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Aline de Freitas Brito,1 Caio Victor Coutinho de Oliveira,2 Maria do Socorro Brasileiro-Santos,1 Amilton da Cruz Santos1 1Physical Education Department, 2Research Laboratory for Physical Training Applied to Performance and Health, Federal University of Paraíba, João Pessoa, Brazil Background: The purpose of this study was to evaluate the effect of two sessions of resistance exercise with different volumes on post-exercise hypotension, forearm blood flow, and forearm vascular resistance in hypertensive elderly subjects.Methods: The study was conducted with ten hypertensive elderly (65±3 years, 28.7±3 kg/m2) subjected to three experimental sessions, ie, a control session, exercise with a set (S1), and exercise with three sets (S3). For each session, the subjects were evaluated before and after intervention. In the pre-intervention period, blood pressure, forearm blood flow, and forearm vascular resistance were measured after 10 minutes of rest in the supine position. Thereafter, the subjects were taken to the gym to perform their exercise sessions or remained at rest during the same time period. Both S1 and S3 comprised a set of ten repetitions of ten exercises, with an interval of 90 seconds between exercises. Subsequently, the measurements were again performed at 10, 30, 50, 70, and 90 minutes of recovery (post-intervention) in the supine position.Results: Post-exercise hypotension was greater in S3 than in S1 (systolic blood pressure, −26.5±4.2 mmHg versus −17.9±4.7 mmHg; diastolic blood pressure, −13.8±4.9 mmHg versus −7.7±5 mmHg, P

Understanding the genotype-by-environment interaction (GEI) and considering it in the selection process is a sine qua non condition for the expansion of Brazilian eucalyptus silviculture. This study's objective is to select high-performance and stable eucalyptus clones based on a novel selection index that considers the Factor Analytic Selection Tools (FAST) and the clone's reliability. The investigation explores the nuances interplay of GEI and extends its insights by scrutinizing the relationship between latent factors and real environmental features. The analysis, conducted across seven trials in five Brazilian states involving 78 clones, employs FAST. The clonal selection was performed using an extended FAST index weighted by the clone's reliability. Further insights about GEI emerge from the integration of factor loadings with 25 environmental features through a principal component analysis. Ten clones, distinguished by high performance, stability, and reliability, have been selected across the target population of environments. The environmental features most closely associated with factor loadings, encompassing air temperature, radiation, and soil characteristics, emerge as pivotal drivers of GEI within this dataset. This study contributes insights to eucalyptus breeders, equipping them to enhance decision-making by harnessing a holistic understanding-from the genotypes under evaluation to the diverse environments anticipated in commercial plantations., (© 2024. The Author(s).)

The apicomplexa Toxoplasma gondii is capable of actively proliferating in numerous types of nucleated cells, and therefore has a high potential for dissemination and resistance. Thus, the present work aimed to correlate the inoculum concentrations and amount of post-infection parasites with porcine hematological parameters (including biochemistry) through in vitro culture. Porcine blood was incubated with different concentrations of parasites (1.2 × 10 7 , 6/3/1.5 × 10 6  cells/mL), then the concentrations of red blood cells (RBC) and their morphology, total and differential leukocytes, and free peptides were evaluated. In addition, eight different blood samples analyzed before inoculation, where subsequent multivariate analysis was applied to correlate different variables with trophozoite concentration. The results showed no significant variation (p < 0.05) in the relative levels of free peptides, or the relative percentage of RBC at all the parasite concentrations tested. However, the normalized percentages of leukocytes and neutrophils showed a significant reduction, while those of lymphocytes, eosinophils and monocytes showed the opposite behavior. Semi-automatic processing of images exhibited significant microcytosis and hypochromia. The multivariate analysis revealed a positive correlation between the amount number of protozoa (AP) and the variables: "Red cells" and "Neutrophils", an indifference between the AP and the content of free peptides, and the concentration of monocytes in the samples; and a negative correlation for AP and the percentages of lymphocytes and eosinophils. Our results suggest that specific changes in hematological parameters may be associated with different degrees of parasitemia, demanding a thorough diagnostic process and adequate treatment., 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 Elsevier Inc. All rights reserved.)

Aim: The objective was to identify if family social exclusion is associated with child motor and social development delay in Southeastern Brazil., Design: A cross-sectional study was conducted using data from a sample of 348 children under 3 years, proportional to the number of children registered in the primary care centres of the municipality., Methods: Child development was measured using the "Developmental Surveillance Instrument" which was developed by the Ministry of Health in Brazil and is used for public health nurses and clinicians in their practice. An index was used to evaluate social exclusion., Results: The prevalence of child motor and socioemotional developmental delay was 27.6% and 17.2%, respectively. Children in the most social excluded group were more likely to have delayed motor development (OR = 3.4; 95% CI = 1.14; 10.55) and socioemotional developmental delay (OR = 3.9; 95% CI = 1.05; 9.02) than children in the least social excluded group., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Antibiotic resistance can be characterized, in biochemical terms, as an antibiotic's inability to reach its bacterial target at a concentration that was previously effective. Microbial resistance to different agents can be intrinsic or acquired. Intrinsic resistance occurs due to inherent functional or structural characteristics of the bacteria, such as antibiotic-inactivating enzymes, nonspecific efflux pumps, and permeability barriers. On the other hand, bacteria can acquire resistance mechanisms via horizontal gene transfer in mobile genetic elements such as plasmids. Acquired resistance mechanisms include another category of efflux pumps with more specific substrates, which are plasmid-encoded. Efflux pumps are considered one of the main mechanisms of bacterial resistance to antibiotics and biocides, presenting themselves as integral membrane transporters. They are essential in both bacterial physiology and defense and are responsible for exporting structurally diverse substrates, falling into the following main families: ATP-binding cassette (ABC), multidrug and toxic compound extrusion (MATE), major facilitator superfamily (MFS), small multidrug resistance (SMR) and resistance-nodulation-cell division (RND). The Efflux pumps NorA and Tet(K) of the MFS family, MepA of the MATE family, and MsrA of the ABC family are some examples of specific efflux pumps that act in the extrusion of antibiotics. In this review, we address bacterial efflux pump inhibitors (EPIs), including 1,8-naphthyridine sulfonamide derivatives, given the pre-existing knowledge about the chemical characteristics that favor their biological activity. The modification and emergence of resistance to new EPIs justify further research on this theme, aiming to develop efficient compounds for clinical use., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Importance: Approximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children's socioemotional development; however, there is limited evidence on these outcomes., Objective: To examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development., Design, Setting, and Participants: This study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020., Exposures: Lifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey., Main Outcomes and Measures: Child socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments., Results: A total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, -0.022; 95% CI, -0.045 to -0.006) and physical and sexual IPV (mean difference, -0.045; 95% CI, -0.077 to -0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, -0.073; 95% CI, -0.103 to -0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors., Conclusions and Relevance: The findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.

Long after Trypanosoma cruzi infection, 40% of individuals develop a progressive chronic chagasic cardiomyopathy (CCC), with systolic dysfunction and arrhythmias. Since we previously showed IL-1β mediates the development of systolic dysfunction and cardiac arrhythmias in diabetes mellitus and cardiorenal syndrome, and IL-1β remains elevated in Chagas disease patients, here we tested the role of IL-1β in CCC using a mouse model. Mice deficient in IL-1R expression ( Il-1r -/- ) survived acute T. cruzi infection with greater parasitemia than controls but did not lose weight as wild-type (WT) did. At the chronic stage, WT presented prolonged ventricular repolarization intervals (QJ), while Il-1r -/- presented intervals like noninfected controls. Infected Il-1r -/- and WT did not differ in stroke volume (SV), the incidence of cardiac arrhythmias on electrocardiography (EKG), whole heart action potential duration (APD), or the incidence of triggered activity after S1-S2 protocol, which is a measure of susceptibility to cardiac arrhythmias. We also treated chronically infected WT mice with an IL-1R antagonist, anakinra. Treatment shortened the QJ interval but did not improve the SV or the incidence of cardiac arrhythmias on EKG. Anakinra failed to reduce triggered activity following the electrical extra-stimulation protocol. In conclusion, the absence of functional IL-1β/IL-1R signaling did not prevent or reverse the decrease of SV or the incidence of cardiac arrhythmias induced by chronic T. cruzi infection, implying this is not a critical mechanism in generating or maintaining CCC. Since similar cardiac abnormalities were previously credited to IL-1β signaling, ruling out this mechanism is important to discourage further attempts of IL-1β blockade as a therapeutical measure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sousa Oliveira, Moreno-Loaiza, Figueiredo-Vanzan, Peroba Ramos, Mata-Santos, Torres Bozza, Neto Paiva and Medei.)

Radioiodine therapy has been widely used for ablation of remnant tissue after surgical treatment of differentiated thyroid carcinoma (DTC). Internal dosimetry provides a new approach to choosing the administered activity-an approach that considers the distribution and retention of 131 I individually per patient. This study used clinical techniques of internal dosimetry to assess the accumulated activity, internal bone marrow dosimetry, and effective half-life in patients undergoing treatment for DTC. Methods: This was a quantitative, retrospective study analyzing diagnostic documents and images. The internal dosimetry method calculated the dose absorbed by the bone marrow per administered activity of 131 I. Calculation of the absorbed dose took into account the accumulated activity, which was obtained through measurements of whole-body images acquired at 4 intervals over 5 d. Results: The median dose absorbed by the bone marrow per administered activity was 0.117 mGy/MBq (range, 0.043-0.152 mGy/MBq). The median whole-body residence time was 22.0 h (range, 12.6-39.4 h). The median effective half-life was 15.6 h (range, 7.6-28.2 h). Conclusion: Internal dosimetry provides information relevant to safe dose limits for DTC radioiodine therapy, especially in advanced cases of the disease for which greater activities may be necessary., (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)

Brazil is among the top ten countries in preterm delivery worldwide. This study assesses the factors associated with preterm birth in the Western Brazilian Amazon. A population-based cross-sectional study was held between July 2015 to June 2016 in Cruzeiro do Sul, Brazilian Amazon. A total of 1525 births were included in this analysis. Preterm birth was defined as births at gestational age < 37 weeks. A stepwise multiple logistic regression was used to identify factors associated with preterm delivery. The prevalence rate of preterm birth was 7.9% ( n  = 120; 95% CI: 6.5-9.3). After adjusting for confounding factors, a positive association with preterm birth was observed for pregnant women who completed less than six antenatal care visits (OR: 2.93; 95% CI: 1.89-4.56), who had a birth interval of < 18 months (OR: 2.65; 95% CI: 1.04-6.75), and who experienced bleeding (OR: 2.17; 95% CI: 1.39-3.38) and hypertension during pregnancy (OR: 1.74; 95% CI: 1.07-2.82). Factors associated with preterm birth in the Western Brazilian Amazon were mostly related to the aspects of health care provided to women, and thus could be prevented. Proper, timely, and regular antenatal care visits can help reduce adverse outcomes, such as hypertension and bleeding.

Background: The impact of the COVID pandemic on liver transplant (LT) programs varied among countries. Few data are available about that impact in pediatric liver transplant (PLT) programs. This study aimed at comparing the data of our program in Brazil (2019 vs. 2020)., Methods: Retrospective cohort study., Results: One hundred and seventy-four PLT were performed in the period (93% living donors). Patients were divided into two groups according to the LT date: pre-COVID-19 period (march/2019-February/2020) and COVID-19 period (March/2020-February 2021). In the pre-COVID-19 period, 97 LTs were performed, and 77 LTs were performed in the COVID-19 period. Patients in the COVID-19 period were younger (10.9 months vs. 16 months, p 0.009), had higher PELD scores (15 vs. 14, p 0.04), more ascites (66.2 vs. 51.5%, p 0.03), and more frequently hospitalized before LT (27.3 vs. 17.5%). However, there was no difference in post-LT complications, retransplantation nor survival rates. Six (6.2%) patients from pre-COVID-19 period were COVID positive at a median of 15.5 months (14-17.5), and 6 (7.8%) patients from COVID-19 period were COVID positive at a median of 3 months (20 days-6 months) from LT. There was neither mortality nor complications in those patients. Four (33%) were hospitalized, and one had prolonged intubation. Four (33%) were asymptomatic, 4 (33%) had upper airways symptoms, and the remaining had gastrointestinal symptoms., Conclusion: Overall, PLT was not affected during COVID-19 period. Even though patients from COVID-19 period were sicker, there was no significant impact in LT outcomes. All the recipients who tested positive for COVID had a favorable outcome., (© 2021 Wiley Periodicals LLC.)

Medial meniscus posterior root tears (MMPRT) can lead to meniscal extrusion, loss of hoop tension, loss of load-sharing ability and increased contact pressure. Currently, the most commonly used technique for root repair is arthroscopic transtibial pullout repair (ATPR). This article aims to illustrate both normal and abnormal postoperative imaging findings of the MMPRT repair performed with ATPR, with emphasis on MRI. The radiologist must highlight the tunnel position, the reduction of the medial meniscus posterior root to its anatomical attachment, the signs of root healing (continuity and lower signal intensity), and eventual meniscal extrusion or signs of osteoarthritis., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Community and family violence are major global health problems. Approximately 1.3 million deaths around the world and 2.5% of global mortality are due to violence. In El Salvador, youth are exposed to multiple levels of physical and emotional violence, abuse, and crime., Objective: The objective of this study was to investigate the various sources of violence against youth and determine the associations with mental distress symptoms, suicidal ideation, and alcohol use outcomes., Participants and Setting: We use information gathered in 2017 from a representative sample of 13- to 24-year-old adolescents and young adults from El Salvador., Methods: Data used in this analysis came from a nationally cross-sectional household survey called Violence Against Children Survey (VACS) in El Salvador. We used logistic regression models to determine the associations between lifetime witnessing violence, exposure to physical, sexual, emotional violence, and youth mental health outcomes., Results: Polyvictimization was associated with greater odds of each mental health outcome after adjusting for confounders. The strongest relative association was observed between emotional violence and mental distress. Sexual violence and emotional violence were predictors of suicidal ideation. Finally, physical violence and sexual violence were associated with alcohol use. The greatest associations were observed between sexual violence perpetrated by a parent, peer, or another adult in the community and suicidal ideation, at a magnitude of approximately six times higher odds., Conclusions: Preventing violence against youth is likely to improve mental health and wellbeing in El Salvador and other similar contexts worldwide., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Parents are the primary caregivers of young children. Responsive parent-child relationships and parental support for learning during the earliest years of life are crucial for promoting early child development (ECD). We conducted a global systematic review and meta-analysis to evaluate the effectiveness of parenting interventions on ECD and parenting outcomes., Methods and Findings: We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Global Health Library for peer-reviewed, published articles from database inception until November 15, 2020. We included randomized controlled trials (RCTs) of parenting interventions delivered during the first 3 years of life that evaluated at least 1 ECD outcome. At least 2 reviewers independently screened, extracted data, and assessed study quality from eligible studies. ECD outcomes included cognitive, language, motor, and socioemotional development, behavior problems, and attachment. Parenting outcomes included parenting knowledge, parenting practices, parent-child interactions, and parental depressive symptoms. We calculated intervention effect sizes as the standardized mean difference (SMD) and estimated pooled effect sizes for each outcome separately using robust variance estimation meta-analytic approaches. We used random-effects meta-regression models to assess potential effect modification by country-income level, child age, intervention content, duration, delivery, setting, and study quality. This review was registered with PROSPERO (CRD42018092458 and CRD42018092461). Of the 11,920 articles identified, we included 111 articles representing 102 unique RCTs. Pooled effect sizes indicated positive benefits of parenting interventions on child cognitive development (SMD = 0.32, 95% CI [confidence interval]: 0.23, 0.40, P < 0.001), language development (SMD = 0.28, 95% CI: 0.18 to 0.37, P < 0.001), motor development (SMD = 0.24, 95% CI: 0.15 to 0.32, P < 0.001), socioemotional development (SMD = 0.19, 95% CI: 0.10 to 0.28, P < 0.001), and attachment (SMD = 0.29, 95% CI: 0.18 to 0.40, P < 0.001) and reductions in behavior problems (SMD = -0.13, 95% CI: -0.18 to -0.08, P < 0.001). Positive benefits were also found on parenting knowledge (SMD = 0.56, 95% CI: 0.33 to 0.79, P < 0.001), parenting practices (SMD = 0.33, 95% CI: 0.22 to 0.44, P < 0.001), and parent-child interactions (SMD = 0.39, 95% CI: 0.24 to 0.53, P < 0.001). However, there was no significant reduction in parental depressive symptoms (SMD = -0.07, 95% CI: -0.16 to 0.02, P = 0.08). Subgroup analyses revealed significantly greater effects on child cognitive, language, and motor development, and parenting practices in low- and middle-income countries compared to high-income countries; and significantly greater effects on child cognitive development, parenting knowledge, parenting practices, and parent-child interactions for programs that focused on responsive caregiving compared to those that did not. On the other hand, there was no clear evidence of effect modification by child age, intervention duration, delivery, setting, or study risk of bias. Study limitations include considerable unexplained heterogeneity, inadequate reporting of intervention content and implementation, and varying quality of evidence in terms of the conduct of trials and robustness of outcome measures used across studies., Conclusions: Parenting interventions for children during the first 3 years of life are effective for improving ECD outcomes and enhancing parenting outcomes across low-, middle-, and high-income countries. Increasing implementation of effective and high-quality parenting interventions is needed globally and at scale in order to support parents and enable young children to achieve their full developmental potential., Competing Interests: The authors have declared that no competing interests exist.

BACKGROUND The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which manifests mainly as a respiratory condition, has become a global pandemic that causes coronavirus disease-2019 (COVID-19). Although the symptoms remain mild in most patients, the elderly and patients with previous comorbidities have higher rates of morbidity and mortality. Patients with liver cirrhosis, especially after decompensation, may be more susceptible to SARS-CoV-2 infection due to systemic immune dysfunction. CASE REPORT The patient was a 51-year-old man who was hypertensive, an ex-alcoholic abstinent for 6 months, and a smoker. He was diagnosed with alcoholic liver cirrhosis in July 2019, and was using norfloxacin at home for secondary prophylaxis of bacterial peritonitis. He was also using furosemide and spironolactone to control ascites and propranolol for primary prophylaxis of esophageal varices. The patient entered our hospital in July 2020 with cough, dyspnea, runny nose, diarrhea, and fever. During hospitalization, we confirmed infection by COVID-19 and secondary nosocomial pulmonary infection. Chest tomography compatible with ground-glass standard was performed. The patient developed the need for auxiliary oxygen but without invasive mechanical ventilation. The patient received dexamethasone 6 mg/day and broad-spectrum antibiotic therapy (he was started on cefepime but switched to meropenem). At the end of the 14-day isolation period, he was discharged with improved respiratory status. CONCLUSIONS Despite high mortality rates in patients with advanced cirrhosis who become infected with COVID-19, we report a case with a favorable outcome. Success has been achieved with the use of medications in studies of broad-spectrum antibiotics and the rapid detection of complications caused by the virus. Further studies in SARS-CoV-2 patients with chronic liver disease are needed.

Background: Granulomatous Lung Diseases (GLD) encompasses a wide range of infectious and non-infectious conditions characterized by chronic inflammatory response. However, different GLD may share similar imaging findings. In this context, the purpose of this study was to outline the etiological profile and their imaging features in patients with GLD who underwent lung biopsy., Methods: Patients with granulomatous lesions in lung biopsies and previous chest CT performed from 2014 to 2017 at our institution had imaging data reviewed by three blinded radiologists. The imaging features were analyzed according to the Fleischner Society glossary. Categorical data were represented by absolute (n) and relative (%) frequency. The contingency matrices were analyzed by Pearson's Chi-square test. Interreader agreement was assessed by calculating the intraclass correlation coefficient, using kappa (κ) statistic., Results: Thirty-eight of 75 (50.7%) patients were women with a mean age of 59 ± 39 years. Infection was the most common cause of GLD (47/75, 62.7%) and Histoplasma capsulatum (27/75, 36%) was the most prevalent etiology. Nodular pattern was the most common imaging feature in histoplasmosis cases (25/27, 92.6%), whereas it occurred in half of cases (24/48) of GLD of other causes (p < 0.05). Among patients with tuberculosis, the second etiology of GLD in our study population, the most common imaging pattern was centrilobular micronodules (3/7, 42.9%), significantly more frequent than in other causes of GLD (6/68, 8.8%). Interreader agreement in detecting imaging features was almost perfect (κ = 0.88-1.00), except the nodular pattern, which had substantial agreement (κ = 0.73)., Conclusions: In our study population, the main etiologies found in patients with granulomatous disease who underwent lung biopsy were fungal or mycobacterial disease, specially histoplasmosis and tuberculosis, and nodular pattern with focal distribution was the most common imaging finding which was detected with substantial interreader agreement., (© 2021 The Authors.)

Purpose: Pulmonary imaging finding of Coronavirus disease 2019 (COVID-19) has been widely described, but until now few studies have been published about abdominal radiological presentation. The aim of this study was to provide an overview of abdominal imaging findings in patients with COVID-19 in a multicenter study and correlate them with worse clinical outcomes., Materials and Methods: This retrospective study included adult COVID-positive patients with abdominal CT performed from 4/1/2020 to 5/1/2020 from two institutions. Demographic, laboratory and clinical data were recorded, including clinical outcomes., Results: Of 81 COVID-positive patients, the average age was 61 years, 42 (52%) women and 45 (55%) had positive abdominopelvic findings. The most common abdominal imaging features were intestinal imaging findings (20/81, 24%), including colorectal (4/81, 5%) and small bowel thickening (10/81, 12%), intestinal distension (15/81, 18%), pneumatosis (1/81, 1%) and intestinal perforation (1/81, 1%). On multivariate analysis, intestinal imaging findings were associated with higher risk of worse outcome (death or invasive mechanical ventilation) (RR = 2.6, p = 0.04) and higher risk of invasive mechanical ventilation alone (RR = 6.2, p = 0.05)., Conclusion: Intestinal abnormalities were common findings in COVID-19 patients who underwent abdominal CT and were significantly correlated to worse outcomes in the clinical follow-up., Competing Interests: The authors declare that they have no conflict of interest., (© 2021 The Authors.)

New World species of the intracellular protozoan parasites of the Leishmania genus can cause mucocutaneous leishmaniases. The presence of an endosymbiotic Leishmania RNA virus (LRV) in Leishmania guyanensis ( L.g .) promotes disease exacerbation and the development of mucocutaneous disease. It was previously reported that LRV blocks the NLRP3 inflammasome, but additional mechanisms remain unclear. Here, we investigated whether LRV interferes with the inflammasome via caspase-11, which induces non-canonical NLRP3 activation and was reported to be activated by Leishmania . By using macrophages and mice, we found that LRV inhibits caspase-11 activation and IL-1β release by L.g . in a TLR3- and ATG5-dependent manner. Moreover, LRV exacerbates disease in C57BL/6 mice but not in Casp11 -/- , Nlrp3 -/- , and 129 mice, a mouse strain that is naturally mutant for caspase-11. These results demonstrate that LRV interferes with caspase-11 activation by Leishmania , expanding our understanding about the mechanisms by which LRV promotes disease exacerbation., Competing Interests: The authors declare no competing interests., (© 2021 The Authors.)

Purpose: Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome., Methods: Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease., Results: Median age was 52 years (IQR 39-63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 and P = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO 2  ≤ 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO 2  ≤ 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017)., Conclusion: Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO 2 and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.

There are a variety of less common diffuse liver diseases that can be asymptomatic or cause severe liver dysfunction. For the majority of them, the association of clinical, laboratory, and imaging findings are needed to narrow the differential diagnosis. In this article, we will review and describe the rarer diffuse liver diseases including drug-related liver disease, inflammatory and infectious diseases, and deposition disorders such as amyloidosis, glycogen storage disease, Wilson's disease, and alpha-1 antitrypsin deficiency. Abdominal radiologists should be familiar with the imaging features of different types of diffuse liver diseases to help the multidisciplinary team involved in the treatment of these patients. The data related to some of these conditions are scarce and sometimes experimental, but we want to demonstrate to the reader the value of imaging techniques in their analysis and introduce the potential of new imaging methods.

The aim of this study is to assess the prevalence of odontogenic infection in low-income Brazilian schoolchildren and evaluate its association with the subjective variables of oral health-related quality of life and dental pain. In this cross-sectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ8-10) and self-reports of dental pain were collected. Data were statistically analyzed using MannWhitney or Kruskal-Wallis test with a post-test by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional well-being (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among low-income Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's self-perception of quality of life.

Helicobacter pylori (H. pylori) infection is the main cause of gastric inflammation and peptic ulcer disease. Diagnosis and treatment are important to prevent these outcomes. The diagnosis of H. pylori infection can be performed by non-invasive methods, such as 13 C-urea breath test ( 13 C-UBT). As endogenous urea is normally released to body cavities, we sought to investigate the usefulness of UBT without 13 C-labelled external urea to detect H. pylori infection. The analysis was performed in a series of adult patients just before upper gastrointestinal endoscopy and biopsy to investigate dyspeptic symptoms. Breath samples were analyzed using isotope ratio mass spectrometry (IRMS). The natural variation of 13 C and 18 O isotopic abundance in the breath samples was also investigated. The results of the isotopic analysis were compared with the findings of the histopathological evaluation of gastric biopsies, which is the gold standard to detect H. pylori infection. No differences between patients with or without H. pylori infection could be detected by the isotope analysis of breath tests without 13 C-urea. Therefore, our results showed that UBT without 13 C-urea, analyzed by IRMS, was not useful to detect H. pylori infection in the study population.

Aim: The objective of the study is to evaluate the cervicalapical sealing of bulk-fill flow resins associated with a universal adhesive system, in endodontically treated teeth, considering two methods of evaluation., Materials and Methods: The samples used in the bacterial leakage analysis were autoclaved, filled inside a laminar flow chamber, and divided into four experimental groups (n = 8) according to the restorative material: Filtek Bulk-fill flow; Surefil SDR flow; TetricEvoflow and the positive control. The samples were inoculated with the Enterococcus faecalis ( E. faecalis), every 7 days and the microleakage was evaluated on a daily basis for 60 days. Microleakage tested with dye (n = 5) was considered in 2-time intervals of evaluation (24 hours and 72 hours), and the results were obtained in scores from 0-5. Data were submitted to the statistical tests, at a level of significance of 0.05., Results: About 12.5% of the FBF specimens showed bacterial microleakage as from the thirteenth day, and SDR, from the 20th day. TEF presented the highest percentage of microleakage at 40 days, concluding the 60 days with 37.5% of viable specimens. The Log-rank test revealed that the survival curve of TEF was statistically significant in comparison with those of the other groups. In the test with dye TEF and SDR presented the highest and lowest rate of microleakage, respectively, with statistically significant differences in the time interval of 72h., Conclusion: The resins FBF, SDR, and TEF were incapable of promoting the hermetic sealing of fillings in the root canal system., Clinical Significance: No bulk-fill flux studied was able to completely eliminate microleakage, despite the best performance with respect to the microleakage time presented by Filtek Bulk fill, followed by Surefil SDR flow.

Activation of the NLRP3 inflammasome by Leishmania parasites is critical for the outcome of leishmaniasis, a disease that affects millions of people worldwide. We investigate the mechanisms involved in NLRP3 activation and demonstrate that caspase-11 (CASP11) is activated in response to infection by Leishmania species and triggers the non-canonical activation of NLRP3. This process accounts for host resistance to infection in macrophages and in vivo. We identify the parasite membrane glycoconjugate lipophosphoglycan (LPG) as the molecule involved in CASP11 activation. Cytosolic delivery of LPG in macrophages triggers CASP11 activation, and infections performed with Lpg1 -/- parasites reduce CASP11/NLRP3 activation. Unlike bacterial LPS, purified LPG does not activate mouse CASP11 (or human Casp4) in vitro, suggesting the participation of additional molecules for LPG-mediated CASP11 activation. Our data identify a parasite molecule involved in CASP11 activation, thereby establishing the mechanisms underlying inflammasome activation in response to Leishmania species., (Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.)

de Freitas Brito, A, Brasileiro Santos, MdS, Coutinho de Oliveira, CV, and da Cruz Santos, A. Postexercise hypotension is volume-dependent in hypertensives: autonomic and forearm blood responses. J Strength Cond Res 33(1): 234-241, 2019-The purpose of this study was to evaluate the effect of 2 sessions of resistance exercise (RE) with different volumes on postexercise hypotension (PEH), forearm blood flow (FBF), and cardiac autonomic balance (LF/HF) in hypertensive elderly woman. The study was conducted with 16 hypertensive elderly (25.7 ± 3 kg·m², 55.5 ± 3 years) subjected to 3 experimental sessions, i.e., a control session, exercise with a set (S1), and exercise with 3 sets (S3). For each session, the subjects were evaluated before and after intervention. In the preintervention period, blood pressure (BP), FBF, and LF/HF were measured after 10 minutes of rest in the supine position. Thereafter, the subjects were taken to the gym to perform their exercise sessions or remained at rest during the same period. Both S1 and S3 comprised a set of ten repetitions of 10 exercises, with an interval of 90 seconds between exercises. Subsequently, the measurements were again performed at 10, 30, 50, 70, and 90 minutes of recovery (postintervention) in the supine position. Postexercise hypotension (systolic/diastolic) was greater in S3 than in S1 (-26 ± 4/-14 ± 5 mm Hg vs. -18 ± 5/-8 ± 5 mm Hg, p ≤ 0.05). Similarly, FBF and cardiac LF/HF increased in both sessions, being more evident in S3 than in S1 (4.98 ± 0.32 vs. 4.36 ± 0.27 ml·min·100 ml, p ≤ 0.05; and LF/HF = 1.69 ± 0.225 vs. 1.37 ± 0.13 p ≤ 0.05, respectively). We conclude that a single RE session with 3 series were able to promote higher PEH in hypertensive women, and this phenomenon was accompanied by increased FBF and increased cardiac autonomic activity.

This study evaluated the in vivo anticonvulsant effect of a spray-dried powder for reconstitution containing phenytoin-loaded lipid-core nanocapsules. The effect of chitosan coating on redispersibility, gastrointestinal stability, and drug release from nanoparticles was evaluated during the development of the powders. Maltodextrin was used as adjuvant in the spray-drying process. Chitosan coating played an important role in redispersibility, and large particles (>100 μm) were obtained using the highest concentration of solids in the feed. However, after aqueous redispersion, volume-based particle size was reduced to about 1 µm. The release of nanoparticles from the surface of the spherical microagglomerates (roundness index = 0.75) was confirmed by SEM analysis. Powders reconstituted in water recovered partially the nanometric properties of the original suspensions and were stable for 24 h. Phenytoin-loaded chitosan-coated nanocapsules and their redispersed powders have good gastrointestinal stability, and are able to control drug release in simulated gastric and intestinal fluids. Besides that, the reconstituted powder containing chitosan-coated nanocapsules exhibited improved anticonvulsant activity against seizures induced by pilocarpine in mice, compared to the non-encapsulated drug, representing an important approach in anticonvulsant treatments for children and adults., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Hepatitis C virus (HCV) infection is a serious public health problem, that affects approximately 170 million people worldwide. Chronic HCV infection is associated with hepatic insulin resistance and an increased risk of diabetes HCV-infected patients has been well documented., Objective: To assess the homeostasis model assessment of insulin resistance (HOMA-IR) index in patients treated with direct acting antiviral (DAAs) medication in the sustained virological response (SVR), categorized by the presence or absence of cirrhosis., Methods: A prospective study was conducted. Data were collected at the beginning of treatment (t-base) and in the twelfth week after the completion of treatment (t-SVR12). The inclusion criteria were presence of: HCV infection (RNA-HCV positive), age ≥18 years, completion of DAAs' therapy, and presence of diabetes with use of oral hypoglycemic agents. All samples were collected during the study period. The exclusion criteria were: presence of HBV/HIV co-infection, hepatocellular carcinoma at baseline, diabetic patients taking insulin and transplanted patients (liver/kidney). Fibrosis was assessed by hepatic elastography or biopsy (METAVIR). Cirrhosis was determined by clinical results or imaging. HOMA-IR was calculated as fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5) The patients were divided into two groups: the general study population (all patients, including the diabetic patients) and the special population (patients with normal values of HOMA-IR, which is >2.5, and without diabetes). The delta HOMA-IR value was calculated as: HOMA-IR at t-base - HOMA-IR at t-SVR12. For the descriptive statistical analysis, the paired t-test and generalized linear model assuming the log binding function were performed. A P value of < 0.05 was considered significant., Results: We included 150 patients, and 75 were cirrhotic. The mean age was 55.3±9.97 and body mass index was 27.4±5.18. Twenty-two (14.67%) were diabetic patients using oral hypoglycemic agents, and 17 (11%) were cirrhotic. In the general study population, the mean glucose and HOMA-IR values increased at t-SVR12, but insulin decreased. Delta HOMA-IR was negative at t-SVR12, but there was no significant difference. Excluding diabetic patients and those with normal HOMA-IR values (<2.5), mean glucose, insulin and HOMA-IR decreased at t-SVR12. Delta HOMA-IR decreased significantly at t-SVR12 (P: 0.02)., Conclusion: In the general population, glucose and HOMA-IR values increased at t-SVR12, but insulin decreased. In the special population, glucose, insulin, HOMA-IR and Delta HOMA-IR decreased at t-SVR12.

Na + , K + -ATPase is an important regulator of brain excitability. Accordingly, compelling evidence indicates that impairment of Na + , K + -ATPase activity contributes to seizure activity in epileptic mice and human with epilepsy. In addition, this enzyme is crucial for plasma membrane transport of water, glucose and several chemical mediators, including glutamate, the major excitatory transmitter in the mammalian brain. Since glucose hypometabolism and increased glutamate levels occur in clinical and experimental epilepsy, we aimed the present study to investigate whether activation of Na + , K + -ATPase activity with specific antibody (DRRSAb) would improve glucose uptake and glutamate release in pilocarpine-treated mice. We found decreased uptake of the glucose fluorescent analog 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-il)amino]-2-desoxi-d-glucose (2-NBDG) in cerebral slices from pilocarpine-treated animals. Interestingly, decreased 2-NBDG uptake was not detected in DRRSAb-treated slices, suggesting a protective effect of the Na + , K + -ATPase activator. Moreover, DRRSAb prevented the increase in glutamate levels in the incubation media of slices from pilocarpine-treated mice. In addition, in vivo intrahippocampal injection of DRRSAb restored crossing activity of pilocarpine-treated mice in the open-field test. Overall, the present data further support the hypothesis that activation of the Na + , K + -ATPase is a promising therapeutic strategy for epilepsy., (Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.)

Background: The process by which a brain insult elicits epilepsy is termed epileptogenesis and it is characterized by numerous molecular and functional alterations. Statins are first-line drugs for hypercholesterolemia and related diseases, and display neuroprotective properties in clinical and experimental studies. Considering the importance in developing therapeutic strategies to prevent or modify epileptogenesis, we aimed the present study to test the hypothesis that atorvastatin modifies seizure susceptibility of mice after status epilepticus (SE)., Methods: Male and female C57BL/6 mice were submitted to the pilocarpine-induced SE and then treated with atorvastatin (10 or 100mg/kg, once daily by gavage) for 14days. At days 7 and 14 post SE we evaluated the susceptibility of mice to the convulsant effects of a low dose of PTZ (30mg/kg). Cell loss in the hilus of dentate gyrus was evaluated by Giemsa staining., Results: Latencies to myoclonic jerks and to tonic-clonic seizures decreased between baseline (before SE) and days 7 and 14 after SE, confirming the development of seizure susceptibility. Atorvastatin protected against PTZ-induced tonic-clonic seizures in both sexes at day 14 post-SE. Protective effects were similar in both female and male mice, except that a high dose of atorvastatin was required for females (protection at 100mg/kg versus 10mg/kg in males). Giemsa staining did not reveal neuroprotective effects of atorvastatin., Conclusions: Atorvastatin treatment during epileptogenesis had slight beneficial effects on seizure susceptibility. These seem not related to neuroprotection. Further studies are needed to determine the disease-modifying potential of atorvastatin in epilepsy., (Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier B.V. All rights reserved.)

Background: The interaction between serum lipids and C virus infection is well known, as are serum lipid levels in the Peg-IFN / RBV-based treatment. However, with direct action antivirals (DAAs) this behavior is still unclear., Objective: To compare serum lipids levels between patients treated with Peg-IFN/RBV and DAAs and to evaluate lipids in sustained virological response (SVR) with DAAs., Methods: Retro prospective study comparing the behavior of total cholesterol (TC), low-density lipoprotein (LDL) and triglycerides (TG) serum levels during treatment with DAAs (G-DAAs) and a control historic group Peg-IFN/RBV (G-PR). Coorte, prospective study, to study the behavior of lipids in the SVR with DAAs. Data were collected at the beginning of treatment (baseline: t-base) and at week 12 of treatment (t-12) for G-DAAs and at week 24 (t-24) for G-PR, groups. In the cohort evaluation, the samples at t-base and at week 12 after the end of treatment (t-SVR). Delta lipids: difference between lipids in t-12 / t-24 minus t-base for comparison between G-PR and G-AADs groups and t-SVR minus t-base for lipid analysis in SVR. Analysis with Kruskal Wallis and Wilcoxon tests to compare the delta lipids of the groups. The P value was 0.05., Results: In the assessment between G-PR and G-DAAs groups, we included 63 and 121 patients, respectively. The groups did not differ one from the other (BMI, sex, genotype, fibrosis, total cholesterol, LDL, and TG) except by age (50.38±10.44 vs 56±9.69, P=0.0006). We observed a decrease in levels of TC and LDL and an increase in TG, in G-PR, and in G-DAAs the opposite (Δ TC -13.9±34.5 vs 4.12±34.3 P=0.0005, Δ LDL -7.16±32 vs 10.13±29.92, P=0.003, Δ TG 4.51±53.7 vs -8.24±49.93, P=0.0025). In the coorte analysis, we included 102 patients, 70% men and 56% F4, 95 of them reached SVR. We observed an increase of TC and LDL and a decrease of TG in both groups (SVR and non SVR), with no statistical difference (Δ TC P=0.68; Δ LDL P=0.69; Δ TG P=0.43). We did not find significant difference in delta evaluation by genotype 1 and 3 (Δ TC +29.7±40.2 vs +13.4±30.3, P=0.06; Δ LDL +21.4±28.6 vs +16.6±31.3, P=0.41; Δ TG -3.6±60.6 vs -0.7±40, P=0.91)., Conclusion: Serum lipids level differed during treatment with Peg-IFN and DAAs. Treatment with DAAs was associated with an increase of TC and LDL and a decrease of TG, independently of SVR.

Temporal lobe epilepsy (TLE) is the most frequent and medically refractory type of epilepsy in humans. In addition to seizures, patients with TLE suffer from behavioral alterations and cognitive deficits. Poststatus epilepticus model of TLE induced by pilocarpine in rodents has enhanced the understanding of the processes leading to epilepsy and thus, of potential targets for antiepileptogenic therapies. Clinical and experimental evidence suggests that inflammatory processes in the brain may critically contribute to epileptogenesis. Statins are inhibitors of cholesterol synthesis, and present pleiotropic effects that include antiinflammatory properties. We aimed the present study to test the hypothesis that atorvastatin prevents behavioral alterations and proinflammatory state in the early period after pilocarpine-induced status epilepticus. Male and female C57BL/6 mice were subjected to status epilepticus induced by pilocarpine and treated with atorvastatin (10 or 100mg/kg) for 14days. Atorvastatin slightly improved the performance of mice in the open-field and object recognition tests. In addition, atorvastatin dose-dependently decreased basal and status epilepticus-induced levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interferon-γ (INF-γ) and increased interleukin-10 (IL-10) levels in the hippocampus and cerebral cortex. The antiinflammatory effects of atorvastatin were qualitatively identical in both sexes. Altogether, these findings extend the range of beneficial actions of atorvastatin and indicate that its antiinflammatory effects may be useful after an epileptogenic insult., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objectives: Epilepsy is a common brain disease and a major worldwide public health problem. The seizures in a significant number of patients suffering from epilepsy remain inadequately controlled by currently available pharmacological treatments. Accordingly, there is a need for the discovery of new anticonvulsant approaches with improved efficacy and a better safety profile. In this context, natural products can be a valuable source of substances with potential anticonvulsant activity. In the present study, we tested the anticonvulsant potential of Caryocar coriaceum Wittm., a plant native from the Brazilian Cerrado biome (tropical savanna ecoregion)., Methods: Adult male C57BL/6 mice were treated with increasing doses of the fixed oil obtained from the pulp of Caryocar coriaceum Wittm. Seizure activity was induced by PTZ (60 mg/kg, i.p.), and evaluated by behavioral and electrographic methods. Potential adverse effects were investigated in the open-field, rotarod, forced swim, or object recognition tests. The antioxidant potential of the oil was evaluated by the DPPH scavenging assay., Results: Administration of the oil at the dose of 100 mg/kg increased the latency for the first myoclonic jerk and the first generalized tonic-clonic seizures. The duration of generalized convulsions induced by PTZ was not altered. No significant behavioral adverse effects were detected in the open-field, rotarod, forced swim, or object recognition tests. Interestingly, a significant antioxidant activity of Caryocar coriaceum Wittm. fixed pulp oil was detected in the DPPH scavenging assay., Discussion: Natural products can be a valuable source of substances with potential anticonvulsant activity and improved safety profile. Further studies are needed to evaluate the mechanisms underlying the anticonvulsant effects of Caryocar coriaceum Wittm. fixed pulp oil as well as the potential of the oil as a source of new anticonvulsant compounds.

Objective: to evaluate the risk factors for the presence of non-sentinel axillary metastatic disease in patients with breast cancer and positive sentinel node biopsy. Methods: retrospective cross-sectional study of women with breast cancer operated at the Cancer Institute of Ceará between 2002 and 2012 and submitted to sentinel lymph node biopsy., Results: Among 946 breast cancer patients, 331 underwent sentinel lymph node biopsy, which was positive in 83. These patients underwent axillary lymphadenectomy and 39 (46%) had metastases in other axillary lymph nodes. The variables that were significant for additional axillary disease included Ki67>14 (p=0.043), angiolymphatic invasion (p=0.01) and tumor size (p=0.027). No association was observed with estrogen, progesterone, tumor grade and Her-2 receptors., Discussion: the presence of angiolymphatic invasion and tumor size have also been related to additional axillary metastasis in other studies. In addition to these variables, the same predictive effect was observed when we evaluated Ki67. The validation of these results may allow the customization of breast cancer treatment, which may reduce its morbidity., Conclusion: angiolymphatic invasion, tumor size (T3/T4) and Ki67>14 were factors predictive of axillary metastasis involvement in addition to the sentinel lymph node.

Nutritional intervention with antioxidants rich foods has been considered a strategy to minimize the effects of overtraining in athletes. This experimental, randomized, and placebo-controlled study evaluated the effects of consumption of sesame ( Sesamum indicum L.) on muscle damage markers, oxidative stress, systemic inflammation, and aerobic performance in male semi-professional soccer players. Twenty athletes were randomly assigned to groups that received 40 g (two tablespoons) per day of sesame or a placebo during 28 days of regular training (exposed to routine training that includes loads of heavy training in the final half of the season). Before and after intervention, creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA), superoxide dismutase (SOD), C-reactive protein (hs-CRP), and aerobic capacity were evaluated. Before intervention, a physiologic imbalance was noted in both groups related to CK and LDH levels. Sesame intake caused a reduction of CK (19%, p < 0.05), LDH (37%, p < 0.05), MDA (55%, p < 0.05) and hs-CRP (53%, p < 0.05) and increased SOD (14%, p < 0.05), vitamin A (25%, p < 0.05), and vitamin E (65%, p < 0.05) in the experimental group. These phenomena were accompanied by increased aerobic capacity (17%, p < 0.05). The placebo group showed an increase in CK (5%, p < 0.05) and no significant change in LDH, SOD or vitamin A. MDA levels decreased (21%, p < 0.05) and vitamin E increased (14%, p < 0.05) in the placebo group, but to a much lesser extent than in the experimental group. These results show that sesame consumption may reduce muscle damage and oxidative stress while improving the aerobic capacity in soccer players.

Epilepsy is a chronic neurological disease characterized by spontaneous recurrent seizures (SRS). Current anticonvulsant drugs are ineffective in nearly one-third of patients and may cause significant adverse effects. Rosmarinic acid is a naturally occurring substance which displays several biological effects including antioxidant and neuroprotective activity. Since oxidative stress and excitotoxicity play a role in the pathophysiology of seizures, we aimed the present study to test the hypothesis that rosmarinic acid displays anticonvulsant and disease-modifying effects. Female C57BL/6 mice received rosmarinic acid (0, 3, 10, or 30mg/kg; p.o.) 60min before the injection of pentylenetetrazol (PTZ, 60mg/kg; i.p.) or pilocarpine (300mg/kg, i.p.). Myoclonic and generalized tonic-clonic seizure latencies and generalized seizure duration were analyzed by behavioral and electroencephalographic (EEG) methods. The effect of acute administration of rosmarinic acid on mice behavior in the open-field, object recognition, rotarod, and forced swim tests was also evaluated. In an independent set of experiments, we evaluated the effect of rosmarinic acid (3 or 30mg/kg, p.o. for 14days) on the development of SRS and behavioral comorbidities in the pilocarpine post-status epilepticus (SE) model of epilepsy. Rosmarinic acid dose-dependently (peak effect at 30mg/kg) increased the latency to myoclonic jerks and generalized seizures in the PTZ model and increased the latency to myoclonic jerks induced by pilocarpine. Rosmarinic acid (30mg/kg) increased the number of crossings, the time at the center of the open field, and the immobility time in the forced swim test. In the chronic epilepsy model, treatment with rosmarinic acid did not prevent the appearance of SRS or behavioral comorbidities. In summary, rosmarinic acid displayed acute anticonvulsant-like activity against seizures induced by PTZ or pilocarpine in mice, but further studies are needed to determine its epilepsy-modifying potential., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Dyslipidemia and genetic polymorphisms are associated with increased risk for developing cardiovascular diseases, and watermelon appears to have the potential to improve hyperlipidemia due to the presence of nutrients such as arginine and citrulline., Objective: To test the hypolipidemic effect of watermelon extract (Citrullus lanatus) and the influence of the methylenetetrahydrofolate reductase genotype (MTHFR C677T) on supplementation response., Methods: This is an experimental clinical phase II randomized and double-blind study. Forty-three subjects with dyslipidemia were randomly divided into 2 groups: experimental (n = 22) and control (n = 21) groups. The subjects were supplemented daily for 42 days with 6 g of watermelon extract or a mixture of carbohydrates (sucrose/glucose/fructose)., Results: The use of watermelon extract reduced plasma total cholesterol (p < 0.05) and low-density lipoprotein (p < 0.01) without modifying triglycerides, high-density lipoprotein, and very low-density lipoprotein values. Only carriers of the T allele (MTHFR C677T) showed decreasing concentrations of low-density lipoprotein (p < 0.01). No changes in anthropometric parameters analyzed were observed. This is the first study to demonstrate the beneficial effect of the consumption of watermelon extract in reducing plasma levels of lipids in humans. The MTHFR C677T polymorphism did not affect the plasma lipid concentration but made individuals more responsive to treatment with watermelon., Conclusions: The consumption of this functional food represents an alternative therapy in the combined treatment of patients with dyslipidemia, promoting health and minimizing the development of risk factors for cardiovascular diseases.

In the last module of this consensus, controversial topics were discussed. Management of the disease after progression during first line chemotherapy was the first discussion. Next, the benefits of liver resection in the presence of extra-hepatic disease were debated, as soon as, the best sequence of treatment. Conversion chemotherapy in the presence of unresectable liver disease was also discussed in this module. Lastly, the approach to the unresectable disease was also discussed, focusing in the best chemotherapy regimens and hole of chemo-embolization., Competing Interests: none

The objectives of this study were to test the interaction of breed (Nellore or Angus) and diet (whole shelled corn [WSC] or ground corn [GC] with silage) on growth performance, carcass characteristics, and ruminal pH of young bulls. Thirty-six bulls (18 Nellore and 18 Angus) with the range in age of 18 to 22 mo and BW of 381 ± 12 kg were used in a completely randomized design experiment with a 2 × 2 factorial arrangement of treatments (2 breeds and 2 diets). Experimental diets (DM basis) included 1) a GC diet containing 30% corn silage and 70% GC- and soybean meal-based concentrate and 2) a WSC diet containing 85% WSC and 15% of a soybean meal- and mineral-based pelleted supplement. An additional 8 bulls were slaughtered at the beginning of the experimental period for determination of initial carcass weight. The treatments were Nellore fed the GC diet, Nellore fed the WSC diet, Angus fed the GC diet, and Angus fed the WSC diet. Greater DMI ( < 0.01), ADG ( < 0.01), and G:F ( < 0.01) were observed in Angus bulls compared with Nellore bulls, regardless of diet. Lower average ruminal pH ( = 0.04), maximum ruminal pH (P = 0.02), and DMI ( < 0.01) were observed in bulls fed the WSC diet than in those fed the GC diet. In addition, bulls fed the WSC diet had greater G:F ( < 0.01). The WSC diet led to greater variation in DMI compared with the GC diet ( < 0.01). Omasum and large intestine percentage was affected by diets only in the Angus breed ( < 0.02) and were greater when bulls were fed the GC diet. The WSC diet without forage may be useful for feedlots because this diet promoted greater G:F than the GC diet, regardless of breed. However, special care must be exercised in feed management during adaptation and throughout the feeding of Nellore animals to avoid digestive disorders and fluctuations in DMI.

Increasing evidence suggests that plant-derived extracts and their isolated components are useful for treatment of seizures and, hence, constitute a valuable source of new antiepileptic drugs with improved efficacy and better adverse effect profile. β-Caryophyllene is a natural bicyclic sesquiterpene that occurs in a wide range of plant species and displays a number of biological actions, including neuroprotective activity. In the present study, we tested the hypothesis that β-caryophyllene displays anticonvulsant effects. In addition, we investigated the effect of β-caryophyllene on behavioral parameters and on seizure-induced oxidative stress. Adult C57BL/6 mice received increasing doses of β-caryophyllene (0, 10, 30, or 100mg/kg). After 60 min, we measured the latencies to myoclonic and generalized seizures induced by pentylenetetrazole (PTZ, 60 mg/kg). We found that β-caryophyllene increased the latency to myoclonic jerks induced by PTZ. This result was confirmed by electroencephalographic analysis. In a separate set of experiments, we found that mice treated with an anticonvulsant dose of β-caryophyllene (100mg/kg) displayed an improved recognition index in the object recognition test. This effect was not accompanied by behavioral changes in the open-field, rotarod, or forced swim tests. Administration of an anticonvulsant dose of β-caryophyllene (100mg/kg) did not prevent PTZ-induced oxidative stress (i.e., increase in the levels of thiobarbituric acid-reactive substances or the decrease in nonprotein thiols content). Altogether, the present data suggest that β-caryophyllene displays anticonvulsant activity against seizures induced by PTZ in mice. Since no adverse effects were observed in the same dose range of the anticonvulsant effect, β-caryophyllene should be further evaluated in future development of new anticonvulsant drugs., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background and Aim: Osteoporosis is well recognized as a cirrhosis complication; however, most studies assessing this condition included only patients on liver transplantation lists with an elevated rate of bone diseases. While general population studies show that handgrip strength is clearly associated with bone mineral density, until now this tool has not been applied to patients with cirrhosis in relation to their bone condition. This study aimed to evaluate whether handgrip strength, bone, and liver tests may be useful as predictors of bone disease in outpatients with cirrhosis., Methods: One hundred twenty-nine subjects were included (77 men and 52 women). Dual-energy X-ray absorptiometry was applied to evaluate lumbar-spine and femoral-neck T scores. Osteoporosis/osteopenia rates were 26.3%/35.6% in the lumbar spine and 6.9%/41.8% in the femoral neck, respectively. Model selections were based on backward procedures to find the best predictors of low T scores., Results: For lumbar spine, only low handgrip strength and high parathyroid hormone levels were clearly related to low T scores. For femoral neck, only age was associated with low T scores., Conclusions: Handgrip strength may serve as an effective predictor of low lumbar spine T score among outpatients with cirrhosis. As cirrhosis affects the lumbar spine more than the femoral neck, these results suggest that handgrip strength should be tested in all patients with cirrhosis as a first indicator of bone health., (© 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)

Carbohydrate ingestion at the end of a single exercise is recognized as delaying fatigue and accelerating recovery, but whether chronic ingestion can prevent overtraining during periods of intense training has not yet been elucidated. This study aimed to determine whether carbohydrate supplementation minimizes overtraining in Wistar rats. The animals underwent 11 weeks of training (running) on a treadmill, and the last 3 weeks were designed to induce overtraining. One group was supplemented with carbohydrates (EX-CHO) (n = 13), 1 group had no supplementation (EX) (n = 10), and a third group remained inactive (C) (n = 9). Performance tests were given before training (Pr1) and at the 8th (Pr2) and 11th (Pr3) training week. Food intake, body weight, testosterone, cortisol, malondialdehyde, creatine kinase, and activities of the PI3-K, Akt-1, mTOR, and GSK-3 enzymes were measured. In the EX group, there was a significant 32.6% performance decrease at Pr3 when compared with Pr2. In addition, at protocol completion, the EX-CHO group had a greater gastrocnemius weight than did the C group (p = 0.02), which the EX group did not. Training caused anorexia, decreased testosterone (p = 0.001), and increased malondialdehyde (p = 0.009) in both exercise groups compared with the C group, with no influence of carbohydrate supplementation on these variables (p > 0.05). Compared with in the C group, the activity of Akt-1 was higher in the EX-CHO group but not in the EX group (p = 0.013). Carbohydrate supplementation promoted an attenuation in the performance decrement and maintained gastrocnemius muscle mass in animals that had undergone overtraining protocols, which was accompanied by increased activity of the Akt-1 molecular indicator.

The purpose of this study was to evaluate the effect of high-intensity resistance exercise (RE) sessions on blood pressure (BP), heart rate (HR), cardiac autonomic modulation, and forearm blood flow (FBF). Sixteen trained hypertensive women (n = 16, 56 ± 3 years) completed the following 3 experimental sessions: control (CS), RE at 50% (EX50%), and RE at 80% (EX80%) of 1 repetition maximum (1RM). Both EX50% and EX80% comprised a set of 10 repetitions of 10 exercises, with an interval of 90 seconds between exercises. Measurements were taken preintervention and postintervention (at 10, 30, 50, 70, and 90 minutes of recovery). Reductions in systolic/diastolic BP after exercise were greater in EX80% (largest declines, -29 ± 4/-14 ± 5 mm Hg) than EX50% (largest declines, -18 ± 6/-8 ± 5 mm Hg, p ≤ 0.05). Heart rate and cardiac sympathovagal balance (LF/HF) increased more in relation to pre-exercise values in EX80% than EX50% (largest increases 96 ± 3 vs. 90 ± 4 b·min, LF/HF = 1.77 ± 0.25 vs. 1.40 ± 0.20, respectively, p ≤ 0.05). Increases in FBF and hyperemia was also higher in EX80% than EX50% compared with pre-exercise (4.97 ± 0.28 vs. 4.36 ± 0.27 ml·min·100 ml and 5.90 ± 0.20 vs. 5.38 ± 0.25 ml·min·100 ml; p ≤ 0.05, respectively). These results suggest that RE of higher intensity promoted greater postexercise hypotension accompanied by greater increases in FBF, vasodilator response, HR, and cardiac sympathovagal balance.

Visceral leishmaniasis is a fatal human disease caused by the intracellular protozoan parasite Leishmania chagasi that is captured by host cells in a process involving classics receptors mediated phagocytosis. The search for molecules involved in this process is important to design strategies to disease control. In this work, we verified the presence of heparin-binding protein (HBP) in L. chagasi promastigotes forms. HBP is a lectin of the group of ubiquitous proteins, whose main characteristic is to bind to carbohydrates present in glycoproteins or glycolipids, which is poorly studied in Leishmania species. L. chagasi HBP (HBPLc) was purified by affinity chromatography using heparin-agarose column in FPLC automated system. Its localization in the parasite was assessed by immunolabeling and electronic transmission microscopy tests using anti-HBPLc polyclonal antibodies, which showed HBP spread over the parasite outer surface and internally next to the kynetoplast. In addition, we verified that HBPLc participates in the process of parasite infection, since its blocking with heparin generated a partial reduction in the internalization of Leishmania by RAW macrophages "in vitro". According to these results, it is believed that, in further "in vivo" studies, interference on this parasitic protein may provide us prophylactic and therapeutic alternatives against visceral leishmaniasis., (Copyright © 2015 Elsevier B.V. All rights reserved.)