An Approach to Establishing Diagnostic Reference Levels in Interventional Pediatric Cardiology from Different Regions of Brazil.

Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out in four Brazilian states, distributed across the three regions of the country. Data were collected from pediatric patients undergoing cardiac interventional procedures (CIPs), including their age and anthropometric characteristics, and at least four parameters (number of images, exposure time, air kerma-area product-PKA, and cumulative air kerma). Data from 279 patients undergoing CIPs were gathered (147 diagnostic and 132 therapeutic procedures). There were no significant differences in exposure time and the number of images between the D&T procedures. A wide range of PKA was observed when the therapeutic procedures were compared to diagnostics for all age groups. There were significant differences between the D&T procedures, whether grouping data by patient weight or age. In terms of cumulative air kerma, it was noted that no value exceeded the level to trigger a monitoring process for patients. This study shows that it is possible to adopt them as the first proposal to establish national DRLs considering pediatric patient groups.

Gut Microbiota Modulation by Bioactive Compounds from Ilex paraguariensis: an In Vivo Study.

Yerba-mate (Ilex paraguariensis) is recognized for its biocompounds and bioactive properties. This study aimed to assess the potential of yerba-mate extract to modulate the intestinal microbiota in rats. After the ethical committee approval (CEUA - UPF, number 025/2018), the Wistar rats were given a daily dose of 3.29 mg of phenolic compounds per animal for 45 days. The antioxidant activity of the extract was assessed by ABTS and FRAP assays and the total phenolic compounds was measured at different pH levels. Identification and quantification of chlorogenic acid isomers were carried out using high-performance liquid chromatography (HPLC). Intestinal microbiota modulation was evaluated by administering the yerba-mate extract or water (control) to Wistar rats via intragastric gavage and its efficiency was measured through PCR. The antioxidant capacity of the yerba-mate extract was 64.53 ± 0.26 µmol Trolox/mL (ABTS) and 52.96 ± 0.86 µmol Trolox/mL (FRAP). The total phenolic compounds showed higher levels at pH 7.5 compared to pH 2.0. Chlorogenic acid isomers were found in greater abundance, with a concentration of 14.22 g/100 g. The administration of the extract resulted in positive modulation of the intestinal microbiota, specifically for the genera Lactobacillus sp. and Prevotella sp. The increase of these genera is related to the promotion of homeostasis of the gut microbiota. Therefore, these findings indicate that yerba-mate extract possesses significant antioxidant activity and can effectively modulate the intestinal microbiota in rats. These results support the potential use of yerba-mate as an alternative for controlling and preventing diseases associated with intestinal dysbiosis.

Bioavailable Phenolic Compounds from Olive Pomace Present Anti-Neuroinflammatory Potential on Microglia Cells.

The neuroinflammatory process is considered one of the main characteristics of central nervous system diseases, where a pro-inflammatory response results in oxidative stress through the generation of reactive oxygen and nitrogen species (ROS and RNS). Olive (Olea europaea L.) pomace is a by-product of olive oil production that is rich in phenolic compounds (PCs), known for their antioxidant and anti-inflammatory properties. This work looked at the antioxidant and anti-neuroinflammatory effects of the bioavailable PC from olive pomace in cell-free models and microglia cells. The bioavailable PC of olive pomace was obtained through the process of in vitro gastrointestinal digestion of fractionated olive pomace (OPF, particles size < 2 mm) and micronized olive pomace (OPM, particles size < 20 µm). The profile of the PC that is present in the bioavailable fraction as well as its in vitro antioxidant capacity were determined. The anti-neuroinflammatory capacity of the bioavailable PC from olive pomace (0.03-3 mg L-1) was evaluated in BV-2 cells activated by lipopolysaccharide (LPS) for 24 h. The total bioavailable PC concentration and antioxidant activity against peroxyl radical were higher in the OPM than those observed in the OPF sample. The activation of BV-2 cells by LPS resulted in increased levels of ROS and nitric oxide (NO). The bioavailable PCs from both OPF and OPM, at their lowest concentrations, were able to reduce the ROS generation in activated BV-2 cells. In contrast, the highest PC concentration of OPF and OPM was able to reduce the NO levels in activated microglial cells. Our results demonstrate that bioavailable PCs from olive pomace can act as anti-neuroinflammatory agents in vitro, independent of particle size. Moreover, studies approaching ways to increase the bioavailability of PCs from olive pomace, as well as any possible toxic effects, are needed before a final statement on its nutritional use is made.

Obesity Cut-Off Points Using Prepregnancy Body Mass Index according to Cardiometabolic Conditions in Pregnancy.

Aim: To suggest cut-off points for body mass index (BMI) using gestational hypertension, preeclampsia, and gestational diabetes mellitus (GDM) as cardiometabolic conditions in pregnancy. Methods: In this prospective study, singleton pregnant women from the fetal medicine service of the Brazilian Unified Health System were included. The pregnancy, perinatal, and newborn data were obtained from the clinical medical records. Maternal anthropometry included an assessment of weight and height and the prepregnancy BMI evaluation categorized according to the World Health Organization cut-off points. The area under the curve and confidence interval values from receiver operator curves were generated to identify the optimal cut-off points using prepregnancy BMI with better sensitivity and specificity. Results: Data on 218 pregnancies were analyzed, with 57.9% (n = 124) being classified as overweight/obese, 11% (n = 24) with GDM, 6.9% (n = 15) with preeclampsia, and 11.0% (n = 24) with gestational hypertension. The BMI cut-off points for predicting cardiometabolic conditions were 27.52 kg/m2 (S: 66.7%; E: 63.8%) for women with GDM; 27.40 kg/m2 (S: 73.3%; E: 62.4%; S: 79.2%; E: 64.9%; S: 70.3%; E: 66.3%) for women with preeclampsia, gestational hypertension, and gestational hypertension plus preeclampsia, respectively; and 27.96 kg/m2 (S: 69.6%; E: 65.6%) for women with preeclampsia plus GDM. Conclusion: The findings suggest that the optimal prepregnancy BMI cut-off point is around 27 kg/m2 for pregnant women with maternal cardiometabolic conditions.

Marcadores de consumo alimentar e diversidade alimentar mínima em diferentes métodos de introdução alimentar: um ensaio clínico randomizado / Food consumption markers and minimum dietary diversity in different complementary feeding methods: a randomized clinical trial

Objetivo: Avaliar os marcadores de consumo alimentar e a diversidade alimentar mínima em lactentes de 12 meses de vida expostos a diferentes métodos de introdução alimentar. Métodos: Ensaio clínico randomizado com pares mãe-lactente submetidos à intervenção sobre introdução alimentar em três métodos: Método tradicional (MT), Baby-led Introduction to SolidS (BLISS) e misto (combinação das duas técnicas). Os marcadores de consumo alimentar foram avaliados por questionário online aos 12 meses com base nos alimentos consumidos no dia anterior, utilizando os marcadores de consumo alimentar para menores de 2 anos do Sistema de Vigilância Alimentar e Nutricional. O estudo foi aprovado no comitê de ética. Resultados: Aos 12 meses foram avaliadas 136 crianças: 45 alocadas no MT, 48 no BLISS e 43 no misto. Os alimentos com maior prevalência de consumo foram: leite materno103 (75,7%), frutas, legumes e verduras 122 (89,7%), carnes ou ovos 135 (99,3%), feijão 115 (84,6%), cereais ou tubérculos 135 (99,3%). Alimentos ultraprocessados que estiveram presentes na dieta dos lactentes foram hambúrguer ou salsichas 3 (2,2%), bebidas açucaradas 2 (1,5%), macarrão instantâneo 4 (2,9%) e biscoito recheado 2 (1,5%).Não foram encontradas diferenças entre os métodos de introdução da alimentação complementar. A diversidade alimentar mínima esteve presente na alimentação de 22 lactentes (16,2%), sendo: 6 (13,3%) no MT, 8 (16,7%) no BLISS e 8 (18,6%) no misto (p=0,793). Conclusão: Leite materno,frutas, legumes e verduras, carne, feijão e arroz estiveram presentes na alimentação da maioria dos lactentes; no entanto, a prevalência de diversidade alimentar mínima foi baixa.O consumo de alimentos ultraprocessados também esteve presente na alimentação dos lactentes. Registro Brasileiro de Ensaios Clínicos (ReBEC) identificação RBR-229scm.

Objective: To evaluate food consumption markers and minimum dietary diversity in 12-month-old infants exposed to different methods of food introduction. Methods: A randomized clinical trial with mother-infant pairs undergoing intervention on food introduction in three methods: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), and mixed (combination of the two techniques). Food consumption markers were evaluated by an online questionnaire at 12 months based on food consumed the previous day, using food consumption markers for children under 2 years of the Food and Nutrition Surveillance System. The study was approved by the ethics committee. Results: At 12 months, 136 children were evaluated: 45 allocated to PLW, 48 to BLISS, and 43 to mixed. The foods with the highest prevalence of consumption were breast milk 103 (75.7%), vegetables 122 (89.7%), meat 135 (99.3%), beans 115 (84.6%), rice, potatoes, or yam 135 (99.3%). Ultra-processed foods were present in the diet of infants, including hamburgers or sausages 3 (2.2%), sweetened beverages 2 (1.5%), instant noodles 4 (2.9%), and sandwich cookies 2 (1.5 %). No differences were found between the methods of introducing complementary feeding. The minimum dietary diversity was present in the diet of 22 infants (16.2%), being: 6 (13.3%) in the PLW, 8 (16.7%) in the BLISS, and 8 (18.6%) in the mixed (p=0.793). Conclusion: Breast milk, vegetables, meat, beans, and rice were present in the diet of most infants; however, the prevalence of minimal dietary diversity was low. The consumption of ultra-processed foods was also present in the diet of infants. Brazilian Registry of Clinical Trials (ReBEC) identification RBR-229scm.

What is the role of phenolic compounds of yerba mate (Ilex paraguariensis) in gut microbiota?

Diet actively influences gut microbiota and body homeostasis. The predominance of beneficial species results in symbiosis, while dysbiosis is characterized by an imbalance between microbial communities. Food plays a key role in this dynamic and in promoting the health of individuals. Ilex paraguariensis, also known as yerba mate, is a traditional plant from Latin America that has a complex matrix of bioactive substances, including methylxanthines, triterpenes, saponins, and phenolics. The consumption of yerba mate is associated with antioxidant, cardioprotective, anti-inflammatory, and anti-obesity effects. However, to the best of our knowledge, there have been no studies on yerba mate as a modulating agent of intestinal microbiota. Phenolics are the major compounds in yerba mate and have been reported to act in modulating the microbiome. In this review, we explore the activity of yerba mate as a possible stimulant of gut microbiota and present its main phenolics and their biological effects. We also propose different mechanisms of action of these phenolics and possible doses for their effectiveness.

Criminalizadas e/ou vulneráveis? A trajetória no crime de mulheres aprisionadas por tráfico de drogas / Criminalizada y/o vulnerable? Una trayectoria en los crímenes de prisioneras arrestadas por narcotráfico / Criminalized and / or vulnerable? The crime trajectory of women arrested for drug trafficking

O artigo tem por objetivo conhecer a trajetória no crime percorrida por mulheres aprisionadas por tráfico de drogas. Pretende-se ainda compreender as motivações para o ingresso das mulheres no crime, a percepção delas sobre o crime de tráfico de drogas e avaliar como o envolvimento com o tráfico de drogas afetou as relações amorosas, familiares e sociais dessas mulheres, além de verificar se existe o desejo de sair do crime. Participaram do estudo três apenadas da Penitenciária Estadual Feminina de Guaíba. Os resultados demonstraram que os problemas sociais e financeiros e o envolvimento familiar foram os principais motivadores para a entrada dessas mulheres no tráfico, que o tráfico era visto como uma atividade de trabalho, que o aprisionamento trouxe prejuízos para as relações, especialmente familiares, e que a saída delas do crime dependia da possibilidade de conseguir um emprego formal.(AU)

El artículo tiene como objetivo comprender la trayectoria de los delitos cubiertos por las mujeres detenidas por tráfico de drogas. Otro de los objetivos es entender las motivaciones para la entrada de las mujeres en el crimen, su percepción sobre el crimen tráfico de drogas y evaluar cómo la participación en el tráfico de drogas afecta a las relaciones sentimentales, familiares y sociales de estas mujeres, así como de verificación hay un deseo de dejar el crimen. El estudio incluyó tres apenadas Penitenciario del Estado de Mujeres Guaíba. Los resultados demostraron que la participación de los problemas sociales y económicos y familiares fueron las principales razones para el ingreso de estas mujeres la trata, el tráfico se vio como una actividad de trabajo, que el encarcelamiento trajo daño a las relaciones, especialmente los miembros de la familia, y a cabo el delito dependía de la posibilidad de conseguir un trabajo formal.(AU)

The article has the objective of know the crime trajectory course of women imprisoned for drug traffic. It is intended to comprehend the motivations for the entering of the women on crime, the perception of the women about the crime on drug traffic and evaluate how the involvement with the drug traffic affected the romantic, familiar and social relationships of these women, also to verify if exists a desire to get out of crime. Three imprisoned women of the Penitênciária Estadual de Guaíba (Guaíba's States Penitentiary) participated in this study. The results show that financial and social problems along with the family involvement, were the principal motivators to the entering of these women in the drug traffic, that the traffic was seen as a work activity, that the imprisonment brought losses for the relationships, especially family, and that the exit of crime was dependent of the possibility of get a formal job.(AU)

High intensity interval exercise decreases IL-8 and enhances the immunomodulatory cytokine interleukin-10 in lean and overweight-obese individuals.

PURPOSE: To compare the effects of two interval exercises with different intensities on acute inflammatory response in lean and overweight-obese subjects. METHODS: Ten lean (BMI<24.9kg/m(2)) and 12 overweight-obese (BMI 25 to <34.9kg/m(2)) males performed two conditions in randomly assigned: (1) high intensity interval exercise (HIIE) 10×60s (85-90%PMax)/75s (50%PMax); (2) moderate intensity interval exercise (MIIE) 10×60s (70-75%PMax)/60s (50%PMax), with blood collections at pre, immediately and 30min post each exercise bouts to evaluate total and differential leukocyte counts, serum creatine kinase (CK), lactate dehydrogenase (LDH) and systemic levels of IL-1ra, IL-6, IL-8, IL-10, IL-17a and CCL2. RESULTS: In lean group, HIIE induced a significant increase in total leukocytes and monocyte, while MIIE session did not change the number of leukocytes. Overweight-obese group presented similar increase in leukocytes, monocytes and lymphocytes in both HIIE and MIIE sessions. At baseline, overweight-obese group showed high levels of CK, IL-8, IL-6 and CCL2 and lower concentrations of IL-10 compared to lean group. The MIIE did not alter the cytokine concentrations in both groups, independently of the time analysis. The HIIE induced significant decrease in IL-8 levels 30min post session in both the groups, and a progressive elevation in IL-10 levels immediately and 30min post in lean and overweight-obese. Regarding IL-6, overweight-obese subjects presented progressive increase either immediately and 30min after HIIE, while lean individuals presented significant increase only 30min after exercise. CONCLUSIONS: The acute inflammatory response to interval exercise is intensity-dependent. Although obesity influences the basal concentrations of several cytokines, only HIIE induced important alterations in IL-8 and IL-10 levels, which may have important implications in the control of chronic low-grade inflammation in obesity.

Efeito do estresse térmico sobre a frequência cardíaca, gasto energético, perda hídrica e ingestão de água em jogadores de voleibol / The effect of thermal stress on heart rate, energy expenditure, water loss and water intake in volleyball players

A presente pesquisa buscou investigar o efeito de diferentes situações de estresse térmico (WBGT) sobre a frequência cardíaca (FC), gasto energético (GE), perda hídrica (PH) e consumo de água (CA) em jovens atletas de voleibol. Participaram do estudo 09 indivíduos (16,5±0,9 anos) integrantes da equipe masculina juvenil de voleibol de Umuarama. As variáveis FC, GE, PH e CA foram mensuradas durante duas sessões de treinamento (S1, S2) de volume (85min) e intensidade semelhantes, porém, com diferentes situações de estresse térmico (S1: WBGT:22,62°C; S2: WBTG: 26.55°C). O estresse térmico (WBGT) do ambiente foi determinado por um termômetro de globo modelo ITWTG2000. A FC e o GE foram mensurados por meio do equipamento Sunnto Team Pod. A PH foi calculada pela diferença entre o peso corporal no início e final das sessões de treinamento. O CA foi ?ad libitum?, porém, o volume total ingerido foi calculado usando copos descartáveis de 180ml. Para análise dos dados foi utilizado o teste T pareado (amostras dependentes). O índice de significância adotado foi de p<0,05. Após análise dos dados, observou-se similar FC (S1: 135,5±16,3bpm vs. S2: 141,5±21,5bpm), GE (S1 :994,44±267,4Kcal vs. S2: 881,2±259,6Kcal), PH (S1: 0,6±0,2Kg vs. S2: 0,4±0,3Kg) e CA (S1 :1120±345mL vs. S2: 760±429mL) nas duas sessões de treinamento. Os resultados indicam que uma pequena variação no estresse térmico do ambiente não afeta de forma marcante a FC, GE, PH e CA durante o treinamento de voleibol.

This paper sought to investigate the effect of different thermal stress situations (WBTG) on heart rate (FC), energy expenditure (GE), water loss (PH) and water intake (CA) in young volleyball players. For such, 09 young male volleyball players from Umuarama Volleyball participated of this research (16.5±0.9 years). The variables FC, GE, PH and CA were measured during two training sessions (S1, S2) with similar volume (85 min) and intensity but, with different thermal stress situations (S1: WBTG: 22.62ºC and S2 WBGT: 26.55ºC). The thermal stress (WBGT) in the training environment was determined by a globe thermometer model ITWTG2000. The FC and the GE were measured by a Suunto Team Pod. PH was calculated by the difference between the body weight at the beginning and at the end of the training sessions. The CA during the training sessions was ?ad libitum? but the total volume ingested was calculated using 180-ml plastic cups. For the data analysis, the paired T test (dependent samples) was used. The significance index adopted was p <0.05. After the analysis of the data, similar FC (S1: 135.5 ±16.3bpm vs. S2: 141.5±21.5bpm), GE (S1: 994.44±267.4 Kcal vs. S2: 881.2±259.6 Kcal), PH (S1: 0.6±0.2 Kg vs. S2: 0.4±0.3 Kg) and CA (S1: 1120±345ml vs. S2: 760±429 ml) were observed in both training sessions. The results indicate that a little variation in the environmental thermal stress does not markedly affect the FC, GE, PH and CA during volleyball training sessions.