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Background: Patients with Parkinson's disease (PD) often report chronic pain, which is one of the most complex non-motor symptoms. Therefore, this study aims to review the literature on the characteristics of pain in patients with PD., Methods: A systematic literature review was conducted following MOOSE recommendations. Observational studies reporting pain in patients with PD were included. No time restrictions were applied, but studies in Portuguese, Spanish, and English were considered. The search was performed in PubMed®, LILACS, and SciELO databases., Results: Twenty-six articles of observational studies were identified, reporting an average pain prevalence of 67.36%, emphasizing the significance of this symptom in the PD population. Pain was reported in various body regions, including lower limbs, upper limbs, lumbar spine, cervical spine, and other joints. Pain classification varied, encompassing musculoskeletal pain, PD-related pain, neuropathic pain, and dystonic pain, among others., Discussion: Pain in patients with PD is a prevalent and multifactorial condition, significantly impacting patients' quality of life., Conclusion: Heterogeneity in data across included studies was observed, highlighting the need for additional research to elucidate the underlying mechanisms of pain in patients with PD and develop effective therapeutic strategies to address this symptom and improve the quality of life for individuals living with the disease., (© 2024 World Institute of Pain.)

Background: Ongoing evaluation of massive transfusion protocol adherence is critical to ensure better trauma patient outcomes., Objective: This quality improvement initiative aimed to determine provider adherence to a recently revised massive transfusion protocol and its relationship to clinical outcomes among trauma patients requiring massive transfusion., Methods: A retrospective, descriptive, correlational design was used to determine the association between provider adherence to a recently revised massive transfusion protocol and clinical outcomes in trauma patients with hemorrhage treated at a Level I trauma center from November 2018 to October 2020. Patient characteristics, provider massive transfusion protocol adherence, and patient outcomes were assessed. Patient characteristics and massive transfusion protocol adherence associations with 24-hr survival and survival to discharge were determined using bivariate statistical methods., Results: A total of 95 trauma patients with massive transfusion protocol activation were evaluated. Of the 95, 71 (75%) survived the initial 24 hr following massive transfusion protocol activation and 65 (68%) survived to discharge. Based on protocol applicable items, the median massive transfusion protocol overall adherence rate per patient was 75% (IQR = 57.1-85.7) for the 65 survivors and 25% (IQR = 12.5-50.0) for the 21 nonsurvivors to discharge whose death occurred at least 1 hr after massive transfusion protocol activation (p < .001)., Conclusion: Findings indicate the importance of ongoing evaluations of adherence to massive transfusion protocols in hospital trauma settings to target areas for improvement., Competing Interests: The authors have no conflicts of interest or funding to declare., (Copyright © 2023 Society of Trauma Nurses.)

The presence of monodominant vegetative formations almost exclusively composed of Acuri palm trees (Attalea phalerata) stands out in some regions of the Pantanal Sul-Mato-Grossense. These formations are generally associated with anthropic, edaphic and/or hydrological factors. However, little is known about the effect of allelopathy on the formation and maintenance of these areas. Herein, we investigated the chemical composition of A. phalerata aqueous leaf extract and the potential allelopathic effects on germination and growth of target L. sativa, L. esculentum and S. obtusifolia species. Thus, extracts at concentrations of 0, 2.5, 5, 10, 15, and 20% were used for germination and growth bioassays with a completely randomised design in a germination chamber and greenhouse. The results showed that the A. phalerata extracts negatively affected the germination speed index and mean germination time of the target species and positively affected seedling length under controlled conditions and were also stimulated in the greenhouse. Thus, the formation of Acurizals can be related to the presence of secondary metabolites in the leaves, in addition to other environmental factors.

Encapsulation via nanotechnology offers a potential method to overcome limited thermal and photo-stability of botanical pesticides. In this study, nanospheres of essential oils (NSEO) derived from Zanthoxylum rhoifolium Lam. fruit were characterized and evaluated for their photostability and insecticidal activity against Bemisia tabaci. Three major compounds of Z. rhoifolium fruits were detected by CG-MS: β-phellandrene (76.8%), β-myrcene (9.6%), and germacrene D (8.3%). The nanoprecipitation method was used to obtain homogeneous spherical NSEO, with ≥98% encapsulation efficiency. Tests with UV/Vis spectrophotometry showed significantly reduced photodegradation from exposed NSEO samples when compared with essential oil (EO) controls. Whitefly screenhouses bioassays with bean plants treated with 0.25, 0.5, 1 and 1.5% suspensions showed EO treatments in both free and nanoencapsulated forms reduced adult whitefly oviposition by up to 71%. In further tests, applications at 1.5% caused ≥64% mortality of second instar nymphs. When the test was conducted under high temperature and light radiation conditions, the insecticidal effect of NSEO treatments was improved (i.e., 84.3% mortality) when compared to the free form (64.8%). Our results indicate the insecticidal potential of EO-derived from Z. rhoifolium fruits with further formulation as nanospheres providing greater photostability and enhanced insecticidal activity against B. tabaci under adverse environmental conditions.

A challenge for cosmetic and dermatologic products is to develop new high-performance and safer anti-aging products based on new compounds to enhance the stability of retinyl palmitate combined with broad-spectrum UV-filters. Consequently, the aim of this work was to evaluate the effects of three often used avobenzone photostabilizers-ethylhexyl methoxycrylene (EHMCR), tris(tetramethylhydroxypiperidinol) citrate (TTMHP) and tris-biphenyl triazine (TBPT)-on the photostability and phototoxicity of the combination of avobenzone (AVO), octyl methoxycinnamate (OMC) and retinyl palmitate (RP). The photostability studies were performed by the exposure of formulations to UVA radiation. The phototoxicity was evaluated by the 3T3 neutral red uptake phototoxic assay (OECD TG 432). The addition of EHMCR, TBPT, and TTMHP in the formulations, with/or without RP, improved the photostability of AVO and RP, but EHMCR was the most effective in stabilizing RP. In the phototoxicity assay, the combinations AVO-OMC containing or not RP showed phototoxic potential. EHMCR and TTMHP reduced the phototoxicity of the combination AVO-OMC, whereas EHMCR also decreased the phototoxicity of the combination containing RP. Therefore, EHMCR might be used to the photostabilization of formulations of AVO-OMC with/or not RP, while TTMHP can be added to this photounstable UV-filter combination., (© 2021 American Society for Photobiology.)

More than 80 percent of African American women struggle with overweight and obesity. We implemented a 5-week physical activity intervention using Facebook™ and pedometers with African American women. Twenty-seven African American women participated in a single-group pre/post design intervention to promote walking and physical activity. Participants were given access to a private Facebook™ group along with a free Omron Alvita pedometer. The five-week intervention challenged participants to increase weekly daily steps and the number of days they were physically active. At the end of the intervention, participants had significantly increased their weekly steps by 190% as compared to baseline (p = .005). Nearly, 80% of participants reported being active two or more days per week as compared to baseline (35.7%). Technologies such as social media and pedometers can assist in educating individuals and improving physical activity. These findings are relevant to public health nurses when implementing programs to increase physical activity for African American women., (© 2021 Wiley Periodicals, Inc.)

Fucoxanthin possesses a well-described antioxidant activity that might be useful for human skin photoprotection. However, there is a lack of scientific information regarding its properties when applied onto human skin. Thus, the objective of the present study was to assess the photoprotective and phototoxicity potential of fucoxanthin based on its ultraviolet (UVB 280-320 nm; UVA 320-400 nm) and visible (VIS 400-700 nm) absorption, photostability, phototoxicity in 3T3 mouse fibroblast culture vs. full-thickness reconstructed human skin (RHS), and its ability to inhibit reactive oxygen species formation that is induced by UVA on HaCaT keratinocytes. Later, we evaluated the antioxidant properties of the sunscreen formulation plus 0.5% fucoxanthin onto RHS to confirm its bioavailability and antioxidant potential through the skin layers. The compound was isolated from the alga Desmarestia anceps . Fucoxanthin, despite presenting chemical photo-instability (dose 6 J/cm 2 : 35% UVA and 21% VIS absorbance reduction), showed acceptable photodegradation (dose 27.5 J/cm 2 : 5.8% UVB and 12.5% UVA absorbance reduction) when it was added to a sunscreen at 0.5% ( w / v ). In addition, it increased by 72% of the total sunscreen UV absorption spectra, presenting UV-booster properties. Fucoxanthin presented phototoxic potential in 3T3 fibroblasts (mean photo effect 0.917), but it was non-phototoxic in the RHS model due to barrier function that was provided by the stratum corneum. In addition, it showed a significant inhibition of ROS formation at 0.01% ( p < 0.001), in HaCat, and in a sunscreen at 0.5% ( w / v ) ( p < 0.001), in RHS. In conclusion, in vitro results showed fucoxanthin protective potential to the skin that might contribute to improving the photoprotective potential of sunscreens in vivo.

Background/Aims: The selection of suitable raw materials in the cosmetic research and development is a key point, not only in order to obtain the expected results but also to avoid undesirable side effects. This study evaluated the in vitro toxicity potential of four different plant extracts and their in vivo acceptability studies. Methods: Spirulina , Palmaria palmata , Cichorium intybus and Medicago sativa extracts were analysed alone or in combination and added in cosmetic formulations. The in vitro toxicity evaluation, Hen's Egg Chorioallantoic Membrane Test (HET-CAM) and 3T3 NRU phototoxicity test were performed to evaluate in vitro potential ocular irritation and photo safety, respectively. Twenty subjects were enrolled in the acceptability studies, who were evaluated for the absence of harmful effects of the formulation by visual assessment and by transepidermal water loss, a biophysical technique, for 30 days. Results: HET-CAM assay showed that the studied extracts added to a gel-cream formulation had no irritant potential. In addition, the combination of Palmaria palmata, alfalfa and chicory extracts did not show phototoxic potential in vitro . Acceptability studies showed that the formulation containing the four extracts combined did not provoke any transepidermal water loss (TEWL) alteration, sensory irritation or erythema in the forearms for the period of analysis. Conclusion: The studied active ingredients, alone or in combination, present no cytotoxicity potential and when added to a gel-cream formulation had no irritant potential in vitro. These results predicting no harmful effects were confirmed in the acceptability tests, which showed no alteration on skin barrier function and no report of irritation perception of sign of erythema, suggesting the potential of these extracts for the development of safe cosmetic products.

Bioassays using the nonforced exposure approach have been shown to be a relevant tool that might complement the traditional ecotoxicological risk assessment. Because the nonforced exposure approach is based on spatial displacement of organisms and the consequent habitat selection processes, the population density might play an important role in the decision to avoid or prefer an ecosystem. Therefore, the aim of the present study was to assess if the avoidance response to contamination, measured in a nonforced exposure system, is density-dependent and how determinant contamination could be for the habitat-selection process in comparison with the population density. The freshwater shrimp Atyaephyra desmarestii was exposed to a copper gradient in a nonforced exposure system formed by 7 interconnected compartments (total volume 600 mL), which contained different copper concentrations. The density treatments used were 3, 5, and 10 organisms per compartment, corresponding to 0.5, 0.8, and 1.7 organisms per 100 mL, respectively. Clearly, the avoidance response to copper was more intense in the population with the lower density: the highest population density showed the lowest avoidance. The concentrations that triggered an avoidance of 50% of the population were 47, 134, and 163 μg L -1 . In summary, it was observed that shrimps were able to detect and avoid potentially toxic copper concentrations but that the avoidance response was affected by population density. Environ Toxicol Chem 2018;37:3095-3101. © 2018 SETAC., (© 2018 SETAC.)

The objective of this study was to assess worker exposure to mineral dust particles, and a metabolic model, based on the model adopted by ICRP, was applied to assess human exposure to Ta, and predicted values of Ta concentrations in excreta. The occupational exposure to Th, U, Nb, and Ta-bearing particles during routine tasks to obtain Fe-Nb alloys was estimated using air samplers and excreta samples. Ta concentrations in food samples and in drinking water were also determined. The results support that workers were occupationally exposed to Ta-bearing particles, and also indicate that a source of Ta exposure for both workers and the control group was the ingestion of drinking water containing soluble compounds of Ta. Therefore, some Ta compounds should be considered soluble compounds in gastrointestinal tract. Consequently, the metabolic model based on ICRP metabolic model and/or the transfer factor f 1 for Ta should be reviewed and the solubility of Ta compounds in gastrointestinal should be determined.

The aim of our study was to produce and characterize poly-ε-caprolactone (PCL) nanospheres containing essential oils from Zanthoxylum riedelianum fruit and to evaluate their stability gains as well as their insecticidal and deterrent activities against whitefly ( Bemisia tabaci ). The PCL nanospheres exhibited a homogeneous spherical morphology, with particle diameters between 106.7 nm and 129.2 nm, pH of approximately 6, zeta potential (ZP) lower than -19.0 mV and encapsulation efficiency higher than 98%. Only 43% of the nanoencapsulated essential oil (NSEO) was degraded in response to ultraviolet light, whereas the essential oil (EO) degraded by 76% over the same period. In a free-choice test, the NSEO and EO reduced the number of whitefly eggs by approximately 70%. NSEO and EO at 1.5% killed 82.87% and 91.23% of 2nd-instar nymphs of whitefly, respectively. Although NSEO displayed lower insecticidal activity, it offers a greater advantage over the free EO, due to protection conferred by polymer against photodegradation. Therefore, its usage may optimize the maintenance of essential oils in the field through photoprotection and controlled release. Our results suggest that the EO of Z. riedelianum fruit can be used for B. tabaci management strategy; nevertheless, the benefits of NSEO require further evaluation at the field level.

Introduction: Facial skeletal asymmetry is commonly found in humans and its main characteristic is menton deviation. The literature suggests that occlusal and masticatory problems arising from tooth absence could be related to the development of such asymmetries., Objective: The aim of this cross-sectional study was to estimate the prevalence of mandibular skeletal asymmetries and to investigate its association with posterior tooth absences., Methods: Tomographic images of 952 individuals aged from 18 to 75 years old were used. Asymmetry was the analyzed outcome, and it was categorized into three groups according to gnathion displacement in relation to the midsagittal plane (relative symmetry, moderate asymmetry, and severe asymmetry). Patients were sorted by the presence of all posterior teeth, unilateral posterior tooth absence, or bilateral posterior tooth absence. Chi-square test with a significance level of 5% was used to verify the association between posterior tooth absence and asymmetry., Results: Results show relative symmetry present in 55.3% of the sample, as well as the prevalence of 27.3% for moderate mandibular asymmetry and 17.4% for severe asymmetry. Moderate and severe mandibular asymmetries occurred in a higher proportion in patients with unilateral posterior tooth absence. However, there was no statistically significant difference between the analyzed groups (p = 0.691)., Conclusions: In this study, mandibular asymmetries did not present any association with the absence of teeth on the posterior area of the arch.

Background: The national mandate for health systems to transition from ICD-9-CM to ICD-10-CM in October 2015 has an impact on research activities. Clinical phenotypes defined by ICD-9-CM codes need to be converted to ICD-10-CM, which has nearly four times more codes and a very different structure than ICD-9-CM., Methods: We used the Centers for Medicare & Medicaid Services (CMS) General Equivalent Maps (GEMs) to translate, using four different methods, condition-specific ICD-9-CM code sets used for pragmatic trials (n=32) into ICD-10-CM. We calculated the recall, precision, and F score of each method. We also used the ICD-9-CM and ICD-10-CM value sets defined for electronic quality measure as an additional evaluation of the mapping methods., Results: The forward-backward mapping (FBM) method had higher precision, recall and F-score metrics than simple forward mapping (SFM). The more aggressive secondary (SM) and tertiary mapping (TM) methods resulted in higher recall but lower precision. For clinical phenotype definition, FBM was the best (F=0.67), but was close to SM (F=0.62) and TM (F=0.60), judging on the F-scores alone. The overall difference between the four methods was statistically significant (one-way ANOVA, F=5.749, p=0.001). However, pairwise comparisons between FBM, SM, and TM did not reach statistical significance. A similar trend was found for the quality measure value sets., Discussion: The optimal method for using the GEMs depends on the relative importance of recall versus precision for a given use case. It appears that for clinically distinct and homogenous conditions, the recall of FBM is sufficient. The performance of all mapping methods was lower for heterogeneous conditions. Since code sets used for phenotype definition and quality measurement can be very similar, there is a possibility of cross-fertilization between the two activities., Conclusion: Different mapping approaches yield different collections of ICD-10-CM codes. All methods require some level of human validation.

The aim of this study was to evaluate the mesiobuccal root of maxillary first molars, according to the root canal configuration, prevalence and location of isthmuses at 3 and 6 mm from the apex, comparing cone-beam computed tomography (CBCT) analysis and cross sectioning of roots by thirds. Images of the mesiobuccal root of 100 maxillary first molars were acquired by CBCT and then roots were cross-sectioned into two parts, starting at 3 mm from the apex. Data were recorded and analyzed according to Weine's classification for root canal configuration, and Hsu and Kim's classification for isthmuses. In the analysis of CBCT images, 8 root canals were classified as type I, 57 as type II, 35 as type III. In the cross-sectioning technique, 19 root canals were classified as type I, 60 as type II, 20 as type III and 1 as type IV. The classification of isthmuses was predominantly type I in both CBCT and cross-sectioning evaluations for sections at 3 mm from the apex, while for sections at 6 mm from the apex, the classification of isthmuses was predominantly types V and II in CBCT and cross-sectioning evaluations, respectively. The cross-sectioning technique showed better results in detection of the internal morphology of root canals than CBCT scanning.

Contamination of enteral diets represents a high risk of compromising the patient's medical condition. To assess the microbiological quality and aseptic conditions in the preparation and administration of handmade and industrialized enteral diets offered in a hospital in the Valley of Jequitinhonha, MG, Brazil, we performed a microbiological analysis of 50 samples of diets and 27 samples of surfaces, utensils, and water used in the preparation of the diets. In addition, we assessed the good handling practices of enteral diets according to the requirements specified by the Brazilian legislation. Both kinds of enteral diets showed contamination by coliforms and Pseudomonas spp. No sample was positive for Staphylococcus aureus and Salmonella spp. On the other hand, Listeria spp. was detected in only one sample of handmade diets. Contamination was significantly higher in the handmade preparations (p < 0.05). Nonconformities were detected with respect to good handling practices, which may compromise the diet safety. The results indicate that the sanitary quality of the enteral diets is unsatisfactory, especially handmade diets. Contamination by Pseudomonas spp. is significant because it is often involved in infection episodes. With regard to aseptic practices, it was observed the need of implementing new procedures for handling enteral diets.

Background: Several trials have demonstrated the efficacy of nurse telephone case management for diabetes (DM) and hypertension (HTN) in academic or vertically integrated systems. Little is known about the real-world potency of these interventions., Objective: To assess the effectiveness of nurse behavioral management of DM and HTN in community practices among patients with both diseases., Design: The study was designed as a patient-level randomized controlled trial., Participants: Participants included adult patients with both type 2 DM and HTN who were receiving care at one of nine community fee-for-service practices. Subjects were required to have inadequately controlled DM (hemoglobin A1c [A1c] ≥ 7.5%) but could have well-controlled HTN., Interventions: All patients received a call from a nurse experienced in DM and HTN management once every two months over a period of two years, for a total of 12 calls. Intervention patients received tailored DM- and HTN- focused behavioral content; control patients received non-tailored, non-interactive information regarding health issues unrelated to DM and HTN (e.g., skin cancer prevention)., Main Outcomes and Measures: Systolic blood pressure (SBP) and A1c were co-primary outcomes, measured at 6, 12, and 24 months; 24 months was the primary time point., Results: Three hundred seventy-seven subjects were enrolled; 193 were randomized to intervention, 184 to control. Subjects were 55% female and 50% white; the mean baseline A1c was 9.1% (SD = 1%) and mean SBP was 142 mmHg (SD = 20). Eighty-two percent of scheduled interviews were conducted; 69% of intervention patients and 70% of control patients reached the 24-month time point. Expressing model estimated differences as (intervention--control), at 24 months, intervention patients had similar A1c [diff = 0.1 %, 95 % CI (-0.3, 0.5), p = 0.51] and SBP [diff = -0.9 mmHg, 95% CI (-5.4, 3.5), p = 0.68] values compared to control patients. Likewise, DBP (diff = 0.4 mmHg, p = 0.76), weight (diff = 0.3 kg, p = 0.80), and physical activity levels (diff = 153 MET-min/week, p = 0.41) were similar between control and intervention patients. Results were also similar at the 6- and 12-month time points., Conclusions: In nine community fee-for-service practices, telephonic nurse case management did not lead to improvement in A1c or SBP. Gains seen in telephonic behavioral self-management interventions in optimal settings may not translate to the wider range of primary care settings.

[Purpose] The purpose of this research was to evaluate the change in muscle function induced by a Kinesio Tape application with no or moderate tension, to the dominant and non-dominant arms. [Subjects and Methods] This research was a quantitative study, in which 75 women participated. The subjects, aged 18-30 years, were divided into 3 groups, Kinesio, Kinesio without Tension, and Control, and they were assessed before the taping intervention and after 30 minutes, 24 hours, and 48 hours of taping. [Results] The Kinesio group subjects demonstrated an increase in handgrip strength after 30 minutes, 24 hours, and 48 hours of tape application compared to control. A statistically significant increase in strength was observed in the Kinesio group comparison to the Control after 24 hours and 48 hours for the right hand, and after 48 hours for the left hand. Improvement in the Kinesio group compared to the Kinesio without Tension was observed only after 24 hours of taping application, and only in the right hand. [Conclusion] The Kinesio Taping method augmented the handgrip strength of healthy women, and the increase in grip strength was maintained for 48 hours after its application; the dominant hand demonstrated the greatest strength values.

Study Objective: To investigate an association between pubertal development and timing of menarche with glycemic control, disease duration, and body mass index (BMI) in patients diagnosed with diabetes mellitus type 1 (DM1) before puberty., Design: Retrospective study., Setting: The study was performed at the diabetes outpatient clinic of Instituto de Puericultura e Pediatria Martagão Gesteira--IPPMG of the Federal University of Rio de Janeiro--UFRJ., Participants: A total of 131 children, 61 girls and 70 boys, diagnosed with DM1 before puberty participated in the study., Main Outcome Measures: The study investigated how age at puberty onset relates to mean glycated hemoglobin (HbA1c) before puberty, BMI percentile, and disease duration; how puberty duration relates to mean HbA1c before and during puberty and to disease duration; and how timing of menarche relates to mean HbA1c before puberty, BMI percentile, and disease duration., Results: Age at puberty onset was positively correlated with mean HbA1c before puberty (r = 0.204, R(2) = 0.042; P = .019) and disease duration (r = 0.451, R(2) = 0.203; P < .0001), and negatively correlated with BMI percentile (r = -0.289, R(2) = 0.084; P = .001). Timing of menarche was negatively correlated with BMI percentile (r = -0.556, R(2) = 0.310; P < .001)., Conclusions: Children with longer disease duration began puberty later than those diagnosed more recently. Girls in higher BMI percentiles reached menarche sooner.

Electron poor benzimidazole substrates were arylated via an intramolecular cross-dehydrogenative coupling (CDC) reaction. These CDC reactions were catalyzed by a Pd(II)/Cu(I) catalyst system, capable of producing moderate yields on a large library of substrates. The substrate scope consisted of tethered arene-benzimidazoles that upon coupling, produced a fused polycyclic motif.

This is an exploratory and descriptive study with a quantitative approach that aimed to understand the social production and reproduction processes of women working at university restaurants and the occurrence and the magnitude of gender-based violence committed against them by their intimate partners. The data were collected through semi-structured interviews. The analysis categories used were social production and reproduction, gender and gender-based violence. The interviewees held a subordinate social position during the productive and reproductive periods of their lives. Approximately 70% reported having experienced gender-based violence from an intimate partner (66% psychological violence, 36.3% physical violence and 28.6% sexual violence). Most of the health problems resulting from violence were related to mental health. The results indicate that the situation requires immediate interventions, mostly guided by the instrumentalization of these women and the support by the state and the university as appropriate to address violence.

Ethnobotanical surveys of Cerrado native plants show that leaves of Celtis iguanaea (Jacq.) Sargent (Cannabaceae), popularly known in Brazil as "esporão de galo", are used in folk medicine for body pain, asthma, cramps, poor digestion, urinary infection, kidney dysfunctions, as well as a stimulant and diuretic. This work aimed at evaluating possible C. iguanaea aqueous leaf extract (CALE) cytotoxicity, genotoxicity, and antigenotoxicity using the mouse bone marrow micronucleous test. To assess CALE genotoxicity, Swiss mice were orally treated with three different extract concentrations (100, 300, and 500 mgkg-1). To evaluate its antigenotoxicity, the same doses were used simultaneously with a single i.p. dose of mitomycin C (MMC, 4mg.kg-1). The frequencies of micronucleated polychromatic erythrocytes (MNPCE) were evaluated 24 h and 48 h after administration except for the negative control (24 h). Genotoxicity was evaluated using the frequency of micronucleated polychromatic erythrocytes (MNPCE), whereas cytotoxicity was assessed by the polychromatic and normochromatic erythrocytes ratio (PCE/NCE). The results showed that CALE did not exhibit a significant reduction in the PCE/NCE ratio, neither a considerable increase in the frequency of MNPCE. Nonetheless, CALE reduced bone marrow toxicity (increased PCE/NCE ratio) and decreased the micronuclei frequency induced by MMC. We can conclude that CALE presented no cytotoxic and genotoxic effects, but showed antigenotoxic and anticytotoxic actions under the experimental conditions applied in this study.

The effects of oxidant and organic acid additives on the oxidative cross-coupling reactions of electron rich heterocycles such as benzofuran with benzene were studied. Both regioselectivity and reaction rate could be controlled by varying the condition parameters. Furthermore, mechanistic insight was achieved via kinetic studies which indicate that reactions that are oxidized by the heteropoly acid H 4 PMo 11 VO 40 operate via a Pd(II)/Pd(IV) mechanisms, while reactions oxidized by either AgOAc or Cu(OAc) 2 operate by a Pd(II)/Pd(0) mechanism.

Introduction: Intrauterine diseases are common morbid disorders. Endometrial and endocervical polyps, myomas, synechiae, uterine malformations, endometrial hyperplasia and endometrial cancer are cited among intrauterine pathology. The investigations using transvaginal sonography and outpatient hysteroscopy had been a gold standard. Transvaginal sonography shows endometrial thickness and heterogeneous variations within the echogenecity of the endometrium uterine pathology. Transvaginal sonography is easy to apply for evaluation of intrauterine pathology and it has high sensitivity to diagnostic for intrauterine disorders. Hysteroscopy was used the gold standard control. It permitted the better identification of intrauterine pathology but the histologic examination has been used for definitive diagnostic. Difficulty apprenticeship this technique had very decrease your access., Objectives: To evaluate the efficiency of transvaginal ultrasonography and outpatient hysteroscopy in the diagnosis of intrauterine pathology., Subjects and Methods: The study conducted was a retrospective diagnostic-type test. They involved a total of 469 women underwent diagnostic hysteroscopy in 2006 in Campinas University. Seventy-nine women were excluded due to lack of ultrasound results in their medical charts. One-hundred and forty-seven premenopausal women and two-hundred and forty-three postmenopausal women. For statistical analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy. The gold standard of the ultrasonography was the hysteroscopy and the gold standard of the hysteroscopy was the endometrium biopsy., Results: The mean age of postmenopausal women was 61 ± 9.4 years. We observed 6.6% of endometrial hyperplasia and cancer and 54% of endometrial polyps. Ultrasonography had a sensitivity of 95.6%, a specificity of 7.4% and an accuracy of 53.7%, while hysteroscopy had a sensitivity of 95.7%, a specificity of 83% and an accuracy of 88.7%. The mean age of premenopausal women was 40 ± 8.2 years. Endometrial cancer was not observed and two cases of endometrial hyperplasia were found. We observed 34% of endometrial polyps. Sensibility was 52.9%, specificity was 68.4% and the accuracy was 61.2% for polyps on ultrasonography while in hysteroscopy was 78.8%, 67.6% and 73.1% respectively. For myoma, sensitivity was 70.6% and 64.3%, specificity was 44.3% and 98.1% and accuracy was 63.3% and 91.2% in ultrasonography and hysteroscopy respectively., Conclusion: Hysteroscopy had better diagnostic accuracy than ultrasonography for the detection of intrauterine pathology.

The present study of the theses and dissertations produced by the Gender, Health and Nursing Research Group, at the University of São Paulo School of Nursing was performed with the objective to describe and analyze the knowledge production of the referred group, its produce and construction process. The outcomes indicate an expressive production in the collection of gender studies in the national setting, revealing that advancing the understanding of the social phenomenon from a gender perspective has improved not only the research, as well as the intervention domain. In the field of health and nursing care practices, it has been shown that it has proved capable of revealing the pervading limitations and strengths.

The most direct method for synthesizing 2-arylindoles is oxidative coupling of an arene with an indole. We have shown that both the activity and regioselectivity of this cross-coupling reaction are correlated with the acidity of the medium. This insight has been applied to predict the best conditions for the oxidative cross-coupling of N-alkylindoles, an important class of substrates that has heretofore been incompatible with the harsh conditions required for oxidative cross-coupling. Both experimental and computational data indicate that the mechanism for C-H palladation of both the indoles and simple arenes is best described as concerted metalation-deprotonation, regardless of the substitution on the arene.

Objective: To compare the efficiency of transvaginal sonography and outpatient hysteroscopy in the diagnosis of intrauterine pathology in postmenopausal women., Methods: Two-hundred and forty-three postmenopausal women were selected. All women had undergone outpatient hysteroscopy in the year 2006. These women were referred from the Basic Healthcare Units in Campinas, where they underwent ultrasonography for the evaluation of the endometrial cavity., Results: The mean age of these women was 61+/-9.4 years. These women were menopausal for 11+/-8.3 years.. We observed 6.6% cases of endometrial hyperplasia and cancer. The ultrasonography had a sensitivity of 95.6%, a specificity of 7.4%, a positive predictive value of 53.3% and a negative predictive value of 60%, while the hysteroscopy had 95.7%, 83%, 82.2% and 95.9% respectively., Conclusion: Hysteroscopy was a more accurate method for the detection of intrauterine pathology than ultrasonography.

Purpose: The aim of this study was to estimate the oral impact on daily performances (OIDPs) and its association with self-reported quality of life, sociodemographic and oral health conditions, self-reported oral symptoms and access to a clinician in elderly people., Materials and Methods: A cross-sectional study was performed involving individuals over the age of 59 years, resident in the city of Florianópolis, Brazil. A sample of 180 individuals selected in a two-stage approach was examined and interviewed. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) was used to collect data on self-reported quality of life. The OIDP questionnaire was used to collect data on oral impact on daily performances. The criteria for the clinical data were those proposed by the World Health Organization. The dependent variable was the oral impact on daily performances. The chi-square test was used to examine the association between the dependent and the exploratory variables. Variables were inserted in a model of multiple logistic regression. The level of significance was set at P < 0.05., Results: The proportion of individuals who reported oral impact on daily performances was 45.6%. The results of the multiple logistic regression analysis showed that only the altered condition of the oral mucosa and the social domain of the WHOQOL-BREF maintained an independent association with oral impact on daily performance., Conclusion: Of the investigated elderly individuals 45.6% reported oral impact on daily performances. Those who presented altered oral mucosa and had a lower performance in the WHOQOL-BREF social domain were more likely to report such an impact.

This report describes the case of a patient with mesenchymal chondrosarcoma in the region of tooth #18 that mimicked apical periodontitis. Forty-five days after endodontic treatment, gingival swelling and intense pain were observed. The endodontist suspected a furcation lesion, and the treatment option that the patient chose was extraction of the tooth. Seven days after suture removal, a rapidly growing swelling was seen in the region. The patient was referred to an oral and maxillofacial surgeon, who recommended an incisional biopsy after evaluating imaging and clinical findings. Microscopic examination confirmed the diagnosis of mesenchymal chondrosarcoma. The patient underwent hemimandibulectomy with wide surgical margins. This clinical case draws attention to the fact that endodontic lesions should be carefully evaluated because malignant tumors such as mesenchymal chondrosarcoma might mimic apical periodontitis.

Context: Nonalcoholic fatty liver disease and polycystic ovary syndrome (PCOS) are both associated with insulin resistance. Thus, women with PCOS may have an increased prevalence of nonalcoholic fatty liver disease, including nonalcoholic steatohepatitis (NASH)., Objective: The objective of the study was to determine the prevalence and characteristics of NASH and abnormal aminotransferase activity in women with PCOS., Design: The study is a retrospective chart review., Setting: The setting is an academic endocrinology clinic., Patients: Patients were 200 women with PCOS, defined as irregular menses and hyperandrogenism., Main Outcome Measures: Biopsy-documented NASH and aminotransferase levels were the main outcome measures., Results: Fifteen percent (29 of 200) had aspartate aminotransferase and/or alanine aminotransferase more than 60 U/liter. Women with aminotransferase elevations had lower high-density lipoprotein (HDL) (41 vs. 50 mg/dl, P = 0.006), higher triglycerides (174 vs. 129 mg/dl, P = 0.024), and higher fasting insulin (21 vs. 12 microIU/ml, P = 0.036) compared with women with normal aminotransferases. Six women (mean age 29 yr) with persistent aminotransferase elevations underwent liver biopsy. All six had NASH with fibrosis. Compared with the 194 of 200 PCOS women who did not undergo biopsy, women with biopsy-documented NASH had lower HDL (median 34 vs. 50 mg/dl, P < 0.001), and higher triglycerides (245 vs. 132 mg/dl, P = 0.025), fasting insulin (26 vs. 13 microIU/ml, P = 0.038), aspartate aminotransferase (144 vs. 22 U/liter, P < 0.001), and alanine aminotransferase (143 vs. 28 U/liter, P < 0.001)., Conclusion: Abnormal aminotransferase activity is common in women with PCOS. Low HDL, high triglycerides, and high fasting insulin were associated with abnormal aminotransferase activity. Some women already had evidence of NASH with fibrosis. Further studies are needed to evaluate whether to screen PCOS women for liver disease at an earlier age than is currently recommended for the general population.

Introduction: Cardiovascular surgery with cardiopulmonary bypass (CPB) has improved in past decades, but inflammatory activation in this setting is still unpredictable and is associated with several postoperative complications. Perioperative levels of macrophage migration inhibitory factor (MIF) and other inflammatory mediators could be implicated in adverse outcomes in cardiac surgery., Methods: Serum levels of MIF, monocyte chemoattractant protein (MCP)-1, soluble CD40 ligand, IL-6 and IL-10 from 93 patients subjected to CPB were measured by enzyme-linked immunosorbent assay and compared with specific and global postoperative organ dysfunctions through multiple organ dysfunction score (MODS) and sequential organ failure assessment (SOFA)., Results: Most of the cytokines measured had a peak of production between 3 and 6 hours after CPB, but maximum levels of MIF occurred earlier, at the cessation of CPB. Among specific organ dysfunctions, the most frequent was hematological, occurring in 82% of the patients. Circulatory impairment was observed in 73.1% of the patients, and 51% of these needed inotropics or vasopressors within the first 24 hours after surgery. The third most frequent dysfunction was pulmonary, occurring in 48.4% of the patients. Preoperative levels of MIF showed a relevant direct correlation with the intensity of global organ dysfunction measured by SOFA (rho = 0.46, p < 0.001) and MODS (rho = 0.50, p < 0.001) on the third day after surgery. MCP-1 production was associated with postoperative thrombocytopenia, and MIF was related to the use of a high dose of vasopressors in patients with cardiovascular impairment and also to lower values of the ratio of partial arterial oxygen tension (PaO2) to fraction of inspired oxygen (FiO2) registered in the first 24 hours after CPB., Conclusion: Despite the multifactorial nature of specific or multiple organ dysfunctions, MIF should be explored as a predicting factor of organ dysfunction, or even as a potential therapeutic target in decreasing postoperative complications.

Production of IFN-gamma guarantees helpful T cell-mediated immunity against Mycobacterium tuberculosis infection. We have evaluated the in vitro immune responses to M. tuberculosis antigens using IFN-gamma production among 43 Brazilian tuberculosis (TB) patients prior to and after specific treatment, and 18 community controls. Peripheral blood mononuclear cells (PBMC) were cultivated in the presence either of purified protein derivative, ferritin, 10 kDa, 38 kDa, MPT59, Ag85A or Ag85B. Also, the two M. tuberculosis and M. bovis heat-shock proteins (hsp) 65 and 70 kDa were compared, and 5 day supernatants were harvested for cytokine detection by ELISA. The results showed that the overall profile of primary PBMC in response to most M. tuberculosis antigens was well correlated, since high IFN-gamma levels were induced by Ag85A, Ag85B, 38 kDa, ferritin and 10 kDa, as well as M. tuberculosis hsp65 in TB patients. In addition, analysis was carried out of the in vitro expression of activation molecules on lymphocytes, as CD25 and CD69 expression assessed in 17 TB patients showed induction on CD4+ T cells by Ag85B. Overall, significantly low responses were found in untreated, in comparison with the treated TB patients. Furthermore, internal community but not healthy control individuals have higher immune responses than do TB patients.

Early detection of Mycobacterium leprae infection is considered an important component of strategies aiming at reducing transmission of infection, but currently available diagnostic tools often lack sufficient sensitivity and specificity to reach this goal. Recent comparative genomics have revealed the presence of 165 M. leprae genes with no homologue in M. tuberculosis. We selected 17 of these genes for further study. All 17 genes were found to be expressed at the mRNA level in M. leprae from infected mice and from a multibacillary leprosy patient. Additional comparative genomic analyses of all currently available mycobacterial genome databases confirmed 12 candidate genes to be unique to M. leprae, whereas 5 genes had homologues in mycobacteria other than M. tuberculosis. Evaluation of the immunogenicity of all 17 recombinant proteins in PBMC from 127 Brazilians showed that five antigens (ML0576, ML1989, ML1990, ML2283, and ML2567) induced significant gamma interferon levels in paucibacillary leprosy patients, reactional leprosy patients, and exposed healthy controls but not in most multibacillary leprosy patients, tuberculosis patients, or endemic controls. Importantly, among exposed healthy controls 71% had no detectable immunoglobulin M antibodies to the M. leprae-specific PGL-I but responded to one or more M. leprae antigen(s). Collectively, the M. leprae proteins identified are expressed at the transcriptome level and can efficiently activate T cells of M. leprae-exposed individuals. These proteins may provide new tools to develop tests for specific diagnosis of M. leprae infection and may enhance our understanding of leprosy and its transmission.

Using a short-term bulk culture protocol designed for an intracellular-staining method based on a flow cytometry approach to the frequencies of cytokine-producing cells from tuberculosis and leprosy patients, we found distinct patterns of T cell subset expression. The method also reveals the profile of peak cytokine production and can provide simultaneous information about the phenotype of cytokine-producing cells, providing a reliable assay for monitoring the immunity of these patients. The immune response of Mycobacterium leprae and purified protein derivative (PPD) in vitro to a panel of mycobacteria-infected patients from an endemic area was assessed in primary mononuclear cell cultures. The kinetics and source of the cytokine pattern were measured at the single-cell level. IFN-gamma-, TNF-alpha-, IL-4- and IL-10-secreting T cells were intracytoplasmic evaluated in an attempt to identify M. leprae- and PPD-specific cells directly from the peripheral blood. The analysis by this approach indicated that TNF-alpha was the first (8 h) to be produced, followed by IFN-gamma (16 h), IL-10 (20 h) and IL-4 (24 h), and double-staining experiments confirmed that CD4+ were a greater source of TNF-alpha than of CD8+ T cells (P < 0.05). Both T cell subsets secreted similar amounts of IFN-gamma. We conclude that the protocol permits rapid evaluation of cytokine production by different T cell populations. The method can also be used to define immune status in non-infected and contact individuals.