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Medication-overuse headache (MOH) can develop from primary headaches. MOH is usually the result of overuse of symptomatic medications. It is a noteworthy personal and societal burden. The identification and treatment of patients at risk for MOH is an essential component of MOH management. Medication overuse can be modifiable and can advance from episodic to chronic migraine. Treatment for MOH is complex, and experts in the field have varied views on the most appropriate strategy for MOH treatment. The objective of this review is to give a comprehensive synopsis of the literature for the management of MOH. Treatment strategies, such as detoxification and prevention, are the debatable issues. Medication withdrawal is the foundation for management. The available literature suggested abrupt withdrawal with preventive approaches for early management. Bridging therapy could be useful to get relief from withdrawal symptoms. Multidisciplinary choices proved beneficial in supporting withdrawal and preventing relapse. Worldwide, the termination of overused medications has been observed as a standard treatment strategy; however, patient-specific approaches should be taken., 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., (© 2023 Krymchantowski, Jevoux, Krymchantowski, Ramos, Barbosa and Silva-Neto.)

In this study, we evaluate the effects of intercropping pigeon pea ( Cajanus cajan (L.) Millsp.) with tropical pastures for feeding Nellore cattle and compared animal performance and enteric CH 4 emissions with other pasture-based systems during the dry and rainy seasons of 2021. Thirty-six Nellore steers (with a body weight of 221 ± 7 kg and an age of 15-16 months) were randomly distributed in three treatments with three replicates (in paddocks of 1.5 hectares each): (1) a degraded pasture of Urochloa spp. (DEG); (2) a recovered and fertilized pasture of Urochloa spp. (REC); and (3) pigeon pea intercropped with Urochloa spp. (MIX). Enteric CH 4 emissions were estimated using the sulfur hexafluoride (SF 6 ) tracer gas technique, and dry matter intake (DMI) was determined using internal (iNDF) and external (TiO 2 ) markers. Forages were collected by hand plucking after observations of ingestive behavior, and feces was collected after voluntary defecation. The proportion of grass and legume intake was estimated by C stable isotopes, and the forage nutritional quality was determined, while animal performance was monitored monthly, and the stocking rate was adjusted by the "put and take" technique. The results indicated that intercropping pigeon pea with tropical grasses is an interesting strategy for sustainable livestock production based on pastures. The MIX treatment was able to meet the nutritional requirements of the animals, which presented higher performance. In addition, there was a reduction in CH 4 emissions up to 70% when expressed per average daily weight gain in comparison to the DEG treatment.

Objective:  To understand the impact of the coronavirus disease 2019 pandemic on in vitro fertilization (IVF) clinical pregnancy rates and analyze factors that may have influenced their outcome., Methods:  This was a retrospective observational study conducted at a tertiary-care Brazilian fertility center. All fresh IVF and embryo warming cycles performed from March 11 to December 31, 2018-2021 were analyzed, and their data were used to calculate fertilization, embryo cleavage, cycle cancellation, embryo transfer (ET), and clinical pregnancy rates. Statistical tests were used to evaluate the alterations found. Logistic regression models were used to explore the association of the categorical variables with the observed clinical pregnancy rates. Data from 2018 and 2019 (prepandemic) and 2020 and 2021 (pandemic) were grouped., Results:  A total of 756 cycles were analyzed ( n  = 360 prepandemic and n  = 396 pandemic). The age group of the patients, fertilization rates, and cleavage rates did not have significant differences ( p  > 0.05). There was a reduction in the percentage of fresh IVF and an increase in embryo warming cycles ( p  = 0.005) during the pandemic. There was also an increase in fresh cycle cancellations ( p  < 0.001) and a reduction in ET rates ( p  < 0.001). The pandemic had a negative impact on clinical pregnancy rates ( p  < 0.001) especially due to the increase in fresh cycle cancellations ( p  < 0.001)., Conclusion:  Embryo warming cycles with subsequent frozen-thawed ET were presented as a viable alternative to continue assisted reproductive treatments against pandemic restrictions on fresh cycles, ensuring clinical pregnancy, albeit at a lower rate than that of the prepandemic period., Competing Interests: The authors have no conflict of interests to declare., (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare clinical laboratory condition with high mortality rates, resulting from ineffective overactivation of the immune system. Data in the Brazilian literature is scarce, contributing to the challenge in standardizing conducts and performing an early diagnosis of HLH., Objective: To describe the clinical, laboratory, and evolutionary findings on HLH patients treated at a pediatric hospital., Methods: This is an observational, cross-sectional and retrospective study on children diagnosed with HLH, hospitalized between 2009 and 2019. The diagnostic criteria were those described in the Histiocyte Society protocol. The authors evaluated HLH patient laboratory tests, myelograms and bone marrow biopsies, clinical characteristics and therapy., Results: Twenty-three patients were included, 52.2% of whom were males. The age at diagnosis ranged from one to one hundred and eighty months. Four cases were classified as Primary HLH and nineteen, as Secondary HLH. The main triggers were infections and rheumatological diseases. All children had bicytopenia, and 95.4% had hyperferritinemia. Nineteen patients had liver dysfunction, sixteen had neurological disorders and fourteen had kidney injury. Pulmonary involvement was seen in 61.9%, acting as a worse prognosis for death (p = 0.01). Nine patients underwent the immuno-chemotherapy protocol proposed in the HLH 2004. The time to confirm the diagnosis varied from five to eighty days. The lethality found was 56.3%., Conclusions: The present study is the most extensive retrospective exclusively pediatric study published in Brazil to date. Despite the limitations, it was possible to demonstrate the importance of discussing HLH as a pediatric emergency., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2021 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder., Objective: The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience., Methods: Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy., Results: From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease., Conclusions: Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options., Competing Interests: AOK: Speaker for Allergan, Ipsen Pharma, Merz, and Onyxcann Cantera; AT: Lilly, Teva, Ache, Supera, Allergan, and Novartis; CAPR: Teva, Novartis, Eli Lilly, Lundbeck, Aché, Apsen, and EJPC: Speaker for Novartis, Allergan, Libbs, and Lilly; EMS: Speaker for Libbs, Allergan, Novartis, Lilly, Lundbeck, and Teva. Advisory board: Allergan, Libbs, Teva, and Lundbeck; EMM: Speaker for Teva, Novartis, Eli Lilly, and Allergan; Advisory board: Libbs and Eli Lilly; GOMT: Speaker for Eli Lilly; HCC: Speaker for Allergan and Eli Lilly; ID, JAMJ, BAJS, MRCFF, MEJ, PFMMF, RPSN, YDF: No conflict of interests to declare; AJS: Speaker for Eli Lilly, Novartis, and Teva; JJC: Speaker for Eli Lilly, Novartis, Teva, and Libbs; Advisory board: Teva, Novartis, and Eli Lilly; JCS: Speaker for Teva, Novartis, and Allergan, Lilly; LCC: Speaker for Allergan, Novartis, and Sanofi; Advisory board: Allergan; LMB: Speaker for Novartis; LPQ: Speaker for Eli Lilly and Allergan; Advisory board: Eli Lilly and Teva; MNPS: Speaker for Eli Lilly, Novartis, Teva, Allergan, and Libbs; Advisory board: Sanofi, Eli Lilly, and Libbs; MENMC: Speaker for Eli Lilly, Novartis, Teva, and Allergan; Advisory board: Eli Lilly; MFPP: Grants from Fapesp and CNPq; personal fees from Allergan, Eurofarma, Eli Lilly, Libbs, Novartis, Pfizer, and Teva, during studies; PMP: Speaker for Novartis, Teva, Eli Lilly, and Libbs; Advisory board: Libbs; PSFS: Speaker for Teva, Novartis, Allergan, EMS, and Politec; Advisory board: Libbs and Eli Lilly; PAK: Fees for services from Libbs, Novartis, Allergan, Livanova, and Teva; PASRF: Speaker for Eli Lilly, Novartis, Allergan, and Libbs; Advisory board: Novartis, and Eli Lilly., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers., Competing Interests: AOK: speaker for Allergan, Ipsen Pharma, Merz, Onyxcann Cantera; ATNMC: speaker for Lilly, Teva, Ache, Supera, Allergan, Novartis; CAPR: speaker for Teva, Novartis, Eli Lilly, Lundbeck, Aché, Apsen, Cellera; EJP: speaker for Novartis, Allergan, Libbs, Lilly; EMS: speaker for Libbs, Allergan, Novartis, Lilly, Lundbeck, Teva; advisory board: Allergan, Libbs, Teva, Lundbeck; EMM: speaker for Teva, Eli Lilly, Allergan; advisory board: Libbs, Eli Lilly; GOMT: speaker for Eli Lilly; HCC: speaker for Allergan, Eli Lilly; JAS: speaker for Eli Lilly, Novartis, Teva; JJFC: speaker for Eli Lilly, Novartis, TEVA, Libbs; advisory board: TEVA, Novartis, Eli Lilly; JGS: speaker for Teva, Novartis, Allergan, Lilly; LCC: speaker for Allergan, Novartis, Sanofi; advisory board: Allergan; LMB: speaker for Novartis; LPQ: speaker for Eli Lilly, Allergan; advisory board: Eli Lilly, TEVA; MNPS: speaker for Lilly, Novartis, Teva, Allergan, Libbs; advisory board: Sanofi, Lilly, Libbs; MENMC: speaker for Eli Lilly, Novartis, Teva, Allergan; advisory board: Eli Lilly; MFPP: Grants from Fapesp and CNPq; personal fees from Allergan, Eurofarma, Eli Lilly, Libbs, Novartis, Pfizer, and Teva, during studies; PMP: speaker for Novartis, Teva, Eli Lilly, Libbs; advisory board: Libbs; PSFS: speaker for Teva, Novartis, Allergan, EMS, Politec; advisory board: Libbs, Lilly; PAK: fees for services to Libbs, Novartis, Allergan, Livanova, Teva; PASRF: speaker for Eli Lilly, Novartis, Allergan, Libbs; advisory board: Novartis, Eli Lilly; IF, JAMJ, JBAS, MRCFF, MEJ, PFMF, RPSN, YDF: no conflict of interests to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The effectiveness of advanced technologies on eliminating antibiotic resistant bacteria (ARB) and resistance genes (ARGs) from wastewaters have been recently investigated. Solar photo-Fenton has been proven effective in combating ARB and ARGs from Municipal Wastewater Treatment Plant effluent (MWWTPE). However, most of these studies have relied solely on cultivable methods to assess ARB removal. This is the first study to investigate the effect of solar photo-Fenton upon ARB and ARGs in MWWTPE by high throughput metagenomic analysis (16S rDNA sequencing and Whole Genome Sequencing). Treatment efficiency upon priority pathogens and resistome profile were also investigated. Solar photo-Fenton (30 mg L -1 of Fe 2+ intermittent additions and 50 mg L -1 of H 2 O 2 ) reached 76-86% removal of main phyla present in MWWTPE. An increase in Proteobacteria abundance was observed after solar photo-Fenton and controls in which H 2 O 2 was present as an oxidant (Fenton, H 2 O 2 only, solar/H 2 O 2 ). Hence, tolerance mechanisms presented by this group should be further assessed. Solar photo-Fenton achieved complete removal of high priority Staphylococcus and Enterococcus, as well as Klebsiella pneumoniae and Pseudomonas aeruginosa. Substantial reduction of intrinsically multi-drug resistant bacteria was detected. Solar photo-Fenton removed nearly 60% of ARGs associated with sulfonamides, macrolides, and tetracyclines, and complete removal of ARGs related to β-lactams and fluoroquinolones. These results indicate the potential of using solar-enhanced photo-Fenton to limit the spread of antimicrobial resistance, especially in developing tropical countries., 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 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: The pandemic caused by the COVID-19 resulted in worldwide social isolation and leading to significant personal distress, particularly among health professionals on the front lines. Those factors' relevance and their impact on sexual function in this population have not yet been established., Aim: To evaluate the impact of the pandemic on sexual function in healthcare professionals and medical students at a reference center in the treatment of COVID-19 in Brazil., Methods: A cross-sectional analysis with online questionnaires about sexual function was sent to health professionals and medical students from the HC-FMUSP medical complex. The questionnaire evaluated Total Sexual and Masturbatory Frequency prior and during the pandemic, libido and sexual satisfaction changes with a detailed inquire about demographics and personal factors. An objective assessment of sexual function was also made using the validated sexual quotient questionnaires., Main Outcome Measures: Differences in intercourse frequency, libido, and overall sexual satisfaction, in a sample of healthcare professionals particularly vulnerable to the pandemic effects., Results: A total of 1,314 responses were available with a mean age of 37 years. Worsening of sexual satisfaction was reported by 44.5% of the participants, with the following associated factors: Lower libido, missing Nightlife, Higher Masturbatory Frequency, and isolation from the partner. Remaning sexualy actively and having higher sexual frequency appear to decrease the chance of worsening sexual function. Worsening of Libido was reported by 37% and had several associated factors, including missing of Nightlife, older age, isolation from the partner among others. Being male and sexually active was associated with a smaller chance of reporting lower libido., Conclusion: We were able to observe a sharp drop in Libido and General Sexual Satisfaction. Although an increase in pornography consumption and masturbatory frequency did occur, these factors were not associated with greater sexual satisfaction. The impact of COVID-19 on this population's sexual health is not to be underestimated and should be further studied in the follow-up of the pandemic. Neto RP, Nascimento BCG, Carvalho dos Anjos Silva G, et al. Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil. Sex Med 2021;9:100408., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

This review aims to gather main achievements and limitations associated to the application of solar photocatalytic processes with regard to the removal of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) from municipal wastewater treatment plant effluent (MWWTPE). Solar photocatalytic processes were chosen considering the context of developing tropical countries. Among these processes, solar photo-Fenton has been proved effective for the elimination of ARB from MWWTPE at neutral pH in bench and pilot scale and also under continuous flow. Yet, ARG removal varies as according to the gene. Irradiation intensity and matrix composition play a key role on treatment efficiency for this purpose. The use of sulfate radical in modified solar photo-Fenton is still incipient for ARB and ARG removal. Also, investigations related to ARB resistance profile and horizontal gene transfer rates after solar photo-Fenton treatment must be further analyzed. Regarding solar heterogeneous photocatalysis, TiO 2 and TiO 2 -composites applied in suspension are the most commonly investigated for the removal of ARB and ARGs. Irradiation intensity, temperature and catalyst dosage affect treatment efficiency. However, most studies were performed in synthetic solutions using reduced sample volumes. Extended exposition times and addition of H 2 O 2 to the system (solar/TiO 2 /H 2 O 2 ) are required to prevent bacteria regrowth and ensure ARG abatement. In addition, enhancement of TiO 2 with graphene or (semi)metals improved ARB elimination. Differences concerning irradiation intensity, matrix composition, catalyst dosage, and model ARB and ARGs used in studies analyzed in this review hinder the comparison of photocatalysts synthesized by various research groups. Finally, future research should aim at evaluating the efficiency of solar photocatalytic processes in real matrices originated from sewage treatment systems applied in developing countries; determining indicators of antimicrobial resistance in MWWTPE; and investigating ARB mutation rate as well as the removal of cell-free ARGs present in suspension in MWWTPE., 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 The Authors. Published by Elsevier B.V. All rights reserved.)

Aim: The aim of this study is to present our experience in the management of hormonally active adrenal tumors in children., Material and Methods: We did a retrospective chart review of all children with hormonally active adrenal tumors evaluated at the endocrinology clinic and operated at our institution between 1983 and 2019., Results: There were 75 patients included in the study, 58 with adrenocortical tumors (ACTs) and 17 with pheochromocytomas (PCCs). Within the group of patients with ACTs, there were 41 females and 17 males. The mean age was 58.3 (SD: 87.9; range: 9-211) months. The clinical manifestation of the tumor's hormonal activity was virilization in 37 cases, Cushing syndrome in 5, and mixed in 16. A positive family history was present in 11 patients (18.9%). The mean tumor size was 48.2 (SD: 22.4; range: 7-120) mm. The pathological diagnosis was adenoma in 42 cases, carcinoma in 15 cases, and macronodular hyperplasia in 1. Median follow-up was 192 (range: 50-290) months. Tumor recurrence occurred in 6 patients (10.3%), and there were three disease-related deaths (5%). Within the group of patients with PCCs, there were 11 males and 6 females. The mean age was 146.7 (SD: 71.2; range: 60-216) months. A positive family history was present in 7 patients (41.2%). The mean tumor size was 36.6 (SD: 16.7; range: 7-120) mm. The pheochromocytoma was classified as benign in 15 cases and as malignant in 2. During a median follow-up of 180 (range: 127-300) months, recurrence was observed in 6 cases (35.3%) and disease-related death in 1 case (5.9%)., Conclusions: Proper diagnosis and management at our referral center were associated with a high cure rate, even in cases of malignant tumors. Familial surveillance is highly recommended., Level of Evidence: Level IV., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Migraine diagnosis is based on clinical aspects and is dependent on the experience of the attending physician. This study aimed to describe the patients journey profile until they start their experience in a tertiary headache center., Methods: In a cross-sectional study, medical charts from migraine patients were reviewed to describe which treatments, procedures and follow-up strategies are performed until the first appointment with a headache specialist. Patients from both sexes, ≥18 years old, which came to their first visit from March to July 2017 were included. Sociodemographic information, headache characteristics, diagnostic methods previously used, clinical history, family history and the treatments previously used were assessed in the first appointment with a specialist. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were also applied. Descriptive analyses were performed to describe the sample profile and statistical tests were used to evaluate factors associated with the type of migraine (chronic or episodic)., Results: The sample consisted of 465 patients. On average, the pain started 17.1 (SD = 11.4) years before the first appointment with a headache specialist. Most of patients were classified as having chronic migraine (51.7%), with an average frequency of 15.5 (SD = 9.9) days per month. Regarding patients' journey until a specialist, most patients were submitted to laboratory tests (74.0%), cranial tomography (66.8%) and magnetic resonance imaging (66.8%) as diagnostic methods, and preventive drugs (70.2%) and acupuncture (61.0%) as treatments. After stratification by migraine type as episodic or chronic, patients with chronic migraine were submitted to more magnetic resonance imaging test, acupuncture, psychotherapy, used preventive drugs, and reported to have used topiramate without beneficial effects., Conclusions: Brazilian patients with migraine experiment a long journey until getting to a headache specialist and are submitted to a great number of unnecessary exams, especially those with chronic migraine.

We propose the small-angle flip-flop (SAFF) pulse sequence as an alternative procedure for the rapid measurement of the 1 H spin-lattice relaxation time in the laboratory frame (T 1 ) of solid and liquid substances, in a time-domain NMR experiment. Based on the original flip-flop pulse sequence, this technique allows the fast estimation of T 1 values of samples that require minutes to hours of acquisition time if traditional pulse sequences are employed. We have applied SAFF to different substances, with T 1 ranging from microseconds up to seconds, including natural clays, polymers, and organic and inorganic solvents. We also demonstrate the potential of the pulse sequence in the real-time monitoring of dynamic processes, such as the conformational changes of polymeric materials during heating. The results we obtained with SAFF are comparable with those acquired with the inversion-recovery pulse sequence, with the addition of several benefits. This pulse sequence obeys steady-state and magnetization-conserving principles, making it possible to dismiss the need for relaxation delay times of the order of 5T 1 . SAFF has shown high sensitivity in the resolution of individual components of T 1 in multiexponential systems and can be easily integrated to well-established pulse sequences, such as Magic Sandwich Echo and Carr-Purcell-Meiboom-Gill, for the single-shot determination of T 1 and T 2 or T 2* ., (© 2019 John Wiley & Sons, Ltd.)

Poly(vinilidene fluoride) was characterized before and after stress relaxation by tensile tests and time-domain nuclear magnetic resonance (TD-NMR). Tensile tests were performed to provide mechanical properties, focused on the data of elastic modulus for this matter. The TD-NMR technique was used to calculate the fraction of crystalline, constrained amorphous and free amorphous phase, and the transversal relaxation time of each of these phases.

The effects of granule disruption, the addition of glycerol and montmorillonite on the granule structure of corn starch were investigated by proton NMR relaxation, through the T 2* , T 1 and T 1ρ relaxation times. Films containing 0%, 1%, 5% and 7%(w/w) of clay were prepared by solution casting and the relaxometry data were compared with those gleaned from WAXD, TGA and SEM techniques. Starch gelatinization without glycerol or clay results in an amorphous and rigid film having a dipole coupling higher than that observed for the granule. The plasticization reduces the chains rigid fraction by more than 20% and increases the adsorption of moisture in the region of greater molecular mobility. The addition of 1% of clay reduces the adsorption of moisture and, in concentrations of 5% and 7%, the agglomerates reduce the plasticization effect. These features studied were observed by the Tube-Reptation and Renormalized Rouse models applied at low frequencies., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The treatment of peptic ulcers induced by H. pylori remains challenging due to the deep mucous layer location of bacteria preventing antimicrobial drug access. The present work aimed to design and evaluate in vitro dual responsive (both pH and magnetic field-sensitive) polymeric magnetic particles loaded with amoxicillin as a smart drug carrier for deep mucous layer penetration and in situ drug release. Magnetite particles were produced by the co-precipitation method and subsequently coated with the Eudragit ® S100 and amoxicillin by using the spray-drying technique. The physicochemical characterization of the obtained particles was carried out by optical and scanning electron microscopy, X-ray powder diffraction, Fourier transform infrared spectroscopy, nitrogen adsorption/desorption isotherms, and vibrating sample magnetometry. Additionally, drug release tests and antibacterial activity tests were evaluated in vitro. Microparticles presented 17.2 ± 0.4 μm in size and their final composition was 4.3 ± 1.5% of amoxicillin, 87.0 ± 2.3% of Eudragit, and 9.0 ± 0.3% of magnetite. They were both pH and magnetic field responsive while presenting antimicrobial activity. On one side, magnetic field responsiveness of particles is expected to prompt them to reach bacterium niche in deep mucous layer by means of magnetic forces. On the other side, pH responsiveness is expected to enable drug release in the neutral pH of the deep mucous layer, preventing undesired delivery in the acidic gastric lumen. Smart microparticles were designed presenting both pH and magnetic field responsiveness as well as antimicrobial activity. These may be promising assets for peptic ulcer treatment.

The objective of this study was to assess the effects of different prebiotic dietary oligosaccharides (inulin, fructo-oligosaccharide, galacto-oligossacaride, short-chain fructo-oligosaccharide, resistant starch, corn dietary oligosaccharide and polydextrose) in non-fat sheep milk ice cream processing through physical parameters, water mobility and thermal analysis. Overall, the fat replacement by dietary prebiotic oligosaccharides significantly decreased the melting time, melting temperature and the fraction and relaxation time for fat and bound water (T 22 ) while increased the white intensity and glass transition temperature. The replacement of sheep milk fat by prebiotics in sheep milk ice cream constitutes an interesting option to enhance nutritional aspects and develop a functional food., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Unlabelled: CYP2D6 is a high polymorphic enzyme from P450, responsible for metabolizing almost 25% of drugs. The distribution of different mutations among CYP2D6 alleles has been associated with poor, intermediate, extensive and ultra-metabolizers., Aim: To evaluate how missenses mutations in CYP2D6*7 and CYP2D6*14A poor metabolizer alleles affect CYP2D6 stability and function., Materials & Methods: CYPalleles database was used to collect polymorphisms data present in 105 alleles. We selected only poor metabolizers alleles that presented exclusively missenses mutations. They were analyzed through seven algorithms to predict the impact on CYP2D6 structure and function., Results: H324P, the unique mutation in CYP2D6*7, has high impact in enzyme function due to its occurrence between two alpha-helixes involved in active site dynamics. G169R, a mutation that occurs only in CYP2D6*14A, leads to the gain of solvent accessibility and severe protein destabilization., Conclusion: Our in silico analysis showed that missenses mutations in CYP2D6*7 and CYP2D6*14A cause CYP2D6 dysfunction.

Leishmaniasis, a human parasitic disease with manifestations ranging from cutaneous ulcerations to fatal visceral infection, is caused by several Leishmania species. These protozoan parasites replicate as extracellular, flagellated promastigotes in the gut of a sandfly vector and as amastigotes inside the parasitophorous vacuole of vertebrate host macrophages. Amastins are surface glycoproteins encoded by large gene families present in the genomes of several trypanosomatids and highly expressed in the intracellular amastigote stages of Trypanosoma cruzi and Leishmania spp. Here, we showed that the genome of L. braziliensis contains 52 amastin genes belonging to all four previously described amastin subfamilies and that the expression of members of all subfamilies is upregulated in L. braziliensis amastigotes. Although primary sequence alignments showed no homology to any known protein sequence, homology searches based on secondary structure predictions indicate that amastins are related to claudins, a group of proteins that are components of eukaryotic tight junction complexes. By knocking-down the expression of δ-amastins in L. braziliensis, their essential role during infection became evident. δ-amastin knockdown parasites showed impaired growth after in vitro infection of mouse macrophages and completely failed to produce infection when inoculated in BALB/c mice, an attenuated phenotype that was reverted by the re-expression of an RNAi-resistant amastin gene. Further highlighting their essential role in host-parasite interactions, electron microscopy analyses of macrophages infected with amastin knockdown parasites showed significant alterations in the tight contact that is normally observed between the surface of wild type amastigotes and the membrane of the parasitophorous vacuole.

Background: Amastins are surface glycoproteins (approximately 180 residues long) initially described in Trypanosoma cruzi as particularly abundant during the amastigote stage of this protozoan parasite. Subsequently, they have been found to be encoded by large gene families also present in the genomes of several species of Leishmania and in other Trypanosomatids. Although most amastin genes are organized in clusters associated with tuzin genes and are up-regulated in the intracellular stage of T. cruzi and Leishmania spp, distinct genomic organizations and mRNA expression patterns have also been reported., Results: Based on the analysis of the complete genome sequences of two T. cruzi strains, we identified a total of 14 copies of amastin genes in T. cruzi and showed that they belong to two of the four previously described amastin subfamilies. Whereas δ-amastin genes are organized in two or more clusters with alternating copies of tuzin genes, the two copies of β-amastins are linked together in a distinct chromosome. Most T. cruzi amastins have similar surface localization as determined by confocal microscopy and western blot analyses. Transcript levels for δ-amastins were found to be up-regulated in amastigotes from several T. cruzi strains, except in the G strain, which is known to have low infection capacity. In contrast, in all strains analysed, β-amastin transcripts are more abundant in epimastigotes, the stage found in the insect vector., Conclusions: Here we showed that not only the number and diversity of T. cruzi amastin genes is larger than what has been predicted, but also their mode of expression during the parasite life cycle is more complex. Although most T. cruzi amastins have a similar surface localization, only δ-amastin genes have their expression up-regulated in amastigotes. The results showing that a sub-group of this family is up-regulated in epimastigotes, suggest that, in addition of their role in intracellular amastigotes, T. cruzi amastins may also serve important functions during the insect stage of the parasite life cycle. Most importantly, evidence for their role as virulence factors was also unveiled from the data showing that δ-amastin expression is down regulated in a strain presenting low infection capacity.

The increasing number of protected and registered cultivars and problems involving seed commercialization make distinction and identification of cultivars imperative. Millet (Pennisetum glaucum), a crop species with protected cultivars in Brazil, has been the target of seed piracy. Thus, with the objective of identifying different lots with regard to origin, we characterized six cultivars of commercialized millet of proven origin by means of the electrophoretic patterns of the isoenzymes alcohol dehydrogenase, esterase and glutamate oxaloacetate transaminase and by microsatellite markers, using primers specific for millet. The six cultivars were separated with four microsatellite loci. Based on this characterization, certification of genetic purity was undertaken for public domain commercialized seed lots. The isoenzymatic markers were also tested for stability of the patterns. Esterase patterns were altered in seeds with different physiological quality and health conditions, but this alteration did not hinder identification of the cultivars. It was observed that most of the millet seed lots commercialized in Brazil as being in public domain belong to other cultivars.

Endosymbiont-bearing trypanosomatids have been considered excellent models for the study of cell evolution because the host protozoan co-evolves with an intracellular bacterium in a mutualistic relationship. Such protozoa inhabit a single invertebrate host during their entire life cycle and exhibit special characteristics that group them in a particular phylogenetic cluster of the Trypanosomatidae family, thus classified as monoxenics. In an effort to better understand such symbiotic association, we used DNA pyrosequencing and a reference-guided assembly to generate reads that predicted 16,960 and 12,162 open reading frames (ORFs) in two symbiont-bearing trypanosomatids, Angomonas deanei (previously named as Crithidia deanei) and Strigomonas culicis (first known as Blastocrithidia culicis), respectively. Identification of each ORF was based primarily on TriTrypDB using tblastn, and each ORF was confirmed by employing getorf from EMBOSS and Newbler 2.6 when necessary. The monoxenic organisms revealed conserved housekeeping functions when compared to other trypanosomatids, especially compared with Leishmania major. However, major differences were found in ORFs corresponding to the cytoskeleton, the kinetoplast, and the paraflagellar structure. The monoxenic organisms also contain a large number of genes for cytosolic calpain-like and surface gp63 metalloproteases and a reduced number of compartmentalized cysteine proteases in comparison to other TriTryp organisms, reflecting adaptations to the presence of the symbiont. The assembled bacterial endosymbiont sequences exhibit a high A+T content with a total of 787 and 769 ORFs for the Angomonas deanei and Strigomonas culicis endosymbionts, respectively, and indicate that these organisms hold a common ancestor related to the Alcaligenaceae family. Importantly, both symbionts contain enzymes that complement essential host cell biosynthetic pathways, such as those for amino acid, lipid and purine/pyrimidine metabolism. These findings increase our understanding of the intricate symbiotic relationship between the bacterium and the trypanosomatid host and provide clues to better understand eukaryotic cell evolution.

Nanocomposites based on polycaprolactone (PCL), containing concentrations of 1, 3 and 5 wt% of sodium montmorillonite (NT-25) and organo-modified montmorillonite clay, with three different salts (Viscogel B7, Viscogel S4 and Viscogel B8), were prepared employing the solution intercalation method using chloroform. The PCL nanocomposites were characterized by relaxometry, through determination of the hydrogen spin-lattice relaxation times using low-field nuclear magnetic resonance (NMR). Conventional X-ray diffraction (XDR) was also used to measure the basal space of the nanoclay. The proton spin-lattice relaxation parameters showed that hybrid nanocomposites were formed, containing different parts of intercalated and exfoliated organoclay. The proton T1rhoH also indicated changes in the microstructure, organization and the molecular mobility of the hybrid materials. NMR relaxometry is a good way to evaluate nanomaterials because it provides complementary information, since it is measured in a different time scale. Furthermore, differential scanning calorimetry and thermogravimetric analysis were also used to investigate the crystallization and thermal behavior of the nanocomposites, respectively. All materials had low crystallization temperature (Tc) and the melting temperature (Tm) were very close to that of the PCL matrix, but the degree of crystallinity of the nanocomposites decreased. TGA analysis demonstrated that montmorillonite accelerates PCL's decomposition while unmodified montmorillonite has the opposite effect.

In Olinda there are an estimated 50 marble quarries, 3 of which are members of the stone extraction and finishing industry's state union. The objective here is to quantitatively evaluate the noise present at the workplace in two of Olinda's unionized marble quarries. The data to be analyzed was collected during December 2010, this month representing one of the four busiest months of production. The samples were collected from Tuesdays to Fridays in order to avoid irregular outcomes. Instantaneous readings were taken with the decibel meter to identify points of Noise Pressure Level (NPL) higher than Action Level (AL). Afterwards, the full procedure for the characterization of noise level with the decibel meter in order to compare the Homogeneous Exposure Group (HEG) to those with High Risk Exposure (HRE) was initiated. The noisiest sources came from humid cutting machines, marble saws and polishing equipment. The activities of cutter and polisher became classified as follows: unsafe, in a critical situation and in need of priority control for the work environment with noise level values varying from 95.0 dB(A) to 103.3 dB(A), calling for the use of ear protection during the entire work day.

The finishing of marble occurs in quarries all over Brazil, being the most significant dimension of the ornamental stone sector, with 7,000 businesses. Recife's Metropolitan Area (RMR) contains approximately 106 marble quarries, 25 of them unionized. The study focused on the application of Preliminary Risk Analysis, conducted at two unionized quarries: M1, a small business; and the second, M2, considered a micro enterprise. In this analysis both the administrative and the productive sectors were evaluated. The fieldwork was done in the month of December 2010. The study revealed that the two quarries carried moderate risks in the administrative sector, mainly due to ergonomic factors, and that in the productive sectors the risks were high, specifically because of excess noise, dust material, and precarious electrical installations. Using the results of the qualitative analysis as a base, the need for quantitative study presents itself in order to determine the most adequate modes of protection to be of assistance in the management of these risks, guaranteeing the safety and health of the worker and consequently the improvement in productivity in this sector.

Objective: To evaluate left ventricular (LV) systolic function by means of echocardiography in patients with osteosarcoma treated with doxorubicin alone or in combination with dexrazoxane., Methods: The study analyzed 55 patients with osteosarcoma, with or without metastasis, undergoing a six-cycle chemotherapy regimen of doxorubicin, who were divided into two groups according to dexrazoxane use. Group I: Thirty-seven patients who did not receive dexrazoxane (28 males, average age 15.4 years). Group II: Eighteen patients who did receive dexrazoxane (15 males, average age 15.1 years). Four echocardiographic evaluations were performed: 1) before the beginning of the chemotherapy (initial evaluation); 2) up to two weeks after the third cycle; 3) up to two weeks after the fifth cycle; and 4) up to four weeks after the sixth cycle of chemotherapy (final evaluation). The left ventricular systolic function was assessed by the fractional percentage of systolic shortening (FS%) on echocardiography. Alterations in the contractile function or cardiac toxicity were defined as FS% values equal to or lower than 29%, and/or by a drop in FS% by an absolute value equal to or greater than 10 units of the baseline value of each patient., Results: No significant difference as to age, gender, and race was observed between the groups. The cumulative dose of doxorubicin was significantly higher in group II throughout all phases of the treatment: 174 x 203 mg/m(2); 292 x 338 mg/m(2) and 345 x 405 mg/(2) (p < 0.0001). According to previously established criteria, the incidence of LV systolic dysfunction was not significantly different (p=0.248) between patients in group I (18.92%) and patients in group II (11.1%). The variance analysis with repeated measurements did not show significant differences in the means of fractional percentage of systolic percentage (FS%) throughout the study (p=0.967). However, a significant difference (p=0.029) was observed between the FS% means in groups I and II at evaluations 2 (35.67 x 37.21%), 3 (34.95 x 38.47%) and 4 (35.26 x 38.22%)., Conclusion: Data in this study show that in patients with osteosarcoma treated with doxorubicin alone or combined with dexrazoxane, the LV systolic function, as assessed by the fractional percentage of systolic shortening mean, showed a better performance in the group that received dexrazoxane. On the other hand, the occurrence of systolic dysfunction was similar in both groups.

In the State of Amazonas and in areas nearby Manaus, the snakes responsible for the majority of accidents are Bothrops atrox and Lachesis muta muta, with a percentage of confirmed species of 76% and 17%, respectively. Frequently, in the absence of the laquetic and bothropic-laquetic antivenoms, the Instituto de Medicina Tropical de Manaus (IMTM) has been using bothropic antivenom in the treatment of laquetic accident. In this paper is related a case of accident caused by L. muta muta; the patient was treated with bothropic antivenom, and after received twenty ampoules of this antivenom, maintained blood incoagulability until the 13th day after the accident. Experiments to obtain the potency of the bothropic antivenom for the coagulant and hemorrhagic activities has been done, using Bothrops atrox venom as control. The results showed that the potency of the antivenom for the hemorrhagic activity was similar, and the potency for the coagulant activity for the L. m. muta venom was 9.2 times minor than that for B. atrox. The antibodies titles from three different lots of bothropic antivenom varied for the L. m. muta venom, and were constant for the B. atrox venom. Due to the inefficiency of the bothropic antivenom on the neutralization of the coagulant activity for the L. m. muta venom, the use of bothropic antivenom is not recommended in the treatment of Lachesis muta muta accidents.