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Background: Aging compromises the ability of the central nervous system to maintain body balance and reduces the capacity for adaptive reactions. To prevent falls, the reception conditions for sensory information need to be improved. Objectives: To evaluate the impact of a structured aquatic and a non-aquatic exercise program for lower-limb muscle endurance on the static and dynamic balance of elderly people. Methods: This was a prospective randomized clinical study in which the variables were assessed before and after the training program. Thirty-six elderly people were evaluated using four tests: the Berg Balance Scale, Dynamic Gait Index, gait speed and tandem gait. The participants were randomized into three groups: aquatic exercise group, non-aquatic exercise group and control group. The exercise groups underwent a program for lower-limb muscle endurance that consisted of 40-minute sessions twice a week for six weeks. The participants were reevaluated after six weeks. The data were analyzed statistically using the univariate ANOVA test for comparisons between the groups before and after the intervention. Results: The program for lower-limb muscle endurance significantly increased balance (p<0.05) in the evaluation tests after the training program. Conclusion: The muscle endurance program provided a significant improvement in static and dynamic balance among community-dwelling elderly people. It was also possible to infer that this improvement occurred regardless of the environment, i.e. aquatic or non-aquatic. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the static and dynamic rheological properties of an ultra-processed powdered goat milk beverage containing carboxymethyl cellulose (CMC), guar gum (GG), and xanthan gum (XG), using a mixture design. Fourteen samples were evaluated, in addition to the original beverage. The flow curves classified the fluids as non-Newtonian and characterized all the reconstituted beverages with pseudoplastic behavior, precisely due to the addition of hydrocolloids that increased the viscosity, and the fresh beverage sample showed the behavior of a dilatant fluid. The stress sweep verified the changes in the storage module (G') and the loss module (G″), the G' ranged from 1.97 to 20.36 (Pa) and the G″ ranged from 5.94 to 11.30 (Pa), demonstrating that there was the formation of beverages with elastic and viscous behaviors. The results showed a synergistic effect between the texture improvers, and the formulations with GG identified a greater effect on the tension. The frequency sweep tests showed that the behavior of the samples was that of a weak gel; however, when subjected to a certain frequency, the values of G' exceeded the value of G″, becoming a sample with more elastic characteristics and consequently, presenting the behavior of a stronger gel. Finally, according to the data presented, it is assumed that formulations containing GG and xanthan gum may produce desirable consumer properties for the reconstituted goat milk drink. Samples with a higher concentration of GG exhibited improved rheological performance, characterized by greater consistency, increased resistance to tension, and higher viscosity at low frequencies. PRACTICAL APPLICATION: The powdered goat milk drink is an innovative product that meets the demands of the food industry and consumers by offering a nutritious and sustainable beverage alternative., (© 2024 Institute of Food Technologists.)

Corynebacterium pseudotuberculosis is a gram-positive bacterium and is the etiologic agent of caseous lymphadenitis (CL) in small ruminants. This disease is characterized by the development of encapsulated granulomas in visceral and superficial lymph nodes, and its clinical treatment is refractory to antibiotic therapy. An important virulence factor of the Corynebacterium genus is the ability to produce biofilm; however, little is known about the characteristics of the biofilm produced by C. pseudotuberculosis and its resistance to antimicrobials. Silver nanoparticles (AgNPs) are considered as promising antimicrobial agents, and are known to have several advantages, such as a broad-spectrum activity, low resistance induction potential, and antibiofilm activity. Therefore, we evaluate herein the activity of AgNPs in C. pseudotuberculosis , through the determination of minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), antibiofilm activity, and visualization of AgNP-treated and AgNP-untreated biofilm through scanning electron microscopy. The AgNPs were able to completely inhibit bacterial growth and inactivate C. pseudotuberculosis at concentrations ranging from 0.08 to 0.312 mg/mL. The AgNPs reduced the formation of biofilm in reference strains and clinical isolates of C. pseudotuberculosis, with interference values greater than 80% at a concentration of 4 mg/mL, controlling the change between the planktonic and biofilm-associated forms, and preventing fixation and colonization. Scanning electron microscopy images showed a significant disruptive activity of AgNP on the consolidated biofilms. The results of this study demonstrate the potential of AgNPs as an effective therapeutic agent against CL., Competing Interests: Vasco Azevedo and Debmalya Barh are Academic Editors for PeerJ., (©2024 Santos et al.)

Purpose: This study aimed to evaluate the capacity of peppermint essential oil to improve the physical performance of runners in running protocol until exhaustion., Methods: In a clinical, randomized, double-blind, cross-over and controlled study, fourteen male recreational runners (37.1 ± 2.0 years; 24 ± 1.1 kg/m 2 ; 53.1 ± 1.7 mL kg min) performed two runs to exhaustion at 70% of VO 2max , after intake of 500 mL of water added with 0.05 mL of peppermint essential oil (PEO) or placebo (PLA), plus 400 mL of the drink during the initial part of the exercise. Records were made of body temperature (BT), thermal sensation (TS), thermal comfort (TC), subjective perception of effort (SPE), sweat rate (SR), and urine volume and density., Results: Time to exhaustion was 109.9 ± 6.9 min in PEO and 98.5 ± 6.2 min in PLA (p = 0.009; effect size: 0.826). No significant changes were observed in the values of BT, TS, TC, SPE, SR, lost body mass, and urine volume and density (p > 0.05)., Conclusion: Peppermint essential oil added to water before and during a race significantly increases the time to exhaustion of recreational runners but without altering BT, TS, TC, or hydration status, so the mechanisms involved were not clarified in this study., Brazilian Registry of Clinical Trials (rebec): RBR-75zt25z., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Diabetic patients frequently develop wounds, which can be colonized by bacteria, mainly Staphylococcus aureus and Pseudomonas aeruginosa , with the ability to form biofilms. This study aimed to evaluate the colonization and biofilm formation of Staphylococcus aureus and Pseudomonas aeruginosa in chronic wounds of diabetic patients treated with a bioactive dressing (EGF-CMC), which consisted of a 2% carboxymethylcellulose (CMC) hydrogel loaded with epidermal growth factor (EGF). This randomized clinical trial was conducted with 25 participants: 14 treated with EGF-CMC hydrogel and 11 treated with CMC hydrogel for 12 weeks. Participants with type 2 diabetes mellitus were selected. All had diabetic foot ulcers or chronic venous ulcers. Swab collections were performed on weeks 1, 6, and 12. The laboratory analyses included the identification of strains, microbial quantification, virulence gene investigation, and the evaluation of biofilm formation. In total, 13 S. aureus strains and 15 P. aeruginosa strains were isolated. There were no statistically significant differences regarding bacterial loads and virulence genes. However, EGF-CMC-hydrogel-treated wounds were colonized by strains with lower biofilm formation abilities. The probability of isolating biofilm-producing strains from CMC-hydrogel-treated wounds was 83% greater than the probability of isolating biofilm-producing strains from EGF-CMC-treated wounds.

Background: Preschool is a crucial period for developing motor skills., Objective: This study evaluated factors associated with motor competence in preschoolers from a Brazilian urban area., Methods: A total of 211 preschoolers (51.2% girls and 48.8% boys) were evaluated. Body mass index was calculated; the Brazilian Economic Research Criterion, the Mini-Mental Scale (MMC) and the Early Childhood Environment Rating Scale®, Revised (ECERS-R™) were applied; the Habitual Physical Activity time was recorded; the Test of Gross Motor Development (TGMD-2) was performed. Univariate analysis was performed using simple linear regression for the independent variables, considering the motor test subscales as dependent variables. Variables with p < 0.20 in the univariate analysis were considered for the multiple linear regression model and were entered into the stepwise method., Results: The independent variables remaining in the Standard Score Locomotor model were BMI, presence of park at school, and MMC (R 2  = 0.16). The independent variables remaining in the Standard Object Control score were MMC and gender (R 2  = 0.03). The variables associated with the highest scores of Gross Motor Quotient were MMC, body mass index, and presence of a park at school, respectively (R 2  = 0.11)., Conclusion: Male eutrophic preschoolers who are physically active and attend schools with parks or courtyards in a Brazilian urban area have the highest scores for global cognitive function and motor competence., Competing Interests: Conflict of InterestThe authors report there are no competing interests to declare., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The analgesic specificity of navicular bursa (NB) anesthetic infiltration is still questionable. The study aimed to determine the mechanical nociceptive threshold of non-specific analgesia in the dorsal lamellar stratum, as well as in the sole, coronary band, and heel bulbs of the hoof, after navicular bursa anesthetic infiltration. Six healthy horses with no clinical or radiographic changes of the digits and no communication between the NB and the distal interphalangeal joint, were used. After random selection, the NB of one of the forelimbs was infiltrated with 2% lidocaine and the contralateral one with lactated ringer's solution. Contrast was added to confirm radiographic infiltration. The mechanical nociceptive threshold was determined using a portable pressure dynamometer, before and at various times after the infiltration, in 10 points of the hoof. The effects of time and treatment were verified by ANOVA (P<0.05). There was no statistical difference in the values of the mechanical nociceptive threshold (P>0.05) in all regions evaluated. However, in one of the six hooves that receives lidocaine, complete absence of response to the painful stimulus (maximum force of 6 Kg over an area of 38.46 mm2, for a maximum of 4 seconds) was observed in the dorsal lamellae between 30 and 60 min after infiltration. In conclusion, lidocaine infiltration of NB did not promote significant increases in the nociceptive threshold of the sole, coronary band, bulbs of the heel and dorsal lamellae clinically healthy horses. However, the occurrence of analgesia in one of the six hooves subjected to NB anesthesia indicates that the technique may not be fully specific in few horses., Competing Interests: The authors have declared that no competing interests exist.

This study aimed to investigate the effects of Malay apple (MA) on the glycaemic response, lipid metabolism and liver health of rats fed a normal- or high-fat diet. Male Wistar rats were initially randomized into two groups: normal-fat diet (NF, n = 16) and high-fat diet (HF, n = 16) for three weeks. Then, they were subdivided into: normal-fat diet (NF, n = 8); normal-fat diet supplemented with MA (NFMA, n = 8); high-fat diet (HF, n = 8); high-fat diet supplemented with MA (HFMA, n = 8), continuing for another three weeks with their respective diets. Simultaneously, the supplemented groups received MA (400 mg/kg body weight) via gavage. MA contains anthocyanins (26.59 mg/100 g), catechin (2.55 ± 0.33 mg/100 g) and gallic acid (1.07 ± 0.20 mg/100 g) as the main phenolics. MA had a low-key effect on insulin and glucose tolerance, however decreased serum lipids and protected the liver from steatosis induced by the high-fat diet. HFMA rats showed changes in the fatty acid composition of the liver and faeces and decreased liver cholesterol levels (20.5%); as well as increased faecal excretion of fat (98%), cholesterol (10.5%) and bile acids (42.2%) when comparing to HF. MA supplementation reduced food and fat intake in HFMA in the last two weeks of the experiment, which may also have influenced these results. Our results suggest that MA was not able to improve glycaemic parameters, however, had hepatoprotective effect and minimizes changes in lipid metabolism caused by high-fat diet intake, which can relate mainly to the phenolic compounds present in this fruit., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: To investigate the validity and within-day reliability of the Glittre activities of daily living test (Glittre ADL-test) in patients on hemodialysis., Methods: Ninety-one patients on hemodialysis were evaluated using Glittre ADL-test, functional tests, health-related quality of life, human activity profile, and social participation. Convergent validity was analyzed by the correlation analysis. The Glittre ADL-test results were compared among different levels of the functional tests, human activity profile, and participation (known-groups validity). Within-day reliability was examined by Intra-class Correlation Coefficient (ICC)., Results: There was a significant moderate to strong correlation between Glittre ADL-test and functional tests ( r  = 0.62 to 0.66 and -0.70 to -0.44). A significant weak correlation was found between Glittre ADL-test, health-related quality of life ( r  = 0.28 to 0.32), and human activity profile ( r =-0.33). There was no significant correlation with participation. Except for participation level, the Glittre ADL-test results were able to identify individuals with low performance in all evaluated tests and were able to differentiate among inactive and active individuals by human activity profile ( p  < 0.05). Within-day reliability was evaluated in 42 patients. The ICC was 0.97., Conclusion: The Glittre ADL-test is a reliable test associated with functional parameters and physical aspects related to health-related quality of life, with potential value in the functional evaluation of patients on hemodialysis.Implications for rehabilitationFunctional impairment is a common clinical finding and is an important predictor of poor prognosis in patients on hemodialysis.The Glittre ADL-test has excellent within-day reliability and is a valid instrument for functional assessment in patients on hemodialysis.Activity limitations of patients on hemodialysis can be assessed by Glittre ADL-test.

Pre-exhaustion (PE) is a popular resistance training strategy that involves performing a single-joint exercise followed by a multi-joint exercise with minimal recovery between the transition. This approach is widely used by bodybuilding athletes and resistance training (RT) enthusiasts with the aim of enhancing muscle strength and hypertrophy. The present paper aimed to provide a narrative review as to the effects of the PE method on different acute and chronic outcomes, and discuss relevant practical applications. When considering the body of literature as a whole, we conclude that current evidence does not support a benefit to the PE method compared to traditional RT models regarding chronic improvements in strength, hypertrophy and body composition. However, the heterogeneous study designs confound the ability to draw strong conclusions on the topic. Further investigations are warranted with strict control of study variables to better elucidate what, if any, benefits may be obtained by the PE method.

GATA-1 is a transcription factor from the GATA family, which features zinc fingers for DNA binding. This protein was initially identified as a crucial regulator of blood cell differentiation, but it is currently known that the Gata-1 gene expression is not limited to this system. Although the testis is also a site of significant GATA-1 expression, its role in testicular cells remains considerably unexplored. In the present study, we evaluated the testicular morphophysiology of adult ΔdblGATA mice with a mutation in the GATA-1 protein. Regarding testicular histology, GATA-1 mutant mice exhibited few changes in the seminiferous tubules, particularly in germ cells. A high proportion of differentiated spermatogonia, an increased number of apoptotic pre-leptotene spermatocytes (Caspase-3-positive), and a high frequency of sperm head defects were observed in ΔdblGATA mice. The main differences were observed in the intertubular compartment, as ΔdblGATA mice showed several morphofunctional changes in Leydig cells. Reduced volume, increased number and down-regulation of steroidogenic enzymes were observed in ΔdblGATA Leydig cells. Moreover, the mutant animal showed lower serum testosterone concentration and high LH levels. These results are consistent with the phenotypic and biometric data of mutant mice, i.e., shorter anogenital index and reduced accessory sexual gland weight. In conclusion, our findings suggest that GATA-1 protein is an important factor for germ cell differentiation as well as for the steroidogenic activity in the testis., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: Arterial hypertension is a cardiovascular disease defined as a sustained high blood pressure, constituting an important risk factor for the development of heart diseases, such as coronary heart disease and heart failure. At the same time, pathophysiological pathways underlying sleeping deprivation provides biological plausibility for a causation connection between sleep deprivation and acute or chronic blood pressure elevation, such as the mechanism behind blood pressure dipping at night, which strongly relies on reduced sympathetic activity provided by sleep, besides empirical and clinical evidence suggesting that sleep disorders incidence is correlate with posterior development of arterial hypertension. The aim of this study was to systematically review published studies analyzing the possible relationship between sleep deprivation and variations in blood pressure during nighttime and daytime., Methods: The research was carried out in the second semester of 2020 following the PRISMA model and using the LILACS, MEDLINE and COCHRANE (CENTRAL) databases. The keywords used were associated using the Boolean method. Only trials and studies in humans unrelated to sleep apnea were included, in an attempt to answer the question proposed. Duplications and articles outside the topic were excluded., Results: After the selection processes, fourteen studies were left, which were classified, depending on the findings, in four categories: 1) blood pressure differences only in sleep deprivation's night; 2) blood pressure differences only in the following day after sleep deprivation's night; 3) blood pressure differences in both nights and 4) those that found no blood pressure differences., Conclusion: It was found an increase in blood pressure on the night of sleep deprivation, suggesting a possible causality with an acute increase in blood pressure depending on the population studied. In general, sleep deprivation is acutely associated with blood pressure elevation or acute elevation of markers that suggest the role of compensatory mechanisms, such as increased natriuresis and increased parasympathetic activity., Competing Interests: This article content has no conflicts of interest. The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: https://doi.org/10.1016/j.sleepx.2022.100042., (© 2022 The Author(s).)

A cross-sectional study was conducted to compare the habitual physical activity level, measured by accelerometry, gait performance, assessed by the GAITRite® system, handgrip strength, and static balance between older Brazilian women who participate (n = 50; 70.7 ± 5.5 years) and do not participate (n = 50; 70.1 ± 5.6 years) in a regular physical exercise program, and to investigate whether participation in a regular exercise program ensures compliance with physical activity recommendations. Older women who participated in a regular physical exercise program had significantly shorter sedentary activity time (effect size [ES] = 0.54), longer moderate activity time (ES = 0.85), and higher energy expenditure (ES = 0.64), number of steps (ES = 0.82), gait speed (ES = 0.49), and step length (ES = 0.45). However, regular participation in an exercise program did not guarantee compliance with physical activity recommendations. Behavioral changes to increase physical activity levels among older women who do and do not participate in a regular exercise program are necessary.

Various photocatalytic nanomaterials for environmental remediation have been promoted due to the pollution caused by different organic pollutants. In this study, Nb 2 O 5 nanofibers were obtained by electrospinning technique, presenting controlled crystallinity and high specific surface area to improve the photoactivity response. The structural characterization indicated Nb 2 O 5 nanofibers with orthorhombic phase formation. The photoluminescence measurements showed different energy levels contributing to the electronic transition events. The nanofibers with a bandgap up to 3.6 eV were applied to photocatalysis of dyes (rhodamine B (RhB) or methylene blue (MB)) and fluoxetine (FLX), listed as an emergent pollutant. In the optimized condition (pH = 9), the RhB and MB photocatalysis was 59% and 93% more efficient than photolysis due to ζ = - 50 mV ± 5 for EtOH&#95;550 sample increased interaction with MB (cationic) compared to RhB unprotonated (pKa = 3.7). Therefore, FLX (pKa = 10.7) was selected due to protonated form at pH = 9 and showed 68% ± 1 adsorption in 30 min for EtOH&#95;550. The FLX photocatalytic degradation under UV light irradiation was up to 17% higher than the photolytic degradation. The formation of hydroxyl radicals in the photocatalytic system (EtOH&#95;550) was proven by the Coumarine probe assay, corroborating with the greater amount of α-[2-(methylamino)ethyl]benzylalcohol (MAEB), a by-product obtained after FLX oxidation. Additionally, the material achieved specific catalytic activity for the different organic compounds (RhB, MB, or FLX). Therefore, Nb 2 O 5 nanofibers were efficient for degrading three different pollutants under UV light, proving a viable alternative for environmental remediation., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background:  Different treatments have been proposed for Fibromyalgia, but only few studies have compared their effects on multiples outcomes over time.  Objective:  The objective of this study was to investigate the effects of aquatic physiotherapy (AP) or a health education program (HEP) in a sample of women with Fibromyalgia (FM).  Methods:  Forty-six women with FM, aged between 25 and 60 years old, whose BMI was less than 30, were assigned to either AP (27 women) or HEP (19 women) groups in a blind randomized clinical trial lasting eleven weeks. Pain (McGill Pain questionnaire), fatigue (Piper Fatigue Scale-Revised), functional capability (Fibromyalgia Impact questionnaire), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory) and quality of sleep (Pittsburgh Sleep Quality Index) data were collected at baseline, after six weeks and post intervention. Two-factor mixed-model analysis of variance (ANOVAs) were used to examine the effects of the treatment on each outcome variable.  Results:  The AP and HEP interventions showed statistically significant within-group differences on all outcome measures except reducing the pain. Between-group differences was statistically significant only for impact of FM on the participant's life [ F (1.82,80.41)  = 31,99; p ≤ 0.01] indicating that patients receiving HEP experienced a greater decrease in FIQ than those treated with AP.  Conclusion:  The findings do not allow to affirm that one intervention is superior to the other for the treatment of people with FM. Future studies should investigate whether the combination of HEP and PA can be effective and long-lasting.

Objective: The aim of this study was to evaluate sexual function in male and female COPD (chronic obstructive pulmonary disease) patients and identify associated factors. Methods: This is a cross-sectional study on 52 COPD patients treated at an outpatient pneumology service of a referral hospital in Northeastern Brazil. Information was collected on demographic, clinical and spirometric variables and exercise capacity. The following instruments and scores were used: modified Medical Research Council (mMRC) for dyspnea, SF-36 for quality of life (QoL), the Beck Depression and Anxiety Inventory, Male and Female Sexual Quotient. Results: Sexual function was satisfactory/excellent in 17% (9/52) and poor/absent in 82% (43/52). Patients with poor/absent sexual function tended to have lower scores on the domain mental health summary score of SF-36 (p = 0.007) and higher anxiety and depression scores than patients with satisfactory/excellent sexual function (p = 0.02 and p = 0.01). In the multivariate analysis, patients with high depression scores displayed a greater likelihood of poor/absent sexual function (OR = 1.13; 95% CI = 1.02-1.25). Conclusion: COPD patients presented a high rate of sexual dysfunction and compromised sexuality was associated with depression.

Objective: to investigate the prevalence of negative self-rated health and associated factors among municipal health service workers in Diamantina, MG, Brazil., Methods: this was a cross-sectional census study using Poisson regression., Results: 203 health workers took part in the study, 70.9% were female, and 57.1% were up to 38 years old; prevalence of negative self-rated health was 28.6% (95%CI22.4;34.8); in the multivariate analysis, the following were associated with the outcome: being 39 years old or more (PR=1.56 - 95%CI1.01;2.40), monthly family income >3 minimum wages (PR=0.63 - 95%CI0.41;0.97), having another paid occupation (PR=0.55 - 95%CI0.34;0.89), poor sleep quality (PR=1.99 - 95%CI1.32;2.99), diagnosis of one disease (PR=2.33 - 95%CI1.13;4.81) or multiple diseases (PR=2.63 - 95%CI1.32;5.24), suffering aggression at work (PR=1.92 - 95%CI1.29;2.85), and frequent participation in domestic activities (PR=0.55 - 95%CI0.38;0.80)., Conclusion: prevalence of negative self-rated health was high and was associated with sociodemographic, occupational, behavioral and health situation factors.

Objective To translate, adapt and validate the Patient Generated Index (PGI) for Brazilians with chronic obstructive pulmonary disease (COPD). Methods 50 volunteers with COPD, mostly men (74%), with 73.1 ± 8.9 years of age, FEV1 of 52.3 ± 14.5% of predicted and FEV1 / FVC of 56.2 ± 8.6% of predicted responded to PGI, to the Saint George Respiratory Questionnaire (SGRQ) and to perform Glittre Activities of Daily Living test (Glittre ADL). After 1-2 weeks, PGI was again applied for the analysis of relative and absolute reliability. Results The translation occurred without changes in the questionnaire. The score obtained in PGI had weak correlation with the SGRQ total score (r = -0.44, p <0.001) and with the impact domain (r = -0.40, p <0.05), presented a moderate correlation with the symptoms domain of the SGRQ (r = -0.55, p <0.001) and weak correlation with the activity domain (r = -0.31, p <0.05). A weak correlation was observed between PGI and Glittre ADL (r = -0.30; p <0.05). It was observed high reliability among the measures of PGI (ICCr = 0.94). Conclusion This study shows that the Brazilian version of PGI is a reliable and valid instrument to measure health-related quality of life (HRQL) in patients with COPD. It is a new and individualized form of evaluation of COPD patient-centered quality of life.

Cacay oil and butter were evaluated as enzymatic inducers for lipase production from Aspergillus terreus NRRL-255 by solid-state fermentation (SSF). Initially, physicochemical characteristics of agro-industrial wastes were evaluated in order to identify a potential solid substrate for lipase production. Higher water absorption index (3.65 g H 2 O/g substrate), adequate mineral content, great carbon source, and nitrogen concentration were factors that influenced the choice of wheat bran as a solid substrate. Cacay butter presented the highest lipolytic activity (308.14 U g -1 ) in the screening of lipid inducer. Then, the effects of lipid inducer concentration (cacay butter), temperature, pH, moisture, and fermentation time were evaluated on process performance using multivariate statistical methodology. Under optimal conditions, the highest lipase activity observed was 2,867.18 U g -1 . Regarding the lipase characterization, maximum relative activity was obtained at pH 7.0 and at 35 °C. An inhibitory effect was observed for Ca 2+ , Mn 2+ , Zn 2+ , Fe 2+ , and Cu 2+ ions. Lipase activity was increased with the reduction of sodium dodecyl sulfate (SDS) concentration and the increase of Triton X-100. Therefore, the use of wheat bran as a solid substrate combined with cacay butter demonstrated a substantial lipase production, indicating its biotechnological industrial potential.

As antibiotics are ineffective when used to treat caseous lymphadenitis, the surgical excision of lesions is often required. Iodine solution (10%) is currently the choice for the post-surgical treatment; however, it may cause histotoxicity. Propolis are resinous substances composed by a mixture of different plants parts and molecules secreted by bees. As green propolis has already proven to possess anti-bacterial and wound healing properties, this study aimed to evaluate the use of a green propolis-based ointment as a therapeutic agent for the post-surgical treatment of caseous lymphadenitis. The caseous lesions of 28 sheep were surgically excised before dividing animals into two groups: (1) iodine-treated animals and (2) sheep treated with an ointment made with a previously characterized green propolis extract. Clinical data of animals, size of the scar area, the presence of moisture and secretion in the surgical wound, the humoral immune response against the bacterium and the susceptibility of C. pseudotuberculosis clinical isolates to the green propolis extract were analyzed. The green propolis-treated group presented complete healing of the surgical wound 1 week before the iodine-treated group. Additionally, animals treated with the green propolis ointment had fewer cases of wound secretion, but it was not statistically different from the iodine-treated group. No clinical signs indicating green propolis toxicity or other side effects were found, associated with a faster and more organized hair recovery by propolis use. The green propolis extract was able to inhibit the growth of 23 from the 27 C. pseudotuberculosis clinical isolates, with minimum inhibitory and minimum bactericide concentrations ranging from 01 to 08 mg/mL, and did not interfere with the humoral immune response against the bacterium. In addition, green propolis was able to inhibit biofilm formation by four of the C. pseudotuberculosis clinical isolates. We concluded that green propolis is a promising therapeutic agent to be used in the post-surgical treatment of caseous lymphadenitis in small ruminants due to its effects on surgical wound healing, hair recovery, inhibition of wound contamination and bacterial growth., (Copyright © 2019 Kalil, Santos, Barral, Rodrigues, Pereira, Sá, Umsza-Guez, Machado, Meyer and Portela.)

There is increasing evidence indicating a role for Fusobacterium nucleatum (F. nucleatum) in colorectal cancer (CRC) development and prognosis. This study evaluated F. nucleatum as a prognostic biomarker, by assessing its association with post-diagnosis survival from CRC. From September 2008 to April 2012 CRC patients (n = 190) were recruited from three hospitals within the Czech Republic. F. nucleatum DNA copies were measured in adjacent non-malignant and colorectal tumor tissues using quantitative real-time PCR. Cox Proportional Hazards (HR) models were applied to evaluate the association between F. nucleatum DNA and overall survival, adjusting for key confounders. Risk prediction modeling was conducted to evaluate the ability to predict survival based on F. nucleatum status. High, compared with low, levels of F. nucleatum in colorectal tumor tissues were associated with poorer overall survival (adjusted HR 1.68, 95% CI 1.02-2.77), which was slightly attenuated after additional adjustment for microsatellite instability status. However, inclusion of F. nucleatum in risk prediction models did not improve the ability to identify patients who died beyond known prognostic factors such as disease pathology staging. Although the increased presence of F. nucleatum was associated with poorer prognosis in CRC patients, this may have limited clinical relevance as a prognostic biomarker.

[This corrects the article DOI: 10.1155/2018/8454125.].

This study investigated the efficiency of the extraction of phenolic compounds from seeds of chia, Salvia hispanica L. utilizing the statistical tool of mixture planning, simplex-lattice design. The solvents used were acetone, ethanol and water and the responses analyzed were total phenolic content (TPC), antioxidant activity by the capture of the free radical DPPH and ferric reduction ability (FRAP). Moderately polar mixtures were highly efficient to extract the antioxidant phenolic compounds. The best results were obtained for the water-acetone (1/3-2/3) binary mixture, presenting TPC, DPPP and FRAP values of 58.44 mg GAE/g, 250.20 μmol TE/g and 720.15 μmol TE/g, respectively. The best ternary mixture was water-ethanol-acetone (1/6-1/6-2/3), with 60.96 mg GAE/g, 380.53 μmol TE/g and 990.15 μmol TE/g, respectively. The phenolic profile showed that the acids rosmarinic, caffeic, salicylic and the flavonoids myricetin and quercetin are the compounds that most contribute to the elevated antioxidant activity., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Aim: To examine the effect of Fusobacterium nucleatum ( F. nucleatum ) on the microenvironment of colonic neoplasms and the expression of inflammatory mediators and microRNAs (miRNAs)., Methods: Levels of F. nucleatum DNA, cytokine gene mRNA ( TLR2 , TLR4 , NFKB1 , TNF , IL1B , IL6 and IL8 ), and potentially interacting miRNAs (miR-21-3p, miR-22-3p, miR-28-5p, miR-34a-5p, miR-135b-5p) were measured by quantitative polymerase chain reaction (qPCR) TaqMan ® assays in DNA and/or RNA extracted from the disease and adjacent normal fresh tissues of 27 colorectal adenoma (CRA) and 43 colorectal cancer (CRC) patients. KRAS mutations were detected by direct sequencing and microsatellite instability (MSI) status by multiplex PCR. Cytoscape v3.1.1 was used to construct the postulated miRNA:mRNA interaction network., Results: Overabundance of F. nucleatum in neoplastic tissue compared to matched normal tissue was detected in CRA (51.8%) and more markedly in CRC (72.1%). We observed significantly greater expression of TLR4 , IL1B , IL8 , and miR-135b in CRA lesions and TLR2 , IL1B , IL6 , IL8 , miR-34a and miR-135b in CRC tumours compared to their respective normal tissues. Only two transcripts for miR-22 and miR-28 were exclusively downregulated in CRC tumour samples. The mRNA expression of IL1B , IL6 , IL8 and miR-22 was positively correlated with F. nucleatum quantification in CRC tumours. The mRNA expression of miR-135b and TNF was inversely correlated. The miRNA:mRNA interaction network suggested that the upregulation of miR-34a in CRC proceeds via a TLR2 / TLR4 -dependent response to F. nucleatum . Finally, KRAS mutations were more frequently observed in CRC samples infected with F. nucleatum and were associated with greater expression of miR-21 in CRA, while IL8 was upregulated in MSI-high CRC., Conclusion: Our findings indicate that F. nucleatum is a risk factor for CRC by increasing the expression of inflammatory mediators through a possible miRNA-mediated activation of TLR2 / TLR4 ., Competing Interests: Conflict-of-interest statement: No conflict-of-interest.

Aim: To evaluate the prevalence and risk factors of H. pylori infection in the pediatric and adult population seen at a public hospital in São José do Rio Preto, SP, Brazil., Methods: This is a retrospective study that evaluated 2406 medical records of children, adolescents, and adults with dyspeptic symptoms who underwent upper gastrointestinal endoscopy. H. pylori diagnosis and demographic and clinical-pathological features were recorded., Results: A total of 852 subjects were H. pylori positive, with an overall prevalence of infection of 35.4%, occurring mainly in adults over 40 years of age, and a 24.7% prevalence considering only children and adolescents. No association was observed between H. pylori infection and risk factors. However, the H. pylori positive individuals showed a higher frequency of pangastritis ( p < 0.01), severe lesions ( p = <0.001), and erosive lesions ( p = 0.04). The bacterium was eradicated in 83.5% (127) of the patients who received the standard therapy., Conclusions: The prevalence of H. pylori detected in a public service in São José do Rio Preto, SP, Brazil, is as expected for developed countries, showing growing rates with increasing age. As H. pylori infection occurs during childhood, screening programs for detection and prevention in the pediatric population are important to reduce the prevalence of this infection in adults.

Objective: The aim of this study was to characterize molecularly multidrug-resistant (MDR) Pseudomonas aeruginosa isolates collected from burn center (BC) patients and environment in a hospital localized in Rio de Janeiro city, RJ, Brazil., Methods: Thirty-five P. aeruginosa isolates were studied. The antimicrobial resistance was tested by disk diffusion method as recommended by CLSI. The assessment of virulence (exoS and exoU) and resistance (bla PER-1 , bla CTX-M , bla OXA-10 , bla GES-1 , bla VIM , bla IMP , bla SPM-1 , bla KPC , bla NDM and bla SIM ) genes were achieved through PCR and biofilm forming capacity was determined using a microtiter plates based-assay, as described previously. Genotyping was performed using Multilocus sequence typing (MLST)., Results: High rate of P. aeruginosa (71.4%; 25/35) were classified as MDR, of them 64% (16/25) were related to clone A, the most prevalent clone found in the BC studied. A total of eight carbapenems resistant isolates were detected; three belonging to clone A and five carrying the exoU virulence gene. In addition, clone A isolates were also biofilm producers. Two new sequence types (ST) were detected in this study: ST2236, grouped in to clone A; and ST2237, classified in the different clones, displaying carbapenem resistance and exoU virulence gene., Conclusion: The high prevalence of biofilm producers and multiresistant P. aeruginosa isolates in BC indicates that prevention programs need to be implemented to avoid infection in highly susceptible patients., (Copyright © 2016. Published by Elsevier Ltd.)

Aim: To investigate the contribution of polymorphisms in the CYP1A1 , CYP2E1 and EPHX1 genes on sporadic colorectal cancer (SCRC) risk., Methods: Six hundred forty-one individuals (227 patients with SCRC and 400 controls) were enrolled in the study. The variables analyzed were age, gender, tobacco and alcohol consumption, and clinical and histopathological tumor parameters. The CYP1A1 *2A, CYP1A1 *2C CYP2E1 *5B and CYP2E1 *6 polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The EPHX1 Tyr113His, EPHX1 His139Arg and CYP1A1 *2C polymorphisms were detected by real-time PCR. Chi-squared test and binary logistic regression were used in the statistical analysis. Haplotype analysis was conducted using the Haploview program, version 2.05., Results: Age over 62 years was a risk factor for SCRC development (OR = 7.54, 95%CI: 4.94-11.50, P < 0.01). Male individuals were less susceptible to SCRC (OR = 0.55, 95%CI: 0.35-0.85, P < 0.01). The CYP2E1*5B polymorphism was associated with SCRC in the codominant (heterozygous genotype: OR = 2.66, 95%CI: 1.64-4.32, P < 0.01), dominant (OR = 2.82, 95%CI: 1.74-4.55, P < 0.01), overdominant (OR = 2.58, 95%CI: 1.59-4.19, P < 0.01), and log-additive models (OR = 2.84, 95%CI: 1.78-4.52, P < 0.01). The CYP2E1*6 polymorphism was associated with an increased SCRC risk in codominant (heterozygous genotype: OR = 2.81, 95%CI: 1.84-4.28, P < 0.01; homozygous polymorphic: OR = 7.32, 95%CI: 1.85-28.96, P < 0.01), dominant (OR = 2.97, 95%CI: 1.97-4.50, P < 0.01), recessive (OR = 5.26, 95%CI: 1.35-20.50, P = 0.016), overdominant (OR = 2.64, 95%CI: 1.74-4.01, P < 0.01), and log-additive models (OR = 2.78, 95%CI: 1.91-4.06, P < 0.01). The haplotype formed by the minor alleles of the CYP2E1*5B (C) and CYP2E1*6 (A) polymorphisms was associated with SCRC ( P = 0.002). However, the CYP1A1 *2A, CYP1A1 *2C, EPHX1 Tyr113His and EPHX1 His139Arg polymorphisms were not associated with SCRC., Conclusion: In conclusion, the results demonstrated that CYP2E1*5B and CYP2E1*6 minor alleles play a role in the development of SCRC., Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest.

Aim: To evaluate the effect of promoter region polymorphisms of toll-like receptor (TLR)2-196 to -174del and TLR4-1607T/C (rs10759932) on mRNA and protein expression in tumor tissue and of TLR4+896A/G (rs4986790) on colorectal cancer (CRC) risk., Methods: The TLR2-196 to -174del polymorphism was investigated using allele-specific polymerase chain reaction (PCR) and the TLR4-1607T/C and TLR4+896A/G by PCR-restriction fragment length polymorphism (RFLP). We genotyped 434 DNA samples from 194 CRC patients and 240 healthy individuals. The mRNA relative quantification (RQ) was performed in 40 tumor tissue samples by quantitative PCR TaqMan assay, using specific probes for TLR2 and TLR4 genes, and ACTB and GAPDH reference genes were used as endogenous controls. Protein expression was analyzed by immunohistochemistry with specific primary antibodies., Results: No association was found for TLR4-1607T/C and TLR4+896A/G by three statistical models (log-additive, dominant and recessive). However, based on dominant and log-additive models, the polymorphic variant TLR2-196 to -174del was associated with increased CRC risk [dominant: odds ratio (OR) = 1.72, 95%CI: 1.03-2.89; P = 0.038 and log-additive: OR =1.59, 95%CI: 1.02-2.48; P = 0.039]. TLR2 mRNA expression was increased in tumor tissue (RQ = 2.36) when compared to adjacent normal tissue (RQ = 1; P < 0.0001), whereas the TLR4 mRNA showed a basal expression (RQ = 0.74 vs RQ = 1, P = 0.452). Immunohistochemistry analysis of TLR2 and TLR4 protein expression was concordant with the findings of mRNA expression. In addition, the TLR2-196 to -174del variant carriers showed mRNA relative expression 2.19 times higher than wild-genotype carriers. The TLR2 protein expression was also higher for the TLR2-196 to -174del variant carriers [117 ± 10 arbitrary unit (a.u.) vs 95 ± 4 a.u., P = 0.03]. However, for the TLR4 -1607T/C polymorphism no significant difference was found for both mRNA (P = 0.56) and protein expression (P = 0.26)., Conclusion: Our findings suggest that TLR2-196 to -174del polymorphism increases TLR2 mRNA expression and is associated with higher CRC risk, indicating an important role in CRC genetic susceptibility.

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumonia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.

Background: The Work Ability Model has a holistic structure that incorporates individual characteristics, work-related factors and life outside of work. The model has been explored in the context of Finland but still needs to be applied in other countries., Objective: The aim of this study was to examine the relationships between age, health, work and work ability in a sample of Brazilian municipal employees., Method: A sample of 5,646 workers answered a web-survey questionnaire that collected information about socio-demographics, health, work characteristics and work ability. Structural equation modeling (SEM) was used to examine the simultaneous relationships between the variables that comprise the Work Ability Model., Results: The sample was predominantly female (68.0%), between 30 and 49 years old (60.0%) and highly educated (66.0%). SEM produced good fit indexes that supported the Work Ability Model. Age was positively related to work ability and negatively related to health. Health and work characteristics positively influenced work ability., Conclusions: The results produced additional support for the conceptualization of work ability as a complex and dynamic phenomenon: a system composed of an individual and various elements of his/her work interact in time and space in a nonlinear way.

Objective: To examine the factors associated with acute kidney injury and outcome in patients with lung disease., Methods: A prospective study was conducted with 100 consecutive patients admitted to a respiratory intensive care unit in Fortaleza (CE), Brazil. The risk factors for acute kidney injury and mortality were investigated in a group of patients with lung diseases., Results: The mean age of the study population was 57 years, and 50% were male. The incidence of acute kidney injury was higher in patients with PaO2/FiO2<200 mmHg (54% versus 23.7%; p=0.02). Death was observed in 40 cases and the rate of mortality of the acute kidney injury group was higher (62.8% versus 27.6%; p=0.01). The independent factor that was found to be associated with acute kidney injury was PaO2/FiO2<200 mmHg (p=0.01), and the independent risk factors for death were PEEP at admission (OR: 3.6; 95%CI: 1.3-9.6; p=0.009) and need for hemodialysis (OR: 7.9; 95%CI: 2.2-28.3; p=0.001)., Conclusion: There was a higher mortality rate in the acute kidney injury group. Increased mortality was associated with mechanical ventilation, high PEEP, urea and need for dialysis. Further studies must be performed to better establish the relationship between kidney and lung injury and its impact on patient outcome.

TP53 genes is one of more important tumor suppressor gene, which acts as a potent transcription factor with fundamental role in the maintenance of genetic stability. The development of esophageal and gastric cancers is a multistep process resulting in successive accumulation of genetic alterations that culminates in the malignant transformation. Thus, this study highlights the participation of the main genetic alterations of the TP53 gene in esophageal and gastric carcinogenesis. Among these changes, high frequency of TP53 mutations, loss of heterozygosity (LOH), overexpression of the p53 protein, and consequently loss of p53 function, which would be early events in esophageal and gastric cancers, as well as an important biomarker of the prognosis and treatment response. Furthermore, Single Nucleotide Polymorphisms (SNPs) of TP53 have been implicated in the development and prognosis of several cancers, mainly TP53 codon 72 polymorphism whose role has been extensively studied in relation to susceptibility for esophageal and gastric cancer development.

Objective: To evaluate the association between degree of asthma control and health-related quality of life in patients with moderate or severe asthma., Methods: This was a descriptive observational study involving 59 outpatients with moderate or severe asthma under treatment at the Asthma Outpatient Clinic of the Federal University of Ceará Walter Cantídio University Hospital, in the city of Fortaleza, Brazil. The patients were evaluated regarding sociodemographic and clinical characteristics, as well as spirometric parameters. The asthma control status was assessed using the asthma control test (ACT), and quality of life was assessed using the Saint George's Respiratory Questionnaire (SGRQ)., Results: The mean age of the patients was 55.0 ± 12.4 years, and 76.3% were female. The ACT score showed statistically significant negative correlations with all SGRQ scores: total (r = -0.72); symptoms (r = -0.78); activity (r = -0.67); and impact (r = -0.68). Multiple regression analysis showed that the most robust predictive variables for SGRQ total score were ACT score (coefficient = -3.18; 95% CI: -4.14 to -2.23) and duration of disease (coefficient = -0.29; 95% CI: -0.54 to -0.03). The ACT score also explained the linear variation of the SGRQ domains: symptoms (coefficient = -3.41; 95% CI: -4.45 to -2.37); activity (coefficient = -3.07; 95% CI: -4.57 to -1.57); and impact (coefficient = -2.68; 95% CI: -3.71 to -1.65)., Conclusions: The degree of asthma control appears to have a significant impact on health-related quality of life.

The objective of this study was to identify the profile of workers receiving temporary or permanent benefit for Work-Related Musculoskeletal Disorders (WMSD) at the Social Welfare Office in Diamantina between 2002 and 2005, and to compare the prevalence among this population. The sample was obtained through analysis of the database containing socio-demographic and clinical variables, and the profile was similar over the years. The most prevalent characteristics were among workers resident in Diamantina, between 40 and 59 years of age of elementary educational level and without difference in gender. The majority were employed in the service sector, with income below US$200 per month. The benefit granted most frequently was social welfare due to illness, the most common diagnosis being back pain with duration of benefit of 10 months. An increase in the incidence of WMSD was observed leading to a marked rise in social welfare retirement due to disability over the years. This study made it possible to establish the profile of workers retired due to WMSD in Diamantina. This tendency of growth in retirement indices reflects the world tendency. The need to implement prevention, promotion and rehabilitation policies for the health of this population arises as a clear priority from this study.

Chronic pain contributes towards less diversified participation centred on household activities, fewer social relationships and smaller number of recreational activities. The aim of the study was to further investigate the effects of chronic pain on participation, focusing on how workers deal with the experienced restrictions. Ten workers with chronic pain participated in the survey, which was conducted with qualitative interviews. Analyses of thematic units revealed that chronic pain has consequences for participation, leading to work restrictions and loss of social roles. Social relationships tend to be limited to family, and workers become isolated from other social groups. The rebuilding of participants' lives was a counterpoint to the identified social rupture. The narratives revealed strategies for dealing with pain, attempts at reorganizing their daily activities and formulating new plans. Understanding what resources individuals use to cope with their difficulties allow occupational therapists to plan client-centred treatment goals. A limitation of the study was to involve employees of very similar socio-economic classes. Studies directed to understanding the relationship between social support and the reconstruction of participation must be conducted to further advance knowledge on possible mechanisms underlying social participation among workers with chronic pain., (Copyright © 2010 John Wiley & Sons, Ltd.)

Background: Aging compromises the ability of the central nervous system to maintain body balance and reduces the capacity for adaptive reactions. To prevent falls, the reception conditions for sensory information need to be improved., Objectives: To evaluate the impact of a structured aquatic and a non-aquatic exercise program for lower-limb muscle endurance on the static and dynamic balance of elderly people., Methods: This was a prospective randomized clinical study in which the variables were assessed before and after the training program. Thirty-six elderly people were evaluated using four tests: the Berg Balance Scale, Dynamic Gait Index, gait speed and tandem gait. The participants were randomized into three groups: aquatic exercise group, non-aquatic exercise group and control group. The exercise groups underwent a program for lower-limb muscle endurance that consisted of 40-minute sessions twice a week for six weeks. The participants were reevaluated after six weeks. The data were analyzed statistically using the univariate ANOVA test for comparisons between the groups before and after the intervention., Results: The program for lower-limb muscle endurance significantly increased balance (p<0.05) in the evaluation tests after the training program., Conclusion: The muscle endurance program provided a significant improvement in static and dynamic balance among community-dwelling elderly people. It was also possible to infer that this improvement occurred regardless of the environment, i.e. aquatic or non-aquatic. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number ACTRN 12609000780257.

The aim of this study was to conduct a histological assessment of the effect of photodynamic therapy (PDT) on the repairing of third-degree-burn wounds made on the backs of rats with a heated scalpel. Ninety-six rats were divided into groups: G1, control (n = 24), cold scalpel; G2, burned, heated scalpel (n = 24); G3, low-level laser therapy (LLLT) (n = 24), on burns; and G4, photodynamic therapy (PDT) (n = 24), toluidine-O blue (100 microg/ml) and LLLT treatment on burns. The laser (685 nm) was applied in continuous mode, 50 mW, 4.5 J/cm(2), contact mode at nine points (9 s/point). Eight animals in each group were killed at 3 days, 7 days or 14 days after surgery, and tissue specimens containing the whole wounded area were removed and processed for histological analysis; the results were statistically analyzed with Kruskal-Wallis and Dunn's tests (P < 0.05). The results demonstrated significant differences between G2 and G3, and between G2 and G4, at both 3 days and 7 days, with regard to acute inflammation scores; G1 and G2 showed significant differences when compared with G4 at 3 days, with regard to neo-angiogenesis scores; G1 and G2 were statistically different from G3 and G4 at both 3 days and 7 days, with regard to re-epithelization scores; G2 showed statistically significant differences when compared with G3 and G4 with regard to collagen fiber scores at 7 days. LLLT and PDT acted as a biostimulating coadjuvant agent, balancing the undesirable effect of the burn on the wound healing process, acting mainly in the early healing stages, hastening inflammation and increasing collagen deposition.

Community-acquired pneumonia continues to be the acute infectious disease that has the greatest medical and social impact regarding morbidity and treatment costs. Children and the elderly are more susceptible to severe complications, thereby justifying the fact that the prevention measures adopted have focused on these age brackets. Despite the advances in the knowledge of etiology and physiopathology, as well as the improvement in preliminary clinical and therapeutic methods, various questions merit further investigation. This is due to the clinical, social, demographical and structural diversity, which cannot be fully predicted. Consequently, guidelines are published in order to compile the most recent knowledge in a systematic way and to promote the rational use of that knowledge in medical practice. Therefore, guidelines are not a rigid set of rules that must be followed, but first and foremost a tool to be used in a critical way, bearing in mind the variability of biological and human responses within their individual and social contexts. This document represents the conclusion of a detailed discussion among the members of the Scientific Board and Respiratory Infection Committee of the Brazilian Thoracic Association. The objective of the work group was to present relevant topics in order to update the previous guidelines. We attempted to avoid the repetition of consensual concepts. The principal objective of creating this document was to present a compilation of the recent advances published in the literature and, consequently, to contribute to improving the quality of the medical care provided to immunocompetent adult patients with community-acquired pneumonia.

Pulmonary alveolar microlithiasis (PAM) is a rare disease that affects both lungs. It is characterized by the presence of small calculi (calcium phosphate) within the alveolar spaces. We report the case of a 26-year-old female whose diagnosis was based on characteristic findings on chest X-rays and high-resolution computed tomography scans. The patient, 28 weeks pregnant, was rehospitalized 10 months after the diagnosis, presenting hypoxemic acute respiratory failure and severe restrictive ventilatory defect on spirometry. After 32 completed weeks of gestation (228 days), she was submitted to cesarean section, and the outcome was successful for mother and newborn. PAM has a variable clinical course. It is suggestive of an autosomal recessive inheritance pattern and has been associated with positive family history. The etiology of PAM is unclear, and many authors speculate that there is a local enzymatic defect responsible for the intra-alveolar accumulation of calcium. Reports of patients with PAM who become pregnant are exceptional, and this is the first case described in Brazil. The course of this disease is usually slow and progressive, and patients typically die of cardiorespiratory failure. The present case illustrates the need to offer female patients, especially those with advanced disease, genetic counseling and orientation regarding the risks of pregnancy. Currently, the only effective therapy is lung transplantation.