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Objetivos: O folato é um micronutriente indispensável para a síntese eritrocitária e a manutenção da integridade genômica. A vitamina B12, por sua vez, além de ser essencial para a formação das células sanguíneas, contribui significativamente com o desenvolvimento cerebral e a mielinização neural. Já a vitamina D desempenha um papel crucial no metabolismo ósseo e na modulação das respostas inflamatórias. Dessa forma, o objetivo deste estudo foi avaliar as concentrações séricas de folato, vitamina B12 e vitamina D em crianças de primeiro ano de escolas públicas localizadas em áreas de vulnerabilidade, de uma cidade do interior do Rio Grande do Sul. Materiais e métodos: Realizou-se um estudo transversal no qual foram incluídas 152 crianças, meninas e meninos, em idade escolar, matriculadas no primeiro ano do ensino fundamental em escolas públicas de Santa Maria - RS. As amostras foram obtidas a partir de punção venosa padrão utilizando tubos com gel separador. As concentrações séricas de folato, vitamina B12 e vitamina D foram determinadas por eletroquimioluminescência utilizando kits comerciais. Das 152 crianças, foi possível calcular o índice de Massa Corpórea (IMC) de 121. Obteve-se as dosagens séricas de vitamina D de 72 crianças, de vitamina B12 de 147 crianças, e folato de 149. A fim de delinear o perfil nutricional e permitir a interpretação dos resultados laboratoriais de acordo com a população do estudo em questão, foram aplicados questionários aos pais ou responsáveis, para coletar informações a respeito da dieta alimentar das crianças, seu histórico de saúde e condições socioeconômicas. Os resultados foram apresentados em termos de mediana e intervalo interquartil. Resultados: A mediana de concentração de folato foi de 13,8 (11,5 – 17,0) ng/mL; de vitamina B12 foi de 701 (537 – 938) pg/mL; e de vitamina D foi de 25,2 (22,0 – 28,8) pg/mL. Já o IMC foi de 15,6 (14,5 – 18,0). Insuficiência de vitamina D (< 20 ng/mL) foi observada em 10 (13,8%) das crianças e 4 (2,7%) exibiram concentrações reduzidas de vitamina B12 (< 300 pg/mL). Em relação à dosagem sérica de folato, todas as crianças mantiveram-se dentro do intervalo de referência. Destaca-se, ainda, que 50% das crianças com hipovitaminose D encontravam-se abaixo do seu IMC ideal. Discussão: Alterações nutricionais têm importante reflexo na saúde de crianças, especialmente durante a primeira infância, que se caracteriza como um período no qual se observa intenso crescimento e desenvolvimento. Essa faixa etária coincide com a fase de alfabetização, que exige plena saúde cognitiva para o sucesso educacional. Em vista disso, avaliar as concentrações séricas de nutrientes em crianças de primeiro ano escolar é de extrema relevância para garantir um crescimento saudável e um desenvolvimento cerebral adequado. Com isso, além da prevenção de inúmeros problemas de saúde relacionados à carência nutricional, corrobora-se para a obtenção de um melhor desempenho escolar. Conclusão: Os resultados obtidos no presente estudo demonstram um perfil nutricional majoritariamente saudável em relação ao folato, à vitamina B12 e à vitamina D das crianças avaliadas. Contudo, cabe destacar que, a deficiência de vitamina D, quando observada, coincide com IMC fora do intervalo esperado para a faixa etária correspondente em um número significativo dos casos. Evidencia-se, portanto, forte relação entre os hábitos de saúde, a dieta alimentar e a saúde nutricional infantil.

Objetivos: O lipedema é uma doença inflamatória de baixo grau caracterizada pelo aumento simétrico e desproporcional de gordura subcutânea fibrótica nos membros. O objetivo deste estudo foi descrever um perfil de leucograma, avaliar a contagem de plaquetas, bem como estimar o índice de imuno-inflamação sistêmica (IIS) e relação monócitos/colesterol HDL (RMHDL) e suas correlações com as concentrações de proteína C reativa (PCR) e a taxa de gordura subcutânea (TGS) em mulheres com lipedema. Material e métodos: Foram incluídas 84 mulheres com fenótipo de lipedema, com idades entre 19 e 71 anos. Foram coletadas amostras de sangue em jejum e o hemograma foi realizado em contador eletrônico Sysmex XE-5000®, a PCR e o colesterol HDL (cHDL) foram analisadas no equipamento Siemens Dimension EXL-200® e a TGS foi determinada por bioimpedância. A partir dos dados obtidos, foram calculados o IIS (plaquetas x neutrófilos/ linfócitos) e a RMHDL. Os resultados foram expressos como mediana (intervalo interquartílico). Resultados: Os valores para os parâmetros analisados foram: leucócitos 6,27 (5,49-7,23) × 103/mm3; neutrófilos 3,26 (2,84-4,13) × 103/mm3; linfócitos 2,45 (1,84-2,71) × 103/mm3; monócitos 0,47 (0,39-0,55) × 103/mm3; plaquetas 259 (221-306) × 103/mm3; PCR 0,27 (0,16-0,80) mg/dL; cHDL 72 (61-82) mg/dL; IIS 368 (287-513) × 103; RMHDL 0,066 (0,047-0,083) e TGS 27,9 (24,3-32,1) %. Foram observadas correlações diretas entre PCR e leucócitos (r: 0,306; p: 0,028); PCR e neutrófilos (r: 0,350; p: 0,005); PCR e plaquetas (r: 0,312; p: 0,004); PCR e IIS (r: 0,318; p: 0,004); PCR e TGS (r: 0,481; p < 0,001); TGS e leucócitos (r: 0,470; p < 0,001); TGS e neutrófilos (r: 0,440; p < 0,001); TGS e monócitos (r: 0,277; p: 0,011); TGS e linfócitos (r: 0,254; p: 0,020); TGS e plaquetas (r: 0,301; p: 0,005); TGS e IIS (r: 0,310; p: 0,004); TGS e RMHDL (r: 0,311; p: 0,004) e RMHDL e neutrófilos (r: 0,512; p < 0,001). Discussão: A fisiopatologia do lipedema é caracterizada pela infiltração de macrófagos e extravasamento do conteúdo dos vasos sanguíneos e linfáticos no tecido adiposo subcutâneo. A progressão da doença ocorre pela hiperplasia e hipertrofia de adipócitos e liberação de citocinas inflamatórias, desencadeando sintomas como fragilidade capilar, edema, dor e hematomas de aparecimento frequente nos membros atingidos. Patton e colaboradores, descreveram um aumento significativo dos níveis de leucócitos e PCR em mulheres com lipedema e obesidade associada em comparação às mulheres com lipedema sem presença de obesidade. Em nosso estudo, as contagens de leucócitos e plaquetas apresentaram correlações com o aumento da PCR e da TGS. Conclusão: As contagens de leucócitos e plaquetas isoladamente, e o IIS e a RMHDL são biomarcadores úteis para avaliação da inflamação sistêmica em mulheres com lipedema. São amplamente disponíveis e de baixo custo, podendo ser empregadas tanto na avaliação clínica, como no monitoramento da eficácia de estratégias nutricionais e de tratamento.

Objetivos: A anemia ferropriva é uma doença caracterizada principalmente pela deficiência de ferro no sangue e diminuição das concentrações de hemoglobina. É considerada a mais comum das anemias. A diminuição da quantidade de ferro, pode ser causada por carência nutricional, hemorragias, parasitoses, entre outros. Além disso, existem estudos que relacionam uma diminuição no desenvolvimento cognitivo e motor em crianças que apresentam ferropenia. O objetivo desse estudo foi avaliar a frequência de anemia e ferropenia em crianças de primeiro ano de escolas públicas. Materiais e métodos: Foram incluídos 153 alunos de primeiro ano do ensino fundamental, de ambos os sexos, com idade entre 6 e 8 anos, de 6 escolas públicas municipais de Santa Maria/RS. Foram coletadas amostras de sangue em jejum para as análises do hemograma e status do ferro. Resultados: Trinta e três (21,6%) participantes apresentaram anemia. Considerando o intervalo de referência de ferritina para crianças de 5 a 12 anos, valores abaixo de 15 μg/L indicam deficiência grave de ferro. É esperado que crianças dessa faixa etária apresentem concentrações de ferritina acima de 30 μg/L. A partir desses critérios, nenhum participante apresentou concentrações abaixo de 15 μg/L, enquanto 14 (9,2%) apresentaram valores entre 15 e 30 μg/L. Já, para as concentrações de ferro, 30 crianças (19,6%) apresentaram valores abaixo de 50 μg/L. Discussão: Estes resultados são dados preliminares de um projeto que pretende avaliar crianças de primeiro ano de diversas escolas públicas municipais de Santa Maria/RS, priorizando àquelas que atendem regiões socialmente mais vulneráveis. Visto que a anemia ferropriva pode causar problemas importantes na saúde de crianças à longo prazo, é bastante relevante informações sobre ferropenia nessa faixa etária. Nesse estudo, mostramos que as taxas de anemia estavam menores do que estudos prévios na população brasileira desta faixa etária. Da mesma forma, a ferropenia foi observada em uma proporção menor do que descrito anteriormente, considerando que os participantes desse estudo eram de escolas públicas localizadas em regiões mais carentes do município. Provavelmente, contribuíram para esses resultados a política de fortificação de alimentos com ferro e ácido fólico, vigente no Brasil desde 2004. Além disso, a merenda escolar disponibilizada nessas escolas, possivelmente tenha contribuído para essas taxas. Conclusão: Por enquanto, os resultados mostraram frequência de anemia e ferropenia menor do que aqueles reportados previamente em outros estudos. Esses dados contribuem para a criação de políticas públicas que impactem positivamente na saúde de crianças que estão iniciando sua caminhada escolar.

Introdução/Objetivo: A COVID-19 trouxe a necessidade da compreensão dos mecanismos de agressão desta doença. Iniciado em 2020, o projeto COVID-19 Patologia Estrutural e Molecular (COVPEM), realizado em parceria entre Instituto Gonçalo Moniz (IGM)-FIOCRUZ-BA e Instituto Couto Maia-BA (ICOM) tem por objetivo estudar os casos fatais de COVID-19 através de Autopsias Minimamente Invasivas (AMIs). Posteriormente, esta parceria foi ampliada para outras doenças infectocontagiosas e realização de biópsias. Os casos estudados foram, periodicamente, utilizados para a realização de Sessões Anatomoclínicas (SACs). O objetivo deste trabalho é descrever as SACs como atividade acadêmica da Residência Médica/internato, bem como refletir sobre a necessidade desta temática na formação médica. Métodos: Uma equipe hospitalar multidisciplinar detecta os casos fatais de COVID-19 e outras doenças infecciosas no ICOM e solicita aos familiares, após aprovação da comissão de ética em pesquisa, a permissão das AMIs e assinatura de termos de consentimentos livres e esclarecidos. No internamento, o serviço social fornece aos responsáveis uma carta de apresentação, com apoio da diretoria da unidade e da Comissão de Ensino e Pesquisa, que menciona o histórico de trabalho desenvolvido no ICOM. Posteriormente, um patologista, realiza as AMIs/biópsias para as SACs, nas quais um residente do ICOM, um patologista do IGM e médicos especialistas/pesquisadores convidados de outras instituições brasileiras apresentam a história clínica, os aspectos anatomopatológicos e uma revisão/debates do tema, respectivamente. Resultados: Foram realizadas mais de 17 AMIs, sendo 13 de casos fatais de COVID-19. Em 2021 foram apresentadas as seguintes SACs: Clinica, Imagem e Patologia em casos de COVID-19 na Bahia, Coagulopatia Associada a COVID, Lesões Musculares na COVID-19, Lesão Renal Aguda na COVID-19. Em 2022 foi apresentado o tema Insuficiência Respiratória em Tempos de SARS-COV2. Dentre as biópsias realizadas os temas foram linfadenopatia a esclarecer e lesões de pele a esclarecer. Em 2023, das biópsias realizadas, os temas discutidos, até o momento, foram Pessoas Vivendo com HIV/AIDS apresentando lesões de pele e Sarcoma de Kaposi. Conclusão: As SACs promovem um ambiente de ensino e debate clínico e anatomopatológico, proporcionando aos residentes e internos uma vivência em áreas de conhecimentos da infectologia que contribuem para a formação médica baseada em evidências científicas.

As atitudes docentes na relação educativa podem contribuir ou dificultar a aprendizagem dos estudantes. O objetivo deste estudo foi compreender a estrutura das representações ao termo atitudes na prática docente e estudar as diferenças dos sentidos dados entre os estudantes investigados. A pesquisa, de delineamento qualitativo, realizada em maio de 2023, em uma universidade pública portuguesa, com 111 estudantes (37 de Ciências da Educação, 25 de Psicologia, 49 de Engenharia Civil), fez uso da técnica de associação livre de palavras. Os resultados revelam, através do núcleo central, que as representações dos estudantes sobre a prática docente são positivas e estabelecidas no diálogo, respeito, profissionalismo e empatia. Foram encontradas no sistema periférico representações negativas (distanciamento, hipocrisia e sem prática) e representações positivas no 4º quadrante (tolerância, trabalho em equipa, honestidade), o que leva à conclusão de que essas representações divergentes propõem aos docentes universitários uma contínua reflexão sobre suas práticas pedagógicas, estabelecidas sobre uma relação educativa que influencie positivamente no processo de ensino-aprendizagem.

Pain is the main symptom of inflammatory arthritis and it can impair physical functional performance and physical activity level. Some individuals can develop kinesiophobia and experience a vicious circle of worsening health. This study aimed to investigate the association between pain and physical functional performance/physical activity and determine whether kinesiophobia mediates this association. This was a cross-sectional study with individuals diagnosed with inflammatory arthritis (rheumatoid arthritis or spondyloarthritis) treated at a Rheumatology Outpatient Clinic. We assessed pain (Visual Analogue Scale), physical activity (International Physical Activity Questionnaire - long form), kinesiophobia (Tampa Scale for Kinesiophobia), and physical functional performance (Handgrip Strength Dynamometry, 30-second Sit-to-Stand test, Static Muscular Endurance test, and Timed Up and Go test). The mediating effect of kinesiophobia on the relationship between pain intensity and physical functional performance/physical activity was analyzed, and the significance of the mediating effect (kinesiophobia) was tested through a bootstrap approach. Thirty-three individuals with inflammatory arthritis (mean age: 48 ± 12 years) participated in the study. Kinesiophobia mediates the relationship between pain intensity and physical functional performance analyzed by the 30-second Sit-to-Stand test [indirect effect (IE)overall = -0.343, bootstrap 95% confidence interval (CI): -0.698 to -0.002] and by knee flexion at 90º of the dominant limb (IEoverall = -1.55, bootstrap 95% CI: -3.43 to -0.237). In conclusion, pain intensity can affect physical functional performance through kinesiophobia in individuals with inflammatory arthritis., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Therapy adherence is a key factor in the control of type 2 diabetes mellitus (T2DM). Optimal self-care requires skills in health literacy (HL)., Objective: This study aims to analyze the relationship between HL and adherence to therapy and to understand the possible influence of other sociodemographic and disease variables., Methods: A multicenter, cross-sectional study was conducted in Portuguese in 13 different primary health care units in both rural and urban environments. A sociodemographic questionnaire and two validated instruments, "Medical Term Recognition Test" and "Summary of Diabetes Self-Care Activities," were applied. The last value of hemoglobin A1c (HbA1c) and the number of chronic medications were collected from clinical records. Descriptive statistics and bivariate correlations were performed as well as multivariable linear regression to assess the association between HL and adherence to therapy., Key Results: Participants (n = 354) were on average age 63.67 ± 10.39 years, 57.1% male and 42.9% female, 68.4% with inadequate HL and an average HbA1c of 7 ± 1.18%. Better HL was correlated with higher adherence to the total of self-care activities, nonpharmacological therapy, and foot care. In multivariable linear regression analyses, better HL ( β = 0.176, p = .003), less than minimum wage (β = -0.197, p = .001) and insulin therapy ( β = 0.272, p = .001) were independently associated with increased adherence to overall self-care activities., Conclusion: In a representative sample of people with T2DM in Portugal, HL was a key factor for greater adherence to demanding self-care activities. [ HLRP: Health Literacy Research and Practice . 2024;8(4):e194-e203. ].

Background: This study evaluated the effects of concurrent isolated training (T) or training combined with the antioxidant N-acetylcysteine (NAC) on cardiac remodeling and oxidative stress in spontaneously hypertensive rats (SHR)., Methods: Six-month-old male SHR were divided into sedentary (S, n = 12), concurrent training (T, n = 13), sedentary supplemented with NAC (SNAC, n = 13), and concurrent training with NAC supplementation (TNAC, n = 14) groups. T and TNAC rats were trained three times a week on a treadmill and ladder; NAC supplemented groups received 120 mg/kg/day NAC in rat chow for eight weeks. Myocardial antioxidant enzyme activity and lipid hydroperoxide concentration were assessed by spectrophotometry. Gene expression of NADPH oxidase subunits Nox2, Nox4, p22 phox, and p47 phox was evaluated by real time RT-PCR. Statistical analysis was performed using ANOVA and Bonferroni or Kruskal-Wallis and Dunn., Results: Echocardiogram showed concentric remodeling in TNAC, characterized by increased relative wall thickness (S 0.40 ± 0.04; T 0.39 ± 0.03; SNAC 0.40 ± 0.04; TNAC 0.43 ± 0.04 *; * p < 0.05 vs T and SNAC) and diastolic posterior wall thickness (S 1.50 ± 0.12; T 1.52 ± 0.10; SNAC 1.56 ± 0.12; TNAC 1.62 ± 0.14 * mm; * p < 0.05 vs T), with improved contractile function (posterior wall shortening velocity: S 39.4 ± 5.01; T 36.4 ± 2.96; SNAC 39.7 ± 3.44; TNAC 41.6 ± 3.57 * mm/s; * p < 0.05 vs T). Myocardial lipid hydroperoxide concentration was lower in NAC treated groups (S 210 ± 48; T 182 ± 43; SNAC 159 ± 33 *; TNAC 110 ± 23 * # nmol/g tissue; * p < 0.05 vs S, # p < 0.05 vs T and SNAC). Nox 2 and p22 phox expression was higher and p47 phox lower in T than S [S 1.37 (0.66-1.66); T 0.78 (0.61-1.04) *; SNAC 1.07 (1.01-1.38); TNAC 1.06 (1.01-1.15) arbitrary units; * p < 0.05 vs S]. NADPH oxidase subunits did not differ between TNAC, SNAC, and S groups., Conclusion: N-acetylcysteine supplementation alone reduces oxidative stress in untreated spontaneously hypertensive rats. The combination of N-acetylcysteine and concurrent exercise further decreases oxidative stress. However, the lower oxidative stress does not translate into improved cardiac remodeling and function in untreated spontaneously hypertensive rats., (© 2024. The Author(s).)

This study aimed to evaluate the influence of combined intermittent fasting (IF) and high-intensity interval training (HIIT) on morphology, caspase-independent apoptosis signaling pathway, and myostatin expression in soleus and gastrocnemius (white portion) muscles from healthy rats. Sixty-day-old male Wistar rats (n = 60) were divided into four groups: control (C), IF, high-intensity-interval training (T), and high-intensity-interval training and intermittent fasting (T-IF). The C and T groups received ad libitum chow daily; IF and T-IF received the same standard chow every other day. Animals from T and T-IF underwent a HIIT protocol five times a week for 12 weeks. IF reduced gastrocnemius mass and increased pro-apoptotic proteins apoptosis-inducing factor (AIF) and endonuclease G (EndoG) in soleus and cleaved-to-non-cleaved PARP-1 ratio and myostatin expression in gastrocnemius white portion. HIIT increased AIF and apoptosis repressor with caspase recruitment domain expression in soleus and cleaved-to-total PARP-1 ratio in gastrocnemius muscle white portion. The combination of IF and HIIT reduced fiber cross-sectional area in both muscles, increased EndoG and AIF expression, and decreased cleaved-to-non-cleaved PARP-1 ratio in gastrocnemius muscle white portion. Muscle responses to IF and HIIT are directly impacted by the muscle fiber type composition and are modulated, at least in part, by myostatin and caspase-independent apoptosis signaling., (© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Objectives: The purpose of this study was to evaluate the effects of air polishing with sodium bicarbonate and erythritol powders on surface roughness and morphological changes in titanium abutments., Methods: A total of 45 grade V titanium discs were divided in three groups: Group A (Control) air polished with air/water; Group B, air polished with sodium bicarbonate powder; and Group C, air polished with erythritol powder. After air polishing, the samples' roughness (S a ) in micrometres were analysed with an optical profilometer. The samples' surface morphology study was conducted via scanning electronic microscope (SEM). Data were described using mean and standard deviation of roughness values (S a ). Inferential analysis was performed using the ANOVA multiple comparison test followed by Tukey's post hoc test. Both tests used a 5% level of significance., Results: After air polishing, average roughness of group A, B and C were 0.036, 0.046 and 0.037 μm, respectively, with statistically significant differences between groups A and B (p < 0.05). No statistically significant differences were found between group A and group C, as well as between group B and C (p > 0.05). As for the morphology analysis, damages to the titanium surface were only observed in group B., Conclusions: The study indicates that air polishing with erythritol powder maintains titanium abutment integrity better than sodium bicarbonate, which increased surface roughness and caused damage. Erythritol is preferable for minimizing surface alterations and maintaining morphological stability., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The literature offers a consensus on the association between exercise training (ET) protocols based on the adequate parameters of intensity and frequency, and several adaptive alterations in the liver. Indeed, regular ET can reverse glucose and lipid metabolism disorders, especially from aerobic modalities, which can decrease intrahepatic fat formation. In terms of molecular mechanisms, the regulation of hepatic fat formation would be directly related to the modulation of the mechanistic target of rapamycin (mTOR), which would be stimulated by insulin signaling and Akt activation, from the following three different primary signaling pathways: (I) growth factor, (II) energy/ATP-sensitive, and (III) amino acid-sensitive signaling pathways, respectively. Hyperactivation of the Akt/mTORC1 pathway induces lipogenesis by regulating the action of sterol regulatory element binding protein-1 (SREBP-1). Exercise training interventions have been associated with multiple metabolic and tissue benefits. However, it is worth highlighting that the mTOR signaling in the liver in response to exercise interventions remains unclear. Hepatic adaptive alterations seem to be most outstanding when sustained by chronic interventions or high-intensity exercise protocols.

Background: High-intensity intermittent training has emerged as an option for treating major depressive disorder (MDD). However, short sprint training (sSIT), an efficient HIIT modality, has not been tested yet for this purpose. The sSIT has been proven to induce the same metabolic adaptations, with the advantage of promoting lower muscle fatigue than other HIIT protocols., Methods: Seventeen adult women diagnosed with moderate/severe MDD were randomly allocated into a sSIT group (n=9) or a control condition (n=8). The sSIT group completed, over two weeks, six 6-10-min sessions which consisted of 3-12 "all out" sprints of 5 s interspersed with low-intensity recovery of 30-45 s. The week before and after the intervention, both groups were evaluated with the Hamilton Depression Rating Scale of 21-itens (HAM-D21), and for physical fitness and incidental physical activity., Results: The sSIT group exhibited significant improvements for HAM-D21 scores (24.6±8.2 vs. 16.8±10.1), maximum aerobic power (140±15 vs. 155±15 W), countermovement jump (13.0±3.4 vs. 14.9±3.1 cm), % of body fatness (32.4±4.4 vs. 29.3±3.8%), and 4-days number of steps (13,626±11,309 vs. 16,643±15,371) after the training period when compared to the control group., Conclusion: Less than 1 hour of a sSIT protocol over two weeks have demonstrated to reduce depressive symptoms, while improving aerobic fitness and body composition, and increasing incidental physical activity in a sample of women diagnosed with MDD., Competing Interests: The 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 © 2024 Ribeiro, Schuch, Tonello, Meneghel Vargas, Oliveira-Junior, Müller and Boullosa.)

Introduction: After anterior cruciate ligament (ACL) reconstruction, determining readiness to return to participation is challenging. The understanding of which neuromuscular performance parameters are associated with limb symmetry and self-reported symptoms may be useful to improve monitoring the rehabilitation towards adequate decision-making to return., Objectives: To compare the ACL-operated and injury-free lower limbs regarding functional performance; and to investigate whether lower limb strength and functional performance are associated with self-reported symptoms and functional lower limb symmetry., Method: Thirty-four participants were included. Functional performance was assessed by using the Y-Balance test, Single-leg Hop, and Functional Movement Screen. An isokinetic dynamometer was used to evaluate the strength levels in open and closed kinetic chains. The functional lower limb symmetry was calculated considering the single-leg hop test results for each lower limb., Results: There were no differences in dynamic balance (Y-Balance) between the operated and injury-free limbs. The operated limb presented a worst performance in the single-leg hop. Self-reported symptoms prevalence and lower limb symmetry were associated with knee extension strength and functional performance (Y-Balance)., Conclusion: Individuals submitted to ACL-reconstruction presented worse functional performance in the operated limb compared to the injury-free limb. Both knee strength and dynamic balance were associated with limb symmetry and self-reported symptoms., Competing Interests: Declaration of competing interest None to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Numerous studies have been published suggesting that troponin levels are related to adverse outcomes in chronic cardiac and non-cardiac conditions. Our study investigated whether troponin levels gathered from unselected blood samples taken during outpatient care are associated with adverse outcomes in a population with stable coronary artery disease. In a cohort of 949 patients with stable coronary artery disease, an average age of 67.5 ± 9.5 years, 69.5% male, 52.1% diabetics, 51.6% with previous myocardial infarction, and 57.9% with triple-vessel disease, 21.7% of patients encountered new events during an average period of monitoring of 2.07 ± 0.81 years. Troponin I/99th percentile categorized into tertiles emerged as an independent predictor of death and combined events risk (hazard ratio: 2.02 (1.13-3.60), p = 0.017; 2.30 (1.37-3.88, p = 0.002, respectively). A troponin ratio > 0.24 was able to identify 53.3% of patients at risk of death and heart failure hospitalization. In patients with stable coronary artery disease who are adherent to treatment, troponin levels are independently associated with death and heart failure hospitalization in a medium-term follow-up.

This study addresses the hypothesis that different acute stressors can cumulatively decrease milk yield. In fact, in a time of global warming, the impact of environmental stress and farm management practices on milk production remains unclear. In this context, our objective was to investigate the effect of acute and cumulative stress on gene expression in mammary tissue and their interactions with physiological responses and milk yield in Saanen goats. Thirty lactating goats were subjected to two treatments: (1) control (CT), in which goats were maintained following a habitual routine under comfort conditions; (2) stress (ST), in which the goats were subjected to different types of environmental stress: heat stress, adrenocorticotropic hormone administration, hoof care management, and exposure to rain. These stressors were performed sequentially, with one stress per day on four consecutive lactation days, to evaluate their effect on milk quality and milk yield. Our results showed that compared to CT goats, cumulative stress increased the gene expression of glucocorticoid receptor (GR), interferon-gamma (IFN-γ), superoxide dismutase (SOD), and catalase (CAT) in mammary tissue, which are indicators of cortisol action, inflammatory response, and antioxidant enzymes. Furthermore, the acute challenges imposed on ST goats changed their rectal temperature and respiratory frequency and increased cortisol, glucose, cholesterol, triglycerides, and high-density lipoprotein release in plasma when compared to CT goats. Although these physiological and metabolic responses restore homeostasis, ST goats showed lower milk yield and higher somatic cell count in milk than CT goats. In conclusion, the results confirmed our initial hypothesis that different acute stressors cumulatively decrease the milk yield in Saanen goats.

Background: Most of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID-19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID-19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID-19 patients and their associations with the incidence of adverse COVID-19 outcomes., Methods: We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID-19 in this prospective observational study. Dental and periodontal status was assessed using in-hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID-19 symptoms, and hospitalization endpoints were tested using chi-square test and incidence rate ratio (IRR) estimation using a generalized linear model with log-Poisson regression. The regression models used a block-wise selection of predictors for oral health-related variables, comorbidities, and patients' ages., Results: Overall, poor oral health conditions were highly prevalent and associated with critical COVID-19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07-1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44-4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12-3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission., Conclusion: There was a positive association between deleterious oral health-related conditions, especially periodontitis, and severe COVID-19 outcomes in hospitalized COVID-19 patients., (© 2022 American Academy of Periodontology.)

Objectives: To assess the accuracy of three immunochromatographic rapid tests for salivary detection of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens and the reliability of these tests comparing saliva with plasma samples., Materials and Methods: Plasma and saliva samples from 62 patients diagnosed with coronavirus disease 2019 (COVID-19) and 20 healthy volunteers were assayed. IgM/IgG antibody against SARS-COV-2 was detected using three immunochromatographic rapid tests and compared with real-time reverse transcription-polymerase chain reaction (qRT-PCR)., Results: The tests' overall accuracy for detecting anti-SARS-CoV-2 antibodies ranged from 75.6 to 79.3 for saliva and 86.6-87.8 for plasma tests. The sensitivity of saliva and plasma tests increased with the severity of COVID-19 signs and symptoms. The chance of a positive plasma test in participants with a positive qRT-PCR test was 2.27 greater than a positive saliva test., Conclusions: Although rapid immunochromatographic tests are more accurate using plasma than saliva, which was expected considering its original use, our findings support the use of saliva as a straightforward supplementary method to assess seroconversion in patients with COVID-19, with important sensitivity and sensibility, especially in severe and critical cases., (© 2021 Wiley Periodicals LLC.)

The objective of this study was to describe if the victims of the Zika have access to essential public policies to guarantee social rights., Methods: We used a cross-sectional study of a historical cohort of children with congenital Zika syndrome (CZS) in a reference hospital. CZS diagnosis was based on the Ministry of Health protocol. The variables analyzed were sociodemographic and social rights of children., Results: Of the 161 children seen from April 2016 to July 2018, 42 were diagnosed with CZS. Of these, 37 children participated in the study and 75.7% of them had severe neurological disorders. Anticonvulsants were used by 73% of the children, with 81% paid by families. The families were also responsible for purchasing nutritional formulas and diapers in, respectively, 79% and 100% of cases, and 89% of the children had access to rehabilitation therapy, although 70% of them faced several barriers to do it. Of the 24 working mothers, 83% did not return to the labor market after the birth of their children., Conclusions: The results showed that the families were at an intersection between the integral activity of caring for a child with severe disabilities and inefficient and omissive public authorities, a disincentive and discouraging context that made them give up in seeking their rights.

Cold-Water-Immersion (CWI) has been frequently used to accelerate muscle recovery and to improve performance after fatigue onset. In the present study, the aim was to investigate the effects of different CWI temperatures on neuromuscular activity on quadriceps after acute fatigue protocol. Thirty-six young athletes (16.9 ± 1.4 years-old; 72.1 ± 13.8 kg; 178.4 ± 7.2 cm) were divided into three groups: passive recovery group (PRG); CWI at 5 °C group (5G); and CWI at 10 °C group (10G). All participants performed a fatigue exercise protocol; afterwards, PRG performed a passive recovery (rest), while 5G and 10G were submitted to CWI by means of 5 °C and 10 °C temperatures during 10 min, respectively. Fatigue protocol was performed by knee extension at 40% of isometric peak force from maximal isometric voluntary contraction. Electromyography was used to evaluate neuromuscular performance. The passive recovery and CWI at 5 °C were associated with normalized isometric force and quadriceps activation amplitude from 15 until 120 min after exercise-induced fatigue (F = 7.169, p < 0.001). CWI at 5 °C and 10 °C showed higher muscle activation (F = 6.850, p < 0.001) and lower median frequency (MF) than passive recovery after 15 and 30 min of fatigue (F = 5.386, p < 0.001). For neuromuscular efficiency (NME) recovery, while PRG normalized NME values after 15 min, 5G and 10G exhibited these responses after 60 and 30 min (F = 4.330, p < 0.01), respectively. Passive recovery and CWI at 5 °C and 10 °C revealed similar effects in terms of recovery of muscle strength and NME, but ice interventions resulted in higher quadriceps activation recovery.