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Emerging research into the human microbiome, an intricate ecosystem of microorganisms residing in and on our bodies, reveals that it plays a pivotal role in maintaining our health, highlighting the potential for microbiome-based interventions to prevent, diagnose, treat, and manage a myriad of diseases. The objective of this review is to highlight the importance of microbiome studies in enhancing our understanding of rare genetic epilepsy and related neurological disorders. Studies suggest that the gut microbiome, acting through the gut-brain axis, impacts the development and severity of epileptic conditions in children. Disruptions in microbial composition can affect neurotransmitter systems, inflammatory responses, and immune regulation, which are all critical factors in the pathogenesis of epilepsy. This growing body of evidence points to the potential of microbiome-targeted therapies, such as probiotics or dietary modifications, as innovative approaches to managing epilepsy. By harnessing the power of the microbiome, we stand to develop more effective and personalized treatment strategies for children affected by this disease and other rare neurological diseases.

Objective: To describe the development and quality analysis stages of a mobile health application for the treatment of urinary incontinence in men after radical prostatectomy., Method: A technological development study. Eight clinical experts and eight software development experts participated in quality assessment. Six characteristics and 22 subcharacteristics were assessed using an online form. Agreement rates above 70% were considered satisfactory., Results: The percentages of agreement of characteristics by clinical experts and developers were performance efficiency (90.5%), compatibility (100%) (both assessed only by the developers), functional suitability (78.5; 100%), usability (74.2; 82.7%), reliability (95.0; 82.3%) and security (87.6; 91.4%). Accessibility, user error protection, maturity and recoverability subcharacteristics showed agreement below 70%, which guided researchers to incorporate software improvements., Conclusion: The application presented satisfactory technical quality, configuring digital technological innovation that favors nursing care for men with urinary incontinence after radical prostatectomy.

Background: Children can learn efficiently with well-designed serious games. The use of applications to promote health has proliferated, but there is a lack of scientific studies on educational games in oral health. Materials and Methods: We developed the Brazilian version of a British and Jordanian oral health education game for children from the perspectives of Brazilian specialists and users. This descriptive study, with a qualitative and quantitative approach, comprised three phases: I-Experts' discussion of the appropriateness of the previous version of the game to Brazil; II-Development of the first Brazilian version of the game; and III-Evaluation of the first version with 15 children from 4 to 8 years of age. Results: In Phase I, the specialists agreed with the development of the Brazilian version of the game, with minor adjustments on: advice on eating; advice on oral hygiene habits, users' age group, game characters, and game purpose. Phase II: a version with a few changes in images and recommendations, written and spoken in Brazilian Portuguese. Phase III: The global average of correct answers in the game's tasks was 75.3%, ranging from 50.0% to 100%. Children reported having fun with the game, and most understood the content and its interface; their parents found the information relevant and enjoyed the gameplay with their children. Conclusions: The Oral Health Education Game offered basic information for preventing dental caries to Brazilian children aged 4-8 years old in an interactive and fun way; it could support professionals in improving oral health education.

The effects of β-mannanase supplementation in metabolizable energy (ME)-reduced diets containing xylanase-phytase were investigated on growth performance, fecal score, ultra-sounded backfat thickness and loin depth, blood profile, apparent total tract digestibility (ATTD), digesta passage rate, and fecal microbiome in grower pigs (n = 40, 26.09 ± 0.96 kg) randomly assigned within 4 treatments: a control diet containing isolated phytase and xylanase valued at 40 kcal of ME/kg (CD0), CD0 + β-mannanase (0.3 g/kg valued at 30 kcal of ME/kg) (CD70), CD0 + β-mannanase (0.3 g/kg valued at 45 kcal of ME/kg) (CD85), and CD0 + β-mannanase (0.3 g/kg valued at 60 kcal of ME/kg) (CD100). Growth performance was not affected in pigs fed ME-reduced diets containing β-mannanase. Pigs with CD100 had lower serum IL-1β concentration, and higher IL-10 was observed in pigs on CD0 than those fed β-mannanase. Coefficients of ATTD, and ATTD of DM and CP were higher in animals fed CD85 or CD100. Pigs with CD85 had higher alpha diversity richness but lower Firmicutes:Bacteroidota ratio. Acidaminococcaceae and Ruminococcaceae were more abundant in pigs fed CD0, but lower for Christensenellaceae NSJ-63 and NSJ-63 sp014384805. Pigs in CD85 showed higher Bacteroidaceae and Prevotella abundance, and lower for Streptococcaceae and Streptococcus. In conclusion, supplementation of β-mannanase in diets containing xylanase-phytase saved 85 to 100 kcal of ME/kg by supporting growth performance and improving nutrient digestibility in grower pigs., (© 2023. The Author(s).)

Background: Homeopathic products (HP) have been proposed for the prevention of disease and as a complementary dietary additive in pig farming, with resulting improved performance and quality of life of the animals and with benefits for food safety. The aim of this study was to assess the addition of HP to pig feed and its effects on growth performance, dietary protein utilization, nutrient digestibility, meat quality, and economic feasibility., Methods: A total of 80 male pigs, body weight 32.8±2.3kg, were allocated in a randomized design, with two treatments of 10 replications and four animals per experimental unit. Treatments were composed of a control diet (CD) or CD+HP (Finalvitaplus+Figotonus, 1.1kg/ton feed of each product). The outcome measures used were growth performance (body weight gain) and feed efficiency (body weight gain per unit of feed consumed), efficiency of dietary protein utilization (blood urea nitrogen), nutrient digestibility (apparent digestibility coefficient and apparent nutrient digestibility), meat quality (including pH, temperature, color, liquid loss by cooking and thawing, intramuscular fat and meat tenderness), and economic feasibility (cost of the diets)., Results: There was no effect ( p >0.05) of treatments on growth performance of the pigs, though the group that received HP showed an 8.93% greater feed efficiency than the control group ( p =0.077). The animals in the control group had a 14.37% higher blood urea nitrogen concentration in the finishing I phase (70-100kg body weight) compared with those fed HP ( p =0.028), indicating lower protein utilization in the controls. There was comparative improvement in digestibility coefficient and in nutrient digestibility in pigs fed HP in the growing-finishing phase ( p <0.05). There was no differential effect of treatments on meat quality or economic feasibility ( p >0.05)., Conclusion: The addition of HP to the diet of growing-finishing pigs produced some improvement in their dietary protein utilization, nutrient digestibility and feed efficiency, though it did not affect their growth performance, meat quality or economic feasibility., Competing Interests: None declared., (Faculty of Homeopathy. This article is published by Thieme.)

This study aimed to assess the effects of β-mannanase supplementation in metabolizable energy (ME)-reduced diets containing xylanase-phytase on performance, fecal score, blood biochemical and immunological profile, apparent total tract digestibility (ATTD), digesta passage rate, fecal microbiome, carcass traits and meat quality in finisher pigs ( n = 40 entire male hybrid, 26.0 ± 0.9 kg) randomly assigned to 1 of 4 dietary treatments: a control diet containing isolated phytase and xylanase valued at 40 kcal of ME/kg (CD0), CD0 + β-mannanase (0.3 g/kg valued at 30 kcal of ME/kg) (CD70), CD0 + β-mannanase (0.3 g/kg valued at 45 kcal of ME/kg) (CD85), and CD0 + β-mannanase (0.3 g/kg valued at 60 kcal of ME/kg) (CD100), with 10 pen replicates. Pigs fed CD0 diet showed ( P = 0.002) greater ADFI. However, pigs fed CD0 diet showed ( P = 0.009) lower G:F than those provided CD70 or CD85 diets. A greater ( P < 0.001) superoxide dismutase concentration was observed in pigs fed CD70 diet. Pigs fed CD85 diet showed ( P = 0.002) greater digestible protein than pigs fed CD0 or CD100 diets. Pigs fed CD70 diet showed an increase of 11.3% in digestible protein than those fed CD0 diet. In addition, greater ( P < 0.001) digestible energy was observed in pigs fed CD85 diet. Pigs fed CD0 or CD100 diets showed greater ( P < 0.05) Firmicutes:Bacteroidota ratio than those fed CD85 diet. The Muribaculaceae was more abundant ( P = 0.030) in pigs fed CD70 diet than in those fed CD0 diet. The Prevotella was more abundant ( P = 0.045) in pigs fed CD85 diet than in those fed CD100 diet. In conclusion, β-mannanase supplementation in diets containing xylanase-phytase allows reducing 85 kcal of ME/kg because it improves gain to feed ratio, energy and protein usage, and backfat thickness without metabolic and intestinal ecosystem disorders in finisher pigs., Competing Interests: MK was employed by Elanco Animal Health Incorporated Company. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Genova, Rupolo, Azevedo, Henz, Carvalho, Kipper, Gonçalves, Vilela, Pasquetti, Oliveira, Dietrich and Carvalho.)

The quality of poultry by-product meal (PBM) is not standardized in the industry. Several factors are detrimental to PBM and compromise its nutritional value and shelf life. Therefore, this study was conducted to determine the main PBM production factors that directly affect its in vitro organic matter digestibility (IVDOM) and protein oxidation (POX). Data on the processing of PBM samples (n = 100) were recorded in a rendering plant. Two types of PBM were used: 1) Low ash (LA, n = 66) with mineral matter (MM) content of 11% and 2) High ash (HA, n = 34) with MM above 11%. Processing traits and chemical composition of PBM were considered independent variables. The IVDOM and POX were determined in each sample and considered dependent variables. Data on independent variables were submitted to factorial and principal components (PC) analyses. In vitro organic matter digestibility data were clustered (P = 0.001) in low (778.92 g/kg), average (822.85 g/kg), and high (890.06 g/kg). The best arrangement was composed of six independent variables distributed in two PC, which explained 82.10% of the total variation. The ash concentration, oil to raw material ratio, collagen, and crude protein comprised PC1 with greater relevance and explained 58.46% of the total variance. The PC2 was composed of the processing time and temperature and explained 23.64% of the total variance. Protein oxidation data were clustered (P < 0.001) in low (265.19 nmol/mg CP), average (393.07 nmol/mg CP), and high (524.40 nmol/mg CP). Based on our results, the composition of the raw material from the slaughterhouse holds most of the information on PBM composition and digestibility. Developing improvements in the slaughtering or in the screening of the raw material that will be used by the rendering process is important to obtain a more nutritionally standardized ingredient., Competing Interests: DISCLOSURES None of the authors of this paper have a financial or personal relationship with other people or organizations that could inappropriately influence or bias the content of the paper. All authors declare that they have no competing interests. All data generated or analyzed during this study are available from the corresponding author upon reasonable request., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This study was to assess the effects of different doses of an essential oil blend (EOB) on growth performance, diarrhea occurrence (DO), hematological and blood biochemical profile, intestinal morphometry, morphology and microbiology, relative weight and length of organs, digestive content pH, and liver antioxidant status in weaning piglets., Methods: A total of 135 barrows (7.09±0.29 kg body weight) were allotted randomly in a randomized complete block design based on body weight with nine replications and three animals per pen. Dietary treatments were a negative control (NC): basal diet; positive control (PC): NC plus 125 mg performance-enhancing antibiotic (enramycin 8%)/kg diet; NC plus 100 mg EOB/kg diet (EO100); NC plus 200 mg EOB/kg diet (EO200); and NC plus 400 mg EOB/kg diet (EO400). Diarrhea occurrence was monitored daily, and performance at the end of each phase., Results: Gain to feed ratio was greater (p<0.05) in starter II pigs fed EO400 and EO200 than in those fed EO100. Pigs fed EO400 had lower (p<0.05) DO than those fed NC and EO100 in the total period. Pre-starter II pigs fed NC had (p<0.05) lower serum total protein and plasma protein than pigs fed PC. Pigs fed EO100 showed smaller (p<0.05) mean corpuscular volume (MCV) than pigs fed EO400. Starter II pigs fed EO400 had (p<0.05) greater MCV and lower mean corpuscular hemoglobin and erythrocytes than those fed EO100. There was a greater concentration (p<0.05) of band cells for PC, similar to EO400 and EO200. Performance-enhancing antibiotic and EOB to diets increased (p<0.05) liver superoxide dismutase activity., Conclusion: Adding 200 and 400 mg EOB/kg diet decreased DO and was advantageous to hematological and blood biochemical profile and liver antioxidant status without being detrimental to growth performance and gastrointestinal health in nursery pigs.

The COVID-19 pandemic has triggered the first widespread vaccination campaign against a coronavirus. Many vaccinated subjects are previously naive to SARS-CoV-2; however, almost all have previously encountered other coronaviruses (CoVs), and the role of this immunity in shaping the vaccine response remains uncharacterized. Here, we use longitudinal samples and highly multiplexed serology to identify mRNA-1273 vaccine-induced antibody responses against a range of CoV Spike epitopes, in both phylogenetically conserved and non-conserved regions. Whereas reactivity to SARS-CoV-2 epitopes shows a delayed but progressive increase following vaccination, we observe distinct kinetics for the endemic CoV homologs at conserved sites in Spike S2: these become detectable sooner and decay at later time points. Using homolog-specific antibody depletion and alanine-substitution experiments, we show that these distinct trajectories reflect an evolving cross-reactive response that can distinguish rare, polymorphic residues within these epitopes. Our results reveal mechanisms for the formation of antibodies with broad reactivity against CoVs., Competing Interests: Declaration of interests The authors declare that they have no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

The study aimed to measure variations in industrial process and nutritional variables of poultry by-product meal (PBM) in rendering plants from batch cookers. A total of 200 samples of low ash PBM with mineral matter (MM) content of 11% (LA, n = 104) or high ash with MM above 11% (HA, n = 96) were collected from 5 industrial processing plants. The highest coefficients of variation in chemical composition were for MM (LA - 19.70%; HA - 19.59%), ether extract (LA - 20.72%; HA - 14.86%), collagen (LA - 21.16%; HA - 30.00%) and water activity (LA - 24.54%; HA - 25.89%). However, the crude protein (LA - 5.07%; HA - 7.39%), dry matter (LA - 1.75%; HA - 2.90%) and organic matter digestibility (LA - 4.81%; HA - 6.78%) were lower. The variability of the data related to the process of PBM was: maximum process temperature (LA - 3.91%; HA - 3.56%), average process temperature (LA - 3.73%; HA - 4.71%), and processing time (LA - 27.37%; HA - 37.59%). This study evidenced that the corrective measures by limiting the amount of bones in the raw material, optimizing the pressing step for the poultry fat extraction, and also controlling the processing time of PBM may favor the production of more standardized PBM in terms of chemical composition and quality., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Hepatorenal syndrome (HRS) occurs in patients with cirrhosis or fulminant hepatic failure and is a kind of pre-renal failure due to intense reduction of kidney perfusion induced by severe hepatic injury. While other causes of pre-renal acute kidney injury (AKI) respond to fluid infusion, HRS does not. HRS incidence is 5% in children with chronic liver conditions before liver transplantation. Type 1 HRS is an acute and rapidly progressive form that often develops after a precipitating factor, including gastrointestinal bleeding or spontaneous bacterial peritonitis, while type 2 is considered a slowly progressive form of kidney failure that often occurs spontaneously in chronic ascites settings. HRS pathogenesis is multifactorial. Cirrhosis causes portal hypertension; therefore, stasis and release of vasodilator substances occur in the hepatic vascular bed, leading to vasodilatation of splanchnic arteries and systemic hypotension. Many mechanisms seem to work together to cause this imbalance: splanchnic vasodilatation; vasoactive mediators; hyperdynamic circulation states and subsequent cardiac dysfunction; neuro-hormonal mechanisms; changes in sympathetic nervous system, renin-angiotensin system, and vasopressin. In patients with AKI and cirrhosis, fluid expansion therapy needs to be initiated as soon as possible and nephrotoxic drugs discontinued. Once HRS is diagnosed, pharmacological treatment with vasoconstrictors, mainly terlipressin plus albumin, should be initiated. If there is no response, other options can include surgical venous shunts and kidney replacement therapy. In this regard, extracorporeal liver support can be a bridge for liver transplantation, which remains as the ideal treatment. Further studies are necessary to investigate early biomarkers and alternative treatments for HRS.

Background: It becomes increasingly evident that the SARS-CoV-2 infection is not limited to the respiratory system. In addition to being a target of the virus, the kidney also seems to have a substantial influence on the outcomes of the disease., Methods: Data was obtained by a comprehensive and non-systematic search in the PubMed, Cochrane, Scopus and SciELO databases, using mainly the terms "SARS-CoV-2", "COVID-19", "chronic kidney disease", "renal transplantation", acute kidney injury" and "renal dysfunction" Discussion: The membrane-bound angiotensin-converting enzyme 2 is the receptor for SARS-CoV- -2, and this interaction may lead to an imbalance of the Renin-Angiotensin System (RAS), associated with worse clinical presentations of COVID-19, including acute pulmonary injury, hyperinflammatory state and hematological alterations. In the framework of renal diseases, the development of acute kidney injury is associated mostly with immune alterations and direct cytopathic lesions by the virus, leading to higher mortality. As for chronic kidney disease, the patients at a non-terminal stage have a worse prognosis, while the hemodialysis patients appear to have mild courses of COVID-19, probably due to lower chances of being affected by the cytokine storm. Furthermore, the current scenario is unfavorable to kidney donation and transplantation. The relationship between COVID-19 and immunosuppression in kidney transplantation recipients has been greatly discussed to determine whether it increases mortality and how it interacts with immunosuppressive medications., Conclusion: The kidney and the RAS exert fundamental roles in the SARS-CoV-2 infection, and more research is required to have a complete understanding of the repercussions caused by COVID-19 in renal diseases., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change., Objective: Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy., Methods: This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation., Results: Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot., Conclusion: There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The ability of erythrocytes, infected by Plasmodium falciparum, to adhere to endothelial cells (cytoadherence) and to capture uninfected erythrocyte (rosetting) is the leading cause of death by severe malaria. Evidences link the binding of the adhesin Duffy Binding Like1-α (DBL1α) domain to the ABH histo-blood antigens with formation of rosettes. Inspired by this very close relationship between the disease susceptibility and individual blood type, here we investigate the structural requirements involved in the interaction of DBL1α with A, B and H histo-blood determinants and their subtypes. Our results evidence the high preference of DBL1α to A epitopes, in comparison to B and H epitopes. DBL1α interacts with ABH epitopes in subtype specific manner, presenting a remarkable affinity for type 2 structures, Fucα1-2Galβ1-4GlcNAcβ1, particularly the A2 epitope. The contacts made by DBL1α binding pocket and the ABH histo-blood groups were mapped by theoretical methods and supported by NMR experiments., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Healthcare workforce shortage can be compensated by using information and communication technologies. Remote patient monitoring systems allow us to identify and communicate complications and anomalies. Integrating social networking services into remote patient monitoring systems enables users to manage their relationships. User defined relationships may be used to disseminate healthcare related notifications. Hence this integration leads to quicker interventions and may reduce hospital readmission rate. As a proof of concept, a module was integrated to a remote patient monitoring platform. A mobile application to manage relationships and receive notifications was also developed.

The objective of this study was to determine the impact of including licuri cake in the diet of Santa Inês crossbred finishing lambs by examining their liver metabolic and histopathological profile. Forty-four uncastrated lambs with an average age of 6 months and an average weight of 21.2 kg ± 2.7 kg. The animals were fed diets with 40 % Tifton 85 hay and 60 % of a mixture consisting of corn and soybean meal, 1 % urea, a mineral-vitamin premix, and an inclusion of licuri cake at a level of 0, 8, 16, and 24 % of the dietary dry matter (DM), which composed the treatments. The experimental design was completely randomized, and the data were analyzed by variance and regression analyses. The animals were confined in individual stalls for 70 days. Blood was collected on the last day of the experimental period, and metabolite, protein, energy, and enzyme profiles of the liver were determined for these samples. Histopathological evaluations of the liver parenchyma were also undertaken. The increase in the level of the licuri cake in the diet caused a linear increase (P < 0.05) in the serum urea content. The protein metabolism was not affected by the licuri cake inclusion levels in the diet. Regarding energy metabolism, a linear increase (P < 0.01) was observed in the serum triglyceride concentrations, but there were no effects on serum cholesterol levels. Regarding the functioning of the liver and muscle, the inclusion of the licuri cake had no effect on the enzymatic activities, except on gamma-glutamyltransferase, which decreased linearly (P < 0.05). The values found for the evaluated parameters varied within a range considered normal for this species. In the postmortem examination at slaughter, no macroscopic alterations in the liver were observed. Histopathological analysis revealed the presence of discrete and nonspecific alterations common to all treatments, suggesting no effect of the level of inclusion of the licuri cake. The use of the licuri cake in composing up to 24 % of the diet did not cause metabolic or liver disorders in the lambs.

Objective: to classify body language used in nursing care, and propose "Body language in nursing care" as an analytical category for nursing communication., Method: quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions., Results: sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches., Conclusion: nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classified body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.

This study aimed to evaluate sunflower cake feed in commercial cut yields and chemical and sensory attributes of goat meat. Thirty-two castrated male goats were distributed in four levels (0, 8, 16 and 24%) of sunflower cake supplementation. The animals were slaughtered and the carcasses were placed in a cold chamber and sectioned into five anatomical regions corresponding to commercial cuts. Samples of the Longissimus lumborum muscle were analyzed for chemical composition and sensory quality. The chemical composition and pH were not affected by the treatments. The smell, taste and 'goatiness' of the aroma and flavor of the meat were also unaffected by the treatments. The appearance, tenderness and juiciness of the meat differed by treatment. The highest level (24%) of sunflower cake increased meat tenderness; however, according to the tasters there was reduced softness, although none of the samples were rejected by the tasters. Sunflower cake can be added to the diet at a level of up to 16% without altering the quantitative and qualitative attributes of the meat., (© 2014 Japanese Society of Animal Science.)

This study identifies some undergraduate nursing students' imaginary manifestations concerning themselves and care delivered to patients with orthopedic and/or trauma disorders. The Social Poetics method was used and the research group was composed of 15 undergraduate students. Only the categories and subcategories exclusively related to the "student" are presented in this paper. Data revealed that care provided by orthopedic nursing students is the result of a care relationship that emerges from their sensitivity toward patients and their own knowledge, skills and attitudes. The orthopedic treatment, equipment and procedures, to which patients are submitted, cause important emotional distress for students, empathic behavior and encourage them to search for ways to minimize their patients' pain. All the aspects that permeate care provided by orthopedic nursing students should be identified in order to enable reassessment of the teaching-learning process.

This study aimed to evaluate the prevalence and factors associated with oral mucosa alterations in patients from Vale do Jequiti-nhonha, Brazil. The sample consisted of 511 patients of both genders. Questionnaires were used to obtain information about patient gender, age, race, systemic disease state, medication use, cigarette use and alcohol consumption. Physical examinations were then performed to identify lesions of the oral mucosa. Descriptive analyses, Chi-squared tests and logistic regressions were then used to analyze the results (p < 0.05, 95% CI). In this population, 84.9% (434/511) of patients were found to have alterations in their oral mucosa. The most common alterations were melanotic maculae (36.0%), linea alba (33.9%), traumatic ulcers (21.5%), Fordyce's granules (20.4%), coated tongue (12.5%) and fissured tongue (10.0%). Melanotic maculae were more frequently observed in black patients, with an odds ration (OR) of 7.51. Being female was a statistically significant predictive factor for having a visible linea alba (OR: 1.90) and a fissured tongue (OR: 2.11). No statistically significant association was found between the presence of oral lesions and systemic disease, medication use, alcohol use and smoking. The high observed prevalence of melanotic maculae and Fordyce's granules suggests that these alterations could be considered typical characteristics of the population of the Vale do Jequitinhonha. Coated tongue may be related to the socioeconomic deprivation in the region. Furthermore, the high prevalence of traumatic ulcers may be associated with the traumatic agents that caused patients to seek dental care.

More than being a sense, vision is a powerful instrument that identifies and selects, hence everything depends on what one has seen before to determine how to interpret what is currently being seen. The objective of this article is to discuss the role that vision plays as an instrument for holistic and quality nursing care. This is a qualitative, exploratory study, using the Sociopoetic method. The data was categorized as follows: (1)Vision as an instrument and (2)Outer body changes. In trauma and orthopedics, nurses should be able to provide patients with care in complex conditions and in an environment which changes fast. Results show that vision is a powerful health care instrument in trauma and orthopedic nursing, promoting professional practice that is truly appropriate to the patients' needs.

Unlabelled: Breast tumors exhibit extensive molecular and clinical heterogeneity. One of the most utilized breast carcinoma classifications is based on its molecular aspects and subdivides breast cancer into five major groups based on the expression of certain genes. In this study, we evaluated which factors are important in determining a prognosis after 5 years of follow-up for patients with clinical stage IIA breast tumors. We took into consideration the different phenotypes (luminal A luminal B HER-2 overexpression, basal and triple-negative), various epithelial-mesenchymal (EMT) molecular markers and adhesion molecules (E-cadherin, P-cadherin, N-cadherin, vimentin, twist snail and slug) and NOS-2, in addition to clinical and demographic data, tumor characteristics and treatment types., Methods: The study population consisted of 82 patients with breast cancer. We analyzed eight molecular markers by immunohistochemistry on tissue microarrays containing breast tumor specimens from patients with ten years of follow-up, and we classified each tumor according to its estrogen receptor, progesterone receptor and HER-2 expression. We then placed the tumor into one of the above categories., Results: The presence of several clinical and demographic factors, various histopathologies, treatment forms and several immunohistochemical markers were not associated with a worse prognosis for group IIA patients. The factors that were associated with a mortality risk were the triple-negative (odds ratio (OR) = 11.8, 95% confident interval (CI) = 2.0-70.3, P = 0.007) and basal (OR =18.4, 95% CI = 1.8-184.7, P= 0.013) phenotypic patterns., Conclusions: The EMT markers and NOS-2 were not mortality risk factors. Basal and triple-negative phenotypic patterns were related to a higher mortality risk in patients with stage IIA tumors.

One of the most interesting aspects of Trypanosoma cruzi is its adaptation to obtain sialic acid from its host, fulfilling this need exclusively through the reaction catalyzed by enzymatically active trans-sialidase (aTS), thought to play an important role in the pathogenesis of Chagas' disease. Herein, we report that 2-difluoromethyl-4-nitrophenyl-3,5-dideoxy-d-glycero-alpha-d-galacto-2-nonulopyranosid acid (NeuNAcFNP) inactivates aTS time- and dose-dependently, and this inhibition was not relieved removing the inhibitor. Also, NeuNAcFNP causes a decrease in infection of mammalian cells. Characterization of labeled aTS by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry revealed that inactivation of the enzyme occurs through formation of a covalent bond between Arg245 and Asp247 and the inhibitor aglycone. Participation of Asp247 in the catalytic mechanism was proved by constructing a TSD247A mutant, which presents only residual activity. Molecular dynamic simulations indicate that the D247A mutation results in a more open catalytic cleft. In summary, NeuNAcFNP is the first reported mechanism-based inhibitor of aTS, representing a new template for drug design and opening new possibilities for chemotherapy of Chagas' disease, as well as for the elucidation of aTS function in T. cruzi pathogenesis and biology.

Upon activation, cytotoxic CD8(+) T lymphocytes are desialylated exposing beta-galactose residues in a physiological change that enhances their effector activity and that can be monitored on the basis of increased binding of the lectin peanut agglutinin. Herein, we investigated the impact of sialylation mediated by trans-sialidase, a specific and unique Trypanosoma transglycosylase for sialic acid, on CD8(+) T cell response of mice infected with T. cruzi. Our data demonstrate that T. cruzi uses its trans-sialidase enzyme to resialylate the CD8(+) T cell surface, thereby dampening antigen-specific CD8(+) T cell response that might favor its own persistence in the mammalian host. Binding of the monoclonal antibody S7, which recognizes sialic acid-containing epitopes on the 115-kDa isoform of CD43, was augmented on CD8(+) T cells from ST3Gal-I-deficient infected mice, indicating that CD43 is one sialic acid acceptor for trans-sialidase activity on the CD8(+) T cell surface. The cytotoxic activity of antigen-experienced CD8(+) T cells against the immunodominant trans-sialidase synthetic peptide IYNVGQVSI was decreased following active trans-sialidase-mediated resialylation in vitro and in vivo. Inhibition of the parasite's native trans-sialidase activity during infection strongly decreased CD8(+) T cell sialylation, reverting it to the glycosylation status expected in the absence of parasite manipulation increasing mouse survival. Taken together, these results demonstrate, for the first time, that T. cruzi subverts sialylation to attenuate CD8(+) T cell interactions with peptide-major histocompatibility complex class I complexes. CD8(+) T cell resialylation may represent a sophisticated strategy to ensure lifetime host parasitism.

Background: Laboratory methods for HER2 assessment currently include immunohistochemical (IHC) methods (measuring protein overexpression) and fluorescence in situ hybridisation (FISH) (measuring gene amplification). The measure of HER2 protein by IHC is usually assessed by the mouse monoclonal antibody CB11, and polyclonal antibodies (Herceptest) directed against the internal portion of the receptor. Recently, chromogenic in situ hybridisation (CISH), in which HER2 is detected by a peroxidase reaction and the gene amplification can be determined by regular bright-field microscopy, has emerged as an alternative to FISH., Aims: To evaluate the status of HER2 in tissue microarrays (TMAs) of invasive breast cancer using the novel rabbit monoclonal antibody SP3 directed against the external portion of HER2, and correlate the results with CB11 and CISH., Methods: IHC was performed with two antibodies (CB11 and SP3) and CISH for HER2 in 10 TMA blocks with 190 formalin-fixed paraffin-embedded cases of invasive breast carcinomas., Results: The correlation between SP3 and CB11 was significant (p<0.001) with an agreement rate of 86.9%. When the staining pattern of the two antibodies was compared, the majority of SP3 immunostainings were assessed more easily, with a strong complete membrane staining pattern without non-specific cytoplasmic staining. There was a good correlation between SP3 and CISH (p<0.001). 23/24 SP3 3+ cases showed gene amplification, 97.3% of the cases without gene amplification were SP3 negative, and 6/7 SP3 2+ were amplified., Conclusion: The high level of agreement between SP3, a monoclonal antibody that recognises the extracellular domain of the HER2 receptor, and CB11 and CISH, shows that this novel antibody is a reliable candidate to evaluate the expression of HER2 in breast cancer.