ainsi que de faibles préoccupations concernant l'applicabilité. L'hétérogénéité méthodologique était élevée parmi les études. CONCLUSIONS: Xpert MTB/RIF a montré une grande précision pour le diagnostic de la MTB, mais un test Xpert MTB/RIF négatif n'exclut pas la MTB. La répétition du tests Xpert peut être nécessaire. Dans la pratique clinique, Xpert MTB/RIF ajoute vitesse et sensibilité par rapport aux méthodes de diagnostic classiques de la MTB ou aux précédentes techniques d'amplification d'acide nucléique commerciales. Des études supplémentaires et de meilleures stratégies pour confirmer rapidement un diagnostic de MTB chez les enfants sont nécessaires d'urgence.

Cell damage induced by polybrominated diphenyl ethers on Chironomus sancticaroli (Diptera: Chironomidae)

Abstract Histological effects of polybrominated diphenyl ethers (PBDEs) were observed in Chironomus sancticaroli larvae which underwent acute exposure. 2,2′,4-triBDE (BDE-17), 2,2′,4,4′-tetraBDE (BDE-47) and 2,2′,4,4′,5-pentaBDE (BDE-99) were evaluated at 0.5, 2.0 and 20 μg L-1. Cytoplasm vacuolisation of oenocytes was observed in the larvae exposed to BDE-17 and BDE-47. Cuénot cells were disrupted at the brush border as an effect of the three evaluated congeners highlighting BDE-47 at 2.0 μg L-1; 60% of larvae displayed this disruption. The midgut showed changes in the morphology of apex cells located next to the lumen of region I exposed to BDE-17 and BDE-47, while BDE-99 induced a narrowing of the lumen diameter. Significant cytoplasm vacuolisation of the larvae exposed to BDE-47 and BDE-99 was observed in region II of the midgut. Salivary glands showed acidophilic granules in the cytoplasm exposed to BDE-17 and BDE-47. The results showed that the tissues of C. sancticaroli were sensitive to flame retardants; these histopathologies can compromise the health and physiology of this organism, highlighting the concern with the presence of PBDEs in freshwater sediments.

PRIMARY SPHINCTEROPLASTY COMPARING TWO DIFFERENT STITCHES IN ANAL FISTULA TREATMENT: EXPERIMENTAL STUDY IN RATS.

BACKGROUND: Anal fistula is by definition the communication between the rectum or anal canal with the perineal region, which may be epithelialized and has cryptoglandular origin in 90% of cases. There are a large number of techniques for successfully treating trans-sphincteric fistulas of 20-50%, including primary sphincteroplasty, but it is not clear whether the material used would influence the outcome. AIM: To analyze the efficacy of polydioxanone and polypropylene wire in primary post-fistulotomy sphincteroplasty in the treatment of trans-sphincteric fistulas in rats. METHODS: Thirty Wistar rats had transfixation of the anal sphincter with steel wire, which remained for 30 days for the development of the anal fistula. After this period, it was removed and four groups were formed: A (control) without treatment; B (fistulotomy) submitted to such procedure and curettage only; C (polidioxanone) in which sphincteroplasty was performed after fistulotomy with polydioxanone wire; D (polypropylene) submitted to the same treatment as group C, but with polypropylene wire. After 30 days, euthanasia and removal of the specimens were performed for qualitative histopathological analysis, measurement of the area between the muscular cables edges and evaluation of the degree of local fibrosis. RESULTS: There was persistence of the anal fistula in all animals of group A. There were no significant differences between groups B, C and D regarding the distance of the muscular cables (p=0.078) and the degree of fibrosis caused by the different treatments (p=0.373). CONCLUSIONS: There was no difference between polydioxanone and polypropylene wires in post-fistulotomy primary sphincteroplasty, and this technique was not superior to simple fistulotomy in relation to the distance of the muscular cables nor did it present differences in relation to the degree of local fibrosis.

Evaluation of polypropylene and polyglactin sutures in primary sphincteroplasty for the treatment of anal fistula in rats / Avaliação dos fios de polipropileno e poliglactina na esfincteroplastia primária no tratamento da fístula anal em ratos

ABSTRACT Rationale: Fistulotomy followed by primary sphincteroplasty is one of the therapeutic options in transsphincteric fistulae; however, it was not known which suture would present a better result. Objective: To compare polypropylene and polyglactin sutures in primary sphincteroplasty in rats subjected to fistulotomy. Method: Thirty Wistar rats were subjected to peritoneal anesthesia with ketamine and xylazine, followed by transfixation of the anal sphincter with steel thread, which remained for 30 days to develop the anal fistula. After this period, the steel thread was removed and four groups were formed: A - Control (n = 5), without treatment; B - Fistulotomy (n = 5), performed fistulotomy only; C - Polypropylene (n = 10), in which fistulotomy was performed followed by primary sphincteroplasty with polypropylene suture; D - Polyglactin (n = 10), in which fistulotomy was performed followed by primary sphincteroplasty with polyglactin suture; after 30 days the animals were anesthetized again and submitted to euthanasia by deepening the anesthetic plane to remove the specimens, analyzing fistula closure, muscle fiber distance, and inflammatory process. Results: The fistula persisted in all animals of the control group and in none of the other groups; the distances between the muscle fibers were 1620 µm, 4665 µm, and 2520 µm, respectively in Groups B, C, and D (p = 0.067); in relation to fibrosis, the means were 2.4, 2.8, and 3.6, respectively in Groups B, C, and D, showing greater fibrosis in the latter group (p = 0.041). Conclusion: There was no persistence of the fistula in any of the treated animals; there was no difference in the distance between the muscle fibers between the groups subjected to primary sphincteroplasty with polypropylene or polyglactin, or between these groups and the one treated only by fistulotomy. There was greater fibrosis in animals treated with primary sphincteroplasty with polyglactin.

RESUMO Racional: A fistulotomia seguida de esfincteroplastia primária é uma das opções terapêuticas nas fístulas transesfincterianas, porém, não se sabe ao certo qual fio poderia apresentar melhor resultado. Objetivo: Comparar os fios de polipropileno e poliglactina na esfincteroplastia primária em ratos submetidos a fistulotomia. Método: Utilizou-se 30 ratos Wistar, confeccionada fístula por transfixação do esfíncter anal com fio de aço, que permaneceu por 30 dias. Após, o fio de aço foi removido e foram formados quatro grupos: A - Controle (n = 5), sem tratamento; B - Fistulotomia (n = 5), realizada fistulotomia apenas; C - Polipropileno (n = 10), em que foi realizada fistulotomia seguida por esfincteroplastia primário com fio de polipropileno; D - Poliglactina (n = 10), mesmo procedimento com fio de poliglactina; após 30 dias analisou-se o fechamento da fístula, afastamento dos cabos musculares e processo inflamatório. Resultados: A fístula persistiu em todos animais do grupo controle e em nenhum dos demais grupos; dos grupos tratados a área de afstamento dos cabos musculares foi 1620 µm, 4665 µm e 2520 µm, respectivamente nos Grupos B, C e D (p = 0,067); em relação à fibrose as médias foram 2,4; 2,8 e 3,6; respectivamente nos Grupos B, C e D, demonstrando maior fibrose neste último grupo (p = 0,041). Conclusão: Não houve persistência da fístula em nenhum dos animais tratados, não houve diferença no afastamento dos cabos musculares entre os grupos submetidos a esfincteroplastia primária com polipropileno ou poliglactina, e nem destes com o grupo tratado apenas por fistulotomia. Houve maior fibrose nos animais tratados por esfincteroplastia primária com poliglactina.

Correction to: Treatment modalities for burning mouth syndrome: a systematic review.

The original version of this article contained two mistakes. First, in the subchapter "Alpha-lipoic acid (ALA)" page 1895, reference 4 is cited three times, however reference 42 is the correct one.