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The global production and disposal of plastics have led to pervasive contamination of natural environments, representing considerable risks to human health and ecosystems. This study introduces a novel oil-based method for extracting microplastics (MPs) from water samples, with a focus on optimizing extraction conditions and improving the quality of MPs identification using Raman spectroscopy. Various parameters including the type of oil, salinity, temperature, air incorporation, and washing solvent were investigated to enhance extraction efficiency and spectroscopic identification accuracy. Sunflower oil emerged as the preferred extraction medium due to its compatibility with Raman spectroscopy, offering high recovery efficiencies for polypropylene (PP) and polystyrene (PS). Additionally, ethanol was identified as a better washing solvent compared to hexane, improving MPs identification. The optimised method was then applied to environmental water samples, revealing matrix effects and challenges with digestion step. Despite these challenges, the proposed method represents a significant advancement in microplastic analysis, offering reliable detection and quantification in aquatic environments. Further optimisation is needed to address matrix effects and improve recovery efficiency, especially for smaller microplastics., 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 © 2024. Published by Elsevier B.V.)

Background: The Baveno VII guidelines were proposed to identify which patients could safely avoid screening esophagogastroduodenoscopy (EGD) for gastroesophageal varices. We aimed to evaluate the frequency of gastric neoplasia in compensated advanced chronic liver disease (cACLD) patients who underwent EGD for screening of gastroesophageal varices (GOEV) compared to a healthy population., Methods: Retrospective study that enrolled all cACLD patients who underwent EGD for GOEV screening (January 2008-June 2018) in a tertiary reference center. cACLD patients were compared with asymptomatic healthy individuals who underwent EGD in a private hospital setting (April 2017-March 2018)., Results: We evaluated 1845 patients (481 cACLD patients, 1364 healthy individuals). A significantly higher frequency of gastric neoplasia was observed in patients with cACLD compared to healthy individuals (4.0% vs. 1.0 %; p < 0.001). Rare histopathological subtypes (WHO Classification) accounted for 28.7 % of gastric carcinoma cases in the cACLD cohort. Seven cases of gastric neoplasia (36.8 % of gastric neoplasia cases in the cACLD patients) were diagnosed in patients who, according to the Baveno VII criteria, would have not been submitted to EGD., Conclusion: We found an increased frequency of gastric neoplasia in patients with cACLD in comparison with healthy individuals. In countries with intermediate-high risk for GC, continuing to perform EGD could be beneficial., Competing Interests: Conflict of interest None., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Widespread habitat-forming invaders inhabiting marinas, such as the spaghetti bryozoan Amathia verticillata, allow exploring facilitation processes across spatiotemporal contexts. Here we investigate the role of this bryozoan as habitat for native and exotic macrofaunal assemblages across different ecoregions of Western Mediterranean and East Atlantic coasts, and a monthly variation over a year. While only 7 (all peracarid crustaceans) of the 54 associated species were NIS, they dominated macrofaunal assemblages in terms of abundance, raising the potential for invasional meltdown. NIS richness and community structure differed among marinas but not among ecoregions, highlighting the importance of marina singularities in modulating facilitation at spatial scale. Despite facilitation did not depend on bryozoan abundance fluctuations, it was affected by its deciduous pattern, peaking in summer and disappearing in late winter. Monitoring A. verticillata in marinas, especially in summer periods, may improve the detection and management of multiple associated NIS., 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 © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Mulches are used to block light and retain soil moisture which may affect the survival of bacterial pathogens on soil. This study examined the effectiveness of different types of mulches to minimize microbial risk from contaminated water used for irrigation of cucumbers. A production bed of 120 ft 2 with 18 beds (30 ft long) covered with five different types of mulch (paper, paper with fertilizer incorporated (PF), maize-based mulch, biodegradable plastic covering, and conventional plastic) including three beds with no cover was planted with Dasher 2 Variety cucumber. Soil samples from each bed were collected for the first five weeks to examine natural E. coli and coliforms. Well water contaminated with or without nalidixic acid-resistant mutant of E. coli (8 Log CFU/mL) was used for drip irrigation for 7 days before harvesting. Prior to irrigation with contaminated water, naturally present E. coli and coliform in the soil samples with or without mulch were in the range of 3.45-3.78 Log CFU/g and 4.18-5.31 Log CFU/g, respectively. E. coli levels on cucumbers harvested from mulched beds and irrigated with contaminated irrigation water had significantly higher (P < 0.05) levels of E. coli as compared with samples from similar beds irrigated with noncontaminated water. However, Cucumber, harvested within each irrigation water quality were not significantly different regardless of the type of mulch with E. coli levels from 1.72 to 3.30 Log CFU/cm 2 (contaminated water) and 0.28-1.86 Log CFU/cm 2 (noncontaminated water). A significant die-off of inoculated E. coli was observed on cucumber within 3 days (>1.17 Log CFU/cm 2 ) and >1.38 Log CFU/cm 2 after 4 days. Beds with maize mulch were effective on minimizing E. coli contamination on cucumber from contaminated irrigation water., 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 © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Neurodegenerative and neuropsychiatric diseases are increasingly affecting individuals' quality of life, thus increasing their cost to social and health systems. These diseases have overlapping mechanisms, such as oxidative stress, protein aggregation, neuroinflammation, neurotransmission impairment, mitochondrial dysfunction, and excitotoxicity. Currently, there is no cure for neurodegenerative diseases, and the available therapies have adverse effects and low efficacy. For neuropsychiatric disorders, such as depression, the current therapies are not adequate to one-third of the patients, the so-called treatment-resistant patients. So, searching for new treatments is fundamental. Medicinal plants appear as a strong alternative and complement towards new treatment protocols, as they have been used for health purposes for thousands of years. Thus, the main goal of this review is to revisit the neuroprotective potential of some of the most predominant medicinal plants (and one fungus) used in traditional Chinese medicine (TCM), focusing on their proven mechanisms of action and their chemical compositions, to give clues on how they can be useful against neurodegeneration progression., (© 2023 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.)

Human trampling represents one of the main anthropogenic pressures in the rocky intertidal. This habitat includes many ecosystem engineers such as mussels that provide biogenic habitat and multiple services. This research assessed potential impacts of human trampling on beds of the mussel, Mytilus galloprovincialis, on NW shores of Portugal. To test for direct effects of trampling on mussels and indirect effects on the associated assemblages, three treatments were applied: control (untouched beds), low and high intensity of trampling. Effects of trampling were dependent on the taxa. Thus, values of shell length of M. galloprovincialis were greater under the highest intensity of trampling while abundances of Arthropoda, Mollusca and Lasaea rubra showed the opposite pattern. Moreover, total number of taxa and abundances of Nematoda and Annelida showed higher values under low trampling intensity. The implications of these results to manage human use in areas with ecosystem engineers are discussed., 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 © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Chitosan-pectin films with iron oxide (Fe 3 O 4 ) magnetic nanoparticles were prepared by solution casting in order to produce biopolymer based magnetically active materials. Infrared (FTIR) spectra indicated physical interactions between the matrix and nanoparticles, corroborated by differential scanning calorimetry (DSC) results. In addition, thermal characterization suggested that the interactions between chitosan, pectin and the nanoparticles resulted in a less compact structure, influencing the film mechanical properties. Regarding vibrating-sample magnetometry (VSM) and electrical analysis, chitosan-pectin films with Fe 3 O 4 nanoparticles showed ferrimagnetic behavior, with an increase of the dielectric constant as the nanoparticle concentration increased. Furthermore, films displayed enhanced antimicrobial activity against Escherichia coli (Gram-negative) and Staphylococcus epidermidis (Gram-positive) bacteria. Therefore, chitosan-pectin films with Fe 3 O 4 magnetic nanoparticles provide promising results for active and intelligent food packaging applications., 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 © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Marinas are hot spots of non-indigenous marine species (NIS). Introductions of NIS, regardless of their actual or potential impacts, can be considered as a biocontamination of the ecosystem. To characterize the biocontamination status of a marina it is important to know which habitats and major taxa can provide the most useful information. To address this issue, we analyze the associated macrofaunal community associated to soft substrate (sediment; SS) and artificial hard substrate (lateral surface of pontoons; AHS) of six marinas from Southern Spain. 9 NIS were found, including 8 crustaceans (7 peracarids) and 1 polychaete; 8 NIS were found on AHS and 4 in sediments. Indeed, site-specific BioContamination Index (SBCI) showed higher values in AHS than SS. Our results indicate peracarids in AHS should be the primary target for assessing the level of biocontamination in marinas. This may help scientists and environmental managers to stablish strategies for monitoring marine bioinvasions., 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 © 2022 Elsevier Ltd. All rights reserved.)

The search for alternative antimicrobial strategies capable of avoiding resistance mechanisms in bacteria are highly needed due to the alarming emergence of antimicrobial resistance. The application of physical stimuli as a mean of sensitizing bacteria for the action of antimicrobials on otherwise resistant bacteria or by allowing the action of low quantity of antimicrobials may be seen as a breakthrough for such purpose. This work proposes the development of antibacterial nanocomposites using the synergy between the electrically active microenvironments, created by a piezoelectric polymer (poly(vinylidene fluoride-co-trifluoroethylene) (PVDF-TrFE)), with green-synthesized silver nanoparticles (AgNPs). The electrical microenvironment is generated via mechanical stimulation of piezoelectric PVDF-TrFE/AgNPs films using a lab-made mechanical bioreactor. The generated material's electrical response further translates to bacterial cells, namely Escherichia coli and Staphylococcus epidermidis which in combination with AgNPs and the specific morphological features of the material induce important antibacterial and antibiofilm activity. Both porous and non-porous PVDF composites have shown antibacterial characteristics when stimulated at a mechanical frequency of 4 Hz being the effect boosted when AgNPs were incorporated in the nanocomposite, reducing in more than 80% the S. epidermidis bacterial growth in planktonic and biofilm form. The electroactive environments sensitize the bacteria allowing the action of a low dose of AgNPs (1.69% (w/w)). Importantly, the material did not compromise the viability of mammalian cells, thus being considered biocompatible. The piezoelectric stimulation of PVDF-based polymeric films may represent a breakthrough in the development of antibacterial coatings for devices used at hospital setting, taking advantage on the use of mechanical stimuli (pressure/touch) to exert antibacterial and antibiofilm activity. STATEMENT OF SIGNIFICANCE: The application of physical methods in alternative to the common chemical ones is seen as a breakthrough for avoiding the emergence of antimicrobial resistance. Antimicrobial strategies that take advantage on the capability of bacteria to sense physical stimuli such as mechanical and electrical cues are scarce. Electroactive nanocomposites comprised of poly(vinylidene fluoride-co-trifluoroethylene (PVDF-TrFE) and green-synthesized silver nanoparticles (AgNPs) were developed to obtain material able to inhibit the colonization of microorganisms. By applying a mechanical stimuli to the nanocomposite, which ultimately mimics movements such as walking or touching, an antimicrobial effect is obtained, resulting from the synergy between the electroactive microenvironments created on the surface of the material and the AgNPs. Such environments sensitize the bacteria to low doses of antimicrobials., 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 © 2021 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Intensity modulated radiation therapy and brachytherapy are standard techniques of irradiation for the treatment of oral cavity cancers. These techniques are detailed in terms of indication, planning, delineation and selection of the volumes of interest, dosimetry and patients positioning control. This is an update of the guidelines of the French Society of Radiotherapy Correspondence., (Copyright © 2021 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Despite the growing interest in recreational boating and the increasing number of marinas along the world's coastlines, environmental knowledge of these ecosystems is still very scarce. Detailed data of pollutants in marinas are necessary to provide a global approach of environmental risks in the context of international management strategies. In the present study, a set of 64 variables (30 in seawater and 34 in sediments) were measured to compare marinas from the Southern Iberian Peninsula (SIP). Uni and multivariate analyses showed significant differences among marinas, evidencing the importance of management on a local scale. The most relevant variables determining these differences were turbidity and the biocide Irgarol 1051 in seawater, and granulometry, hydrocarbons and faecal coliforms in sediment. The use of normalization techniques with Al or Fe, and the suitability of different methodologies to measure Total Organic Matter in marinas were also discussed. Additionally, we perform a comprehensive literature review of worldwide marina stressors and develop a simple and straightforward method for assessing environmental quality. The method was tested using SIP marinas and was based on the comparison of 15 selected sediment stressors with background values, concentrations of worldwide sediment quality guidelines (SQGs), and reference conditions/security thresholds established by the programme of coastal waters in port areas (ROM 5.1). A global score was assigned using a new proposed index, Marinas Environmental Pollution Index (MEPI), ranging from 0 to 150 points according to the environmental quality (<90: bad, 90-120: moderate, >120: good). MEPI of marinas from SIP ranged from 60 to 110 points indicating bad or moderate levels of pollution. Environmental quality is one of the decisive factors for awarding eco-labels or eco-certifications, such as Blue Flags in marinas. Therefore, pollution baseline information and environmental tools are mandatory for correct assignation of these awards and necessary for assessing the efficiency of management actions., Competing Interests: Declaration of competing interest We declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Introduction: Therapy with cationic amphiphilic drugs (Amiodarone or hydroxychloroquine) may result in biochemically and ultrastructurally similar lipid inclusions in many cells also affected by Fabry disease (FD). In addition, it often results in similar clinical manifestations such as cornea verticillata. This may lead to a FD misdiagnosis, especially when a complete medical history is not available to the ophthalmologist confronted with cornea verticillata or to the pathologist examining a kidney biopsy. When enzymatic/genetic test or pathological studies are not conclusive, a specific biomarker may help clarify this dilemma. The plasma globotriaosylsphingosine (lyso-Gb3) assay has high sensitivity and specificity and is elevated above normal levels in FD., Materials and Methods: We measured plasma lyso-Gb3 levels in male patients receiving Amiodarone or hydroxychloroquine and compared it with male patients with classic and late onset variant of FD., Results: In all Fabry patients (classic and late onset variant) α-GalA activity was deficient in dried blood spot and plasma lyso-Gb3 was above normal levels. Patients on treatment with Amiodarone or hydroxychloroquine had normal values for α-GalA activity and lyso-Gb3 in plasma., Conclusions: Even when Amiodarone or hydroxychloroquine may decrease α-GalA activity in vitro or in cell culture, our results showed that in all patients lyso-Gb3 plasma levels remain normal with no evidence of reduction in α-GalA activity, confirming the specificity of this biomarker for the diagnosis of FD., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Plant growth-promoting bacteria are a promising alternative to improve agricultural sustainability. Gluconacetobacter diazotrophicus is an osmotolerant bacterium able to colonize several plant species, including sugarcane, coffee, and rice. Despite its biotechnological potential, the mechanisms controlling such osmotolerance remain unclear. The present study investigated the key mechanisms of resistance to osmotic stress in G. diazotrophicus. The molecular pathways regulated by the stress were investigated by comparative proteomics, and proteins essential for resistance were identified by knock-out mutagenesis. Proteomics analysis led to identify regulatory pathways for osmotic adjustment, de novo saturated fatty acids biosynthesis, and uptake of nutrients. The mutagenesis analysis showed that the lack of AccC protein, an essential component of de novo fatty acid biosynthesis, severely affected G. diazotrophicus resistance to osmotic stress. Additionally, knock-out mutants for nutrients uptake (Δtbdr and ΔoprB) and compatible solutes synthesis (ΔmtlK and ΔotsA) became more sensitive to osmotic stress. Together, our results identified specific genes and mechanisms regulated by osmotic stress in an osmotolerant bacterium, shedding light on the essential role of cell envelope and extracytoplasmic proteins for osmotolerance., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2020 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: To compare the discriminatory capacity of the quick sequential organ failure assessment (qSOFA) vs. the systemic inflammatory response syndrome (SIRS) score for predicting 30-day mortality and intensive care unit (ICU) admission in patients with suspicion of infection at an HIV reference centre., Methods: We performed a prospective cohort study including consecutive adult patients who had suspected infection and who were subsequently admitted to the medical ward. Variables related to qSOFA and SIRS were measured at admission. The performance (area under the receiver operating curve, AUROC) of qSOFA (score ≥2) and SIRS (≥2 criteria) as a predictor of 30-day mortality and ICU admission was evaluated., Results: One hundred seventy-three patients (mean ± standard deviation age, 42.6 ± 12.4 years) were included in the analysis; 107 (61.8%) were male, and 111 (64.2%) were HIV positive. Respiratory and gastrointestinal infections occurred in 49 (28.3%) and 23 (13.3%), respectively. The 30-day mortality rate was 9 (5.2%) of 173. The prognostic performance of qSOFA was similar compared to SIRS, with an AUROC of 0.68 (95% confidence interval, 0.55-0.81) and 0.69 (95% confidence interval, 0.53-0.86) (p 0.96). Twenty patients (11%) were admitted to the ICU; qSOFA and SIRS had a similar discriminatory capacity for ICU admission (AUROC 0.63 (95% confidence interval, 0.51-0.75) and 0.63 (95% confidence interval, 0.50-0.76)), respectively)., Conclusions: We found a poor prognostic accuracy of the qSOFA to predict 30-day mortality in hospitalized patients suspected of infection in a setting with a high burden of HIV infection., (Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

The increasing number of anthropogenic areas in the marine environment results in significant impact to adjacent ecosystems. In fact, the presence of marinas modifies the original environmental conditions and ends up disturbing the faunal community. However, despite the essential role displayed by the macrofauna on marinas' fouling biota, certain taxa such as polychaetes have been poorly studied. The present study provides the first spatial characterization of the epibiont polychaete fauna associated with the bryozoan Bugula neritina in marinas along the Iberian Peninsula and the north of Morocco. A total of 32 polychaete species were identified, with Syllidae being the most diverse family. Furthermore, the environmental factors involved in the occurrence and abundance of the dominant species Salvatoria clavata were also analyzed by Generalized Linear Models; results showed that the highest predicted values of S. clavata abundance appeared at marinas with high levels of nutrient enrichment and of heavy metals concentration., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Biofouling represents a major economic, environmental and health concern for which new eco-friendly solutions are needed. International legislation has restricted the use of biocidal-based antifouling coatings, and increasing efforts have been applied in the search for environmentally friendly antifouling agents. This research work deals with the assessment of the interest of a series of synthetic chalcone derivatives for antifouling applications. Sixteen chalcone derivatives were synthesized with moderate yields (38-85%). Antifouling bioactivity of these compounds was assessed at different levels of biological organization using both anti-macrofouling and anti-microfouling bioassays, namely an anti-settlement assay using mussel (Mytilus galloprovincialis) larvae, as well as marine bacteria and microalgal biofilms growth inhibition bioassays. Results showed that three compounds (11, 12, and 16) were particularly active against the settlement of mussel larvae (EC 50 7.24-34.63 μM), being compounds 12 and 16 also able to inhibit the growth of microfouling species (EC 50 4.09-20.31 μM). Moreover, the most potent compounds 12 and 16 were found to be non-toxic to the non-target species Artemia salina (<10% mortality at 25 μM). A quantitative structure-activity relationship model predicted that descriptors describing the ability of molecules to form hydrogen bonds and encoding the shape, branching ratio and constitutional diversity of the molecule were implied in the antifouling activity against the settlement of mussel larvae. This work elucidates for the first time the relevance of synthesizing chalcone derivatives to generate new non-toxic products to prevent marine biofouling., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The Neonatal Behavioral Assessment Scale (NBAS) is a widely used in the neurobehavioral assessment of neonates in clinical practice and research. Lester's data reduction system for the NBAS items is the most often used in research, but the few factor analytic studies carried out with it leave gaps in its validation. The current study aimed to test and compare (a) the factorial structure of the Lester's data reduction system for the NBAS and (b) an alternative data reduction system, slightly modified from Lester's system. The NBAS was administered to 196 healthy Portuguese full-term infants (51% male) in the first 72 h of life (M = 43.63 h). Construct validity of the data reduction systems was tested through confirmatory factor analysis (CFA). Lester's original system was compared to three alternative models, two of which included a revision of the scoring rules for three items and the exclusion of five items. The CFA generally supported the six-factor structure. However, fit indices for Lester's original model were only fair. An alternative, revised model with a second-order factor - Self-Organizing System - demonstrated a better fit. The results provide evidence to support a modified form of Lester's six behavioral clusters as a data reduction model for the NBAS items., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The causes of acute febrile illness (AFI) in Latin America are diverse and their complexity increases as the proportion of fever due to malaria decreases, as malaria control measures and new pathogens emerge in the region. In this context, it is important to shed light on the gaps in the epidemiological characteristics and the geographic range for many AFI aetiologies., Objectives: To review studies on community-acquired fever aetiology other than malaria in Latin America, and to highlight knowledge gaps and challenges needing further investigation., Sources: PubMed from 2012 to April 2018., Content: We found 17 eligible studies describing 13 539 patients. The median number of pathogens tested per individual was 3.5 (range 2-17). A causative pathogen could be determined for 6661 (49.2%) individuals. The most frequently reported pathogen during the study periods was dengue virus (DENV) (14 studies), followed by chikungunya virus (nine studies) and Zika virus (seven studies). Among the studies reporting concurrent infections, 296 individuals (2.2%) were found to have co-infections. In-hospital mortality was reported in eight (47%) studies, ranging between 0% and 18%., Implications: DENV fever is the febrile illness most frequently reported, reflecting its importance, while chikungunya and zika viruses present increasing trends since their emergence in the region. Studies with systematic and harmonized approaches for detection of multiple pathogens are needed and would probably reveal a higher burden of neglected pathogens such as Rickettsia spp. and arenaviruses. The lack of point-of-care tests and harmonized approach limits the care provided by health professionals and the efficacy of surveillance for AFI in the region., (Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Purpose: Epilepsy is a common neurologic disorder requiring continued treatment during pregnancy. Treatment with antiepileptic drugs (AEDs) is needed for seizure control, but the risk of adverse events has to be minimized for both mother and foetus. Available data on pregnancy and foetal/postnatal outcomes following eslicarbazepine acetate (ESL) exposure via parent is herein presented for the first time., Methods: ESL's global safety database was reviewed to identify pregnancy cases with exposure to ESL reported up to October 21st, 2017. The EMBASE™ and MEDLINE ® databases were searched to identify literature reports of such cases published between May 1st, 2009 and October 21st, 2017., Results: Overall, 91 notifications of pregnancy were identified, of which 79 involved ESL exposure: 28 during clinical trials and 51 from 8-years of post-marketing surveillance. Thirty pregnancies resulted in live birth without congenital anomalies; in 25 pregnancies the outcome was ongoing and 3 was unknown; 18 cases resulted in abortion (10 spontaneous and 8 induced) and congenital anomalies were identified in 5 cases (no clear relationship with ESL was established). ESL was used concomitantly to other AEDs in 11 of the 15 pregnancies for which the outcome was spontaneous abortion and congenital anomaly. Literature review did not yield additional information., Conclusions: Available data are insufficient to draw conclusions regarding ESL use during pregnancy. Although no particular safety problem was identified, ESL exposure during pregnancy will continue to be monitored and evaluated., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Hyperglycemia occurs in tuberculosis (TB), but the long-term impact is unknown. We estimated the prevalence of hyperglycemia and compared the TB treatment outcomes and 1-year mortality rate according to the glycemic status noted during TB treatment., Methods: We conducted a retrospective cohort analysis of adult patients who had TB and HIV coinfection and started receiving TB treatment at the Instituto Nacional de Infectologia Evandro Chagas, Brazil, between 2010-2015. Diabetes Mellitus (DM) and hyperglycemia were defined according to the American Diabetes Association. After excluding for known DM at baseline, the proportion of participants who developed new-onset DM after TB treatment was assessed. TB outcome was classified as successful or adverse (i.e., treatment failure, abandonment, and death). Kaplan-Meier survival curves were compared by the log-rank test based on the glycemic status of patients. Multivariate Cox regression models were used to assess the association between hyperglycemia and 1-year mortality. Two-sided p values <0.05 were considered statistically significant., Results: We identified 414 euglycemic patients (87.5%), 49 hyperglycemic patients (10.3%), and 10 patients with known DM (2.1%). Diabetic patients were older compared to the euglycemic and hyperglycemic patients (47.9 vs. 37 vs. 39.7 years, respectively, p=0.001). Diabetic patients frequently had cavitation on chest image compared to hyperglycemic and euglycemic patients (50% vs. 23.4% vs. 15.3%, p=0.007, respectively). Hyperglycemic patients had more new-onset DM at follow-up compared to euglycemic (22 vs. 1; p<0001). Hyperglycemia was associated with adverse outcomes (71.4% vs. 24.6%, p<0.0001) compared to euglycemia. Crude 1-year mortality was significantly higher in patients with hyperglycemia compared with euglycemia (48.9% vs. 7.9%; unadjusted HR: 5.79 (3.74-8.96)). In the adjusted Cox models, hyperglycemia remained a significant factor for increased 1-year mortality (adjusted HR: 3.72 (2.17-6.38)]., Conclusions: Hyperglycemia frequently occurs in HIV-infected patients who commence TB treatment, and it increases the risks of adverse TB outcomes and 1-year mortality. Glucose testing during TB treatment detects patients at risk of adverse outcomes., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Zika virus (ZIKV) is transmitted to humans primarily by Aedes mosquito bites. However, circumstantial evidence points to a sexual transmission route., Objectives: To assess the sexually acquired ZIKV cases and to investigate the shedding of ZIKV in genital fluids., Data Sources: PubMed, Scopus, Pro-MED-mail and WHO ZIKV notification databases from inception to December 2016., Selection Criteria: Reports describing ZIKV acquisition through sex and studies reporting the detection or isolation of ZIKV in the genital fluids were included., Risk-Of-Bias Assessment: The risk of bias was assessed using the National Institute of Health Tool., Results: Eighteen studies reporting on sex-acquired ZIKV and 21 describing the presence of ZIKV in genital fluids were included. The overall risk of bias was moderate. Sexual transmission was male-female (92.5%), female-male (3.7%) and male-male (3.7%). Modes of sexual transmission were unprotected vaginal (96.2%), oral (18.5%) and anal (7.4%) intercourse. The median time between onset of symptoms in the index partner and presumed sexual transmission was 13 days (range 4-44 days). ZIKV RNA was detected in semen as late as 188 days (range 3-188 days) following symptom onset, and infectious virus was isolated in semen up to 69 days after symptom onset. No study reported ZIKV isolation from female genital samples, but detection did occur up to 13 days after symptom onset., Conclusions: ZIKV is potentially sexually transmitted and persists in male genital secretions for a prolonged period after symptom onset. PROSPERO systematic review registration number CRD42016041475., (Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

The biointeractions of graphene-based materials depend on their physico-chemical properties. These properties can be manipulated by polymer adsorption. Graphene nanoplatelets (GNP-C) were modified with PVA, HEC, PEG, PVP, chondroitin, glucosamine, and hyaluronic acid. These materials were characterized by SEM, DLS, XPS, Raman spectroscopy, and TGA. Surface adsorption was confirmed for all polymers. Biocompatibility evaluation showed that all of these materials induced low haemolysis (<1.7%) at concentrations up to 500μgmL(-1). GNP-C-PVA and GNP-C-HEC presented the lowest haemolysis percentages and were therefore more thoroughly studied. The morphology of HFF-1 cells was investigated by microscopy (optical, fluorescence, TEM) in order to evaluate interactions with GNP materials. Small GNP-C nanoplatelets were observed to enter cells independently of the surface treatment. For pristine GNP-C at a concentration of 50μgmL(-1), ROS production increased 4.4-fold. This effect is lower for GNP-C-PVA (3.3-fold) and higher for GNP-C-HEC (5.1-fold). Resazurin assays showed that GNP-C caused toxicity in HFF-1 cells at concentrations above 20μgmL(-1) at 24h, which decreased at 48 and 72h. PVA surface adsorption rendered GNP-C non-toxic at concentrations up to 50μgmL(-1). LIVE/DEAD assays showed that at 20 and 50μgmL(-1) cell death is significantly lower for GNP-C-PVA compared to pristine GNP-C. Modification of nanoplatelets with HEC resulted in no benefit in terms of biocompatibility, whereas PVA considerably improved the biocompatibility., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Intensity modulated radiation therapy (IMRT) and brachytherapy are standard techniques for the irradiation of oral cavity cancers. These techniques are detailed in terms of indication, preparation, delineation and selection of the volumes, dosimetry and patient positioning control., (Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Study Objective: The study objective is to determine the incidence of oral soft tissue trauma during classic direct laryngoscopy for tracheal intubation and the risk factors associated with it., Design: This is a prospective observational study., Setting: The setting is at a ward., Patients: The patients are adults submitted to elective interventions in general surgery requiring tracheal intubation by classic direct laryngoscopy., Interventions: During 6 months, all patients were interviewed 12-24 hours before anesthesia and after surgery and underwent a detailed oral examination performed by an anesthesiology blind to anesthetic management details and preoperative patient care., Measurements: Evaluation of oral soft tissue injuries includes oral mucosa including the gums; the alveolar mucosa in the edentulous patient, palate, and the buccal mucosa; lips (mucosa and skin); and the tongue. Injury severity was assessed using the severity scale presented routinely in Portuguese legal medicine research: grade 0, no injuries had; grade 1, mild severity injuries; grade 2, medium severity injuries; and grade 3, major severity injuries., Main Results: Soft tissue trauma was observed in 278 (52.1%) patients. Soft tissue injury occurred once in 204 (38.2%) patients, 2 in 64 (38.2%) patients, and 3 times in 10 (1.9%) patients. Tongue injury was the most common type of soft tissue trauma (36.3%) followed by lower lip injury (22.3%), upper lip injury (7.1%), and oral mucosa injury (2.1%). All the lesions were grade 1 or 2. Only oral mucosa injury was found to be associated with age group (P = .021)., Conclusions: Our study reveals a high incidence of lesions grade 1 or 2 in soft tissue., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The presence of naphthenic acids (NAs) and other organic constituents in oil sands process-affected water (OSPW) stored in tailings ponds, poses a serious environmental threat due to their potential toxicity to aquatic organisms and wild life. In this work, four fractions of OSPW, extracted by dichloromethane at different pHs, were ozonated to determine the ozone impact on NAs degradation. Extracts distributions showed that high carbon number NAs (14-22) were associated with higher pH fractions (pH>7) and smaller carbon number NAs (7-13) with lower pH fractions (pH≤7). Extracts showed similar hydrogen deficiency (Z-number) patterns centered on Z=6. Analysis of the speciation of NAs and oxidized NAs in the four fractions showed that ozonation degraded most NAs (55% to 98%). Despite the high degradation levels, there was still significant toxicity of the fractions toward goldfish macrophages and measurable toxicity toward Vibrio fischeri. The toxicity of such a complex matrix as OSPW may be attributed to other organic compounds and degradation by-products not currently detected. Thus, there is a need to elucidate which compounds are responsible for the remaining OSPW toxicity and to determine if combined processes, such as ozonation followed by biological treatment, are able to completely detoxify OSPW. This work is taking the first steps into this direction, narrowing down the range of compounds which might be responsible for the toxicity., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The adhesion of Escherichia coli to glass and polydimethylsiloxane (PDMS) at different flow rates (between 1 and 10 ml s(-1)) was monitored in a parallel plate flow chamber in order to understand the effect of surface properties and hydrodynamic conditions on adhesion. Computational fluid dynamics was used to assess the applicability of this flow chamber in the simulation of the hydrodynamics of relevant biomedical systems. Wall shear stresses between 0.005 and 0.07 Pa were obtained and these are similar to those found in the circulatory, reproductive and urinary systems. Results demonstrate that E. coli adhesion to hydrophobic PDMS and hydrophilic glass surfaces is modulated by shear stress with surface properties having a stronger effect at the lower and highest flow rates tested and with negligible effects at intermediate flow rates. These findings suggest that when expensive materials or coatings are selected to produce biomedical devices, this choice should take into account the physiological hydrodynamic conditions that will occur during the utilization of those devices., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Oil sands process-affected water (OSPW) is a complex mixture of organic and inorganic contaminants, and suspended solids, generated by the oil sands industry during the bitumen extraction process. OSPW contains a large number of structurally diverse organic compounds, and due to variability of the water quality of different OSPW matrices, there is a need to select a group of easily measured surrogate parameters for monitoring and treatment process control. In this study, kinetic and surrogate correlation models were developed to predict the degradation of naphthenic acids (NAs) species during the ozonation of OSPW. Additionally, the speciation and distribution of classical and oxidized NA species in raw and ozonated OSPW were also examined. The structure-reactivity of NA species indicated that the reactivity of individual NA species increased as the carbon and hydrogen deficiency numbers increased. The kinetic parameters obtained in this study allowed calculating the evolution of the concentrations of the acid-extractable fraction (AEF), chemical oxygen demand (COD), and NA distributions for a given ozonation process. High correlations between the AEF and COD and NA species were found, suggesting that AEF and COD can be used as surrogate parameters to predict the degradation of NAs during the ozonation of OSPW., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Abdominal fat is associated with metabolic disorders, leading to cardiovascular risk factors and numerous diseases. This study aimed to analyze the effect of plaster body wrap in combination with aerobic exercise on abdominal fat., Methods: Nineteen female volunteers were randomly divided into intervention group (IG; n  = 10) performing aerobic exercise with plaster body wrap, and control group (CG; n  = 9) performing only exercise. Subcutaneous and visceral fat were measured using ultrasound; subcutaneous fat was also estimated on analysis of skinfolds and abdominal perimeters., Results: At the end of the 10-sessions protocol, the IG demonstrated a significant decrease ( p ≤ 0.05) in subcutaneous fat at the left anterior superior iliac spine (ASIS) level and in iliac crest perimeter measurements. A large intervention effect size strength (0.80) was found in subcutaneous fat below the navel and a moderate effect size strength on the vertical abdominal skinfold (0.62) and the perimeter of the most prominent abdominal point (0.57). Comparing the initial and final data of each group, the IG showed a significant decrease in numerous variables including visceral and subcutaneous fat above and below the navel measured by ultrasound ( p ≤ 0.05)., Conclusion: Plaster body wrap in combination with aerobic exercise seems to be effective for abdominal fat reduction.

The main indications of brachytherapy for head and neck cancers are limited tumours of the oral cavity, the oropharynx and the nasopharynx. This technique can be exclusive, associated with external radiotherapy or postoperative. This is also a treatment for second localizations in previously irradiated areas. If low-dose rate brachytherapy is the reference, the pulse dose rate brachytherapy by control of the dose rate and optimisation of the dose distribution is the technique to be preferred. High-dose rate brachytherapy is an option. The major prognosis factors of local control and complications are the use of a leaded protection of the mandible, the intersource spacing (1.2-1.4 cm), the volume treated (30 cm(3), i.e. three loops), the safety margin (5 mm), the dose rate (0.5 Gy/h), the total dose (65 Gy in case of exclusive brachytherapy, 25 Gy in case of a combination of external beam irradiation [50 Gy] and brachytherapy in the oropharyngeal carcinomas, 35 Gy in case of a combination of external beam irradiation [40 Gy] and brachytherapy in the oral cavity carcinomas, 60 Gy in case of a second localization in previous irradiated tissues), the delay between external irradiation and brachytherapy (<20 days), the dose per fraction and the treated volume for high-dose rate brachytherapy. Brachytherapy, when possible, is the optimal method of irradiation of head and neck carcinomas with limited volume., (Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Background: The British Medical Research Council (BMRC) staging has been extensively used to evaluate the disease severity and establish the approximate prognosis of tuberculous meningitis., Aims: This study aimed at analyzing the predictive accuracy for mortality and neurological sequelae of a set of clinical features, laboratory tests and imaging., Methods: We compared the British Medical Research Council (BMRC) staging with a new scoring proposal to predict the prognosis of patients with Central Nervous System Tuberculosis. Data from Ecuador was collected. A score was built using a Spiegelhalter and Knill-Jones method and compared with BMRC staging with a ROC curve., Results: A total of 213/310 patients (68.7%) were in BMRC stage II or III. Fifty-seven patients died (18.3%) and 101 (32.5%) survived with sequelae. The associated predictors were consciousness impairment (p = 0.010), motor deficit (p = 0.003), cisternal effacement (p = 0.006) and infarcts (p = 0.015). The new score based on these predictors yielded a larger area under the curve of 0.76 (95% CI: 0.70-0.82), but not significantly different from the BMRC (0.72: 95% CI: 0.65-0.77)., Conclusions: This modern score is easy to apply and could be a sound predictor of poor prognosis. However, the availability of modern tests did not improve the ability to predict a bad outcome.

Glycolaldehyde (GA) is a highly reactive aldehyde that can be generated during inflammation and hyperglycemia. It can react with arginine and lysine residues impairing protein function. As inflammation and diabetes present haemostatic dysfunction, we hypothesized that GA could participate in this process. The aim of this study was to investigate if plasma incubated in the presence of GA presents alteration in the coagulation process. We also aimed to evaluate the role of fibrinogen in GA-induced haemostatic dysfunction. For this purpose, plasma and fibrinogen were each incubated separately, either in the presence or absence of 1 mM GA for 8 and 4 h, respectively. After that, plasma coagulation and fibrin polymerization kinetics were recorded, as well as the kinetic of plasma clot digestion and fibrinolysis protein carbonylation was quantified. An SDS-PAGE was run to check the presence of cross-linking between fibrinogen chains. GA induced a delay in plasma coagulation and in fibrin polymerization. Maximum absorbance decreased after GA treatment, indicating the generation of thinner fibers. Fibrin generated after complete coagulation showed resistance to enzymatic digestion, which could be related to the generation of thinner fibers. Protein carbonylation also increased after GA treatment. All parameters could be reversed with AMG (a carbonyl trap) co-treatment. The data presented herein indicate that GA causes post-translational modification of lysine and arginine residues, which are central to many events involving fibrinogen to fibrin conversion, as well as to fibrinolysis. These modifications lead to the generation of persistent clots and may contribute to mortality seen in pathologies such diabetes and sepsis.

Aggregates of the amyloid-beta peptide (Abeta) play a central role in the pathogenesis of Alzheimer's disease (AD). Identification of proteins that physiologically bind Abeta and modulate its aggregation and neurotoxicity could lead to the development of novel disease-modifying approaches in AD. By screening a phage display peptide library for high affinity ligands of aggregated Abeta(1-42), we isolated a peptide homologous to a highly conserved amino acid sequence present in the N-terminus of apolipoprotein A-I (apoA-I). We show that purified human apoA-I and Abeta form non-covalent complexes and that interaction with apoA-I affects the morphology of amyloid aggregates formed by Abeta. Significantly, Abeta/apoA-I complexes were also detected in cerebrospinal fluid from AD patients. Interestingly, apoA-I and apoA-I-containing reconstituted high density lipoprotein particles protect hippocampal neuronal cultures from Abeta-induced oxidative stress and neurodegeneration. These results suggest that human apoA-I modulates Abeta aggregation and Abeta-induced neuronal damage and that the Abeta-binding domain in apoA-I may constitute a novel framework for the design of inhibitors of Abeta toxicity.

Gingival leishmaniasis is unusual and is mainly observed in immunocompromised patients. We report a case involving the palate, uvula, and gingiva of an HIV-negative patient who was initially diagnosed as having paracoccidioidomycosis. The patient underwent a biopsy for parasite isolation and in situ histopathology and immunohistochemistry. The Leishmania spp. were detected in lesions of the uvula and gingiva. Despite the poor state of teeth, the gingival lesions were caused by American tegumentary leishmaniasis (ATL). The gingival lesions presented an intense inflammatory infiltrate permeated by neutrophils. Immunohistochemistry revealed a predominantly lymphocytic infiltrate. The patient responded well to treatment, with no reactivation during follow-up. The rarity of gingival involvement in immunocompetent patients and the need for inclusion of ATL in the differential diagnosis of gingival lesions are discussed.

Pulmonary rehabilitation (PR) improves physical capacity and health quality in patients with chronic obstructive pulmonary disease (COPD). However, the effect of exercise on oxidative stress markers in COPD patients is only partially known. This study was designed to evaluate the oxidative stress response to long-term exercise in patients with COPD enrolled in a PR program. Fifteen COPD patients (FEV1 < 60%), age between 50 and 60 years, ex-smokers, were separated in two groups: exercise-trained (n=8) and sedentary group (n=7). Exercise consisted of an 8-week conditioning program using a cycle ergometer (three times a week, 1h session). An endurance test (60% of maximal load in an incremental cycle test) was performed before and after PR. Blood samples were obtained at baseline and immediately after each endurance test. We measured the index of lipid peroxidation, thiobarbituric acid reactive species (TBARS), total radical-trapping antioxidant parameter (TRAP) and xanthine oxidase (XO) activity. TRAP was significantly different between the exercise-trained group and sedentary group of COPD patients. Baseline TBARS values were increased after the exercise training program but decreased after the endurance test. XO decrease after effort in the trained and untrained groups. The results suggest that patients with COPD are characterized by increased systemic and pulmonary oxidative stress markers both at rest as well as induced by cardiopulmonary exercise test and that PR program was associated with decreased systemic exercise-induced oxidative damage.

Obesity is frequently associated with consumption of high amounts of sugar and/or fat. Studies have demonstrated a high prevalence of overweight and obesity associated or not with increase rates of psychiatry disorders, in particular mood and anxiety disorders. Recent works have demonstrated an association between specific genes involved in oxidative stress metabolism and anxiety-like behavior. The aim of this study was to investigate the effect of a highly palatable diet enriched with sucrose in body fat mass composition, anxiety behavior and brain oxidative status. Twenty male Wistar rats received two different diets during four months: standard chow (SC) and highly palatable (HP). Metabolic parameters, behavioral tests and oxidative stress status were evaluated. Body fat mass, insulin sensitivity and glucose tolerance were altered in the HP group (p<0.01). The same group spends less time in light compartment and had a lower risk assessment behavior (p<0.05) but no differences were observed in the open field test habituation (p>0.05). Protein degradation, DCF and TBARS levels were not different in the hippocampus between groups; however, there were higher levels of protein degration in frontal cortex of HP groups (p<0.05), although DCF and TBARS levels don't differ from the SC group (p>0.05). In conclusion, our data suggest that the consumption of HP diet leads to an obese phenotype, increases protein oxidation in frontal cortex and appears to induce anxiety-like behavior in rats.

Metal speciation analysis in MTs was carried out in two tropical fish species of Brazil, the freshwater fish pearl cichlid (Geophagus brasiliensis) and the marine fish white sea catfish (Netuma barba), that are presently used to monitor the effects of heavy metal pollution in aquatic ecosystems in Brazil. In order to obtain the MT fraction, liver cytosols from both fish species where subjected to size exclusion fractionation, monitoring on-line the metal signal (Cd, Cu and Zn) by ICP-MS while protein elution was followed by on-line UV detection. That MT fraction was then separated by anion-exchange (AE)-FPLC, whose optimal chromatographic conditions were optimized for the separation of the different hepatic MT isoforms existing in both fish species. Specific detection of separated metalloforms was carried out again by the hyphenation of the AE chromatographic system with the ICP-MS instrument. The analytical results showed that MTs of these fish species, unknown so far, exhibited unique characteristics in comparison with standard MTs and other fish liver MTs. In fact, MT isoforms of N. barba turned out to be very anionic, as indicated by their high retention in the Mono Q column and the strong ionic strength required to separate them. As for G. brasiliensis, cadmium was exclusively present in only one of the peaks of the MT isoforms showing a unique metal-binding behavior for MT in this fish species. The differences between the MTs among these species and the different association of metals in particular MT isoforms display the importance of the metal speciation analysis in these proteins prior to its use as bioindicators.

The primary objective of this study was to evaluate the possible role of leptin, body weight and immune status on reproductive activity throughout the transition period from cyclicity to seasonal anestrus, during anestrus and resumption of ovarian activity in Lusitano mares. Mares in good body condition were monthly monitored throughout 2 years (10 mares in each year) for evaluation of their reproductive status by sequential ultrasonography and plasma progesterone determinations. On the second year, all mares were weighed. Progesterone and leptin were assayed by radioimmunoassay (RIA). Parameters of the immune status (phagocytosis and oxidative burst of neutrophils, characterisation of circulating lymphocyte subsets) were also evaluated. Phagocytosis and oxidative burst in blood neutrophils were measured by flow cytometry using commercially available kits. Lymphocyte subsets were assessed by indirect immunofluorescence staining after incubation with monoclonal antibodies specific for CD2, CD19, CD4, CD8 cells markers by flow cytometry. Natural killer cells and B cells were estimated mathematically. No significant difference was found in phagocytosis, oxidative burst and circulating lymphocyte subsets at anestrus and at either phase of the estrous cycle (p>0.05), suggesting that the immune status of the mare was not influenced by the seasonal changes in ovarian activity. This study also suggests that body weight has a direct relationship with plasma leptin levels. Increased concentrations of this hormone in circulation might be associated with the restart or maintenance of ovarian cyclicity in Lusitano mares.

Background: Lung infection with Burkholderia cepacia complex before lung transplantation in patients with cystic fibrosis is a major risk factor for decreased post-operative survival rates compared with those of patients colonized with the more common opportunistic pathogen Pseudomonas aeruginosa. Because adherence to mucosal surfaces is an important initial step in infection, we investigated the use of non-toxic neutral polysaccharides and a sugar alcohol to prevent adherence of B cepacia complex to allograft airway epithelium., Methods: We used human airway explants prepared from donor tracheobronchial tissue to test the effect of dextrans and xylitol in inhibiting the binding of Burkholderia cepacia complex. We used immunofluorescence and electron microscopy to determine the distribution of bacteria in the explants., Results: Burkholderia cepacia complex bound to the explants and was found only in the surface mucus layer. Dextran 40 kd applied before adding the bacteria decreased the number of bound organisms by 80% to 99%. Smaller molecular mass dextrans (4 and 20 kd) were ineffective. Xylitol inhibited bacterial binding by 67% to 85%. Both agents seemed to decrease the thickness of the surface mucus, suggesting that they may indirectly inhibit bacterial binding by removing adherent surface mucus., Conclusions: Treating donor lungs with dextran 40 kd or xylitol before (and possibly after) surgery may inhibit the adherence of Burkholderia cepacia complex to airways and may prevent or decrease subsequent infection of the allografts.

In this study we compared the antioxidant properties of five different extracts of different composition obtained from Achyrocline satureioides' inflorescences (Compositae), a widely used Brazilian folk medicinal herb. All of the extracts presented significant antioxidant potential identified by TRAP assay, which increased in the presence of human plasma. Characterization of the content of flavonoids in each extract showed that the FDP80 (ethanol 80%) and FFr (enriched flavonoid fraction) extracts contained a higher content of flavonoids. Cytotoxicity of the extracts as determined in Sertoli cell culture showed that FDP80 and FFr were highly toxic at most concentrations tested. The extracts induced a significant increase in lipid peroxidation levels in Sertoli cells. These results suggest that medicinal herb extracts that contain higher flavonoid concentrations and shows higher antioxidant protection in vitro might not always produce the greatest benefit.